Posted by My OB said WHAT?!?.
Jul
4
Posted by My OB said WHAT?!?.
“I Don’t Know How to Help You, Except To Induce You.”
“I don’t know how to help you, except to induce you.” -OB to mother who had a precipitous first birth and was now pregnant again.
There are 40 comments to this post.
My midwife, when faced with me and my history of precipitous births, said, “Call me at the first contraction. Don’t wait around figuring things out. Just call.”
See? Quite helpful.
Now, if the mom lives 90 minutes from the hospital and the majority of the space between home and the hospital is a cell-phone dead zone, I can see what the doctor is saying. But births are all different (82 minute birth was followed by a 3 hour birth and a 4 hour birth) and it’s possible the mom doesnt’ need to worry at all.
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Sarah Dorrance-Minch Reply:
July 4th, 2010 at 9:21 am (Quote)
Yeah, my midwife is saying the same thing. Since both she and her apprentice live an hour away, and that’s when they drive at Warp 9, we’re already half assuming that this will probably be another unassisted birth, and her job will probably be aftercare.
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Must be nice to be faced with this dilemma.
Signed,
My shortest labor was 21 hours
(Yes, I am bitter)
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Erin Reply:
July 5th, 2010 at 6:02 am (Quote)
I had one 22 hour labor and one labor that we jokingly refer to as 22 minutes, though it was a little longer… and while I get what you’re saying, in all honesty, the precipitous labor was scary and much more painful than the 22 hour one, because I went from 0 to 60 in too quick a time for my body or brain to really process what was happening. So, don’t be bitter, it’s not all it’s cracked up to be.;)
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Tara Reply:
July 5th, 2010 at 7:53 am (Quote)
I agree – though I’ve not had a precipitous labor, I’m a doula, and some of my moms who have had the roughest time, especially after the birth, had very quick labors. It can be very rough on the body.
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cheeks023 Reply:
July 5th, 2010 at 8:11 am (Quote)
I didn’t find my precipitous labours more painful or hard on my body, but they were definitely more difficult mentally. I had a hard time wrapping my brain around the fact that I had been having contractions for only a short amount of time and was already supposed to be pushing…
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Lisa Reply:
July 5th, 2010 at 8:50 am (Quote)
Well, my second labor was 40 hours and was horrendously painful (baby just barely fit and literally pushed my pelvis apart coming through – I had SPD *after* he was born). I can’t imagine being in any more pain than I was. I don’t think it’s possible. It was also a homebirth and I was begging to transfer to the hospital because I could. not. do. it. any. more. but nobody listened to me, so I have issues with that too. So, anyway…getting it overwith in an hour would have been much better than being in agony for 2 days, with no sleep in 3 days. The 21 hour labor was much better but still long and exhausting with little sleep.
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cheeks023 Reply:
July 5th, 2010 at 9:11 am (Quote)
yeoch….I’m sorry. That’s just crazy. My longest labour was a 22h vaginal breech in hospital…and I would have given anything to go home!!!
I wouldn’t change anything with my fast labours…Like I said, it wasn’t more painful or hard, just confusing. I hit transition and the contractions were long and non-stop, I had no breaks in between. Because I had only been in labour for less then 2 hours I wasn’t thinking transition, and started to panic because I knew I couldn’t stay at home much longer with contractions that terrible. Even when my midwife told me I was at 10cm and she was calling EMS for back-up (her second was over an hour away) I still couldn’t mentally process that I was at the end. Only when I saw the baby’s head did I realize what was going on and I calmed down instantly…but it was a scary (mentally) 15 minutes…
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Sarah Dorrance-Minch Reply:
July 5th, 2010 at 3:23 pm (Quote)
I feel rather lucky to have had such fast labours. As you more or less point out, yes, they hurt like hell, but they’re over almost before I know what hit me.
I’m not sure what I’d do if confronted with thirty or forty hours of extreme pain – a lot of women find doulas to be of great help in relieving that pain, both by helping them find a more comfortable position and by simply doing little things that feel good, like giving back rubs and comfort. I personally am the solitary sort, and would find “mothering the mother” to be less of a comfort. Probably I’d just grin and bear it, because at this point I’ve become so paranoid regarding maternity wards that the only thing that would induce me to avail myself of a hospital birth would be an emergency that obviously meant “c-section.”
