Laying Down to Deliver - Tearing - Treatment of GBS
beautiflaw
member
Thanks to everyone who replied to my last post about natural birth in a hospital. The one about the mean maternity ward nurse who was super duper anti natural birth. https://community.thebump.com/cs/ks/forums/thread/56950968.aspx Reading the things that everyone posted really helped encourage me and DH and I am feeling much more confident now, except for this one blow to that confidence today that I am kind of reeling from. I'm hoping to get your thoughts again. I apologize again for the length of this post, I need to rant and rave real, real bad to people who I know will understand.
I know that after I post this a lot of commenters will probably suggest changing practitioners. I have been thinking about it but I don't know because I am down to the 11th hour and I know that he will only be at the birth when I am ready to push anyway... and also I kind of want to prove him wrong so I can say nannynannybooboo when I do come through this. But I dunno. I am super conflicted right now.
So one of my biggest fears is about tearing. And I read that squatting or sitting during the pushing stage helps since you are not working against gravity like you are if you push while laying down. I asked my doctor about a lot of the stuff the L&D nurse said and while he did say that I could labor off monitors, he told me that I can't eat or drink anything (ice chips only) and that I have to have saline in an IV no matter what (I said I'd prefer a hep lock and he said no way) and that when I am pushing I will have to be on my back with my feet in the stirrups.
So a lot of no, no, no. I didn't like that. I asked him if there was a medical reason why and he said, "No, its just really difficult to deliver a baby while someone is squatting or sitting because there is almost no access." Um. I'm the one having a baby. The last thing in the world that I need to be doing is going out of my way to accommodate you. Everyone in the room who is not pushing out a kid needs to be doing whatever they have to do to make me comfortable. Not the other way around. I was so mad I would have started crying if DH hadn't been there. He could tell I was upset so he tried to steer the conversation in another direction. I wanted to tell the doctor exactly what I thought about all that but it is kind of hard to feel confident enough to express yourself when you are wearing a paper dress. I think he was trying to make me feel less worried, but he goes, "You two have just been reading too much."
I nearly exploded right then and there. I'm sorry, but this is the day that my first child will be born. This is going to be a huge day for me and my family for a million and half reasons, so excuse me if I want to be prepared for it. Yeah, I have been reading a lot of stuff. I want to be prepared. I don't blindly go into any situation ever, least of all a huge event like childbirth. I sat there with my mouth open and DH started asking about something else while I regained my composure. When he left DH was like, "I know you're mad. Its gonna be okay. Lets just get out of here and we can talk about it in the car." So having him there was great because I just felt defeated in that moment.
I asked about how they treat GBS since in my last post someone commented saying that they can do a shot for it in case I don't get to the hospital in time for them to do the 2 antibiotic IV's. I mentioned the shot and he goes, "I am curious about what you have been reading because I have never heard of anyone doing that. You have to come in as soon as you go into labor to get the IV. That is the only way to treat it." Now I am worried. Does he really not know that the shot for it exists or does he just not do them because then his patient isn't lying in a bed in a situation he has control over? I don't know. Now I am PRAYING that I don't have GBS because I don't want to be at that stupid hospital for the time it will require for me to get the antibiotics, since I am determined to labor at home until I am in transition.
I really just don't know what to think right now. I know I can have a natural birth, but it seems like everybody that should be helping me work towards that goal is against me! DH and I hired a doula and she is amazing, so I know that I will have support. I am just so fed up. I wish I didn't have to fight so hard for something that should be my right as a woman and a mother. Shouldn't I be allowed to make my own healthcare choices? I am so tired of doctors and nurses treating me like my own health is none of my business!
Re: Laying Down to Deliver - Tearing - Treatment of GBS
Keep in mind that they can't hold you down and make you do anything you are not comfortable with. If they try say, "I do not consent" plain and simple! That is great that you found a doula, she is going to be a huge help in this.
The fact that you got the doctor to support intermittent monitoring is great! That will be huge!
You could ask about pushing on your hands and knees or on your side. You would still be in bed and I would think it would still put him in a good position to catch the baby if that's what he is really concerned about. Don't totally discount pushing on your back though. I could have pushed in any position and pushing on my back seemed to work the best for me. I could feel myself really making progress and after having been in labor for 16.5 hours it felt good to just lay back between contractions.
And don't feel bad about the length of your posts, we are here to listen and support each other! Keep your head up! Just keep thinking in a few weeks this will all be a distant memory and you will have your baby in your arms.
