Question's you wished you would have asked BEFORE birth - Page 2 - Mothering Forums
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#31 of 59 Old 11-30-2006, 01:42 PM
 
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"How will my labor be effected by this pitocin?"
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#32 of 59 Old 11-30-2006, 02:56 PM
 
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If I'd known enough to ask, I would have asked "What can you do to help in the case of a malpositioned baby?"

turned out they had no concept of fetal position whatsoever beyond "head down" and their only technique to deal with a less than perfect position and labor was c/s.
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#33 of 59 Old 11-30-2006, 03:30 PM - Thread Starter
 
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Actually, viewing this as a "things to ask before you select a care provider" list, what's making me twitch is all the stories about how the provider was supportive and saying all the right things until the actual time came.
I actually started this thread as my SIL found out she was pregnant and was considering interviewing her gynocologist before deciding to use the gyno as her OB. I urged her a couple times (then I dropped it even though in my head I'm shouting PLEASE INTERVIEW AT LEAST THREE!) to at least interview her gyno and then a couple others before deciding who she was going to deliver with.

I think another interesting point about questions has been brought up, too. A couple years ago a first time pregnant friend and I were talking about episiotomies. She didn't know what they were & I pulled a few books for her. She immediately understood the overuse and damage that they can cause. She decided she didn't want one. I asked her what her OB's view of episiotomies were and she had no clue. The next appt she asked and he told her "reasuringly" that she'd never have an episiotomy unless she needed one. She was very calmed until she told me triumphantly and I as lovingly as I could asked her what he meant by that. She went back the next month and asked, "In your last 10 vaginal births how many women did you give an epitsiotomy to?" He responded 9. He gave episiotomies to 9 out of 10 vaginally birthing women! My friend was quitely outraged. The next month she went in and said she didn't want any episiotomy. He said he'd try but she might need one. Every appointment she got firmer until finally she said "I do not consent to an episotomy." He finally heard her. The next week she went into labor, ended up with a different OB on duty and a big episiotomy. She was fine at first, but a year later she was really upset and felt defeated.

I started this thread in hopes of preventing another person I care about suffering. It's not just the information we want to get from a provider, but also how we really get a clear picture.

If you never ask the question, you never know the answer. That goes for asking your own self, your MW, you OB, your doula, your partner or who ever you choose to be present as you birth your baby.

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#34 of 59 Old 11-30-2006, 04:40 PM
 
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Nothing with my first - there's nothing I could have asked that would have prevented the section.

With my second...I don't know...I'm still working through a lot of crap about the whole situation. (2nd section)

With my third...intended VBA2C: "What will you do if I go past 41 weeks?"
If I'd known that he was going to ditch me as a patient if I didn't agree to be cut, I'd have tried to find someone else...

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#35 of 59 Old 12-01-2006, 04:44 PM
 
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I actually DID ask this question the second time around, but not with my first...

"What were YOUR births like?" (Assuming you have a woman attendant.) I think their answers can be VERY insightful.

Mama K: Child of God, wife to S, mama to 3 little beauties and 1 handsome little guy!

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#36 of 59 Old 12-01-2006, 04:46 PM
 
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Will med students be working on me?
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#37 of 59 Old 12-01-2006, 04:50 PM
 
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I had an intervention-happy OB with my first and a very natural-childbirth-friendly OB with my second. I wish wish wish I had known the first time around to ask about her episiotomy RATE. When I asked her about episiotomies before the birth she said she only did them "if necessary." What a load of crap. My baby was crowning when she came into the delivery room and she didn't even take time to assess the situation before she cut a great big episiotomy. :

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#38 of 59 Old 12-01-2006, 05:24 PM
 
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Originally Posted by Spark View Post
It's not just the information we want to get from a provider, but also how we really get a clear picture.
The two questions I'm planning to start with are:
"Describe a typical birth."
"Describe an ideal birth."
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#39 of 59 Old 12-01-2006, 06:13 PM
 
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I probably would have asked

"What do you feel the differences are between the care you'll be offering me versus the care I could receive through a Dr/OB/Gyn?"

"What are some similarities?"

These questions would have helped me since I was under the "impression" that being a midwife automatically made you LESS interventionist which is not necessarily the case.
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#40 of 59 Old 12-01-2006, 06:51 PM
 
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I would have asked about the hospital's anesthesiologists.

"If I decide on an epidural, or if I need anesthesia for a c-section--do they usually get in the epidural without problems? Do they usually work? Well?"

