Paul Harvey mentioned this study on his noon news broadcast: Redheaded women feel less pain (that is just one of several articles on the study that came up when I Googled it)
Guess that explains why I never needed any anesthetics when I had my three children -- never felt the need to. Probably why I also need to work on my sympathy for others who whine about pain.
(I wonder why it is only women, and not redheaded men) Farmgirl
[ August 12, 2005, 11:41 AM: Message edited by: Farmgirl ]
Posted by Noemon (Member # 1115) on :
Interesting!
Posted by ketchupqueen (Member # 6877) on :
Well, there you go. Blondes have more fun, but if you're going to have a baby, better to be a redhead. Posted by mr_porteiro_head (Member # 4644) on :
I am scared of my wife. She's planning on giving birth naturally again. I get ill just thinking about it.
Posted by Belle (Member # 2314) on :
I used to have a study that I can't put my fingers on right now that said that endometriosis was more common in redheads.
I wish I could find it, it was very interesting. Especially for me, since my family is chock full of redheads and strawberry blondes and every woman in our family going back three generations has been diagnosed with endometriosis. I mean every one. My grandmother and her sister, my mother and my mother's three sisters, me and my three female cousins.
Most of us have red hair or are like me - my hair is brown with natural red highlights but my mom is a redhead.
It's possible those studies are related. I know we're in the realm of conjecture here, but bear with me. Endo's main symptom is pain. Is it possible that women with endo experience so much pain in their lives they build up a tolerance and are able to handle pain better?
Posted by beverly (Member # 6246) on :
I need a doula.
I do want to give birth naturally again. But I'm not sure I can do it without support. Last time my sis-in-law who is a massage therapist was there with me throughout my pregnancy as well as the birth. She won't be around this time.
It just seems wrong for me to demand that Porter be there for me every moment when he is fighting every instinct just to be in the same room with me. I still want him there, but I can't count on him. In every birth, he has had the freedom to leave the room when he needs to. Otherwise we'd have two patients in there.
I don't know what I'll do. Posted by TheHumanTarget (Member # 7129) on :
Interesting. This is the exact opposite of a study released last year that showed redheads being more sensitive to pain. Apparently, further research has shown that this tolerance to pain only applies to female redheads... Here is another article that discuess the matter more:
quote:Two recent studies suggest that women with natural red hair color have an increased risk of developing endometriosis.
The studies quoted are cited below.
quote:15. Woodworth SH, Singh M, Yussman MA, Sanfilippo JS, Cook CL, Lincoln SR. A prospective study on the association between red hair color and endometriosis in infertile patients. Fertil Steril. 1995;64:651-652.
16. Frisch RE, Wyshak G, Albert LS, Sober AJ. Dysplastic nevi, cutaneous melanoma and gynecologic disorders. Int J Dermatol. 1992;31:331-335.
There is speculation that the same gene that causes red hair and fair skin also makes one susceptible to autoimmune disorders. There is also a link between endo and melanoma. That could just be the red hair link, though because red heads are definitely at higher risk of developing melanoma.
Posted by ketchupqueen (Member # 6877) on :
bev, are you planning on homebirth or a birthing center or hospital? Most birthing centers have doulas available through them. Or you can check Doula Network or Midwifery Today, both of which have searchable doula listings.
(I hope I'm not suggesting something you've already tried.)
Posted by steven (Member # 8099) on :
I read that redheads have worse luck than other people. I think it was in a Chinese face-reading book, which is funny because of all the red-heads in China (not).
Posted by mr_porteiro_head (Member # 4644) on :
quote:bev, are you planning on homebirth or a birthing center or hospital?
She's doing it at the hospital. That's one thing that I'm insisting on.
Posted by ketchupqueen (Member # 6877) on :
You're insisting on that even though birthing centers are often (depending on the center) just as safe or safer and are a more supportive environment for the woman who wants a truly natural childbirth without intervention as long as possible, have medically trained staff (nurse-midwives), and often have doctors on staff as well for emergencies?
Not ragging on you, just curious as to whether you had all the available information. Posted by beverly (Member # 6246) on :
KQ, I wish there were a birthing center in the area. You'd think with all the women giving birth in Utah Valley, someone would think of it. But no, most women here still go to OBs. Doctors tend to have a far more rigid view of birth as a medical process and seem less concerned about the holistic aspect. I am glad to get away from that!
I go to a CN Midwife. They are rising in popularity here, which I think is *very* good. Maybe birthing centers would be next. I have even joked about starting up a birthing center and seeing how much money I could make. (The hospitals here are still pretty strict--nothing but ice chips, no waterbirths, etc.) But I'm no entrepreneur.
I am not up for giving birth at home, unfortunately.
I have not tried those links yet, I will take a look now.
Posted by Belle (Member # 2314) on :
Depending on your doctor and the extent to which you are able to make your wishes clear and understood, most hospitals are extremely supportive of natural childbirth. In fact, where I delivered, my nurse had delivered naturally herself and was very supportive and helpful when I attempted to deliver naturally with my first child.
Hospitals have huge advantages too that no birth center can match - ORs right down the hall and anesthesiologists and OB's on call for emergency surgeries. Granted, most of the time it's not necessary, but when it IS necessary, I would want myself or someone I love as close to that emergency intervention as possible. mph's insistence is perfectly understandable.
Considering that two of my four children were in distress and required the intervention of a physician during delivery, I'm a big proponent of hospital birth. Posted by beverly (Member # 6246) on :
Will they press on my back and hold the pressure point on my arm for nausea? At the same time?
Will they rub my feet with lotion and hum to me?
It is true that my hospital is fine with natural births. My midwives work exclusively there, and while certainly not all their patients even want to go natural, a lot do.
I think that a good birthing center should have access to those same things. Being located near a hospital or even connected to one would be fine. But they would have more relaxed regulations (like on the things I mentioned above) and they would be dedicated to having a birthing experience tailored to the mother's needs/desires rather than so focused on medical emergency.
Don't get me wrong, I love the hospital I delivered my three children at. But I am frustrated with some of their regulations. They feel a bit too tight for my liking.
Posted by steven (Member # 8099) on :
Speaking of pressure points, there are several that are used for pain in childbirth. Spleen-6, above the ankle, and the Gallbladder point in the trapezius neck/back muscle. There are others.
Posted by ketchupqueen (Member # 6877) on :
That is exactly why I would go to a birthing center if a good one was available and I wanted a natural experience. (Personally, I tense up when in pain, so no dice on the natural childbirth for me.) I think being on a hospital campus is an excellent thing, too, since I think it's a good thing to have an OR nearby, as well as an NICU within a minute or two. But I agree, many hospitals still have regulations that stymie things for women's birthing experiences even when an OB or CNM is willing to accommodate them.
Posted by beverly (Member # 6246) on :
My sis-in-law studied pressure points as part of her education in massage therapy.
I'm gonna miss her. Posted by Belle (Member # 2314) on :
quote:Will they press on my back and hold the pressure point on my arm for nausea? At the same time?
Will they rub my feet with lotion and hum to me?
There's certainly no rules in most hospitals AGAINST these things - while your nurse herself may not be trained on the particular techniques you are wanting, there's no reason why someone else can't. Rubbing my feet and humming to me sounds like an excellent job for my husband, actually.
My nurse did do things like fold heated blankets and put them behind my back for relief, hold my hand and talk soothingly to me through contractions, give me advice on my breathing, etc. In my hospital you were also assigned one nurse, who stayed with you, she wasn't going back and forth checking on other patients, she was there for the duration with you.
There's no reason to turn this into an argument over which type of birth is better, I think every woman should make her choice, but she should make an informed choice. Just like most women who want a safe birth aren't educated on birthing centers and think hospitals are their only option, many people who want a natural birth aren't educated on how accomodating the hospitals can be. There is misinformation on both sides, and I just wanted to make sure that the flow of information on the thread goes in both directions.
Posted by beverly (Member # 6246) on :
quote: But I agree, many hospitals still have regulations that stymie things for women's birthing experiences even when an OB or CNM is willing to accomadate them.
Amen. My CNM are required to uphold hospital policy about the no food/drink rule. But they don't personally believe in it. When I asked them, they said, eat/drink if you want to, I'll turn a blind eye. Just don't let them see you doing it. Posted by ketchupqueen (Member # 6877) on :
Oh, bev, you should try the Utah Doula Association. And if you call around (or e-mail), I bet you'll be able to find one trained in massage, too!
