4cm at L&D..

Nhbaby

37w, 6d with soon to be LO2. 1st babe was 38w, 3d so maybe it's time! Could also be a waiting game so I'll be checked again shortly... Waiting is tough especially at this hour!!!! Guess I need to firm up his name!!!! Eeek!!!!!

MaliKaela

Good luck!

Nhbaby

Another hour to wait.. Went up to 5ish!

medicmomma6115

Are you in L&D just because you're 4-5 cms? Or are you having contractions?

Good luck!

Nhbaby

I was at home w back pain, shivering and feelings of more than "normal" pelvic pressure and some contractions.

medicmomma6115

Good luck, dear! I am envious! I'm a FTM at 38w & 3 days. I've been 3-4 cm's for a week with no BHs or contractions. So, I'm getting anxious! Another appt Tuesday & praying SOMETHING happens soon.

Nhbaby

I have a teeny feeling I won't progress and they will send me home but it's ok, whatever is best for babe, right?

btm013

Can they send you home at 5cm if you aren't progressing? FTM so my apologies if this is a silly question but i thought they admit you at 4cm and if things fizzle out them it's pitocin time?

nicnnatesmom

Due to lovely new federal guidelines they can not legally do anything to make you progress if your labor stalls and you are not yet 39 wks and there are zero complications or signs of baby or you being in distress. How do I know this? I'm at a 4cm and 60% effaced and 36 +6 . Went in yesterday having full blown contractions. But I was not progressing after several hours. So they gave me pain meds and sent me home. And with my last LO I was at a 6-7 and they sent me home when my labor completely stalled b/c I was only 36 wks. So yeah. You can get sent home.

MrsWiggleWaggle

nicnnatesmom said:

Due to lovely new federal guidelines they can not legally do anything to make you progress if your labor stalls and you are not yet 39 wks and there are zero complications or signs of baby or you being in distress. How do I know this? I'm at a 4cm and 60% effaced and 36 +6 . Went in yesterday having full blown contractions. But I was not progressing after several hours. So they gave me pain meds and sent me home. And with my last LO I was at a 6-7 and they sent me home when my labor completely stalled b/c I was only 36 wks. So yeah. You can get sent home.

This is bizarre? Is this a law or just a best practices standard?

nicnnatesmom

No. Federal. Regulations. It's a new law that was passed. My doctor explained to me. That if mom and baby are fine. Not in any distress and labor has stopped then she can be escorted from the room and a new doc will come in and discharge me. And she can lose her license if there is no medical need for intervention. So my baby was a happy camper on the monitor. Other then me having regular contractions for 12 hours that were doing nothing to make me progress I was fine. So I was sent home. I'm not considered full term at 36 +6 so she can't intervene if my body stops and there's nothing wrong with me or baby. The only exception is I have gestational diabetes. So if my blood sugars were off the wall crazy I would get to stay. But even then unless they were making me have seizures or something crazy she can't intervene this early. It. Sucks.

Frogger5

@nicnnatesmom, do you have some kind of source or a name for this new Federal regulation besides what you think your doctor told you? I have never heard anything about that and would be amazed if the Federal government cared enough to set a law like that down. It sound very much against the same laws that make abortion legal - they aren't really in a position to tell you and your doctor how to handle your medical care. I could be wrong, but pretty much I'm calling BS.

KonaCoffeeBean

Frogger5 said:

@nicnnatesmom, do you have some kind of source or a name for this new Federal regulation besides what you think your doctor told you? I have never heard anything about that and would be amazed if the Federal government cared enough to set a law like that down. It sound very much against the same laws that make abortion legal - they aren't really in a position to tell you and your doctor how to handle your medical care. I could be wrong, but pretty much I'm calling BS.

Agreed. Health care law is not my area of practice, but I don't think this passes the red face test. (I assume we are talking about the US?) Maybe one of my fellow lawyers on here has more knowledge of this than I do.

momtobe613

It was initially a March of dimes initiative but it has been adopted by acog. https://m.acog.org/About-ACOG/ACOG-Departments/Deliveries-Before-39-Weeks?IsMobileSet=true

They say 39 weeks+ is the least chance of complications and healthiest baby so they adopted a goal of not inducing or scheduling c sections before 39 weeks. My hospital told me straight out that they would not induce or schedule a section unless there was a medical risk to mom or baby as per this initiative.

MrsWiggleWaggle

KonaCoffeeBean said:

Frogger5 said:

@nicnnatesmom, do you have some kind of source or a name for this new Federal regulation besides what you think your doctor told you? I have never heard anything about that and would be amazed if the Federal government cared enough to set a law like that down. It sound very much against the same laws that make abortion legal - they aren't really in a position to tell you and your doctor how to handle your medical care. I could be wrong, but pretty much I'm calling BS.

Agreed. Health care law is not my area of practice, but I don't think this passes the red face test. (I assume we are talking about the US?) Maybe one of my fellow lawyers on here has more knowledge of this than I do.

just googled red face test....love this term! it is now in my smartypants toolbox thanks @KonaCoffeeBean !

Erinrhea77

This still doesn't look like a "law" or a reason to lose a medical license???

Frogger5

momtobe613 said:

It was initially a March of dimes initiative but it has been adopted by acog. https://m.acog.org/About-ACOG/ACOG-Departments/Deliveries-Before-39-Weeks?IsMobileSet=true

They say 39 weeks+ is the least chance of complications and healthiest baby so they adopted a goal of not inducing or scheduling c sections before 39 weeks. My hospital told me straight out that they would not induce or schedule a section unless there was a medical risk to mom or baby as per this initiative.