But it really sucks that no one would listen to you. Who was the one labouring? You. You should have been treated like a person who know her own mind. Maybe the way your wishes were overrode was part of what slowed your labour down.
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After docs missed my births 3 times…I went with a midwife still in the hospital. She was there for all the labor and birth. Amazing when someone can BE in the room and give good care…they tend to not miss the birth.
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Jane Reply:
July 4th, 2010 at 1:12 pm (Quote)
It’s a case of obstetricians not being able to adjust to the idea that the labor nurses should call when the mom reaches 8 cm based on hourly internal observations.
A midwife who remains with the laboring mom the entire time is able to judge dilation and is right there if it happens quicker than they expected. She also won’t be judging dilation based on the clock but based on the mother’s behavior and self-reported experience.
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Dawn Reply:
July 4th, 2010 at 1:22 pm (Quote)
Foolish to wait until I’m 8cm. I’ve had two babies that went from something like 4 cm to born in 6 mintues. Once I said to a nurse, “I think you better call the doctor ” and she said, “not until you are 8cm.” I had the baby on the bed without anyone catching. I’ve also been at 9 1/2 cm for several hours before my OP baby turned and came out in the caul caught by a nervous nurse. I am a grand multipara (mom of many) and when they are positioned correctly, there is little warning by dilation. When they are malpositioned, I stay at a strange dilation for a longer time than doctors like. I also have babies go from high and floating to born. They “drop” in birth.
My midwife only did one cervical check per my request this last time, I was at 9cm I think, and because baby was turned op…I didn’t feel pushy for a while. However, there was a point when I was pushing involuntarily, she caught that. Baby was born probably within 10 minutes after I started grunting and pushing with no urge. Some docs would not have made it into the room to catch by then. My last was born OP with the head tilted to the right. With an OB, I may have had instruments…who knows?
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Sarah Dorrance-Minch Reply:
July 4th, 2010 at 3:05 pm (Quote)
I don’t care how far I’m dilated, and I don’t see why anybody should need to know that, either. When I’m far enough along that I can’t stop screaming, I know the baby is coming soon. When my screaming is turning into grunting and I’m starting to feel something like pressure, I know the baby is coming REALLY soon, like, within a few minutes (max).
That’s all I need to know, and that’s all anyone helping me needs to know, too, aside from checking in every now and then with a fetoscope to make sure everything is more or less okay in there. (Not recommended when I’m in mid-scream.)
Hmm. This is probably another reason why hospitals and I don’t get aling too well. 
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Who said she needed help?
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Sarah Dorrance-Minch Reply:
July 4th, 2010 at 3:07 pm (Quote)
Really wish there were a “like” button…
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Sheva had this to say,
Jul 4, 2010 @ 1:16 pm (Quote)
Sharing concerns or filling him in on her history if he wasn’t the doctor for her first birth does not mean she is presenting a problem that needs fixing.
And even if it is, how does induction fix anything? It just prevents natural labor from having a chance to have happen on its own. How is that a good thing?
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Sheva had this to say,
Jul 4, 2010 @ 1:22 pm (Quote)
But Jane, how’s a mom to know what she’s really up to or how she’s feeling?? She’s not qualified or trained!
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Jane Reply:
July 4th, 2010 at 1:28 pm (Quote)
Yeah, I forgot. My bad. :-b
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Sarah Dorrance-Minch Reply:
July 4th, 2010 at 3:09 pm (Quote)
I’m surprised at both of you. The answer is quite obvious: She knows what she is feeling because she can go out and buy twinkle lights! Well, preferably well before labour commences, if she’s given to precipitous labour. Otherwise, the baby might very well make its debut into the world at Menard’s or something. Which could get awkward.
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Cmat Reply:
July 4th, 2010 at 3:13 pm (Quote)
I prefer Home Depot. Better selection on twinkle lights there . They’re fast at the check outs too so if you’re in labor you’re bound to at least make it out to your car.
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Jane Reply:
July 4th, 2010 at 4:38 pm (Quote)
I’d like to deliver in Home Depot. Those lumber yard guys always seem to know exactly what kind of equipment you need to get a job done, and they tell you everything is easy. 
