Just finished my OB/GYN rotation here in Upstate NY, and I don't think...

[NNguyenMD]

that defensive medicine is the reason of a higher incidence of C-Sections. Sure there are doctors who would do it to cover their asses, but after learning more about the indications for C-section its pretty apparent to me that it definitely is more of a safety issue than legal.

I assisted in 8 sections in the two weeks I worked on the labor and delivery ward and the indication for each one was either the baby had failed to decend at the appropiate stage of labor, or because the mother with history of previous c-section elected to do a repeat section to reduce rist of uterine rupture.

I also learned that sections can be done very safely now, granted its not a "haircut" procedure, and can be very costly to ohealthcare, it can be done as safe as any other surgical procedure.

The alternatives maneuvers that are availiable in lieu of c-section are also pretty crude, I can understand why doctors would rather section versus using drastic delivery techniques such as breakign the clavicle or applying suprapubic pressure. Anyways though, I thought you guys would be interseted in hearing about my experience.

[nothingshocksmeanymore]

1. My ex is an obgyn

She's been practicing for about ten years and often avoided C-sections to her own detriment as there is SO much that can go wrong with delivery and the doc is on the hook until the child reaches the age of 7

Congrats on the completion of your rotation, btw

[knitter4democracy]

20. Depends on the state.

In our state, the doc's on the hook until the child is 21. Personally, I think that's ridiculous.

[crispini]

2. What are your thoughts

on women having labor induced? It seems to me that every other pregnant woman I hear about is telling me, "If I don't deliver by X date, we're going to go in and have it induced." That doesn't seem very natural to me.....

[MockSwede]

22. oxytocin

give 'em oxytocin to induce labor because it's supposed to happen like clockwork and by the book and when it doesn't - it's c-section time or else. but then, again, it's alway the Ob/Gyn's 'fault' that the baby isn't perfect at birth and must pay for any defects....

Too many expectations and not enough reality. Hard situation.

[prayin4rain]

50. Oxytocin is linked to post partum depression

I think inducing is fine but the mother and husband should know that oxytocin is linked to PPD so they can keep an eye out.

[Carni]

87. Damn wish I'd known that 9 years ago-I had oxytocin

And had one whopping case of post partum depression.

It was the worst time period of my life and in retrospect I think I was half insane.

[NNguyenMD]

24. After a certain period of time, say 42 weeks its time to deliver because

the communication between mom and baby starts to slow and that eventually leads to poor blood delivery to the baby. WHy would mom's induce? I've heard some pretty weird reasons myself, my favorite was because the husband was leaving down for a month by the end of the week and he wanted to be there for the delivery. Once you hit 38 weeks, they'll induce you for jsut abotu anythign you ask for.

[Ilsa]

51. I keep hearing from moms that they are induced by their due dates.

And that is for the first baby, no allowances made. I rarely hear of pregnancies going to 41 or 42 weeks.

One thing about the c-section, though: it is a DAMN BITCH to recover from, having had two myself, neither "for convenience". Lactogenesis is usually delayed also, placing baby at risk for having to be fed artificial milk, thereby messing with lactogenesis again (positive feedback cycle get gets interrupted).

I saw a patient when I was a student whose nurse had just told her she was progressing fine. The doc came in fifteen minutes later and said she wasn't and did the CS. The new mom was devastated. BTW, it was around 5pm on a Thursday. I saw the mom the next day, and she was a total mess.


I wanted to mention: Congrats on finishing this rotation and learning so much about new moms!

[ultraist]

3. That's is an interesting observation

I had a C-Section, but not until after 20 hours of contractions (which had been induced with pytocin, after my water broke) and no dilation.

I'm not so sure they should have waited that long, but the nurses said, they wait longer, in many cases.

Why do they often wait until the baby shows signs of distress before doing the C-Section?

[NNguyenMD]

7. Depends on what stage of labor you were stuck in, and which # baby it was

Stage One labor is defined as anything <4cm dilation, its also often the stage that takes the longest to get through. There is no average to how fast you're suppose to progrgess though it, everyone is differnt. After you break the 4cm mark, you're officially in Stage two aka Active labor. At this point you shoudlbe dilating at 1.2cm/hr if its your first, and 1.5cm/hr if its your second of greater.

When that takes too long, they push the pytocin and insert servidol or meso to get your uterus going. If there's still little or no progress, then the doc comes in to talk about sectioning. Thats basically how things went in my experience, but generally thats how its suppose to work out.

Maybe you just took awhile in stage one, even though I think they shoudl have given you the Meso or Servidol to ripen your cervix. If you had an epidural, it might have dulled the quality of your contractions and possibly slowed progression, but there is no clinical evidence that can generalize epidurals slowing down labor, even though every single OB you meet will tell you that. Hope that was helpful.

[Clark2008]

15. I'm 5'1" and weighed 120 pounds before I got pregnant

My son was 10 pounds 2 ounces and 23-inches long. He was stuck in stage 2 for hours. In total, after that pill they gave me to loosen my cervix (12 hours) and the pitocin (16 hours), he still wasn't coming out of my tiny hips that did not rotate back.

He should have been a C-Section from the get-go, in my opinion, because they KNEW he was at least 9 pounds and probably bigger. I simply couldn't get that out, his being my first.

