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Midwives and my birth/story



 
 
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  #11  
Old May 17th 04, 04:46 PM
Nikki
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Default Midwives and my birth/story

Elfanie wrote:

administering pitocin a couple hours after water breaks spontaniously

If the midwife HADN'T have given you Pitocin, and if you'd ended up
with an infection from having your membranes ruptured for longer, then
the midwife could have been brought up on charges of malpractice for
not doing the "standard of practice", which is to administer Pitocin.


Is it really 'standard of practice' to administer pitocin so soon after a
person's water breaks? I thought they waited a number of hours for labor to
start on its own before taking that step?

I'm just curious since pitocin was never mentioned to me when my water
broke. It was quite awhile before contractions began, a few hours longer
before they got serious and regular. Baby was born 23 hours after my water
broke. I was under OB care but dealt with the hospital and nurses until
things were fairly far along (perhaps about 6cm/14 hours after my water
broke - as a guesstimate). Then the doctor started popping in and out, but
not much. He was a stand in for my regular OB. He was actually a fertility
specialist and was not usually at births. I'm just curious to know if he
followed protocol or not.

My regular OB was at #2 and she was in and out a lot more from the get go, I
was induced with that one though.
--
Nikki
Mama to Hunter (5) and Luke (3)


  #12  
Old May 17th 04, 05:17 PM
Nikki
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Default Midwives and my birth/story

Elfanie wrote:
On Mon, 17 May 2004 10:46:03 -0500, "Nikki" wrote:

Elfanie wrote:

administering pitocin a couple hours after water breaks
spontaniously

If the midwife HADN'T have given you Pitocin, and if you'd ended up
with an infection from having your membranes ruptured for longer,
then the midwife could have been brought up on charges of
malpractice for not doing the "standard of practice", which is to
administer Pitocin.


Is it really 'standard of practice' to administer pitocin so soon
after a person's water breaks? I thought they waited a number of
hours for labor to start on its own before taking that step?


This REALLY depends on where you are...
Most places will wait 5-12 hours, depending on where you are of
course.
the "24-hour mark" also depends on where you are...some care
providers want you "in good active labor" 24 hours after your water
breaks, and thus might feel comfortable waiting for 12-14 hours.
Others want the baby BORN 24 hours after your water breaks...those
care providers usually start pushing pitocin after just a few hours.


Oh I didn't realize things like that varied so much by region. I thought
there was some universal standard of care protocol out there somewhere, lol.
I realized that individual professionals often did things very differently
but I thought the were just going off their own experience/preferences then.

Thanks for the explanation!
--
Nikki
Mama to Hunter (5) and Luke (3)


  #13  
Old May 17th 04, 05:21 PM
Welches
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Default Midwives and my birth/story


Elfanie wrote in message
...
On Mon, 17 May 2004 10:46:03 -0500, "Nikki" wrote:

Elfanie wrote:

administering pitocin a couple hours after water breaks

spontaniously

If the midwife HADN'T have given you Pitocin, and if you'd ended up
with an infection from having your membranes ruptured for longer, then
the midwife could have been brought up on charges of malpractice for
not doing the "standard of practice", which is to administer Pitocin.


Is it really 'standard of practice' to administer pitocin so soon after a
person's water breaks? I thought they waited a number of hours for labor

to
start on its own before taking that step?


This REALLY depends on where you are...
Most places will wait 5-12 hours, depending on where you are of
course.
the "24-hour mark" also depends on where you are...some care
providers want you "in good active labor" 24 hours after your water
breaks, and thus might feel comfortable waiting for 12-14 hours.
Others want the baby BORN 24 hours after your water breaks...those
care providers usually start pushing pitocin after just a few hours.

They'll wait 24-48 hours assuming there's no sign on infection (eg rise in
temperature) here before inducing.
Debbie


  #14  
Old May 17th 04, 05:29 PM
Fer
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Default Midwives and my birth/story

Jill wrote:
|| Argh. While my husband is holding the baby, I just wanted to post
|| about my birth experience. (Motherhood is great! But ouch....I am in
|| soooooo much pain, a whole week later! read on...)
snipped birth story

Ohhhh I am sorry that things didn't go better for you Jill. Until you've
gone through a delivery with your caregiver it seems pretty difficult to
really *know* how your birth will be managed by them. Although I do agree
with some of the other posters that it is easy for another caregiver to look
back and tell you how they think it could have been managed better.

As for your tears, it sounds *just* like mine and I had forceps as well with
my first. Those tools, while helpful, do seem to cause a lot of damage! It
took me four weeks to sit properly and it took months for my 'dissolvable
stitches to go away! So I would suggest sitz baths with Epsom salts, the
herbal bath Ericka suggested, witch hazel pads, sit on harder surfaces and
take it EASY

Hopefully in the future things will go better for you!
--?

