Posted by My OB said WHAT?!?.
Mar
17
Posted by My OB said WHAT?!?.
“This Is To Stop The Stinging When The Head Is Crowning…”
“This is to stop the stinging when the head is crowning” -OB to mother while the OB administered a local, just before cutting an episiotomy as the mother stated “Don’t cut me.”
There are 46 comments to this post.
WOW…The irony of this one really hurts. A couple of seconds of stinging…vs months of healing from an episiotomy. It astounds me that these people make it through medical school with such a lack of common sense. I feel so sorry for this woman…
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I didn’t find the local to work when I had an episiotomy. It stunk! I thought it was very stupid. I did tear the second time I gave birth badly with no episiotomy and healed in a similar amount of time. Have never torn again where I tore before, but this birth (my 7th) my larger OP baby came out and I had a small tear right along the episiotomy scar. Annoying.
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Note to all the doctors out there who think we’re needlessly angry at the medical establishment, it’s because too many of us have experienced exactly this sort of treatment. It’s as if the doctor is fixing a doorway and the woman’s needs, wants or preferences never enter the doctor’s mind. Too many doctors treat us as if we lose all our rights the moment the first contraction hits, and many others also act as if we lose all intelligence too.
The above should be considered assault, and I hope the woman pursued action against this doctor.
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WellBegun Reply:
March 17th, 2010 at 4:50 pm (Quote)
Actually, it seems most people think we lose all our rights the moment we decide to do something as airheaded as carry a pregnancy to term and have a baby, much less raise it!
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Wendy Reply:
March 17th, 2010 at 4:59 pm (Quote)
Right on, Jane! With all of the blather about defensive medicine and tort “reform,” there’s an unacknowledged elephant in the room: There *are* doctors, albeit on rare occasions, who deserve to be sued…and for full compensation at that. It goes without saying that this is one of them.
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Correct me if I’m wrong…but doesn’t the stinging only last a short minute and then the rest of the area numbs itself? Giving a local to stop the stinging is a little redundant, don’t you think? And the episiotomy thing….I won’t even touch that, I think everyone else has already covered that area.
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The Deranged Housewife had this to say,
Mar 17, 2010 @ 6:35 pm (Quote)
Oh, so *that’s* what they’re calling it now…
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Knitted in the Womb had this to say,
Mar 17, 2010 @ 9:10 pm (Quote)
Actually, there was a lawsuit about 10 years ago in my area that was over an unnecessary episiotomy–and the mother won. Unforutnately though, it is VERY hard to even get a lawyer to take this kind of case as it is “standard of care,” and pressing charges for assault is very hard because the law is specifically written to protect Dr’s who are treating a patient! GGGGRRRRR.
I do agree that medical care providers need to be protected against assault charges when they are providing medical care to an individual who is not in a mental state to make wise decisions (like the drunk I had the privilege to be in the bed next to in the ER years ago who had a cut to his head and kept yelling at the nurse who was attempting to treat him “I’m not f***ing swearing” when she asked him to stop swearing and stop yelling at her), but when a mentally compentant adult makes her decision about whether or not to accept a medical procedure clear, and her decision is ignored, that should be considered assault…sexual assault in the case of episiotomy.
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Jena Reply:
March 18th, 2010 at 1:11 am (Quote)
I think you hit on a key point here…
Going along with what Jane said, I think–just going alone on many of the comments posted here and knowing there’s many untold/ungathered stories out there–some doctors truly believe we lose not only mental capacity but rights, especially if we’re unmedicated, or we have a doula, or we don’t want to follow the status quo to the letter. We MUST be crazy. Or crazy out of our minds with pain. We can’t know what we’re talking about, compared with a person with outstanding med school student loans, a diploma on their office wall, and a scalpel in hand. Not all doctors, but some. Clearly this is one one of them.
I hope she found/finds a lawyer, and I hoped she won/wins.
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Stacie Hogan Reply:
February 8th, 2011 at 5:21 pm (Quote)
This is exactly why I told my husband I do NOT want an episiotomy regardless of what the dr thinks is necessary. That way, even if im totally out of it from the epidural, someone logical knows my wishes.
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eutraphalia had this to say,
Mar 17, 2010 @ 11:45 pm (Quote)
not to mention the fact that you’re experiencing the stinging for a reason – you are stretching so your baby can come through. It’s totally normal!! No intervention required thanks.
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it is becoming more and more well known that episiotomies arent something that should be performed routinely. Anyone who does natural births on a regular basis knows that cutting an episiotomy actually increases the risk of having a 3rd or 4th degree tear. Why cant people just put down the scalpel and use counter pressure, massage, oil, or warm compresses. If you wanted to cut you should have become a surgeon.
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Jane Reply:
March 18th, 2010 at 4:06 am (Quote)
Obstetricians ARE surgeons. C-sections are surgery. That’s why they want to turn a normal birth into a surgical procedure.