I love my doctor, don't get me wrong, but sometimes I think they should listen to the patient a little more. I knew Ramzey wasn't coming out - and so did my nurse.

[Clark2008]

16. PS - I was also a week past due.

I knew exactly when I got pregnant - down to feeling the flutter the next morning (yes, please call me the Princess and the Pea) - and so I also knew when his gestation would be complete, by the textbook.

[ultraist]

19. Stage one did take a loooong time...

After a few hours of stage two and no progress, I was given an epidural. I don't think they gave me Meso or Servidol, maybe my husband remembers, that entire 24 hours is a bit foggy.

Although, I do remember joking with the doctors as they were making the incision. They cut my daughter's ear, slightly (well, the intern did), but it was just a minor surface cut. Certainly not something I was concerned about considering they likely saved my daughter's and my life.

See, what happens when you get women talking about their child birthing experiences? ;)

Thanks for the info!

[NNguyenMD]

26. haha well thanks for sharing your experience with me. FYI I never before

understood the pain women go through in labor until I was witnessing them day after day, its an incredibly brave thing you put yourselves do. I'm pretty amazed at moms now.

[JDPriestly]

37. From a political point of view, you should read the

beautiful paragraph that O'Connor wrote in Casey v. Planned Parenthood on women and childbirth. You can find it at www.Findlaw.com, U.S. Supreme Court decisions.

[annabanana]

65. It's hard work..

that's why they call it "labor"
(mother of 2, with 1 C-section)
:hi:

[FlaGranny]

76. Ha, when the head is crowning

you feel like a thousand scalpels are ripping you apart.

[SoCalDem]

4. I had 3 sections in 5 years and I was happy to have them

Abruption on #1 & #3...textbook pregnancy on #2.

Forceps and suction seem more severe than a clean & safe section ..to me at least:)

[Mayberry Machiavelli]

5. You will find, though, as you go through your career, if you stay involved

with labor/OB medicine, that the "failure to progress/descend" is very subjective in the sense that OB's willingness to wait and see varies widely depending on the patient, the situation, and their own biases. And that is far and away the leading indication for C-sections aside from previous C-section.

It's too much to generalize that basically all C-section indications are legit, or that they are mostly not... depending on where you work, and who you work with, the truth is usually somewhere in between...

[HockeyMom]

6. My first child was breech

27 years ago this February. She was 8 lbs and 1 oz. The hospital staff thought she should be a section, but my "old school" doctor said no and proceeded to show the entire OB staff, including the anesthesiologist (mild epidural and I could still push) what to do. I must have had about 10 people witnessing her birth. They all applauded when she was delivered.

[NNguyenMD]

11. Older OB/Gyns are better trained in the labor techniques before secionts

were as common as they are today. Younger doctors are poorly trained in manuveurs considered to be abandoned, but there are some who make it a point ot master them. You are fortunate to have such a good doctor perform deliver your child in a breech position.

[Coexist]

63. My sister was feet-first...

my mom's first - and c-sections were almost unheard of. They spent a long time maneuvering - but she came out fine!

[wysi]

8. The stats I've seen...

... indicate C-sections are safer for both babies and mum. Both of our girls arrived via c-section, the first elective (an IVF baby and we weren't taking any chances), the second emergency after 20 hours labor. I'm glad my wife wasn't opposed to medical intervention.

[Carni]

88. I was in labor for about 24 hours

They could have cut my head off and it would have been an improvement over what I went through. I was basically BEGGING for a c-section but for some unknown reason things didn't go that way.

I was in a rollover accident about three years ago and it was far more pleasant than the delivery of my daughter.

Did I mention that I just have the one child? :(

[Mayberry Machiavelli]

9. Are you a student or intern in the SUNY system?

[NNguyenMD]

14. 3rd year Student at SUNY Upstate, I'm on my Internal Med rotation now

[knitter4democracy]

18. Yay internal medicine!

That's what my hubby's in, and he loves it. :D

Btw, please consider doing a community-based residency. You wouldn't believe how much you learn when there aren't fellows around. My husband helped in dozens of codes and led almost thirty himself as a resident. The attendings here love the extra help and teach the residents more than they often get in academic settings.

[NNguyenMD]

23. no I agree, internal has been great I really like it a lot.

I'm still bouncing around where I want to go for residencies, but i start in a community based setting come December and I'll defintely keep your advice in mind.

[knitter4democracy]

59. Kalamazoo is a great place! ;-)

My husband was told to go community by my OB (he'd started in medicine and switched to OB after his chief year of all things and had done residencies in a community-based program and an academic program), and he's been very happy.

The program that David was in in Kalamazoo is very family-friendly (most residents are married with kids) and very good. If you want to learn more, there's no one standing in your way. David was very well-prepared for the practice he's in now and then some.

[wildeyed]

10. My understanding is that the higher c-section rate has

more to do with the over use of pitocin and epidurals. Deliveries that are induced or have an epidural very early in the labor process are more likely to stall and need intervention than a labor that is allowed to proceed naturally. At least that is what I read.

