not telling the whole truth........midwives - Mothering Forums

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#1 of 28 Old 03-18-2007, 01:10 AM - Thread Starter
 
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midwives,
What happens if a client does not tell you the whole truth about previous pregnancies and in the end, it could get you in trouble?
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#2 of 28 Old 03-18-2007, 02:02 AM
 
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Scenario? A little hypothetical sitch please?
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#3 of 28 Old 03-18-2007, 02:53 AM
 
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what like I can't see the previous uterine surgery scar because it is in the pubic hair line-- or one of the folds ? has happened--
drug addict that has lost her other kids- and is hiding out to keep this one-- if she is straight through out pregnancy- then what will trip her up is the birth certificate- that we will file-- still using drugs we will find out usually--don't want a sick baby at home and more likely than not serious drugs = sick baby even if only temporarily -- also have to worry about stds-- do you have a different senario?
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#4 of 28 Old 03-18-2007, 10:10 AM
 
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what like I can't see the previous uterine surgery scar because it is in the pubic hair line-- or one of the folds ? has happened--
drug addict that has lost her other kids- and is hiding out to keep this one-- is she is straight through out pregnancy- the what will trip her up is the birth certificate- that we will file-- still using drugs will find out usually--don't want a sick baby at home an more likely than not serious drugs = sick baby even if only temporarily -- also have to worry about stds-- do you have a different senario?
OR..."really -- I have cut back to only one or two cigarettes a day!," when, in fact, the mother was still smoking a couple PACKS a day. And this little bit of information didn't come out until her extremely sick baby was transferred to the hospital, where the poor child subsequently died of meconium aspiration.

Please don't lie to the midwife. Nobody wins.

Valerie
Illinois
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#5 of 28 Old 03-19-2007, 12:51 AM
 
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I've found that stuff comes up when it needs to ---please, be honest, it's so much easier/simpler to navigate, but sometimes mamas don't know the truth.
Only after a scary waterbirth dystocia does she say that "oh, they did that last time, too" meaning 4-5 manuevers taking several minutes. She honestly didn't know it was unusual. It would have been nice to have some more towels and a pre-talk with the dad to let him know where we wanted her if she had to get out.

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#6 of 28 Old 03-19-2007, 02:32 AM - Thread Starter
 
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sorry, that was a horribly vague question

If you, the midwife, were not allowed by state regulations to take on a VBAC patient for an out of hospital birth.........
but your patient never disclosed the fact she had a c-section but only told you she had vaginal births.

The truth would be she did have a c-section 13 years ago and 4 extremely successful VBAC's.

Just curious. I am NOT seeing a midwife.

Thank you.
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#7 of 28 Old 03-19-2007, 08:16 AM
 
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Off topic, but this reminds me of something. We've had patients who have said they are 1st time mom's, but have visable episiotomy scars. In the absence of a drug or CPS history, I can't figure out the point of lying
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#8 of 28 Old 03-19-2007, 09:18 AM
 
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Off topic, but this reminds me of something. We've had patients who have said they are 1st time mom's, but have visable episiotomy scars. In the absence of a drug or CPS history, I can't figure out the point of lying
Maybe she had an adoption and her new partner doesn't know?

I never ask for a Hx with the partner present; pregnancy, birth, abortion, STI Hx's are not always disclosed to the present partner and if we put mama on the spot, we're likely to get an un-truth.
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#9 of 28 Old 03-19-2007, 10:03 AM
 
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I used to work in a clinic with lots of new immigrants. We'd ask about their history, they (this happened numerous times) would say it was the first or second baby, then later on we'd find out they also had 4 babies "back home." They didn't think to count the babies they'd left in the old country with grandma. Thought we were only asking about how many babies they had right now. :
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#10 of 28 Old 03-19-2007, 11:00 AM
 
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I wish I could lie about my cesarean. Boy how life would be easier if I could erase that. There are no records anymore (Fla doesnt keep them after 7 yrs) but it still haunts me every time I walk into the OB's office. (since midwives cant see VBACs in SC)
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#11 of 28 Old 03-19-2007, 12:50 PM
 
