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

Posted on November 14, 2012 by Jonathan Weinstein

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

 

Postdates: Separating Fact from Fiction

So I am now 41 weeks pregnant, and the most common question I am getting is ‘so when are you being induced?’  On facebook, I answered that question ten times over a period of 3 days, so ended up making a new status message that consisted of this:

 

Thankyou for all your questions, thoughts and concerns regarding induction. I am comfortable, and bub is comfortable. I still have 1 more week before I am officially post-term. I will not be getting induced naturally or medically at any stage unless medically indicated. Now no more talk of induction! 😀

But I know that the people who were asking, were only asking and suggesting things because they care about me.  So I looked around and found this fantastic article that has some great research and simple facts that you can share with others.  This link was my status update this morning. This is how I introduced it:

 

Here’s some interesting research regarding ‘late babies’:
“Facts:
• A pregnancy is NOT “Postdates” until after 42 weeks.
• The risk of stillbirth is nearly a flat line between 38 weeks and 43.
• Amniotic fluid is dependent on maternal hydration, in the absence of congenital abnormalities.
• A baby’s weight virtually plateaus after 40 weeks.”
Good to know hey! 🙂

 

Why I won’t leave my births up to chance

This is a great article by The Feminist Breeder.  She totally explains how I feel about why you have to prepare for a natural birth, and what you can do to get the birth you want.  I didn’t do the courses she recommends, but I read sooooo many good quality birth books while pregnant, which of course has an impact on your mental preparation.  Birth is probably the most vulnerable time in a woman’s life, and I don’t think you can be too prepared.

 

[edit] I’ve had to take down most of this article, as apparently having more than 100 words on here would actually violate her copyright and impact on her income.  And I don’t want to do that!  So to read her fantastic article go to her blog!

 

http://thefeministbreeder.com/why-i-wont-leave-my-births-up-to-chance/
May 29th 2010

The Feminist Breeder came across a Mumma’s website where she was asking people if they thought she was crazy for wanting a natural birth…

“There were around a dozen interviews with different mothers, and every single one of the moms supported her decision to have a natural birth. In fact, every single one of the moms said they had planned to go natural as well.  However, out of all the moms, only ONE mentioned taking a 12-week intensive natural birth class … only that mom actually reported getting the birth she wanted.

Coincidence? I think not.

What happens during a woman’s birth is not all up to chance. Maybe some of it, but certainly not all of it.”

To read the rest of this article go to The Feminist Breeder’s website: http://thefeministbreeder.com/why-i-wont-leave-my-births-up-to-chance/

 

Induction risks

interesting article on how similar a mum getting an induction with synto (pit) has similar risks to a VBAC – and no-one really talks about the dangers of induction, but recommend against VBACs!!

http://networkedblogs.com/r4rIV

Not Just Another Induction Post

You might remember me posting on my Banned From Baby Showers Facebook page about a mom who had been declared “high risk” due to “maternal age.”  She is 35 years old.  Her OB had also told her that her amniotic fluids levels were low.  At about 37 or 38 weeks, she recommended induction.

 

Incontinence, Prolapse & Pelvic Floor Health

Pelvic Floor Health.

This is my very first ‘proper’ blog!  I hope you enjoy.

Have you ever heard the rumour that if you sneeze 6 times in a row, you orgasm?  Well guess what, I’ve managed to sneeze 6 times in a row, and man I wish that were true.  The actual results of my sneezing attack were devastating, and have impacted on my quality of life ever since.  Here is my story and what I have learned about pelvic floor health since that day.

FYI: I think all women should read what I’ve written in this article, because 77% of women will have a pelvic organ prolapse at some stage in their lives – and most of them will have incontinence.  The medical world believe that surgery is the only way to deal with prolapse, but once a woman has had surgery (including a hysterectomy) she has a 500% greater chance than the rest of the population to go on and develop a further prolapse.  Prolapses and stress incontinence are largely preventable with the tips I have shared below.

 

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

Posted on December 30, 2008 by gloria

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.

 

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!

 

Don’t stop your hormones from helping!

This article is written by the Australian Doctor Sarah J Buckley.  Her work on the function of hormones during labour is well respected around the world. 

 

Pain in Labour: Your hormones are your helpers

http://www.sarahbuckley.com/pain-in-labour-your-hormones-are-your-helpers/
@ Dr Sarah J. Buckley MD 2005 www.sarahbuckley.com
Previously published in Australia’s Parents Pregnancy magazine, Autumn 1999, as “Your Hormones are your Helpers”
An updated version is published in Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices (Sarah J Buckley MD, Celestial Arts, 2009).

Look out for the new Instinctive Birth ebook-audio package coming soon!
See other ebook-audio packages

Imagine this. Your cat is pregnant, due to give birth around the same time as you are. You have your bags packed for hospital, and are awaiting the first signs of labour with excitement and a little nervousness.Meanwhile your cat has been hunting for an out-of-the way place — your socks drawer or laundry basket — where she in unlikely to be disturbed. When you notice, you open the wardrobe door, but she moves again. Intrigued, you notice that your observation, even your presence, seems to disturb the whole process. And, wish as you might to get a glimpse into the mysteries of birth before it is your turn, you wake up the next morning to find her washing her four newborn kittens in the linen cupboard.