And there's an 888 number at the bottom of that page; they could probably tell you if any in your area are instead of you having to go through all of them. Of course, you might want to talk to all the ones in your area. Posted by Belle (Member # 2314) on :
quote:But I agree, many hospitals still have regulations that stymie things for women's birthing experiences even when an OB or CNM is willing to accommodate them. --------------------------------------------------------------------------------
And let's not forget, there are really good reasons for those rules. For example, I was distressed that I couldn't deliver my twins in a birthing room. My doctor accomodated my wish for a vaginal birth (and my daughter was breech, so that was a huge accomodation on his part many doctors wouldn't have considered it), but he insisted I give birth in the OR.
Turns out my daughter flipped transverse after my son was born, and for a few agonizing minutes they weren't able to locate her heart rate and were afraid the placenta might have separated, putting both her and me in severe danger. Because I was in the OR, they were prepared to do an immediate C-section which would have saved our lives. Thank God my doctor was able to turn her and deliver her and she was fine, but for a few moments they were preparing for the c-section and I was profoundly grateful I was in the OR. Even though it would only have been a matter of minutes to get me from a birthing room to the OR, those minutes could have meant the difference between life and death for my baby.
Doctors don't do things just to annoy you or make you uncomfortable. There are very good reasons for their rules. Granted, in a normal childbirth, the rules don't matter. But if something goes wrong they matter a great deal.
Posted by beverly (Member # 6246) on :
Yeah, Belle. That is good advice.
quote: while your nurse herself may not be trained on the particular techniques you are wanting, there's no reason why someone else can't.
I think I do want a doula.
You have to understand, Porter will do his best for me, always has. But he is fighting his own fear/panic/revulsion/nausea/shock and I can't *count* on him for *anything*.
Last time, he and my sis-in-law worked together as a team. It was pretty cool. When I had severe back-pain through transition, her pressing on my back was the only thing that got me through it. But when I was about to throw up, she was able to tell Porter right where to press on my arm to help supress the feeling. I don't care if the effect was only psycosomatic--it worked for me!
But on top of this, she cleaned my house for me each week during my last month or so, gave me massages, anticipated and gabbed long hours with me, and was an excellent friend and companion through it all.
I'm not sure if money can buy as good a service as I got from her.
Posted by Farmgirl (Member # 5567) on :
quote: It's possible those studies are related. I know we're in the realm of conjecture here, but bear with me. Endo's main symptom is pain. Is it possible that women with endo experience so much pain in their lives they build up a tolerance and are able to handle pain better?
Belle - that was very interesting.
Because over 10 years ago, I had a huge endometrial tumor, the size of a canteloupe -- that was found during a regularly yearly female exam. I had NO pain. The doctor was amazed because he said some women come in, in great agony, with a tiny spot of edometriosis, and here I had this huge amount and never knew it. (and still have problems with endo, but no pain).
Farmgirl
Posted by beverly (Member # 6246) on :
KQ, I just found that group on the link you sent. It does look promising! Posted by beverly (Member # 6246) on :
Farmgirl, you are amazing! Posted by ketchupqueen (Member # 6877) on :
bev, some doulas do provide live-in service before and/or after birth, and all good doulas make sure they spend plenty of time with you before hand to bond with you and become friends, and they always make themselves available to listen when you need a cry or a talk. Ask them up-front when you're interviewing them what kind of services they provide and be open about your needs, and you should be able to find someone who suits. Hopefully. Posted by Olivet (Member # 1104) on :
If I'd had my first baby at home, I'd be dead now.
I'm just saying that sometimes hospitals are good for some things.
Posted by beverly (Member # 6246) on :
Cool. Posted by beverly (Member # 6246) on :
Belle, I guess having twins is always considered a high risk situation. It is totally understandable that you'd want to make sure all the provisions close at hand from the start.
Same would go for any laboring mother with a breech-position baby.
VBACs might be borderline.
(I'm imagining in my little dream-world running a birthing center and advising high-risk birth mothers to strongly consider the hospital. )
Posted by ketchupqueen (Member # 6877) on :
Most birthing centers do. At least, the reputable ones.
Posted by Olivet (Member # 1104) on :
I wasn't high risk, though. I mean, stuff happens. You can bleed out VERY fast.
But, on the other hand, I could have birthed my second while squatting in a rice paddy, wiped him off and gone straight back to work.
But I didn't know that beforehand. Posted by mr_porteiro_head (Member # 4644) on :
quote:Originally posted by Olivet: If I'd had my first baby at home, I'd be dead now.
I'm just saying that sometimes hospitals are good for some things.
This is why I insist on a hospital birth.
Posted by katharina (Member # 827) on :
I agree with Porter. Everything was fine with my mom with her first going in, but it got bad very quickly. The baby died, and my mom would have if she hadn't been in a hospital.
Posted by beverly (Member # 6246) on :
I don't particularly want to give birth at home. But I do like the idea of a place that has all the medical advantages/resources of a hospital but is more relaxed about birth and focused on the holistic approach.
I would like to have a waterbirth. But while my hospital just recently put jacuzzis in every birthing room, waterbirths are strictly prohibited (not enough room for a CNM or OB to maneuver.) I don't like the idea of getting into that nice, warm water in labor only to have to get out again into the bitterly cold air as my child is ready to come out! No thanks!
Maybe I should start a birthing center. Posted by ClaudiaTherese (Member # 923) on :
(Redheads may feel less pain, but they cause more of it. Severe Heart-Burn. )
There can be good reasons for restrictions on eating. If you do eat, just make sure there is always someone there who will tell the nurse or physician if things go bad fast and you need to get to an OR (like Olivia or Belle). They may need to pump your stomach first, if they have time. General anesthesia would make you suck all that into your lungs.
Posted by Miriya (Member # 7822) on :
Hospitals are important and wonderful to have when you need them. I would certainly recommend having a first baby in hospital or a fully equiped birthing centre (I did). However there are many down sides to the hospital setting and I have to say I'm really glad to have had home births for my subsequent children.
I would certainly go to hospital were I expecting twins or a breech delivery or had other risk factors. However most of these things are predictable before hand, especially if you have successfully given birth before.
Also, midwives (of the certified variety) and doctors who do home births are NOT limited to hot water. They bring significant equipement with them for unexpected problems. I also don't think I'd recommend home birth to women who are a great distance away from their back up hospital.
I think the most important consideration is what works for a particular family but I don't like the implication that having a baby away from hospital is irresponsible. Just my two cents.
Posted by Farmgirl (Member # 5567) on :
quote: (Redheads may feel less pain, but they cause more of it. Severe Heart-Burn. [Kiss] )
(most of my family would agree)
FG
Posted by beverly (Member # 6246) on :
Just out of curiosity, if the patient bed were inclined while a birthing mother was given general anesthesia, would the danger of breathing in stomach contents be there?
Also, considering there is almost certainly stuff in my stomach *anyway*, why the restriction? I can understand it being a bad idea to stuff myself while in labor, but I imagine few laboring women *want* to do that.
But a little water, please!
Posted by Miriya (Member # 7822) on :
quote:Because over 10 years ago, I had a huge endometrial tumor, the size of a canteloupe -- that was found during a regularly yearly female exam. I had NO pain.
BTW This isn't uncommon. While endometriosis can cause mind boggling amounts of pain, this is appearantly unrelated to the level of disease. Many women with stage 4 endo are only diagnosed when they either seek treatment for infertility or have cysts/tumours. Other women have stage one disease and are completely disabled by pain.
It is unclear why this happens but may be related to differing imflammatory response to the internal bleeding.
Posted by Jon Boy (Member # 4284) on :
quote:Originally posted by Belle: There is speculation that the same gene that causes red hair and fair skin also makes one susceptible to autoimmune disorders. There is also a link between endo and melanoma. That could just be the red hair link, though because red heads are definitely at higher risk of developing melanoma.
Interesting! There's a lot of fibromyalgia and chronic fatigue syndrome on my mom's side of the family, which, coincidentally, also has a lot of redheads. We also seem to have a lot of joint problems.
Posted by ClaudiaTherese (Member # 923) on :
quote:Just out of curiosity, if the patient bed were inclined while a birthing mother was given general anesthesia, would the danger of breathing in stomach contents be there?
First of all, it is highy unlikely you would need to go under general anesthesia. However, part of my training was to be called to such situations, so the "problem cases" are over-represented in my own experience of attending births. (That is, don't freak out. This isn't likely to happen, but if it does, whoever is with you needs to know to speak up and be frank, because you may not be able to.)
