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My BIL and his DW are due Nov. 12th. I am going to be the doula, my 1st birth ever!!<br><br>
They have really liked their OB until Friday...the OB was doing the pelvic exam and said SIL was 2cm, 30% effaced (great!), and then BIL said that his DW started screaming!! BIL said, "what's going on?" and the OB said, "oh, I'm just stripping her membranes." then pulled her hand away and her entire hand was bloody!!<br><br>
She did this with no warning, let alone without permission!!<br><br>
Then they were going over SIL's birth plan, and her OB said that she will give SIL an episiotomy during the birth, and a dose of pitocin afterward to shed the placenta!! My SIL and her DH objected to both those, and the OB said "If <span style="text-decoration:underline;"><b>I</b></span> think you need it, you're getting it. <span style="text-decoration:underline;"><b>Period</b></span>."<br><br>
They left that appointment very dissappointed and now are afraid and nervous, (panicked!), and they don't trust her anymore. But they are too close to birth to find someone else that they can trust/build up a trust.<br><br>
BIL said to me, "We're really counting on you to keep an eye on her, (the OB), and make sure she doesn't do anything wrong."<br><br>
Now I'm nervous!! This will the 1st birth i've ever attended, and I want to make sure it goes as smoothly as possible. But now I'm worried about incompatibility w/ the OB, (between me and the OB), and between SIL, BIL and the OB!<br><br>
I"ve read <span style="text-decoration:underline;">The Birth Partner</span>'s section about the "take charge routine" several times, but if she starts reaching for the scissors, what do I do??<br><br>
Please help me help my SIL. I feel betrayed for her. I"ve had that kind of negative experience w/ a care provider, and I know how she feels. I want her to be comfortable and not worry the entire labor about getting an episiotomy, or pitocin.
 

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wow, thats just sick and sadistic, imo. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry">: i hope you guys can figure out something, and fast, though im honestly not sure WHAT since shes 39 weeks... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

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REPORT HER!!! NO OB should get away with doing any procedure as invasive and objectionable as membrane stripping w/o consent. We have to stop these OBs every chance we get!
 

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Wow that is horrible. There is no way they can find a midwife who works out of their hospital or talk to others who have given birth with OBGYN's at the hospital?<br><br>
If they go into the situation knowing she has this attitude it may happen.<br><br>
Hugs to you as the doula, that is a very hard position.<br><br>
The only thing I can think of is if you see her going for the scissors, say to the parents the Dr. is getting ready to do the episiotomy now. Is this okay with you?<br><br>
If the patient straight out says No, with a nurse, you, and dad there, perhaps she will think twice?<br><br>
I am so sorry you are all going through this. I wish they could find another care provider. This Doc sounds less then ideal.
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/9666059"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">REPORT HER!!! NO OB should get away with doing any procedure as invasive and objectionable as membrane stripping w/o consent. We have to stop these OBs every chance we get!</div>
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YES THIS!
 

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Unbelieveable. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shake.gif" style="border:0px solid;" title="shake"> I don't even know how to respond to that.<br><br>
I would encourage her to find out what her OB thinks is a valid reason for episiotomy. If she just gives them to everyone, blindly, I would encourage them to find someone else. I would ask if her having a Doc she doesn't know as well catch the baby in ther delivery room and delivering over an intact perineum is a better situation than having someone she knows cutting her, or doing procedures she has specifically refused.<br><br>
You will be able to advocate for the mom and dad during labor, but if the Dr is bent on giving an episiotomy, she likely will no matter what anyone says. Going into a birthing environment knowing that there is going to be conflict like that isn't the best situation by any means.<br><br>
I was so blissfully ignorant with my first birth- I remember talking to my ob about episiotomies, and having him tell me that he did episiotomies on 95% of first time moms. I blindly nodded my head, not knowing what I had agreed to.<br>
Healing from an episiotomy is extremely painful, and I still have some problems from my scar, and my dd is six years old! One of my biggest priorities for a future delivery is that I deliver over an intact perineum.<br><br>
And good luck on your first birth! I have my second coming up very soon- and its my first hospital birth. I'm excited, and nervous too.
 

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Discussion Starter #8
They really don't want to switch b/c they don't feel that they have enough time to build up trust w/ anyone else...She is stuck w/ a certain hospital b/c of her insurance, so she can't go anywhere else.<br><br>
I think the OB is in a partnership type practice, and maybe she won't the one 'on call' when SIL delivers. But still...They feel stuck with her, and want me to watch her and stop her if she tries to give SIL these things.<br><br>
I plan on talking to the OB when I get there, go over the birth plan quickly, and tell her that SIL flat out refuses an episiotomy or pit injection. That the thought of either one terrify her. Is that enough? What can I do? What can I say?<br><br>
BIL expects me to yank the scissors out of the OB's hands if she tries an epi. I don't really know what to tell him, either.<br><br>
Help! what do I say to these people!
 

