Posted by My OB said WHAT?!?.
Jun
6
Posted by My OB said WHAT?!?.
“If You Don’t Let Me Turn The Pitocin Back On, The Doctor Will Be In To Section You.”
“If you don’t let me turn the pitocin back on, the doctor will be in to section you.” -L&D Nurse, referring to her phone conversation with the OB, after the mother insisted on the nurse turning the pitocin off.
There are 26 comments to this post.
The Deranged Housewife had this to say,
Jun 6, 2010 @ 5:25 pm (Quote)
I find this kind of behavior/attitude the most singularly frustrating thing about birth today. Either way, it sounds like a c/s was on the verge of happening. Hopefully the mama was able to stand her ground and avoid having one.
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I had 2 L&D nurses with #3 that were Jekyl and Hyde. One was trying to shove pit down my throat every time she came into my room, the other nurse was a godsend and told me if I didn’t want it she wouldn’t turn it on, no matter what the doc said. She said that I was already at 4cm on my own and if they’d just let me be, I’d progress fine. Just because I wasn’t moving along on their schedule, well, tough shit, Lol. She was AWESOME!
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sounds like a threat to me…it’s appalling to think that women have so little control that they can be threatened and bullied like this. Is this kind of thing done in any other type of medical practice?
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Jane Reply:
June 6th, 2010 at 7:12 pm (Quote)
It’s the timeclock that’s the problem with labor. If you refuse to take your heart medication, your cardiologist has to sit down and talk to you about it. He doesn’t send in a cardiac nurse to say “If you don’t take your pills, the doctor will just come right in here and give you a heart transplant!”
The fact that the baby is coming and they can’t control it drives OBs and OB nurses into a state where, as we see too often on this site, they try to control everything they *can* control because it makes up for the sense of failure about all the things they can’t control. Which is driven by fear of the natural process and fear of everything that could go wrong.
And they transmit that fear to the mom, and if she doesn’t react by becoming compliant, they bully her because then they’ve controlled one more factor in the birth.
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Boy that sounds familiar. I was told, during my VBAC, when I asked if I could have a VE to check for progress before they started pit when they said they were going to and if it was safe since I was a VBAC, that it was “Well, I can call the OB, but I know what he’ll say. It’s either the pit or we can start the section.”
I, btw, despise the term “c-section”–makes me feel like a cut of meat or a medical procedure, not a human being.
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Jane Reply:
June 7th, 2010 at 3:16 am (Quote)
But “c-section” sounds so much nicer than “vaginal bypass surgery.”
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“c-section” just raises trauma issues for me.
CCindy Reply:
June 7th, 2010 at 5:05 am (Quote)
Pit during a VBAC is not safe. Repeat Pit with a VBAC is not safe. Your doctor is/was an idiot!
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Jane Reply:
June 7th, 2010 at 5:39 am (Quote)
Stop me if I”m wrong, but doesn’t ACOG say NOT to give Pit during a VBAC?
So let me get this straight:
Doctor says, “We can’t do a VBAC past 41 weeks; ACOG says it’s not safe” and doctor says, “You can’t have a VBAC if you’ve had two cesareans; ACOG says it’s not safe” and doctor says “You can’t have a VBAC unless you’re in bed, strapped to a monitor, with an epidural in place and the anesthesiologist in the hospital; ACOG says it’s not safe otherwise.”
But then those same doctors say, “Crank up the pitocin. I know ACOG says it’s not safe, but it’ll be fine.”
Why the double-standard? Or is that the only way they know how to deliver babies?
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CCindy Reply:
June 7th, 2010 at 6:01 am (Quote)
You want to know why hospital ban VBAC? Because Doctors don’t follow their own advise. All it takes in one Doctor who insists on using Cytotec on a VBAC to get a hospital to ban all VBAC! That is how it works! Remember Kindergarten when one kid did something stupid and the whole class got punished… Thank you stupid doctor!
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Jane Reply:
June 7th, 2010 at 6:05 am (Quote)
And it takes a couple reeling from the loss of their baby because the doctor assured them induction or labor augmentation was safe who then sue exactly because the doctor promised this was safe. The doctor then decides VBAC is unsafe and follows all the guidelines except for the one that would inconvenience the doctor.
But really, I think it’s that many doctors don’t know how to manage birth any other way than by giving pitocin if the woman doesn’t follow the magical chart curve. They’re not in the hospital, so the only thing they have to judge the progression of labor is the progress chart.
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Heather Reply:
June 7th, 2010 at 1:29 pm (Quote)
I know the statistics and risks; it was informed consent. And he’s done hundreds of VBACs, has one of the best rates in the state, apparently uses pit very often and has never had a rupture. I didn’t go to him because I didn’t trust him.