Why does birth seem so easy to our animal friends when it is so difficult for us? One obvious difference is the altered shape of the pelvis and birth outlet that is caused by our upright stance; our babies need to twist and turn to navigate these unique bends. Even our nearest cousins, the great apes, have a near-straight birth canal.

However, in every other way, human birth is like that of other mammals — those animals that suckle their young — and involves the same hormones: the body’s chemical messengers. These hormones, which originate in the deepest and oldest parts of our brain, cause the physical processes of labour and birth, as well as exerting a powerful influence on our emotions and behaviour.

 

VBAC vs Repeat C/Sec

I’m going to preface this by saying that I have never had a c-section, so I have no idea of the mental games that having one plays on you.  My main aim in posting this is to encourage and help women develop their faith in their God-given bodies.  You aren’t broken! You are an amazing woman, and I have every faith that you can have the birth you want next time.

 

Here is an article I found by expert in evidence based maternity care, Henci Goer, and my next post will have some statistics and information that I have collated that you might find interesting and / or helpful.

The NIH VBAC Consensus Conference: Will It Pave the Road to Hell with Good Intentions?

http://www.scienceandsensibility.org/?p=1022
First the good news: based on the presenters, it looks like the NIH VBAC conference will be a great improvement over the elective cesarean surgery travesty of four years ago. The conference seems likely to provide solid, evidence-based information on for whom and under what circumstances VBAC is safest and most likely to end in vaginal birth. Objective, unbiased information on these points is sorely needed, as illustrated by this 2008 response by ACOG vice president Dr. Ralph Hale, who one would expect to know better, to a plea to make VBAC more available:

VBAC is potentially an extremely dangerous procedure for both mother and infant. Although 98% of women can potentially have a successful VBAC, in two percent of cases the result can be a rupture of the old scar. If this happens, then death of the baby is almost certain and death of the mother is probable. Even if the mother does not die, virtually 100% will lose their child bearing ability. To prevent these disasters, the ability to perform immediate surgery is critical.

In point of fact, with appropriate care the scar rupture rate can be 0.5% or less (6,13,15), not 2%, and the chance of the baby dying as a result of scar rupture is 5% (9), not “almost certain.” As for the mother, women rarely die or have hysterectomies, but both are more common with elective repeat cesarean than planned VBAC (3,17,18,19).

 

The Slow Labour: Patience is a Virtue

This is a chapter from a book by Henci Goer called The Thinking Woman’s Guide to a Better Birth.  This chapter is on slow labours and inductions.

 

The Thinking Woman’s Guide to a Better Birth
http://hencigoer.com/betterbirth/sample/

Practical Information for a Safe, Satisfying Childbirth

• Table of Contents
• Sample Chapter: Introduction
• Sample Chapter: Slow Labor
• Sample Chapter: References
• Order a Copy Today

Chapter 7: The Slow Labor: Patience is a Virtue

1. Problems with Typical Management
   1. Active Management of Labor
   2. Procedures
2. The Bottom Line
   1. Benefits and Risks of Techniques for Coping With Poor Progress
   2. Strategies to Avoid the Need for IV Oxytocin, Instrumental Delivery or Cesarean Section
3. Gleanings from the Medical Literature
4. Bibliography

Problems with Typical Management

Obstetricians treat women laboring slowly the way Peter Pan treated the Lost Boys. He expected everyone to adapt to his ideas of the way things should be. If they didn’t, Peter saw to it that they did. For example, the boys entered the Neverland underground home through hollow trees. If a boy didn’t fit his tree, James Barrie writes, Peter “did something” to the boy. So too with obstetric management. Obstetricians have inflexible ideas of how labor ought to go. If your labor doesn’t conform to that pattern, typical doctors “do something” to you to make you fit. There are, as you may gather, a number of drawbacks to this myopic approach.

The first is that the standard for labor progress doesn’t give you nearly enough time before you are declared over the line. Doctors base their standard on studies from the 1950s and 60s supposedly of normal labors, but many women had interventions that could shorten labor such as oxytocin (trade name: Pitocin or “Pit”) or forceps delivery. A recent study evaluating healthy women who had no interventions that would affect labor length got very different results. For example, the standard says that starting from 4 centimeters cervical dilation, the average first-time mother will take 6 hours to achieve full dilation of 10 centimeters. Doctors set the cutoff defining “abnormal” progress in dilation at 12 hours for first-time mothers and 6 hours for women with previous births because, according to the standard-setting studies, only 5% of women will take longer than this. However, the new study found that average duration in first-time mothers was 7 1/2 hours, not 6, and the threshold for abnormal, fell at 19 1/2 hours, not 12, in first-time mothers and over 13 1/2 hours, not 6, in women with prior births. The standard also stipulates smooth, linear progress. More than a relatively brief halt is thought to require action. However, averaging many labors together evens out the variations. Individual labors often don’t work this way.