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Ok, not a birth professional but I just had to chime in...<br><br>
They already don't have trust in their doctor, so there is no reason for them not to switch. I'd totally rather have a stranger than an actively hostile OB...have to you tried framing the suggestion by asking them first if they trust their current ob?<br><br>
If they still refuse to switch, you need to make sure they are abolutely aware that they are putting themselves at this person's mercy. I'm pretty sure that in most hospitals, the OB can have you removed from the room for pretty much no reason at all. While you can try and make sure their wishes are known, you have absolutely NO enforcement power whatsoever. You aren't a patient nor do you have the legal right to speak for the patient. I'm afraid you are setting up a nasty situation where things will go badly and they'll blame YOU for not stopping the doctor.<br><br>
Maybe they could complain to the other docs in the practice and try to get one of them to agree to be on call for them, no matter when they go into labor, and come in instead of this awful woman. Not sure how likely that is though.<br><br>
That's a tough situation, I don't envy you.
 

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Discussion Starter #10
I'm going to talk to SIL tomorrow. I'll talk to her about her rights and make certain she knows her options, as well as she has the option to fire this OB.<br><br>
She's going to the OB weekly now, and if she wants me to, I'll accompany her to her appt. and talk to the OB then about this, too, if SIL doesn't switch.<br><br>
VERY frustrating!!!<br><br>
This OB was great up until Friday. She was exactly what they wanted and had the right attitude and everything.<br><br>
My membranes were stripped w/o permission w/ my DD, so I know the betrayal SIL is feeling. I had just said, "DO NOT strip my membranes," and the MW (yes, a MW!), said, "Oh, I won't," then proceeded to strip them anyway, (I didn't know for sure what a membrane stripping felt like), saying that she was examining my pelvis and told me that my pelvis was too small and I would need a c-sec!!!!! I didn't realize what she had really done until I got home and chatted about it on MDC w/ my due date club. I had my DD 12 days after getting my membranes stripped, but I was only 1cm and 90% eff. at the time of the stripping. Luckily, she was not the MW that attended me, and I had a natural, vaginal delivery w/ no problems except that DD was posterior.<br><br>
so this has really brought up alot of old fear and anxiety in me, too.<br><br>
I just want SIL to have a better birth experience than I did. And yes, going into the birth with anxiety about what might happen later is not an ideal situation. I just need to know exactly what to do and be prepared, incase SIL won't switch.
 

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<div>Originally Posted by <strong>dinahx</strong> <a href="/community/forum/post/9666059"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">REPORT HER!!! NO OB should get away with doing any procedure as invasive and objectionable as membrane stripping w/o consent. We have to stop these OBs every chance we get!</div>
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<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">:<br><br>
I feel sickened and shocked to read this.<br>
she actually <i>stripped the woman's membranes without warning</i>!!?!?!?!?!?!?<br><img alt="" class="inlineimg" src="/img/vbsmilies/smilies/hopmad.gif" style="border:0px solid;" title="hopping mad"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/censored.gif" style="border:0px solid;" title="censored">:<br><br>
Report her immediately! dont even finish reading this, get on the phone!<br><br>
and get a new OB.<br>
you say the parents dont want to change because they wont have a chance to build another relationship, but they can not trust the OB they have.<br><br>
Do contact the OB immediately, find out what she thinks is "necessary" for an episiotomy. Write out a birth plan that states very clearly that the mother does NOT consent to episiotomy nor pitocin. If the OB can't agree to that, then get another one.<br><br>
as a doula, you can encourage the mother to stay home as long as possible. The longer you stay home, the less chance the OB has of r#$&ing her. You might also be able to find out what the OB's schedule is, and try to time your arrival at a time she wont be there.<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><br><br>
just in case I wasn't clear; fire the OB. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol">
 

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You really are in a tough situation. It is not the doulas role to go over the birth plan with the OB, or to tell the OB what the mom will or will not agree to. That's the *moms* responsibility. Doulas should not be speaking for the mom -- they should be empowering the mom to speak for herself, or perhaps asking questions which help guide the conversation.<br><br>
You need to disentangle yourself here. The best way to do it is to tell the mom that the only way to ensure she gets the birth she wants, is to go back and have another conversation with this doctor, immediately. Although I don't think she is doing it on purpose, the mom is really taking advantage of the fact that she thinks she has you to speak for her and protect her. The reality is that she needs to be ready to protect herself. You need to encourage her to get this straightened out with the doc NOW. Immediately. Maybe you could do a little role play with her beforehand on how to get the doc to answer her questions. Or, maybe you could go with her to an appointment to help discuss this.<br><br>
Also, help your SIL clarify her options right now. Truly, I think the goal of the doula should be to get the mom to take responsibility HERSELF for the choices she is making. If your SIL is absolutely unwilling/unable to find alternative care at this point (which you could quickly do some research for her to see if she really does have any options) then she has to do her best to sort this out with her doc, and ultimately realize that this problem is not on YOUR shoulders.<br><br>
Let us know how it goes!
 

