Free Birthing

[jewelz617]

Date: 3/11/2010 5:00:53 PM
Author: Hudson_Hawk

Date: 3/11/2010 2:30:53 PM

Author: PinkAsscher678

Date: 3/11/2010 1:33:18 PM


Author: part gypsy


Jas - I think your experiences regarding pictocin are unusual. The vast majority of women I knew who gave birth (in a hospital) did not receive pictocin. My first birth I had pictocin because my water broke and my labor did not progress, but my second birth (at the hospital) progressed naturally, no pictocin.




Getting away from the free birth argument, I do see the allure of home births as being: less medical, less interventionist, and less expensive. It''s a sad thing to say, but the high rate of c-section in the US is not just due to doctor preference, but the poor physical health of high percentage of mothers in the US. But I do feel there can be things done especially regarding billing, that gives people more choice about more natural versus more medicalized births, especially as there is more demand for it.




I was thinking about my mother. She did have a bad experience with her first birth (unneeded med). Did that mean she wanted the rest of her births at home? Nope, her following births she just made her wishes abundantly clear so there was no room for misunderstanding!

Could you clarify what you mean by ''It''s a sad thing to say, but the high rate of c-section in the US is not just due to doctor preference, but the poor physical health of high percentage of mothers in the US.''



Just not sure I get what that is supposed to mean.

Perhaps our overall problem with poor stamina/endurance? To not have good stamina and endurance means you''re going to tire quickly and not necessarily be able to push as effectively as needed. That''s all I can think of. I mean, there are very fit obese women and very poorly fit thin women, so I doubt she''s making a blanket generalization that because American''s are more likely to be obese we have a higher rate of medicalized births. That would be feeding herself to the vultures and she''s too smart for that

I guess I just don''t get the connection. I mean, it''s good to be physically fit anyway, but the fact of the matter is you either progress or you don''t. Your body calls the shots (actually, the baby does!) when it''s time to go into labor.

My friend Nikki is a runner and plays volleyball 4 times a week. She did not progress, was barely dilated even after her water broke and the baby''s heart rate dropped. She needed a c-section. I on the other hand consider shopping to be cardio and I pushed my daughter out in 20 minutes.

I never thought (perhaps mistakenly) that labor and the physical fitness of the mother were related. That''s why I was looking for more of an explanation.

 

[megumic]

See, here''s my problem. At what point do medical professionals indicate that a birthing mother NEEDS
pitocin, or a c-section, or magnesium, etc, etc, etc. Since I haven''t given birth yet, I just don''t know. How much longer could most moms go without the pitocin before serious infectious dangers arise? (It''s my understanding pitocin is used when the water has been broken for hours, little progress and there is danger of infection - correct me if I am mistaken.) How high is that risk of infection vs. the potential to progress w/o the drug? I get concerned that many couples don''t weigh the options of waiting for medical intervention to be necessary, but rather just accept it b/c it will (potentially) help and is precautionary. As another PS''er pointed out, sometimes it''s the medical intervention that causes and then results in subsequent further medical intervention.

Do you think doctors are over-zealous in treating birthing moms?

 

[taovandel]

Maybe I missed it, but I''ve yet to hear why people wouldn''t want a professional at least in the room in case of an emergency---well other than money---which sounds like a completely selfish reason. They wouldn''t have to do anything unless necessary....why not that option? Why risk anything---when it comes to the birth of a child, why put any added risk to it.

I also love the differ view of how things are in third world countries---where they really want midwifes and hospitals to help with births...and here we are throwing that option out the window for selfish reasons....it''s just weird to me and yes, a little crazy.


Meg: I can only speak from my own experience. I was at 9 1/2 cm for a few hours and I wound up with pitocin because my contractions weren''t strong enough after 14 1/2 hours in the hospital (I came in at 4 cm) to get me to 10 cm. My Dr and nurses did everything they possibly could to make sure I gave birth vaginally. I had a few problems that made them concerned I wouldn''t be able to (tilted pubic bone, baby wanting to stay on my right side, facing sideways, Epi was too strong, etc.). I had one nurse who actually stayed past her shift because she wanted to see me through it and to ensure I had a VB. I wound up with the VB I wanted.

So I don''t think all Dr''s are prone to just running to the operating room unless absolutely necessary.

 

[somethingshiny]

RE: Post about the high rate of c-section in the US. Obese women are also more likely to have c-sections according to the statistics. Obviously the majority of the population is currently overweight so I assume that has increased c-sections generally.