I do have friends who labored without intervention for long periods, and then the baby just slid out after the epidural, too. :shrug:

[NNguyenMD]

17. There are a lot of docotrs who agree with you on that, actually nearly all

the OB's I worked with were at the consensus that you shoudl expect anomalies anytime you fiddle with labor. But apparently there has been no publication or study that can prove a significant slow down in labor with epidurals.

[wildeyed]

21. That was true with my labors.

I had one with an epidural (although I was very far along when I had it) and one without. They were about the same length.

My impression was that if you got the epidural early, you were more likely to have complications because you can't move around, shift the baby to a better position, etc. Kind of made intuitive sense to me. The pain of labor evolved for a reason; to tell you what the optimal position for labor and delivery will be.

My OB was very supportive of my pain med choices. But neither of the nurses I had were. They wanted me to get the epidural, shut up and lie down. If I had a third child, I would seriously consider home birth just to avoid the pissy nurses.

[SoCalDem]

30. My friend's 10 yr old son delivered his new sister

on the kitchen floor (new white carpet throughout the house),,He used kitchen shears to cut the cord.. his shoelaces soaked in bleach and rinsed to tie the cord..a clothes basket lined with a clean rug to put the baby in.. after the placenta passed, Mom cleaned herself up and drove them ALL to the hospital.. The hospital made him wait downstairs because he was "not old enough" to go to the maternity floor..


She called her sister from the hospital to come and get her son..

This was Kansas ..late 70's.. an ice storm with 20" snowfall..phone lines and electricity came down in the storm.. no cell phones..Dad was out of town, and Gail (the baby sister) decided to arrive at about 3 am...

The house they lived in was the ONLY occupied one on the block..

Talk about modern day pioneer woman.:)

[wildeyed]

33. Kudos to her son!

That is one way to have a home birth!

[Coexist]

64. one thing about labor pain that I never understood re: fundie women:

the bible, it taken literally, says that labor pain is the result of Eve's apple bit.

Shouldn't they refuse any and all interventions?

[wildeyed]

79. Some of them do.

Home birth is one of the areas where the left reaches around to meet the far right. Some of the doulas in my area advertise themselves as being "bible centered", whatever that means. I guess they read bible passages to you while you are in labor or something. :shrug:

[GreenPartyVoter]

12. My OB joked that my first kid gave me an internal C-section

His little elbow unzipped me from top to bottom and front to back in the birth canal. Took almost two hours to zip me back up.

So there was some question that I might not have been able to deilver vaginally on the second one but I did just fine. The scar tissue held with nary a problem. :)

[knitter4democracy]

13. It's still surgery.

Surgery has many risks, no matter how much we try to whitewash them or wish them away. Yes, c-sections are safe as far as surgery goes, but they are not safer than a normal vaginal birth.

Studies seem to show that any intervention, even just putting in the IV, slows down labor and increases the risk of a c-section. Of course, the IV is put in so that, if the mother crashes later, they don't have to worry about trying to find a vein, but it is still an intervention for a worst-case scenario.

I gave birth naturally twice. My first was in a hospital with an OB, and I had a second degree tear and lost a good bit of blood. The IV did slow things down a bit, but my contractions got going again just fine after awhile. My OB hadn't done a natural birth in over a year, and my nurse literally couldn't remember her last one, so it was no suprise that they put me in a bad position and didn't know a natural birth's timing. Also annoying was the nurse telling me over and over how to push--trust me, if there are no drugs covering it up, the mom knows how to push.

My second was in a hospital's birthing center with a midwife. My son was two pounds heavier and only one inch longer than my daughter, but I only had one stitch. My midwife kept me in the labor tub as long as she could and then got me on all fours on the bed, knowing it would make an easier birth for me. She also constantly manipulated my son as soon as she could get a grip on his head to help me push him out easier. There was no IV, no yelling (well, I do believe in scream therapy for the mama and did scream quite a bit during pushes), and very focused bright lights. I lost so little blood that I went home less than twelve hours later by choice. I felt great afterwards--much less sore and weak than with my first.

C-Sections happen when people think they're in control of the birth or try to control it somehow. There are many much-needed c-sections every year, don't get me wrong, but there are also many that were caused by the decisions everyone made along the way.

[MrsMatt]

32. I gave birth 12 weeks ago

and your statement " if there are no drugs covering it up, the mom knows how to push." was NOT true for me.

First pregancy was induced, and I had an intrathecal shot of morphine (not an epidural - just took the edge off the pain) - when it came time to push, I had no urge. Pushed for two hours, and rather inefficiently. It was all force of will.

This pregnancy - progressed normally, no pain meds (as I figured that the morphine had interferred with my pushing), and when it came time to push, I AGAIN had no urge. Pushed for 1 1/2 hours (rather long for a second prenancy). That kind of sucked.

Both labors were about the same length (contraction wise, that is) - 9 hours start to finish.

But, I agree - no pain meds was much better in the end as I was much more alert and recovery was much quicker.

[wildeyed]

34. My nurse wouldn't let me push!

She couldn't tell if I was fully dilated. I practically had to stand on my head to avoid pushing when the urge came. Finally she got the doctor and he said ok, push. He left to go back to the break room. Of course the baby came out in two pushes, so the clueless nurse got to catch the baby, too!

