So MAD about STUPID OB Procedures! - Page 2

[jspring0308]

Last Friday I had lunch w/DH and one of his coworker's wives is due this month with their 1st. I asked him how many weeks she is and he said "38, so it could be any day now, right?" I kinda laughed and casually said, "well actually average 1st babies usually don't show up til around 41 weeks," he totally looked stunned! So later my DH was talking w/this man and man goes "we can always induce" and DH (who is not crunchy at all) said "but why would you want to increase the chance of a c/s?" Other man of course had no idea that induction is often totally chemical and can lead to "complications" which in turn can lead to c/s so my very uncrunchy DH explained all this to 1st time Daddy. Probably won't stop anything but at least he has a little forewarning. DH was my hero all weekend!

[2lilsweetfoxes]

Originally Posted by ChetMC

I bite my tongue a lot. I look at DH, and he acknowledges, and then I rant in the car on the way home.

I find it especially hard when I'm within earshot of a mom spreading the misinformation she's been given to another mom or mom-to-be. I know too that being a militant, left wing, statistics spouter doesn't advance any of my causes. It's difficult though when somebody assures you that they, "are physically unable to dilate."

However, when moms share war stories I do tell people with pride that I stood up to my OB and why... so at least they know that it's possible.

I'm one of those moms who could have very easily be insisting right now that I am "physically unable to dilate". I stay at 3 for-freaking-ever (longer than most OBs are really comfortable), then get to four, then within an hour, to 5 (yay! can finally get the epidural so I can sleep for these next few hours--yah, right!) and within 30 minutes, the baby is in my arms and at my breast (and finally the anesthesiologist gets around to me for the epidural--kinda late now, buddy!). If I'd listened to the OB, rather than asking "am I doing fine? Is the baby doing fine? Could we have a little more time?" (to which the answer was a grudging "ok, a few more hours, but we want to monitor you closely...you've been going longer than we like, already, and not progressing") I probably would have had c-sections for FTP. Most of these mums need: more time or to kick out some of their (not-so-supportive) support people and well-wishers. My midwife put my "dilation history" in my records. Probably helped that I labored over Saturday night (w/ #1) and on Sunday (w/#2)

[vendaga]

I know how you feel. My sister in law was complaining while she was pregnant that they wouldn't induce her when she went past her due date, and I'm sitting there going it's only been two days. Then they did induce her at three days over due and it didn't take, she was due the 21st of Jan, and didn't have the baby until the 4th of Feb, they tried inducing her like three times none of them took. She finally just went into labor on her own. I couldn't believe they were trying to induce her at only three days over, when my older sister was a month over due, before they would even think about inducing her. One of my aunts had five kids and all of them were 10 month babies.

Me on the other hand they could never track down a definate due date, because I have very irregular cycles, I didn't even find out I was pregnant until my 14th week, or at least that's what they guessed. Then I went into labor around what they said was supposed to be my 38th week, but I wouldn't dilate. I was in labor for two weeks, I'm talking contraction three minutes apart for a full two weeks, before a nurse at the hospital finally convinced the doctor to break my water. My doctor said she couldn't do it until I was at least 39 weeks along. All the time I'm thinking to myself you know I could be full term already you just don't know it, because we can't figure out when exactly I got pregnant. After they broke my water it was like three hours I delivered, and I went from 7.5 cm dilated to delivered in 15 minutes. I was the talk of the hospital for the whole day no one there had ever heard of a delivery that fast.

Doctors can be so stupid sometimes.

[MegBoz]

Originally Posted by 2lilsweetfoxes

My midwife put my "dilation history" in my records.

I told my MWs I didn't even want to know how far dilated I was. I understand they want to check to confirm active labor prior to admitting me to the hospital, then check when I feel the urge to push to confirm I am 10cm, but everything in between - just leave me alone!
Considering it can take 10 hours to make it to 4 cm, then only 2 more hours to make it the rest of the way, etc. What's the point of continually checking? (of course, presuming Mom & Baby are OK!)