I totally forgot this question....I got an anesthesiologist that didn't really like fat women, and he tried to replace an epidural for over 45 minutes (after taking 30 minutes to put in #1 that didn't work). All this at 9.5 cms. (I needed a good epidural for an eventual c-section that I had). I DID NOT consent to a general (what they wanted), so the head of anesthesia came in from home to place my epidural.

But what a pain.
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#41 of 59 Old 12-01-2006, 08:05 PM
 
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Wow, this thread is really good! I asked many of these questions this time around during the hospital tours, mainly because I am in a new city (which means new hospitals and new providers from my previous 2 deliveries). I do think finding out how things work at the hospital is just as important as finding out info about your provider's policies.

Part of the reason I switched hospitals midway through my pregnancy was the first hospital refused to use the term VBAC, but insisted on calling it a "Trial of Labor after c/s" I was totally offended by that. It just sounded like they planned on you failing!!! Then once I found out my OB was going on vacation the day after my due date, I switched hospitals and providers. I liked my provider, but I wasn't about to risk ending up with one of his non-VBAC friendly partners.

My first appointment with my new OB she asked "so how do you plan on having this one, since you had a c/s last time?" I said "I plan on a VBAC and natural as possible." She said "Oh good! I can't understand these women that just want a repeat c/s." I was sooooo floored!! It was almost like being back with midwives!

I haven't asked quite as many questions this time as much as made firm statements during my OB appointments though. I know this is going to be my last time around and definitely don't want certain things done!!! I gave my OB my 5 page birth plan and she okay'd everything in it.
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#42 of 59 Old 12-03-2006, 05:58 PM
 
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I asked a ton of questions and got a ton of answers (for the most part very good ones). I asked about situations I never thought would come up, and things I knew would. The one question I didn't ask, though it should have been an obvious one...

Should a c/s be required, who will do the surgery?

My care provider wasn't an OB and obviously couldn't do the surgery herself...so some doctor I'd never met before in my life appeared, said "yup, looks like a cesarean, she's been in labor how long?! Why didn't you call me sooner?", did the surgery, and then vanished (I saw him once more when he removed the staples before I went home). It made a stressful situation a little bit more stressful/surreal. It also made follow up care confusing since my own doctor had no experience with that sort of major wound care situation and couldn't advise me on things like scar massage...while the OB who did the surgery wouldn't answer my questions since I "wasn't his patient".

So even if you don't expect a c/s (I know I didn't!) it's a good thing to ask a non-OB.

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#43 of 59 Old 12-03-2006, 06:49 PM
 
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With my first dd I had on my birth plan that I preferred to tear, not to be cut unless it was an emergency situation. To this day I don't even know if the doc did an episiotomy. Just recently my dh said he noticed the doctor had scissors and said something about cutting me while I was pushing. Because of the epidural of course I didn't feel anything. I asked my doc at my last appt and he said I could look it up in the hospital records because he wasn't sure but if my dh saw scissors I probably had an episiotomy. I'm not really upset about getting the cut, I actually healed very quickly and wasn't in a lot of pain after birth. Which is why I figured I was left to tear, also because my doc said I had a 2nd degree tear and needed stitches after the birth and never mentioned cutting to my recollection. BUT I am ticked off that despite my birth plan my wishes could have been either ignored or forgotten. Now I'm worried the same thing will happen this time, that my doctor is just paying lip service to respecting my wishes but when we get in there he'll do whatever he wants anyway.

I didn't ask about delaying or avoiding IV's completely, when I got to the hospital and asked to delay the IV the nurse said it was "hospital policy" like it was a law or something.

I would switch docs but there are only 2 OBs in the entire city and they switch for on-calls so I could end up with this OB anyway. I went to my last doctor appt with a slew of questions:

Intermittent Fetal monitoring vs Continous (Answer: During active labor continuous fetal monitoring is best. When I pressed and said I didn't want continuous because I didn't want to be tied down to the bed like last time and also asked if they had wireless monitoring (no) he said "What's the point in having a hospital birth if you don't want monitoring?"

Forceps vs vacuum (forceps are more effective, rarely use vacuum, I was just curious about this one, he didn't use it on my last)

Food & Drink during labor( fine until active labor, then only clear fluids.)

