tag:blogger.com,1999:blog-20642800.post880911897674945446..comments2024-03-05T11:36:50.299-05:00Comments on Stand and Deliver: Lamaze/ICEA Conference part 3Rixahttp://www.blogger.com/profile/07908864785513937876noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-20642800.post-42940353197076409572010-10-07T13:28:28.268-04:002010-10-07T13:28:28.268-04:00Are these findings including "natural inducti...Are these findings including "natural inductions", things like membrane sweeps and cohash, AROM, etc? Or are they only appropriate for drug induced inductions? I'm speaking more of babies reaction and the bodies natural chemical response during labor.. Also, do you think that having an actual minute of conception ( like in IVF situations) rather than the guesstimate conception date from a spontaneous pregnancy makes a difference as far as the timing aspect of this research goes?Sabrinahttps://www.blogger.com/profile/00980369680517012936noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-44758342483149509492010-10-07T03:07:37.236-04:002010-10-07T03:07:37.236-04:00Hi Rixa. Speaking of evidence about effects on bre...Hi Rixa. Speaking of evidence about effects on breastfeeding and the interaction with interventions in birth - <br /><br />I recently came across a remark that could be turned into a hypothesis in Maureen Minchin's book 'Breastfeeding Matters'. She came across a dairy farmer who reports that cows given artificial oxytocin have reduced milk yield; and speculates as to whether the same effect happens with human mothers given large doses of synthetic oxytocin. Could explain why so many mothers seem to be struggling to produce 'sufficient milk' in industrialized countries?<br /><br />Do you know if anyone has tested this hypothesis? I've not found any evidence so far but wouldn't be too hard to design a good study.Alice Y.https://www.blogger.com/profile/16267449289432878102noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-50358850992243674822010-10-06T19:59:01.200-04:002010-10-06T19:59:01.200-04:00Thanks for the info. For the record, I did eat and...Thanks for the info. For the record, I did eat and drink a lot before the u/s and NST - I was warned and came prepared. It probably will always nag at me a little bit. My best guess is that he probably needed to come out sooner rather than later (he was pretty cooked, and my second, who was born at 41w4d after A LOT of help to get into labor, was much more robust in utero at 41 weeks), but I wish I could have tried some other stuff before going straight for induction. <br /><br />More than anything, I wish I'd known enough to ask more questions at the time - just so I would really know what happened and why.<br /><br /><i>But gauging from many conversations I had or listened to at the Lamaze conference, it is a rampant practice and frustrates childbirth educators to no end.</i><br /><br />I know. My sister-in-law was induced at 40w2d with her first. Her OB told her on her due date that if she hadn't gone into labor yet, she probably never would go into labor on her own. She also was told "I know you really want a vaginal birth, and the longer you wait, the more your risk of a c-section goes up."<br /><br />She ended up with a c-section 12 hours into the induction.<br /><br /><i>it just goes to show how SO LITTLE a change in the system can result in SUCH A POSITIVE outcome!</i><br /><br />This is what struck me, as well.chingonanoreply@blogger.comtag:blogger.com,1999:blog-20642800.post-57107697368502049732010-10-06T18:07:29.202-04:002010-10-06T18:07:29.202-04:00A couple of thoughts: I understand what the other...A couple of thoughts: I understand what the other commenters have stated, but even that -- it just goes to show how SO LITTLE a change in the system can result in SUCH A POSITIVE outcome! From Anonymous' comments above, it appears that Magee has a long way to go. But, still! "Do not despise the day of small beginnings", eh?<br /><br />Though I had chosen the OB for my 5th on the recommendation of a midwife, as he was friendly to natural birth practices, he was quite adamant that he induce me the day I hit 39 weeks. I refused, and gave birth to a 8 lb 13 oz baby (tied for my smallest) at 40/2 with no complications, save some minor hemorrhage that was stopped by IV pitocin (I had had no pitocin, nor any other meds for the birth). <br /><br />The reasons for his concern were: 1) it was my 5th and risk for hemorrhage in general increase after a woman's 4th child. 2) I had *HORRID* venous problems, including extensive, large, painful vulvar and vaginal varicosities. 3) Historically, I give birth to large babies (8-13 to 10 lbs even). He was concerned that even "mild" macrosomia would lead to a major hemorrhage... so he framed it in the sense that he was putting my life ahead of the baby's. <br /><br />I knew enough to not be swayed, but I could *easily* see how someone, especially a primip, could be easily talked into an elective induction.<br /><br />I had to go in for several NSTs and u/s (I guess I could have refused those, too!) to put him at ease, and I just made sure that I ate food beforehand (so the baby would be active), and drank a LOT of water in the few hours leading up to it, so that my fluid wouldn't be low. <br /><br />(Once I was in labor, he was very favorable to natural birth practices, and the "worst" he suggested -- which I refused -- was breaking my water, after I was "stuck" at 8 cm for 5+ hours. He was very patient, much more so than the nurses assigned to me.)Karen Joyhttps://www.blogger.com/profile/02850358574732662426noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-25419813573276715692010-10-06T17:25:03.334-04:002010-10-06T17:25:03.334-04:00Re: comments about Magee hospital, we're only ...Re: comments about Magee hospital, we're only talking about the effort to eliminate elective deliveries before 39 weeks. Not about any other evidence-based or non-evidence based practice. Not about elective induction or cesarean starting at 39 weeks.Rixahttps://www.blogger.com/profile/07908864785513937876noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-67445356570389652892010-10-06T17:24:00.972-04:002010-10-06T17:24:00.972-04:00"Low fluid", being "overdue," ..."Low fluid", being "overdue," often the day you hit 40 weeks, and having "big baby" are all reasons given for induction that are, for the most part, not medically indicated. (Now there is some debate once a woman is truly post-dates as to the real incidence of increased stillbirth rates, and at which point should induction be recommended or offered--41 weeks? 