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Category Archives: Dilation

Heading Down the Road to C Section?



This article is written by an OB who has been practicing for 14 years. http://www.friscowomenshealth.com/?option=com_wordpress&Itemid=205&lang=en&p=89
I hope you enjoy.

Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On You

I have been a practicing OB/GYN for fourteen years. I live in Frisco, Texas, one of the fastest growing cities in the United States, and I truly enjoy living and working here.  It is a great place for my family and, for the first time, my office is attached to the actual hospital I practice in.  This is the third and final place I will practice medicine.  I trained with some of the most respected academic OB/GYN’s in the country.  These physicians have contributed to books on Obstetrics, created practice guidelines for the American Congress of Obstetricians and Gynecologists (ACOG), and taught me to practice medicine based on scientific evidence.

I follow a few simple rules: do no harm, give your patients options, and provide information so they can make informed decisions.  So, last night I was sitting in my office looking at the fourth Cesarean Section (C/S) operative report of the day for yet another patient who wants to have a vaginal delivery following a previous C/S. I am frustrated and feel like I am fighting a losing battle.

When did Cesarean Sections (C/S) and elect Read the rest of this entry »

 

Hints for Pushing


I love this article!  It has so many helpful hints and tips for how to let your pushing stage be straightforward and productive!  I wish I had read it when pregnant with my first!  This article talks a lot about primips – primips are women having their first babies, and multips are women who have already had one.  But either way, the advice in here is great. 🙂

http://www.glorialemay.com/blog/?p=72

Pushing for Primips

This article originally appeared in Midwifery Today Magazine, Issue 55 (Winter, 2000). “Primips”-women having their first babies.

-by Gloria Lemay
The expulsion of a first baby from a woman’s body is a space in time for much mischief and mishap to occur. It is also a space in time where her obstetrical future often gets decided and where she can be well served by a patient, rested midwife. Why do I make the distinction between primip pushing and multip pushing? The multiparous uterus is faster and more efficient at pushing babies out and the multiparous woman can often bypass obstetrical mismanagement simply because she is too quick to get any.

It actually amazes me to see multips [women having second or more babies] being shouted at to “push, push, push” on the televised births on “A Baby Story”. My experience is that midwives must do everything they can to slow down the pushing in multips because the body is so good at expelling those second, third and fourth babies. In most cases with multips, having the mother do the minimum pushing possible will result in a nice intact perineum. As far as direction from the midwife goes, first babies are a different matter. I am not saying they need to be pushed out forcefully or worked hard on. Rather, I say they require more time and patience on the part of the midwife, and a smooth birth requires a dance to a different tune. Read the rest of this entry »

 

I needed to dilate to 12!


There is a massive myth that when you reach 10cm, you are ready to push out baby.  Apparently all babies have the exact same size head!  Why else would everyone need to reach the same dilation!  My DS2’s head circumference was 37cm (15.4″), which meant I needed to dilate to 12cm to birth him (He was 8lb 10oz).  With my smaller (6lb 8oz) DS1’s head circumference of 34cm (13.3″), I still needed to dilate to 11cm .Thinking about this, I really do think it is important that women wait until their bodies start to push, and then work with it, rather than submit to promptings from caregivers!  I mean, you might have 2 more centimeters to dilate – and we all know how long that can take!

Anyway, here is an interesting article for you! Read the rest of this entry »

 

Dilation – self check


IF, IF, IF you feel it is totally necessary to check your dilation, here are some ways you can DIY.  The only reason I can possibly think of why you might need to know how to check your dilation, is so that if you are having a hospital birth, you don’t go into hospital to early!

