So at my Dr.'s appt. yesterday, I was speaking to the Dr. about my prefernces for a natural birth. She brought up using pitocin "for instance if you're stuck at a 7." I was so caught off guard that I didn't ask her to define how long 'stuck' was, etc. It is really bothering me the more I think about it and I am kind of getting freaked out. I'm just not sure if she was prepping me for all scenarios in case my birth doesn't go as planned, or if they use pitocin frequently. Other than this comment, I liked her okay and overall the practice is very pro-vaginal birth.
We have HMO insurance, so I really don't have many options for switching doctors. The practice has 4 doctors and 1 midwife who deliver. Up to this point I've only met with the NP who doesn't deliver. They have the lowest c-section rate in the area. Part of me feels like there is no point in continuing these conversations with the 5 different people I will rotate through from now on, because I just end up annoyed and frustrated. DH feels like I need to stop focusing on it, and focus instead of thinking about how I'm strong, baby is strong and things will be fine. I do feel like he will be a strong advocate for me in labor. I also have a friend who is a doula, who will likely doula for me.
I guess I'm asking if anyone has experienced something similar with their dr. and what the outcome was with labor. I am planning on laboring at my mom's (she's 10 min. from the hospital, and we are an hour away) for as long as I possibly can. I had hoped for a homebirth, but the cost is over $4000 vs. the $250 we'll pay for the hospital and I just can't justify it.
Thanks if you made it this far!
Successfully used FAM to avoid pregnancy for 57 cycles
TTC 1 cycle, BFP 9/5/11!
Make a pregnancy ticker
I don't have this experience, but my advice is you need to be honest and open about your concerns with someone at the practice. Honest doesn't mean rude, so you can be nice about how you're feeling, just try to get clarification on how they do things. I would also see if they approve of any non-pitocin methods to help a stalled labor (your doula-friend should be able to help you determine what some of these might be). Are you hoping for a non-medicated vaginal birth? The practice may be pro-vaginal birth, but they may push epidurals (and pitocin leads to a greater chance of using pain meds). Where I'm giving birth has a 90%+ epidural rate and a 42% c-section rate, BUT my doula explained that the doctor I chose is very open to people's natural-birth desires, and as long as I'm open with him about what I want, he will honor it (and the others in his practice will honor my birth plan). She said the only way to not get the status quo of care is to let them know what you want.
I definitely think you should hire your doula friend -- having her there with you will lessen your statistical chances of needing pitocin or epidural or c-section.
Good luck to you!
My Charts
DH Me, and
Be joyful in hope, patient in affliction, and faithful in prayer. ~Romans 12:12~
Just remember that you have the right to refuse treatment. If your baby isn't showing signs of distress, regardless of how long you've "stalled", there's no reason to push things along. I was "stalled" for 74 hours, had no clue how much I was dilated because it doesn't matter and everything I did to get labor going resulted in it stalling out again. It was only when I let go of the idea of speeding it up and just relaxed that labor finally became regular. I would say laboring at your mom's place for as long as possible is a good idea. Prepare your husband and doula to be as on guard as possible, and don't be afraid to lock yourself in the bathroom to get them to leave you alone. Peace and quiet is what laboring women need most.
I wanted a birth center birth with my first, but like you I couldn't justify the cost when we had insurance that would pay most of the hospital. My labor started with my water breaking, and I labored at home for 8 hours, when I got to the hospital, I was only 1 cm.
Over the next 20-something hours, I had only progressed to 4. I had a very specific birth plan and it was completely honored. I had 6 different nurses and 4 different midwives (and OBs who over saw them, but I am not sure since I didn't actually meet but 1 of them). Not one of them pressured me into using any medication, although some of them did offer BUT only when discussing my options. (Like "Okay, well, you're still at 4... here's what we can do...)
My advice is - don't get an IV for as long as you can. And write out your birth plan. Have a doula if you can. I think that helped them respect me. If they suggest Pitocin and you are sure you don't want it - just tell them, let me do one more hour and we'll talk again. Or I want to try walking, then we'll see what happens.
After 35 hours, I ended up asking for pitocin and the epidural, but it was completely my choice. Just remember that they cannot make you do anything. As long as the baby and you are not in distress or showing any signs of infection, stand up for yourself... and make sure your hubby does too. My husband was the BEST advocate for me!
