Yup. If you don’t get to nurse in that first hour (or anything else about your labor and delivery isn’t perfectly aligned with what Parenting told you it should be), it’s a bummer, but it’s not catastrophic. It is, IMO, certainly not something you should beat yourself up about if you chose to risk it rather than forego pain medication when it’s offered after you’ve been suffering for eight hours already.
I had a fetal monitor, and therefore I was lying flat on my back in bed, and although I was not bullied into it whatsoever, I don’t consider it a bad choice at all. And, to be quite honest, I kind of resent your saying that it was. It was an informed decision, and I believe a prudent one.
Trusting your doctor, or more specifically, your hospital, is probably the worst choice of all. Their number one priority is their legal department, not their patient.
Does it suck? Yes. Am I smug about it? No. I’m sad about it. I’m frustrated about it. Most of all, I’m really, really pissed off about it. That’s why I can’t be an OB nurse, as much as I would love to educate and empower women on a one to one level about this when it’s most important to them. I’d get fired for it.
It would be wonderful if the doctors did the educating, or didn’t order interventions when they’re not medically necessary. But while they’ve got the hospital administration breathing down their necks, they’ve got to play by the rules of the legal department first, and medical need second. That’s why my books and teachers tell us that there are very specific criteria for risk that you go through before deciding to put a mother on a monitor (or induce labor or perform a vaginal exam or lots of other things) and you don’t do it to people who don’t need it - but at the hospital, it’s done routinely without medical need. It covers their ass, not yours.
I hope what “productive” about my bringing it up is getting people to stop trusting blindly and inform themselves. I don’t know how else to go about it, short of massive reform of our entire health care system. You *have *to be your own advocate, because no one else is free to be, not even the nurses and doctors you’re paying for.
Freudian Slit, the monitor is a strap with two doodads that sense the heartbeat of the fetus and the contractions of the uterus. They slip, they don’t always read well, and if the result looks like the baby’s heart is slowing down, the staff gets very nervous about that. And, if it’s really happening, that is something to be worried about, for sure! But many times it’s not the baby’s heart, it’s the monitor not reading it well.
If the healthy mother wasn’t on the monitor, we wouldn’t notice these “decelerations” in heart rate and she’d be left alone to deliver, most of the time without trouble. With a monitor, people panic, and then start thinking we have to do something more. Sometimes that means putting an internal monitor in, a little screw wire that goes into the scalp. That gets a good accurate read on the baby’s heart rate, but to get it in there, you have to break the bag of waters. In the hospital, you have a lot of rules about how long a woman can have her water broken before she must deliver. There’s a risk that infection can set in through the hole in her bag. So if she can’t deliver vaginally in that time, she’s going to get a c-section.
So, by the textbook, only mothers with certain illnesses, previous history of late term miscarriage or fetal death should be on monitors. We don’t want to put *every *mom on a monitor, because we don’t want to freak ourselves out and intervene when it isn’t required. (Much like you might have heard screening every man for prostate cancer isn’t really recommended any more, because it causes too many unnecessary biopsies for what turn out to be nothing that will harm the man. They only want to test men with risk factors for cancer now.) But in reality, everyone goes on the monitor when they get to Labor and Delivery, so if Something Bad does happen, the hospital can say that the patient was monitored and they did everything they could to ensure a safe delivery. The fact that more often than catching Something Bad, the monitor causes Something Bad seems lost on the legal department.
I’ll say that in our case, the monitors picked up a small problem and prevented it from becoming a huge problem.
Real decelerations that were caused by real baby heart rate drops that we had no reason to anticipate had it not been for the monitors on an otherwise healthy pregnancy. We owe our son’s life to them
Me too.
Daughter, first and only birth. I’m still upset that I had to fight for pain relief after 13 hours because my midwife wanted a natural birth. Without the doctors overruling her, my kid would have died due to two separate issues she hadn’t picked up on.
Best intentions.
The kid’s fine and was unaffected by the drugs enough to latch on while I was being stitched up.
MMV indeed.
It isn’t a guarantee of success though. My daughter didn’t latch for almost a week, despite trying to feed her during that first hour.
I don’t get it. If something goes horribly wrong, I will sue, so they work hard to prevent complications. It sounds like a win/win.
I guess you are saying that they are more cautions than they need to be, but again, how does this work to the disadvantage of the patient?
Yes,I would think that ultimately the legal department wants to minimize risk. Due to this, doctors and hospitals tend to make more cautious decicions, and those decisions may lead to more c-sections than normally would have to occur. On the other hand, it also leads to more live births than otherwise would occur, so I think it’s not reasonable to consider that taking these extra precautions is a mistake.