In a "crash c-section" where the baby has to come out as soon as possible, there is less than 15 minutes to get into the uterus. I've seen them cut into a uterus less than 5 minutes after calling a crash section. There isn't any time for anything but putting the woman flat, knocking her out and inserting a breathing tube, and doing the surgery.
This is very different from a planned or even "emergency c-section." There is more flexibility for technique then. But remember that whenever you go under general anesthesia, all the muscles in the body relax, including the ones at the top of the stomach. Have you ever had reflux up into your throat (breath tastes like vomit) even if you're sitting upright, sometimes after a burp? That is what can happen even if your muscles have normal tone.
quote:Also, considering there is almost certainly stuff in my stomach *anyway*, why the restriction? I can understand it being a bad idea to stuff myself while in labor, but I imagine few laboring women *want* to do that.
But a little water, please!
It's just like instructions for any major surgery (again, this is for general anesthesia). You know how they say not to drink or eat anything after midnight, or for such-and-such number of hours before a surgery? It's because of the anesthesia-associated risks of aspiration. And yes, even little bits count.
I'd never tell you not to do anything. Not my style and not my business! Just encourage you to be sure that someone professionally involved knows when you last had anything to eat or drink should the unforeseeable happen. It isn't a good time to fudge around. (I was present when a woman with sudden placental abruption had to be anesthetized for a crash c-section, and she aspirated. her husband was afraid to say she'd been eating toast and cheese, or maybe he didn't know it would really matter. She made it through okay, but she did have to spend some days in the ICU away from her baby. )
Posted by mackillian (Member # 586) on :
Very interesting. My aunt is a strawberry blonde and also had a huge endometrial tumor years ago. She also suffered from a huge amount of pain daily because of a car accident she was in when she was in her mid twenties but has been told that the pain her injuries inflict would floor other people.
Weeeeird.
...what IS a strawberry blonde anyway? A redhead or a blonde?
Posted by beverly (Member # 6246) on :
But the logic here is that it is *highly* unlikely that any laboring woman coming into the hospital will have been fasting long enough for general anesthesia to be safe *anyway*.
So considering the rarity of the need for general anesthesia in birth, why require this in-hospital when most women have already ruined the chances of it being safe?
Why not instead have the policy be that the woman (or whoever came with her) should report what she has been eating/drinking for the last few hours? If she qualifies for safe GA, then maybe counseling her to keep doing so would actually be worthwhile. Otherwise, it just seems like needless beaurocracy.
Posted by ClaudiaTherese (Member # 923) on :
bev, here is some more info about aspiration pneumonia. Again, it isn't common! Just worth knowing why some of the rules are there and what to do if you were to have "bent" them in certain situations.
Water is easier for the body to quickly absorb than anything else. Anything flavored, though, can stimulate additional acid production in the stomach and -- again, in those rare cases -- make the risks higher if general anesthesia is given.
I've heard women complain that the nurses just don't want to have to clean up things if the woman were to puke. From being behind doors with OB nurses, I can tell you that this hasn't come up in any conversations I've overheard. (Besides, it's often -- though far from always -- our friendly janitorial staff that do the clean-up. *smile) If we heard that someone who was on restrictions had been eating and drinking anyway, the conversation turned to calculating her likelihood of needing anesthesia.
All sorts of stuff gets slopped around in delivery rooms sometimes. Even with uncomplicated vaginal births, there is blood and poop and amnioic fluid and whatnot. Some vomit is no biggie. Sending your patient to the ICU is.
Again -- just remember that someone knows and can (and will) convey that information if they need to. If it were to come up, they can suck some of the stomach stuff back out, and they can use a larger diameter breathing tube to help close off areas tighter (but that isn't as good for your windpipe). Also affects what anesthetics they may choose and some of the techniques they use.
Posted by Farmgirl (Member # 5567) on :
quote:BTW This isn't uncommon. While endometriosis can cause mind boggling amounts of pain, this is appearantly unrelated to the level of disease. Many women with stage 4 endo are only diagnosed when they either seek treatment for infertility or have cysts/tumours. Other women have stage one disease and are completely disabled by pain
That was interesting, Miriya, and I'll add it to my information. I really don't know much about endo, even though I have it, because it hasn't disrupted my lifestyle very much. I didn't realize there were identified different "stages" of it. I will read up on it.
Farmgirl
Posted by beverly (Member # 6246) on :
I am not one to assume that the regulation is to keep nurses from having to clean up. I mean, I make enough mess giving birth with other fluids! Some more foul than vomit.
At least hospitals don't require enemas anymore.
So, if water is the easiest to absorb, I am certainly not going to feel guilty about sneaking water during labor. Especially since I probably just had a big meal before coming in. But I will resent having to sneak it.
Out of curiosity, when giving general anesthesia how possible/difficult would it be to put a tube in the esophagus or a draining hose (like what the dentists use to remove excess fluids)? How effective would that be in removing the danger? And why wouldn't it be regulation to do that anyway, since the danger is life threatening?
Posted by ketchupqueen (Member # 6877) on :
I vomited even fasting during labor, so I can testify that isn't it.
I am very curious, though: why are women allowed ice chips but not water? Some hospitals even allow you to put flavoring on the ice chips (like a snow cone.) I was so thirsty during labor-- even with an IV pumping saline into me-- that I went through about 10 cups of ice chips in only a couple of hours. (No flavoring on mine.)
And when you let them sit a little, they turn into water anyway. So why do they let you have ice chips but not water? It just seems kind of idiotic to me.
Posted by beverly (Member # 6246) on :
And if you can vomit, why can't you aspirate?
It don't make no sense!
Posted by beverly (Member # 6246) on :
KQ, I think it is to keep you from taking in too much water. If it is in the form of ice, you can't gulp it like you wanna. Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by beverly: But the logic here is that it is *highly* unlikely that any laboring woman coming into the hospital will have been fasting long enough for general anesthesia to be safe *anyway*.
So considering the rarity of the need for general anesthesia in birth, why require this in-hospital when most women have already ruined the chances of it being safe?
Why not instead have the policy be that the woman (or whoever came with her) should report what she has been eating/drinking for the last few hours? If she qualifies for safe GA, then maybe counseling her to keep doing so would actually be worthwhile. Otherwise, it just seems like needless beaurocracy.
Hmm. I think it has to do with perspective. From a laboring woman's perspective, it is unlikely this will come up for her. From the caregivers' perspectives, we know that a certain number of women we care for will be affected -- we just can't predict which ones.
The tricks anesthesiologists can do to deal with stuff in the belly can be pretty traumatic. Useful if necessary, but much better to avoid. An extra-wide breathing tube or one with an over-inflated cuff can help block the reflux -- but it increases the damage to the surrounding tissue and really ups the risk of scarring. Pumping the stomach can trigger contractions at a time when you definitely don't want them (like a placental abruption bleeding out) -- and remember, if they are pumping before giving the anesthesia to make the anesthesia safer, then the uterus muscles can still contract.
Where I trained, there were something like 20-40 births a day. Probably less than 2% had any significant problems at all, but we saw a few hundred patients a week, and so you knew that it would turn up. You only need to see one person who sucked acid into their lungs to never want to see it again.
But for each 5 women we saw with problems, there were hundreds that sailed through delivery, relatively speaking. Is it worth restricting all of them in order to try to save the few from serious complications? I don't know. I do think people should be able to decide things for themselves, but if you haven't seen what can happen, it's hard to make an informed decision.
On the other hand, if all you see are the worst things that can happen (like those of us who only get called in when things go bad), then your view is probably skewed the other way.
Anyway, it is your body, and I would suppot you in whatever you chose. I'm pro-beverly. I did want to offer another perspective to take into account, that's all.
Posted by beverly (Member # 6246) on :
quote: Is it worth restricting all of them in order to try to save the few from serious complications? I don't know.
This is the sort of difference in perspective I speak of when I compare a birthing center to a hospital. I prefer the relaxed atmosphere. And considering it seems I'm in danger of aspirating acid *regardless* of having broken hospital policy, I think I'd rather take my chances with a tummy tube.
quote:Anyway, it is your body, and I would suppot you in whatever you chose. I'm pro-beverly. [Smile] I did want to offer another perspective to take into account, that's all.
Thanks, CT, I do appreciate the sentiment. But unfortunately I still have to suffer through my hospitals policies--no matter how silly *I* think they are. They put their policies before me, it seems. I really like having the choice--it puts the power back in my hands.
