Posted by My OB said WHAT?!?.
Sep
1
Posted by My OB said WHAT?!?.
“…Have A Cesarean Now Or You Can Wait Until The Baby Goes Into Distress & Then Have A Cesarean.”
“You can have a cesarean now, or you can wait until the baby goes into distress and THEN have a cesarean.” – OB to mother who was dilating “too slowly,” but baby showed no signs of distress.
There are 59 comments to this post.
The problem is that once the doctor is of that mindset, s/he is going to find SOMETHING, some reason, to believe the baby is in distress. And once the doctor is gunning for the c-section, the mother doesn’t have the medical knowledge to go to the mat with the doctor over interpreting the strip, for example.
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Why would a slow labor put a baby in distress? A super fast labor, maybe. A pitocin induced or augemented labor, could be. But a slow labor? There is no cause and effect here! Why would slow labor cause distress. Oh I know, slow labor so we start the pit then the baby goes in distress, then we do our c-section. Doctor just wants to skip the pitocin and get home early. How about we skip the pit, you go home, and they call you at 3 am when I hit 8 cm!
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Cmat Reply:
September 1st, 2010 at 5:50 am (Quote)
“And even if I’m not at 8 yet by 3am, I’ll still give you a courtesy call so you’ll be awake when I do hit 8cm!”
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JulietsButterfly Reply:
September 1st, 2010 at 6:03 am (Quote)
Pitocin or not, I hit 8 around 1am and push them out right before 3am! My OB should have it in my chart “This one delivers at 3am” I fully expect him to take a nap from 7p-midnight for my last baby so he’s up and ready to catch by 3am. Never bothered him, and if it did, he never said anything to me. Most babies, if left on their own, will come in the late evening/early morning. 9-5 was the worst time to give birth for our ancestors as they had to go back to hunting and gathering by that time of day!
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Melissa Reply:
September 1st, 2010 at 9:02 am (Quote)
Yeah, mom is dilating “too slowly” for:
(best case scenario) Doc’s (mis)understanding of the normal progress of labor based on the “1 hr rule”
(worst case scenario) Doc’s tee time.
She is not dilating “too slowly” for her body or her baby.
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Sarah Dorrance-Minch had this to say,
Sep 1, 2010 @ 5:13 am (Quote)
I have no doubt that if I’d gone the hospital-and-OB-or-hospitalist-medwife route like 99% or so of American mothers, they’d have sectioned me to get Catharine out befor you could shout, “grapefruit.” A prior c-section in 2002, “elderly” multipara (I’m forty, so over the hill apparently), had a “macrosomic” baby, was a week “overdue,” active labour took about thirty hours… on part of Thursday, all of Friday and into Saturday.
So glad I avoided physician distress.
Which is a far likelier “emergency” of birth than foetal distress, provided one just says no to things like routine augmentation with Pitocin and routine use of the Friedman curve as an indication of distress.
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Rebecca Reply:
September 1st, 2010 at 5:23 am (Quote)
Sarah, you had your baby? Congrats!
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Cmat Reply:
September 1st, 2010 at 5:47 am (Quote)
I like that.. physician distress. That’s pretty much what it is too.
Sarah- at the very least, they’d have tried to put you on pit or something. Despite your prior c-section. My labor was 26 hours then I pushed for two. I think it only was that short because I was on pit for the last half (or who knows, maybe would have been faster?). I can only imagine what they would have pressured me into had it gone longer.
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Sarah Dorrance-Minch Reply:
September 1st, 2010 at 6:23 am (Quote)
7 August, at 3.33 am. 10 lbs, 5 oz, about 22″, nuchal cord and hand – almost born en caul, too, but water balloon popped just as she emerged. Placenta the size of Nantucket. Skid marks, slightly bruised tailbone, no tears (for the first time – usually I have some superficial tearing near my urethra, maybe this time the angle of exit was better).
One week later, my husband was hit by an SUV while biking to work, shattered his left leg and got broken or banged in a few other places, spent a week in the trauma unit, rendering me a complete basket case. Funny thing was that I had a migraine that did not go away until I kissed him in the hospital, and I started to haemorrhage and only stopped when he got brought home (I was a lovely shade of corpse white, which with my dyed red hair made me look like Sally from The Nightmare Before Christmas – I lived on Gatorade that week). Go figure.
Visiting him in the hospital was very interesting. The reaction of the student nurses (it was a teaching hospital) when I showed off my little butterball and mentioned, in response to the usual queries one might expect, that not only did I give birth vaginally, but did so at home, on purpose, was something akin to abject horror. I can only imagine what they’re being taught when they’re doing their maternity rotations. Emergency room nurses and EMTs seem so much more sensible about such matters. Usually.
