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#1 of 12 Old 02-24-2004, 10:04 PM - Thread Starter
 
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I was watching Baby Story today (asking for trouble, I know) and they had a woman who wanted a natural birth, brought her tub to the hospital, and had a doula. She had a long hard labor, and the only way she could tolerate her contractions was to be standing up. However, they told her that because of fluctuations in the baby's heart rate, she had to lay down. Huh? I've never heard of that. What could their rationale possibly be? Of course, since that was so painful for her, she asked for an epidural, her labor slowed, so they gave her pitocin, she pushed for 3 hours with no progress, and ended up with a C-Section.

I understand the ramifications of the other interventions. But I've never heard of being told that you had to lay down because of the baby's heart rate. Has anyone heard of this?
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#2 of 12 Old 02-24-2004, 10:29 PM
 
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I've seen that one.


Anyway my guess would be if the babies heartrate was in fact dropping it would be easiest for the drs to monitor when laying down. You know if you are standing the nurse would actually have to hold the monitor to your belly. So not for the baby or mom, but for drs convience.

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#3 of 12 Old 02-24-2004, 10:32 PM
 
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It makes no sense to me. I'm in the midst of some serious reading and have found that EFM isn't even that accurate.......so it sounds to me like just another tool to get a mom to conform.
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#4 of 12 Old 02-24-2004, 10:53 PM
 
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doctors are nuts
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#5 of 12 Old 02-25-2004, 12:24 AM
 
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Quote:
Originally posted by oceanbaby
She had a long hard labor, and the only way she could tolerate her contractions was to be standing up. However, they told her that because of fluctuations in the baby's heart rate, she had to lay down.


I understand the ramifications of the other interventions. But I've never heard of being told that you had to lay down because of the baby's heart rate. Has anyone heard of this?
Ooh, I can't even watch those shows. Just chaps my hide. But, I do have a thought. The first thing that needs to be done when you have non reassuring heart tones is a position change. The baby's position could be restricting cord blood flow- for example if the cord is looped up near the baby's head, the head can press against it during contractions and decrease oxygen. Getting the mom in a different position can resolve that problem quickly. I probably would have had her try knees-chest position for a couple of contractions and see if that helped the heart rate. Lying down wouldn't have been my first choice.

Anothermama is absolutely right- EFM is notoriously inaccurate, but most hospitals require that it be done in case there is a lawsuit. They need to have evidence to show that they did what they should have. And it is absolutely true that in general, hospital based nurses and doctors are made incredibly nervous by those pesky mamas that won't lie down in the bed like a good little girl where they can see what's going on better.
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#6 of 12 Old 02-25-2004, 12:29 AM
 
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Did she have to lie down on her left side?
Midwives and doctors alike have moms lie on their left sides if there are signs of distress. I can't remember how or why, but it increases blood and oxygen flow to the baby. If that doesn't work, along with some oxygen for mom, then they resort to more invasive methods. I assume that lying on the left side moves the baby over and allows more room for the major artery (can't think of what it's called) to function.
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#7 of 12 Old 02-25-2004, 12:34 AM
 
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When my baby was having decelerations during labor, the L&D staff asked me to lie on one particular side. I think they said they thought dd was pressing on the cord, or something to do with oxygen... my memory is a little vague.

Actually I had a posterior labor and I tried to stay upright and use my birthing ball and even with the help of dh and my doula, I just couldn't. It was too painful - I had severe pain in one spot, not my back but the best position was lying on my side.
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#8 of 12 Old 02-25-2004, 02:03 AM
 
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I saw that show too. Actually more than once. I really felt sorry for the mom. I asked my sister told me (who used to be an OB nurse) that its possible that when she was standing that there was some compressions on the cord. When the mom in the show, if I am not mistaken laid on her left side, the baby was tolerating things better. Wasnt she in labor like 40 hours? I cant remember, but it was a very long time.

I also agree that EFM are not always accurate. I think some doctors wig with them and use them to much to gauge a baby's condition but I do know they can be useful tools as well. Like my friend who had prolapse cord. The baby had decels and then wasnt recovering from the contractions, the nurse checks and realized there was cord there (they were getting the OR ready for a sectoin due to footling breech) Also, with my daughter I had EFM after a failed version. My daughter did not recover from it well at all. Her heart rate was all over the place and then just bottomed out. Of course I didnt fair to well either.
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#9 of 12 Old 02-25-2004, 04:21 AM - Thread Starter
 
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They didn't say anything about being on her left side. In fact, I think they mentioned her being flat on her back, which is how she was laying when they came in to give her an epidural. They didn't mention anything about a prolapsed cord either.

I just thought it was really odd because up until then they had been pretty cool with what she wanted - allowing her to bring a tub, I saw the nurse giving her backrubs along with the doula, etc. Just everything really went south once they insisted she lie down in the bed. I mean, she was already having a hard time, but this made everything worse.
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#10 of 12 Old 02-25-2004, 12:34 PM
 
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Quote:
Originally posted by oceanbaby
They didn't say anything about being on her left side. In fact, I think they mentioned her being flat on her back, which is how she was laying when they came in to give her an epidural. They didn't mention anything about a prolapsed cord either.

I just thought it was really odd because up until then they had been pretty cool with what she wanted - allowing her to bring a tub, I saw the nurse giving her backrubs along with the doula, etc. Just everything really went south once they insisted she lie down in the bed. I mean, she was already having a hard time, but this made everything worse.
I thought they were going south before then. JMO. I think the hospital did try to give her what she wanted and did work with her for that to happen.

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#11 of 12 Old 02-25-2004, 01:22 PM - Thread Starter
 
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Oh yea, she was definitely having a hard time before then. And that's what I thought too, was that the hospital was being very cooperative. That's why I was wondering about why she had to lay down on her back.
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#12 of 12 Old 02-28-2004, 03:31 AM
 
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I think her biggest problem may have been that she got in the tub too early. She was only at 2 cms, if I remember correctly. A little to soon to be using a tub, really. Probably slowed down an already slow labor.

Still, she did seem to be managing well until they made her lie on her back.
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