Here is one thing I noticed about no pain meds vs. pain meds. My milk came in much more easily and the baby was more alert after the birth without meds. I thought it might be because it was a second baby, but my neighbor just had her second with tons of intervention, and it took forever for her milk to come in.

on edit: Congratulations on your new baby!

[MrsMatt]

44. Agree - my son was much more alert

than my daughter had been. The added bonus was we were able to avoid the jaundice my daughter experienced because she was too sleepy to eat.

However, my milk didn't come in until over a day after my son's appetite woke, so I've been struggling with production issues since.

Thanks for the congrats - he's a beautiful, healthy and smiley baby! And I'm not biased. . .

[knitter4democracy]

58. The second can make milk come in faster.

I was still nursing my daughter, so my milk was still in and gushing fountains. :blush: My son took full advantage of that and then some.

I think it's just one of those things. Each baby is different and each delivery is different. Each one of mine nursed very differently, to the point I was running in to the lactation consultant in fear that my son (whose suck was weaker) wasn't getting enough milk. He was fine and still is. :)

[wildeyed]

80. I never gushed fountains.

Wish that I did. Would have made pumping *much* easier. My body never made one single drop more milk than the baby could consume at one session. My body was very efficient in that way........

[knitter4democracy]

84. I couldn't pump much, though.

I could hit a target across the room if he pulled off too soon, but my son ate so much so frequently that I just couldn't pump much more than an ounce at a time. Waste of time, I thought, so I quit.

I was always worried that I didn't have enough milk until I realized that my son was gaining quite a bit every day. My daughter did the same--grew quite quickly at first and then slowed down, making the doctors nervous. After talking to my MIL and finding out that my hubby didn't even double his birth weight by his first birthday (now he's 6'2" and 240lbs), I stopped worrying permanently. Apparently, it is just how his family is--small for their age until middle school when they all shoot up.

[knitter4democracy]

57. Wow.

It was all I could do not to push and finally gave up and pushed anyway. My mom told the nurse, since the OB had gotten stuck in traffic and was late, that she could deliver the baby in a pinch, and the nurse agreed. I wasn't going to wait and hold everything back when my whole body was screaming to push. Of course, that also is why she came flying out . . . :)

I had nurses coming in to see both of mine with no pain meds like it was a museum exhibit or something. Did that happen to you, too?

That's a long time to push. I'll bet you were tired. I hope you had lots of support once you got home to help with everything and let you rest when you need to.

It's an amazing experience, that's for sure, and everyone's is different.

[MrsMatt]

61. I was very envious of those women

who would push for only minutes and voila - baby is here!

The hospital I gave birth at also services quite a number of Somali and Hmong immigrants, who typically don't use pain meds so I wasn't much of a curiosity.

The only unexpected "visitor" I had was a Hmong woman who just walked right in the middle of everything. It took a minute to figure out why she was there because she didn't speak English, but it seems that her daughter had given birth in my delivery room earlier, but had been moved to another room. We all had a good laugh over that (of course, I could only laugh between contractions)!

[knitter4democracy]

67. Yeah, me too.

I had to push for an hour for my daughter and just over half an hour for my son (midwife really helped on that, as he didn't come flying out and took several pushes after his head was out just to get his body out).

I got two extra nurses during my daughter's birth because I screamed so loudly. Apparently, that's more unusual these days. I really believe in scream therapy. ;) You should've seen the look my nurse gave the one who didn't want to leave right away. Talk about the hairy eyeball--I still remember it.

Do you find that you have time missing in your memories of labor and birth? I sure do. It took hours all told, but I don't remember that much time. I also remember people popping in and out but have found out they left for a long time or were there longer than I remember. It's really odd how my brain mostly shut down during labor and delivery.

[MrsMatt]

78. I labored at home for the first 5 hours

and I remember that very clearly - I think where it starts to get fuzzy is when they broke my waters about two hours after I got the to hospital (I was 9 cm dilated) because "it will get things moving along pretty fast". It got much more painful after that, so I suppose that's why I don't remember so much.

It's funny, but I never had any desire to scream until they put me into a labor position that I really really hated (I discovered that I do NOT like to labor on my hands & knees). The nurse told me I was very controlled throughout (especially transition) - aside from some strong grunting and a couple exclamations of "Man that hurts!) I didn't expend much energy vocalizing. I was too busy concentrating on trying to remember how to push!

[knitter4democracy]

83. I hate the birthing bed.

That position was just awful. Hands and knees worked well for the second one and was what I wanted to do during the first one but couldn't get across (lost the ability to speak somehow for a few hours). I remember hating the counting, though, and so made my midwife promise not to count at me the second time around.

They had to break my waters both times at ten cm and a baby ready to come out. I think they broke them a bit early for my daughter, but I'm not too sure. It sure does up the pain level quickly, though.

[SmokingJacket]

25. I had two, reluctantly at the time.

My first kid was large and turned to a transverse (cross-wise, facing up) lie during early labor (if not earlier). When my water broke with him in this untenable position, it was an emergency situation and an immediate c-section with a tee-shaped incision. I had wanted a natural birth! :( But wow, I was happy we made it through okay.

Because of the unusual internal incision with the first birth, my doctors refused to do a VBAC for the second. I was bummed about this... but in retrospect I'm very glad they didn't take any chances at all. Two healthy beautiful babies. One lucky woman.