I wish I’d met the orthopedic surgeons-in-training who repaired my husband’s lower leg and knee (in two grueling surgeries that took more than eight hours each, I am told). They sound like the sort of geeks I’d get along with. So in love with their work that they had to give my husband an enthusiastic blow-by-blow description of what they planned to do, before they knocked him out; and one of them asked him to hold the permanent markers for him. My husband, the pencil cup.
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The Deranged Housewife Reply:
September 1st, 2010 at 7:05 am (Quote)
It certainly is an interesting contrast to the usual talking over the patient and refusing to answer any questions that moms get during cesareans. It definitely lends a lot to the “you’re just a vessel” idea that you’re just a piece of flesh having a baby removed like a tumor, which is exactly what I felt like when my last was born. I’m imagining their horrified looks when you told them the baby was born at home “on purpose” – I love it! 
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Sarah Dorrance-Minch Reply:
September 1st, 2010 at 8:36 am (Quote)
All ten pounds, five ounces of her.
I rather suspect the geeky interns would have had a better reaction to the homebirth. “Really? How interesting, we don’t get much of that around here. What was it like? What position were you in? Did it work? How are the baby’s shoulders? Was it more like bench pressing weights, or more like playing Tetris?…”
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Heather P Reply:
September 1st, 2010 at 11:58 am (Quote)
I had to chuckle at that. You do get the most insane reactions when people learn that you gave birth at home, on purpose. Its like nobody ever heard of such a thing before.
Then I get people who say “Oh, my baby had his cord wrapped around his neck and he would have died if he’d been born at home”. My homebirthed daughter had the cord wrapped around her neck twice. She’s not dead and she didn’t need oxygen. (though it was available)
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Lisa Reply:
September 2nd, 2010 at 12:44 pm (Quote)
I work at a medical center and was in a meeting about OB ultrasound procedures with a bunch of OB nurses and a couple of OBs when it came about that I used a midwife and had a homebirth with my last baby – the gasps throughout the room just astounding. I had to bite my cheek to keep from laughing.
And at my son’s birth 9 days ago he also had the cord wrapped around his neck at least once and he’s snoozing peacefully in his Boppy right now. But apparently I birth zombie children.
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Elizabeth Reply:
September 1st, 2010 at 12:29 pm (Quote)
Not to sound stalkerish, but I’m sure I’m not the only one who has been waiting for you to get back here and tell us what happened! Congrats mama, so sorry about what happened with your husband, though =/
And yes I’m sure it was quite amusing to see their looks when they said that; I love the reactions I get when I tell people I had my UC on purpose. I think my favorite was “how did you get the placenta out?!” Are people really *that* clueless???
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The Deranged Housewife Reply:
September 1st, 2010 at 7:36 pm (Quote)
LOL sarah – one of my FB friends practically has to post in code when she’s talking about home birth stuff. She’s planning her second one this fall! 
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I saw a doctor say this same thing on the only episode of Gray’s Anatomy I’ve ever watched. The baby was doing fine and they were really pushing for a cesearean. The parents didn’t want one because the baby was fine. The mother wanted to get up and walk around and squat but the doctors rolled their eyes and confined her to bed. The doctors harrassed the mother so much and did so many things to intervene with her “slow labor” that the baby eventually did go into distress. Then the parents were apologizing to the doctor for their idiocy and thanking the doctors for saving the baby’s life. I felt sick watching it.
I hope the OP told the doctor where to go in this case.
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The Deranged Housewife Reply:
September 1st, 2010 at 5:51 am (Quote)
Interesting … I’ve never watched that show. But I know – even though it’s just a stupid tv show – that it could change the people’s perception if it’s portrayed accurately enough. Unfortunately, for many that is true – and for some, everything is accurate until the ending. You wonder what kind of writers they’ve got there that could write that scene like that – a disgruntled mom, a physician advisor who thinks all his patients are idiots and that he’s superior and in charge? 
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Erica Douglas Reply:
September 1st, 2010 at 6:09 am (Quote)
That’s why I stopped watching Grey’s Anatomy and couldn’t watch Private Practice – the constant stories about difficult labors and scary things drove me insane! I spent more time yelling at the tv than watching it.
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Cmat Reply:
September 1st, 2010 at 7:40 am (Quote)
Why can I picture some lady yelling at the TV??
Oh wait, because its something I would do too.