 

[waxing lyrical]

Date: 3/11/2010 7:03:51 PM
Author: megumic
See, here''s my problem. At what point do medical professionals indicate that a birthing mother NEEDS

pitocin, or a c-section, or magnesium, etc, etc, etc. Since I haven''t given birth yet, I just don''t know. How much longer could most moms go without the pitocin before serious infectious dangers arise? (It''s my understanding pitocin is used when the water has been broken for hours, little progress and there is danger of infection - correct me if I am mistaken.) How high is that risk of infection vs. the potential to progress w/o the drug? I get concerned that many couples don''t weigh the options of waiting for medical intervention to be necessary, but rather just accept it b/c it will (potentially) help and is precautionary. As another PS''er pointed out, sometimes it''s the medical intervention that causes and then results in subsequent further medical intervention.


Do you think doctors are over-zealous in treating birthing moms?

Pitocin and uterine stimulants are used a lot, and not just in cases where labor needs to be induced or augmented due to prolonged rupture of membranes. A L&D friend of mine said she rarely ever sees a birth that doesn''t include pitocin, misoprostol or cervidil. The only ones that don''t get induced/augmented are those opting for NCB or the ones that come in late in labor--transition.

The risk of infection increases with VEs. In a OOHB (out of hospital birth), after 24 hours of ROM and things aren''t progressing it''s encouraged to transfer. The 24 hour mark also exists as protocol in hospitals. Some will push it longer as long as baby is tolerating labor well and mom isn''t showing signs of infection--fever and tachycardia in baby.

Pitocin, misoprostol (off label drug) and cervidil are not without serious risks. Misoprostol shouldn''t be used at all, but it''s cheap and it''s reliable, so why not? It''s not without disastrous effects. It''s not like a pitocin drip that can be turned down or cervidil that can be removed. The pills dissolve and whats done is done. If contractions come on too strong it can''t be undone (though terbutaline may be used to manage it). Uterine stimulants are known to cause unnaturally strong contractions and this leads to IV narcotics or anesthesia. There''s a cascading effect that comes with interventions.

The OB on duty when I had ds1 was nuts when he suggested misoprotol to induce labor--before he even checked me. Downright nuts. Was he not thinking? I had uterine overdistension which is more susceptible to uterine rupture and misoprostol increases the chance of rupture. He was clearly not thinking about that. He also didn''t consider that having poly, precipitous births and being induced with miso increase my chances of uterine atony. I told him I wasn''t going to have it and he looked at me like I had a third eye. I mentioned cervidil and pitocin. Since I was already 4 cm we went straight to pitocin.

The effects of the drugs--direct and indirect, need to be weighed. Uterine stimulants can lead to uterine hyperstimulation, which can lead to uterine tetany and fetal distress and the need for a c-section. They can also lead to uterine atony which accounts for 80-90% of PPH cases.

You can read more about it here You can also check out what Marsden Wagner says about misoprostol (he''s no crock, either .

)

 

[LtlFirecracker]

Date: 3/11/2010 8:02:57 PM
Author: somethingshiny
RE: Post about the high rate of c-section in the US. Obese women are also more likely to have c-sections according to the statistics. Obviously the majority of the population is currently overweight so I assume that has increased c-sections generally.

My guess is because there is a higher rate of insulin resistance in the obese population which can manifest as gestational diabetes in pregnancy which can lead to big babies who can't get out.

But I don't think that fully describes our c-section rate. I fully believe there are other reasons such as inductions too early, defensive medicine, fear of v-backs, and my favorite the "elective" first time c-section. I think plenty of thing can be done to bring it down.

Whenever I have children, I do plan to give birth in the hospital, but I will have a birth plan (as much as I know that will annoy the OB's) that will state my preferences, most which focus on allowing the birth to progress naturally. But of course I will change it if me or my baby are at risk. I would make a point to request that if the baby has a spontaneous cry that the initial assessment would be done on the abdomen and that the eye ointment and shots would be delayed until after the first breast feed.

But I think if others have concerns about the medical system, there are far safer alternatives than giving birth without a professional present.

 

[waxing lyrical]

Date: 3/11/2010 8:02:57 PM
Author: somethingshiny
RE: Post about the high rate of c-section in the US. Obese women are also more likely to have c-sections according to the statistics. Obviously the majority of the population is currently overweight so I assume that has increased c-sections generally.

I wonder if obese patients fall in the 20% that is high risk. I would think so since obese patients are more likely to have glucose problems and uncontrolled glucose in pregnancy may necessitate induction or c-section due to suspected macrosomia (which the ACOG doesn''t advocate--yet, it''s done all-the-time with no evidence to back it up) pre-e, fetal distress, RDS, etc. They would already fall in that 20%, so it would stand to reason that c-sections are more common in the high risk group. I''m curious to know what percentage of c-sections are performed on high risk patients vs. patients that are low risk and end up with a c-section.

