Posted by My OB said WHAT?!?.
Apr
11
Posted by My OB said WHAT?!?.
“…We Typically Look For A Dilation Of About 1.5 cm/Hour
“After active labor (4 cm), we typically look for a dilation of about 1.5 cm an hour” – OB when asked what the hospital’s definition of “failure to progress” was.
There are 38 comments to this post.
Even the old standards (that I know many OBs still use) say 1 cm an hour. I should note that although this was my 2nd child, this was going to be my first time going into labor and they wanted to do an epidural at 3 cm. So, that makes this comment even more unreasonable.
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Jane Reply:
April 11th, 2011 at 4:01 pm (Quote)
Wow– I’m hoping that means you were only interviewing this doctor and weren’t trapped with him/her?
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MarfMom Reply:
April 11th, 2011 at 6:58 pm (Quote)
Sadly, I HAD to use this practitioner. He told me this about a week before I had my son.
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Dawn Reply:
April 11th, 2011 at 7:16 pm (Quote)
Hope you were able to avoid a c-section! My policy if healthy and doing okay, try to wait and wait to go to L&D. Stall, stall, stall.
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MarfMom Reply:
April 11th, 2011 at 11:10 pm (Quote)
I ended up needing to have one after a failed induction. The baby’s baseline was below 100 bpm and he was having troubling decels, even with no contractions, so they offered an induction or a c-section and I chose induction. Because I was VBACing they tried to do 1 unti of pit every 4 hours, starting with just 1 unit, but he couldn’t even tolerate 4 units. So, they took me off the pit to give him a break but he kept having decels and a c-section seemed necessary.
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devil is in the details Reply:
April 12th, 2011 at 5:21 am (Quote)
The baby’s baseline was below 100 when? Before the pit or after? If your baby had a baseline of 100 before the induction started and you were a VBAC trial they were morons for ever starting the pit. Pit leads to distress, it doesn’t prevent it, and you could have ruptured. You don’t take a baby who is having heart rate problems and introduce pit.
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MarfMom Reply:
April 12th, 2011 at 9:13 am (Quote)
This was before. The decels had been happening for a week or so, and then the baseline was a little below 100 for hours. I wasn’t at all dilated. Their rational was introduce the smallest amount of pit possible (usually it’s 2 units every 15 minutes, and they were doing 1 unit every 4 hours) to try to prevent further distress, rupture, and then stop it as soon as I was dilated 1/2 cm so they could do a foley cath instead. It was either that or c-section. My doula and I couldn’t think of another way to go. If the heart issues had just happened that day I would have gone home and come back the next day for more monitoring. :-/
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Dawn Reply:
April 11th, 2011 at 7:17 pm (Quote)
Oh, and no vaginal exams means…no time table.
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Maddy Reply:
April 11th, 2011 at 9:47 pm (Quote)
How does that work (refusing vaginal exams)? Don’t they need to do one before they admit you? I’m really curious – if there’s a way for me to avoid it (if I ever have another hospital birth again), I’d love to. Vaginal exams from inexperienced nurses HURT, no matter how perky and kind and compassionate they are.
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Kat Reply:
April 11th, 2011 at 9:57 pm (Quote)
You say “No, I do not consent” and then they cannot legally force you.
That’s how it works. And no, there is generally no medical need for nurses to shove their hands up you every hour on the hour. It doesn’t accomplish anything except hurting you, and increasing the risk of infection for every time it happens.
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VW Reply:
April 12th, 2011 at 1:17 am (Quote)
Also, watch what you sign when you sign admission papers. Often, they contain a clause giving them permission to do anything they deem medically necessary. If they won’t admit you without signing this, withdraw your consent in writing (piece of paper should be enough) once you’re admitted so that they have to ask you permission before doing anything. (I got this info from Penny Simkin’s The Birth Partner)
Also practice saying no in front of a mirror or something because it can be hard to do in an environment where there’s a lot of pressure to go along and be a good patient.
Finally, bring allies to help support you if/when you do say no to something, in case you get badgered or threatened.
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Dawn Reply:
April 12th, 2011 at 9:47 am (Quote)
Also, you can talk with your midwife/ob. If you want someone who won’t do VE’s without permission, you need to make sure they are with you on this. My midwife did do a VE on me after I asked her, I was at a 9 I think. I could have gone the whole time without it. Upon admission, the nurse might say to you that you need one before they call your OB/midwife. If you have spoken to your provider earlier, you can just say that you only want your provider to do it, and that was the agreement.
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MuseOddity had this to say,
Apr 11, 2011 @ 4:17 pm (Quote)
I was “stuck” at 5 cm for at least 8 hours and no one at my hospital even said boo about it. Ironically it is the same hospital that is featured in a reality birthing show and people are in an uproar about their c-section rate. It is a terrible c-section rate (although, unfortunately, typical among large hospitals) so I think so much of your experience depends on the OB calling the shots and not the facility itself. Seriously some OB’s should practice emergency medicine since they insist on treating labor and delivery as such.
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I was “stuck” at nearly 2cm for well over 24 hours. I was in the hospital for 18 of those hours. At hour 24 I decided to get an epidural, and then my labor FINALLY took off. I got to 10cm after 36 hours of labor. Not ONCE did ANYONE say I was failing to progress!!!
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laura grace Reply:
April 11th, 2011 at 7:21 pm (Quote)
And there are lots of people who are at 2 cm for literally days or weeks, and even that’s not failure to progress!! 