Posted by ClaudiaTherese (Member # 923) on :
Sara, that's a good article. Thanks. Posted by ketchupqueen (Member # 6877) on :
But bev, it seems to me that 10 cups (and they were 10-oz. cups) full of ice in the span of 2 1/4 hours is a lot of water. Posted by ClaudiaTherese (Member # 923) on :
quote:This is the sort of difference in perspective I speak of when I compare a birthing center to a hospital. I prefer the relaxed atmosphere. And considering it seems I'm in danger of aspirating acid *regardless* of having broken hospital policy, I think I'd rather take my chances with a tummy tube.
The risk levels are different, but I appreciate your desire to stay in charge. That, too, is important.
quote:Thanks, CT, I do appreciate the sentiment. But unfortunately I still have to suffer through my hospitals policies--no matter how silly *I* think they are. They put their policies before me, it seems. I really like having the choice--it puts the power back in my hands.
I'm all for you having all the power and choice you can, beverly. That isn't just a sentiment.
Posted by beverly (Member # 6246) on :
lol@KQ.
Ayup. It's called beaurocracy.
Sara: Posted by ClaudiaTherese (Member # 923) on :
And for what it's worth, where I trained, we had a free refrigerator on every birthing floor that was kept stocked for the women at low-risk and all caregivers. Sodas, hard-boiled eggs, cheese, toast, fruit, snack crackers, jello, pudding, and lots of yummy stuff. It was only when women moved to higher risk that restrictions went into place. That made sense to me.
Have you done a walk-through of the place where you will deliver? Maybe they have fewer restrictions than you expect. (And maybe they don't. ) But I'll keep my fingers crossed for you. {--- for a full frig! Posted by ketchupqueen (Member # 6877) on :
That makes a lot of sense, CT.
Of course, sometimes we don't have a choice of what hospital we deliver at, and don't get to choose the ones with "progressive" regulations. Posted by beverly (Member # 6246) on :
quote:Have you done a walk-through of the place where you will deliver? Maybe they have fewer restrictions than you expect. (And maybe they don't. [Frown] ) But I'll keep my fingers crossed for you.
Is this addressed to me? Well, I will be giving birth at the same place where I've birthed three already, so I am extremely familiar with their policies. I really wish their policies were more like where you were trained. They just can't seem to let go of this outdated notion.
But things slowly change over time. After all, the jacuzzies were a new addition at my last birth, though I didn't get a chance to use them. I know that my Midwives are supportive of a more relaxed approach (like where you trained) but since they have to work at this hospital, they have to follow their rules.
Since there are no birthing centers around here and I don't want to give birth at home, this is my best option. And I really do like the place, all things considered.
Posted by Miriya (Member # 7822) on :
Hospital maternity wards are all very different. It was ice chips at the one where I delivered my first. (yet I did throw up in labour anyway)
In one hospital near me they had the most outrageous restrictions (ie. post partum mothers were not allow to carry their babies, they had to wheel them around in little carts. ) The other nearby hospital was much more relaxed. It helps to check out all the nearby maternity wards to figure out which one works for you. (EDIT: I should add I'm in Canada where shopping around for health care is a little less difficult)
Posted by beverly (Member # 6246) on :
quote:(ie. post partum mothers were not allow to carry their babies, they had to wheel them around in little carts. [Roll Eyes] )
Ooo, they've got that rule at our hospital too.
Unfortunately, there really aren't any other good hospital choices for me. The one that is right next to this one doesn't take my insurance or my Midwives. The one way south is even more strict and stuffy and all the things I hate about older, more established, stuck-in-their-ways hospitals, and the one a bit north... well, that's a possibility. But I don't know much about them, and my Midwives don't go their either. Posted by ketchupqueen (Member # 6877) on :
quote:ie. post partum mothers were not allow to carry their babies, they had to wheel them around in little carts.
Yup, they had that one at mine. And yet, they are rated the best in the area for a normal delivery-- because the other hospitals in that area are worse.
The only rule that really upset me was that they would not allow my husband to stay with me and hold my hand while I got my epidural (I had to get it on my side because of blood pressure issues.) I was not in a position to argue much, since every minute I tried delayed my much-needed pain relief (I was at this point getting 6 units of Pitocin, nasty stuff), and I hadn't made it clear before hand to my husband that I really wanted him to stay with me the whole time, including then (he's assisted on dog and cat surgeries of all sorts, and not the type to be grossed out by anything.) (I had mentioned it to my doctor, but my doctor wasn't there when they gave the epidural, just the anesthesiologist and the nurse.) I did ask why they had that regulation, and they said it was because they'd had husbands faint before. I said mine wouldn't, but they told him to leave anyway.
I cried. But eventually the pain relief kicked in and I was happy enough about that to let it go.
At least until afterward. Be assured, when they asked on the phone survey two weeks later what they could do next time to make my experience more pleasant, I brought that up (along with the water/ice chip issue.)
Posted by beverly (Member # 6246) on :
quote:The only rule that really upset me was that they would not allow my husband to stay with me and hold my hand while I got my epidural
Wild horses couldn't have kept my husband by my side while I was getting my epidural. Er, something like that. :sad smile:
See, Porter *would* faint. But he knows himself well enough to take the precaution without anyone telling him to.
But still, they should let you have the freakin' @#$%@#$ choice!
Posted by Miriya (Member # 7822) on :
That sucks. Luckily the midwives near me can now practice at all five hospitals within reasonable distance of me. I am still planning a home birth, however I needed to pick out a hospital to have my birth in case anything comes up.
I didn't register at either the hospital with the babies in carts thing or the one with the "latest greatest" electronic records system where appearantly one of your midwives spends a couple hours after the birth "entering all your info" instead of looking after the mother and baby. Posted by beverly (Member # 6246) on :
I guess we're still a bit in the dark ages as far as birthing is concerned. I expect things will be better for our next generation.
Posted by Miriya (Member # 7822) on :
Yeah, you're probably right. Things will get better. Midwives push for more "natural options" for low risk women and OBs are starting to listen. At the hospital I mentioned the Chief resident OB has said "the only one getting one-to-one care at his maternity ward is the computer" and is working to change it.
If only more of them listened.
Posted by ketchupqueen (Member # 6877) on :
quote:But he knows himself well enough to take the precaution without anyone telling him to.
But still, they should let you have the freakin' @#$%@#$ choice!
Exactly! Especially since, as you said, people know themselves-- and their husbands-- better than the staff does.
They can always ask a husband to leave later if he's having a problem rather than kicking him out before they even get you in position.
Next time, he knows that I want him with me for the epidural, and he'll be ready to fight to stay with me if need be.
Posted by Miriya (Member # 7822) on :
I have to say epidurals scare me... >I< would rather not be in the room.
That said, I would just die if I needed one and they made my husband leave with they put it in. Posted by beverly (Member # 6246) on :
KQ, you know, my son and daughter had cavities they needed filled this month. I was having my own mouth worked on while my son was in the other room.
The dentist came in and told me that my son was being *very* difficult. (The guy was obviously quite frustrated with my son.) He said he wasn't able to get anything done unless he got tough and pushed it. He was asking me if I wanted him to proceed.
I asked if I could be in the room with my son. The dentist was very hesitant. He finally told me that most children are *worse* behaved when Mom is there. I assured him that my son is amazingly brave, and would do fabulous with me there. He is not used to being alone, and that was what was scaring him.
Finally the densist relented.
My son was beautifully behaved from that moment on, even when I had to leave the room again.
When my daughter had her cavity filled, I was there the whole time (thank goodness) and she was like a dream.
The dentist laughed after it all and said that we always needed to be sure that I was in the room with my kids.
He had his own ideas, and thought he was right, but fortunately he was willing to listen to reason and be flexible as well. Posted by ketchupqueen (Member # 6877) on :
Add to that the fact that I'm allergic to rubbing alcohol ( >_< ) and that the nurse kept forgetting it, and so I had to be the one to notice through my haze of pain that the anesthesiologist was about to prep me with it because my husband was out of the room... Posted by Miriya (Member # 7822) on :
quote:I asked if I could be in the room with my son. The dentist was very hesitant. He finally told me that most children are *worse* behaved when Mom is there.
I've heard this before too. It doesn't apply to my children either. Luckily my dentist is also understanding and allows my kids to sit on my lap while they work. He even let me into the OR until my daughter was asleep during her oral surgery.
Posted by beverly (Member # 6246) on :
It is possible that one of the reasons why many Moms cause their kids to be even more antsy is because the Moms worry and concern for the kids is so thick in the room you could *taste* it. The Mom is tense and scared, the kids sense it, and it just escalates.
But I am a very calm person. And when it comes to "scary" things with my kids, I become even more so. Perhaps I instinctively know how my fear will effect them and go into overdrive to mask it. I act ultra happy, affectionate, playful, and the kids are more at ease than ever.
