Update: Take out your crystal ball and tell me what's going to happen with my client!

706 Views 10 Replies 9 Participants Last post by mamato3cherubs, Apr 13, 2006

doula and mom

Discussion Starter · Apr 11, 2006

ETA: Well, the word I meant was macrosomia. This medwife insists the baby is at least 10lbs. I said to the medwife (in private, not in front of client) "You can't be 100% sure that the baby is so big." She said, "I can't palpate because all I can feel is baby." I think that's bullcrap. All she can feel is, uh, fat -- the woman weighs nearly 400lbs! That is not all baby. Client asked to get induced today. I sympathize to an extent -- she is huge and miserable, can't sleep, and has done all she can to get the labor going on her own. Thankfully, there was no room in the hospital to schedule an induction. So at this point the medwife is trying to get her on the schedule for Friday evening. So now I'm REALLY hoping she goes in on her own on Thursday or Friday morning. She tried a tincture of blue cohosh, lobelia, and red cayenne (medwife's tincture for when she has HOMEBIRTH clients. Yes, this medwife is the one in our small town who actually does homebirths. Which makes me think I'm going to have to either do a UC or move before I have another kid!) and it did nothing. I'm trying to keep client positive. Please cross your fingers that she goes in on her own before an induction!

She is such an awesome amazing woman, I am absolutely praying for a positive birthing experience for her. And I'm not much of a pray-er.

The basics: She's 6ft tall, 375lbs, gbs+, measuring 4-5w ahead (because of her size, duh), and the "medwife" thinks the baby is at least 10-11lbs. Baby's hr is fine, mom's bp is fine, urine is fine. She really wants to labor and deliver medication-free in the hospital, and has told the medwife that she does NOT want to be induced with pitocin, cytotec, etc. We have talked about trying safe natural methods (breast pump, sex, massaging that inner-ankle spot) and she has been having ctx every 15 min for about the last 2 days. Today she took 2oz castor oil with oj and it did nothing other than give her some bathroom time.

Throughout all of this, she's managed to stay really positive. She has an appt with the medwife on Weds (I'm going too) and I'm just hoping... I just really want to see this client have a positive birth experience. The medwife keeps mentioning hypersomia or something -somia. Meaning she's having a 352lb baby, right? Le sigh.

Just wanted to keep you all abrest of the situation. I don't even know if going into labor spontaneously will keep her from being cut open, but I'm still hoping for a late-night call.

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ariahsmum

· #2 · Apr 11, 2006

Course I am fresh out of crystal balls... but is this a first pregnancy? And how many weeks is this woman? By who's dates? What are her fears if any? Her care provider is a Nurse midwife? Hospital?

Is there any way to tell what position the baby is in? She sound very obese if I read that # right and so I am assuming it is hard to tell from external palpation. I ask cause it sounds that with the on and off labor there are either fears going on or more likely baby trying to rotate into better position. Have you had her doing OFP?

What does SHE think about the baby being big? How does she view her body and its capability to birth a large baby if it is? IOW, how much have the fears that the medpros have planted affected her subconscioulsy?

Is this woman so commited to birth at this hospital that she will birth there regardless of route- c/s, vaginal, induced, etc?

I am asking so many questions and I have more, b/c altho no one can tell you how this will turn out as you know, there is a lot of missing info to even begin to help with the situation.

If you don't want to post all of this on line, but are serious about talking about it, then feel free to pm me.

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courtenay_e

· #3 · Apr 11, 2006

Uh, yes, she sounds obese to me...but she's also tall. Tall people often make tall babies...and those babies often happen to have some meat on their bones...this doesn't mean that she won't be able to birth the baby that is made to fit her body, just that she's tall and her baby shares her genetics. I've said this before, but my grandmother was 5'4 and had thirteen babies vaginally...four of whom were over eleven pounds. No drugs, no forceps. She cooked 'em and she birthed 'em. Wonder of wonders. Get your client to a hypnotherapist and be sure that she is rid of any fears this medwife may have put into her psyche. It makes a huge, huge difference. Blessings to both of you!

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doula mary

· #4 · Apr 11, 2006

My crystal ball is lost...

How many weeks is she?