Good luck mama. You can do it!!
Jennie, 27 DH, 29
My Baby Boy - Matthew born April 6th, 5:52 am 6lbs 15 oz and 19 inches
Thank you so much for all of your replies- they are really helpful! I especially like the locking myself in the bathroom plan Thanks also for not suggesting that I switch docs, b/c this practice really makes the most sense for me and they also deliver at the only baby friendly hospital in my area.
@April, I know you are right that I need to keep bringing it up at each appointment, so that everyone is on board with me. The dr. I saw yesterday and the NP have both assured me that the practice will support my desire for a non-medicated birth, and the Dr. did seem happy/receptive when I told her that I am doing hypnobirthing. I have a colleague who birthed her son with this practice w/o pain meds, but she did get pitocin to augment her labor (although it was completely her choice). My main objection to pitocin is fear of the cascade of interventions, and I think that is how I will express my concerns about pitocin to the rest of the practice at my future appointments. I don't want to come off as combative (I am pretty hot-headed so I don't want to piss anyone off at the office w/o thinking about it), so I think that's why I just kept my mouth shut when she mentioned the pitocin.
I totally understand where you're coming from - I too have limited options because of my insurance (and my prior c-section). I find that what you're doing works well - ask general questions at one visit, then go back the next time and say "ok, I've thought about it - you said we do x, but could we do y instead as long as baby is looking fine?" Mostly you find they are open to these things and will honestly tell you what they're cool with as alternatives. If you approach it in a friendly way, you are likely to get a good response... Just because "pit for stalled labor" is standard doesn't mean you have to accept it unless you WANT to. For example, induction at 40 weeks for VBACs is standard at my office, but we've already talked about going at least a few days overdue with extra monitoring.
Susan - 30 married to Chris - 32
Catherine Anne born via c-section June 30, 2008
Rebecca Marie born naturally April 18, 2010
John McNary born naturally January 9, 2012
Calladona: I find that what you're doing works well - ask general questions at one visit, then go back the next time and say "ok, I've thought about it - you said we do x, but could we do y instead as long as baby is looking fine?" Mostly you find they are open to these things and will honestly tell you what they're cool with as alternatives. If you approach it in a friendly way, you are likely to get a good response... Just because "pit for stalled labor" is standard doesn't mean you have to accept it unless you WANT to.
I find that what you're doing works well - ask general questions at one visit, then go back the next time and say "ok, I've thought about it - you said we do x, but could we do y instead as long as baby is looking fine?" Mostly you find they are open to these things and will honestly tell you what they're cool with as alternatives. If you approach it in a friendly way, you are likely to get a good response... Just because "pit for stalled labor" is standard doesn't mean you have to accept it unless you WANT to.
This is excellent advice. I have used the same approach with my OB and have been pleasantly surprised at how open to alternatives from the norm he is.
With my first delivery, I got a bad feeling from my (different) OB at 38 weeks and simply could not change -- no one would take me . I went to see another OB in the practice and told her my concerns about wanting to have an intervention-free birth. She acknowledged that the hospital was intervention-heavy and if I wanted to go natural, my best bet was to stay at home as long as possible. So I did. After 22 hours of labor, I got to the hospital at 9.5cm. And then I stalled. We tried everything natural first and then eventually I gave in to pitocin to get things moving (the baby was fine, so there was no rush). Eight hours later and still nothing happening. I consented to jacking up the pitocin, as I was getting pretty desperate. What I did not know was that I was carrying a 10lb baby in a posterior position, so she was unable to descend at all to help push open my cervix. I ended up with a c-section after all of that, but I have to say that even for an intervention-heavy hospital, my plan to stay at home as long as possible worked, in the sense that by the time we were trying pitocin, it was pretty much a last resort. If you are only 10 minutes away, you can hold out for a while. If you show up at 9cm, there's usually not much left to do!
Laura
(6), (4), (2), born May 16, 2012!
The shop is closed. Our perfect family is complete
Yes, I'm planning on staying away from the hospital as long as I can.
