Ok, ladies. I'm on my way out the door to help my third client. Here's the background:
1. Water broke at 9 last night. Clear fluid, trickle, no odor.
2. Mom is GBS+
3. Light, irregular ctx all night
4. Saw Dr. this morning. She yelled at Mom for not going to the hospital ASAP.
5. Monitors baby in office. Baby is fine. Mom is 1cm/50%.
6. Dr. sends mom the hosp for more monitoring and pitocin. MOM DOES NOT WANT PIT!
So I'm planning my strategy: Walking, nipple stim...
What else can I do to help get her labor going without resorting to pit?
Other advice?
Thanks!
Last edited by hoosierdoula; 03-28-2007 at 11:07 AM.
Relax is all that is coming to mind. Let her body know that it is ok to start labor now...
__________________
Ashley Motzenbecker, CD (CBI), RP, PED
Certified Labor Doula, Certified Perinatal Educator, Level II Reiki Certified
Regional Coordinator and Volunteer Doula for Operation Special Delivery www.wiregrassdoulaservices.com
Relax is all that is coming to mind. Let her body know that it is ok to start labor now...
Remind her that her baby is willing to come anytime now (of course that's depending on whether she is 39 weeks vs 34 weeks). Sometimes women get it stuck in their head that b/c of the Pit threat, that the baby isn't ready to come.
You might want to take a look back through the birth stories really quick. That's what I do when I have a question sometimes. It shows what works, and what doesn't. &
Relax and walk. Ankle massage. Let nature takes its course. REFUSE THE PIT!!!
__________________ Wife to John married now for 7 years. MOM to Charity 20, Ashley 17, Brandon, 16. Stepmom to Amber 11, and John 9. Proud Grandma to Austin 3 and new grandson Oliver born Sept 2nd Working on Doula certificaton Working on CBE certification
Mods, time to move this to birth stories, iffin ya wanna.
Wow! Is it possible to have a long and short labor at the same time?
My client, C, was ordered by her (s)OB to go to the hospital IMMEDIATLY because her water had broken 12 hours before (9pm the Sunday night, her standing appt w/ doc was at 9am Monday morning), and C was GBS+. It was a bummer to go to the hosp because she was only 1 cm dilated, and she was sure it was too early. She was right.
Once at the hospital, C labored verrry slowly. Her OB wanted her on pit, but C didn't want that. Mom and baby looked great on the monitors, so OB backed off and "let" C labor naturally. From about 10am Monday until Tuesday morning, C walked, rested, relaxed, tried nipple stim, other positions, to get labor going. Nada. She creeped to 4cm, 70% thinned out. Her labor was not painful at all for her at this point. She rated the pain a 2 or 3, merely uncomfortable.
Her husband was TERRIFIC support for her, so I felt comfortable when I left to grab dinner and nurse my son. On my way back to the hospital, J called to ask if I'd pick up a protein shake for C. Sure thing! Then he told me they'd really been enjoying their time alone together (they already have 3 boys, so alone time is a luxury), and they weren't in any rush for me to get back. I dropped off C's shake and they agreed they'd call me when things picked up and C needed more support. I went home and slept through the night, awaking at 2am to call and check in. I was worried I'd wake them up, but the nurse had just come in to check C's BP, so they were awake. Still early easy labor, they were going back to sleep, so that's what I did too.
The next morning I arrived at the hospital at 9am to find C hooked up to pit and in tears. The pit wasn't making her cry -- she agreed with her OB that it was probably a good next step for her labor. But, her grouchy OB came in with guns blazing -- "You either go on pit or we do a c-section." Grr. That threat pissed all of us off. What a jerk.
Anyway, C labored beautifully on pit. We walked, sat on her birth ball, massaged, and rested for the next few hours. The nurse increased the pit 4 times, and C's ctx became more intense. Nurse checked her cervix around 1:30. Still 4cm, but 100% effaced. C layed on her side in the bed and worked through some non-stop ctx for the next 15 minutes or so, then she fell asleep for a few minutes. All of a sudden, her eyes flew open, she looked at me and said "It's pushing!" I got the nurse. C was complete and the baby was coming! 4cm to complete in 30 minutes! Baby was born 15 minutes later. Perfect pushing, no tears, and no other meds!
One good thing I can say for the s(OB) is that she wasn't quick to cut an epi, and encouraged C to push slowly, allowing her perineum to stretch.
Mom is doing fabulous, but baby boy had to spend the night in the nursery. Apparently he had some wetness in his lungs that contributed a small tear on one of his lungs when he took his first breath. His breathing, color and oxygen levels were a bit scary at first. He was already improving when I left, and the neonatologist told C and J that baby would probably be back with them by morning. The tear should heal itself shortly. I felt so sad for mom and baby that they weren't together. I'm going to check on them later today.
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EXCUSE ME but time to fire the OB! who was having the baby anyway? she was laboring and making progress, yes she was GBS+ BUT MOST infants never have complications even if not treated with antibiotics but yes it is a gamble. THE OB CANNOT SAY you must do A or B that is taking away your patient rights. They need to discuss risks and benefits and the patient STILL has the right to REFUSE and wait. If the OB wanted to push it so bad she would have to get a court order to force the mom to do what she didnt want to do.....and the court would likely not agree as risk would not have been enough . BUT docs are EXCELLENT manipulators what do you think they learn as residents? It is like boot camp hell. They learn manipulation (it is way easier to get the patient to do what you want than get a court order)...maybe not directly but what child doesnt know what a temper tanturm can do to get the results they want? Its Very important to teach our clients about informed refusal and that they may need to be pig headed and understand they CANNOT be forced into ANY invasive procedure without their consent unless there is a court order........which is a LOT of work for the MD and will probably not be done unless there is a real concern. SORRY but this is just the kind of thing that boils my blood this is where defensive teaching comes into play. A couple may totally love their OB and think oh that would never happen but it does and better to know what to do than be disappointed with your birth. I really love the informed decision making card that Penny Simkin put together. Get them - teach parents how to use them role play if necessary and remind them if they say NO then it is NO. Nothing the providers can do; they cannot give you 2 unacceptable options to choose from, MAKE them give reasons with research to back up what they are saying then the patient Still has the right to refuse. The provider needs to PROVE that if what they say is not done then a bad thing WILL not might happen to the baby.
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Congrats to all! Hope baby boy is healing quickly and that he and C can bond now! Poor baby! Sounds like you were awesome support! Good for you!
Ash
__________________ Looking forward to better protection of my privacy so that I can once again post and forge personal and lasting relationships with the amazing doulas here
Need help fast! -avoiding Pit
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Congrats to all! Hope baby boy is healing quickly and that he and C can bond now! Poor baby! 
Sounds like you were awesome support! Good for you!