This information is largely from the forum that I visit – http://www.bornfreeforum.com/viewtopic.php?f=65&t=6880

How to Check Your Own Cervix- “it’s not rocket science”

“I think it’s a good and empowering thing for a woman to check her own cervix for dilation. This is not rocket science, and you hardly need a medical degree or years of training to do it. Your vagina is a lot like your nose- other people may do harm if they put fingers or instruments up there but you have a greater sensitivity and will not do yourself any harm. Read the rest of this entry »

 
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Posted by on May 16, 2011 in All, Dilation

 

Cervical scars – commonly stop dilation


In my first year of being a birth doula, I had this client. She desperately wanted a VBAC (vaginal birth after c-section). She told me how in her first birth that she was in labor for hours. Waters broken, Pitocin, epidural, tubes and wires coming from every direction. During her extremely long ordeal the only change to her cervix was the effacement (the thinning of the cervix). Her cervix never opened at all. I assumed at the time that this was because her baby was just not ready to come out. This time could and would be different. She would wait for labor to start. We would stay at home and labor where she was comfortable. When the day came, that is exactly what she did. Her labor seemed to be moving right along. When we got to the hospital I expected they would tell her that she was 4-5 cms. Instead what we got was, 100% effaced but only a finger tip dilated. I think I may have even gasped out loud. Read the rest of this entry »

 
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Posted by on March 11, 2011 in All, Dilation

 

Should you have a cervical exam?


CERVICAL EXAMS: WHO NEEDS THEM?

http://www.nurturingheartsbirthservices.com/blog/?p=50

Internal cervical exams….a rant. Okay, so I know I’m about to get a whole slew of doctors upset at me – but you know what? I’m big…I can take it.

Lets start at the beginning…not the beginning of the pregnancy, but the beginning of the debate over internal exams which starts at around 36-38 weeks of pregnancy. Usually I will have a client of mine ask me sometime between 36 and 38 weeks if we’re going to check her cervix to see what it’s doing.

My response is always – WHY?

internalexam

That’s a bigger question than you probably think. I’m not just asking why she wants to check as in, “what do you want to find out”….but I’m also asking why she wants to check as in, “why do you feel the need to know?”

What do you want to find out? How far dilated you are? You’re 38 weeks…what does it matter? Oooohhhh… you hoping that someone (me) could tell you how much longer you will be pregnant? I BET YOU ARE!! That is the million dollar question, and one that I wish I could find out the answer to – because I would be one rich midwife if I could!! If I had been the Divine creator and designed our bodies, I would have put that belly button to use and make it glow bright green 24 hours before labor was going to begin! Read the rest of this entry »

 
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Posted by on March 9, 2011 in All, Dilation, trusting birth

 

Anterior Cervical Lip – something to avoid?


The Anterior Cervical Lip: how to ruin a perfectly good birth

http://midwifethinking.com/2011/01/22/the-anterior-cervical-lip-how-to-ruin-a-perfectly-good-birth/

Here is a scenario I keep hearing over and over: A woman is labouring away and all is good. She begins to push with contractions, and her midwife encourages her to follow her body. After a little while the midwife checks to ‘see what is happening’ and finds an anterior cervical lip. The woman is told to stop pushing because she is not fully dilated and will damage herself. Her body is lying to her – she is not ready to push. The woman becomes confused and frightened. She is unable to stop pushing and fights her body creating more pain. Because she is unable to stop pushing she may be advised to have an epidural. An epidural is inserted along with all the accompanying machines and monitoring. Later, another vaginal examination finds that the cervix has fully dilated and now she is coached to push. The end of the story is usually an instrumental birth (ventouse or forceps) for an epidural related problem – fetal distress caused by directed pushing; ‘failure to progress’; baby mal-positioned due to supine position and reduced pelvic tone. The message the woman takes from her birth is that her body failed her, when in fact it was the midwife/system that failed her. Before anyone gets defensive – I am not pointing fingers or blaming individuals, because I have been that midwife. Like most midwives I was taught that women must not push until the cervix has fully dilated. This assumption has been taught to midwives since the 1930s and Ina May herself warned against ‘early pushing’ in Spiritual Midwifery. This post is an attempt to prompt some re-thinking about this issue, or rather this non-issue. Read the rest of this entry »

 
 
 
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