Posted by My OB said WHAT?!?.
Posted by My OB said WHAT?!?.
“I Can’t Be Held Responsible For What Might Happen With An Unapproved Heating Pad.”
“I can’t be held responsible for what might happen with an unapproved heating pad.” – OB to mother after her parents brought a heating pad from the local Walgreen’s to help the mother with her back labor.
Translation:
“I’m sorry you didn’t use our heating pad that we got in bulk and can charge you $200 for that is identical to the one you got on sale at Walgreens for $7.99″
Can you tell that I’ve been charged $28 for a single 500mg ibuprophen before?
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After asking for the cough syrup that had already been prescribed by the ob after labor for almost 5 hours I told them my husband would go buy me some. The rn said they didn’t want me taking anything I didn’t get from them and my cough sryup arrived within 10 min. Funny how that worked
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Alissa Reply:
June 1st, 2010 at 7:04 pm (Quote)
lol i know how that is, they refused to let me take my own tums at the hospital the other day. I got stuck taking their nasty chalky gross antacids instead of my yummy smooth dissolve tums.
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beccaisadoula Reply:
June 2nd, 2010 at 5:28 am (Quote)
What are they gonna do, take away your twinkle lights?? Next baby I have, I’m taking my own ibuprofen. WATCH ME TAKE IT nurse lady!
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Wait, are you so blinded by anti-doctor and hospital hate that you can’t see where the OB was coming from? With sue-happy people coming into hospitals everyday they have to let people know that using a non hospital issued devise is NOT their responsibility! Get over yourselves, really.
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Lucia Reply:
June 1st, 2010 at 7:54 pm (Quote)
I think the Drs and hospitals need to be more concerned with the off label uses of Pitocin for augmentation of labor, and Cytotec for induction (since it’s basically illegal to use meds off label and with good reason… cytotec ruptures uteruses and kills moms and babies and Pit leads to c-section and maternal and fetal complications and death). I think they have a little more to be concerning themselves over then a rouge heating pad. Yes there needs to be tort reform so that drs don’t need to worry about dangerous heating pads and their pain relieving mayhem but COME ON! It’s a freaking heating pad!
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Robyn Reply:
June 2nd, 2010 at 4:44 am (Quote)
That’s just it. The maternity care in America (and other places) is full of nothing but cover-your-ass policies. And doctors who actually care about the patients and don’t practice the CYA policies get kicked out of their hospitals.
I know a woman in Turkey who got sectioned. She spent a YEAR drafting a letter to her OB because she felt it was unnecessary. When she finally sat down with her OB, the OB admitted that the section was unnecessary. The only reason it was done was because of insurance. They wouldn’t pay if the woman wasn’t sectioned in X ammount of time; as it is, they gave the OB a hard time about paying because they thought she waited too long to section the woman. She took the time to sit down with her OB and point out everything that had made her feel inadequate and/or scared, and on almost everything the OB agreed about. A friend of hers has since delivered with said OB and had a completely different experience for the better.
Plain and simple, hospital policy SUCKS for the laboring mother. They take away your clothes and put you in uncomfortable/undignified hospital gowns, put an IV in you which straps you here, put belts around your middle which straps you there, lay you on your back (which is uncomfortable for you and tends to hinder the labor/delivery process) because it’s convenient to shove their hands in your hole whenever they want and it’s convenient to catch when you’re ready, and they put you on the Almighty Clock. If you have met critera X by time C, they put you on pit, rupture your membranes, force you to push when you are not ready to push, and won’t let you eat or drink (sometimes for more than 24 hours). And if you haven’t delivered a baby by the time Clock reaches zero, you’re cut open. All in the name of cover-your-ass policy. They laugh at you and wear you down anytime you want to do something that doesn’t fit with their views of birth (such as walking, or hiring a doula). For most OBs out there, your birth means NOTHING to them. It’s all about how much money they can suck out of your insurance company and making sure their own ass is covered.
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Jane Reply:
June 2nd, 2010 at 6:14 am (Quote)
There’s protection and there’s common sense. If I bring my own labor materials to the hospital, then I’m responsible for the use of those. If the hospital wants the mom to use only an approved heating pad for back labor, then the hospital should provide heating pads.