Arguing with people while in labor is HARD. Trust me. Better to find someone you're more comfortable with.
But, honestly, tearing isn't that closely related to position. I have friends who did natural with MW who tore badly. I pushed on my back and had "skidmarks."
Being on my back was really the only option w/#1 because there was NO way my legs or knees could have supported in ANY position. Nothing that required balance was possible. With #2, I could have, but I was more concerned about blacking out every time I pushed.
I am hoping to have a third natural birth (gotta have a pregnancy stick around first), and my big thing about that one will be OXYGEN and a MW center--it was the nasty nurse that drove me nuts, plus my idiot OB.GYN who thought it is a good idea to jerk on your labia while you're pushing. FAIL.
TTC since 6/02 (age 22) K/U instantly despite no AF for 5 months--preemie baby boy 1/03
M/C 11/04 - M/C 05 - M/C 06 - BFP 2/08--fullterm baby girl 10/08 - M/C 4/11 - went to RE at age 31
DX: crappy quality & infrequent ovulation, mild MFI
Stimmed cycle #1 C/P 7/11 - Stimmed cycle #2 C/P 8/11 - Stimmed cycle #4 C/P 10/11
On Stimmed Cycle #5
Always thought I'd be a "mom of many"--now just hoping to be a "mom of one or two more!"
You doctor sounds absolutely terrible.
I know it's overwhelming to think about, but switching really is your best chance at improving your odds of a positive birth experience. If something goes badly, won't you always wonder what would have happened if you followed your gut and delivered with someone else?
Good to hear you have a doula and a husband on your team, because like pp said - it will be their fight. You really aren't in a place physically or mentally to fight battles while delivering a baby.
I delivered on my hands and knees and still had a third degree tear. The thing is... at least I know that I got to deliver how I wanted. I don't need to blame that tear on an oppressive lazy doctor; it was just a thing that was part of my birth. It's easier to accept even an unpleasant outcome because I felt respected in my choices. Find someone that can respect yours.
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I remember your first post. Your OB sounds truly awful. A bad doctor and a mean person. I know it's the 11th hour, but I really, really encourage you to find a different provider. I think you posted about insurance issues with a birth center? (Correct me if I'm wrong.) Honestly, I would pay a LOT of money out of pocket to avoid this OB and this hospital. How much $$ are we talking here? Can the birth center work out a payment plan?
I pray that you aren't GBS+ too, just so you can avoid that stress! From what I understand, you need two doses of antibiotics, 4 hours apart. For a first time mom, your chances of having a labor less than 4 hours total is almost zero, so it doesn't make sense to get to the hospital as soon as you go into labor.
Wanting to push on your back is one thing, but being told you HAVE to for an OB's convenience? No.
Ugh ugh ugh. I'm angry for you. Please keep up updated, and don't give up on finding a new provider!
*delurking*
Also, with the GBS antibiotics I didn't have a second dose and I delivered just short of 4 hours after the first and I nobody seemed concerned? I did have clyndomicin (sp?) b/c I am allergic to penicillin and sulfa. I don't know if that makes a difference
That is how I feel too. I would at least know that I did everything I could to avoid it. I don't want to look back on this and be like, "if only I'd switched doctors..." I am going to DH this post and hopefully we can work something out with our insurance.
um. whut?
please tell me i read that wrong. there can't be a good reason for doing that to somebody!
Make a pregnancy ticker
FWIW I pushed whilst on my back. it was honestly what felt most comfortable to me. Like pp there is no way my legs could have supported me for any length of time.
I needed two stitches which healed super quick and were no problem.
My biggest issue is that your OB sounds like a douche. Good job that you have a doula to help you out, because like pp said arguing with someone whilst in labour is really hard. Having said that thought I agree with pp who said they cannot pin you down and make you do something you do not want.
Good luck.
Elizabeth 5yrs old Jane 3yrs old
Just wanted to let you know that I delivered my first two lying down in stirrups and didn't tear, so don't be afraid of that. Good perineal massage and guided pushing will help with that, but it sounds like your current doc will be useless in that department. Maybe your doula could help.
You are definitely allowed to make your own healthcare choices and can decline ANYTHING that they request that you do. The nurses and doc may make things difficult for you if you do decline, but that is your right.
It sounds like you would do a lot better with a likeminded MW. Good luck!
Everyone's labor is different, but I can tell you that things you're worrying about won't keep you from delivering naturally.