Heplock vs IV ( Again he said something about what's the point of having a hospital birth? I agreed to an IV if I am GBS positive but otherwise I only want a heplock)

Is this hospital a teaching hospital? (no for doctors, yes for nurses. I'm requesting no student nurses)

Hospital stay length? (24 hrs without GBS, 48 hours with GBS)

Is there a cut off for getting the epidural? I'm going to try to go natural this time but I've had friends/relatives who got to the hospital at 8cm, wanted the epi and couldn't get one (No cut off, even if you're 10 cm you can have one as long as you can sit still, although if you make it that far you might as well go natural for the rest of it)

I agree with what others said about phrasing things as a demand, not a wish. "I will not be having xyz" vs "I prefer to avoid having xyz"
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#44 of 59 Old 12-03-2006, 07:29 PM
 
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I wished I'd asked what side effects I might experieince with nubain. It make me really loopy and made me so out of it during the labor with my second. Consequently, I'm not even sure if i asked some of the questions I wanted to ask about her birth. I think I asked if she'd be okay, her chances of any long term effects of the prematurity, and that's about it.

I wish I'd asked, "What will my baby look like?"
"What happens when she goes to the NICU? Who goes with her?"
"When will I be able to see her?"
"What procedures can I expect her to have (routinely)?"
"What are some common concerns with babies born at this stage?"

I just wasn't really prepared at all for a 33 week birth. My previous birth ( at 36 weeks) was pretty uneventful and my dd came home from the hospital with me.
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#45 of 59 Old 12-03-2006, 08:48 PM
 
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subbing
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#46 of 59 Old 02-08-2007, 02:03 AM
 
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This thread was so great, let's have some more suggestions. Particularly from people who had babies last fall and have had a chance to process things a bit now.
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#47 of 59 Old 02-08-2007, 04:22 AM
 
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Not a question to ask the OB really, but I should have found out somehow that NO, they CANNOT refuse you care because you refuse any procedure. They are NEVER allowed to kick you out of the hospital, it is illegal (in the US at least).

But when the head nurse (I'm still furious about this) threatened to send me home because I didn't want an (excruciating) internal exam while I was in active labor (5 cm as it turned out), this possibly after my water had broken already (did they ever hear of infection?!)... I just didn't know any better, and felt like I had no choice.

Loads of blessings, and learning on the job.
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#48 of 59 Old 02-08-2007, 03:29 PM
 
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I was glad DH thought to ask: What will labor be like if we induce? Well you could be in labor for 48 hours. We turned it down. The doctor felt so sorry for me. He knew how miserable I was.

What I wish I had asked the first time and did ask this time: What is your schedule like around my due date? I asked my frist dr if he was going to be here on my due date (it was joke because I was due on his birthday) and he said yes. he forgot to tell me that he was going to be gone that entire weekend before my due date. I think the shock of him not being there really hurt my labor. I started crying when I found out he wasn't there.
Unfortunately my ob this time is not on call during my due date and the two days before my due date. I dont' know what I'm going to do if I go into labor during that time.
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#49 of 59 Old 02-08-2007, 05:15 PM
 
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Originally Posted by FreeThinkinMama View Post
Is this hospital a teaching hospital? (no for doctors, yes for nurses. I'm requesting no student nurses)
This is a personal preference for everyone, of course, but I just wanted to share my experience in case someone is curious about it.

After my c-section, I had a rotation of about 10 different nurses, plus two pairs of 2 student nurses. The student nurses were the BEST. They were kind, friendly, helpful, and willing to explain everything to me. Most of the veteran nurses seemed to have this attitude of "you're just the patient, you don't need to know anything." The student nurses would actually talk to me about things like whether my incision was healing normally. Also, having their instructor demonstrate things to them meant I got more information than I would otherwise, because she explained all the procedures in detail.

I also got lucky because of the student nurses (I speculate that she was a CNA going for her RN, but I don't know for sure) had worked for a plastic surgeon for 14 years, and knew more about helping my incision heal than the regular nurses did.

Anyway, YMMV, but if anyone isn't sure whether to request no students, I thought I'd share my positive experience.
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#50 of 59 Old 02-08-2007, 05:21 PM
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Just to add my .02, which I am sure is biased. I am a student nurse and I would love to have a student nurse at my birth- they have all the time in the world to work with you, they are still excited about the process, and their instructors are generally very experienced OB nurses who do not work for that hospital and therefore have other opinions on some things. Their education is very current and they tend to ask a lot of questions of nurse and ensure things are done the right way.