 

[somethingshiny]

Of the 2 c-sections that are in my family and one of my friends, we were all high risk. I was high risk due to previous miscarriages, SIL was high risk due to her age, and friend was high risk due to diabetes (which she''s had since childhood). I am overweight but the other 2 aren''t. SIL and I both had c-sections due to the size of our babies after prolonged labors. (large babies run in our family and all the others still delivered vaginally.)

Obesity also indicates a higher blood pressure (generally) and could be another reason for high-risk and/or c-section (due to preeclampsia).

 

[Jas12]

Cara--those are all really good points. Just to touch on one thing you bring up, I certainly agree that women who opt for the homebirth are "different". In developed nations generally they are often more educated (esp. in birthing and their bodies) and want to experience birth in a different way & bring a different attitude to it. This can certainly effect outcomes, b/c although it''s not talked about much, fear and attitude are huge components of dealing with pain and the unknown (2 major factors influencing the progress/management of birth). I remember my labor stalling to an eventual stop when my OB was bombarding me with potential risks and complications after i arrived at my hospital. My adrenaline was responsible, things started again after i relaxed.
But that makes me think that we have even *more* work to be done in terms of changing the way birth is managed in our society. The mechanics are one thing, the attitudes are another. The homebirthers don''t have superior birthing bodies, but something is clearly different. The stats don''t paint a perfectly clear picture, as with anything in social science. The social part is hard to suss out, but they pose good questions and are worth examining. As are birthing centers like that run by Ina May (who report intervention rates as low as 2%).

SomethingShiny: i am not saying every c-section and every induction or augmentation is unnecessary. I always feel like i need to repeat that I DO think medicine has a place in birth. Complications are real, complications warrant OBs. It''s not those legit circumstances i have an issue with, it''s the fact that it seems like most women fall into this category when they arrive at a hospital. It''s like almost everyone has something wrong with them. I think most healthy women should be able to arrive at the hospital and deliver without meds of any kind (unless they want pain meds) under the watchful eye of good nurses and an OB in the wings. That doesn''t happen most of the time. Why?

Instead, approx ONE in THREE woman apparently *need* c-sections and apparently MOST women need a heavy drug sometime during their labor. Are most of our bodies grossly failing us? Or is the medical system? Why isn''t there a better way?
Why have rates skyrocked in the past 20 years? Why do we defend this practice? These are the things that really interest me as a mom...

I understand the compulsion to defend the medical practices that we were exposed to. I don''t like to think the pit i received and the time line i was held to before being basically threatened with the c-section was poor medicine. I want to think i needed everything that happened to me b/c otherwise I’d feel cheated and guilty for exposing my unborn kid to that stuff (i speak for myself btw, not everyone). But the truth is even though i agreed to use pitocin to deliver by 3pm and even though i went against the recommendation to have an epi and risked being too tired to push, i do see where things could have been managed much much better. I think that''s what keeps me questioning medicine and wondering what the alternatives are

Oy, i am such a rambler, sorry gang. I am just super interested in this stuff. Always thought about becoming a midwife, became a teacher instead. Maybe i need a career change

 

[MonkeyPie]

I was considered obese before I was PG, I have gained only 12 pounds, and by cutting back on the starches and sugars my blood sugar has been great. So being obese doesn''t automatically mean you will have blood sugar issues, if you actually care enough to try and prevent it. I have had the occasional soda and I won''t even lie, I have an addiction to french fries since being PG, but I didn''t overdo it and all my tests have been good. I think there are a lot more "elective" c-sections nowadays...and I won''t even lie, I would do it if it meant I could skip labor!

I won''t presume to understand the logic behind free birthing. I would never do it, because my fear of something going wrong would dominate my logic in that area. I can see having a phobia of doctors, maybe, but a midwife is not the same...I don''t know. It seems too much like tempting fate to me.

 

[Pandora II]

Date: 3/11/2010 7:03:51 PM
Author: megumic
See, here''s my problem. At what point do medical professionals indicate that a birthing mother NEEDS
pitocin, or a c-section, or magnesium, etc, etc, etc. Since I haven''t given birth yet, I just don''t know. How much longer could most moms go without the pitocin before serious infectious dangers arise? (It''s my understanding pitocin is used when the water has been broken for hours, little progress and there is danger of infection - correct me if I am mistaken.) How high is that risk of infection vs. the potential to progress w/o the drug? I get concerned that many couples don''t weigh the options of waiting for medical intervention to be necessary, but rather just accept it b/c it will (potentially) help and is precautionary. As another PS''er pointed out, sometimes it''s the medical intervention that causes and then results in subsequent further medical intervention.