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Erica Douglas had this to say,
Apr 11, 2011 @ 5:09 pm (Quote)
My mom is absolutely unflinchingly honest. If my water breaks at home, she’s going to remember the exact time and tell anyone at the hospital who asks. I hate having to ask my mom to lie and say, “Oh, it broke a little bit ago” but I do not want to be on the hospital’s clock! Of course, I pretty much plan to show up ready to push, so maybe it’s a moot point.
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Louisa Reply:
April 11th, 2011 at 5:35 pm (Quote)
Do you live with your mum or vise versa? Do you need that pressure of wondering if she would override your wishes and have a “quiet word” to someone when you are not looking? Just saying that is all.
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Erica Douglas Reply:
April 11th, 2011 at 6:07 pm (Quote)
My mom wouldn’t intentionally undermine me – she would want to help the hospital take good care of me, so if they ask a question and I’m busy with a contraction, she’ll want to help.
My mom is also much more trusting of hospital personnel and policies than I am, so she’ll assume it’s for a good reason that they ask when my water broke.
I’ll just forewarn her to be vague on the water breaking and on what foods I’ve eaten when! The doula will also help, I’m sure. Our doula is lovely.
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Bonita Reply:
April 11th, 2011 at 6:20 pm (Quote)
Don’t do it! My mom was this way and she TRASHED my dd’s labor and birth. She practially pushed my dh out of the way to go get me an epidural while he was encouraging me to keep going like I had asked him to. She made it HELL! I didn’t think my mom would undermine me either… :’(
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Dawn Reply:
April 11th, 2011 at 7:18 pm (Quote)
I think I wouldn’t have mom there…but that’s just me.
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Mandie Reply:
April 11th, 2011 at 8:17 pm (Quote)
And THIS is exactly why I wouldn’t be able to have a “homebirth at the hospital” It’s just too much to ask someone I love so much to shut the heck up! Not necessarily on the times and stuff, but more the “are you sure you don’t want anything?” coming from my mom would be soooooo hard to say no to. Or just having her try to talk me into the hospital interventions because “its better for the baby”
So I’ll just have my homebirth at home.
And 1.5 per hour? talk about pressure!
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Wow, my first labor would have hit this, but not my second one at all. I was 4cm before I started active labor, and even then it took 30 hours before I was complete with about 16 of those in the hospital. My doc is known for being pit and knife happy, but for some reason he was ok with my wishes and didn’t bring up pit once.
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Brisa had this to say,
Apr 11, 2011 @ 9:04 pm (Quote)
My mom was AWFUL at my homebirths! You think I’d have learned after the first! Lol. At my second, 7 months ago, she told my midwives to transport me to the hospital while I was in transition (I’m very vocal during transition) and then shoved one midwife over and almost fell into the birth tub herself when I screamed as DD was crowning/shooting out after the first push! She won’t be at the next one for sure! She’s on babysitting duty from now on!!
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I attended a birth yesterday, and the doctor (a lovely woman who labor sat with us for 5 hours straight – she didn’t have any other patients in that day) told us that the ‘official’ rate of dilation is now an average of 3 cms/hour!! I told her I thought it was one, she said that 1 is the minimum, but that 3cm an hour is the average!
I told her that it’s not fair – they’re averaging in women like me who went 6 cm in 15 minutes once.
She laughed – and proceeded to labor sit our textbook 1 cm an hour labor. It was lovely.
She was telling us the official numbers, but she doesn’t keep track, as long as mom and baby were fine, she ignores the clock.
Has anyone else ever heard of this new average?
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Katie R Reply:
April 12th, 2011 at 11:33 am (Quote)
Sheva- 3 cm an hour seems totally unreasonable. 3cm an hour dictates around a 3 1/2 hour labor. Which, my friends, I would not wish on my worst enemy.
In my quick study of pubmed, I found something that correlates this 1.5cm/hour dilation rate with a slowing at 9cm.
http://www.ncbi.nlm.nih.gov/pubmed/21332772
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Cmat Reply:
April 12th, 2011 at 12:27 pm (Quote)
I’ve never heard of that. With DS1 they claimed it was 1.5 which imo is ridiculous for first time moms! Well, just ridiculous in general. I never ran into any of the standards this last time because I went through my entire labor and delivery in just under 3 hours. No one ever mentioned any of the numbers to me because I showed up about a half hour before needing to push.
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Cmat Reply:
April 12th, 2011 at 12:29 pm (Quote)
Oh and the 3ish hour labor wasn’t bad at all until my water broke right as I got to the hospital. At that point it was incredibly intense. Prior to that I didn’t really think i was in labor. DH had to convince me that we needed to go. I have a feeling that I am one of those that sat at 3-4cm for a week or so though, so I didn’t have that far to go when true labor hit.
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lilmrsmchenry had this to say,
Apr 13, 2011 @ 2:40 pm (Quote)
They wouldn’t have known what to do with me then. With my last one (my 5th) I was at 4cm for at least 2 weeks before I had him. I also refused any inductions offered and had him after his due date.
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Add Your Comment.
I’m glad I had a homebirth! I was in labor for almost 24 hours, it took me several HOURS to get from an 8 to a 9, and my labor actually STALLED 3 separate times.
Oh, my midwife didn’t even show up until I’d been in labor almost 12 hours…the doula called her and said, “We’re ready.”
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