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Discussion Starter #13
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<div>Originally Posted by <strong>andreac</strong> <a href="/community/forum/post/9666243"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">have to you tried framing the suggestion by asking them first if they trust their current ob?<br><br>
If they still refuse to switch, you need to make sure they are abolutely aware that <b>they</b> are putting themselves at this person's mercy. I'm pretty sure that in most hospitals, the OB can have you removed from the room for pretty much no reason at all. While you can try and make sure their wishes are known, you have absolutely <b>NO enforcement</b> power whatsoever. You aren't a patient nor do you have the <b>legal right</b> to speak for the patient. I'm afraid you are setting up a nasty situation where things will go badly and they'll blame YOU for not stopping the doctor.</div>
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Thank you! I am going to say this to SIL tomorrow. I'm their doual, their advocate, and I can't stop an OB from doing something she already has decided to do.
 

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Discussion Starter #14
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<div>Originally Posted by <strong>Contented73</strong> <a href="/community/forum/post/9666331"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">You really are in a tough situation. It is not the doulas role to go over the birth plan with the OB, or to tell the OB what the mom will or will not agree to. That's the *moms* responsibility. Doulas should not be speaking for the mom -- they should be empowering the mom to speak for herself, or perhaps asking questions which help guide the conversation.<br><br>
You need to disentangle yourself here. The best way to do it is to tell the mom that the only way to ensure she gets the birth she wants, is to go back and have another conversation with this doctor, immediately. Although I don't think she is doing it on purpose, the mom is really taking advantage of the fact that she thinks she has you to speak for her and protect her. The reality is that she needs to be ready to protect herself. You need to encourage her to get this straightened out with the doc NOW. Immediately. Maybe you could do a little role play with her beforehand on how to get the doc to answer her questions. Or, maybe you could go with her to an appointment to help discuss this.<br><br>
Also, help your SIL clarify her options right now. Truly, I think the goal of the doula should be to get the mom to take responsibility HERSELF for the choices she is making. If your SIL is absolutely unwilling/unable to find alternative care at this point (which you could quickly do some research for her to see if she really does have any options) then she has to do her best to sort this out with her doc, and ultimately realize that this problem is not on YOUR shoulders.<br><br>
Let us know how it goes!</div>
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THANK YOU! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">: what contented 73 said! she's totally right.
 

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Discussion Starter #16
just to add, SIL did go over the birth plan, but when the OB siad that about the episio and pit shots, BIL said that SIL just wilted, ("got 'stupid' and forgot to stick up for herself" were his exact words) and let the OB tear her birth plan to pieces. BIL tried to stick up for his DW, and the birth plan, but the OB just sort of shrugged him off and didn't pay him any attention. He's not the one giving birth, after all.<br><br>
ps, BIL didn't mean "stupid" as a derogatory term, he meant it as in her eyes glazed over and she went to her happy-place in her mind, and the OB took the opportunity to run her over.
 

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Uh, been there. Sorry that you are related to this case, as you really need to understand that SHE ...IS...making a CHOICE to stay.<br><br>
First, I'd go to your finding your tribe, and ask around. See if anybody there knows who at your sister's hospital, if anybody, backs up the homebirth midwives in the area. Then ask said midwives WHY they use said OB as their backup, and whether they'd trust them in this situation. If you come up with a relatively trustworthy candidate, I'd suggest this person to your sil.<br><br>
THEN, realizing that they will probably refuse, go on to plan B. Bring them the info from the ICAN site about refusing to sign/amending the general consent form. In this manner, your SIL can make it so that every SINGLE procedure, deemed emergent or "necessary" or not, MUST be okayed by your sil or her husband if she is incapacitated before it is done. This will be annoying for everybody involved. However, if the doc then does either of the procedures that your sister has already told her she is refusing the permission to the doctor to have done, your sil can sue that doc's butt to the wall. Not, of course, that your sil will want to sue...but the doc can't afford to take that chance. If said doc wants to play hardball, well, then, hardball it is. You might also tell her that the doc will NOT listen to you, as she can legally only take direction from the patient, and will use that against the doula. You CAN do things like say, "Doc X, I think it's a GREAT idea if you tell SIL what those scissors are for before you use them on her!" But if you don't get it in fast enough, it'll be done before you get the words out. Another option is to just go in pushing, and then have dad at the foot of the bed instead of doc. *shrug* If he's in the way, it's hard for anybody to cut her, you know?<br><br>
Sad, but I have seen over and over again people make choices that put them in grave danger of losing every single thing they have written on their birth plan, but depending on a doula to be a miracle worker and change the outcome that they've already written by choosing the place of birth and the person who is catching...and refusing to change for whatever reason, regardless of knowing the relative unsafe environment they'll be birthing in. For the most part, we're good at what we do, but we are NOT miracle workers. We can't undo choices that these women have made...and the women need to take responsibility for those choices.<br><br>
In the end, please remember that it was her choice not to switch...whether or not she feels she has a choice is irrelevent. By choosing to stay, she is making it significantly more likely that those procedures will take place.<br><br>
You'll do great in the capacity you are allowed to serve her. Have fun...birth is really wonderous thing to be part of.
 