Do you think doctors are over-zealous in treating birthing moms?

Here in the UK they are very hands off.

My hospital which has the largest maternity unit in Britain has 3 options available: home birth with midwives; home from home birth unit with midwives and high-risk hospital unit, again with midwives. The home-from-home unit and the high-risk one are across the corridor from each other. There is a team of OBs and two operating theatres on standby 24/7.

The place looks amazing, there''s an indoor garden with music and mood lighting, private bathrooms with piped Entonox into the baths, water-birth facilities and a one-to-one midwife/mother ratio. Natural birth is strongly encouraged.

I had pitocin because my waters had been broken for 42 hours and I was only finger-tip dilated despite very strong contractions for 40 hours. At 36 hours they started me on IV antibiotics and then at 42 they said we had to go with the pitocin because of no progress.

I opted to have a mobile epidural once I knew they were starting pitocin. I''d been walking around and upright until that point, so I know that the problems weren''t caused by being flat on my back and having an epidural. Once I got the pitocin, I was at 10cm within 12 hours.

They only did an instrumental delivery because she could not be born any other way - 3 of them tried to manually turn her before making the call. They also wanted to avoid a c-section if at all possible.

I wonder if epidural, pitocin and c-section rates would be reduced if you had Entenox in the USA? I am a total wuss, but I think if Daisy hadn''t been Occipito Transverse that I could have probably done the whole thing on just Entenox. It''s far safer than any other options - you even have it for homebirths... the midwives bring some canisters with them. It''s also really nice and makes you feel all floaty.

Is in standard in the USA like it is here to wait for at least an hour after reaching 10cm with an epidural to allow the head to descend before starting to push?

 

[Jas12]

Pandora--i think that kind of centre is what i am getting at. A much better balance of medicine and trust in women''s bodies. it sounds great. Hands off unless hands are *truly* needed. 42 hours with broken waters and no progress seems like a very reasonable time to start pitocin. My pitocin was started less than 12 hours after my waters broke (and the loss of fluid was very slow), i was having regular contractions and was about 2-3 cms when i went to the hospital. I wanted to wait a few more hours to see where things were headed, but that was not one of the options my OB gave me.

 

[somethingshiny]

Date: 3/12/2010 10:28:42 AM
Author: Jas12

SomethingShiny: i am not saying every c-section and every induction or augmentation is unnecessary. I always feel like i need to repeat that I DO think medicine has a place in birth. Complications are real, complications warrant OBs. It''s not those legit circumstances i have an issue with, it''s the fact that it seems like most women fall into this category when they arrive at a hospital. It''s like almost everyone has something wrong with them. I think most healthy women should be able to arrive at the hospital and deliver without meds of any kind (unless they want pain meds) under the watchful eye of good nurses and an OB in the wings. That doesn''t happen most of the time. Why?

jas~ I completely agree with the bolded part. I posted my own experiences to show that ALL hospitals and drs do not treat patients that way. IF a woman is afraid of having a hospital birth because of the high rate of c-section or whatever, there ARE drs who are similar to mine. Apparently these days you have to LOOK for a dr who will allow a woman to labor and deliver naturally, but they are out there and they are an alternative to homebirth or UC.


I believe someone asked earlier at what point are medial interventions necessary. I was induced with cervadil and pitocin, then my water was broken. I did beg for an induction because I couldn''t eat or breathe at 39 weeks. My c-section was 39 hrs after induction and approx 20 hrs after my water was broken. I quit progressing about 28 hrs into labor (only got to a 6). The dr "let" me continue to labor for over 12 hrs to see if I would start progressing again. He did mention c-section a few hours after I quit progressing, but I told him I wasn''t done (there was no fetal distress at that point). The bottom line is YOU are in charge of your body. If you don''t want a c-section (I really didn''t want one), you just tell the dr that you''re going to continue to labor. I must have picked a really good dr for my beliefs because I was in charge the entire time. We discussed every option and I felt good about my choices. I certainly don''t feel like I didn''t try long enough or hard enough like I hear a lot of c-section women say. You really have to do your research and be proactive in choosing your dr.


