Posted by My OB said WHAT?!?.
Jul
18
Posted by My OB said WHAT?!?.
“…You’re Probably Going To Tear, So I’m About To Do An Episiotomy.”
“Oh, you’re probably going to tear so I’m about to do an episiotomy.” – OB during pushing.
There are 18 comments to this post.
For some reason, this was the first thing to come to mind:
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Dreamy had this to say,
Jul 18, 2011 @ 4:39 pm (Quote)
This is meant for Jane– can’t respond directly bc I’m on my phone…
There definitely are other areas of medicine in which this make sense… This just ain’t one of those times. Just thinking about it because I decided to pop a giant blister that had been filling and refilling for 8 weeks (I’m training for a marathon). I used a sterilized needle, covered it with abx and a bandage, etc., because if it popped on a run as it was threatening to, it would be much more likely to get infected. But in that case, my “cut” really was self-limiting and controlled. If it were analogous to an episiotomy, I would have removed all the skin with a random pair of dirty scissors and left it exposed, believing that just the mere fact that I– and not nature– popped it would make it safer.
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Jane Reply:
July 19th, 2011 at 4:22 pm (Quote)
I didn’t see this until today. I wasn’t ignoring you. 
I understand what you’re saying, and yes, sometimes doing something in a controlled way will help. But the way the quote sounded to me, the doctor seemed to think that the cure for tearing was to cut an episiotomy. You are saying about the blister that it was a matter of “when” and therefore better to do it in a controlled fashion.
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This is mine. I began pushing and the nurses told me to stop (since I had “only” been 8-9 5 minutes earlier), which I ignored, so they checked my cervix in the middle of a push (lol) and put me at a full 10. When the oncall OB decided to make an appearance, I suddenly felt a bunch of sharp pricks and asked her WTF she was doing. So she said she was freezing me and [^^quote]. I screamed at her and told her to stop, that if I was going to tear, so be it. Of course, I tore, probably because my perineum was numb and I couldn’t tell to hold back and let it stretch.
A pediatrician at this same hospital also told me I’d probably get a “dead baby” because I wanted to leave AMA 6 hours early with an unknown GBS status. Even though we still got the antibiotics.
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Mama Mirage Reply:
July 19th, 2011 at 8:07 am (Quote)
Well first of all, good for you for standing up for yourself! I’m sorry there seemed to be such an overabundance of idiots in you path! :p
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Jenny Islander had this to say,
Jul 19, 2011 @ 12:47 am (Quote)
Are other medical specialties infected with this assumption that another person’s body is the rightful property and domain of the specialist? Or is this just an OB and (sadly) occasionally a midwife thing? Is it just, as one poster already put it, a matter of being a total control freak? Labor that hasn’t been screwed around doesn’t proceed by the clock or the checklist, so let’s screw it around and force it to be predictable and controllable by us? And if that hurts the mother or baby during the process, well, we’ll make them healthy again, and in the meantime we will have control? And if we seriously injure or kill the mother or baby by putting them in this Procrustean bed, we can say that we did everything we could? Is that it?
I have three children. I am still fertile. I am afraid of becoming pregnant again because we no longer have a local midwife. I would feel safer in a ditch than giving birth under the hands of the local OBs. I would get whoever was on rotation. Perhaps Doctor Short Cord, who announces “Short cord!” at every single birth and yanks on every single placenta within minutes of the baby’s first breath. Perhaps Doctor Eeyore, who told me that he would have to shoot me full of drugs and cut me up and down to get the baby out because nobody as fat as me could possibly have a baby without an OB there to deliver her. (Three. At home. In my bed. Go step on a Lego, Dcotor Eeyore.) Maybe I would get that horrible nurse who treated my husband like a criminal when we went to the hospital for removal of a placenta that really didn’t want to come.
We need properly trained midwives in this country. We need them desperately. We need people who understand that they are not there to jump in and get that labor back on schedule in conformation to the checklist. We need people who are not so afraid of the unknown that they will deliberately create a surgical wound so that they won’t have to think about possibly stitching a perineal tear.
We need birth attendants who realize that they are not the ones bringing the baby into the world and that the best option is usually staying the hell out of the way. Or, you know, opening a bottle of olive oil or applying a hot compress–actually helping the process that doesn’t need their permission to go on!
This just–this–wow, this one made me angry. Just the matter-of-fact, “Well, you might be hurt in a way that I don’t control, so I will control the situation by definitely hurting you.” Damn it, you horrible excuse for a doctor, who died and made you God?
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Jessica had this to say,
Jul 19, 2011 @ 5:20 am (Quote)
To OP, I’m on my phone can’t reply. I am so sorry that not only did the on call cause the situation to be stressful and cause a tear…but your Ped at hosp. Sounds like a walking medical book without any common sense! Shame on them, {hugs} to you.
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I have to cut you beacause I have no idea how to suture a tear (or even know how to assess if it even *needs* suturing) so I’ll stick to what I know thanks, with those nice familiar straight edges. I’m *really* good at those, Ive practised, ALOT!
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Sarah Dorrance-Minch had this to say,
Jul 19, 2011 @ 7:46 pm (Quote)
My Tae Kwon Leap sensei does not believe in non-evidence-based practice or medical battery, an neither do I. BOOTTOTHEHEAD.
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I think your perineum might get injured, so let me get some scissors and make absolutely certain that it does. No consent necessary!
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Sara M Reply:
July 18th, 2011 at 2:31 pm Sara M(Quote)
Just what I was thinking… lol.
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Jane Reply:
July 18th, 2011 at 3:45 pm Jane(Quote)
I cannot figure out in what universe this doctor’s logic makes sense, and yet it’s not just this doctor. It’s all of obstetrics. “OH NOEZ!!!! She’s going to tear! We’d better slice her open!”
Do they do that in cardiac medicine as well? “It looks like you’re going to have a heart attack due to clogged arteries, so we’ll just shoot your arteries full of glue”?
How about sports medicine? “Man, it looks like he could have injured his spine falling off that horse! I’ll go get a mallet…”
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jaed Reply:
July 18th, 2011 at 6:09 pm jaed(Quote)
A tear is an injury. Doctors are supposed to prevent injuries, which are bad. Injuries are uncontrolled and can result in infection.
An episiotomy is a surgical procedure. Doctors do surgical procedures all the time. Such procedures are controlled and clean. They are benign, and done for the patient’s own good.
(Hey, I’m not saying it makes sense, exactly, here in *our* timeline. But I think it is what they’re thinking. Or feeling. Or something.)
(I’ll also bet a lot of them 1) blow off second-degree tears as no big deal while 2) mistakenly believing that inflicting an epi will prevent more serious tearing.)
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shannon Reply:
July 18th, 2011 at 6:52 pm shannon(Quote)
I think this is the same reasoning that makes a c/s preferable to a vaginal breech or a vbac or… just waiting till baby’s actually ready to be born. Though sections carry their own risk, doctors seem ready to overlook those risks because they view c-section as a “managed” procedure, which they are comfortable with.
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jaed Reply:
July 18th, 2011 at 10:09 pm jaed(Quote)
There’s definitely something to that. Consider how often “managed” or “active management” shows up in OB jargon about various procedures. (The example I’m thinking of is the way yanking out the placenta by the cord before it’s ready to detach is euphemized as “active management of the third stage of labor”.)
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