Witness to an UNNECESAREAN

Hi Everybody

I want to share my agony with you as I was a witness to an unnecesarean (unnecessary C-section) yesterday. I supported a couple from yesterday 6 am to 11 in the night. They wanted a home birth kind of experience, read up everything on pregancy & natural childbirth, chose a doc recommended to them as a non intervention doc, attended my classes and wanted me as their labor coach.

As they discussed their Birth Plan with their doc , She promised

will wait 3 - 4 days after due date and then monitor and decide
no routine interventions, definitely no Pit , AROM

Due date Sept 15th, the couple went to their doc and before that discussed with on negotiating time. I told them that they could easily wait 4 - 5 days as she had nothing wrong with the pregnancy and the baby was doing excellent. I asked them to assure their doc that they would do maybe 2 fetal doppler / day and monitor movements etc. But ultimately she insisted they get induced the next day itself, however the couple pushed and got ONE day more. She was scheduled for an induction on 17th Sept.

The Procedure: Woken up at 4 am , administered enema and moved her to a dingy waiting room near the labor room. Inserted Cervix Gel at 6.30 am and refused to let her go back to her room (10 steps away) saying that anything could happen at anytime!!!! She had not even begun dilating. She was upset and could even take a nap there as the nurses were gossiping so loudly outside with duty docs and cleaning staff. Finally I asked her husband to request the doc to let her move to her room for a short for her to have some sleep. She said " you are putting me in a tight spot" and then agreed. Thankfully when she moved to her room , she was more relaxed and slept for an hour and half.

AT 12 pm , she was moved to the labor waiting room and given one more gel. Finally around 1 pm she started feeling contractions. We started working on positions and also massages and the contractions were coming at 3-4 min interval lasting 1 min. At the internal exam at 2.30 pm , she was 3 cm dilated and the doc said she would be assessed again in 2 hrs and then given one more dose or start Pitocin.

The day before , the Doc had told the couple that she would give her Cx gels 2 or 3 times and wait even Overnight if the situation demanded and would not use Pitocin and the couple trusted her completely. But from nowhere came the Pit in 2 hours diagnosis.

We decided that we will work with positions during the next 2 hrs and used squatting, lunging, birth ball and rest in between . Mean while as they had restricted food intake after 9 am , we kept her well hydrated with glucose drinks, juices.

She kept getting good contractions and required a lot of support and got it from me , her husband and her mother. At around 5 pm her contractions were getting reduced in intensity and were slowing down. She was re-assessed at 5.30 pm and she had dilated 5 cm but her Cx was still think and was not effacing. She was moved to the delivery room and a drip of saline started. At this point they administered epidocin, a drug that will help in softening Cx and also bring in contractions.

They also started continous electronic monitoring as they were using induction agents. She did not quit elike ENtonox and was handling her ctx with support from us and just holding the entonox mask in her hand for moral support.

Vag exams happening every 1 hour and 3 doses (6.30 pm , 7.30pm) of epidocin , 2 more cervix gel, 1 rectum gel and Pitocin. She was writhing in pain, threw up, legs shaking , feeling cold and unwilling to go further. So we were hopeful that she moved to 7 cm dilation but could work any more positions as she was strapped and hooked. Did not even allow her to use the toilet, used a catheter that was painful and when she was hurting , Doc tells her the nurse is not doign it on purpose but bcox it was difficult to put it in with the baby's head there. They could have just let use the toilet by disconnecting things for 5 min.

A drama happened when the fetal monitoring sensor moved from position bcoz she turn sideways. The alarm rang on the machine, doc ran in and stopped pit. Then realised sensor was misplaced and immediatelt heart beat got corrected , jumped back right on. But the imression created was lets watch closely and be careful.

Pit started again and at 8.30 pm she was still at 5cm. Performed AROM and then walks a nurse who says starting pushing and also refused to let her have semi incline which was asked for in the first place. Made the mother push and push , telling her she was not putting effort and doing things the right way. Finally I told her that she is awake from 4 am , show some consideration. I told the mother to switch her off and observed her contractions. They were only happening for 30 secs and not at all intense and were almost 5 - 7 min paced out. I told her not to push and waste her energy bcoz these contracttions were not strong enough. Duty doc examined , she was still at 5 cm and she broke down completely. It was so traumatic fro her and us also and told her vent her feelings. Let it all out and then muster courage from inside you and support her baby to come out as we were supporting her. But by then I knew where all this was heading.

At 9.45 pm, her Doc called her husband out and said she has been struggling for too long and the cervix was not thining out and did not want to lose the opportunity of baby's heart beat being strong and perform a C-section when things were good. We were worried how the mother would react but she was up from 4 am and it was almost 16 to 18 hrs.

After being probed and poked from every direction She just said "do whatever and deliver me" and then started the procedure for epidural(thankfully) and she delivered by 10.30 ish, her daughter was fine and I had to leave as it was 11 pm and I was going to drop from exhaustion. I think we also need strength training to handle long labors!!!