I just hate to think that there are women who think homebirth or UC is there ONLY option because they don''t want medical interventions. When did we stop being in charge of our bodies??



ditto MP that being obese doesn''t always mean high blood sugars. My sugars and bp were great during my entire pregnancy with JT. I haven''t had my glucose done with this pregnancy but my bp is still great. However, I''m expecting to fail my glucose test this time around. I''ve gained 4 lbs at 22 weeks but I''m measuring 4 weeks ahead. If I do have GD, I will not consider it my "fault" for being obese. My weight gain has been minimal so if I do have GD, there''s nothing I could have done to prevent it.


sorry, that was really long and rambly....it''s the hormones....

 

[waxing lyrical]

The UK seems to be much more accommodating when it comes to childbirth. I much prefer the birth culture in the UK.

 

[Mrs Mitchell]

Pandora, entonox is a wonderful thing! Isn''t it available in the US? OMG! I would happily have gone with just that if Amelia hadn''t become distressed. After 17 hours, I had an emergency c-section, but that was partly due to meconium in the amniotic fluid. Otherwise, I''d have been left to my own devices, as I was in a midwife led birthing clinic.

 

[waxing lyrical]

Date: 3/12/2010 10:39:13 AM
Author: Pandora II

Date: 3/11/2010 7:03:51 PM

Author: megumic

See, here''s my problem. At what point do medical professionals indicate that a birthing mother NEEDS

pitocin, or a c-section, or magnesium, etc, etc, etc. Since I haven''t given birth yet, I just don''t know. How much longer could most moms go without the pitocin before serious infectious dangers arise? (It''s my understanding pitocin is used when the water has been broken for hours, little progress and there is danger of infection - correct me if I am mistaken.) How high is that risk of infection vs. the potential to progress w/o the drug? I get concerned that many couples don''t weigh the options of waiting for medical intervention to be necessary, but rather just accept it b/c it will (potentially) help and is precautionary. As another PS''er pointed out, sometimes it''s the medical intervention that causes and then results in subsequent further medical intervention.


Do you think doctors are over-zealous in treating birthing moms?

Here in the UK they are very hands off.


My hospital which has the largest maternity unit in Britain has 3 options available: home birth with midwives; home from home birth unit with midwives and high-risk hospital unit, again with midwives. The home-from-home unit and the high-risk one are across the corridor from each other. There is a team of OBs and two operating theatres on standby 24/7.


The place looks amazing, there''s an indoor garden with music and mood lighting, private bathrooms with piped Entonox into the baths, water-birth facilities and a one-to-one midwife/mother ratio. Natural birth is strongly encouraged.


I had pitocin because my waters had been broken for 42 hours and I was only finger-tip dilated despite very strong contractions for 40 hours. At 36 hours they started me on IV antibiotics and then at 42 they said we had to go with the pitocin because of no progress.


I opted to have a mobile epidural once I knew they were starting pitocin. I''d been walking around and upright until that point, so I know that the problems weren''t caused by being flat on my back and having an epidural. Once I got the pitocin, I was at 10cm within 12 hours.


They only did an instrumental delivery because she could not be born any other way - 3 of them tried to manually turn her before making the call. They also wanted to avoid a c-section if at all possible.


I wonder if epidural, pitocin and c-section rates would be reduced if you had Entenox in the USA? I am a total wuss, but I think if Daisy hadn''t been Occipito Transverse that I could have probably done the whole thing on just Entenox. It''s far safer than any other options - you even have it for homebirths... the midwives bring some canisters with them. It''s also really nice and makes you feel all floaty.

Is in standard in the USA like it is here to wait for at least an hour after reaching 10cm with an epidural to allow the head to descend before starting to push?

To the underlined, see, I don''t think many in the States are even aware how important it is to be upright and mobile during labor/birth. Sitting/lying in bed increases the chances of baby being malpositioned. It can also slow labor down. Gravity works wonders. It''s meant to help the baby descend and help with cervical progression with the pressure from baby''s head. This is ignored the vast majority of the time in U.S. hospitals. Mom is hooked up to an IV (or hep/saline lock if she declines the IV) and ECFM, which evidence shows doesn''t improve outcomes. Mobility is halted or reduced and this begins the state of usually many interventions. It''s especially important for moms suspected to have bigger babies upright and mobile.

I hear a lot about laughing gas being offered in the UK. I know it''s preferred over IV narcotics and anesthesia. I wonder why it''s not offered in the States. I''m a big believer in the fear/tension/pain cycle causing a lot of issues in childbirth. That plus highly medicalized births.