If you're not medicated, you can feel if the uterus is contracting. If those contractions are continuing to get stronger, longer & closer to gether, doesn't that mean that, the majority of the time, the cervix will indeed be opening?

I guess I can understand checking if like 10+ hours have gone by just to make sure mom is continuing to progress. But I have the impression in hospitals they check like every 1-2 hours. (I don't know because I was, by accident, already in 2nd stage when I arrived at the hospital.)

I guess I just don't understand what is the point of scrutinzing dilation progress?

[BugMacGee]

I dunno. I "labored at home" with my first. Painful contractions 5-7 minutes apart from midnight until 5 am when my water broke. Wayyyy more painful contractions 2 minutes apart by the time we arrived at the hospital. We though we were just in time. MW checked me. I was "Closed and firm". Stupid clueless cervix. I didn't have DD#1 for another 14 hours.

[happyhats]

I really lucked out and so far my obgyn isn't intervention crazy. We haven't spoken specifics yet, I guess because honestly I cannot definitively say what I do or do not want until a situation arises (this is my first baby, but I am educated on procedures and their affects, I just cannot say I don't EVER want an episotomy or an epidural or a c/s, etc. cause I don't want to unduly put more pressure on myself, kwim?). However, whenever he wants a test done or is giving me a checkup we talk extensively about everything and why he thinks it's best, etc, not just "it's what we do". I am not really comfortable with induction myself, but I may need it done because my dd is a two vessel cord baby. The good news however is my obgyn didn't say we would need any extra intervention when we found out or that we should worry because the ultrasound came out perfectly normal, etc.

[OceansEve]

sweetfoxes- just curious how long are your labors, I was at a 2 for over 12 hours, before finally consenting to epidural, which eventually led to pitocin and a 36 hour overall labor. Would love to hear how long you stayed at 3 to give me some hope this time

[Redifer]

See, I had the opposite problem: I FLY OPEN as far as dilation. With DD2, I went from (supposedly) 4 cm to 7 in 40 minutes, and then the rest in another 20 minutes.

Of course, they left me in an exam room for the entire hour, because when they left me I was only 4 cm, despite my telling them with my first daughter I dilated just as fast and went from mild cramps to "here she is!" in about 2 hours total.

By the time they came to get me, I was pushing in the exam room, because she was coming and she was coming FAST.


But yea, I'm another "Get's really aggravated, but keeps her mouth shut and gripes in the car on the ride home, and then for another 2 hours after that". Luckily, my DH is just as crunchy when it comes to childbirth as I am, and chimes right in!

[MegBoz]

My coworker still hasn't had her baby. When she comes into the office in the mornings, everyone keeps saying, “What’s going on?! Anything?!” She sighs & says, “Nope, nothing! Only 2 CM.”


I just don’t get why they keep even CHECKING for dilation at this point! She could be closed & firm, yet still go into active labor tonight. Likewise, she could be at 3 or 4 cm now & for another week before labor really starts. <sigh>

I also overheard her say she’ll be induced Thursday night… still before average gestational length for 41W1D for first-time Moms. She hasn’t mentioned any physiological reason for induction (pre-e, low AFI, suspected macrosomia, etc.) She also doesn’t seem uncomfortable, making me think she’s not begging for induction just to get it all over with. (I don't know & I'm not going to ask.)

I REALLY want to email her with some links to extensive studies that show that “expectant management” is safer & better than induction up till 43 weeks. Plus some studies on the risks of induction. But I know that I’ve said enough already so I need to ‘zip my lip’ (& ‘zip’ my fingers! Hehe)

I just find this all so infuriating! It’s so hard to keep my mouth shut.. because it’s not just about this one lady – it’s about the other ladies in the office too who need to know for their own future reference not to bother worrying about cervical dilation (or lack thereof) in late pregnancy (Excluding need to obtain Bishop's score), not to expect anything before 41W 1D (i.e. don't feel "late" at 40W 5D!), not to consider induction without adequate cause, etc. It’s the entire cultural perception of birth that absolutely infuriates me!!!!!!