SO many questions in my head:

Why could the doc not wait even a day from due date ? Does a switch turn on inside on due date. I am begining to feel that only if a woman goes on a spontaneous labor before her due date will she have a normal delivery, with the hype around EDD as a deadline, docs will perform inductions on all women who go even a day beyond due date and there is atleast a 50% chance of failure.

What about Bishop's score for induction? In this case, the mother would have got 3 points or less thereby indicating failure


She said she will only use gels and WAIT overnight but then decides in Pit and nobody has a chance to re-negotiate.

Interventions one on top of the other , gels, epidocin, pit, AROM - What else was she going to "avoid"

How did a doc who won the trust of the couple of being non interventionistic suddendly do a flip flop ON the due date and still assured them she will wait and wait.

I was feeling rotten, like I had let the couple down, But they called me an angel:-) it was traumatic for me and I dont even want to imagine how bad it was for the mother. And the father said Lets get your birthing center plan going please.....God Grant me that wish.

Do give me your inputs and your feelings and experiences , so we can continue to learn....

Deepa

The Experience of Birth

For all you women who want to know and experience birth

http://http://www.youtube.com/watch?v=BuM8dzDcraI

A Father gives birth!!!!

I received a call on 5th Sept at 3.30 am and one of my expectant father's told me " She's in labor and we are at the hospital". I assured him that I would be there shortly. At the hospital after spending couple of hours I see that he is completely in charge and coaxing her to breathe and massaging her back through every contraction.

The expectant mother seeks his presence and he is with her all the time, everywhere. When she needs his strong hands, as she rocks on the birth ball, when she throws up, in the labor room, as she pushes her baby and as she gets stiched up and then when establishing breastfeeding.

I felt I was seeing my own birthing experience in front of me. I had completely surrendered myself into my husband's hands and he steered me with all his might through 2 most beautiful journeys in our lives.

This to-be father's voice never faltered, never showed the pain or tension. He was calm and in control and kept saying Relax ma , dont clench. He would say " Breathe" and show her and she would follow his cue. At a point when she was really down, he told her one contraction at a time, you can do it and She did it. She had lost all energy but somehow she pushed with all her might and soon enough she saw her baby being born and put on her abdomen.

The doctor announced " Congratulations Baby Girl. She held her baby and looked at her husband not believing that she had birthed. When the baby was put near her face, the tiny little one's eyes dart between amma and appa making straight eye contact with her parents. It was simply amazing and this intimate bonding between the 3 of them was the greatest reward for the excellent team effort that they had put in.

When their immediate family heard of the baby girl, their eyes poured out with immense happiness emotions on welcoming this beautiful princess into their lives.

This is how every couple should give birth and that's why the title which recognises the father to be a very important contributor not only to create this baby but also the need for him to be there with the mother during birth.

I think I have the best job in the world when I support a couple during pregnancy and birth!!!!

P.S I have one more labor support happening tomorrow and I am praying for the couple to have a beautiful birthing experience.

My Dream launched on March 8th,2009 Women's Day

Launched PreggyJoy - Childbirth Education Center
on March 8th, Women's Day. Its the begining of a new journey, a dream that began one year ago. Its a conscious decision to be an independent childbirth educator as I do not want to be biased by hospital policy and want to provide information and skills for couples on evidence based practices and help make wise decisions through informed consent.

I am ready to enjoy this roller coaster ride!!!

Back again!!!

OK I am beginning to understand how difficult it is to maintain a blog along side all the other things one has to do. But I still can't resist. WHat have I been doing all this while professionally....

I supported one woman through her delivery infact I did not plan to but eventually made it during the final 2 hours before birth. It was an intense experience ad all the while i just held her hand and spoke to her, getting her to breathe, calm her and just had her focus while pushing and delivering her baby. Her husband was there by her side massaging her and comforting her and telling her what was happening. I did quite a balancing act between the couple who wanted a completely natural birth and the doctor who is a very compassionate person but really believes that interventions like episiotomy would help and must be a routine. Finally the baby boy was born and everybody was thrilled and thanking everyone else!!!

I also supported a woman who was hoping for a normal delivery after her first C-section (VBAC). We succeeded in negotiating with the doctor to wait for 40 weeks but when she crossed that date her doctor decided on a C-section. The VBAC woman did not have too many options because there is absolutely no way of finding a medical practioner who wold have wanted to wait and let her labor start normally. She was very dissappointed but she was atleast felt consoled that she tried her best.

I am hunting for a space to start my classes and that is becoming a tough cookie to crack too. Meanwhile Birth India has revamped its website www.birthindia.org and its looking beautiful and is a major resource for expectant couples looking for a more natural birth. I have a page in the services directory...So have a look.

Hope to become more regular with my blog and post atleast twice a month!