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If you want to lie to a provider, see an OB. I would be willing to go out on a limb for a client that was honest and had integrity. I feel totally unwilling to work with clients who are not honest.
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#12 of 28 Old 03-19-2007, 02:54 PM
 
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Its really sad that we live in a birthing environment where its so much like walking on egg shells. I obviously couldn't lie about my cesarean, but the ringer I was put through because of the laws and attitudes in place in my state, all because of a 10 yr old uterine scar was unbelievable. I was actively persuing a career as a doula and eventually a midwife (have all of my training package/books/etc and had a doula lined up to mentor me), until I got entangled in the web of garbage that surrounds birth in my state. I just knew that I would be unable to sit by and watch it all happen, without "fighting the system" and as a doula, my role would be to support mom even if she was doing something I didnt agree with, and even worse, as a midwife, it would be to follow the rules, stupid as some of them are, or risk persecution. As I said elsewhere, I don't blame midwives, but the system is screwed UP. After awhile it feels like banging your head into a brick wall trying to elicit change.

As for lying about smoking/drinking/etc... Honestly if I'm paying someone to be my care provider, I would want to get the most I possibly could out of it, and I would want to be able to trust them. I don't see that happening if there are lies on either side. The biggest problem I've had with OBs and CNMs that I've headbutted with, is that they lied to me in order to elicit the response they wanted and after I found out about the lies, I could no longer trust them with my care.
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#13 of 28 Old 03-19-2007, 06:44 PM
 
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Jenlaana--

I also had a cesarean in Florida, and now live in SC. The VBAC climate here just really sets women up for failure, and ties midwives hands in ways I can't even imagine...

Wife of one and mom of five, including my HBAC twins!
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#14 of 28 Old 03-19-2007, 10:19 PM
 
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If it is in your questionnaire- like # of prev. births, or # of abortions or cervical operations or uterine surgeries- or in your umm... case.... a c-sec. Then the MW can not be held responsible. It seems that if there has been successful vbac's then I am sure there is a MW that would take see someone in that situation- even if vbac's were not leagal. I think MW's tend to be more on the side of the human body than on the side of the hard book laws. I would fear more about not telling a MW and in the end it came out during labor- because not only does/would that MW look bad for not knowing, so will the mother for not disclosing. It is better in the case of safety to be honest.

I have heard of mothers not saying things to their MW's on many occasions, only in the end to need medical assistance that could have been foreseen or prevented if only they had been honest.

[B][I]~Ang~ Mom to 2 sport-head crazy girls: Rainey and Breeze  and my little lost love- @18 weeks with gestational age of 7 weeks

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#15 of 28 Old 03-20-2007, 01:16 AM
 
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Or my personal fav. an undisclosed LEEP. Dr. Friendlyob missed it too. Four days later....
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#16 of 28 Old 03-20-2007, 03:01 AM
 
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I have heard of mothers not saying things to their MW's on many occasions, only in the end to need medical assistance that could have been foreseen or prevented if only they had been honest.
Can you give me an example of this type of situation?
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#17 of 28 Old 03-20-2007, 03:41 AM
 
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Can you give me an example of this type of situation?
Sure, how about a previous pelvis fracture that was not disclosed. Or what if a mother had a biopsy on the cervix that was not disclosed, yet caused scar tissue to build up. I am sure even when people have non-pregnancy related uterine procedure- such as a cyst removed had some scar tissue build up. All these things a woman could easily no see relevant to pregnancy- or to birth and not disclose it. The problem is they do not understand that scar tissued area can be weak- or that scar tissue on the cervix can stop or prevent dilation- or that a pelvic injury when they were a child could cause problems later in life. They just bypass these things as old history and I can see some women no disclosing it- not because they are trying to hid it, but honestly (in most cases) because they didn't think it of a pregnancy issue.