@Susan- thanks for the support. Sometimes I feel like this all has to be sorted out NOW, but really there is plenty of time for me to continue the conversations. I know having time to think it over makes me much more pleasant!
@Tortuga- Stories like that give me faith that the best interests of mom and baby are at heart
What were your mom's pregnancies like? I ask only because my family has a history of fast labors, and had I waited around too long before going to the hospital it would have meant an unexpected delivery at home. This time around I'm 45 minutes away from the hospital and planning to go as soon as I suspect I'm in labor. That's why, for me, it's most important to ensure my OB, his staff, and my birth plan are all in concurrence... Then again - being a fast laborer, there's not much time for them to do many interventions on me ;) I just bring it up, because my mom almost didn't make it to the hospital in time for me to be born :)
I have to agree with snurfy: you have the right to refuse anything and if your baby is not in distress they can't really say anything to force you into things. That being said, DO NOT let them break your water if you are stalled because that has a 24 hour window, sometimes 12 hours depending on where you are and their "policies".
I was induced so that my hubby could see our son before being deployed (I was 9 days late, it's not like I didn't try to wait to go naturally!) and even though I was on pitocin, I totally told them how much they could give me and at what point it was almost too much and they could NOT increase it. I didn't want any pain medicine so I was making sure that it was in check, and they respected that and kept it at a tolerable rate for me.
I think that would be great to labor at home for as long as possible. Especially with your first, unless you have unnaturally quick labor/birth, you really don't need to go until your contractions are 1-2 minutes apart and lasting at least 30 seconds.
I personally didn't bother bringing my birth plan with me and didn't tell the staff anything other than I don't want pain medicine. I delivered at a military hospital and my attitude was deal with it when I get there because there are going to be so many different people on call and people I've never met before. It seemed to work just fine.
You will be great! GL!
Alicia (24) Levi (24)High-School Sweethearts
Went off BCP 12/2009 Born 3/18.
TTA until July or August
I just wanted to touch back to your first post. You had mentioned that you haven't met everyone at your practice, and didn't want to have the conversation with the rest of the docs/mw. I would just like to share a quick story. With DD, I was seeing an OB through my pregnancy. Towards the end of the pg I started meeting the other docs who would possibly be delivering. While my original OB was very supportive of a natural birth and my birth plan, the one woman doctor basically told me that she was angling for a c-section. I was shocked by how up front she was about disregarding my wishes and just jumping right to where I did NOT want to be. I argued with her for a few minutes but it was pointless.
I too thought about changing practices, but I am so glad I didn't. I ended up delivering at the hospital with one of the midwives, and it was a great experience. I share this because I want to emphasize that different doctors at a practice will have different philosophies, and you shouldn't assume that they all share the same ideas. Keep talking to the other docs and midwife, and try to make sure that you request the midwife to deliver if at all possible. At least have a hierarchy of who you think will work best.
The thing is, you go into labor and one of the docs will be there, it might not be who you want. I realized that it didn't matter so much who was there to catch the baby - it was more about the nurses, my doula, and my husband. I HIGHLY recommend having a doula. She was the best and soooo helpful, even though I had a pretty easy labor I'm so glad she was there to help.
All in all, you will do great. You've got your idea of what you want to happen, and that is good. BUT labor does funny things to a woman, and try not to be too disappointed if it doesn't all go as planned. There's really no controlling your labor, all you can do is be as informed as possible and it seems like you're doing that.
Anwyay good luck!
Me (35) DH (36) =
TR (2)
TTC #2 since June 2010
December 26, 2010 @ 7 weeks
Due May 2012 -
My chart
Just to piggy-back on lava2's comments... this is something I took into consideration when choosing my OB this time around. I talked to my doula to get the scoop on how the other OBs were and whether they would respect my wishes like the OB I wanted would. I always warn friends that they need to be aware of everyone in their practice and understand how the hospital they will deliver works. You may love one OB and hate all the others :)
I will say, though, that while it may not seem like it matters who catches the baby, I have heard stories from my doula friends about doctors who are obnoxious, impatient, and completely insensitive push the nurses to push something just so they can get home for dinner. So, while the doctor won't be there most of the time, he/she may still be calling the shots and pushing the nurses to do something.
Let me give you a brief version of my story - an appropriate use of pitocin for stalled labor.