Wouldn’t any laboring mom ask the nurse for it first before asking her parents to go buy one? If the hospital isn’t providing approved items, particularly normal items like heating pads, then it should be fine for the patient to bring her own.
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Brige Reply:
June 2nd, 2010 at 10:12 am (Quote)
Wow… Jessica… where is all your hate coming from… a heating pad… I don’t hate Dr.’s and I’m not Anti-Hospital… what I am is pro the re-humanization of birth, and for womens choices and bodies being respected… and well for informed consent… and doctors separating their personal opinion from facts to gain that consent… seriously where is your hateful sentiment coming from… we are here to shine light on the plight of maternity care in the States, where Doctors aren’t making decisions anymore, its malpractice insurance companies that are dictating protocol that has nothing to do with the overall well-being of mothers and babies, but their own bottom line…
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Jessica Reply:
June 7th, 2010 at 9:09 am (Quote)
People making hateful comments because an OB has to cover his butt gets my back up. It never said they tackled her husband at the door as he tried to bring in a heating pad. It only says he told her he could not be responsible. How is that wrong?
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Brige Reply:
June 7th, 2010 at 11:17 am (Quote)
they aren’t hateful comments, it just never ceases to amaze any of us that a Dr. will pitch a fit over a possibly “un approved” heating pad, yet do absolutely nothing in the mothers best interest… ie. iv, pit, cytotec, forced to say in bed, if you don’t have this baby in 12 hours we’re going to section you, etc.
A doctors job is not to cover his ass but to FIRST DO NO HARM, to respect the mom, her autonomy, her body her choices and her baby, if he simply follows those precepts and not the Malpractice Insurance Companies Protocol or Mandates that protect their bottom line, not mom or baby… thats what gets my back up
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Linda Reply:
June 7th, 2010 at 11:28 am (Quote)
Brige, you don’t know that this doctor “pitched a fit,” nor that s/he used an IV, pitocin, cytotec, or anything else.
I agree with you completely that there are some pretty horrible things going on these days, in some areas, in some hospitals, and with some doctors. However, I fear that you weaken your case when you’re not willing to attack the specifics, after being assured that you have the whole story.
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Eve Reply:
June 7th, 2010 at 11:40 am (Quote)
As the mother in question, I wanted to fill in a bit more of the story (which I outlined below).
• I was not allowed to walk, stand or even sit up, even though my baby’s head was completely engaged and my water had broken naturally at home.
• This doctor’s first impulse was always surgery. In my experience, this dated back to early in my pregnancy, when he advocated an oophorectomy in response to a large luetal cyst. I worked with a man whose wife had delivered with this same doctor and he told me that this doctor was pretty useless except in terms of Caesareans.
• Pitching a fit? Well, not an explosive one, but he was derisive toward my doula the moment she appeared and didn’t he understand why I didn’t want drugs the moment I got there. He was also fond of saying that he wanted his tombstone epitaph to read, I WAS RIGHT.
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Sarah Dorrance-Minch Reply:
June 7th, 2010 at 4:10 pm (Quote)
See, Jessica? This is why some of us don’t feel an urgent need to give a doctor the benefit of the doubt, if he’s been quoted on this site.
There are some truly wonderful, amazing doctors – as witnessed by the quotes we see on Thoughtful Thursdays. And sometimes, RARELY, there are medical emergencies that render all questions of bedside manner, openmindedness, etc temporarily moot provided the doctor who operates on us is competent.
Most of the time, however, why give the benefit of the doubt? That’s how we wind up getting induced at thirty nine weeks just because. That’s how we wind up getting tethered to the bed with continuous monitoring that we don’t want, in a position that makes the epidural seem a lot more tempting, that gets us sectioned for failure-to-progress or non-reassuring heartbeat or labour dystocia or VBAC not going as planned and it’s too risky anyway. That caesarean that, of course, is statistically superfluous or at least preventable MOST of the time, going by WHO statistics, but which for us was always, ALWAYS life-saving, how dare we suggest otherwise.
Because the doctor had his/her reasons and we ought to respect them, or at least allow the doctor some slack…
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 4:55 pm (Quote)
That “defensive medicine” approach brought on by fear of lawsuits is one of the reasons so many of us hate going to obstetricians for anything other than a true emergency to begin with.
