Help me have a better labor

[ExcitedMamma]

I am only 5 wks pregnant now so I know it's way early to be asking about L&D issues except that I need to choose a hospital so I can choose an OB. I have an appt scheduled but I am still angry about my delivery with my son and I need to know if I should be or not so I can decide if I should switch OBs and go to another hospital or not.

I labored great at home using Hypnobabies and being in my tub. It's a blur now but my contractions were coming faster and harder and I think my DH insisted we go to the hospital when they were somewhere around 3 to 5 min apart. We checked in around 10 PM. At my first check I think I was between 5 and 6 cm dilated and still doing great with the labor naturally. Then everything went downhill. The guy who came to take blood messed up my arm badly jabbing and didn't get any blood and then jabbed my other arm badly and I never recovered my focus after that. At my last check drug free I was 8 cm and from reading up on this after I believe I was entering transition. I was hysterical and begging for drugs and got an epi.

I think about an hour or so later my Dr. came in and checked me and told me she wax going off to do a C section and would come in after to deliver me. Then the nurse came over and said it was almost time to starr pushing but I told her I didn't feel the need to push and wanted to avoid purple pushing and the consequences of pushing too soon. Then a different nurse came in and said it was time to push and the baby was right there so of course after that I said ok. I ended up pushing for 3 hours and needed oxygen, ended up with purple pushing, and at some point the Dr. threatened to do an episiotomy which made me so upset and I begged her not to as I had told her so many times not to do one. My DH told me after that after saying that she told him she always says that to get moms to push harder.

at the very end the baby's heart monitored showed decels and the Dr. hit the panic button and a bunch of other nurses came in, forget the name of the unit but when baby is at risk and may need special attention. Then she did the episiotomy and out came my son. Healthy and great Apgar scores.

So I know the natural labor failure was my fault but should I be angry at being forced to push too soon? Wouldn't my body have labored down on it's own and ended up with less pushing? Is my having the epi completely to blame?

My son was 9 lbs 4 oz 21 1/2 in long and head in 90 th %. My ped was shocked I didn't have a c section because of the size of his head. Was an epiosotomy really necessary? My son was certainly big but what about everything I read that tearing is better? I have had so much pain and discomfort from it. I know I'll never know how tearing would have felt for better or worse but I'm angry about it.

Please tell me honestly what you think. Should I be angry at the OB and nurses and switch? Or was it the fault of the epi and size of my baby? Thank you so much!!

[wellyes]

Congratulations on the pregnancy!
It sounds like this is bringing up some intense emotions and anxiety. I personally would not go with that same OB for any reason. She threatened you with an episiotomy to make you push harder? What a betrayal of doctor-patient trust.


And I also encourage you to be a little less hard on yourself. 'it was my fault' is not a phrase I ever like to hear about a successful delivery!

You have a right to be angry but I hope you can get to a more hopeful, happy emotional place before long. GL!

[edurnemk]

I don't think it was your fault AT ALL. Everything happens so fast at the end of the labor.

After that experience, I think you won't be able to fully trust your OB and feel comfortable with her, that alone warrants a switch IMO.

I switched for a lot less than that (not the OB that delivered my son, he was wonderful, but the OB at my current town, I think he's very prone to inductions and planned C-sections that are not really necessary, I don't know this for a fact, but the impression was enough for me to look for another OB)

[Melanie]

I did Hypnobirthing, so I'm not familiar with the specifics of HypnoBabies but I get the gist. I think you're going to have stuff like that in most hospitals.

One thing that our Hypnobirthing classes did is really reinforce to the partners that they are the front-line protection between you and the hospital staff. I think in your case, that would have helped avoid the pressure they put on you to push (save for once baby started having issues).

They taught them to say, "Is my (wife) or baby in any immediate danger?" ((answer is no...usually)) Respond: "Then no thank you, we are fine. Please leave us be." I think they even talked about putting signs on hospital doors (we went to a birthing center so that wasn't an issue with us).

Perhaps focusing more on your partner's roll might help you next time? And/or hiring a Hypnobirthing-trained birth attendant/doula. Our instructor also did it for an extra fee. In retrospect I wish I would have as I think at some points she could have helped speed things along to avoid other interventions that eventually became necessary, in my case.