If they are bright enough, they will learn that those traits are signs of danger. Posted by Miriya (Member # 7822) on :
My kids sense my concern but they feel more at ease because they know I will be straight with them. If something will hurt I says so and help them brace for it. If something won't hurt, they believe me. I think part of the problem for some kids is that they expect dishonesty from medical settings. I find kids (and adults actually) do far better when they know what to expect.
Posted by Olivet (Member # 1104) on :
*raises hand*
I was put under a general anesthetic before it was all over with my firstborn. Not BEFORE they got him out, but after, when they were trying to put me back together.
I couldn't keep food down until the next day, and hadn't eaten for about a day before he was born. At least I felt too crappy to be hungry. Posted by Theaca (Member # 8325) on :
I've never had kids, and don't have any nieces or nephews, nor have any close frieds who have kids. So, I don't have any personal experience with childbirth. That means I don't see the big deal about making it natural, getting feet rubbed, getting lotion, getting food, etc, etc. Not that I disagree with those things. They are just foreign concepts to me, you know? But all my experience is on the medical side of things. And I only had 2-4 weeks in labor and delivery experience in medschool so I don't have much medical experience either, I suppose.
So anyway here is how I look at it as a medical procedure (so you can see the other side. CT is more in the middle since she has more experience.) OBs see it all, you know. They see the easy deliveries and love them. But more and more often they see the complicated, high risk pregnancies. They see the tragedies and they eventually get burned from some case or other where things were supposed to go smoothly but then tragedy happens. It is natural for doctors to want to prevent more tragedies. The best way? Keep things nice and orderly and sterile and by the rules.
Bev, you say you want to be in charge. And kq, you think you know your husband well enough to decide he can stay during the epidural. The problem is, it isn't just you guys who are at risk in the labor process. If the doctor or the hospital lets the patient make choices, some of which are great ideas but lead to a less sterile, less controlled environment for the doctor, and then tragedy strikes, everyone loses. The doctor gets sued, too. Doctors HATE being sued. Trust me, I have experience. We do ANYTHING to avoid being sued. The doctor wants to maintain the control so he doesn't get sued and so that there is a low complication rate as possible.
KQ, did you hear about that guy who was holding onto his wife during her epidural, and he fainted and hit his head and died? The hospital and the doctor got sued. So now I bet there is another hospital who won't allow husbands in the room during epidurals. They are just trying to protect themselves.
I'm not saying they are right to do these things. There's probably a happy medium. Unfortunately patients and doctors will probably NEVER agree to the perfect setting for the perfect labor experience.
Malpractice insurance for OBs is through the roof, and that is because so many people sue. They sue for anything. Well documented, perfect deliveries also make the doctors' and hospitals' cases look better in court.
Posted by ketchupqueen (Member # 6877) on :
If they had told me beforehand that he would need to leave, I would have done anything I could to keep them from making him leave-- including sign papers saying that if he was allowed to remain, we would not hold the hospital liable for anything that happened to him, me, or the baby as a result of him being in the room. (Heck, you already have to sign the part about you or the baby being injured as a result of the epidural, they could have written it right in to that! I would have paid a lawyer's fees to come write the contract, even!) But they didn't tell me this until it was time, even though I had asked, "Will he be able to be with me the whole time?" They said yes to that. I feel that was not completely honest-- not intentionally, maybe, but there you are. Posted by Theaca (Member # 8325) on :
Yeah, a whole bunch of wavers, that's the way to go, maybe. I was thinking about that. They'd have to have that all written up ahead of time. Should be fairly easy. Or maybe it's more complicated than I think it is. Also it could be that the "rule" was just the anesthesiologist's policy. It's his choice, basically, since it is his procedure.
Posted by ketchupqueen (Member # 6877) on :
The anesthesiologist didn't seem to have anything to do with it; the nurses kept saying it was hospital policy. Next time I will ask and do whatever it takes to make sure he can stay.
Posted by Belle (Member # 2314) on :
Personally, if a man is inserting a very sharp needle next to my spinal cord, I don't want him distracted in any way. I want him and the nurse with him in total control over the situation, and for that to happen, they need to know nothing will interrupt them, not a husband hitting the floor or even a husband who's curious and wants to lean over and check things out too closely.
Epidurals take, what - ten minutes max?
Hubby can take that time to go to the restroom, get some coffee, call relatives, etc. He can take care of all those things that he needs to take care of, but doesn't want to because when he's in the room with his laboring wife he wants to be totally focused on her.
Posted by Olivet (Member # 1104) on :
Hmmm. They never made my husband leave the room. They did have him stand back, and asked if he could handle seeing the needle.
I think he stood where he didn't actually have to see the needle.
Posted by beverly (Member # 6246) on :
So it is the sue-happy people that are to blame!
You know, there are so many places where people can experience injury. Dojos, gyms, swimming pools. A lot of these places have disclaimers that the people involved are responsible for their own safety, and some make people sign papers that they will not sue for injury or even death. Whenever my children have had general anesthesia, I think they've made us sign something that made it clear that death could result and that we would not sue (I think.)
I am curious, could more doctors offices do similar things to avoid lawsuits? I hate our sue-happy society. Tragic things happen, and we have to blame someone *else* for them, even when there was no fault there. We all know this. Seems to me I'd rather sign a paper saying I will not sue than have to be restricted in ways I'd rather not be.
Let me take responsibility for my own life and safety! If the doctor really did make a careless, life endangering mistake of negligence, I can understand the desire to sue. But so many lawsuits are simply excuses to put the blame elsewhere. If I have been warned of the dangers of eating/drinking in labor, the hospital should not be held accountable if there is injury and death because of it. Just as I was warned when my son went under general anesthesia that he could die, and that I would not sue for it. I knew the risks going in, I took the risk knowingly, the responsibility is mine.
Could these things be taken care of at the time of registration at the hospital? (Hopefully done before the woman is in labor at all?)
Posted by Belle (Member # 2314) on :
My husband was also able to stay if he wished, the doctor figured a paramedic wasn't going to freak out at the sight of a needle, but he left to do all that stuff that I mentioned, because it was a good time to do it - I was obviously busy, and in capable hands so didn't need him.
quote:So it is the sue-happy people that are to blame!
That's not all the reason though I don't doubt it plays a part. As CT said, you must remember that while you don't think it's logical to keep all pregnant women from eating on the small chance that they may need emergency surgery, the doctors HAVE seen women present with perfectly normal healthy pregnancies, and no reason to think anything would go wrong, and then wind up in the OR. There is no good way to predict who it will happen to and no one can look at you and say "You'll have no trouble delivering" and be assured of being 100% correct. It's impossible.
The doctors are indeed weighing risks - should I have everybody refrain from eating, or should I risk that someone will die from aspiration pneumonia that I could have prevented?
Ask yourself if your friend or sister died because she ate during labor, what advice would you give to someone going into labor? Now consider that doctors that have been through ob/gyn specialist training have seen multiple women die because of complications and have performed multiple emergency surgeries where eating would have presented a problem. Is it the easy way out for them to just blanketly prevent all eating during labor? Sure, of course it's an easy way out for them. Sure, most women could eat during labor and it never cause a problem.
But like CT said, it's not a question, to the doctor, of IF someone will need a crash c-section, it's a question of WHEN. And they don't know whether it will be you or the woman in the next room. So the safest course is to tell you both not to eat. It's not just the safest course for the doctor to avoid a lawsuit, but the safest course for them to protect you and your baby.
I lost my grandfather to aspiration pneumonia. I was told by the doctors there was nothing that could really be done once it was contracted. It's almost invariably fatal. I would hate to hear about a young mother dying from it soon after the birth of her child. That would be an incredible tragedy. Especially if it were a preventable tragedy.
Posted by Theaca (Member # 8325) on :
Belle's got it nailed, all right. Yep. Although, aspiration pneumonia isn't as fatal in younger healthier people. Can cause lots of trouble, though.
Posted by beverly (Member # 6246) on :
quote:The doctors are indeed weighing risks - should I have everybody refrain from eating, or should I risk that someone will die from aspiration pneumonia that I could have prevented?
The point is, hospital policy about not eating/drinking while in the hospital does not prevent anything since most of these women likely come to the hospital with food in their bellies. *That* is my beef with this silly policy.
If all labor was a planned event where the women could come into the hospital having fasted for the previous 12 hours, well, wouldn't that be convenient? But we all know that isn't what actually happens.