I practice defensive birthing by staying at home.
Where I can use my own heating pad if I feel like it.
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Cmat Reply:
June 5th, 2010 at 5:52 am (Quote)
The heating pad the hospital gave me BLEW. So no, I’m not blinded by anything, I just know from experience. Next time I will bring my own heating pad rather than a craptastic little rice sock that only stays warm (and I mean luke warm) for about 10 minutes).
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That was me, by the way. Thanks for posting it.
This same doctor snickered when he saw my doula: ‘What is SHE doing here?’ He was the only doctor in the practice who I did not like, and unfortunately my regular OB had just gotten off a two-day shift when my water broke at home, so I got stuck with this bozo. My labor went on for twenty-one hours, no thanks to Dr. I-Can’t-Be-Held-Responsible.
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Sarah Reply:
June 1st, 2010 at 8:26 pm (Quote)
Thanks for sharing, Eve. Would you like to share the rest of your birth story? Did you get the birth you hoped for?
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Eve Reply:
June 2nd, 2010 at 10:38 am (Quote)
Actually, that was the one ‘normal’ part of my pregnancy. I was high risk (three previous losses) and at about eleven weeks an ovarian cyst grew to the size of an eggplant (obviously much larger than a fetus at that stage). For nine hellish days and nights, even with heavy narcotics that didn’t touch the pain, it was the worst pain I ever experienced (including at seven cm labor, at which point I asked for the epidural), and that was my first experience with Dr.-I-Can’t-Be-Held-Responsible. He was on call when I went to the ER and his sage advice was to ‘yank the ovary.’ Despite my delirium I vehemently refused, knowing that there was an excellent chance I’d lose this baby too, then be left with only one ovary.
Fast-forward to my due date. My water broke at six in the morning, and an ultrasound two days beforehand had shown the offending cyst to have shrunk to the size of an apricot—still not normal, but not so huge as to risk a C-section due to it obstructing anything. The doula gets to the hospital right after I do and Dr.-I-Can’t-Be-Held-Responsible effectively muzzles her from the start. I am on my back for the entire time. At fourteen hours and seven centimeters I calmly ask for the epidural. Still, it’s another seven hours before it’s time for me to push. I push twice and then the nurse has me stop so she can get Dr.-I-Can’t-Be-Held-Responsible, who catches the baby after two more pushes, then stitches me up so tightly I don’t feel like myself for a year, if you know what I’m saying. He also nearly broke his arm patting himself on his back for doing such a great job with the delivery.
Between my experience with this doctor, my troubled pregnancies and the fact that my regular, nonalarmist, pro-woman OB (same practice) is my parents’ age and talking retirement, I will not be having another child. I’m almost forty and my daughter is two and a half and we like to say that we quit while ahead.
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Lindsey Carr-Ruck Reply:
June 2nd, 2010 at 7:43 pm (Quote)
If you do find yourself expecting in the future, please consider using an “out of hospital” midwife. It would be totally different for you.
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Mama Mirage Reply:
June 2nd, 2010 at 9:26 am (Quote)
What an idiot. I’m sorry you had to put up with him for your L&D. That’s one of my pet peeves is how most women don’t even get to deliver with the doctor they had their prental appointments with. I think I’d flip out.
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 4:57 pm (Quote)
Wow, you managed to birth your baby anyway, in spite of him?
That’s strength.
Two points for you.
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I think that the really sad thing here is that we live in a society where the doctor actually feels that s/he is in danger of being “held responsible” for the use of a heating pad.
I got a “can’t be held responsible” speech for refusing the top-of-the-head fetal monitor while I was pushing, when the doc had some concern that the external fetal monitor might not be giving an accurate reading. I told her that yes, of course I understood that, and that was that.
I did not, however, get any such speech about the TENS unit that I brought to help with my back labor, which I would consider a step up from a heating pad.
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Not sure what the concern is, but we know that they’re not worried about the heating pad exploding. Vaginas explode, not heating pads.
… right?