I would like to think that doctors always take the safer option. Thanks for your hard work!!

[NNguyenMD]

27. thats very sweet of your to say, and I'm glad your births worked out so

well for you

[wellstone_democrat]

28. Failure to have a C-section *cost* me in the long term--badly

I had a "frank breech" (I believe that's what it is/was called) 22 years ago next week---little darlin' came out (all 8 pds 4 ozs of him) *behind* first. The OB resident wanted to try "the natural way" and we did! I thought that this was the ONLY way to go because I had read, and read, and read on the *evils* of the c-section.

I was torn straight up through the cervix and lucky I lived. By the time he was done *he* was crying and another resident took over the stitching. All I got was a local during the stitching (so I could "help"!) which didn't last nearly long enough!

Years later another gyn doc said that I had "scar tissue in the cervix/uterus that she'd seen only in central American immigrants before" upshot was that I was never allowed by anyone I consulted to have another pregnancy. The fear was that the uterus could rupture.

My one rule? You probably don't want to go into labor and have your husband *panic* and take you to Cook County Hospital---well, unless you have an attending do the delivery. ***and before the entire staff of CC shows up to flame away---read this again, think of what they likely DIDN"T tell me after this mess, and consider that I didn't sue. I just got away from there (against medical advice) as soon as I could walk.************

C-sections sometimes not only save a baby or a mother, they save the ability to have more children.

[JDPriestly]

38. Mine ruptured.

I was in one of the best maternity hospitals in the world. The doctors surrounded my bed when I woke up after the C-section and advised me that it was a miracle that I and my baby had survived. I was in pain nearly all the time during the first and final months of the pregnancy. I didn't heal properly because I became pregnant too soon after my first C-section. Both my babies were absolutely delightful, and I'm so happy I have them. See my post below.

[peacebird]

29. bless my doc -Sam never let his ladies have "dry birth"

as he put it - so once the water broke you knew the baby WOULD be born...
fortunately my son was cooperative and arrived after just under an hour of back labor, about 20 minutes after my water broke!

i cannot fathom how other women can deal with long labor - for me it was watching the clock! Breathe for 15 seconds spend 45 seconds of agony and then get to breathe for 15 seconds... thank goodness it was only an hour!

[annabanana]

66. AN HOUR!

jeez louise!

[patdem]

31. ALL I know about labor is that with my first child..I HATED my husband

while in labor. The second child was like shopping for clothes...a pain but not horrible! (I hate shopping for clothes, by the way)

And I mean I HATED HIM!...If they gave me a gun during labor,(of my first child) I would have shot him dead and giggled my way through the REST of my labor!...TRUST ME!

[TNDemo]

35. I *loved* my section.

Wish I had had three instead of all the damage I had from the first two. Was actually on the table for a section with the second one when the baby started coming, the anesthesiologist hadn't shown up and he got out the hard way (ICU trip for me). The last one was planned and it was a day at the beach in comparison. No labor, no peeing and pooping through incisions (and yes, I was doing that after my 4th degree episiotomy that broke open) and people bringing me my meals and cleaning up my room and taking care of my baby. It was definitely the way to go.

[JDPriestly]

36. I thank the Creator of nature, my beloved, dear significant other

and two competent surgeons for my two wonderful, perfect (almost) grown children. My second C-section did not heal. I nearly died in my second pregnancy, and was told I could not have more children. But, two is really enough, especially when they are as adored and appreciated as ours are. C-sections should be done when necessary. And society should not look askance at women who have them or doctors who perform them.

[wellstone_democrat]

39. I gave my "amen" to that above! in every way

I'm lucky to be alive and to have enjoyed seeing the best boy in the world become the best man in the world. I wish he wasn't an "only" child but if one has to have only one child---this is the one you would want to have!

[JDPriestly]

49. I understand what you mean. My experience exactly.

Maybe our children are so wonderful because they were spared the birth trauma. I'm not saying other children aren't just as wonderful, but I found mine to be particularly easy to raise.

[Stuckinthebush]

40. My wife had three

First...cord wrapped around my daughters neck restricting her oxygen flow.

Second...breach

Third...two prior, risky to try vaginal delivery.


They were hell to recover from, but we both thank the fates that C-sections were available and done quickly and expertly.

[Arugula Latte]

42. Wow!

Scary stuff.

I had long labors w/ both of mine. My first was sunny-side-up, and, thanks to a 4th degree episiotomy and a vacuum suction, he came out after 24 hours of labor. I was close to a c-section, though.

[Stuckinthebush]

48. 24 hours!!!!

Oh, wow! You are a machine!

I'm very anti blood and guts, so it was tough for me to be in the operating room with the c-sections going on. I had steeled myself for the regular vaginal birth, but I had not planned on the c-section! Of course, my wife was the one actually going through with it, so I didn't have any grounds to complain!

But it was cool to be there. On the third, the spinal block didn't work for her, so they had to knock her out. I couldn't be in the operating room since she was knocked out, so it was like a 1950's birth. They came in and handed me a baby.