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Wendy Reply:
March 18th, 2010 at 6:00 am (Quote)
And, I will add, *episiotomy* is also surgery. It is absolutely insane how every last woman is expected to hire–and turn her body over to–an obstetrician, *a surgical specialist,* for normal childbirth. I am convinced that this bizarre cultural practice of ours accounts for the overkill of surgery during childbirth, i.e. episiotomy and cesarean.
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Jane Reply:
March 18th, 2010 at 6:16 am (Quote)
Exactly–and an episiotomy in an otherwise normal childbirth turns it into a surgical procedure and allows the obstetrician to feel useful. They may not consciously be aware of this, but as Jerome Groopman wrote in “How Doctors Think,” they became doctors in order to perform lifesaving maneuvers and they get a good feeling from having done so.
Yes, once I realized that obstetrics was a surgical specialty, I also realized I ought to have known chances were slim I would walk away from a surgeon without having been cut. But obstetrics is usually presented as a health-based specialty, helping you grow a healthy baby, and not as an area of surgical expertise.
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Kelsy Reply:
March 18th, 2010 at 12:44 pm (Quote)
Sorry about that i just get so worked up about these things that sometimes when i talk about them i black out a little bit and forget that the people delivering our healthy babies are surgeons. Denial maybe?
Wouldn’t it be perfect if this was how it worked…
You go see a midwife for your prenatal care and as long as everything is okay you go ahead with a midwife for the birth. Only when there is a complication would having an OB be necessary. Because it really doesn’t make sense to have someone who is trained in surgery doing normal births, (not to mention how much more it costs to have a baby in the hospital with an).
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Kelsy Reply:
March 18th, 2010 at 12:44 pm (Quote)
…with an OB) is what i meant to have on the end there.
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Jane Reply:
March 18th, 2010 at 1:02 pm (Quote)
And that model of care is used in other countries, Kelsy, but an issue in the US is that our medical schools are turning out too many OBs for them to limit themselves only to high-risk pregnancies. They need the money, to the point that in my local hospital, the doctors banded together and made its so the midwives lost their hospital privileges because “too many women are choosing midwifery births.”
(I wrote a scathing letter to the editor and left the practice then, because it was clear they were not in it for the best interests of the women, which they claimed. How could “Too many women are choosing to deliver with midwives, so we’re taking away that option” possibly translate to “We care what women want”?)
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VW Reply:
March 18th, 2010 at 4:51 pm (Quote)
That’s how it usually works here in NZ…I was planning a home birth, but had a questionable result on the NT scan and saw an OB for an amnio and a heart scan, but retained my midwife as my so-called lead maternity carer. The results were normal so I never saw the OB again (until I needed a transport, but that’s another story). The best part? The OB knew I was planning a home birth but never said a single word about this!
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Kelsy Reply:
March 18th, 2010 at 7:50 pm (Quote)
That is amazing! So do a lot of women there do home birth? or is there still hospital births but with midwives? im interested to learn how other countries do it.
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VW Reply:
March 19th, 2010 at 1:20 am (Quote)
I think in some areas it’s up to 10%. It’s covered by the national health system, and actually the govt is trying to encourage women to stay home or go to so-called primary units that are more like US birth centers…cause it’s a whole lot cheaper, probably. Midwives do a lot of the hospital births unless there are complications. I think some people do sign up with OBs as their lead maternity carers, but it’s less than 20%. The midwife also does the post-partum and well baby care until 6 weeks, which I loved.
I know I was very lucky with my midwife, but overall the system seems so much saner than the US (where we used to live).
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Wendy Reply:
March 19th, 2010 at 6:11 am (Quote)
You just made my morning! 
I’m so happy to hear this about NZ. Those poor women in “neighboring” Australia are living under a much more draconian medical regime. 
http://www.homebirthaustralia.org/
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Liz Chalmers Reply:
March 18th, 2010 at 7:13 am (Quote)
Or how about “put down the scalpel, and do NOTHING”. I wish the recent study that found that warm compresses were the most effective anti-tear strategy could be re-done, with 3 groups: Group A is subjected to whatever the midwife/OB thinks should be done to prevent tearing; Group B has warm compresses only; Group C the midwife/OB has her hands tied behind her back. I would put money on the fact that the warm compresses are protective against tearing because they PREVENT massaging/cutting/poking/etc and that therefore Group C would be just as effective.
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Kelsy Reply:
March 18th, 2010 at 1:02 pm (Quote)
I wouldn’t be so quick to lump massaging the perineum in the same group as episiotomies. That sentence reads a lot like you think that somehow massaging would not only do nothing to prevent tearing, but that it would cause it?
The reason for massaging is to prevent the ‘need’ to cut or chance of tearing, and cutting is exactly the opposite. Massage works on the idea of relaxing the perineum, just like a warm bath or warm compress does. Im not saying that it has the exact same effect, but I don’t think it would be the cause of tearing either. I also think that the warm compress or water thing really works to relax the area, call me crazy but im a lot less tense in a warm bath than half naked out of the water. There is a reason episiotomy rates are so low with water births.
