NYC Doulas - St. Vincent's C-section policy? - Mothering Forums

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#1 of 12 Old 06-25-2008, 10:10 PM - Thread Starter
 
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X-posted in Birth Professionals...

My BFF was planning a hospital birth w/ Maureen at St.Vincent's. She is 37.3 weeks and her baby is breech. Today, she was not able to undergo her scheduled ECV because of cord positioning. Dr. M has recommended a scheduled section at 39 weeks. She is comfortable with the decision, though obviously disappointed and is concerned about hospital policy on who can be in the room during the birth.

I was to be her labor support person (I'm a trained doula, but live in another state) and she would still like me to be present at the birth, along with her husband. She is concerned that limits will be placed on support people and that she won;t be in a position to argue over the these policies.

Does anyone have experience attending C-births at St. Vincents as a doula? Were you allowed to support your clients during the procedure?

TIA for any information!

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#2 of 12 Old 06-26-2008, 10:59 AM
 
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Pretty standard policy to only allow one person in the OR with the women getting a c/sec.

So it is either you or her partner.

There is not that much room, the anesthesiologist stands by the women's head on one side, you would sit on the other of her head.
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#3 of 12 Old 06-26-2008, 12:21 PM
 
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Has she considered waiting for labor to start before undergoing the c-section? If there are no other extenuating circumstances, she might as well, it's likely to improve outcomes.

Perhaps she will need support in recovery while the partner is staying with the baby?
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#4 of 12 Old 06-26-2008, 12:25 PM
 
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I'm sorry Alana. That is a bummer. Policy will be that no one is in the room with her while she gets prepared. They will then let one person it (her dh) right as they begin the surgery. He can stay until the baby is out and then they either give him the baby or they take it to the NICU depending on need. You can be in the recovery room and stay with her if the baby and dh have to go elsewhere.

They will not let two people in the OR - that is pretty much an impossibility.

Good luck!

Megan Davidson, Labor & Postpartum Doula, Breastfeeding Counselor, Anthropologist, Mom to August (9) and Clay (4), Partner to Shawn.

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#5 of 12 Old 06-26-2008, 01:04 PM
 
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Just curious - why are they recommending a c-section before 40 weeks? Is the fetus in danger somehow and needs to come out early?
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#6 of 12 Old 06-26-2008, 01:07 PM
 
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What you can do when the room is assigned is to set up the room before she gets there, a vase filled with flowers, balloons tied to her bed. Bring her pillows from home. Get the TV service turned on. Unpack her bag, generally make it all nice for when she comes back from recovery.

This is greatly appreciated by anyone who has to stay in a hospital.

Once she is allowed clear Liquids bring her a big cup of starbucks coffee to make her fart and poop. It is the only thing that works after a c/sec.
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#7 of 12 Old 06-26-2008, 01:12 PM
 
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Quote:
Originally Posted by Citykid View Post
Just curious - why are they recommending a c-section before 40 weeks? Is the fetus in danger somehow and needs to come out early?
Quote:
Originally Posted by laneysprout View Post
Today, she was not able to undergo her scheduled ECV because of cord positioning.
A sonogram showed a problem with the cord so they could not try a EVC (External cephalic version)
That usually means it is a very tangled stuck cord around the baby's legs, arms, neck, sholders, or just a very short cord, either one is preventing the baby from moving or turning.

This is normal standard hospital policies to not let a breech go into labor so they give a c/sec at 38/39 weeks.


`
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#8 of 12 Old 06-26-2008, 07:45 PM - Thread Starter
 
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Quote:
Originally Posted by dewi View Post
A sonogram showed a problem with the cord so they could not try a EVC (External cephalic version)
That usually means it is a very tangled stuck cord around the baby's legs, arms, neck, sholders, or just a very short cord, either one is preventing the baby from moving or turning.

This is normal standard hospital policies to not let a breech go into labor so they give a c/sec at 38/39 weeks.


`
Yup, that's the case. She has been trying to get the babe to turn for some time, and the version was going to be the last attempt. The doc who was to perform the version said he is completely comfortable attempting a vaginal breech when appropriate, but given the placement of the cord (across the neck and shoulders and tangled around the arms), they couldn't do the ECV because he thinks it's just too risky. He has recommended a section at 39 weeks because of concerns about her going into labor and the babe's hips engaging, thus necessitating the need for a true emergency c-section. He has been very supportive of her desire to attempt VBAC in the future and thinks a planned section will increase the likelihood of this happening.

Thanks so much for the info and all the suggestions. I'll pass it along and do my best so that she feels empowered about the choices she CAN make at this point.

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#9 of 12 Old 06-27-2008, 10:14 AM
 
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I had been planning a birth at the Brooklyn Birthing Center, and had a scheduled section at 39 weeks under similar circumstances... only after a failed ECV and with a footling babe. We were at Victory Memorial (awful place, not where I was supposed to be--long story) but they let my DP and midwife come into the OR with me. I'd check with the OB--the person doing the surgery might have some sway over the standard policy.
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#10 of 12 Old 07-08-2008, 08:19 PM - Thread Starter
 
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Just wanted to update y'all since you were so helpful with information and suggestions:

K was scheduled for her C-section this coming Thursday. Then early Sunday morning - surprise! - her waters release! She was relieved that the baby was ready to come, but her MW was concerned about the cord prolapsing so off to the hospital she went!

I immediately drove the 2 1/2 hours to St. Vincent's and met her in recovery with her beautiful babe, a daughter named Roxie. Her arms were free during the procedure and she got to hold the baby right after the birth. Within a few hours, breastfeeding was going well, though, understandably, both mom and baby were exhausted.

K was walking and using the bathroom on her own within 24 hours and headed home today! Her MW and her DH were present during the birth, and everyone was respectful of the fact that this was not the kind of birth she had wanted. The surgeon proclaimed her an excellent candidate for a VBAC, the nurses left her and her family alone to bond, and all things considered, she felt empowered by the choices she was able to make.

Thanks again to everyone who posted a reply to the OP. It meant so much to her (and to me!) that I could be there assisting where I was able to.

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#11 of 12 Old 07-08-2008, 11:38 PM
 
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Thanks for the update ! For those of us who are planning a natural birth at a hospital (and in my personal plan--at St. Vincents) it is sooooo nice to hear positive birth-at-a-hospital stories and perhaps even more, positive c-section stories (the biggest fear!)
thanks again, I'm glad your friend is home and that all is well.
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#12 of 12 Old 07-11-2008, 01:52 AM
 
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That's great Alana. Congrats to you and her. Since she is my neighbor, right?, hopefully I'll get to see Roxie (and Iris) soon.

Megan Davidson, Labor & Postpartum Doula, Breastfeeding Counselor, Anthropologist, Mom to August (9) and Clay (4), Partner to Shawn.

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