[leesa]

41. But did you practice your love with those women as Bush insisted?

[knitter4democracy]

68. *Snort*

My hubby and I still laugh at that stupid quote. He teases the OBs every chance he gets with that (and of course, they call him a flea, the standard put-down for an internist).

[mainer]

43. Glad you're sticking up for M.D.'s. DUers often sneer at them.

and I'm tired of docs being characterized as money-crazed slaves for the pharmaceutical industry.
s
Doctors really do try to do the best job they can. Few doctors get sued for doing a C-section, but a whole lot of them have been sued for NOT doing one.

[knitter4democracy]

69. Thank you!

My hubby's a doctor, and I get tired of that anti-doc attitude around here, too. Not all docs are Republicans (many we know aren't), not all docs are money-grubbing Pharma fanatics, and not all docs are lazy good-for-nothings who don't know which end of a speculum is up. There are many good doctors out there working their tails off trying the best they can for each and every patient.

[samplegirl]

45. What i am still amazed at

is how little time OBGYNs spend time being educated
on Menopause. I havent found a one who seems to know
much about it especially males.
Its a major issue that women face and need good OBGYN
care during this phase as well.
Seems the only alternative they know is conventinal
HRT inspite of the warnings of cancer.

[knitter4democracy]

71. Really? Odd.

The ones I've seen here are pretty good, but the best ones are the older women MDs or DOs. Maybe it's because they research for themselves or family members?

OBs spend five years in residency, much of that in surgery (both Obstetrics and gyn surgery), and many go on for further fellowships, too. I wonder how they get trained for menopausal issues and where it comes in the training.

[NNadir]

46. My wife had a botched C-section.

They cut her bladder.

It took her a long time to recover. She was weak from the loss of blood. It sucked. I was so scared that I would lose my love.

My mother had a very long labor with me, over two days. I lived and she lived.

We had a planned C-section for our second, because of the risks associated with the first section, a rupture of the scars. We were terrified, even with a different doctor, but it went like a piece of cake. Even with the second case, overall I have to say I'm not a big fan of C-sections.

[cynatnite]

47. My second delivery was by c-section...third was vaginal...

I had a very smart doctor with the third one. He saw no medical reason to do another c-section. My first one was a vaginal delivery so that could explain it. I was still capable of a vaginal delivery.

It always seemed to me that doctors opted for c-section because of the risks of lawsuits...especially those who had previous ones.

The one thing I will say is this. Problems with vaginal deliveries after a previous c-section are rare from what I've read, but ask a mom-to-be and chances are they'll go with the safest option in order to ensure their baby enters the world healthy.

[OmmmSweetOmmm]

54. My second son was a v-back (vaginal delivery after a c-section).

When I discovered I was pregnant with him, my doctor asked when I wanted to schedule the c-section. I told him I didn't.

My first son's birth by c-section was necessary, and thank goodness for technology. I suffered placenta previa (the placenta covered the birth canal) and if I went into labor we both might have died. So I told my oby that I wanted to go natural the second time, and we could monitor my situation closely to make sure it would be safe.

Having painful periods for years actually prepared me for the labor which for most of the 12 hours was quite livable. I stood up for most of it, which helped. By the time I was asking for anything to ease the pain, the nurse laid me down and saw my son's head was crowning and he was also in distress, the cord was around his neck. I was rushed into the delivery room (where I started to crack jokes..I do that under duress). He was out in 3 pushes. There was a complication. I delivered him so quickly in the third stage, there was fluid still in his lungs, and they had to siphon him to clear his lungs. Then he took his first hearty cry. A minute or so means a lot, and he has borderline CP. He was muscularly behind by about a year from his peers. As he's gotten older, he's 15 now, he's all caught up.

Due to my choice, and what the result was, I would have gone c-section again considering what my son has gone through.

[cynatnite]

55. I had plancenta previa with my second, too...

When I had my third, from the start to the end was less than four hours. I was progressing too fast for any real medication to do any good. The pain was all in my back and felt like it was splitting me in half. I got one shot to take the edge off.

The rest of it, I had to just go through it. I honestly could feel him moving through the birth canal and while it did hurt, it was also a sensation unlike anything and I've never forgotten it.

He hadn't dropped so the pushing took a little longer than my first one. That one was three pushes, but this little guy was stubborn and took his time. The cord was wrapped around his neck, too, and they had him under oxygen for a while as well. There were no effects from any of this.

I think when it comes to birth after a previous c-section it should be left to the mother and the doctor to decide. Both would more than likely have a better idea of how best to proceed.

[spotbird]

52. The trajectory of my life was changed

because my treating physicians chose to risk a vaginal birth for their own reasons. If the mom agrees and there is reason, just do the surgery. The lunatics treating me opted for induction despite a small abruption, hypertension and evidence of fetal growth retardation.

My husband held our newborn son as a nurse who couldn't find my blood pressure told the doctor I was dead. The following nightmare of surgeries, life support, the impossible number of transfusions, consequent the lock box infertility left me wishing someone had just not acted bravely to save me the pain and expense of a surgical delivery.

[knitter4democracy]

72. I'm so sorry.

That's horrible. Why on earth would they take that kind of risk? I don't know any doc who'd think they could get away with a vaginal birth with those kind of complications. How awful!