ETA: I thought my post was a bit arrogant. Who am I to say what women should know?! Not everyone has to birth the way I did... but the thing is, this is NOT about opposing my own views on others. WOMEN should know the facts!! They should have maternity care that is evidence-based! If they want to induce for sheer convenience, fine! So long as they know the facts.

I don't think that's arrogant at all to say women ought to know, and be encouraged to follow scientific evidence-based practices (i.e. don't worry & feel "late" when you are at 40W 5D gestation!) it's the blatent disregard for science in so many OB practices that infuriates me.

[BugMacGee]

Can I see the studies you're referring to? I'd researched this pretty extensively a while back and IIRC, waiting until 43 weeks was not the recommendation. New studies come out about this?

[2lilsweetfoxes]

Originally Posted by OceansEve

sweetfoxes- just curious how long are your labors, I was at a 2 for over 12 hours, before finally consenting to epidural, which eventually led to pitocin and a 36 hour overall labor. Would love to hear how long you stayed at 3 to give me some hope this time

With #1, I went to the hospital when my contractions were 3 minutes apart lasting about a minute. I figured i was 5 or so cm. Nope--barely 3. (Don't know how long I was at 3 before that). That was about 6 pm. I was admitted around 9:30-10 pm when I finally got to 4--my contractions by that time were about 2 minutes apart, lasting 1.5 minutes. I was left alone to labor being told they did not expect me to birth before morning. (I'd been up since 5 that morning because I had had to work that day--so I was begging for the epidural so I could get some sleep.) Around 10:45, they checked me and I was at 5, so they said they'd send the anesthesiologist in as soon as they could so I could get some relief. They refused to give me anything in the meantime to "take the edge off". Around 11:15, I felt like I had to push and told my husband. He was like, "yeah, right. The doctor said you had several hours to go." I'm asking him to find someone to check me. Then the nurse bursts in, panicky because they could not detect her heartbeat. The kid had turned away from the monitor and was crowning. The delivery room was occupied, so they grabbed the precip kit and delivered her in the labor room. She's fine. Home from school today due to a cold and bad eczema outbreak.

My second, the water broke right after lunch on Saturday and I went to the hospital after walking for a few hours. I was barely a 2. The next morning, I consented to pitocin to "get things started" around 8. Still at 2. I got to 3 around 9-10. Around 3 pm, was still barely at 3. The doctor basically told me that since it had been over 24 hours since my water broke, I needed to deliver or at least make progress or they would section me. My neighbor had accompanied me, (I did not want her there, but did not want to be rude--which I think was the main thing hindering progress for me) so I kicked her out--by sending her to get me a cheesecake from a certain bakery. I was told that if I had not made progress by 5 pm, they would do the section. No more checks until I said I had to push right after 4:30, but he was born at 4:50 pm. (I wonder though, how fast they would have done surgery had I gone into labor Friday afternoon rather than on Sunday). Then I got to eat my dinner (finally--I was starved, hadn't eaten since lunch the day before) while my MIL held my son and dd poked at her new toy (ds).

I guess they aren't "long" it is just that they don't follow the "1 cm per hour curve" the OB's like.

And I had my kids in a teaching hospital...and this third will be born in a tertiary hospital, which is also a teaching hospital. So, teaching hospitals seem to be even more by-the-book.

[OceansEve]

Thanks that makes me feel better. Also makes me feel better about my hospital, the only thing they started talking about at the 24 hour mark was antibiotics, since my water had been broken for so long

[MegBoz]

Originally Posted by BugMacGee

Can I see the studies you're referring to? I'd researched this pretty extensively a while back and IIRC, waiting until 43 weeks was not the recommendation. New studies come out about this?

I looked for it on the NIH site & can't find it! I recall one study out of Sweden with about 150,000 births included! (I always look at sample size of a study, since research based on small samples is not statistically significant. I can't believe studies with sample size of under 100 are even printed!!!)

I remember I was surprised it was not until 43 weeks when routine induction became preferable to mere monitoring. I'll look again to see if I can find it.

[vendaga]

Originally Posted by MegBoz

I guess I just don't understand what is the point of scrutinzing dilation progress?