Well, as per everything else in this thread, YMMV. I’m in Canada and this is NOT SOP.
As I mentioned, I was induced and for the first 4 hours I wasn’t on a monitor. Sadly, the induction worked a little bit TOO well and I collapsed from pain. I had an epidural at that point and they did have to put me on the monitor at that point. However, I wasn’t flat on my back either, I was moving around, on my sides, sitting up in bed, and attempted to walk to the bathroom (a big failure, but I attempted). All of this was at the urging of my Labour and Delivery NURSE who would have basically delivered my son if things had gone smoother - a family doctor would have come in at the end and supervised, but it’s a nurse who typically does the deed here.
So - while I agree that putting every intervention on every pregnant woman in every situation probably isn’t a good idea, it’s certainly not standard medical practice. Perhaps where you delivered/did your training/worked it is, but here it is not. I’ve been led to believe that it’s not standard in Canada at all and my experience supports that, although I can’t speak for every hospital.
Yep, in my mind, my OB, the hospital legal department and I all had the same goal…minimize risk and maximize the chance the baby and I were going to be safe and healthy. If that could be done in a manner consistent with my “birth plan” my OB was for that (my OB nurse on the other hand, felt the natural childbirth I didn’t want was superior and refused to check my cervix or call the CRNA team)
I mentioned cramps way upthread, as they are the only thing I have ever experienced that is (for those who’ve experienced both anyway) even 1/10th as intense as labor, and if that was only 1/10th as intense, I have no doubt that there can be a whole fucking hell of a lot of pain in labor. No direct comparison intended.
Well, there are no guarantees about anything. I am saying that generally speaking, it is better for establishing breastfeeding to try to nurse in that first hour, than not to. No, you shouldn’t feel traumatized or beat yourself up if you didn’t manage this for whatever reason, and no, it is certainly not the death knell for breastfeeding. It’s just better, generally speaking, and that’s all I’m saying.
There are a lot of other factors that can play into this stuff, too. Like, Baby 1 had a god-awful latch and breastfeeding him was a complete and total nightmare (complicated by a multi-week NICU stay starting at age 4 weeks for RSV/MRSA pneumonia) until things finally started clicking around the two-month point. I did nurse him within the first hour of delivery, but he’d been a C-section baby, so maybe the drugs made him sluggish, or maybe the incision made it too hard for me to position him correctly or maybe it was none of the above and he just would have been a crappy breastfeeder no matter what. I don’t know. My second and third babies had no problem breastfeeding from their very first attempt. Baby 2 didn’t get the chance for almost four hours after delivery for a variety of reasons. Baby 3 was on the breast within 5 minutes after being born.
As for the whole “don’t trust your doctor” thing, I will respectfully disagree. I get where WhyNot is coming from. There are a lot of doctors out there that don’t really care about what you want for your own birth or even what will lead to the optimal outcome; they mostly care about minimizing their exposure to malpractice lawsuits, and about being accountable to their insurance companies. This happens. My first OB was like that; she had a policy that all gestational diabetic patients had to be induced at 38 weeks of gestation, regardless of the fact that no current research indicates that early induction for well-controlled diabetic patients leads to improved outcomes. So I found a doctor for my second and third pregnancies that does practice evidence-based medicine. He told me up-front that there were no guarantees that everything on my birth plan would happen, because circumstances can change, and he was going to do whatever was necessary to ensure my health and my baby’s health, but that within reason, he would be happy to follow my birth plan. I said that that is exactly what I would expect from him. Finding the right doctor was well worth it for me, and IMO led to a much better outcome for me and my kids than I would have had with yet another cookie-cutter “we have to induce at 38 weeks” doctor. And I wouldn’t have bothered looking for another doctor if I’d believed that all doctors are equally untrustworthy. (Which is a really, really common attitude in certain granola-crunchy parenting circles, trust me.)
I realize this is all hugely tangential to the original topic, so on the original topic, I’ll just say, uh, yeah, that never happened for me. Negatory.
The problem with your viewpoint (and I don’t know what textbooks you’re talking about) is that the Something Bads aren’t equivalent. The Something Bad they are seeking to catch is death or serious impairment to the infant or mother. The Something Bad they cause is an intervention that may not have been necessary. I know which side I’d rather err on. Providing a mother with the “birth experience” she wants is far less important than ensuring the health and safety of mother and child.
According to my mom, I came out screaming at the top of my lungs, and kept on screaming as long as I was in the delivery room. There was no alert but quiet hour.
I asked my mom how long it was before I stopped screaming. She said six years.