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Cmat Reply:
July 4th, 2010 at 5:31 pm (Quote)
Anyone checked prices and selection on twinkle lights at Ace Hardware or Fleet Farm lately?
Tee hee.
Jane- I agree. I’ve rented tools from those guys before. They know their stuff!
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Jane Reply:
July 4th, 2010 at 5:35 pm (Quote)
Check your state laws, but I believe if you deliver at Ace Hardware that you have to name your baby Ace if it’s a boy.
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Sarah Dorrance-Minch Reply:
July 5th, 2010 at 6:22 am (Quote)
No reason you can’t name a baby girl Ace. It would be a great tribute to Dr. Who.
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Amy W. Reply:
July 5th, 2010 at 7:07 am (Quote)
You guys always crack me up!
My husband works at Home Depot AND I have extremely quick births. I’ve always worried about what I should do if I go into labor while he is away at work. I guess there is no need to worry, I should just go meet him at work and have the baby there
Oh wait, we only have one vehicle. Back to square one!
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I got into a fight with Dr. Amy about this a few weeks back. She was ranting (as usual) about how bad midwives are and insisted that the world would be a better place without them. I asked in all sincerity and with real intent what a person like me to do was? My last 2 births were 2.5 hours and 55 minutes respectively. Even with prearranged child care I would have ended up delivering on the side of the road. The 2.5H one was progressing quite normally, and I figured I had a few hours to go still. The midwife showed up and a minute later my membranes ruptured, the baby was born less then 15 minutes later. With my 55 minute labour, The midwife showed up managed to get all her stuff in the house, spread a plastic sheet and dove to the ground in front of me to catch the baby that literally fell out!
Dr. Amy said I made the wrong choice, and that the only choice for me would be an induction at 39 weeks to prevent such a thing.
But then in her blog yesterday she said that inductions for anything other then medically necessary were wrong, and shouldn’t be considered. Is a precipitous labour classified as a medical necessity?
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Sarah Dorrance-Minch Reply:
July 4th, 2010 at 3:30 pm (Quote)
Wow. You have the patience to carry on a conversation (argumentative or otherwise) with Dr. Amy?!?
I’m impressed. I could never do it.
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The Deranged Housewife Reply:
July 4th, 2010 at 3:52 pm (Quote)
LOL! I totally agree, Sarah! You deserve a medal, cheeks!
I’m convinced it wouldn’t have mattered what your individual situation was, though. Nothing satisfies her and she just can’t accept that you could deliver a baby with minimal help. That somehow your body just *knows* what to do and that your thinking brain could make such a decision. *eyeroll*
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Heather P Reply:
July 4th, 2010 at 3:54 pm (Quote)
Yeah, I wouldn’t bother arguing with her. I went to her blog once and noticed her dismissing the 2000 BMJ and Ina May Gaskin’s studies on HB and grossly distorting the numbers on them. It’s just not good for my blood pressure to dwell on it.
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cheeks023 Reply:
July 4th, 2010 at 4:49 pm (Quote)
I can’t say it was patience. I was feeling a wee bit punchy, and needed someone to take it out on *blush*. Dr. Amy fit the bill!!! Two of her latest posts were a direct result of our run in. The breech birth one from a couple weeks back, and the CPD one from just this past week!
I claim a minor victory…in that she does agree that my homebirths were probably MORE safe then not, because I am in Canada and our midwives are all legally bound to the same amount of education, so they are more trained then the US’s CPM’s, and DEM’s.
Whatever I maintain she needs to change the name of her blog to “The Jaded OB”, as skeptical implies a certain amount of indecision and doubt, but still wiling to listen and learn before forming a final opinion! Which she is clearly not!!!
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adrienne Reply:
July 4th, 2010 at 4:36 pm (Quote)
what about my sister, then? her first (and so far only) was a 1.5 hour labor at 37 weeks. 36-week induction for her?