Jenn
-DS Feb'92
-DD Feb'97
-34 weeks!


  #15  
Old May 17th 04, 06:05 PM
Jennifer and Robert Howe
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Default Midwives and my birth/story

wow you sound like you had the same midwife I did. Mine was the same way a
real witch to be nice. Only differences was I had to have a c-section due
to I had a lip mine couldn't get passed.

Sorry that you had such a bad birth experience. I hope everything else is
going ok.

Jennifer
Ariana 8/17/03
Home.earthlink.net/~soalus

"Jill" wrote in message
om...
Argh. While my husband is holding the baby, I just wanted to post about my
birth experience. (Motherhood is great! But ouch....I am in soooooo much
pain, a whole week later! read on...)

I had discussed my birthing plans with the midwife beforehand and had told
her definitely, I did not want to be in any more pain that I had to and
would want an epidural (and would let her know if by chance I didn't end

up
feeling like I needed one). When they asked me what was most important to
me, I said the health of the baby- I will consent to any procedure
necessary, if it IS necessary, for the baby's safety, and also- it was
really imoprtant to me not to be in pain. They emphasized to me that it is
my choice and they fully support whatever I want be it epidural or IV meds
or nothing at all. But they assured me, they would have no problems with

me
having an epidural, that a lot of their patients have them.

But what happened....was traumatic, I labored for 18 hours! My water broke
at 4am. I had no pain or cramping or contractions. We went to the hospital
at about 5:30am. It took a while to get me checked in, and still no
contractions. The midwife showed up and immediately ordered an IV drip of
Pitocin!! She didn't even ask me, but she did tell me she wanted to do it
and her reasoning. She just said she didn't want me going any longer

without
contractions. I don't understand this? I told her I've heard Pitocin

causes
more painful contractions and also can increase chances of a C-section.

She
said it increases C-section chances ONLY when used in someone whose cervix
is not ready and probably in people who would end up having a C anyway.

She
did say the contractions hit harder, and told me they would increase my
pitocin very slowly and give me an epidural as soon as the pain became too
bad.

Well, it was a few hours but the pain hit HARD. She orderedn the epidural
and checked me and I was only dilated to 2cm. Since I had the epidural she
turned up the Pitocin. I had NO problems with the epidural..I could move

my
legs and feel everything, but felt no pain, it didn't bother my back or
leave me with a headache. But.,......in 2 hours it wore off, and they

called
anesthesia to give me more meds. They checked me and I was dilated 10-

fully
dilated! This was about 3pm. She wanted me to "labor down" before pushing

so
she had the Pitocin turned off and had me rest for an hour. My epidural

wore
off again! This time she wanted me to push before ythe epidural and it

went
on for a long time until I was hurting SO bad and nothing was

accomplished.
I was pushing hard but the baby wasn't moving. I begged for the epidural
again and she finally called anesthesia back. Well.......after more

pushing
and no baby, and me being completely exhausted and in pain....the epidural
wore off again!!! I was crying out in pain, and insisting I wanted and
needed pain relief per my birth plan. It was way too long before she
actually agreed to get the anesthesia person back in. THEN the midwife

told
the anesthesiologist "Give her only half the amount you have been since

she
needs to push". The anesthesiologist shot her a look and looked at me (I'm
crying by now) and said "If I give half I may as well not even give ANY
because it won't help" and the anesthesiologist gave me MORE--- GOD BLESS
HER!!!! I was truly in agony, I don't know why it was so bad. Or why the
midwife seemed to not care if my epodural wore off. So anyway after 2 more
hours of pushing, they had been seeing the baby's head all this time but

she
was STUCK, and the midwife even said she could see I was truly pushing

hard.
She finally told me that I was a good pusher and the baby should have been
out by now but wasn't coming down. The midwife told me she was calling the
OB and transferring care to him, and she told me to get ready for a
C-section!!! She told me it would be the doctor's decision, her hands

were
out of it now, but in allhonesty I was headed for a C-section so she was
having the nurses prepare me. I was SO tense!!! And worried. Also by this
time the midwife had caused a vaginal tear while reaching in me.

Well...the OB, a really wonderful doctor who I had never met, came in and
checked me and said he thought he could get the baby out himself. He did
have to use forceps and I did have to push but he had the baby out in 10
minutes!!! He also scolded the nurses for some equipment being labelled
wrong, my husband said (I wasn't paying attention!) The dr was

all-business
and he got the job done.