To answer your question in bold, I''m confident that''s not the case in the vast majority of births. We''re big on the time clock here. Purple-pushing/pushing too soon is oh so common here and accounts for many cases of prolonged/unsuccessful second stage. A poorly managed second stage can certainly send one in for a c-section. Not to mention being immobile throughout the first stage leading to babe being malpositioned. I remember when I was pregnant with my first the nurses were saying how the average second stage lasts 90 minutes and some 3 hours. Pushing before the baby is low enough in the pelvis can lead to maternal exhaustion. Pushing too soon and being directed to push is counterproductive.

I was fortunate to have a midwife suggest I labor down before pushing as we were suspecting she was a bigger baby. She didn''t want be to wear out, ya know? So, we let her descend on her own for 45 minutes. I could feel her descend. By the time it was time to push I only had to push for 2-3 minutes.

 

[partgypsy]

From these responses I think quality of care during labor seems to really vary. Maybe my friends since they are on average more educated, just lucked out, but these were at different hospitals, so who knows.

I still don't understand the adversarial attitudes towards doctors, for example "I'm going to have a birth plan though that will piss off the doctor". These are not our mothers' doctors. During my prenatal visits it was the doctors that ENCOURAGED I complete a birth plan, and they discussed with me topics to touch upon. For example I asked in birthplan to wait 1 hour to put drops in baby's eyes, and no problem with that. And during labor other than dilation checks, you see the OB during a relatively brief period of time when it is time to deliver (it's not like they are hanging out in the room). In most cases the nurses have a bigger impact on quality of care, because they are the one there for the hours and hours it takes. One of my nurses was originally from Ireland, and I agree, a more supportive, naturalistic approach. She was completely delightful.

I found it nice to be at the hospital. Yes, someone cleans up the sheets. In my labor room there was a jacuzzi tub. Cable on the tv and people bringing you meals! For my second birth I stayed just 1 night. It was relaxing. When I got home I regreted not staying for another night, realizing that was the last "break" I'd have in a long time.

I hope people didn't take my out of shape comment the wrong way. It was something a friend who is a doula brought up, telling me that many expectant mothers are "not prepared". She probably meant both physically and mentally (though she did refer to the obesity epidemic). Also the trend for expectant mothers to request either planned inductions or c-sections. I just wanted to point out the high c-section rate in US is not totally due to doctors/hospitals.

 

[partgypsy]

Date: 3/11/2010 4:51:30 PM
Author: Jas12
somthingshiny--actually, your experience would be more the exception. Most women have their labor augmented or induced at some point. I think the commonly quoted study from the uni of texas is around 80% !!!! Whoa. I am not sure if it has changed (haven''t look into myself) but my hunch would be that it has not changed much. Of course, i am sure it''s different in certain hospitals, states etc. But i know it is staggeringly high. My labor was already 12 hours in and i still got it b/c things were not ''fast enough'' for the OB on call. All my friends who birthed in the hospital got it too...in varying degrees

If I thought hospitals were inducing 80% of labors I''d also be scared!!! I don''t have access to OB journals so could be off, but a quick google scholar search brought: Pettker 2009: "The frequency of induction of labor in the United States has increased from 9.5% to 20.6% of all births from 1990 to 2003." I really don''t know what the correct number is, but yes 80% is way too high. Where did the 80% come from?

 

[somethingshiny]

Don''t know if laughing gas is still offered, but it was the only thing my mom ever had. She took it with one of my little sis''s and got so high she told the dr that if he found a clitoris on the floor it was hers! But, I guess I haven''t heard of using gas in years.

 

[MustangGal]

To add to the occurance of c-section discussion, in DH''s family 2 of us have had children, both c-section. SIL went into labor fine, got an epi at around 6-7 cm, and had an emergency c-section when the baby''s heart rate was dropping while she pushed. He has the cord around his throat twice, and when she pushed it was tightening. I was induced (overdue) with pitocin, after making it to 10cm and pushing for 2 hours, baby wouldn''t turn, and I had a fever, so ended up with a c-section.

I think part of the high c-section rate is also the reluctance of some OBs to even let women try VBAC. My SIL is convinced that she can not fit a baby out (her 1st did have a very large head), so she''s scheduling a c-section for baby #2. My OB already mentioned not having to go through labor again to me. So the vast majority of women, who for whatever reason had a c-section with one child, are just automatically sent straight to a c-section the next time around.

 

[Dreamer_D]

Date: 3/11/2010 4:51:30 PM
Author: Jas12
somthingshiny--actually, your experience would be more the exception. Most women have their labor augmented or induced at some point. I think the commonly quoted study from the uni of texas is around 80% !!!! Whoa. I am not sure if it has changed (haven''t look into myself) but my hunch would be that it has not changed much. Of course, i am sure it''s different in certain hospitals, states etc. But i know it is staggeringly high. My labor was already 12 hours in and i still got it b/c things were not ''fast enough'' for the OB on call. All my friends who birthed in the hospital got it too...in varying degrees

Yes. I am dismayed to report that every woman I know was given pitocin for her first labour.

