08 February 2007

CBE class birth outcomes

All of the mamas in my first childbirth ed classes have had their babies. We had a fabulous class reunion where everyone shared their birth stories, showed off their babies, and discussed what it was like being new parents.

First birth: They were using a gov't hospital and the doctor had been talking about C-sections from day one. Guess what she got? First he tried the "your pelvis is too small" excuse. Then the "you're too fat for vaginal birth" excuse. Then the "you have PIH (pregnancy induced hypertension" excuse. Well, they fell for the PIH one. Her blood pressure was slightly elevated but in the safe range. AND the doctor recommended c-section when inducing would have been the safer, evidence-based alternative. The baby was born on its due date by C-section. The hospital kept the baby for "observation" for 2 days and breast-feeding was a nightmare. As I said in my classes, you get what you sign up for. If you know your doctor has a high C-section or intervention rate, you're playing the odds that you'll get the same. They are happy overall. Breastfeeding lasted less than 6 weeks after she went back to work =(

Second birth: Mama was at a great natural-birth hospital, totally set on natural birth. Went 8 days overdue. Decided she wanted the baby out "because it's more days I can spend with him before I go back to work." So she traded 1 or 2 more days inside for an unnecessary C-section. What happened? EXACTLY as the "mock scenario" we played out in class. She asks for her water to be broken. Never mind she'd been slowly in labor the last couple days. We had discussed the risks of the water being broken. But that's what happened, and the result? A posterior baby. The early "prodromal" labor that happens for a few days is usually the uterus rotating the baby into a better birthing position. So the baby is posterior, she has major back labor, not dilated enough to get in the birth tub, so asks for... an epidural. The epidural eventually wears out, so it gets topped off. A typical side affect happens to her... too low blood pressure. So they give her a drug to keep it up. The result? The baby's heart rate goes way up. So all of a sudden... ding ding ding. Emergency, must get out baby NOW. Aaaarrrggghhh. See the cascade of interventions here? Well, at least breastfeeding is going fabulous for them.

Third birth: Aaahh, finally a vaginal birth. I was supposed to doula for them, but she went into labor 3 weeks before her due date, didn't have my contact info with them (since they'd gone in for an appointment and they realized she was in labor), and so I missed a birth =( She was in labor, but the doctor wanted to using EFM (electric fetal monitoring) to see what was going on. It was showing the baby's heart rate reacting slowly to contractions. Her doctor said, you need a C-section now. She said, "no way." The doctor said, your baby is going to die then. She says, "no, I do not consent to a C-section." They waited a little while and she prayed and prayed and had more EFM done. Which showed the heart rate doing better, so the doctor said, yes you can "try" for a vaginal birth, but you have to have EFM during your whole labor. What that means is you are stuck on the bed during all of labor and can really do nothing for pain management. My hero stuck to her plans. Yes, her water was broken, yes, she was stuck on her bed, but 4 hours later and NO PAIN DRUGS, birthed a beautiful 5 lb 5oz baby!! She said she wanted me there so bad, but I told her when visiting her at the hospital... "What did you need me for? You did just fine." Breastfeeding went really well, until she went back to work 8 weeks later.

I have advertisements out for a new series starting up, but no responses yet. In a way, I'm hoping no one wants classes right now as I'm too tired, but I really love the teaching and want more of it!

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At 1:23 AM, Blogger Laura said...

Okay trying to comment again...maybe it will let me this time.
Enjoyed reading the birth stories-I'm not sure if I could have gone w/out any pain medicine if I had to have my water broken and be confined to a hospital bed! Kudos to her!
Glad all the moms and babies are doing well!

At 3:42 AM, Blogger rcsnickers said...

I too enjoyed reading the birth stories.

I just recently watched National Geographics "In The Womb." It was good. I was thrilled that they had a natural birth at the end.


At 1:06 AM, Blogger Emily said...

Thanks for posting the birth stories. What a determined woman to stick to her birthplan in spite of the pressure. I think it would be tempting to go with the doctor's advice, but she apparently chose correctly...good for her!


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