26 March 2010

Disposable innards

Susan has kindly shared her cautionary story of unwanted induction and eventual C-section (and the exciting conclusion, which she just posted). I am very sorry this happened to Susan (and everyone else I know to whom it has happened, which is way too many people) not only because it's awful on its own merits, but also because of the CSPP angle. For those of us who don't plan to retire after 1, 2, or 3, what happens to the equipment is a big old deal.

But retiring after 1-3 is normal, and most medical providers operate under that assumption. They might as well hack it all up or leave it a mess because you only use it a few times anyway. During my most recent trip to the maternity floor, my regular doctor (who knows where I stand and wouldn't have given me occasion to tell a tale like this) was unavailable and I got someone else from her group. Assessing my situation (you'll recall this is after the main event), he asked with what I perceived to be uncertainty if we were going for six. Apparently this affected his decision about what kind of care I was going to get.

This made me very unhappy. The kind of care I want is the kind that leaves me optimally operational, and this is the kind of care every patient should get. I can't imagine that cutting corners or "going easy" on a patient in need of treatment is doing her any favor, regardless of her plans for the future (and 30 minutes after giving birth is hardly the best time to ask someone about such plans).

I become increasingly convinced that an obstetrical care provider needs to know not only a patient's medical history, but also her anticipated medical future. I know this business is terribly awkward to bring up. But maybe we also shouldn't sell medical professionals short. A good one will know that it's not his/her business to offer commentary on lifestyle. I certainly don't want to be under the care of someone who holds an aggressive belief that I should be Done anyway. And chances are that if we show ourselves to be reasonable and intelligent people we'll win ourselves a little credibility as assets to the genepool who might be dealt with gently for excessive procreation.

I've got more of a claim on this body than any health professional, and a health professional can only call the shots I want if she knows how I want them called.

(Incidentally, the first piece of advice I'd give to any pregnant lady based on all the birth stories I've ever heard is avoid inductions.)


Liz said...

Though this is a Catholic resource, http://onemoresoul.com/ One More Soul allows members of the general public to find NFP classes and NFP physicians. If you're fortunate enough to have one in your area, frequent that physician. That's where I found my GP.

Sarah Osbun said...

My husband has two jobs in the delivery (and recovery) room. First, he is to support me and keep me as sane as possible. Second, he is to protect me from the doctors and their knives. I might be all woozy and worn-out but he is strong enough to physically stand between me and them until I'm capable of articulating my wishes for my body. (He also keeps track of the baby. I'm always afraid the little one will disappear.)

ekg said...

Being one of those induction-to-inevitable-c-section stories with baby #1, I heartily affirm: avoid induction without just cause.

I would also remark that baby #2 came VBAC style under the care of a most marvelous midwife. Once in labor, it did take 2 hours of driving (nay, speeding! vroooom!) to get me to the nearest VBAC-approved hospital. But. It's fending off those argumentative OBs for now.

Elaine said...

I am Susan's mom (she is the third of my four children). Thanks for helping spread her story. My heart and prayers are with Susan, you and your Concordian sisters. If I had known back then what I know now, I would have done things differently regarding children and reproduction. But that is a regret I will just have to live with. Keep up the good work you are doing in promoting godly marriage and families. Love you all!

MooreMama said...

I become increasingly convinced that an obstetrical care provider needs to know not only a patient's medical history, but also her anticipated medical future....A good one will know that it's not his/her business to offer commentary on lifestyle.

Tuesday, we had the Conversation with my OB. He said that two kids was the perfect number for him and his wife, but that he'd put himself out of business if he thought two kids was the perfect number for everyone. He's a smart dude, and is out of the ordinary in that he feels that it is his job to HELP me through the pregnancy/delivery/post-partum/repeat stage of my life.

As for avoiding inductions... the day that I delivered Callie was (apparently) the day that I won the Induction Lottery.

Rebekah said...

Liz, thanks for mentioning OMS. I hope that provider list continues to grow.

SO, that's the exact arrangement my husband and I have in place.

EKG, nice work. I don't envy that drive.

Elaine, thanks for visiting. :) We've learned a lot from Susan.

MM, sounds like a good doc. And you are the only person I can think of whose induction didn't end up including other interventions the mom didn't want.

Karen said...