 

[Dreamer_D]

Date: 3/11/2010 5:23:43 PM
Author: PinkAsscher678

Date: 3/11/2010 5:00:53 PM
Author: Hudson_Hawk

Date: 3/11/2010 2:30:53 PM

Author: PinkAsscher678

Date: 3/11/2010 1:33:18 PM


Author: part gypsy


Jas - I think your experiences regarding pictocin are unusual. The vast majority of women I knew who gave birth (in a hospital) did not receive pictocin. My first birth I had pictocin because my water broke and my labor did not progress, but my second birth (at the hospital) progressed naturally, no pictocin.




Getting away from the free birth argument, I do see the allure of home births as being: less medical, less interventionist, and less expensive. It''s a sad thing to say, but the high rate of c-section in the US is not just due to doctor preference, but the poor physical health of high percentage of mothers in the US. But I do feel there can be things done especially regarding billing, that gives people more choice about more natural versus more medicalized births, especially as there is more demand for it.




I was thinking about my mother. She did have a bad experience with her first birth (unneeded med). Did that mean she wanted the rest of her births at home? Nope, her following births she just made her wishes abundantly clear so there was no room for misunderstanding!

Could you clarify what you mean by ''It''s a sad thing to say, but the high rate of c-section in the US is not just due to doctor preference, but the poor physical health of high percentage of mothers in the US.''



Just not sure I get what that is supposed to mean.

Perhaps our overall problem with poor stamina/endurance? To not have good stamina and endurance means you''re going to tire quickly and not necessarily be able to push as effectively as needed. That''s all I can think of. I mean, there are very fit obese women and very poorly fit thin women, so I doubt she''s making a blanket generalization that because American''s are more likely to be obese we have a higher rate of medicalized births. That would be feeding herself to the vultures and she''s too smart for that

I guess I just don''t get the connection. I mean, it''s good to be physically fit anyway, but the fact of the matter is you either progress or you don''t. Your body calls the shots (actually, the baby does!) when it''s time to go into labor.

My friend Nikki is a runner and plays volleyball 4 times a week. She did not progress, was barely dilated even after her water broke and the baby''s heart rate dropped. She needed a c-section. I on the other hand consider shopping to be cardio and I pushed my daughter out in 20 minutes.

I never thought (perhaps mistakenly) that labor and the physical fitness of the mother were related. That''s why I was looking for more of an explanation.

Maternal age matters a lot and predicts birth progress and outcomes.

 

[Dreamer_D]

Date: 3/12/2010 12:52:45 PM
Author: waxing lyrical

Date: 3/12/2010 10:39:13 AM
Author: Pandora II



Is in standard in the USA like it is here to wait for at least an hour after reaching 10cm with an epidural to allow the head to descend before starting to push?

It is in Canada.

 

[sbde]

Date: 3/12/2010 10:39:13 AM
Author: Pandora II

Date: 3/11/2010 7:03:51 PM

Author: megumic

See, here''s my problem. At what point do medical professionals indicate that a birthing mother NEEDS

pitocin, or a c-section, or magnesium, etc, etc, etc. Since I haven''t given birth yet, I just don''t know. How much longer could most moms go without the pitocin before serious infectious dangers arise? (It''s my understanding pitocin is used when the water has been broken for hours, little progress and there is danger of infection - correct me if I am mistaken.) How high is that risk of infection vs. the potential to progress w/o the drug? I get concerned that many couples don''t weigh the options of waiting for medical intervention to be necessary, but rather just accept it b/c it will (potentially) help and is precautionary. As another PS''er pointed out, sometimes it''s the medical intervention that causes and then results in subsequent further medical intervention.


Do you think doctors are over-zealous in treating birthing moms?

Here in the UK they are very hands off.


My hospital which has the largest maternity unit in Britain has 3 options available: home birth with midwives; home from home birth unit with midwives and high-risk hospital unit, again with midwives. The home-from-home unit and the high-risk one are across the corridor from each other. There is a team of OBs and two operating theatres on standby 24/7.


The place looks amazing, there''s an indoor garden with music and mood lighting, private bathrooms with piped Entonox into the baths, water-birth facilities and a one-to-one midwife/mother ratio. Natural birth is strongly encouraged.


I had pitocin because my waters had been broken for 42 hours and I was only finger-tip dilated despite very strong contractions for 40 hours. At 36 hours they started me on IV antibiotics and then at 42 they said we had to go with the pitocin because of no progress.