My labor with my son was very fast. I woke up one morning feeling funny around 9 am. I started having diarrhea and vomiting. I couldn't hold down any liquids and had no interest in eating. DH and I thought I had food poisoning. I didn't realize I was in labor until I got to the hospital and the nurses in L&D told me I was having contractions. By the time my midwife got there and checked me, I was 9 cm. I started pushing shortly after that around 2 pm.
DH offered me ice chips and water, but I barely had any interest in that since I felt so sick.
I was flat on back to push. With the dehydration, there is no way I would've had the strength to squat to deliver. The nurses had trouble getting me to even lay on my side. I only wanted to be on my back. I didn't give a c$%p about gravity, I was tired.
Anyway, I had tested positive for GBS a couple of weeks before I went into labor. When I arrived at the hospital, I was super dehydrated from the vomiting/diarrhea. The nurses couldn't get an IV started, but they kept trying to poke me. When my midwife arrived, she told them to knock it off. In the end, my son got the antibiotic shot shortly after he was born. This article describes what happens when the mom can't get the IV in time: https://www.babiesonline.com/articles/health/groupbstrep.asp Your doctor is full of c$%p.
Tearing. I tore. Second degree. It happens. The midwife stitched me up. It healed within 3 or 4 weeks. I was having sex within 4 weeks of delivery. It was a bit tender for another few months after that. I don't pee my pants. I don't poop my pants. I can still have orgasms every time we have sex. Sex is no different than it was before. There is no scar and it looks the same as it always did. You can't tell I tore. Yeah, it hurt. And it itched while it was healing. But it's not the end of the world. If it's not a serious tear and you don't get infected, it will be okay.
So here's some personal experience. I did most of my pushing in a squat, but when DS was crowning I was told to get on my back because the doctor wasn't going to deliver a baby in that position. I got on my back. And I tore, probably for a variety of reasons - aggressive perineal massage, posterior baby, and I was on my freaking back. Who knows if I would have torn had I stayed where I was. Doesn't really matter. What matters is that I let that doctor bully me and I regret it. If I had to do it all over again I would have stayed right where I was. Whether that doctor wanted to deliver a baby in a squat or not doesn't really matter. That baby would have come either way. Really, I don't give a rats ass if she was in the room when it happened.
My advice - switch providers if you can, get a good doula and be ready to stand up for yourself. This is your body and your baby.
ETA: Stay at home as long as you can. I arrived at the hospital at 10 cm dilated and I am glad that I waited. I ate and I labored in the tub and moved as I wished.
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I can't remember if it was you I suggested the birthing bar to, but I don't see how the doctor wouldn't have enough access to deliver a baby with the mom on the bed squatting with the birthing bar.
I would at least look into your options as far as changing providers. The stirrups thing is ridiculous. Saying they prefer it is one thing. Requiring a laboring woman to do it for their convenience is, IMO, out of the question. Maybe you will end up preferring to push on your back, but the doctor's attitude about the whole thing would send me running.
Is your OB in a group practice? If so, might any of the other doctors in the practice be willing to accommodate you? If not, be willing to look at family doctors, too, not just OB-GYNs. Ask about their views on this points before you switch. Don't worry about it being the 11th hour. I mean, all your doctor has really done up to this point is take your blood pressure (and make you feel like crap). 95% of the work is still in the future, is this really the doctor you want to do it?
As far as eating and drinking go, my advice is to break the rules if you want.
DH and I packed a bag with bottled water, bread, a jar of peanut butter and knife, and other snacks. I ate whatever I wanted when the nurses weren't there. Either they thought it was DH's snack or they didn't care.
At least he is being very upfront and honest about what he expects...
My OB told me I could push any way I wanted to when I was pregnant and discussing my upcoming birth with her. When I was actually in labor though they told me I had to push lying in the bed. So that's how I pushed (I did tear unfortunately, but it wasn't the worst thing in the world). I was and am very angry that I was blatantly lied to while I was pregnant, because had I know that was how it was going to be I would have made different decisions.
I spoke to my OB about it about 6 months later and asked if things could possibly be different if I delivered any more children with her. She said no, probably not. She also said that the only time she'd ever delivered a baby with a mom who wasn't on her back was with a drugged out mom who was uncooperative and refused to lie down. You don't HAVE to lie down, you can refuse, but you doctor has already told you he expects you to lie down. But at least you know it going into it that that is what is going to be expected. That means you can make the choice to be uncooperative ahead of time or you can make the choice to be be cooperative or you can make the choice to find a provider who better fits your needs. They aren't springing this on you when you are literally already pushing a baby out of your vagina, that's a good thing. You have options at this point.