42 weeks? etc...) But a lot of women are induced for these three reasons that sound like medical indications, but are not supported by evidence. I don't know why some physicians push induction so strongly at 39 or 40 weeks. But gauging from many conversations I had or listened to at the Lamaze conference, it is a rampant practice and frustrates childbirth educators to no end. <br /><br />Back to low fluid: if there are no other risk factors present, low fluid isn't associated with adverse outcomes. Read more here:<br />http://www.jfponline.com/pages.asp?aid=1847&UID=<br />Fluid levels also vary depending on maternal hydration--they're not fixed in stone. <br /><br />ACOG is very clear that elective induction/cesarean for a suspected big baby in a non-diabetic mother is not recommended. <br /><br />More later, but it's time to eat dinner...Rixahttps://www.blogger.com/profile/07908864785513937876noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-10307580655693694902010-10-06T16:58:01.994-04:002010-10-06T16:58:01.994-04:00A few questions:
What is it with these docs? Why...A few questions: <br /><br />What is it with these docs? Why are they so keen to induce at 39 weeks? Or even at term? I get the issues that come after 41 weeks (though, as someone who has carried quite long with both of my pregnancies, I wish they were a little less trigger happy), but why are they so hot to trot before the due date has even come and gone? <br /><br /><i>...for less-than valid reasons. Low fluid and fetal macrosomia are the most common.</i><br /><br />What's the deal with low fluid? Is that not legit? I was induced at 41w2d with my first for low fluid and a non-reactive NST. (I'd also noted a pretty big drop-off in fetal movement, though he'd actually picked up again on the day I had the bad NST.) So is low fluid not a legitimate sign of pending problems? Or is the problem using it in isolation instead of in conjunction with other symptoms or recommending induction for fluid that is borderline and stuff like that?chingonanoreply@blogger.comtag:blogger.com,1999:blog-20642800.post-57553590679170663792010-10-06T13:41:37.636-04:002010-10-06T13:41:37.636-04:00I was also surprised to see Magee (Pittsburgh) lis...I was also surprised to see Magee (Pittsburgh) listed in a positive light. I don't doubt that they have instituted this change (with good results), but I found them to be less than committed to evidence based practices. When I toured, I was informed that continuous fetal monitoring was the norm, but I could request that it not be used, and that I should remind the nurses to practice kangaroo care because some will "forget."Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20642800.post-28673084505538325672010-10-06T11:38:48.696-04:002010-10-06T11:38:48.696-04:00As always- Thank you, Rixa, for keeping me informe...As always- Thank you, Rixa, for keeping me informed!<br />natalieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-20642800.post-37562423947946300952010-10-06T09:49:02.193-04:002010-10-06T09:49:02.193-04:00Never mind! I see Penny was your midwife for Dio? ...Never mind! I see Penny was your midwife for Dio? Not so weird anymore : )Emilyhttps://www.blogger.com/profile/17738480873379373228noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-815057791713772942010-10-06T09:41:21.315-04:002010-10-06T09:41:21.315-04:00I was looking for a home birth midwife in Indiana....I was looking for a home birth midwife in Indiana. I was surprised to see a picture from Dio's birth on the website! I assume they asked your permission to use the pic. If not, here's the link:<br /><br />http://www.believemidwiferyservices.com/practice_statistics<br /><br />Just thought it was interesting since the place is in Indiana. I assume you know them?Emilyhttps://www.blogger.com/profile/17738480873379373228noreply@blogger.comtag:blogger.com,1999:blog-20642800.post-56751600700116801652010-10-06T08:05:48.154-04:002010-10-06T08:05:48.154-04:00As a doula in Pittsburgh, I am really shocked to h...As a doula in Pittsburgh, I am really shocked to hear those numbers from Magee. It seems like me. and my colleagues are constantly helping clients to negotiate their ways out of inductions at 39 weeks for less-than valid reasons. Low fluid and fetal macrosomia are the most common. Then when the mothers are unable to progress past 5-6cm the are given a cesarean.<br /><br />On the ground here, I strongly question anyone who sets Magee up as a model. They are filled with practices that ignore evidence and interfere with the morherbaby.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-20642800.post-34891411427912598932010-10-05T20:01:41.713-04:002010-10-05T20:01:41.713-04:00That video looks great! I hope you do get to see ...That video looks great! I hope you do get to see the whole DVD. I'm curious about what circumstances they define as times when separation is necessary for the baby. Both of my babies have been taken to warmers for things like suctioning/oxygen, which could have been done on my chest if the hospitals were set up for it. (Though whether the suctioning was necessary at all is debatable)Brittanyhttps://www.blogger.com/profile/00621569580858604541noreply@blogger.com