I think you have given her good advice, and think it's good you are going to her appointment with her.

Mom can refuse anything medical intervention

Would she be open to acupuncture? If she is at her due date or passed, this is a good option to get things going.
Keep us updated!
Mary

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amydidit

· #5 · Apr 11, 2006

I was 300lbs (5'6") with DD1 and continually measured at least 8 weeks ahead. My midwife would still palpate for position, but thought the baby would be at LEAST 8-9lbs. She was 5lbs 10oz when born completely complication free, and naturally, at 38 weeks.

Are you worried about your client, or the medwife? It sounds to me like your client has a good attitude. Does she have a good support system, aside from you? The way you keep mentioned mEdwife makes me think you're afraid the birth will end up full of interventions, correct? Just try to keep your client positive, let her know she's not the only large woman who's measured big before, and not to be afraid. She needs to trust her body the most.

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Jane

· #6 · Apr 12, 2006

Well, I can't accurately palpate babies when the mom has lots of belly fat. I do can usually tell position, but I am usualy over by at least a pound on my estimates.
What's her gestation? Why is she inducing? Has she had other babies? I hope so. The normal labor pattern and average 2.5 hours of pushing seen with primips can scare providers when the mom has another "risk" factor.

Hypersomnia is excessive sleeping. Perhaps polyhydramnios (too much fluid) or oligohydramios (too little fluid) or hypoglycemia (low blood sugar)? Those don't seem close, but neither doesn't "too sleepy".

One more tip she might want to discuss with her midwife - using protein with the castor oil. Making it in eggs, or half-n-half ice cream + protein powder, or something to bind the castor oil will help increase the amount of time that it stays in the body and give it more time to work. I've usually seen moms do 2 oz, then 2 oz more in 4 hours if no contractions. She may also want to time it to work overnight. There's something to be said for timing things to work with her circadian rhythm, taking the castor oil at 10 pm and the potential second dose at 2 am. I emphasize that she should coordinate with her midwife, please, as not to step on toes.

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courtenay_e

· #7 · Apr 12, 2006

Quote:

Originally Posted by Apricot
Well, I can't accurately palpate babies when the mom has lots of belly fat. I do can usually tell position, but I am usualy over by at least a pound on my estimates.
What's her gestation? Why is she inducing? Has she had other babies? I hope so. The normal labor pattern and average 2.5 hours of pushing seen with primips can scare providers when the mom has another "risk" factor.

Hypersomnia is excessive sleeping. Perhaps polyhydramnios (too much fluid) or oligohydramios (too little fluid) or hypoglycemia (low blood sugar)? Those don't seem close, but neither doesn't "too sleepy".

One more tip she might want to discuss with her midwife - using protein with the castor oil. Making it in eggs, or half-n-half ice cream + protein powder, or something to bind the castor oil will help increase the amount of time that it stays in the body and give it more time to work. I've usually seen moms do 2 oz, then 2 oz more in 4 hours if no contractions. She may also want to time it to work overnight. There's something to be said for timing things to work with her circadian rhythm, taking the castor oil at 10 pm and the potential second dose at 2 am. I emphasize that she should coordinate with her midwife, please, as not to step on toes.

I learn something new every day, here...makes sense to make it with protein.

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TurboClaudia

· #8 · Apr 12, 2006

sounds like they are talking about macrosomia for the baby (large baby). have they been concerned about her blood sugar or gestational diabetes?

~claudia

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Midwife Kris

· #9 · Apr 12, 2006

I'm 5'3", weighed 155 or so at term with my 11lb 5oz macrosomia boy. It will take a lot for my clients to upset my guestimations of size

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doula and mom

Discussion Starter · #10 · Apr 13, 2006

bumping with the update

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mamato3cherubs

· #11 · Apr 13, 2006

Just wanted to wish your client the best and remind you to get your sleep as it looks like you may have a difficult one ahead of you! sounds to me like you are offering wonderful support for the wishes of your client, keep up the good work. and I just thought Id add to your list, get her out walking. Sometimes thats all it takes to turn babe into a good postition to put that preasure on the cervix. But im sure you are very well aware of that! Now I'm sort of anxious to see how this turns out, guees I'd better follow up here!

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