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All outside appliances have to be checked by maintenance to make sure the item meets fire code/safety standards. Some items brought from home have frayed cords or patients don’t understand you can’t just lie on one for indefinite amounts of time because it feels good. To receive maximum benefit from a heating pad, a person should use it for 20 minutes and stay off of it for one hour to receive maximum benefit again. Also, there should be a layer of cloth between a person and the heating pad. I’ve worked in several facilities and each offered heating pads of some sort or another. Ours is water based at a slightly higher than normal body temperature to reduce the incidence of burns and before you ask, yes, I have seen some crazy burns from heating pads from individuals that seemed intelligent. If you’re pregnant,your OB does not want a heating pad applied to the abdoman for any reason. I know you ladies already know this so I won’t beat a dead horse. Please don’t any of you take Motrin after 32-34 weeks tops. Motrin interferes with closure of the PDA of the baby’s heart. I don’t know how much is too much but that is a Standard of Care. Patient’s can bring their own medications to the hospital but the pharmacy has to check it and label it as OK to use. This procedure came into play with the increase in drug use and people using other drugs other than the ones stated on the bottle.
Yes, we are guilty of CYA practice but keep in mind tort reform would help but also a change in American litigous attitude. We bring suit over everything. Some people would see tort reform as socialism. Personally, I support tort reform but I don’t think 250,000.00 is enough. Yet people are not required to carry more than 25,000.00 in liability insurance for cars. How much is a life worth? How much should someone have to pay for another’s life? Why are there discrepancies?
The only drug approved for use in Labor and Delivery is cervidel(sp). Everything else is off label use and that is because pregnant woman are not agreeable to drug trials while pregnant. Who can blame them. OK, flame retardant suit on. Thea
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 4:59 pm (Quote)
All appliances have to be checked for safety compliance and so on, huh?
Well, phooey. That means no twinkle lights, I guess.
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Linda Reply:
June 2nd, 2010 at 6:18 pm (Quote)
Policies on appliances clearly vary from hospital to hospital, as the hospital where I delivered my baby had no policy like this. When I asked them if they had any opinion about my TENS unit, for instance, their reaction was more along the lines of “Why would we care?” They left me and my appliances to our own devices.
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CCindy Reply:
June 3rd, 2010 at 6:32 am (Quote)
These rules do not exist in a vacuum. Clearly somebody burned themselves or electrocuted themselves at some point. Not every patient is as upstanding as we are. Did I ever tell you about my roommate whose husband was sneaking beer into our room for her and all the while she was demanding more pain meds after a vag delivery? Meanwhle, I’m recovering from a c-section and breastfeeding with them waltzing past and bellowing at the top of their lungs. I hated her.
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P.S. I have my own stash of OTC drugs in my locker. I’m the Motrin, Tums, Tylenol, Pepto Bismol, gas-X nurse. LOL. The other nurses call me mom.
Thea
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 5:00 pm (Quote)
Your locker sounds like my purse.
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Sarah
You can press my buttons faster than my son and I didn’t think that was possible. I once nailed him with the car keys from 10 feet. Felt good too. This much I can tell you…….Your mama didn’t beat you enough when you were little. And yes oh doubting one, appliances brought into the hospital need to be checked. If they are safe, no big deal.
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Aunt4God Reply:
June 2nd, 2010 at 6:32 pm (Quote)
Thea, I don’t think Sarah was trying to “push buttons” w/that last comment. The way I’m reading her comment is that she is trying to be funny about the ever-present twinkle-light jokes. Just MHO, but I think she was trying to be funny…..and trying to show she is understanding and maybe agreeing w/you. Just my two cents….not that two cents is worth much anymore!
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Sarah Dorrance-Minch Reply:
June 3rd, 2010 at 1:57 pm (Quote)
I got beat plenty as a child. It’s why I decided to research other parenting styles and decided on attachment parenting as found in the books of Dr William Sears. I don’t see my parents as appropriate role models.
Tangent…
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Dear Peacekeeper,
No, I didn’t take it personally. Sarah is who she is and I like her opinions because she makes me think……..oftentimes, of how I’m going to kill her if I get my hands on her. LOL. Thea
P.S. What exactly are twinkle-lights?
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Robyn Reply:
June 3rd, 2010 at 4:47 am (Quote)
I don’t think anyone’s figured that out yet. I get varying images in my head ranging from a string of white christmas lights that twinkle on and off to those fiber-optic lamps.