I think the point of scrutinizing the dilation progress is because of how different women's bodies work. My MIL for instance took forever to get to 7 cm dilated but after she reached that she would delver in two hours, she had four kids and all were about the same. When she was in labor with my husband her contractions never regulated, and since she was taking so long to dilate they kept sending her home. They almost sent her home the last time she went in and he was delivered like half an hour later.

For me my contractions regulated at 3 minutes apart two weeks before I delivered, but I wouldn't dilate more than 1.5 cm before they broke my water, and it took me forever to convince them to do it. I actually went into the hospital because I had a fever of 100.9 and the nurse took forever to put an IV in me so when the doctor wanted to send me home, the nurse convinced her to just keep me and break my water because I already had an IV in, and had already had some anti-biotic. I'm so thankful for that nurse, if it wasn't for her I would have been in labor for two more weeks before my doctor would have broken my water.

[MegBoz]

Originally Posted by vendaga

I think the point of scrutinizing the dilation progress is because of how different women's bodies work. My MIL for instance took forever to get to 7 cm

I think I'm just feeling a little mentally slow today, but I still don't get it! When your MIL had her 1st baby, how would anyone have known that even though she took forever to get to 7 cm, she'd deliver fast after that? How would you know with the 1st? Even with the 2nd, labors don't always follow the same pattern, so it's not a given that it will proceed the same way.

Even with the 4th, so what if she DIDN'T follow that pattern? Then what? I guess I just don't see the point of a medical diagnostic test if the results won't alter the care given. In other words, if Mom & baby are fine & the uterus is still working, I would not want my labor augmented if I wasn't moving at 1cm per hour, so what's the point of monitoring to see where I am?

For me, I never had a single exam between having membranes stripped when I hadn't yet had ANY contractions & being all the way through 1st stage - so I have no idea what my dilation progress was.

[vendaga]

Originally Posted by MegBoz

I think I'm just feeling a little mentally slow today, but I still don't get it! When your MIL had her 1st baby, how would anyone have known that even though she took forever to get to 7 cm, she'd deliver fast after that? How would you know with the 1st? Even with the 2nd, labors don't always follow the same pattern, so it's not a given that it will proceed the same way.

Even with the 4th, so what if she DIDN'T follow that pattern? Then what? I guess I just don't see the point of a medical diagnostic test if the results won't alter the care given. In other words, if Mom & baby are fine & the uterus is still working, I would not want my labor augmented if I wasn't moving at 1cm per hour, so what's the point of monitoring to see where I am?

For me, I never had a single exam between having membranes stripped when I hadn't yet had ANY contractions & being all the way through 1st stage - so I have no idea what my dilation progress was.

Well my husband was her second, but I see your point that not all labors go the same, her's just happened to all go the same, and I guess that's why it's good to have a record of it. The point of monitoring it is that if your moving up very slowly and your giving birth in the hospital they'll keep sending you home. Because I was only 1.5 cm dilated for two weeks I was sent home three times before they kept me. I guess hospitals don't want you there until you're really ready to have the baby. On the other hand if you have a history of dilating fast, and they send you home because well you're only 7cm dilated and you contractions aren't regulated then you give birth in the car you could probably sue the hospital.

[Juniperberry]

It's been very helpful reading all your answers.

When I had #1 I was pretty clueless to everything and I pretty much just let the doctors do what they wanted. It resulted in me being induced.. then having an epidural because I went from hardly any contractions to super duper one of top of the other contractions with no help from anyone there.. they just kept saying I could get an epidural... so I did in the end, I couldn't handle it...and they had to use a ventouse/vaccuum to get him out. I wasn't happy with the whole birth experience at all and I felt really duped.

This time around I'm going to the same hospital and have the same ob/gyn (despite everything she is a very good doctor and I feel safe in her hands). But I will a kine with me through labour this time and I've done alot of research on how to handle labour.