So A., that's not a "Federal regulation," B., that's talking about elective inductions which is not what we're talking about here, and C., your hospital's policies don't have any bearing on this question. Sorry, no dice.

amhowell14

For what it's worth, Just asked my OB friend about this. She said this is not true, not a Fed Regulation, and that the hospital/doc that dished out that info is full of sh*t! She said, if your at 4cm, having regular contractions, and at 35+ weeks, her hospital will admit you, and not stop labor.

klkonwi

It's not an actual law. Our hospital has a policy on it..... So it's kind of a law for us.... But we don't have a 4cm rule. If you are 3-4 and contracting with pain we keep you. Or say if your a repeat cesarean you only need to be 1cm and in dire pain and we keep you. If the pt is not 39 weeks and is being induced we have a form that we fill out stating true medical need. Policies are laws in hospitals ..... I don't know anything about actual federal law lol

momtobe613

Frogger5 said:

momtobe613 said:

It was initially a March of dimes initiative but it has been adopted by acog. https://m.acog.org/About-ACOG/ACOG-Departments/Deliveries-Before-39-Weeks?IsMobileSet=true

They say 39 weeks+ is the least chance of complications and healthiest baby so they adopted a goal of not inducing or scheduling c sections before 39 weeks. My hospital told me straight out that they would not induce or schedule a section unless there was a medical risk to mom or baby as per this initiative.

So A., that's not a "Federal regulation," B., that's talking about elective inductions which is not what we're talking about here, and C., your hospital's policies don't have any bearing on this question. Sorry, no dice.

I never said it was a federal regulation. It is a guideline that many hospitals and physicians are following.

I don't think EVERY hospital or doctor is following it, I know that my hospital is one of fifteen locally that is provided with funding for following these initiatives and have to provide evidence of WHY if they don't follow. So yes, the doctors that work within the hospital need to comply with the regulation even though it isn't federal, although going after an individual medical license seems over the top and unlikely.

And lastly no, you weren't talking about elective inductions but assuming someone is 37 weeks pregnant only 4 cm dilated and 50% effaced with irregular contractions that are not progressing labor, and there is no ill effects on mom or baby's health- then yes if induced it would be elective. There would be no medical reason to induce you if labor has stopped- you'd just go home and play the waiting game.

Totally not trying to argue you with you. Just telling you that the March of dimes initiative adopted by the acog may be where a lot of people are getting this misconception from because the doctors and hospitals are flaunting it around like it is a law when in reality it's how they're getting paid.

Frogger5

momtobe613 said:

Frogger5 said:

momtobe613 said:

It was initially a March of dimes initiative but it has been adopted by acog. https://m.acog.org/About-ACOG/ACOG-Departments/Deliveries-Before-39-Weeks?IsMobileSet=true

They say 39 weeks+ is the least chance of complications and healthiest baby so they adopted a goal of not inducing or scheduling c sections before 39 weeks. My hospital told me straight out that they would not induce or schedule a section unless there was a medical risk to mom or baby as per this initiative.

So A., that's not a "Federal regulation," B., that's talking about elective inductions which is not what we're talking about here, and C., your hospital's policies don't have any bearing on this question. Sorry, no dice.

I never said it was a federal regulation. It is a guideline that many hospitals and physicians are following.

I don't think EVERY hospital or doctor is following it, I know that my hospital is one of fifteen that is provided with funding for following these initiatives and have to provide evidence of WHY if they don't follow.

And lastly no, you weren't talking about elective inductions but assuming someone is 37 weeks pregnant only 4 cm dilated and effaced with irregular contractions that are not progressing labor, and there is no ill effects on mom or baby's health- then yes if induced it would be elective. There would be no medical reason to induce you.

No, you didn't explicitly say it was a federal regulation, but the reason you posted was to explain another's post, and she did say it. There is a difference between elective induction and augmentation or intervention. If productive labor truly hasn't started then of course there's no reason to intervene and you should go home, but no one's going to loose their license if that isn't the decision you make with your HCP when you're 6-7 cm dilated.

momtobe613

No they don't lose their license totally agree with you. But honestly these initiatives were initially investigated and started by insurance companies that are paying billions for babies born early to spend weeks in nicu. && now the insurance companies are holding the doctors accountable for complications related to early intervention that was not medically necessary by not paying them.

I understand that it isn't a law. But doctors are paid from insurance companies who are denying their claims if they don't meet minimum standards, that's the bottom line. So although they won't lose their license , if there is a complication after birth they are risking not getting paid without adequate evidence of why they performed the intervention they did.

Frogger5

momtobe613 said:

No they don't lose their license totally agree with you. But honestly these initiatives were initially investigated and started by insurance companies that are paying billions for babies born early to spend weeks in nicu. && now the insurance companies are holding the doctors accountable for complications related to early intervention that was not medically necessary by not paying them.

I understand that it isn't a law. But doctors are paid from insurance companies who are denying their claims if they don't meet minimum standards, that's the bottom line. So although they won't lose their license , if there is a complication after birth they are risking not getting paid without adequate evidence of why they performed the intervention they did.

Not disagreeing with anything you're saying here, it's just not what the original discussion was about. I'm glad to see less interventions going on, whether it's because of insurance company demands or not. It seems like OBs really lost their way, and if they are finding their way back to more ethical, safe decision making, that's awesome. It's just frustrating for people to say that such and such a thing is illegal when it isn't.

Nhbaby

Wow! What a day and what a conversation! They ended up keeping me and our Son was born at 1:18pm! 13 hours of labor! I'll post stats in the birth announcements section! Thanks for all your care and support!!

mccall35

Congratulations!! I'm glad all is well So exciting!

KaLikeAWind

I saw your birth announcement and was like 'Whaaa?! She just posted about something!' Sounds like you knew what was going on! You've had a day!
Congratulations! Thanks for sharing your journey! <:-P