And one more thing I forgot to mention, all the while my epidural had worn
off, the midwife kept telling me "You said it hurts once- don't mention it
again! We are going to think about something else now", and wouldn't let
them redo my epidural until SHE wantd them to. My mom did come to the
hospital and heard the midwife telling me at the beginning that they would
give me pain medication to take care of my pain, not to be nervous. My
husband never left my side the entire labor so he witnessed how the

midwife
did. But anyway, every time after that I said I hurt and was asking for
epidural, the midwife would get on me and tell me I had to think about
something else, my pain would "not be zero", I would hurt some. !!!! I was
furious. Actually that was afterwards, during labor I was just upset and

in
a lot of pain.

I feel the midwife was WAY wrong to deny me the epidural after it kept
wearing off. My labor nurse said hers wore off every 2 hours also. Also,

if
the midwife had turned me over to the OB in the first place, soon after
realizxing the baby wasn't coming out, I wonder if I would have as many
stitches. They did not do episiotomy but I tore through the muscles and

had
a lot of stitches.

The past few days I have been in excriciating pain. The midwives , every
time I call them , get on me for mentioning the pain. They gave me Lortab
which is ineffective and finally ended up giving me Percocet. But my

bottom
is SO sore. One of the midwives in the groups told me over the phone that
they didn't think I hurt any more than anyone else, that it was my

"anxiety"
causing me to "think" I hurt bad. !!!!!!Then she said "Do you think that's
what it is Jiiiiiiill?" My husband was in the room, and looked kind of
surprised when I took a tone with her for the rest of the phone call. My
husband had me call the midwife on call because he wanted them to meet me

at
the ER to make sure my stitches aren't coming out or I am not bleeding
internally. I finally ended up calling the OB on call for the OBs office
that the midwives partner with. I told him about all of this. He told me

his
wife had the same thing happen (had a tear through her muscles) and that

it
is very painful indeed and he knew that's what happened to me from what
happened during labor and my description of the pain now. He's having me
come in Monday to see the OB who delivered my baby to check me. He said
unfortunately, the midwives don't like to treat pain with medicines, that
the OBs are more pain-centered. I told him-- they told me at my initial
consult that they had no problem giving you whatever pain relief you need-
then I told him about the anxiety comment. He sort of couldn't believe

that.
But he also couldn't believe the midwife let me keep pushing when the baby
was stuck, for 4 hours...

Sigh..................I will not be seeing the midwives anymore. They were
fantastic during my appointments but labor with them was hell. Their
treatment after labor when I have been in very bad pain from the stitches,
has been horrid too. My husband even commented that for no reason, they

have
been kind of attitudey and sarcastic, whenever the subject of pain or
request for pain relief comes up and he agrees with me if they want to be
unhelpful with it, they should have told me when I told them I didn't want

a
natural birth instead of telling me they give epidurals and whatever else
the patient needs or prefers.

But the bottom line is, my daughter is beautiful and worth it, perfect and
healthy,and I would do it all over again to have her. Oh- the OB also told
me if I HAD labored naturally without Pitocin, I probably really wouldn't
have hurt as bad THEN as I did this time with the epidurals that wore off,
because my contractions priobably wouldn't have been nearly as bad!! he

also
said a recovery from a c-section would potentially be less painful than
recovery from the kind of tears and stitches I had. NOW they tell me!

I think next time I will stick with an OB and have a doula, instead of a
nurse-midwife.




  #16  
Old May 17th 04, 06:29 PM
Catherine C.
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Default Midwives and my birth/story

(((((((Jill)))))))

Your post reminds me very much of how my DD felt after the birth of
dear grand-son in Sept./02...the circumstances were different(she had
an OB who was late getting to the hospital and she didn't get an
epidural at all, despite repeatedly asking for one) and making her
wishes (exactly the same as yours) known before the delivery...to this
day she feels traumatized and unable to let it go...as for your
midwife's attitude toward your pain, I think that is very
unprofessional...as someone else said, everyone experiences pain
differently, anxiety or not (I'm a fairly anxious person and know that
I experience more pain from my arthritis than others may, but it
doesn't make it any less real)...I'm so sorry that you've had this
traumatic and painful experience but so happy that you have a
beautiful healthy daughter...please take good care of
yourself...Catherine
  #17  
Old May 17th 04, 06:49 PM
Jamie Clark
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Default Midwives and my birth/story

Jill,
I'm sorry that you had a bad birthing experience, and that your midwife was
pulling some inappropriate attitude with you regarding pain meds. I'm sorry
that you had to go through that.

You wrote: "I did not want to be in any more pain that I had to and would
want an epidural (and would let her know if by chance I didn't end up
feeling like I needed one). When they asked me what was most important to
me, I said the health of the baby- I will consent to any procedure
necessary, if it IS necessary, for the baby's safety, and also- it was
really important to me not to be in pain."

I do want to say that perhaps your expectations of no pain were unrealistic.
I mean, even with an epidural, you can't get through all of labor and
delivery with no pain. And, isn't it fairly normal to let the epidural wear
off during pushing so the mom can feel more accurately what is going on and
push better?