All kidding aside, this is the reason underwater births freak me out. The doctor didn’t need to slap me to get me to take my first breath. Suppose I was underwater when I started screaming and got a lungful of water?
I feel this is appropriate time to link to this.
ping
I know this isn’t GD, but I’d still like to see some kind of cite on this.
I find it very troubling when non-doctors counsel pregnant women to ignore their doctors or even to make the actively hostile to them. I see no reason for it, and even the best educated women can get confused when they’re in labor (even a candles and swimming pool labor).
What most reasonable people should do (and I include men in this too - I get very angry when they are left out of the birthing process and decision making) is do their research, ask questions, and make decisions based on the opinions of the people they trust. And you doctor should be the one you trust the most - they went to medical school and specialize in obstetrics.
I mean, really :rolleyes:
I heartily disagree with this. As a mother of 3 and an acute care RN for over 20 years (but not an OB nurse), I can state categorically that the “hospital” and the “doctor” do not have the legal department as their #1 priority. The overwhelming majority of physicians and nurses have the welfare of their patients as their #1 priority. If you have not found this to be true, WhyNot, as you undergo nursing school, perhaps you are not being schooled correctly.
There is quite a bit of over-medicalizing in the current state of health care today–and not just in Labor and Delivery. But I will say again that the health care team has 2 equally important goals: the safety and health of mother AND baby. To think otherwise is to not only undermine the essential trust required in the patient/MD relationship (and the RN/pt one as well), but to beg the question: what is the purpose in attempting this undermining? No layperson (or even a health care practitioner) can be expected to learn as much as an OB or an OB nurse knows. We must rely on experts and to do so, we must trust those experts. By all means listen to your gut; judge the doc’s bedside manner, remember s/he works for you, and learn what you can about the birth process, but there is no need to second guess or mistrust your practitioner.
The vast majority of women (American, Canadian and Western world) will give birth in some kind of health care facility. This is not a bad or evil thing in its own right. OB was the first place where consumer demand actually changed hospital practice and policy–not only in my lifetime, but in my professional time as well. Modern labor and delivery is unrecognizable from our mother’s (well, most of us. Some of you are pretty damned young).
Expectant mothers are given choices today that their mothers did not/could not even consider. Could improvements still be made? Of course. But the choice is not between Evil Empire Health Care Doctor Team vs Sentimental Earth Woman Birthing via Midwife or whatever, nor should it be.
I thank god I did not have (and did not choose to) to give birth at home–which probably would have likely resulted in our daughter dying; given that something went wrong just as she was emerging. For others, that choice was the right one for them. WhyNot, I find your responses in this thread puzzling: your own daughter benefitted mightily from this same hospital care that you say put the legal department first.
As to the OP: I’ll come out and say it. I did orgasm upon the birth of my last child. It was not a long drawn out affair by any means (the orgasm. Believe me, the labor and delivery was). It was literally over in a flash. I thought (as much as I can be said to have thought at that time), “my god, that felt just like–” and it was over. Later I read that orgasm sometimes occurs (and it makes sense, given the stimulation of the nerves in that body region). It is not my favored way of getting off, though. 
And as for IO and others here who say that L&D is not painful: please stop talking. It may or may not have been for you, but you are not the arbiter of others labors. While pain has it socialization aspects, determining that pain felt during labor is due solely to expecting it is specious. Pain is a subjective response and is unique to each individual. To deny that others have pain (and worse, to say that they should not feel pain) is no way to win friends or influence people. Just my 2 cents. It’s a weird twist on the whole meme that women shouldn’t get pain relief during birth due to Eve “causing” the fall of man–which was commonly thought throughout history. I refuse to feel guilty or inadequate because I have a functioning nervous system. It’s ridiculous.
Not only troubling, but dangerous. I have a friend whose daughter has CP because - against doctors advice and with multiple indications his wife should have a c-section - she chose to go for an unmonitored, natural childbirth via a midwife. Fortunately, at least it was a hospital birth or she and the baby would be dead.
Because “doctors aren’t interested in giving you a healthy baby, they are just recommending the c-section because its more convenient for THEM.”
Now, she isn’t the brightest bulb on the Christmas tree, but the information she was cherry picking was dangerous.
Because I had a medical disease process. I had an infection and placental abruption which required medical intervention. Normal childbirth isn’t a disease process, yet we treat it like it is.
I’m going to bow out of the thread now, I think. I’m not helping anyone or making things any clearer despite my attempts, and I’m just getting myself upset. Time to walk away.
Aren’t you in training to become a nurse? I mean, I know you say you can’t be an OB nurse but if your attitude is that hospitals and doctors care less about their patients and more about not being sued…why are you going into a medical profession?