[all.of.me]

53. ah....... birth stories!

my first was a c-section. i started at the birthing center with the midwives for the first 12 hours or so. i hadn't proceeded enough, so they shipped me off to the hospital (1/2 block away) to a doctor i had not even met! i hated him immediately. i did not like his energy.

the baby was posterior, and i was not dilating quickly enough. they administered pitocin, and that worked for a little while. i was hooked up to machines and drips and all kinds of stuff. it was late may. i just wanted to be outside walking around.

finally i was allowed to push, and i could have delivered vaginally IF IF IF he had let me squat. that was so comfortable for me, but he made me lay on my back. no progress. now it was about 10 p.m., and the doctor made my friends and family leave the room. it was him and me. he sat in an arm chair at the end of the bed and TAPPED HIS FINGERS WITH IMPATIENCE! i am not making this up.

he finally ordered a c-section about 10:30 or 10:45. i asked to push a little longer (this was much harder to do with no support around me), and he said, no, his staff was going home at 11, and it made no sense to call them back in at 1 a.m. if need be. it was necessary to do a c-section NOW. then he threatened me with tongs and permanent marks on the babies head. i caved. we all cried.

i was not asked if i wanted general anesthesia or not, which i got, scared to death i'd never come out of it. i was not asked what kind of incision i wanted, which ended up going from my belly button to my pubic bone. my arms were strapped to a table, and i was being invaded. it was horrible.

when the baby was born, she was given all types of shots and drops in her eyes, none of which i wanted for her. a few days later, i had an infection in my incision. the doctor said it was a surface infection, and good thing, because if it was inside, he'd have to cut me open and 'stuff me full of gauze.' nice bedside manner.

i wrote to the newspaper, the doctor's office and the hospital. the first said to make my letter more objective, and they would print it. the other two said they followed the standards of the something something society (can't remember the name). when i got my records, it said i REQUESTED a c-section. it said that everything he did i requested! i didn't have a leg to stand on.

i complained to the midwives, and they said all that was unnecessary. that was the last time they used this man as their doctor. i was a turning point for them, which is a double-edged sword.

despite the trauma, i now have a beautiful, smart and talented 15 year old.

my second was a VBAC at home with a midwife and friends. i was in another state, where there were fewer regulations. when i went to the clinic in the morning for a small tear and check ups for us both, the doctors were horrified. they tried to stitch me up with a guilt trip, but it wasn't going to work. it was incredibly satisfying to give birth the way i wanted to do it the first time, and nothing was going to ruin that for me. i also healed faster mentally and physically. the baby, now an 11 year old girl, is more relaxed and centered, and i attribute part of that to the birth. the first one came out screaming, the second came out sleeping.

anyway, i could write volumes, so i think i'll just cut this off and go to bed.

[cynatnite]

56. Asshole doctor treated you like you didn't know your own body...

These types really piss me off. My sister had one of those. She told him she'd have to have a c-section when she was in labor with her second. Her first kid weighed over 10 lbs and she had one with him.

Two doctors said she has a tendency to have big babies and her body couldn't stretch enough.

When she moved and got a new doctor, she already knew, but he didn't listen to her. The asshole waited until the baby's head was stuck before ordering a c-section.

She raised hell with the hospital for two months afterwards and the doctor was disciplined with a fucking letter in his record.

[knitter4democracy]

74. I met one of those during my first pregnancy.

I had an early labor scare and went to the ER in the middle of the night. This total jerkwad never even talks to me, only to the nurse, and decides to do the strep B test while I am there without any explanation. Needless to say, he was really rough, and I lit into my OB the next time I was in. He told me that everyone knew about that guy and that if he were the house doc when I went into labor I could refuse to have him touch me.

One of the women in my birthing class wasn't so lucky. He was the house doc when she went in, and he literally slapped her legs and told her to "open up." I would've kicked him, personally. She said he was so rough that she threatened to kick him in the face and screamed for him to get out of there. The nurse dragged his cussing ass out of there and got her doc there pronto.

It's really hard to get rid of docs like that. It shouldn't be that way, imho. My husband has specialists he refuses to send patients to and rescues them from as soon as he hears that they're in those incompetent idiots' care. It can happen if you go into the ER without your doc being on-call, and he gets so upset when it does. I've tried to get him to write a letter to the state licensing board, but he said that if he's found out, they can sue us for libel, and they have deeper pockets than we do. It sucks.

[cynatnite]

85. Patients really need to know their rights...

Too many are intimidated by doctors and are afraid to speak out. I've told many in my own family if they have problems with a doctor either to discuss it with him/her or get another one. There is nothing wrong with doing so. This is about their health and piece of mind.

[knitter4democracy]

93. Absolutely!

My husband gets patients from other docs all the time and has patients move on to other docs all the time, too. It happens for all sorts of reasons. Life's too short to put up with a bad doctor.

[lawladyprof]

60. I came close to having one with my second child

Water broke but no labor for twelve hours so I was given Pit to get started. Eight hours later no progress. Eventually, someone discovered that a piece of the amniotic sac had gotten caught and formed a small cushion filled with fluid. All the contractions were doing were slamming the baby's head into this "cushion." A nurse "reached up" with an instrument, punctured the remaining bit of membrane, and we were off to the races. She was born a half an hour later.