Posted by ClaudiaTherese (Member # 923) on :
And there is another issue, one I almost hesitate to bring up. It may sound condescending -- if so, call me on it, please.
There is no physician who has been in practice for long that hasn't heard, "But if I'd really known what could happen, I wouldn't have done it. You didn't try hard enough to convince me." Gettting sued sucks. But letting down someone you care for who has put their trust in you really sucks.
So what do you do? On the one hand, there is what we do with children (who don't understand that even if it's painful, a broken bone needs to be reset, etc) -- we just do it anyway, "for their own good," with parental permission (or a court's if need be and appropriate). But kids are very very different from grown-up people who are autonomous agents and (rightly) should be in charge of their own bodies and decisions.
We don't just "do it anyway" to adults -- or at least, we shouldn't if at all avoidable (of course, if you are delirious and bleeding to death, you can't make that decision, so we make it for you -- until you can, ideally). One reason not to "just do it" is that physicians are only experts on the medical aspect of the situation. Patients are the experts on their own values and what a good life means to them. Having a physician make decisions for a patient means that doctor has decided that he or she knows better what is worthwhile and not worthwhile for that patient -- regardless of what that patient thinks.
And we know that physicians are often wrong about these sorts of decisions. We routinely underestimate the value of life to people who are disabled, we don't have some kind of special access into other people's brains and hearts, anf it's just plain arrogant to assume otherwise.
And yet, and yet. And yet there is how ashen you feel when someone says, "I didn't know. I couldn't have known. You should have known better." Not everyone will say that, of course, but you know some will. And you know that it's impossible to imagine how bad it can get, because it was impossible for you to accept what was happening the first time you saw it with your own eyes. It was like a war zone, a movie rated "X" for violence, a dream so bad it couldn't be true.
And if you couldn't believe it even when you saw it happen, how could someone understand it who never saw it?
But I'm not willing to take over autonomy from someone else, even if I think I know better. Not if they have strong feelings and reasons to do otherwise. I don't say "You have to do this" or "I won't let you do that" anymore. Not my decision to make. I do, however, urge strongly, give the soundest reasons I can, point to other accurate resources for more information, and use a lot of "I-statements:"
"I will be very worried about you if you don't do this."
"I'm afraid that X will happen, and I am afraid I will have let you down by not trying harder to convince you."
"If you choose to do Y, I'm pretty sure I'll be up at 3am worrying about what's happening to you. Of course, you have to do what you have to do -- but I just wanted you to know how concerned I will be."
That's about all I can do, I think. Really, it's the same as in any other interpersonal relationship: you have two people with different perspectives and different goals, sometimes which coincide (but sometimes not), each of which is working together to try to get somewhere better. All I can do (I think) is do my very best to be a good partner in that enterprise.
Posted by Theaca (Member # 8325) on :
I think surgeons often don't have the same bedside manner as you, CT. It's faster to just make rules "for the good of the patient."
This might sound condescending (CT's didn't) but sometimes ignorance is bliss. I can't tell you how many nurses and doctors and even my favorite biology teacher have told me that if they knew back when they were pregnant what they know NOW, they would have been petrified during the pregnancy and labor and taken their doctors' recommendations more seriously.
Ela did her nurse training after her pregnancies, come to think of it. I wonder what her thoughts would be on this subject.
Posted by beverly (Member # 6246) on :
You see, I am all for free will and putting the power of choice in the person's hand. I enjoy doctors who treat me as an adult, who don't patronize, don't talk down to me. I love it when they treat me as intelligent enough to handle all the information (even if they have to explain some of the vocab to me. ) Quite often they will give me *strong* suggestions of what they think is best, but they leave the decision up to me.
And frankly, if I were to whine to this doctor later that they didn't try hard enough to convince me, they would have every right to look me in the eye and say, "I did warn you. You are an adult, and you made a decision. You are repsonsible for the consequences."
And to those who think they are grown up enough to take responsibility and later whine, they need to learn what being grown up and responsible really means.
Posted by ClaudiaTherese (Member # 923) on :
quote:The point is, hospital policy about not eating/drinking while in the hospital does not prevent anything since most of these women likely come to the hospital with food in their bellies. *That* is my beef with this silly policy.
If all labor was a planned event where the women could come into the hospital having fasted for the previous 12 hours, well, wouldn't that be convenient? But we all know that isn't what actually happens.
It's a matter of making the best of whatever situation presents itself. A woman coming in from the street with a full belly isn't the ideal situation. Just because that happens, though, doesn't mean that things can't be made more ideal in other situations. Most women who go through a hospital delivery labor for more than 6 hours in the hospital before delivering there.
Consider having your child in to have surgery on his throat (say, to have his tonsils removed). You could make the argument that some kids come in off the street with full bellies and need immediate throat surgery (say, have torn their windpipe in a car accident, or were running with scissors and jammed them through the back of the throat). Surely the anesthesiologist finds a way to deal with that, so why can't my child have something to eat and drink, rather than cry all morning with hunger or thirst?
But the anesthesiologist will turn down the surgery and make you reschedule if that happens. SO long as he or she doesn't absolutely have to do it right then, they won't -- not will anything extra in the belly.
This is despite having their schedules screwed up, despite getting chewed out buy administrators or tech staff for "wasting ER time," despite even making themselves or someone else to come in over the weekend in order to take care of the wonked schedule. It's that important.
I don't know any way of explaining why it is that important without actually showing you. On the other hand, I know how convincing "just trust me" is. I don't blame you for your irritation at the policy, that's for sure.
Again, I wish you a very safe and smooth experience, however you decide to handle it for yourself.
Posted by Theaca (Member # 8325) on :
Reminds me of the person who cheats on a diet and eats two cookies. Then says, oh well, the diet is blown, I'll just eat six more cookies.
Posted by ClaudiaTherese (Member # 923) on :
quote: I think surgeons often don't have the same bedside manner as you, CT. It's faster to just make rules "for the good of the patient."
Yeah. I have the luxury of having more time. Very different jobs, eh?
Posted by ClaudiaTherese (Member # 923) on :
I worry, though, about how that tack of "doing it for the good of the patient" works out long term in issues of compliance and attitudes toward allopathic medical care. There are some good reasons why alternative and complementary practices have exploded in popularity.
What I want is good outcomes for my patients. Part of that is acknowledging that I don't know all about what "good" means to each of them. I also have to think about what the long term effects of my actions are.
Posted by Theaca (Member # 8325) on :
I agree. I am definitely NOT a paternalistic type of doctor.
Posted by ClaudiaTherese (Member # 923) on :
I will never, never , never forget the first patient I met who died of AIDS. I was a medical student, and we were to meet with some patients who volunteered to tell us their stories.
His partner wheeled him in. He was on oxygen, emaciated, but had a sweet smile. He wore a brightly colored t-shirt.
When he had been diagnosed, it was early in the first throes of the epidemic. The physician and nurse treated him like shit. When the med tech took his blood pressure and it was nice and low, she said "Well, we don't know exactly what you'll die from, but at least it won't be a heart attack."
It was a ghastly story, but the kicker was that the pain that was caused was truly unintentional. (He could see that from the perspective of years, but it cut deep at the time.)
He and his partner didn't go back to an allopathic physician for something like 5 years. Instead, he researched nutritional therapy, traveled to Mexico for shamen treatment, tried all sorts of stuff from all around the world. Macrobiotic diet, you name it.
Now, when I met him, there had just come out an "HIV cocktail" of retroviral threrapy that was really, truly, for the first time saving people. It required a lot of work and dedication -- there were dozens of pills a day -- but it worked for many. And my guy had all the dediation and strength of mind in the world.
But -- you knew this, right? -- it was too late for him. He already had progressed too far, and he wasn't strong enough for those meds, although he would have been an excellent candidate otherwise. So he was waiting to die.
How can we not take the long term effects of our actions into account? Save them this once, save their lives and save yourself time to save someone else, too, but lose them all when they say "To hell with you, Doc, I'm never going through that again." And they fly off to Mexico or drink herbal teas or what have you, and sometimes it's okay, but sometimes they die. And sometimes they die because you, you, you -- you let them down.
It's a damned if you do, damned if you don't kind of job. A balancing act on the ringside seat to humanity.
Posted by beverly (Member # 6246) on :
Sara, I have actually never wanted to eat in labor--not that I remember. It is more the water issue that directly effects me. I don't see myself guzzling water either. But being able to swallow water--even just a few swallows!--is *so* much more satisfying than chewing ice cubes.
quote: But the anesthesiologist will turn down the surgery and make you reschedule if that happens. SO long as he or she doesn't absolutely have to do it right then, they won't -- not will anything extra in the belly.