I'm still scared because here you are kind of looked down on for wanting to go natural and let your body take care of things. It is so encouraged to be induced to 'help you along' and it is really the norm here to get the epidural. If you don't get it instead of really helping you through it they sort of look at you like.. well, you've dug your own grave, now deal with it. That's why I caved the first time and got it, they made me feel so foolish. I just hope I'm strong enough to get through it.. I so want to. I've already told my ob'gyn that I don't want pitocin this time unless it's really medically necessary. And I am determined to do it this time without help. Good thing is my partner is behind me 100%.

Pfff... sorry for the rant, but it makes me SO SO mad too. Especially as I feel sort of a victim to all the wrong infomation that's out there. I had it from collegues, friends and doctors.....

[MegBoz]

Hi Juniperberry,

I'm curious why you wouldn't look to birth elsewhere after you state that this hospital is such a negative environment. (looking at you not JUST like you're silly for going natural, but with contempt for doing so! Yikes!) Do you have other options?

Have you thought about hiring a doula? I think one more person who is very pro-natural CB in your corner might be really helpful. A doula is always great, but particularlly important in such a negative environment.

[Britishmum]

ITA. I'd definitely go looking for a doula. My doula saved me from giving into all sorts of pressure when I had my first. It was still stressful, but without her I'm sure I'd have been the classic failure to progress to c-section case.

[MegBoz]

Originally Posted by Britishmum

My doula saved me from giving into

Yes, and if you want a doula to do this for you (prevent unnecessary intervention and/or save you from yourself if you are close to caving in) then I'd recommend someone who is tough & vehemently holds the belief that natural CB is best. Someone TOUGH! Ha! That's why I picked my doula. She's a beautiful, petite woman but man, I PITY the OB or MW who would try to give an unnecessary episiotomy to a client of hers! She's a tiger! Someone you want on YOUR side!

OK, yesterday I heard my co-worker tell someone for like the 5th time that she’ll be induced Thur night if nothing happens. So I finally couldn’t take it anymore! If she was telling that many people, then clearly she didn’t mind discussing it, so I felt I wasn’t out of line to go ask WHY she was being induced.

Of course, if I just asked “Why will you be induced?” She’d find that question wacky & just say, “Because I haven’t gone into labor & I’m past my due date.” Even though she won’t hit that AVERAGE due date of 41W 1D until Saturday!! And I keep saying that when everyone else comes up to her with that nonsense of “No baby yet?”

So instead, I decided to say, “OK, I can’t help myself anymore. You say you’ll be induced Thursday night. Is everything OK? Is your blood pressure OK?”
Since High BP or potentially will-elevate-in-the-future BP is a common reason to induce.

She says, “Well, I’m just ready.”

I reply, “Oh, OK. Cuz inducing does increase your risk of CS and I know you wanted to avoid CS.”

“Yeah, but I’m just ready. I can’t sleep.”

“Well do you know their induction protocol?”
(Goodness, don’t let them give you Cytotec!!!!! & certainly try alternative means before moving to pharmacological induction!)

She said, “Well,they already stripped my membranes this morning. Then, I think they give you… what is it… tocin…”

She didn’t know the word “pitocin” or how to pronounce it.

I also mentioned having her membranes stripped repeatedly if it doesn't work - since research shows the odds of it working DO INCREASE if it's done repeatedly. She had not known that.

I just don’t get how people can just blindly trust their health care provider & not get educated themselves.
As DH says, people seem to do more research before buying a car than before having a baby!

At least I feel better knowing that she does know induction increases the risk of CS. (I don’t know with certainty, but I have a feeling that is one of many facts OBs fail to mention…) If she’s willing to take that chance, than that is her choice. But I feel better knowing it is truly an informed choice she's making.

ETA: I would bet my co-worker, and most ladies, would feel a bit more patient at the 40w+ mark if it weren't for the fact that they were expecting their babies at 40W!! If healthy first-time Moms were told their due dates were at 41W 1D (Which research shows is average, and thus that would be "evidence-based practice) then they might be more resistant to inducting at prior to that date.

Another co-worker walked over & said, "Well, 1st babies are always 2 weeks late." Again, I piped up, "NO! The OBs set the dates early!"