[BamaGirl]

62. Congrats on finishing

and posting. I always get a little pissed at c/sections arguments. I've had two c/sections and a vbac, and I swear they tried to kill her. Everything that could go wrong with that delivery did. She was my only baby who was not alert at birth, and was sick for weeks. I would never choose another vbac. Thank Gawd my last was born at a different hospital.

[knitter4democracy]

75. Is she okay now? It's so scary when they start out like that.

C-Sections are there for a reason and very much needed. I hope your daughter is okay now. I can't even begin to imagine how hard it was to start out her life that way.

[BamaGirl]

92. All things considered, we were very lucky

She had no oxygen off and on for an hour during labor and many times those babies have serious lifelong problems. She has add, asthma, probably a ld, and gets sick pretty often, and generally her dr "blames" the labor problem. But she's bright and cheerful and dealing with those problems with grace that is amazing for an 8yo. She's a great kid. :D

[knitter4democracy]

94. Wow.

I'm so sorry about the asthma and all. That's so hard for the little ones to deal with. Tell her I think she's an amazing, wonderful person for living with all of that as well as she is. It sounds like she has a great mama, too. ;)

[benburch]

70. My son was 11.5 lbs...

And was MUCH too large to pass through.

So I have no doubt why he was delivered C-section.

[ChickMagic]

73. Thanks for the shout out to docs

I work at a medical school. There are scummy doctors just like there are scummy anything else you can name. But most are very caring and respectful. BTW - I once knew an OBGYN named Dr. Pugh. (infantile humor, but true).

[Czolgosz]

77. Congratulations! I'm so glad to see an OB/GYN who's a Democrat.

Where I live the OB/GYNs have all become Republican activists. The issue for them is medical negligence reform. I certainly see why doctors would not want to be sued (hell, I don't want to be sued), but they have taken up this issue as their calling card.

I understand how it can seem unfair that an OB/GYN could have liability for a careless error for two decades after the error, but I don't know see another way to balance the extended period of liability against the child's right to reach the age of maturity (18 years old) before they can be required to determine whether to bring suit.

Also, we have come to a situation where some OB/GYNs feel it is unfair that they be asked to account for what seems like undeniable negligence and even intentional bad practices.

I'd be interested in talking to you about how there can be a better balance between protecting doctors from unfair claims yet having them share responsibility fairly in those circumstances where their conduct has fallen below accepted standards and has harmed someone.

[NNguyenMD]

90. thats very nice of you to say thanks, I'm actually jsut a student BUT...

many of the OBs I met had no love for Bush, even though they probably support his stance on the HR5 legislation concerning medical malpractice, I didn't meet a single OB doc who was happy about Bush's America in general.

[Czolgosz]

96. That's encouraging. The medico-legal atmosphere here is Texas has become

toxic over the past couple of years in the wake of a statewide referendum regarding a constitutional amendment to cap medical negligence damages, and this polarizing issue seems to have driven all the OB/GYNs in town to become staunch Republicans. I'm happy to hear that this isn't a nationwide trend.

[EnfantTerrible]

81. Our midwife told us

that the increase in C-sections was primarily due to the fact that prenatal care is so effective nowadays the unborn baby's are bigger than ever before. There is also an insurance factor regarding how long a delivering mother is allowed to occupy the delivery room and the on call hours of the OB/GYN...

My wife almost had a c-section when it was discovered that our daughter was "face present" at birth. She was also a big baby at 9lbs 12 oz. My hero of a wife had our little girl vaginally, without drugs... 2 years later they are stilll talking about it at the hospital (and this is a big NYC hospital).

[MsTryska]

82. How far upstate are you?

My dad used to do rounds at St. Josephs in Syracuse and before that he was at St Clare's i think in Schenectady.

It always surprises me when people think doctors perform various surgeries for frivolous reasons - i guess thye jsut don't understand.

One misconception that's a pet peeve of mine is that doctors are running around like mad scientists performing late-term abortions on anybody that wants one.

[NNguyenMD]

91. I'm in downtown Syracuse about about away from University Hospital

St. Joe's has a great Family Residency program btw, a lot of students I know who rotated through there really liked their experience quite a bit.

[McCamy Taylor]

86. Epidurals slow down labor for 1st timers, increase chances of C-section.

I did medical school in a place where almost no one got an epidural and the term uncomplicated primaps almost always had uncompliacted vaginal deliveries.

I did my internship in a place where anesthesia used to come by and offer all the women epidurals, and the primaps (not the other women) would have prolonged labor, require fourth degree episiotomies, forceps and C-sections.

This was 20 years ago.

If the standard of care is to give every woman everywhere an epidural now then I can see how C-section would seem like a more sensible choice for first timers.

[Sgent]

89. I just wanted to mention

that conditions in upstate New York maybe different...

but I know in Mississippi any physician who performs a planned VBAC is not convered for insurance -- its been excluded from even the OB's policy.

[Bridget Burke]

95. All this non-Mom can say is "Ouch! Ouch! Ouch!"

The stories remind me of Baby Showers, where veterans try to top each other.

I'd like to salute the women who "labour" to bring forth the next generation. And all those in ages past who did not survive the experience.

With an extra salute for the MD's, RN's & Midwives who help.