Say What?
Heard in turnover report this morning: "GY is a 38 y/o G2P1 EDC today who presented to triage last night for a labor evaluation. She was contracting every 3-5 minutes, cervix 5cms. Her bag of water is intact, baby is looking good, no pregnancy complications. Medical hx significant for 11 year use of Zoloft. She does not want an epidural and has had 1 dose of Stadol. She is in active labor and plan is to manage expectantly." Ahh, I breath deeply and savor the moment. This means we are just GOING TO LEAVE HER ALONE, TO LABOR AND BIRTH IN PEACE.
Mind you, this is the ONLY patient on our board who is in spontaneous labor. i.e. no induction. Everybody else has real or imagined complications necessitating inducing their labor around 38 weeks, so of course are being actively managed. That is, doing everything we can to speed things up. (See last post) I am SICK of 38 week inductions for pre-eclampsia, gestational hypertension, gestational diabetes, too much amniotic fluid, not enough amniotic fluid, baby's too small, baby's too big. Not to forget the garden variety induction for "post dates" at 40+6 weeks. Actually, postdates is 42 weeks, but oh well, what's a week?
So, back to my educated 38 year old G2P1 who was lucky enough to drop through the induction cracks and manage to make it to her due date without being induced for any manner of flaws: being 38 years old, being overweight, taking Zoloft, having not 1 but 2 slightly elevated BPs (seriously, HOW did that happen?) While I am still feeling all warm and cozy that it looks like there will be at least 1 normal labor patient today I am stunned to hear Dr. S ask the resident "And why would you manage her expectantly?"
Oh my gosh, if it wasn't so SAD it would be so FUNNY! The OBs see normal so rarely, they really don't know how to manage it appropriately! And no, he wasn't trying to be funny. He doesn't know WHY you would want to let labor take it's natural course. I have to feel sorry for him and all the other OBs out there like him who have only experienced the outcome of meddlesome obstetrics. Without being aware that it was their meddling that CAUSED the outcomes: the fetal distress, crash sections, retained placentas, postpartum hemorrhages, infections, etc, that is part and parcel of OB practice. What is it they say..."Sucks to be you"?
Anyway, my day consisted of 1 nice quick labor and birth when GY pushed her baby out 2 hours later in 1 push sans epidural, amniotomy OR pitocin. Imagine that! THe rest of the day was spent doing my darndest to expain to the rest of the patients that cervical ripening and induction of labor takes 3 days. I'm sorry you're hungry. I'm sorry you're tired and hurting and swollen and sick of laying in bed. I'm sorry your baby is showing signs of being stressed. I am SO sorry. I wish you weren't here doing this to yourself or your baby. I wish you knew better. That while this is what your doctor recommended, it isn't what is best for you or your baby. I wish you had somehow known that an offer of induction is NOT a gift. It is a curse. It is a ticket to vaginal bypass surgery. But only after 3 days of trying to get your baby born in our timing and on our terms. Of course, you are blessedly grateful for the c-section by that time since you are fully convinced that your body was NEVER going to deliver on it's own.
I don't know. It's just so very sad. I left the labor deck tonight with 5 patients. All but 1 38 weeks, all inductions, all VERY far away (1 cm dilated) from delivery. All thinking that this is what they needed to do for the sake of their baby. I guess that's the 1 positive note to end on. Even though it is very sad that they DON'T have to have a terrible labor and birth experience for the wellbeing of their baby, they are willing to because they believe it is best for their baby. Mother love. Misguided in this case, but very powerful. It is amazing what a woman will do for love of her baby. But oh how tragic that they lay it all on the line and as it turns out, their greatest sacrifice ends up HURTING rather than helping their baby. What a pack of lies straight from the pit of hell modern obstetrics has bought into. And the women who blindly put their trust in obstetricians. Satan must really HATE life and therefore glorious, victorious, supernatural, powerful labor and birth how and when God does it. Of all the natural wonders I've ever seen, birth on God's terms gives Him GLORY GLORY GLORY! A person can't witness it without being blown away and knowing they have just been in the presence of God and seen the hand of God. I am so thankful for that one every now and then that I get to witness. I'm glad I'm a midwife. Even here. Because no matter how hard they try, there will always be the occasional, rogue woman who avoids the meddling long enuogh to have a "breakthrough labor" and I get the joy of just being there to see it and catch the baby. And give God glory.