But this brings it back to the extent of the emergency. If they can reschedule, it obviously isn't an emergency. But if it is an emergency, and life is at stake, they aren't going to stop because the child just had breakfast! Why can't it be the same for the few cases where a c-section needs to happen *now* or there will be death? So it isn't an ideal situation. Neither is the little boy who just ate breakfast and has to have surgery or DIE. It happens. That's life.
quote:Most women who go through a hospital delivery labor for more than 6 hours in the hospital before delivering there.
I guess I forget that labor tends to be this long or longer. For my last child, I was in the hospital about 2 hours before the birth. (No desire to eat whatsoever, of course.) But I had had dinner just a few hours before. If I had needed emergency general anesthesia, how much more danger would I have been in than if I'd had a snack in the hospital? Is there a significant difference in the danger? Is it worth it?
You know, it's funny, but almost *anywhere* you read about early labor (usually spent at home) they tell you to have a light snack, since you might have to go without for a long time in the hospital--and you will need the energy. This runs so contrary to the hospital policy/perspective. And yet the advise is pretty standard wherever you look.
I guess I still don't really see the sense in it.
Posted by ClaudiaTherese (Member # 923) on :
quote:I guess I still don't really see the sense in it.
I know you don't. I do, but I don't know how to share that effectively. Looks like we're at an impasse.
But I do respect your decisions. I'll just be a little extra worried, and I'll be a lot extra relieved when you post pretty picture of you and Porter and your new baby, and when you tell us how wonderfully it all went. Posted by beverly (Member # 6246) on :
quote:It's a damned if you do, damned if you don't kind of job. A balancing act on the ringside seat to humanity.
That really sucks. I guess that feeling is going to come in any job that deals with life-death situations. What more could I have done? If I'd done this other thing, would they still be alive today? That is a horribly heavy burden to carry. Firefighters, emergency rescue teams, doctors, they all have to carry this burden. And it isn't fair, because if it weren't for them there would be a heckuva lot more death in the world.
Posted by Theaca (Member # 8325) on :
Helping a patient choose therapy should be like a partnership, with mutual respect. Patients just drink in education and rational explanations for things. I've had patients tell me they've never had a doctor take the time to explain anything before. Just order them around. People aren't going to change their lives, pay for meds, take them properly if they don't know WHY and don't realize the importance of it.
Posted by Olivet (Member # 1104) on :
When I went in for my surgery, they requested a urine sample as a part of the normal pre-op stuff. I didn't know why, but it turned out to be a pregnancy test.
The drugs they give you can be very, very bad on unborn babies, and they simply can't afford to take a person's word for it, even on the waiver forms.
The nurse said she'd only ever had two positives. One was happy about it. A little surprised, but married and prepared for it.
The other was TWELVE. Can you imagine the hairball that could have turned into if they had not done the test? Oy, vey. I generally don't question the 'rules' when it comes to stuff like that.
Posted by beverly (Member # 6246) on :
Sara, thanks. And don't worry, if my birth was as quick as last time, I probably won't be eating or drinking in the hospital anyway. And with the wonderful sense of humor the universe has, after complaining so much, I will probably have to have an emergency c-section and will aspirate the previous morning's breakfast. But the hospital staff will sleep well that night, knowing that it wasn't their fault. Posted by Theaca (Member # 8325) on :
Yeah, when I was a medstudent in the ER needing antibiotics I told them not to do a pregnancy test. I lied and stated my period was a week earlier. But I wasn't sexually active, so I didn't need the test. They nodded and agreed not to but later I looked. Yes, they DID do it. By blood test. I've seen so many pregnant people in denial since then that I'm not angry anymore. They shouldn't have lied to me though.
Posted by beverly (Member # 6246) on :
Funny, I am not at all bothered by insisting on a preg test. Posted by beverly (Member # 6246) on :
Quick question--if a woman has an epidural and it is working well, will they forego the general anesthesia in rush c-sections?
Is that one of the reasons why OBs tend to favor epidurals?
Posted by ClaudiaTherese (Member # 923) on :
quote:Quick question--if a woman has an epidural and it is working well, will they forego the general anesthesia in rush c-sections?
Is that one of the reasons why OBs tend to favor epidurals?
To the first question, I believe the answer would generally be "yes," but I'm not an OB/Gyn, so it's just an educated guess. What you need is to be able to cut and sew back up, and any sort of anesthesia that allows you to do that (relaxed muscles and pain control) should suffice.
As to whether that is why they tend to prefer epidurals, I have no idea. Could be plenty of things that factor into that. (Honest answer -- culture and comfort level could be big factors, too.)
Posted by beverly (Member # 6246) on :
I imagine it greatly depends on how the epidural works on that person--a very difficult thing to ascertain from the outside.
I have had two epidurals, and both knocked out all sensation of all kinds from the waist down, and probably higher than that. They could have cut off my leg, and I wouldn't have known it if my eyes were averted. My leg fell off the table, and I had to ask, "Which one?"
I think a lot of women have epidurals for c-sections also--it seems like a lot of women are awake for them (though these are planned c-sections a lot of the time--I think.)
If epidurals do prepare a woman for the worst of emergencies, I can understand doctors encouraging women to have them. My first OB thought any woman who wanted to go through natural childbirth voluntarily wasn't right in the head. My husband tends to agree. Posted by Miriya (Member # 7822) on :
When I had my son in hospital I refused to have an epidural. The nurses repeatedly said, 'but what if you need an emergency c-section?'. I know many women who have had c-sections, all of them had them awake and with epidurals. So I'd say yeah ... they would forgo general almost all the time for c-sections when you have an epidural.
However I know of women who were put under after c-section delivery to do other procedures/repairs where needed.
I'm glad to know I'm not right in the head but I know many OBs who avoid epidurals when they aren't demanded or needed as they can slow labour and cause ineffective pushing. I'd prefer a quick natural labour to a long haul with a large catheter in my back. Posted by ClaudiaTherese (Member # 923) on :
I'm pretty sure you're "right in the head," bev. *grin
You have a good head on your shoulders. You also have strong and well-thought-out opinions, and you have a steel-spined character. That doesn't make for a very easy person to push around.
*high-fives
We need all the strong women we can get in the world.
[You, too, Miriya. And welcome to Hatrack! ]
[Edit 2: Ack! I see you've been here for quite awhile, Miriya. I'm so sorry -- I'm just slow. ]
Posted by theCrowsWife (Member # 8302) on :
At least at my hospital, they only used general anesthesia for c-sections if it was an absolute emergency. I didn't plan to have one, but ended up with a semi-emergency one anyway because my daughter was in distress. I had had an epidural put in already, and they just increased the dosage in preparation for the operation.
It was very strange, because I could sort of feel things, but not pain. When they delivered her I felt a huge amount of tugging, which the doctors had warned me about before-hand.
Luckily, they let my husband come to the OR with me and hold my hand. I'm not sure how well I would have done if he hadn't been there. Not many things scare me, but abdominal surgery is definitely one of them.
--Mel
Posted by ketchupqueen (Member # 6877) on :
Epidurals don't work for everyone, and they don't work perfectly for even more. For instance, I had an epidural that worked well enough to dull the pain for me to relax and have the baby, but never stopped the pain completely. (They kept pinching me to make sure I knew the difference between "pain" and "just pressure". ) So I don't think that would have been good enough for a c-section, even though it worked for labor. And doesn't it complicate things if you have an epidural and then they want to do a spinal block or need to do general for an emergency? (They had to stop upping the dosage at one point because the room started spinning for me and my speech got garbled.)
Posted by beverly (Member # 6246) on :
Thanks, Sara. Of course, after my ranting is done, I start second-guessing myself and wondering if I went overboard.
Miriya, I went natural last time (by choice) and intend to do so again this time. My husband is freaked out, but he doesn't try to change my mind either. Wise man.
One of the reasons why I like my CNMs is that they are so much more oriented towards supporting me in what I want rather than getting on a soapbox and pushing their preconceived notions (my first OB). I know there are wonderful, supportive doctors out there too, but the hunt for the right doctor can be exhausting. I'm happy with what I've found. It takes energy to go against the grain, and I prefer to have less obstacles in my way.