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Aron Reply:
June 3rd, 2010 at 5:11 am (Quote)
I think the jury is still out on the exact nature of twinkle lights, but somewhere in the archives is a now infamous quote from a doctor (vastly paraphrasing) along the lines of “you can’t have a water birth, intermittent EFM, birth ball, or push in any position you want, but it doesn’t matter because we have twinkle lights!”
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CCindy Reply:
June 3rd, 2010 at 6:22 am (Quote)
My image of twinkle lights is fiberoptics embedded in the ceiling over the bed that blink on and off. I’ve seen something along those lines at an observatory. They formed constellations with comets that moved across the ceiling as one set came on and another switched off. Fun to watch. I can see where it would be distracting and relaxing.
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Sarah Dorrance-Minch Reply:
June 3rd, 2010 at 1:59 pm (Quote)
Watch it, Thea, or I might show up in labour and ask for you as my nurse.
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Heather P Reply:
June 4th, 2010 at 7:50 am (Quote)
Here’s the quote on twinkle lights. http://myobsaidwhat.com/2010/03/31/but-ill-let-have-twinkle-lights/
Just for fun, I like to picture twinkle lights as kind of a laser light show with Pink Floyd playing The Wall in the background. Maybe some mood fog along with it. Perfect atmosphere for birthing.
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You know, I take a comment like this exactly at face value. You can’t be held responsible for my own personal equipment? Well, no, I wouldn’t expect you to be, and in fact I *don’t* expect you to be.
Often when a person says something like this, it is exactly because they fear that you *will* hold them responsible. I had an exchange like this with a doctor during my birth, regarding something else entirely. Once I made it clear that I was “letting her off the hook,” and in fact had no intention of “holding her responsible” for something that was clearly my responsibility and not hers, everything changed, and we were both a lot happier.
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Linda,
There are regulatory agencies that dictate to us what we do and don’t do, ie: we can’t put our food in the same refrigerator as the patients’, we can’t have anything within 18 inches from the ceiling, all cabinets with medications, syringes,and needles have to be double locked, etc, etc, etc. Sadly Linda, even signing a waiver to not hold any of us accountable does not obsolve us of responsibility in some cases. I know it’s crazy.
FYI. There is a higher incidence of suits among those on public assistance.
Sarah,
Touche’ on parenting. In terms of delivering with me. I’m not really worried since you birth your babies inside of an hour; however, if you were to accidently make it to NC, well….. let me put this delicately, you may have youth and vigor, but I’ve got age and trickery. LOL. Thea
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Sarah Dorrance-Minch Reply:
June 4th, 2010 at 6:17 am (Quote)
Young! You called me young! Oh, my. At my age, that really is flattery. Thank you.
My threatening to sic my labouring self on you was pretty much tongue in cheek. As I’ve mentioned a couple of other times, I am the patient from hell. We definitely have differing philosophies of what constitutes “necessary involvement” in birth, on the part of the medical professionals, and what does not, but you’re a lot more open-minded than most of the labour nurses that I’ve talked to (certainly more open-minded than the kind that get roasted on this board when they say something appalling), and more importantly, you do have a patient’s best interests at heart rather than convenience or routine.
It would mean getting the full, um, benefit of medical micromanagement, but the only thing that would get me into a hospital maternity ward would be a genuine emergency like a placental abruption or a cord prolapse or something, and if that was happening, I’d actually want the whole medical shebang, and I’d rather have a nurse like you than a nurse who deserved to put up with the likes of me as punishment for her sins.
BTW, my one-hour labours are probably the result of idiosyncratic oxytocin release. I’m autistic. A few years ago, I read an article in the local paper about how autistic people and people with social anxiety disorders don’t have a slow, steady trickle of oxytocin like most people do – when we release it all, it’s usually in a huge flood, followed by another long period of not releasing any, and that, the scientists speculated, might be why we are often socially maladroit, phobic, uninterested, etc, and part of why we have sensory hypersensitivities. I’ve noticed that when I’m breastfeeding, while I make enough milk to feed sextuplets, I have almost no let-down and have to press down on my mammaries to start the milk flowing at all. And when it does come in, it comes in about once every half hour and so strongly that it feels like the teat fairy is inflating me with a bicycle pump. My husband saw me grow two bra sizes in a few seconds. My first two labours were kind of like that too, in that I only noticed contractions every half hour, although in the second instance, after a couple of hours of that it was more like every couple of minutes, and because it fit the pattern of my gastroenteritis, it didn’t occur to me that it was actually labour.