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Sherry J Reply:
September 1st, 2010 at 7:56 am (Quote)
I don’t think my family would LET me watch shows like that. They KNOW I would be yelling at the tv the whole time.
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Serene Reply:
September 1st, 2010 at 8:13 am (Quote)
Pretty much same here.
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Aleyna Reply:
September 1st, 2010 at 12:31 pm (Quote)
I don’t really yell. I groan, cover my eyes and shake my head. DH will look at me and say, “They get it wrong again?”
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cheeks023 Reply:
September 2nd, 2010 at 1:25 pm (Quote)
I don’t watch shows like that because it is my DH who starts mumbling under his breath and rolling his eyes and lamenting how stupid women everywhere are going to watch this show because of “Dr. McDreamy” and believe it to be the truth,” and “What a shame when they get it so wrong.” and “Why the He77 would a writer make something so dramatically incorrect in such a “correct setting”.
UGH…it’s too much for me when he gets like this! LOL
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Sarah Dorrance-Minch Reply:
September 1st, 2010 at 8:50 am (Quote)
That sounds like me watching the birth shows on Discovery Health a couple of years ago. I’d be sitting there on the sofa yelling out advice… commentary… okay, heckling… My husband said all I needed was a wide screen television, a bottle of beer, and some buffalo wings, and I’d be indistinguishable from your average ESPN viewer during NFL playoffs.
Eventually I stopped watching. It was bad for my blood pressure.
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sara Reply:
September 2nd, 2010 at 5:35 am (Quote)
Yep, the other day I went to visit a friend of mine that had a baby at the end of July- by probably unnecesarean and she was wondering why I was yelling at TLC and “I didn’t know I was pregnant”. They pulled the “LOW FLUID OMG” card on a woman who didn’t know she was pregnant and gave her a stat c-section…umm…so if you hadn’t checked she might have given birth to a perfectly healthy baby in a couple more weeks…why is it an emergency NOW? uughghghgh.
Rant over- I don’t watch those shows either! It’s like watching anything about the Bible on the History Channel. blech.
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Katy Reply:
September 1st, 2010 at 11:21 am (Quote)
I believe since the show is based on surgeons that most of those scenes where the doctors keep saying “We must cut, we must cut” are pretty unrealistic and dangerous. The show needs some blood to make it intense, no matter what the fictitious situation.
In reality I think the best surgeon, be it obstetrician or not, is the one who is reluctant to cut – and who looks for reasons to help the patient without cutting. Then you know the risks are worth it when they do have to help you out.
But I live in a perfect world where I’m currently in labor and eating my breakfast while surfing birth websites…and my OB is perfectly fine with it.
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decemberbaby Reply:
September 1st, 2010 at 11:50 am (Quote)
You’re currently in labor? Gah! Someone call EMS… Katy needs a heplock, stat! For the love of GOD, stop eating – you could aspirate that breakfast if we have to do an emerg c-section! Stop putting your serene, twinkle-light birth experience first and think of the baby… won’t somebody PLEASE think of the children?!?!?
I hope you laugh that baby out. Good luck!
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Cmat Reply:
September 1st, 2010 at 2:11 pm (Quote)
But if you’re in labor and eating.. AND on the computer at HOME.. you’re going to have a zombie baby!!!! You’re not certified to use twinkle lights either, are you?!
Good luck 
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Sarah Dorrance-Minch Reply:
September 1st, 2010 at 6:19 pm (Quote)
Hey, sounds like what I did a few weeks ago. May I recommend the lobster ravioli?
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The Deranged Housewife Reply:
September 1st, 2010 at 7:39 pm (Quote)
I DO seem to remember watching an episode of ER where the woman died in childbirth – I think she bled out or perhaps they were doing a cesarean. I don’t know if I knew enough at that point to express disdain at the television LOL. Perhaps someone here can help me out in trying to remember the gist of it.
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Alyson Miers Reply:
September 1st, 2010 at 8:17 pm (Quote)
I recall an episode of ER where a woman came in and immediately delivered twin girls (I think she was in a car accident and came by ambulance) who were both perfectly healthy, then she suffered a complete uterine prolapse and bled out while waiting for surgery.
There may have been other episodes, though.
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Alyson Miers had this to say,
Sep 1, 2010 @ 8:29 am (Quote)
That sounds like a promise, not a prediction.
Does Doctor Stabby-Hands here allow ANY women to give birth vaginally?
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So you’re saying, “Damned if I do, damned if I don’t?”
Not what I signed up for, Doc. Next!