[B][I]~Ang~ Mom to 2 sport-head crazy girls: Rainey and Breeze  and my little lost love- @18 weeks with gestational age of 7 weeks

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#18 of 28 Old 03-20-2007, 12:16 PM
 
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I have heard of mothers not saying things to their MW's on many occasions, only in the end to need medical assistance that could have been foreseen or prevented if only they had been honest.
Oh I know a lot of things should be disclosed. But which things do you think could be PREVENTED if only the midwife knew about them beforehand? They can't prevent scar tissue or do anything about old fractures. Not saying that it isn't nice for them to know about beforehand.
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#19 of 28 Old 03-20-2007, 01:35 PM
 
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Originally Posted by 1stimestar View Post
Oh I know a lot of things should be disclosed. But which things do you think could be PREVENTED if only the midwife knew about them beforehand? They can't prevent scar tissue or do anything about old fractures. Not saying that it isn't nice for them to know about beforehand.
I am sorry, what I meant by prevented was that mass panic at a birth could be prevented. Scar tissue on the cervix can be dealt with if it is known. A previous pelvic injury could be addressed instead of a mother laboring for hours and hours and hours with no chance of a baby coming down.

I would rather women feel like they were informed and educated than feel like their bodies failed them after a long drawn out labor that could gone different if a MW would have known.

I do feel that many times women do not even view these things as "pregnancy" issues, and that is why at the birth- when they come out- there is panic and letdown.

[B][I]~Ang~ Mom to 2 sport-head crazy girls: Rainey and Breeze  and my little lost love- @18 weeks with gestational age of 7 weeks

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#20 of 28 Old 03-20-2007, 04:13 PM
 
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so for cervical scar tissue- which we see more often now because of the discovery and treatments available for HPV that can prevent cancer- so the treatments are great but the scar tissue can prevent dilation -- and with our typical hands off approach and we don't check mom until days into laboring-- and we find a closed cervix- she is too worn out to do anything but transfer care- and if the hospital doesn't see progress nor have any more history than we have- she can end up with a c-section or a rupture-- if we know that a woman has had a procedure- cone, laser, frozen, cauterized- chemically removed HPV we should be checking early in what would be considered active labor by contractions and then a second time and if we did not find any changes we could do something similar to stripping membranes that would break up the scar tissue and allow mom to dilate-- often what I have felt and seen is mom is 2 cm and after the scar tissue is broken up she jumps to 6 or even 8 cm so I don't think that we have been doing it none too soon-- I also know of women who have been transfered for failure to progress/worn out mom or baby--
as for broken bones there may be some positions that are better than others-- also there are massage and moxa points that can be used to help loosen the scar tissue around a break--
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#21 of 28 Old 03-20-2007, 06:51 PM
 
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Right, I do get what you are saying. But what I meant was, knowing those things beforehand, can not prevent them. If you know about them, there are things you may be able to do to deal with them effectively in labor, but knowing about them can not make them have never happened. My point was that using the phrase "...or prevented if only they had been honest." was not really an accurate idea. The situations could not have been prevented just by the midwife knowing about them. The way the problem is DEALT with or the woman is treated may be different if the midwife knows about a problem, but that is different then being able to prevent the original situation.
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#22 of 28 Old 03-20-2007, 07:12 PM
 
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I lied to my midwife with DS1's birth. : I felt driven to do so to both protect her and have the birth I wanted. My bag of waters started leaking about 48 hours before the birth and ruptured more about 36 hours before the birth. Hospital policy was delivery within 12-18 hours of rupture, no exceptions.

I do recognize that this might not have been the smartest or safest thing to do. There was no *obvious prolapse (and ultimately no prolapse at all) and I took no baths/allowed no cervical checks/was GBS neg at testing. I kept tabs on my temperature. I kept tabs on baby's movement and heartbeat while I "labored" (really, just waited for labor to start) at home before I went to the hospital.

Midwife FOUGHT to allow me to labor from 24 hours from when she thought my water broke (I padded the time from the "big" rupture about 12 hours - that was the information she was going on). I did not want her to get into trouble (she did anyhow, but not over this issue. She *gasp* allowed me to EAT in LABOR!). DS came 27 hours after what I told them was the rupture time, and luckily I went into actual labor those last two hours on my own. Ohh there were fights and stress with hospital "officials" the whole time!