I don’t think I needed the pit (and honestly, I doubt that they even consulted him regarding turning it on); I was sleeping, but who knows. Epidurals kill labor and it didn’t really matter to me enough to fight it. I know that I don’t get super-contractions from pit and since 8 hours of my labor before the epidural calmed things down consisted of contractions like other people say pit caused them (nonstop pain, piggybacking without rest), I know my scar was handling it just fine.
I just wanted to confirm necessity, which I disagreed with… though I don’t know how long I was “stalled” since I’d been sleeping peacefully with my toddler, who’d nursed to sleep and kept my contractions going until she did fall asleep.
I was not induced, btw. Pit was started a couple hours before I gave birth in a 23 1/2 hour labor.
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Nicole Reply:
June 7th, 2010 at 8:40 am (Quote)
I had a similar thing happen in my VBAC attempt. I consented to Syntocinon (just another brand name of Pit which is used at out hospital) when I was given a deadline to complete dilation or have a cesarean. The doctor had already tried to give it to me earlier since I had SROM 24 hours before the “induction” he wanted to give me, but by then I was already in labour.
SOGC (Society of Obstetricians and Gynaecologists of Canada) IIRC, says no to induction with Synto/Pit but augmentation is ok.
OP, I am sorry you were threatened like that. It sucks. I hope you were able to have a successful VBAC despite that.
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Nicole Reply:
June 7th, 2010 at 9:16 am (Quote)
Found the resource. From SOGC Clinical Practice Guidelines – Guidelines for Vaginal Birth After Previous Caesarean Birth. http://www.sogc.org/guidelines/public/155E-CPG-February2005.pdf
“8. Oxytocin augmentation is not contraindicated in women undergoing a TOL after Caesarean section (II-2A).
9. Medical induction of labour with oxytocin may be associated with an increased risk of uterine rupture and should be used carefully after appropriate counselling (II-2B).”
I have heard other places that it (augmentation) may not be safe
in a VBAC, but those are the most recent guidelines I can find.
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Nicole Reply:
June 7th, 2010 at 9:50 am (Quote)
I found the SOGC VBAC Guidelines and under Recommendations it says
“8. Oxytocin augmentation is not contraindicated in women undergoing a TOL after Caesarean section (II-2A).
9. Medical induction of labour with oxytocin may be associated with an increased risk of uterine rupture and should be used carefully after appropriate counselling (II-2B).”
Of course, this is from 5 years ago and I have since heard that augmentation in a VBAC can be risky, but these are the most recent guidelines I can find. ACOGs are probably similar, but I don’t know for certain.
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CCindy Reply:
June 7th, 2010 at 10:17 am (Quote)
I would go bck to the recommendation that were being made in the early 90′s when doctors who did VBAC where interested in natural childbirth and the welfare of their patients and had to fight for the right to try this “questionable” procedure before it became a fad and every Dr. with a shingle was expected to know how to do them. At least when I was trying for my VBAC’s any doctor with any misgivings about the safety would tell you to your face. Now they lie and lie until you are in labor and then it is bait and switch time. Now VBAC is a sales pitch!
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This sounds like a threat to me, which, btw, is called battery.
Also, this sounds like the threat was coming from the doc, and the nurse was the unlucky messenger.
Which brings me to my question: Any nurses out there, is there anything you can do, if doc orders pit when you feel it’s unnecessary, like in this case, or unsafe? (or any other meds, for that matter.)
I’m not saying the nurse here was innocent. But there’s got to be some kind of checks and balances system for the hospital to be a safe place. For anything, not only birth.
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brige had this to say,
Jun 6, 2010 @ 10:51 pm (Quote)
Heather… I thought they weren’t supposed to augment vbacs? Because of the change in the physiology of the contractions on pit/cytotec vs. Normal labor
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Sara Reply:
June 7th, 2010 at 12:51 am (Quote)
But that would mean using logic or practicing evidence-based medicine, and we can’t have that…
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Michelle Potter Reply:
June 7th, 2010 at 9:30 am (Quote)
That’s what my OB told me before my first VBAC, but once I was in the hospital the nurses were constantly harassing me to have Pitocin, which they said my doctor had ordered. I refused, and then narrowly avoided a c-section for “failure to progress,” only because I gave birth while they were prepping the OR.
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Sarah Dorrance-Minch had this to say,
Jun 7, 2010 @ 7:23 am (Quote)
Not without power of attorney and a court order, he’s not. I do not consent to surgery. Nor do I consent to this pit drip. Scram.
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“And the medical reason for this section would be…?”
If the baby was tolerating the pitocin-contractions well enough, how is it possible the baby wouldn’t tolerate regular non-augmented labor? How obnoxious. “Either take this drug that hurts you, for no reason, or we’ll cut you.”
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