People who I would not let near me: medical students. They are just doing homework by doing interviews. The interviews they do in my hospital are solely for the purpose of their homework and nothing else. They are majorly annoying to my patients. Residents scare me, they have too much control and too little experience. Although there are many good residents, I would never let one care for me unless I needed an emergency c-section.
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#51 of 59 Old 02-08-2007, 06:17 PM
 
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I gotta agree with the student nurses thing. I've been a nursing instructor and as far as I know, "my" students never did anything that would aggravate a laboring woman. At least at the school where I taught, they were not allowed to do VEs, give meds, etc. They were to watch and learn, stay out of the way, but try to be helpful. Hard job, really. If you have a student nurse assigned to you, you have a permanent step-and-fetch-it to get you ice chips, water, juice, snacks, warm blankets, cold washcloths, etc. They generally don't practice procedures (except maybe IV starts, because pregnant women are generally really easy sticks), just ask questions for their homework. I always told mine not to ask too many questions of women who were in hard labor, and that if some things had to be left blank on their homework, that was better than aggravating a laboring mom. Ditto in postpartum, they didn't do procedures or give complicated meds (other than a routine prenatal vit, tylenol, and a stool softener). They do really great assessments, generally better than the floor nurses have time for. And they have time to talk to you, help find answers to questions, etc. If they give you any trouble, you can talk to the instructor and get an immediate resolution--you won't find that with the floor nurses!

My DD was delivered by a medical resident 13 1/2 years ago. Mine was his second delivery--ever. It was only because he was so wet behind the ears that I was "allowed" to push for 4 hours and managed not to have a cesarean.
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#52 of 59 Old 02-08-2007, 06:22 PM
 
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5 Questions to ask before ANY procedure or test or intervention:
What is it and how is it done?

How will is affect my baby?

How will it affect me?

How will it affect my labor?

Any alternitives/is it okay if we wait?
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#53 of 59 Old 02-08-2007, 06:27 PM
 
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I third (fourth) the thumbs up for student nurses...during my labor a student nurse asked if she could participate (since she'd just started her maternity rotation and never seen a mama laboring drug free). I said sure and even though I did eventually wind up with a c/s after 19 hours at 7cm (so not the best example of the wonders of natural labor!) she stayed with me the whole time and was more help than my doula! My doula suddenly realized that she couldn't bear the thought of being in the OR with me so after DH left with DD this student nurse stayed with me and explained what was happening and held my hand and, well...she made a really traumatic experience a HECK of a lot better.

I would say no to a medical student, and I'd say no to having any significant interventions done by a student, but all the student nurses I met during my hospital stay were amazingly friendly, patient, helpful, supportive, and really really eager to learn.

Though obviously every mama deseves the right to choose who participates in her care and birth experience!

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#54 of 59 Old 02-08-2007, 07:41 PM
 
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Now I wonder if it's possible to request EXTRA student nurses ...
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#55 of 59 Old 02-08-2007, 07:50 PM
 
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I have to disagree on the medical students - DD was delivered by a student who was WONDERFUL!

She was too short to see over me on the table {I actually thought she was sitting on a chair thru the delivery} but she had hands from heaven! I swear she must have had some training as a midwife, because she knew exactly how to stretch to keep me from tearing, which wasn't easy as DD came very fast.

Myself though, I didn't want any student nurses. Not because they aren't great or anything, but because I"m in college with most of them!
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#56 of 59 Old 02-08-2007, 08:01 PM
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I have to disagree on the medical students - DD was delivered by a student who was WONDERFUL!

She was too short to see over me on the table {I actually thought she was sitting on a chair thru the delivery} but she had hands from heaven! I swear she must have had some training as a midwife, because she knew exactly how to stretch to keep me from tearing, which wasn't easy as DD came very fast.

Myself though, I didn't want any student nurses. Not because they aren't great or anything, but because I"m in college with most of them!
I just want to clarify- at least where I am, medical students don't do anything clinical- they are there to observe, maybe do a couple of simple things. No baby catchin. The interns and residents do that. It may not be the same everywhere, that's just my experience.
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#57 of 59 Old 02-08-2007, 08:05 PM
 
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I just want to clarify- at least where I am, medical students don't do anything clinical- they are there to observe, maybe do a couple of simple things. No baby catchin. The interns and residents do that. It may not be the same everywhere, that's just my experience.
she might have been an intern or resident - I was pretty out of it from various medications they gave me.
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#58 of 59 Old 02-08-2007, 11:54 PM
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she might have been an intern or resident - I was pretty out of it from various medications they gave me.
I don't think it really matters she may have been a med student, just wanted to clarify for other people thinking about what they might request. Glad you had a good experience. Sometimes I have to remind myself they aren't all evil
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#59 of 59 Old 02-09-2007, 08:16 AM
 
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Originally Posted by pookel View Post
Now I wonder if it's possible to request EXTRA student nurses ...
Probably. I know I always had more students than patients who were laboring. Sometimes they would double up if a mama was okay with that. Depends on the number of laboring mamas and number of students available.
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