Your OB (or midwife) still does WHAT? (Pitocin Rate)

Janelle over at the Birth Sense blog is rapidly becoming one of my favorite blogs because of her very well written posts that include references to current research findings.  Using one of my comments as a spring board for a post made my day today, because once again, she has provided references to current research that is of use to laboring women.

Janelle writes:

Over the 28 years I’ve been a labor nurse and then a midwife, I’ve seen Continue Reading…

Posted 4 years, 11 months ago at 6:02 pm.

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“Spa-like atmosphere”

The Morning Call has a new parenting blog which has had some interesting posts.  A recent one though, I found to be mildly amusing.  The post, which I’d say is little more than an advertisement, gushes with enthusiasm about the new maternity unit opening at Grandview Hospital which is supposedly “spa like.”  Actually, I discovered that some of the text of the blog post is lifted directly from the hospital website–without acknowledgment. Continue Reading…

Posted 5 years, 3 months ago at 4:34 pm.

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Is “Suspected Big Baby” a Good Reason to Induce Labor?

I was asked recently for some information on induction, specifically if the reason is “suspected big baby.”  The person was asking on behalf of a friend, who was being induced at just a few days past her due date.

Well first, lets start with the medical reasons that the American College of Obstetrics and Gynecology (ACOG) indicate in a patient education brochure that labor should be induced for: Continue Reading…

Posted 5 years, 3 months ago at 9:53 pm.

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Pit to Distress…Does it Really Happen?

The blog-o-sphere is buzzing right now about a practice called “Pit to Distress.”  Apparently Keyboard Revolutionary started it all with her post, which was quickly followed by Unnecesarean the same day.  Now both of these blogs are written by “lay women”–that is, “JUST” moms, not medical professionals.  So I was quite happy to see one of my favorite L&D nurse blogs jump into the fray–Nursing Birth.  The Nursing Birth piece should be required reading for ANY woman who is planning a hospital birth, so that she doesn’t let this happen to her.

Pitocin seems to be almost synonomous with hospital labors anymore. I wonder how many women who labor actually manage to get through without using it at some point. One client I had switched OB practices because she had been informed that when she arrived at the hospital in active labor she would be put on Pitocin. No waiting to see how labor was progressing and if it was really needed…it was just the policy of this practice to use Pitocin on all laboring women. Medical staff will often explain away any concerns with the use of Pitocin by saying that it is just a synthetic form of the same hormone that your body produces. Which is true. But that doesn’t mean that putting it into an IV is the same as letting your body produce it!

I’ve seen some “interesting” things happen with Pitocin in my doula experience. 

Top 10 Ways to Have An Unnecessary Cesarean

In “honor” of Cesarean Section Awareness month, this post has been making the rounds, with a new “way” being added by each blogger.  I first saw the list in “Faint Star Light” with 7 reasons.  Then “Nursing Birth” joined the party, and finally “Enjoy Birth” jumped on the band wagon.  And now…me.  ;-)  (you should note that each author has put her own spin on the text–so go read them all!)

#10 Only take the hospital sponsored childbirth classes, or no classes at all.  After all, an independent viewpoint isn’t important–you’d accept a Ford dealer telling you that the Ford Windstar is the ONLY option for a family vehicle, and never consider a Honda Oddessy or Toyota Sienna, right?

 

#9 Choose a care provider without research – Some OB’s are cesarean happy.  Some OB’s say they support vaginal birth or VBAC’s but their statistics don’t back it up.  Make sure to ask your care provider about her cesarean rate–if it is over 20%, she ISN’T committed to avoiding cesarean–and that is being generous!  My OB practice in my first pregnancy had a 16% cesarean rate (and they aren’t VBAC friendly, despite “talking the talk”), so I know it is possible for even an OB to have such a rate. 

 

#8  Agree to a labor induction without medical indication. This is a sure fire way to make a birth more of a challenge.  Ask LOTS of questions.  Or, the variation on this, the “back door induction“…allow yourself to be convinced that you are in labor and in need of “augmentation” when you aren’t really in labor.

 

#7  Go the hospital in the early phases of labor.   Because hey, what helps you to relax and allow your body to “do its thing” more than entering a bright, noisy environment where people you’ve never met before want to touch your most private parts.  Remember…(assuming you conceived naturally)…the environment that was necessary to get the baby *in* is the best one to get the baby *out.*  Including some smooching if you are so moved.

         

#6  Don’t eat or drink during a long labor.   Because you really don’t want to do what I did.  I mean really, eating a breakfast befitting a lumberjack while having contractions 3 minutes apart was just CRAZY.  I didn’t have a crystal ball that told me I wouldn’t eat again for nearly 24 hrs.

         

#5  Get an amniotomy too soon.  Because hey, after having 2 or more vaginal births, it’s fun to have an emergency cesarean for cord prolapse (yes, despite what one of my cousins is being told to scare her into a primary cesarean with her second baby, it is QUITE common for babies to still be “high and floating” until a multipara is in active labor–even my 5th baby, who was a petite 6 lbs 3 oz didn’t “engage” until well into labor).  Scaring all your family half to death is fun!  (Yes, I do know someone who had this happen–and frustratingly enough, the family was singing the praises of the Dr. who broke the water because he knew just what to do to save the baby!)

          

#4  Accept pitocin to induce or stimulate contractions.

          

#3  Request an epidural.  Despite having 5 babies with nary a pain medication on board (okay, I did take one dose of Tylenol with Sophie after my midwife confirmed that I wasn’t making progress), I don’t begrudge women epidurals.  I just think women ought to be aware that being restricted to bed increases your risk of having a posterior baby, which increases your chance of cesarean.  Having an epidural (or Pitocin) also means constant fetal monitoring, which has also been shown to increase the risk of cesarean–without improving fetal outcomes.  And finally, I’ve had clients who needed to change positions in order to birth–two in particular needed to use hands & knees.  If they hadn’t been able to get into that position, they would have either needed a cesarean, or had a very poor fetal outcome (9 lb 11 oz baby with shoulder dystocia–mom flipped to hands & knees and the baby slid right out with no tearing.  Had she been stuck on her back she would have needed a big episiotomy and possibly forceps).

          

#2  Accept hospital staff’s comments on lack of progress without challenge.  Don’t concern yourself with stats that shown that “failure to progress” cesearans are much more likely to be performed at 4 p.m. than 4 a.m.–its not that your care provider is just wanting to get home for dinner. 

          

#1 Just ask – or Failure to Ask Questions! – Sure, some moms ask for cesareans, though despite media reports that make you think it is common, survey research indicates that it is very rare.  It is more likely that moms are told they need a cesarean because of xyz (breech baby, twins, big baby) and they don’t ask questions, get second opinions, etc. 

Posted 5 years, 8 months ago at 12:51 am.

3 comments

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