Wow. I don't know what to say. So not my experience with my GP, and the ER doc just sat on the edge of the bed for a minute and basically watched the delivery the second time around.
A doula should really help, I would think.
I would like to add that I delivered both of my kids lying down. My choice. I squatted to push much of the time with my first, but the actual delivery (last 2 pushes or so) were reclined. Most of the work was over by then anyway.
I guess small town hospitals are kind of a blessing that way. Epidural may or may not be available to a labouring mom depending on where that specialist is or what s/he is doing at the time of the request. The on-call doc arrived after the birth of my second, the nurses had to call a dude up from the ER. I think I made his day frankly.
In some med schools, apparently that they teach that this "stretches" you to prevent tearing. Really, it is super freaking distracting and uncomfortable and can cause swelling which in turn causes tearing. I had NEVER hear dof this until she did it.
TTC since 6/02 (age 22) K/U instantly despite no AF for 5 months--preemie baby boy 1/03
M/C 11/04 - M/C 05 - M/C 06 - BFP 2/08--fullterm baby girl 10/08 - M/C 4/11 - went to RE at age 31
DX: crappy quality & infrequent ovulation, mild MFI
Stimmed cycle #1 C/P 7/11 - Stimmed cycle #2 C/P 8/11 - Stimmed cycle #4 C/P 10/11
On Stimmed Cycle #5
Always thought I'd be a "mom of many"--now just hoping to be a "mom of one or two more!"
In some med schools, apparently that they teach that this "stretches" you to prevent tearing. Really, it is super freaking distracting and uncomfortable and can cause swelling which in turn causes tearing. I had NEVER hear dof this until she did it.
TTC since 6/02 (age 22) K/U instantly despite no AF for 5 months--preemie baby boy 1/03
M/C 11/04 - M/C 05 - M/C 06 - BFP 2/08--fullterm baby girl 10/08 - M/C 4/11 - went to RE at age 31
DX: crappy quality & infrequent ovulation, mild MFI
Stimmed cycle #1 C/P 7/11 - Stimmed cycle #2 C/P 8/11 - Stimmed cycle #4 C/P 10/11
On Stimmed Cycle #5
Always thought I'd be a "mom of many"--now just hoping to be a "mom of one or two more!"
DS2 - Oct 2010 (my VBAC baby!)
So, you don't even know if you have GBS yet? Why are you so concerned about having it? I got tested for GBS 4 days before I had my baby (I came early). I got the results after I had the baby. But I also did a home birth because after the hospital tour I didn't want to deal with all that (our tour was given by the c-section nurse, guess which way that hospital swung). I ended up on my back giving birth, but only after trying various positions. I had major back labor so that was the only position where the pressure was off my back. I also only had a skid mark.
As for changing providers, I've mentioned this before, but my friend left her OB at 38 weeks because he wanted to induce her (she had GD which she had managed very well). She found a MW at 39 weeks and had a home birth at 41. Everything was fine.
I won't get to find out until early next week. I am concerned about having it because everything in my pregnancy has gone well and I'm the type of person that is always waiting on the other shoe to drop so to speak. I'm kind of like, "everything is good right now, so that means something will go terribly wrong when I least expect it." I know that's not a very good way to look at life but yeah... I'm in therapy. Anyway I've also heard like, a million horror stories about GBS too. I don't know why but people sure do like to scare the pewpty out of a pregnant woman. That is partly why I am so scared of laying down while the baby is crowning, because my mom keeps telling me the story of how my grandmother delivered my uncle (on an army base in Germany in the mid 60's, by a doctor that all the women on base referred to as 'the butcher') and she was forced to lay down flat on a table and the nurses held her down while the baby was crowning, and she "ripped from one end to the other" (her words, not mine). Even though I know that the circumstances are completely different and that no one will be holding me down like some kind of animal, I still am scared. I guess I think, "Oh it happened to her, so it will happen to me..." or something. I don't know. I might change my mind completely whenever I am actually in labor about how I want to push, I may end up wanting to be on my back, but for that butthead to tell me that I have no choice is just wrong to me.
I am so glad to hear that your friend was able to switch providers. That does make me feel a lot better to know that its been done. Me and DH are looking at some over the weekend and making calls on Monday to set up consultations. Unfortunately our insurance does not cover any of the birthing centers around here or any midwives or nurse midwives (it does cover some, just not any that are less than 100 miles from where I live) so the best I can hope for is a doctor that is less opposed to natural birth than this sorry excuse for an MD.