Posted by My OB said WHAT?!?.
Jan
29
Posted by My OB said WHAT?!?.
“If You Were Still With The Clinic…I’d Admit You Now And Start The Pitocin.”
“If you were still with the clinic and not with a midwife, I’d admit you now and start the pitocin.” – On call OB to VBAC mother with regular contractions, after the 41 week BPP she went in for was normal.
There are 14 comments to this post.
Mom of One had this to say,
Jan 29, 2012 @ 6:52 am (Quote)
So, apparently, this woman made exactly the right decision since she is NOT still with the clinic and therefore NOT subject to your unnecessary interventions!
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This is mine! The kick to this is, this oncall doc doesn’t even belong to my regular clinic! My regular clinic is the one that got me the bpp appointment (midwife needed one since I was “overdue” and transfer of care would happen if I reached 42 weeks). My regular clinic didn’t even say anything about it, except, “your contractions are pretty regular. you’ll have the baby soon!” Although, I know they wanted to say a bit more (I’ve been with them for 12 years now).
I don’t know why this doc thought she would be able to admit me if I were still with the clinic. Even if I were, I would not have accepted and walked out. I did let her know I wouldn’t accept pitocin anyway since I was a vbac. She’s the same doc who I posted about a couple of weeks ago about it “being a matter of opinion” on my home birth, when my regular fp was for it. This doc was a mess.
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Always a great plan for a…
1) Woman with a previous Cesarean
2) Woman who is already having regular contractions
3) Woman whose BPP results in no way indicate the medical need for induction or augmentation
4) Pregnant woman of any kind, after about 38 weeks, apparently
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Jane Reply:
January 29th, 2012 at 7:14 am Jane(Quote)
It’s #1 that gets me. Doctors pitch a nutty over anything that has a 1/10000 chance of problems, but they’ll give pitocin to a woman with a uterine scar.
“VBACs are dangerous! You could rupture!!!”
“Actually, they’re only dangerous if induced or augmented with pitocin.”
“Oh, then in that case, let’s hook you up to the monitor and start the pitocin.”
It makes no sense. You can’t eat brie because it MIGHT contain listeria, and you can’t eat anything during labor because you MIGHT aspirate if they have to give you general anesthesia, but pitocin augmentation of a VBAC is totally cool. It’s as if these doctors know no other way to manage birth and it just-does-not-compute that there are women who shouldn’t labor that way.
Suggested reply: “Thank you for confirming my decision to birth with a midwife.”
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veronica Reply:
January 29th, 2012 at 7:46 am veronica(Quote)
you can’ eat brie?? Oops. Must be why both my kids are prefect!
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C.Pratt Reply:
January 29th, 2012 at 2:45 pm C.Pratt(Quote)
My friend was told not to eat *pasturized* feta. But no one said a thing to her about Spinich even though there had just been a nationwide outbreak of… was it e-coli or listeria? I forget. Her baby was born Oct 2010.
I ate whatever I wanted since I’ve never had any of those bad nasties. I’m reasonably comfortable if it is going to happen it’s gonna be a real long shot anyway.
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Mama Wrench Reply:
January 29th, 2012 at 7:51 am Mama Wrench(Quote)
The thing is, though, a BPP doesn’t measure uterine wall integrity, and the risk of rupture does increase for a TOLAC mother after 40 weeks (all other things being equal.) In which case, yes, augmented/induced labor obviously increases that risk, but I’m not really sure why a reassuring BPP makes a difference one way or the other, since it has no bearing on her overall risk of rupture, just the health of her and her baby *when the BPP was performed.*
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Krista Reply:
January 29th, 2012 at 10:37 am Krista(Quote)
Because statistically a good BPP will give you a few more days of “fine.” And if the baby is fine there’s no reason to augment labor, just let it happen on its own.
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Mama Wrench Reply:
January 29th, 2012 at 11:18 am Mama Wrench(Quote)
Which I understand, but a perfect BPP says less about overall risk of rupture than gestational age and method of labor initiation/continuation.
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Krista Reply:
January 29th, 2012 at 11:38 am Krista(Quote)
That is true, but I was getting the feeling the doctor wanted to augment because the baby was overdue, neglecting the fact that the BPP was normal. I don’t think he was taking the chance of rupture into the equation at all, he just wanted to get that [sarcasm]insanely overdue[/sarcasm] baby out!
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Renai Reply:
January 30th, 2012 at 12:44 pm Renai(Quote)
BPP aside, why would she need to augment a vbac with perfectly fine regular contractions? The bpp simply gives assurance the baby is ok at that moment with no need to speed up anything. Augmenting would place stress on the baby and the scar for absolutely no reason. She just wanted to…heck, I don’t know. Do what she always does and pit everybody, I guess.
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