Posted by Miriya (Member # 7822) on :
quote:[Edit 2: Ack! I see you've been here for quite awhile, Miriya. I'm so sorry -- I'm just slow. [Blushing] ]
CT: No worries... I haven't posted all that much outside the pregnancy thread since I've spend most of the last five months in the clutches of nausea and crankiness. (pregnant with hyperemesis... ick)
Epidurals: my understanding is that in a c-section you do feel a lot of pressure and pulling, etc but not so much the pain of being cut open, etc. It is still prefered for c-sections I believe because the medication doesn't affect the baby as adversely as general anesthesia and because that way moms are awake to see their babies immediately. I don't know what they do with women where it doesn't take... but I hope there aren't too many of them Posted by beverly (Member # 6246) on :
I think that is why most hospitals, if not all, insist that you have the "plug" in your hand for an IV drip (I can't remember the proper name). They can give you general anesthesia very quickly through it. A not-working epidural would probably be cause for it to be used.
Posted by Miriya (Member # 7822) on :
quote: One of the reasons why I like my CNMs is that they are so much more oriented towards supporting me in what I want rather than getting on a soapbox and pushing their preconceived notions (my first OB). I know there are wonderful, supportive doctors out there too, but the hunt for the right doctor can be exhausting. I'm happy with what I've found. [Smile] It takes energy to go against the grain, and I prefer to have less obstacles in my way.
I agree. "Informed Choice", as opposed to informed consent, is one of the three tenets of midwifery care in Ontario. That makes it pretty standard to expect midwives will take your preferences and choices seriously so long as they aren't seriously unsafe. It's hit or miss with OBs although there are wonderful ones!
By the way, I really hope I don't come across as one of those "natural childbirth is the only way" people. I find that attitude quite distasteful. A successful childbirth is one with a healthy outcome for mom and baby. Whatever works for you. Good luck! Posted by ketchupqueen (Member # 6877) on :
I had a dream last night (well, really, this morning) that I was pregnant, with twins, and didn't know it because I had gotten my period every month anyway and we always use condoms. I went to the ER with severe back pain and cramps and they rushed me to L & D. And my mom had to take off work to watch my other child and then I had to have an emergency c-section and one of the babies was born with Down Syndrome. And then everyone kept trying to get me to give the baby with Down Syndrome up for adoption because I wasn't capable of handling it and two other children under two. And I didn't want to because it was my baby but they were trying to make me.
I guess all my worries kind of morphed together and mixed with this thread. But it was a scary dream.
Posted by Belle (Member # 2314) on :
I needed an x-ray once after my hysterectomy and the tech asked me if I was pregnant. I said no, I've had a hysterectomy. She said "Are you sure?"
Um...yeah, I'm pretty sure I've had a hysterectomy. Posted by ketchupqueen (Member # 6877) on :
Oh, Belle, that's a great story.
They used to ask me over and over if I was pregnant before my dental x-rays. Like I was going to change my mind if they asked three times. I finally told them, "I'm not sexually active. Are you happy? Now please stop asking me!" I was 14! Sheesh!
Posted by beverly (Member # 6246) on :
quote:By the way, I really hope I don't come across as one of those "natural childbirth is the only way" people.
Not at all! Just letting you know a bit about where I was coming from after my "not right in the head" comments. Posted by Belle (Member # 2314) on :
CT, Theca - what's with shaving before a surgery? Is it just for the ease for the surgeon, or is there really that much higher risk of infection if you don't shave the area?
Because I remember a family friend who had a terrible accident, she was just 11 years old, and needed a plastic surgeon to sew up the head wound. He left all her hair, only clipping and shaving the barest minimum of skin, so that once it was done you couldn't even tell she'd had surgery, everything was covered by her hair. I remember thinking that when she came out of surgery she'd be practically shaved bald on one side of her head, but instead, she came out with pretty much all her long hair intact.
That made me think, if he could do that, how necessary is shaving in every other case?
Posted by jeniwren (Member # 2002) on :
I've done it both ways...my son was natural, my daughter with an epidural. I liked my son's birth much better. Much. He came in 7 hours. She took twice as long. Truthfully, by comparison, his birth didn't hurt nearly as much.
But they were very different experiences from start to finish, and I wouldn't have been without that epidural for the world. It made it bearable.
Posted by ClaudiaTherese (Member # 923) on :
Belle, my understanding is that the research shows that shaving actually increases the risk of infection. Where I trained, the women were not routinely shaved for childbirth.
This is a fairly recent change, though. When I had my first open-heart surgery in 1987, I had to shave everything except eyebrows and head hair -- pubic region, arms, everything. In contrast, I shaved nothing for the same surgery done 3 yrs ago.
quote:Best Pract Res Clin Obstet Gynaecol. 2005 Feb;19(1):103-15. Epub 2004 Dec 13.
Evidence-based intrapartum care. Hofmeyr GJ.
Effective Care Research Unit, East London Hospital Complex, University of the Witwatersrand/University of Fort Hare/Eastern Cape Department of Health, P Bag x9047, East London 5201, South Africa. gjh@global.co.za
Routine care in normal labour may range from supportive care at home to intensive monitoring and multiple interventions in hospital. Good evidence of effectiveness is necessary to justify interventions in the normal process of labour. Inadequate evidence is available to support perineal shaving, routine enemas, starvation in labour and excluding the choice for home births. Evidence supports continuity of care led by midwives, companionship in labour, restricting the use of episiotomy, and active management of the third stage of labour, including routine use of 10 units of oxytocin. Both benefits and risks are associated with routine amniotomy, continuous electronic fetal heart rate monitoring, epidural analgesia, and oxytocin-ergometrine to prevent postpartum haemorrhage. More evidence is needed regarding the emotional consequences of labour interventions, home births, vaginal cleansing, opioid use, the partograph, second-stage labour techniques, misoprostol for primary prevention of postpartum haemorrhage, and strategies to promote evidence-based care in labour.
Posted by Belle (Member # 2314) on :
CT, I've never been shaved for childbirth, only for surgery. In particular, shaving the groin area for my hysterectomy was most uncomfortable.
Posted by ketchupqueen (Member # 6877) on :
They do need to shave at least the part of the head they're going to be cutting into on head surgeries, though. But most surgeons, especially ones who work with children, are careful to shave only what they need to for clear access and the nurses show the children (or parents) how to comb hair over the scar if they end up with one. (Most surgeons, especially the plastic surgeons who are often the ones doing cranial surgeries, also take pride in careful stitching that creates the least amount of scarring possible.) That's a fairly recent change that has occured with the last couple of generations of surgeons, but it's really become very standard. (My mom is the nurse-coordinator for craniofacial services for Kaiser Southern CA, so I hear a lot about this stuff.)
Posted by ClaudiaTherese (Member # 923) on :
I think medical practices change slowly. I think (think) that the evidence does not support shaving prior to surgery unless it is necessary to get a clear view (and then, only what is necessary). The scraped skin seems to pose more of an infection risk than clean hair does.
People are most comfortable how they've been trained, though, regardless of evidence-based guidelines. The best predictor of how a physician will treat back pain is when he or she graduated -- many older docs still recommend rest, even though moderate activity seems to help in controlled clinical trials.
It's good that things change slowly, in some ways, though. You definitely don't want fads and bandwagons to be too popular in medicine. There has to be a happy medium, even if it is hard to hit.
Posted by ClaudiaTherese (Member # 923) on :
^----- (awarded Most "Thoughs" in a Post Trophy)
Posted by Miriya (Member # 7822) on :
Thanks for the study quote CT. Lots of good info!
Posted by ketchupqueen (Member # 6877) on :
One good thing is that if you have a good doctor who is willing to discuss things, you can bring in these studies and bring up your concerns.
Of course, my last OB graduated from med school in 1956 and he is one of the most progressive and accommodating OBs in Dallas. I guess he's just what you'd call "open-minded" (and keeps up with his CE.) He was just a sweetheart all around. I'd recommend him to anyone having a baby in Dallas.
Posted by rivka (Member # 4859) on :
quote:Originally posted by ketchupqueen: Epidurals don't work for everyone, and they don't work perfectly for even more. For instance, I had an epidural that worked well enough to dull the pain for me to relax and have the baby, but never stopped the pain completely.
That's how they work on me, too. Apparently I am one of the percentage of women (I once heard an estimate of 10-20%) whose brains interpret pressure as pain.
Makes going to the dentist (as I did today) extra fun too.
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) The other nearby hospital was much more relaxed. It helps to check out all the nearby maternity wards to figure out which one works for you. (EDIT: I should add I'm in Canada where shopping around for health care is a little less difficult)
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Can you imagine the hairball that could have turned into if they had not done the test? Oy, vey. I generally don't question the 'rules' when it comes to stuff like that.
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Apparently I am one of the percentage of women (I once heard an estimate of 10-20%) whose brains interpret pressure as pain.