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cheeks023 Reply:
July 4th, 2010 at 4:43 pm (Quote)
Exactly Adrienne, that was my point to Dr. Amy!! You can’t tell me that OB’s are so clairvoyant that they KNOW without a shadow of a doubt that scheduling an induction is what is best for baby-just so Mom doesn’t have to deliver at home. What if my baby wasn’t ready to come until 42 weeks? a 39 week induction would NEVER have worked, and I would have ended up a C/S for FTP. And “OH, THANK HEAVENS YOU WERE HERE. We just saved you. If you had been at home…oh perish the thought…” It’s just SO backwards.
Congrats to your Sister by the way, tell her that if she has more she should prepare for UC, just in case!!!
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And this is why I will be going with a home birth next time- if the birth does go any faster (or as fast!) as the first one I don’t want anyone suggesting that I go to the hospital when I’m pushing. I’ll be doing research on unassisted birth just in case the midwife doesn’t make it in time i can’t imagine why anyone would be induced after experiencing a fast natural birth, but maybe that’s just my experience.
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yeah… I had a precipitous labor for my second. My first was 19 hours, my second, 50 minutes. Im kinda scared for my third (who knows when it will be, second is only 6 months old), but will NOT be induced… Here is my birth story for my second, if anyone wants to read the crazyness…
http://lifeofasahm-lisa.blogspot.com/2009/12/you-know-what-they-say-about-best-laid.html
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JulietsButterfly had this to say,
Jul 6, 2010 @ 7:18 am (Quote)
I had a fast labor with my first. Checked into the hospital a few minutes after midnight, had a baby girl by 3am. Fun times! Never had to think about an epidural and I let the dr break my waters when I finally hit 10cm.
With my second, I did want a bit more control, so we did discuss induction. My dr never pushed it, but never kept it off the table. We went ahead after I scored an awesome Bishop score (after labor had stalled out on me two days before my appt). I wouldn’t advocate anyone going into an induction unless they knew what they were getting into and had an OB who was patient and willing to wait (mine double checked that I didn’t want my water broken). He was in a great mood after the birth…I think the right before 3am birth with my second was better for him because he was already up and hopefully had time for a nap before I really started going. He did have another mom in labor at the same time down the hall, so the scariest moment I had was when I knew I was complete and he was running from her room to mine, scrubbing up fast while they got the bed broken down.
The main difference between my two births was I knew my oldest was with mother-in-law and in good hands and my long hospital stay warranted me a yummy tray of clear liquids (lots of Jello).
No two labors are the same
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Hi all this was my submission . This OB was crazy fortunately we did not stay with her. I’d much rather deliver in home depot then be induced because some OB who supposidly sees a gazzilion births does trust me to know my body. My first birth was 4hours and pain free and the only reason I knew I was in labor was my water broke. My second started the same but ended up being a csection cause baby was breach. Fortunately it was not this OB but instead a parentologist who believed midwives have it right and obs have it wrong. Loved it!
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Depending on the tone of voice and the context, this could either be an opportunity for education, or a sign that it’s time to find a new care provider
If the OB sounds polite but helpless and flummoxed, this is a good time to point out that not all births are alike, but if it looks like this birth will be as precipitous as the last, induction or augmentation would be a bad idea because it would risk tetanic contractions and all that tetanic contractions entail.
In fact, the best thing to “do” would be to do nothing at all other than watch and wait. If a birthing goes really, REALLY fast, there isn’t even any point administering pain relief, because by the time the requested drug or epidural arrived and was administered, the baby would already be on its way out. (So I was told when I was in the hospital the second time.I’d been saying, “Give me something.” At the time I had no idea I was giving birth; I was asking for an opiate or something because I wanted to stop both the gut cramps and the diarrhoea, and opiates are good for both of those things. If I’d known I was in labour, I would have told the paramedics to wait until the baby was out, and THEN take us to the hospital with the best NICU since it was obviously a premature birth.)
If the comment was delivered snidely, or in a rude context, it would call for a snappy comeback along the lines of “Since when did I ask you to do anything for me except give me good prenatal care, and be there to catch the baby when I push it out? Try taking up yoga or tai ch’i if you feel like you have to keep busy and ‘do’ something. Or maybe knitting. You could try knitting my baby a cap. I saw a wonderful picture of a boob hat on the internet a few days ago. It was so cool that I put it on my gift registry. That’s it. Make my baby a hat that’s shaped and coloured like a giant berk. There’s something you can do.”
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