Mind you, this is the ONLY patient on our board who is in spontaneous labor. i.e. no induction. Everybody else has real or imagined complications necessitating inducing their labor around 38 weeks, so of course are being actively managed. That is, doing everything we can to speed things up. (See last post) I am SICK of 38 week inductions for pre-eclampsia, gestational hypertension, gestational diabetes, too much amniotic fluid, not enough amniotic fluid, baby's too small, baby's too big. Not to forget the garden variety induction for "post dates" at 40+6 weeks. Actually, postdates is 42 weeks, but oh well, what's a week?
So, back to my educated 38 year old G2P1 who was lucky enough to drop through the induction cracks and manage to make it to her due date without being induced for any manner of flaws: being 38 years old, being overweight, taking Zoloft, having not 1 but 2 slightly elevated BPs (seriously, HOW did that happen?) While I am still feeling all warm and cozy that it looks like there will be at least 1 normal labor patient today I am stunned to hear Dr. S ask the resident "And why would you manage her expectantly?"
Oh my gosh, if it wasn't so SAD it would be so FUNNY! The OBs see normal so rarely, they really don't know how to manage it appropriately! And no, he wasn't trying to be funny. He doesn't know WHY you would want to let labor take it's natural course. I have to feel sorry for him and all the other OBs out there like him who have only experienced the outcome of meddlesome obstetrics. Without being aware that it was their meddling that CAUSED the outcomes: the fetal distress, crash sections, retained placentas, postpartum hemorrhages, infections, etc, that is part and parcel of OB practice. What is it they say..."Sucks to be you"?
Anyway, my day consisted of 1 nice quick labor and birth when GY pushed her baby out 2 hours later in 1 push sans epidural, amniotomy OR pitocin. Imagine that! THe rest of the day was spent doing my darndest to expain to the rest of the patients that cervical ripening and induction of labor takes 3 days. I'm sorry you're hungry. I'm sorry you're tired and hurting and swollen and sick of laying in bed. I'm sorry your baby is showing signs of being stressed. I am SO sorry. I wish you weren't here doing this to yourself or your baby. I wish you knew better. That while this is what your doctor recommended, it isn't what is best for you or your baby. I wish you had somehow known that an offer of induction is NOT a gift. It is a curse. It is a ticket to vaginal bypass surgery. But only after 3 days of trying to get your baby born in our timing and on our terms. Of course, you are blessedly grateful for the c-section by that time since you are fully convinced that your body was NEVER going to deliver on it's own.
I don't know. It's just so very sad. I left the labor deck tonight with 5 patients. All but 1 38 weeks, all inductions, all VERY far away (1 cm dilated) from delivery. All thinking that this is what they needed to do for the sake of their baby. I guess that's the 1 positive note to end on. Even though it is very sad that they DON'T have to have a terrible labor and birth experience for the wellbeing of their baby, they are willing to because they believe it is best for their baby. Mother love. Misguided in this case, but very powerful. It is amazing what a woman will do for love of her baby. But oh how tragic that they lay it all on the line and as it turns out, their greatest sacrifice ends up HURTING rather than helping their baby. What a pack of lies straight from the pit of hell modern obstetrics has bought into. And the women who blindly put their trust in obstetricians. Satan must really HATE life and therefore glorious, victorious, supernatural, powerful labor and birth how and when God does it. Of all the natural wonders I've ever seen, birth on God's terms gives Him GLORY GLORY GLORY! A person can't witness it without being blown away and knowing they have just been in the presence of God and seen the hand of God. I am so thankful for that one every now and then that I get to witness. I'm glad I'm a midwife. Even here. Because no matter how hard they try, there will always be the occasional, rogue woman who avoids the meddling long enuogh to have a "breakthrough labor" and I get the joy of just being there to see it and catch the baby. And give God glory.
posted by kirsten | 7:17 PM
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