Yes, it might not have turned out as well. I'd hope that I could have been the one to get into trouble and not her since she honestly didn't know (as it was CPS was threatened no less than 3 different times to us). And, FTR, I did not and would not ever lie to my homebirth midwife I used for DS2. She's the only HB CNM within about 3 hours and I was doing anything I could to protect her and her license!

Bean : Mama to DSs and (& :, 4 goats & 7 ) and two fraternal twin BOYS 9-19-09 (+ 1 daytime boy)
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#23 of 28 Old 03-20-2007, 07:27 PM
 
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This thread just brought to mind the case of the triplets born at home. The parents and midwife stated they didnt know it was trips. Im sure you can easily mistake 2 for 3? But it just kind of always made me wonder. Did the parents only say there was one, or were they all in the know?

This just makes me wish the laws would CHANGE. When did the way a woman's body gave birth become something that a law can regulate? Why can my 14 yo daughter miss school to have an abortion without any parental consent or knowledge, but I can or cant do certain things about how that 14 yo is born into this world????

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#24 of 28 Old 03-20-2007, 08:51 PM
 
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Originally Posted by 1stimestar View Post
Right, I do get what you are saying. But what I meant was, knowing those things beforehand, can not prevent them. If you know about them, there are things you may be able to do to deal with them effectively in labor, but knowing about them can not make them have never happened. My point was that using the phrase "...or prevented if only they had been honest." was not really an accurate idea. The situations could not have been prevented just by the midwife knowing about them. The way the problem is DEALT with or the woman is treated may be different if the midwife knows about a problem, but that is different then being able to prevent the original situation.
What I meant was that a medical outcome could (perhaps) be prevented- not that the cause could be prevented, that is already fact- but the outcome and how the pregnancy/labor is dealt with could be different- or trama prevented. Maybe I just wrote it wrong??? I know of women who do not want cervical checks at all during labor and have not disclosed cervical issues in the past- that lead to a very long tramatic labor- that could have been prevented (perhaps) if the MW would have been told and the possiblity of issues could have been addressed.

But to the OP, you can not hold a MW responsible if she was not infromed by your choice to not tell her.

[B][I]~Ang~ Mom to 2 sport-head crazy girls: Rainey and Breeze  and my little lost love- @18 weeks with gestational age of 7 weeks

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#25 of 28 Old 03-20-2007, 09:03 PM
 
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and as a note to other providers this is a good reason to have your clients fill out their own forms-- that way it cannot be said you skipped that part of the form--
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#26 of 28 Old 03-21-2007, 12:03 AM
 
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I guess I come to this discussion from the midwife's point of view but I can provide ever so much better care if I know what is going on..I'm not just nosey, I just really want to help if I can. Of course I am blessed to work in a place where I have a LOT of leeway as to what I choose to take on..ie:PROM,Vbac, Twins,etc but if I know about previous difficulties, at least I can discuss it with Mom and make appropriate decisions.
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#27 of 28 Old 03-23-2007, 03:50 AM
 
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To me, you wouldn't want your nurse, or doc, or midwife, to lie to you. Gosh, to me, if I found out someone was lying to me about something about the mom or baby's health...I would feel used. Let's say you have a C/S scar you don't want to tell her about because to you the HBAC is a safe choice...lets say that she sees something that haunts her forever...in labor that might have tipped her into transferring you. Or maybe she genuinely doesn't believe in HBAC, it just isn't right to trick her.

When tragedies happen, I have seen docs, nurses, and midwives change careers. Even if they did everything right. Obviously, parents and babies have so much more trauma when something goes wrong, but care providers do too, and they have the right, I think, to the truth.



Just another voice heard from.
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#28 of 28 Old 03-24-2007, 12:38 AM
 
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Amen to mamabearing.I absolutely have no place in my world for those who feel inclined to lie. If you have had a c/s,a leep proceedure/even a d/c or abortion..these all have the potential to impact the course of your labor. If I personally feel that I cannot safely attend your birth for whatever reason, wouldn't you rather have that up front so that you could perhaps search for other options? If you lie to me, how will I know what to watch for? How can I research and find better ways to help you?
Just my perspective..
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