(Zheeeeesh! Whatever happened to “medically necessary” or at least “medically indicated” as a criteria for major abdominal surgery? Yes, doc…I DO plan on waiting on major surgery unless–not until–baby shows signs of distress. And even then, unless it’s really serious, we’re not going to skip ahead. No bringing out the big guns when a change of position will do, capische?)
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OB’s can be ridiculous with their scare tactics. At my last appointment I said, “I’d like to tear naturally vs. an episiotomy.” OB responded, “most women tend to tear into their clitoris and if you do, I can’t repair that.” I let that comment go. Then, just as I’m leaving, she says, “If the baby is in distress, I WILL snip you.”
Thanks Dr. You rock! I am leaving on such a good note…have a nice day! (or piss off!)
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MG Reply:
September 1st, 2010 at 7:23 pm (Quote)
Wow. Thank G-d the OB said that now, so you can find another OB, rather than while you were in labor!
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Melissa Reply:
September 1st, 2010 at 7:57 pm (Quote)
Why doesn’t she just pee on your shoe or something already? Sheeeeeesh.
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sara Reply:
September 2nd, 2010 at 5:37 am (Quote)
Are you going to stay with her? If one of my docs had said that I would have called a midwife for sure!
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Jane Reply:
September 2nd, 2010 at 6:08 am (Quote)
I wonder what this doctor is doing wrong, that most of her patients tend to tear into the clitoris? I’d ask her that point-blank. “Since that’s such an unusual tear, and since you see so much of it, what are you doing wrong?”
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Aron Reply:
September 2nd, 2010 at 7:38 am (Quote)
That’s exactly what I was thinking. My canned response (that I use when trying to bite back the more sarcastic responses) to that sort of remark is usually: “I bet you do see a lot of those!” Imperative that you say it with perfect sincerity. Then follow up with just enough silence to get them thinking about what you’re implying before finishing with whatever remark seems appropriate at the time.
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ok, THIS is stupid. Maybe it’s the culture at that hospital to instantly do sections on every mom who is too posh to push/tired. the rates of surgical infection/complications/post partum healing of considerable worse than a so-called “natural” delivery.
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Melissa Reply:
September 1st, 2010 at 12:11 pm (Quote)
jubejubes–I’m glad that we agree that this situation is wrong. However….
You’re still assuming that this is somehow the mother’s fault. To whit: “Maybe it’s the culture at that hospital to instantly do sections on every mom WHO IS TOO POSH TO PUSH/TIRED.” (emphasis mine)
If it’s on this website, it’s because a mom had a problem with what was said or done to her. Sure doesn’t sound like she was the one who asked for the c-section, does it? Sounds like her doctor told her the baby was going to need it (contrary to evidence–remember the “baby showed no signs of distress” part?) and she could either submit now to what the doctor wanted for her, or else risk her baby, and still get stuck with something she–wait for it–didn’t want. The very fact that laboring further was an option even in her doctor’s perception of the situation should be a strong clue that she WAS able and willing. “Too posh to push/tired” my foot.
Though, I must say I’m delighted that we agree on the disparity between healing from a natural birth vs a surgical procedure.
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Jane Reply:
September 1st, 2010 at 12:46 pm (Quote)
A non-posh mom can have a slow rate of dilation. The baby’s positioning could be bad, or she might have scarring on the cervix that makes dilation more difficult. The recommended numbers may be 1 cm per hour, but there has to be a range that’s good and still safe. The doctor wouldn’t give a woman something to slow her labor if she’s dilating at 1 cm ever 40 minutes, right? But a woman dilating 1 cm every 90 minutes is in TERRRRRRRRRIBLE DANNNNNNNGER!!!! and must be cut…?
BTW, isn’t it convenient how the guideline are “1 cm per hour”? One even centimeter, one even hour? That sounds more like a mnemonic device than a medical standard. 
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CCindy Reply:
September 1st, 2010 at 1:11 pm (Quote)
I think that 1 cm an hour thing only works at night. There are too darn many distractions during the day, especially right around 5pm.
If it is the culture of the hospital to blah blah blah, then the hospital needs to be shut down, put on notice, reported to somebody, etc. You don’t get to just write that kind of thing off and roll with it. Jubejubes, in case you didn’t get the hint Never Never Never say too posh to push again. Very very bad. Please notify your medical school and whichever hospital you did you residency at to send a memo to their students. If you think like that you are a bad OB! Please google burn out. Thank you
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Jane Reply:
September 1st, 2010 at 1:28 pm (Quote)
“Too posh to push” is just the medical establishment’s way of feeling better about frightening the hell out of women about how horrible the pain of birth can be. They tell these graphic and gory stories (“You’ll tear ALL THE WAY TO YOUR BELLY-BUTTON!”) and then they’re stunned–stunned, I tell you–when women hold back while pushing because they don’t want to tear all the way to their belly-button.
