Archive for October, 2009

This doesn’t have anything to do with narcolepsy…
October 20, 2009

…but it does have to do with my passion for healthy births and my future as a VBAC candidate.  This is crossposted to my xanga, so I apologize for the weird formatting going on.

 

I saw this on The Unnecesarean’s blog, and almost peed my pants.

A woman in Texas said her doctor handed her this “birth plan,” his philosophy on birth.  I got so pissed reading it that I could barely see straight.  WHAT WILL IT TAKE?  (I want to add, for the record, that I had an awesome OB with Noah’s birth, who was a DO and let me do a lot of things most doctors wouldn’t, like labor for FIVE DAYS, or go almost 24 hours with broken water, or stay all night even though he’d been up since two and wasn’t the doctor on call.  And, since I had to get a new OB/GYN for insurance reasons, I also want to point out that my new doc is also hella awesome and highly recommended by ICAN.  I’m not anti-OB by any means!  I’m just anti-FLIPPING RETARDED NON EVIDENCE BASED OBS WITH GOD COMPLEXES. [I’d also like to point out that I’m not on Nyquil right now.  This sass comes straight from a lucid heart.])

 

DR. ________ “BIRTH PLAN”

 

Dear Patient:

As your obstetrician, it is my goal and responsibility to ensure your safety and your baby’s safety during your pregnancy, delivery, and the postpartum period. My practice approach is to use the latest advances in modern obstetrics. There is no doubt that modern obstetrical advances have significantly decreased the incidence of maternal and fetal complications. The following information should clarify my position and is meant to address some commonly asked questions. Please review this information carefully and let me know if you feel uncomfortable in any way with my approach as outlined below.

* Home delivery, underwater delivery, and delivery in a dark room is not allowed.

* I do not accept birth plans. Many birth plans conflict with approved modern obstetrical techniques and guidelines. I follow the guidelines of the American College of Obstetrics and Gynecology which is the organization responsible for setting the standard of care in the United States. Certain organizations, under the guise of “Natural Birth” promote practices that are outdated and unsafe. You should notify me immediately, if you are enrolled in courses that encourage a specific birth plan. Conflicts should be resolved long before we approach your due date. Please note that I do not accept the Bradley Birth Plan. You may ask my office staff for our list of recommended childbirth classes.

* Doulas and labor coaches are allowed and will be treated like other visitors. However, like other visitors, they may be asked to leave if their presence or recommendations hinder my ability to monitor your labor or your baby’s well-being.

* IV access during labor is mandatory. Even though labor usually progresses well, not too infrequently, emergencies arise suddenly, necessitating an emergency c-section. The precious few minutes wasted trying to start an IV in an emergency may be crucial to your and your baby’s well being.

* Continuous monitoring of your baby’s heart rate during the active phase (usually when your cervix is dilated 4cm) is mandatory. This may be done using external belts or if not adequate, by using internal monitors at my discretion. This is the only way I can be sure that your baby is tolerating every contraction. Labor positions that hinder my ability to continuously monitor your baby’s heart rate are not allowed.

* Rupture of membranes may become helpful or necessary during your labor. The decision as whether and when to perform this procedure is made at my discretion.

* Epidural anesthesia is optional and available at all times. The most recent scientific data suggest that epidurals are safe and do not interfere with labor in anyway even if administered very early in labor.

* I perform all vaginal deliveries on a standard labor and delivery bed. Your legs will be positioned in the standard delivery stirrups. This is the most comfortable position for you. It also provides maximum space in your pelvis, minimizing the risk of trauma to you and your baby during delivery.

* Episiotomy is a surgical incision made at the vaginal opening just before the baby’s head is delivered. I routinely perform other standard techniques such as massage and stretching to decrease the need for episiotomies. However, depending on the size of the baby’s head and the degree of flexibility of the vaginal tissue, an episiotomy may become necessary at my discretion to minimize the risk of trauma to you and your baby.

* I will clamp the umbilical cord shortly after I deliver your baby. Delaying this procedure is not beneficial and can potentially be harmful to your baby.

* If your pregnancy is normal, it should not extend much beyond your due date. The rate of maternal and fetal complications increases rapidly after 39 weeks. For this reason, I recommend delivering your baby at around 39-40 weeks of pregnancy. This may happen through spontaneous onset of labor or by inducing labor. Contrary to many outdated beliefs, inducing labor, when done appropriately and at the right time, is safe, and does not increase the amount of pain or the risk of complications or the need for a c-section.

* Compared to the national average, I have a very low c-section rate. However, a c-section may become necessary at any time during labor due to maternal or fetal concerns. The decision as to whether and when to perform this procedure is made at my discretion and it is not negotiable, especially when done for fetal concerns.

 

DON’T YOU WANT TO TEAR YOUR HAIR OUT READING THIS?  These are the things that make me wish I was ballsy enough to have a baby at home…I’m scared of having to fight like The Feminist Breeder did for her VBAC while she WAS IN LABOR she had to fight and fight and fight.  What if my doctor isn’t on call and I get a d-bag like this waving a Pitocin bag in my face?  I’d just like to point out that NONE of these practices result in a healthier mom and baby, just more money and convenience for the doctor.  The United States has the most expensive medical system in the world, yet our outcomes?  We are ranking 28th in the world for maternal mortality and last in developed nations for infant outcomes.  This is the fruit of the above birth philosophies.  More dead moms, more dead babies, not less.  And how many moms are scarred, literally and spiritually?  How can we know the effects of non-physiological birth in the long run?  A new study suggests that c-section births LITERALLY CHANGE YOUR DNA.  A third of our babies are being born this way…it’s not something to take lightly.  (I want to add here that I am extremely grateful for c-sections as a lifesaving tool.  Noah was in transverse arrest and was not coming out any other way.  Dr. Curry saved his life.  But the fact is that my situation is fairly rare and we tried everything we could, even a healthy tincture of time, to get Noah out the normal exit.  Cesareans save lives.  No one doubts that.  They are just overused–31% to the 10 to 15% the WHO recommends.) 

I saw this picture somewhere, and I thought it was such a jarring, sad image, yet so true.  I was so disappointed that I had to surgically birth my son, and my recovery was so painful, physically and emotionally, as it delayed my bonding and breast-feeding.  Yet I heard this sentiment a lot, as if my pain wasn’t valid.

allthatmatters

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