My birth plan included a birth-center waterbirth, all natural.
Thursday night, I had prodromal labor and did not sleep. Friday I went to work, no contractions. Friday night, real contractions started. Lasted all night and I, again, did not sleep. My doula came over the next day at noon and after two hours was about to leave (my contractions were every 4-5 minutes, but I could talk and laugh and even took a walk without a problem) when my water broke all over the kitchen floor. I was GBS positive and needed to get started on antibiotics right away.
We went to the birth center. When they did a cervical check, I think they expected me to not be that far along but I was 8 cm! I labored like a champ for the next 14 hours, but 14 hours later, I was still only 8 cm - the anterior lip of my cervix would not dilate. We believe this was due to cervical scarring from a colposcopy done 7 years ago (you can google stalled labor and cervical scarring - actually pretty common). My contractions were also not speeding up and sometimes there would be a long interval between them. I felt as if I was circling the drain. As I was GBS positive with a broken water, we couldn't wait much longer, esp b/c a hospital will basically do a c-section if you go 18-24 hours past a broken water if you are GBS positive. We didn't want to get to that point.
The decision was made that I would be transferred to the hospital and induced with pitocin. I was, at this point, about 30 hours into labor with no sleep for the past 3 nights. I was put on a mild pain killer and they started the pit drip. I HATED pitocin, but it was necessary. I was admitted at 4am and delivered at 10am. My husband said I said I felt a "pop" at some point (I don't recall this) and they think that was when the scarred portion of my cervix finally gave and they had me start pushing.
Did I enjoy being induced? Of course not. But it was necessary - my body would not give. I remember being at the birthing center and taking a moment to "grieve" my original birth plan but making peace with this new plan as it was the best thing for myself and my baby. In the end, Zachary was born and he is the best thing ever, no matter which way he came out. My midwife said that she has no doubt that had my cervix not been stuck, I would have delivered shortly after arriving at the birth center.
I will say, if there is something you do NOT consent to, be adamant about it. They cannot do anything that you explicitly do not give them consent to do. I did NOT want an episiotomy and I made that VERY clear to the OB that delivered my son. She insisted she wasn't going to do it, but I remember (in my hazy state) at one point her pouring iodine all over me and me screaming "Do not cut!" (my husband and doula both agreed they thought she was probably going to do an episiotomy as well, so my instincts were good). She said that I might tear "all the way to my bottom" and I said I would rather tear naturally. In the end, they did a lot of perineal massage and I only had a 2nd degree tear which healed nicely.
Best wishes to you! Take some consolation in knowing that however your baby is born, it will be the right way because in the end they will be in your arms! I wouldn't choose a hospital, pit-induced birth again, but that's how my little man came into this world and so it was still perfect!
myTCOYF WebCharts™
TTC for 3 months
First BFN on January 19, 2011!
BTW, I am not 46 weeks pregnant - my LO was born Oct 30th. I changed my sig in my settings TWICE, but for some reason it won't take.
@April, my mom said she was in "active," painful labor with me for about 3 hours, but total labor was about 18 hours. She is so low-key about the whole thing (has, for my whole life, said it was just like taking a big BM) so it's hard to pin her down on details. She walked a lot during her labor with me, and told me yesterday that she basically stopped walking, they checked her and she was ready to push. She had med-free birth.
It's hard because I don't really want to be in transition in the car, but I don't want to get to the hospital too much before I hit transition. I'm trying to be loose with my mental image of how it all goes. I do know that I am planning on not laboring at my own house for too long. We live on top of a mountain, and I am dreading the 40 minute winding drive off the hill in labor.
@Scurtis- thanks so much for sharing your story, it's so helpful to hear instances like that. It basically sounds like the pitocin prevented you from needing a c-section.
@lava- yeah, after reading all of these posts I see that I do need to keep bringing up my wishes with all the providers and not get lazy about that.
As for comparing to mom's labors --- my mom had 4 kids - all natural. Water broke at 38 weeks... had 8,6,4, and 4 hour deliveries.
My water broke at 38 weeks and I was in labor for 40 hours and ended up getting pitocin to help.
Sooo... don't expect it to be quick. I just say that because I did, and I was really disappointed when it was not.