Four of my 7 children were induced without any other interventions, but the last child was delivered c-section. I think that all the inductions harmed my ability to have contractions without the drugs.
My ob/gyn stated that my uterus was "worn out", but women historically have had more children than I. In hindsight, I should have fought the first time an induction was recommended.

Untamed Shrew said...

As a woman who does not have a 40 or 41 week gestation, I have to say it really stinks that I should have to choose between going into labor or my own and getting my own OB who will surely be my advocate and with whom I've developed implicit trust. So with #3, I chose to be induced on the Tuesday after 41 weeks, because my doc was on call Tuesdays. Any other day I'd have been at the mercy of a stranger who would have scolded me for carrying so long and likely would have sliced me open after 6-8 hours (it took 19).

Anonymous said...

having had a rather recent and rough birth scenario myself (who hasn't?), i have to admit that i tend to live in a lovely cloud of naivete that leads me to believe that everyone involved did the best they could at the time, no matter how different the reality is from what i had dreamed.
life is hard.
i hope don't get induced again.
i need a nap.


Emommy said...

Thanks for the link to Susan's blog and for addressing the induction-and-section relationship, especially in terms of practitioner attitudes. My husband and I have been fantastically blessed; a few years ago, practically by accident (though I know God was definitely directing us) I stumbled across a great practice, was asked if I'd be willing to see a midwife for a GYN appt, and Terry entered our life. She's a terrific, mother-and-child centered provider, and best of all she's a confessional Lutheran (so we've spent many appointments discussing points of doctrine--Wow.). Long story short: the day before my due date at a scheduled appt, the docs discovered my amniotic fluid was low--really, really low (never found out exactly why). Terry agreed that I had to be induced, but the entire process was driven by natural methods first; drugs and any other procedures would only happen if absolutely necessary (i.e. my life or baby's life at actual risk). So she used a Cook catheter to try to dialate me (basically a balloon filled with water inserted into my uterus--no drugs, no Pitocin until I carried that for over 12 hours). It partly worked, then she agreed to Pitocin, then yelled at our nurse when she came in (after delivering three other babies) and my contractions were 1 minute apart and the dosage wasn't lowered. She pulled the plug on the Pitocin, my body took over, she let me push for a few hours, and Paul was born on a birthing chair (which none of the nurses on the ward had ever seen) roughly 26 hours after the whole experience started. Thanks mostly to her advocacy, encouragement from a doula (who we didn't use but who was a great prenatal resource for us), and God's grace, we avoided the nightmares that so many others have faced. I know sometimes c-sections are inevitable, but thanks to online info, narrative sharing and conversations about too-common experiences like this one, more mothers can stand up to defend their children and their bodies.
Oh, and my husband and I are expecting our second son's arrival in a few weeks. Terry might be in Haiti, teaching other midwives, when I go into labor, but we'll see one of the other two fantastic midwives on call--thank goodness.

Pam said...

Oh, yes, avoid inductions if possible! I will add, Rebekah, if you don't mind, that I would personally qualify that based on my own experience...

I have been artificially induced three times, the first was with my second child when I didn't have the backbone I do now, and it was too early! The other two were my 7th and 8th, after I fought HARD to make sure I was NEVER induced again for the four deliveries in between. They went well, actually, and I was in such upheaval from the stresses at home then that I needed the break.

Now I am two weeks from delivering my ninth living, and I am determined not to need the artificial induction. What I mean is, I know a LOT more now than I did then about what other more natural methods can help start labor... and btw ALL my labors which started naturally were post 40 weeks, once 41 1/2...

I'm not talking castor oil either, LOL, which I have heard of. EWW on both fronts, er, ends!

I will have to let you know if it all works out for me, but I am really encouraged that my earliest starting labor and easiest delivery was naturally induced by a very competent laymidwifeturnedphysician by stripping membranes. Labor WAS going within 24 hours, it was a piece of cake compared to any of the others (hear me, compared to!)and I felt awesome after.

I'm also going to go in for a massage on my feet when that time comes near. I'm told ankles and heels are the spots. Don't have my usual myotherapist to do my heels right, but she's started labors this way before. And late periods, for that matter. Huh. Isn't it grand the way God designed the body to have its own ways of handling things? And there is much to be said for naturopathy as well, which I understand is much more standard as a part of medical practice in other parts of the world. But that's another topic...

But yeah, drugs... I avoid them whenever possible. That and overzealous doctors etc who THINK they know what they're doing, and worse, that somehow they're doing you a favor. Blah.