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Micah Reply:
March 18th, 2010 at 4:16 pm (Quote)
Some people believe that massaging the perineum during labor can cause the tissue to swell, thus causing it to tear…not sure if this has been actually studied or not though.
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Kelsy Reply:
March 18th, 2010 at 7:52 pm (Quote)
Thats really interesting, im intrigued to see what they find (because im sure there will be a study on it soonish). Really though personally i would rather not have the massaging done anyways, I just really think you cant go wrong with a waterbirth.
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Lisa Reply:
April 8th, 2010 at 5:15 pm (Quote)
Looks like massage prior to labour reduces tearing http://www2.cochrane.org/reviews/en/ab005123.html but massage during labour makes no difference http://www2.cochrane.org/reviews/en/ab005123.html
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blessedwith4 had this to say,
Mar 18, 2010 @ 7:01 am (Quote)
My sisters and I LOVE our family doctor, who is part of a group of doctors that specializes in home births here in Chicago suburbs! If the need to transfer a patient to the hospital arises, he is known to drop the tool on the floor rather than do an episiotomy! This groups whole approach to childbirth is to sit and observe and, only when needed, intervene. They have delivered 10 babies just in my immediate family and all have been safe, natural deliveries with health (many 10+ lbs.) babies!
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Unfortunately, this one is mine.
I was planning a VBAC, and my regular ob. was holidaying when I went into labour. This ob. was quite obviously against VBACs, as she spent her entire time with me claiming that my baby was too big to be delivered vaginally, that I HAD to deliver on my back, this was ‘non negotiable’, because she was certain that the baby would suffer shoulder dystocia (as far as I am aware, that is probably the worst position to deliver in when the baby is suspected to be big) and that I simply couldn’t do it alone and drug-free.
She tried everything she could to undermine me and my positive attitude. I went from calm and in control to a screaming banshee when she attended.
I am convinced the only reason I was given an episiotomy was so that she could attempt to save face. Of course, my baby WASN’T too big, he DIDN’T have shoulder dystocia and, I DID deliver him naturally, and as far as I know, he was born in perfect health.
The following morning I was told that my baby’s heart rate was probematic, which is why she wanted him out immediately. During labour, she mentioned nothing to me (understandably, as I was obviously mentally incapable of understanding anything a doctor might have told me), or to my perfectly able husband, who was in the room the entire time.
I am yet to press charges, but since I’m still fuming about the whole experience, 5 months later, I will never say never. (I’m currently waiting on the arrival of my hospital records).
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VW Reply:
March 19th, 2010 at 1:26 am (Quote)
Gosh, I am so sorry you had to go through that. Sometimes I hope that the stuff on here didn’t happen to real people.
Good for you for not backing down and getting your hospital records -hopefully they will be clear and the OB will have incriminated herself with what she told you.
My baby did have shoulder dystocia and the only reason putting someone on their back can be helpful in that situation is to do the McRoberts maneuvre, but I haven’t heard of doing this preventatively…and episiotomies are pretty useless for resolving shoulder dystocia since the perineum isn’t where the baby is stuck.
But even if it had been necessary, what about informed consent and not lying to your face?! I’m fuming for you!!!
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brigette Reply:
March 22nd, 2010 at 5:16 pm (Quote)
Did she ask you if it was okay to perform the episiotomy, if not she did not receive informed consent. Charge her with assault, get her license taken away so that she can’t do that to other women!
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SistaC Reply:
March 23rd, 2010 at 8:56 pm (Quote)
She didn’t ask.
I noticed her reaching down to give me the local, and when I asked her what she was doing, she replied with an outright lie (‘This is to stop the stinging when the head is crowning’). I knew what she was about to do when I said, very clearly, ‘Don’t cut me!’
The following day, she actually apologised for lying, but told me she ‘had to do it’.
I’m still so angry about this (and my treatment by her throughout my entire labour), that I have finally decided to take legal action.
Thanks everyone for your comments. They’ve most definitely helped me validate my feelings.
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SistaC…
It was a WOMAN OB? I (and many other previous respondents) had assumed it was a man, based on the complete disregard for your body and independence. I CAN NOT BELIEVE that one woman would do this to another. That takes it to a whole new level of awful.
That being said, I had a pretty bad tear myself, and so I feel for you as you undergo this healing process- both mentally and physically.
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I think that if the mother requests no episiotomy, and the OB goes ahead and does it, then this is tantamount to assault. Unless it is absolutely neccessary of course..but here it sounds like it was done for the hell of it.
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Michelle Potter Reply:
March 17th, 2010 at 8:26 pm Michelle Potter(Quote)
Just me, but I would call it assault regardless, unless she said, “Don’t cut me unless it’s necessary!” Necessary or not, it’s still her choice.
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