I opted to have a mobile epidural once I knew they were starting pitocin. I''d been walking around and upright until that point, so I know that the problems weren''t caused by being flat on my back and having an epidural. Once I got the pitocin, I was at 10cm within 12 hours.


They only did an instrumental delivery because she could not be born any other way - 3 of them tried to manually turn her before making the call. They also wanted to avoid a c-section if at all possible.


I wonder if epidural, pitocin and c-section rates would be reduced if you had Entenox in the USA? I am a total wuss, but I think if Daisy hadn''t been Occipito Transverse that I could have probably done the whole thing on just Entenox. It''s far safer than any other options - you even have it for homebirths... the midwives bring some canisters with them. It''s also really nice and makes you feel all floaty.

Is in standard in the USA like it is here to wait for at least an hour after reaching 10cm with an epidural to allow the head to descend before starting to push?

yes, I was asked to wait at least an hour after reaching 10 cm before pushing. i actually waited 1.5 hrs.

i also was not given pitocin.

oh, and i had my baby in the US

 

[somethingshiny]

Wow, my experiences are apparently VERY unusual. Here, as soon as you hit 10, you're pushing. In fact, most of my family/friends started "practicing" at just over 9 while the dr got ready for delivery. Most of them were on their hands and knees too. Actual delivery has been primarily while laying, but they really try to keep you off your back until the last minute.

I'm beginning to wonder why the drs here are so different. I live in a rural area with mostly older drs. Maybe they've been on the farm too long!



eta~ sorry, I didn't see the "epidural" part! Most of the women I know didn't use epidurals so maybe it's different??

 

[Pandora II]

I hear a lot of people talking about ''waiting for the OB for the actual birth''? Is there a reason why? Here the midwife will do the delivery unless there are problems at which point they will call in an OB.

It''s very normal in the UK to never see an OB at all. I was high-risk and still only saw the OB twice during the pregnancy. I wouldn''t have seen them at all during the delivery if she hadn''t been stuck - my midwife kept them updated and they waved at me from the door during their ward round but otherwise that was it until things weren''t going well at the pushing stage.

I wonder if they are more hands off here because people are less likely to sue?

 

[Mrs Mitchell]

I had a consultant OB with me a lot of the time, even before things started to go really wrong. I had a midwife with me all through L&D too.

Maybe something to do with the wanting to sue angle. I had my law degree finals coming up and I was revising during the early stages, and finishing off my dissertation. I had a big heap of legal text books with me- perhaps they thought I was high risk for litigation...

 

[ljmorgan]

I agree that quality prenatal and birthing care can be provided by a range of providers (OBs, midwives, etc) and in a range of settings to include your home, a birth center, a hospital, or more. These decisions are personal and I can''t fault anyone for the type of care that they think is best.

However, unassisted childbirth by choice is the ultimate in irresponsibility. I''m sorry, but I just don''t see how someone can justify their own "birthing experience" taking precedence over providing medical care for their soon to be born child. No matter how educated someone is about childbirth, they should have some form of medical assistance ready should an emergency occur. Childbirth has risks in any setting, even birthing in a hospital cannot eliminate all risk -- but to completely forgo all forms of medical assistance is neglectful. If you want an "experience" -- try an African safari. Because in my opinion once you have made the decision to get pregnant and you''re carrying that child, their needs now come before your own. You have the responsibility to make the best decisions possible -- including obtaining medical care.

 

[Jas12]

SomethingShiny: i guess things really do vary from hospital to hospital. I know in my community, our isolation from a major medical centre necessitates the "play it safe'' attitude and so the intervention rate is crrrrazy high. I would guess your docs are more hands off and that decreases the rates of everything in general (since epis, pitocin and often c-sections go hand in hand).
I am in canada and did not have to wait to start pushing, i couldn''t possibly have stopped my body. However, i didn''t have an epi so i wonder if i would have been instructed too if i had. I''d actually never heard of that and i am going to ask my midwife. I had 8 hours of *brutal* pitocin augmented contractions and when i had to push i was absolutely at the mercy of my body!!! I can see why most women want the epi with the pitocin.

Makes me think of THIS clip from the documentary The Business of Being Born (if you haven''t seen it, it''s eye-opening!)

 

[megumic]

Date: 3/14/2010 9:29:06 PM
Author: Jas12




Makes me think of THIS clip from the documentary The Business of Being Born (if you haven''t seen it, it''s eye-opening!)

Thanks for sharing this clip - definitely eye-opening. I wonder what the rate of similar experiences there have been just on PS?