Or on the flip side, women who are epiduralized and so numb that they can’t feel their own bodies enough to push. Consequently they can’t get a good push going, so we blame them for being “too posh to push.”
And the third side (I know we’re losing the coin imagery here, but tough) we have women who are being SCREAMED AT by nurses to PUSH PUSH PUSH!!!! when they don’t yet have a pushing urge. They push, but without their body’s guidance they’re pushing ineffectively. The uterus wants to rest but instead the mom is trying to override because the doctor is looking at his watch and tapping his foot and the nurse is bellowing as if the world is about to end unless the mom births NOW SO PUSH NOW!!!
And when that mom isn’t able to push, she too is labelled “too posh to push.”
But really, blaming the mother is just something doctors and nurses say so they don’t have to look at themselves.
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Sarah Dorrance-Minch Reply:
September 1st, 2010 at 6:23 pm (Quote)
The origin of the phrase “too posh to push” comes from tabloid descriptions of Victoria Beckham, aka Posh Spice. She had her baby abdominally extracted to fit around her husband’s soccer schedule, and to avoid any, well, labour. Slow recovery? Meh, she could afford baby nurses and housekeepers and so on. Why would she care?
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Jane Reply:
September 1st, 2010 at 6:30 pm (Quote)
And it’s still in use because it’s a nice handy way for the medical establishment to blame the mother when a medicalized birth ends in a cesarean section.
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mg Reply:
September 1st, 2010 at 7:31 pm (Quote)
I think its still in use primarily because there are a LOT of idiots out there like Mrs. Bechkham.
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Jane Reply:
September 2nd, 2010 at 6:06 am (Quote)
Then there must also be a lot of idiot doctors who will perform abdominal surgery for reasons of convenience and money. 
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CCindy Reply:
September 2nd, 2010 at 6:55 am (Quote)
Did you miss the female OB 3 weeks ago who was having her first baby by scheduled c-section fot “save her pelvic floor?” That is my definition of Too Posh to Push. The term should NEVER be applied to anyone who undergoes labor. If you schedule (espeically your first) for no medical reason whatsoever then you can get slapped with that obnoxious term. But those of us who try and fail deserve more respect than that!
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Sarah Dorrance-Minch Reply:
September 2nd, 2010 at 7:29 pm (Quote)
Heh heh heh.
The pelvic floor gets stretched and strained by pregnancy itself, far more than it does by birthing, which lasts a relatively short time compared to pregnancy.
Although sometimes abdominal surgery can have interesting effects on elimination, whether it’s pee (the bladder sometimes reacts to being moved out of the way to make room for uterine repair and placement) or poop (intestinal adhesions happen, they’re quite common really; that’s where I got my ghastly IBS from).
There’s a very good chance this doctor who’s so protective of her pelvic floor that she’ll undergo elective open womb surgery to keep it pristine will wind up wearing Depends anyway.
Sarah Dorrance-Minch Reply:
September 2nd, 2010 at 7:21 pm (Quote)
Alas, this time the medical establishment can’t take ALL the blame. A few years ago I read a couple of “edgy,” critic-loved memoirs about pregnancy. One was called _You Make Me Feel Like An Unnatural Woman_, by a middle aged muppie who wrote about what it was like to be pregnant when all her friends were going to Botox parties. The other was written by a spoiled brat princess and was called _knocked up_. Can’t remember the names of the authors, but the books came out in 2004 or 2005, and both authors proudly recounted their asking to bypass labour and just get c-sections. Also their refusal to breastfeed because they wanted to remain sexy and besides, they found it creepy to be food.
I wanted to throw the books at the wall. Also the authors.
Yes, they represent a tiny minority of mothers – but they screw things up for the rest of us. They probably screw things up for their offspring, too.
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Cmat Reply:
September 1st, 2010 at 2:15 pm (Quote)
Funny how “1cm an hour” works because in order for the doc to know that they’ve got to be jamming their hands up there quite a bit.
I’ll be refusing every single exam during labor this time, so they’ll have no freaking gauge at how slow I’m going. They’ll just have to guess and keep anything pointy/sharp away from me.
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I JUST posted an article on FB about how part of the reason for such high c-section rates is because doctors fail to wait.
I hope the OP didn’t give in to this a$$wipe.
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