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Wow. Sickening. As for suggestions, has her OB actually signed her birth plan? Because if she hasn't, it doesn't hold much weight in terms of a communication tool (also read: legality) between mom and the OB.<br><br>
Language is really crucial here, given OB's broad based use of epis. not to mention procedures without consent! So rather than "we would prefer not to..." or "It is our wish that..." her birth plan needs to read firm and non-negotiable on the things that she does not want to negotiate. i.e., "I do not consent to an episiotomy." "All medical interventions are to be discussed with me prior to taking place." Ditto for language in the labor room. If you see scissors coming, and you communicate that to mom, and mom says, "I do not want an epis.", OB will liekly (hopefully!) think twice about doing it, if for no other reason that legality and litigation. Sad, but true.<br><br>
Of course, some OBs can perform a procedure and claim it was necessary, but if strong language is used both birth plan and during labor, that "necessary" better be really obvious and supportable.<br><br>
And I totally agree with COntented's earlier post. Mom and dad need to do the talking, or you're really set up for possible blame for something that's truly not in your hands. Best you can do is support, educate, encourage, and be there. Good luck!
 

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<div>Originally Posted by <strong>Christy1980</strong> <a href="/community/forum/post/9666449"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">just to add, SIL did go over the birth plan, but when the OB siad that about the episio and pit shots, BIL said that SIL just wilted, ("got 'stupid' and forgot to stick up for herself" were his exact words) and let the OB tear her birth plan to pieces. BIL tried to stick up for his DW, and the birth plan, but the OB just sort of shrugged him off and didn't pay him any attention. He's not the one giving birth, after all.<br><br>
ps, BIL didn't mean "stupid" as a derogatory term, he meant it as in her eyes glazed over and she went to her happy-place in her mind, and the OB took the opportunity to run her over.</div>
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Here is a big problem in my eyes.<br><br>
Her DH has authority to talk to the OB and hospital staff on her behalf. He is going to have to be the one who advocates for her. While he's not the one giving birth, he does have standing to speak for their wishes and to confront the staff.<br><br>
As her doula, you have no authority at the hosptial. Trying to stop the doctor from doing something is a sure fire way to get yourself kicked out of the room. It also gives the doctor and nurses a bad impression of doulas. Your role is to support the parents and empower them to speak for themselves, but it's 100% in their hands once they are at the hospital.<br><br>
Arm them with the information they need, but please don't let them think that you have the power to stop the abuses this doctor dishes out.
 

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this is not shaping up to be a good scenario at all. Your SIL already knows what this OB is capable of--basically, of doing whatever she damn pleases, identifying herself as The Boss no matter what her clients wish. The membrane stripping was a personal violation, and it was also illegal--informed consent for all procedures/treatments is REQUIRED UNDER THE LAW; the OB knows this very well, but has clearly become quite accustomed to having her way and disregarding this law. As long as patients ALSO disregard this law (their own rights), OBs like this will continue to run people over in this way. Your SIL has already refused to stand up for herself--and she is NOT likely to get stronger about that while in labor (and who could blame her?). As I read it, there is no way for your kin to get anything like the birth they hope for with this OB. And there is not a thing YOU can do about this--you are there to support mom, but not to do this birth for her or see to it that her rights are respected. Sorry to seem negative, but I have to be very blunt because time is short.<br><br>
They either need to find another care provider NOW, or prepare not to have much of the birth they want--if any of it. If they are not going to find a new provider, then I think you need to be prepared to be a comfort and support but also to just put up with what happens...again, sorry, but this is the bald and sad fact of things.<br><br>
It is an emotional risk, considering a new provider, but--they already know positively adn without a doubt that this OB CANNOT BE TRUSTED, is capable of violation and domination. So...how is staying with her better than trying someone else, who frankly could not be much worse for them? I'm serious--they probably could not do much worse than this lady. Which means that if they try to meet other providers, they may well find someone who will be *better* for them/their birth.<br><br>
I am so sorry that this is happening. STay strong, and love your family through this...if you can be there in a supportive way no matter what they choose, you will have helped, even if their birth plan goes very much astray.
 
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