I have no desire to be in the car for transition either ;) My mom tells stories about driving to the hospital when in labor with both me and my brother, and how horrible and uncomfy it was. For me, I'd much rather drive to the hospital before active labor sets in, and then just sit in the parking lot until I'm ready to go in ;) This is my current plan ;) I know how those windy mountain roads are, and that does not sound like fun ;)
I agree, I am kinda thinking about driving down to the hospital and then just walking around the area there... Of course with my luck, there'll be driving snow at the time.
I am one of those people who got 'stuck'. It's good you're asking these questions now, because it's good to be armed with information. I thought I was, but this was something I didn't really anticipate. I had a LEEP procedure about 13 years ago, and they think the scar tissue caused the problem.
I had a 4pm appt the day before I had my DD. I was 1cm dilated, which was the same as I had been a month before, the only other time I had been checked. I had had some irregular, but more painful than BH contractions throughout the day, so I was hoping that I would be further progressed and felt pretty discouraged. That night, I woke up around midnight with more contractions and by 4am we were at the hospital because I could not speak through them and they were every 2 minutes. When I checked in, I was at 4cm and within probably an hour, I was at 6. When they checked again around 7am, I was at a 7. My doctor came in and told me she was going to break my water. This is the first place in the process, I wish I had asked questions. I just took it as part of the process and let her break my water. Well, it was not long after that that the contractions that had been very regularly clocking at two minutes or less apart started spreading apart again. We walked, bounced on the ball, took a bath and tried nipple stimulation, but when they checked me awhile later, I was still at 7cm. Kept trying the walking, etc, but nothing was making much difference. The doctor suggested starting pitocin, but I did speak up then and said, no, that I wanted to avoid pit. I also was hoping to not have an epidural and to that point had been doing pretty good. She suggested trying to restart labor for a couple more hours and then starting the pit. Well, two hours later, no progress and the contractions would come and go. Finally, I was feeling so discouraged, I gave the go ahead for the pitocin. My nurse was very encouraging to me that I was doing great without pain meds so far, so I did not elect an epidural at that point.
Well, once the pitocin took effect, I soon realized why people end up getting an epidural. It was like one continuous contraction that was either painful or very painful all the time. I don't remember how long it took me to break, but i finally asked for the epidural. Thank goodness, I did finally dilate the remainder of the way. They had trouble with the epidural kinking, so the anesthesiologist came in four different times to attempt to fix it. Each time he would give me a ballast (sp?) of the epidural. Pretty soon, I had zero feeling from my lower ribcage down. I had absolutely no sensation of contractions, so when I finally started pushing, I had a very difficult time feeling when to push (had to go completely by the monitor) and when I was pushing, I couldn't tell what i was doing (the doctor even told me at one point that all I was doing was clenching my jaw). I had already asked them to turn off the epidural the last time they tried to fix it about an hour before, so I was no longer getting new anesthetic. Finally after about an hour of pushing, I started getting feeling in the top of my stomach and the bottom of my feet. I think I only pushed a couple more times and she was out. Just having that bit of sensation made a world of difference.
Anyway, sorry for the novel. I don't know that I wouldn't have eventually gotten the pitocin had I not had my water broken, but I do know that this time around, I plan to not let her break my water. Because it had been broken, I was pretty much on the clock once I allowed them to do that. If anything similar happens in terms of being 'stuck', I would like to make a longer attempt at getting labor going without intervention, or if there are no signs of distress to the baby, maybe even go home if I can. I'm also hoping that if it was the scar tissue that caused me to get stuck that it won't be an issue this time. Knowing what I know now, I am hoping to make it with no pitocin or epidural.
Jill
Jill-40 and Daron-46
Adan - 6, Maya - 2, Zachary - just arrived 3/26/12
TTC'd #1 for 4 years before adopting DS#1 - "God bless the broken road that led me straight to you"
After natural hormone therapies and change to more organic foods/products - 2 m\c, then DD#1 and DS#2
Jill, I hope the same thing about my scar tissue! While I accept my son's hospital birth, I am so excited to hopefully have my next one in a birthing center/home birth as a water birth! Everyone at the birthing center said they're pretty sure that, had my cervix cooperated, I would have had a great and fast birth!