Also, you wrote: "But what happened....was traumatic, I labored for 18
hours!" Isn't that a pretty average labor time?

I'm sorry your labor didn't go how you wanted it to, and hope that when you
are ready for #2, you interview midwives, doctors, doula's, etc, and find
the best fit, regardless of the "title." As others have said, there are
good and bad in every profession. I do agree that your OB was wrong to "arm
chair quarterback." It's impossible to know how your labor might have gone
had you been able to make different choices. You might have ended up with
far worse pain from a c-section, you just never know. Hugs.

Congrats on a beautiful daughter. I hope that helps ease the memories of
her delivery.
--

Jamie & Taylor
Earth Angel, 1/3/03

Check out Taylor Marlys -- www.MyFamily.com, User ID: Clarkguest, Password:
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  #18  
Old May 17th 04, 08:16 PM
Ilse Witch
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Default Midwives and my birth/story

Jill,

I'm sorry to hear that your midwife was so uncooperative during the birth.
At that time, you should be the one in control, and it is unfair of her to
deny you that control. Like you, I had long labour with DS and was put on
pitocin drip (didn't want epidural though). The reason I was given (I
asked afterwards again) was that the contractions were not productive and
just making me tired. The way things were going, I'd be labouring for days
and just get very exhausted. Then I wouldn't have energy left to push,
which is the hardest bit.

It is always hard to tell in advance what will happen, but at least you
should be in control, and if not you, your husband. I am glad that you are
at least enjoying your little one, that is the most important, but I
understand your anger. Talk things through with your midwife when you are
ready for it, it may shed some light on things, and it may make you feel
better to put it behind you.

--
-- I
mommy to DS (22m)
mommy to two tiny angels (28 Oct 2003 & 17 Feb 2004)
guardian of DH (33)




  #19  
Old May 17th 04, 08:24 PM
Welches
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Default Midwives and my birth/story


Jill wrote in message
om...
Argh. While my husband is holding the baby, I just wanted to post about my
birth experience. (Motherhood is great! But ouch....I am in soooooo much
pain, a whole week later! read on...)

Sorry to hear you had a rough ride.

I think next time I will stick with an OB and have a doula, instead of a
nurse-midwife.

At least you're thinking about "next time"! Much as I loved #1 I couldn't
visualise putting myself through labour again for about 6 months.
However #2 was a much easier time.
Debbie


  #20  
Old May 17th 04, 08:36 PM
Karen
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Default Midwives and my birth/story

My comments:
- not such a good idea to head straight to the hospital after your water
breaks if there are no contractions. Chances are awfully good that for a
first baby, it isn't going to just appear from nowhere if there are no
contractions! I'd wait many, many hours to see if labor starts on its own
before heading to the hospital.
- 18 hours from beginning to end for a first baby is average, maybe a little
less, for a first baby. For my first, it was around 25 hours. I felt that
was pretty good!
- not sure where you got the idea that birth would be pain free, even with
an epidural. I've never had one, but I believe at the hospital I use, it's
standard to wait until the mother is 5 cm. I've always had a lot of pain to
deal with getting from 0-5 myself (drug free births). It's not like
transition, but it hurts.
- I totally sympathize with you regarding Pitocin. Some people think it's
no big deal. My water broke with my first with no ensuing labor. I went to
the hospital after 12 hours and got Pitocin. I handle pain quite well, but
Pitocin put me on a roller coaster of contractions that gave me no rest. It
was wild! I think I may have been insane to do it without an epidural, in
hindsight. However, I now have the confidence to know I can handle
anything!
- The worst thing about epidurals, IMO, is that unless they are walking,
they do often impede the progress of the baby. I had to have a brief vacuum
with my first, as his head was stuck - once he got moved down via vacuum, I
was able to push him out on my own. I think it's just a bad, bad idea to
lie down during labor at all.
- the good news is that a first birth that does not meet your expectations
usually results in a mother who knows what she wants for her second! Now
you can talk from experience. My second birth was idyllic and a romp in the
park. I got every single thing I wanted...no...insisted upon. Written birth
plans help a lot. When you are experienced, you will be taken more
seriously. However, I think it's contradictory to lay yourself at their
feet and say you'll do anything but then get very worked up about having any
pain. It's better IMO to learn ways of dealing with pain, of reaching
inside yourself to cope, and if an epidural is your thing, then relishing
the pain free periods. While being fully aware that epidurals slow down
labor, make pushing less effective, and often don't completely work. You
gotta take the bad with the good and take responsibility for your choices.
This is childbirth, after all! Every labor is different, even if you have
the same plan. But unless they fully knock you out at the first contraction,
you are going to feel pain. And since the health of the baby was paramount,
they probably did put the baby ahead of you.
Congrats. Enjoy that baby!
Karen


 




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