Anyway, I mention this because if you get a person on your ward who you got a heads-up to the effect of her being on the autistic spectrum (we constitute about one percent of the population, according to current estimates) and she’s not “progressing,” it might be that she was admitted to early and her oxytocin flood hasn’t kicked in, never mind what her cervix says. When the flood comes, labour will pick up… fast. Also, after she’s given birth, given our weird hormonal release pattern, it might be a good idea to hook her up with a lactation consultant ASAP to help out with the breastfeeding. I didn’t need coaching, but I could have used a warning that my milk might come in really hard and fast when it came in, and that it would probably hurt until I got used to it. It isn’t exactly pleasant to feel like one’s boobs are being inflated by a bicycle pump. A little preparation would have prepared me better, mentally.
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Sarah,
I wouldn’t have been in OB nursing all these years if patient’s cursing, jumping up and down, kicking, scratching and chewing. I have always felt honored to be present at a natural birth……well, as close as we come to natural birth. I work with a Maternal Fetal Medicine Fellow and he is sharp, sharp and sharp; in addition, to being kind. I will ask him for an inservice on this subject and pull our Lactation Consultant into it. I love learning and often find myself frustrated with the restrictions I have to practice under. But, I like to eat. Have you guys ever considered writing your experiences in something like ” Chicken Soup for the All Natural birth Mothers?” Consider your experiences to show your support for natural birth. Many women can identify with your experiences regardless of how they gave birth. Part of the revenues can go toward studies for natural birth or whatever the groups focus is. Your strength would come out in every page. OK, I’m putting the mother away. Have a great weekend everyone. Thea
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Sarah Dorrance-Minch Reply:
June 4th, 2010 at 4:46 pm (Quote)
If there is a Chicken Soup book that focuses on natural childbirth, please, give me a heads up! So far, the only writing I’ve actually been PAID for was a mediocre poem about Sir William Wallace. I’d like to use my English degrees for *something*.
There are a couple of collections of positive birth stories out there if you ever have time to read through them (after ploughing through the long list of interesting stuff I gave you to read earlier)
Tree of Life – Diane Gregg
Journey Into Motherhood – Sheri Menelli
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Maybe it’s not the comment in and if itself but how it was said ie: I can say I’m sorry but if I roll my eyes just after verbalizing this, then the comment takes on a different context.
to the woman that uses the TENS unit…..isn’t it amazing. I had to have shoulder surgery recently and I know I wouldn’t have made it through PT without it. I never thought to use it on a pregnant woman. I’ll suggest it and see where it goes.
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Linda Reply:
June 7th, 2010 at 11:45 am (Quote)
Thea,
I read about the use of a TENS unit during labor in one of my pregnancy/birth books (Sears & Sears, I think). Since we already own one, I figured I’d try it. I had some horrible back labor, and the TENS unit really did help. It didn’t miraculously make the pain go away, mind you, but it definitely helped. I’d say it’s worth a shot.
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BWAHAHAAHAHAHAHAHA!!!!!!! An “unapproved” heating pad?
DAHAHAHAHA!!!!
I’m sorry. This is a terribly serious situation that calls for a very serious regulation of–
BWAHAHAHAHAH!!!!
*wipes away tears of laughter because the OB was probably dead serious on saying this.*
(Note: heating pad plus epidural would be bad b/c mom couldn’t feel if she was getting burned. Heating pad plus mom not medicated should be fine. Seriously.)
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Heather P Reply:
June 1st, 2010 at 5:47 pm Heather P(Quote)
My sentiments exactly. Once I got over my laughing fit.
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Mama Mirage Reply:
June 2nd, 2010 at 9:23 am Mama Mirage(Quote)
Precisely! I about fell out of my chair laughing, then when I sobered up I just shook my head at the the stupidity.
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 11:29 am Sarah Dorrance-Minch(Quote)
I have no way to improve on this.
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