[ohsara430]

Oh goodness that wasn't your fault, please don't be so hard on yourself. I agree with PPs that I wouldn't be able to trust that dr/practice again. Have you thought about talking to a doula? Our doula was indispensable. Even if you don't hire one you can always ask their opinion of the dr you're considering. Good luck, having a dr who supports yout decisions is invaluable!

[MWmom]

I don't have much to add. But I did want to say I don't think it was your fault! I used a doula with my DD. I'm very nervous and just having someone with so much experience there to discuss everything was great for me. I told her what I wanted and she gave suggestions and supported me. Very good experience for us. Again Good luck to you and have a great pregnancy!

[bostonsmama]

I had a great OB, but I missed her by like 3 hours b/c she wasn't on call at the time. So, don't worry so much about who you get as your OB, just make sure you go into this next labor/birth prepared with whatever you want to do differently (birth plan?) and hire yourself a doula. Mine was indispensible! I know I couldn't have had the birth I wanted without her, as DD was also allegedly in distress towards the end, too. Don't freak out about the misleading comment. My doula told me to dig deep when my OB threatened intervention, too, and it helped me get her out quickly. I only pushed for 35 min, although my DD was just under 7 lbs. I think fully laboring down until I could no longer NOT push helped, as did using gravity (I pushed in the squat position over the squat bar on the bed). DH reminded me we had to get a 2nd bar b/c the first wasn't the right height...but I was blissfully unaware b/c my doula was running interference and helping me out while he handled the docs and nurses.

[AnnieW625]

I am not one to rule out having an epidural esp. if other meds like penicilin for strep B, or piticon is needed for stalled labor, but I did make a mental list of things that I wanted to avoid with DD2, and my main one was to not go to the hospital until my water broke. My water had been broken for me with DD1 and I ended up needing pitocin, which worked very very quickly with me (I went from stalled at 5cm (probably should've sent me home, but my water had already been broken) to 10+ cm in less than 3/1/2 hrs.

With DD2 my water broke at home and I told the nurses as soon as I checked in that an epidural would be my last resort, and only if I needed to have pitocin (although my water had broken I was still maybe 1 cm dialated). I did get an IV of Nubane which was great. I was able to rest up through some of the early contractions, and by the time it wore off my labor had rapidly sped up so by 6 am I was just about 4 or 5 cm and the details get fuzzy after that but I remember sending DH to go and get himself some breakfast, call our daycare, and his work to let them know what was happening, and within the 20 minutes he was gone I had a few hard, but not horrible contractions and I was 7 cm. By 8 am when the nurse told me I couldn't have any more nubane as I was more than 8 cm I told them after the next round of contractions I wanted to start pushing. No lying 20 minutes later (and after about 5 minutes of really heavy this hurts like hell labor) I started pushing. I pushed in a very inclined position for 20 minutes.

We did lamaze with DD1, and I didn't do Hypnobabies or Bradley with either child. We didn't have a doula either, although I thought about it with DD2, but there weren't many options in my area and I was afraid she was booked too much already.With DD1 everything went out the window, but honestly with both births although they weren't 100% intervention free I was happy just to have my girls.

[Hawkeyewife]

I would definitely interview OBs and Midwives in your area that support noninterventional birth. With our third baby, I bounced through 3 different providers until I found a group of CNM's that did homebirth and chose that route. When you interview, make sure you get a chance to meet ALL of the providers. They WANT your business so they should be able to find time to meet with you.

I suggest that you find a Doula who will be able to help you achieve the kind of birth you and your partner desire. Most Doulas are really good at gently advocating for their client so as not to step on your healthcare providers toes and still getting you what you want. Doctors and Nurses are not bad, but they know what they know and it's hard for them to understand when they have a Mom who trusts enough in her body to do what is normal and natural and not follow the typical medical model practiced in most hospitals here in the US.

I also suggest you get in touch with a local birth circle or meeting of local doulas and childbirth educators and see if you can work through some of your feelings from your last birth. You need to resolve those feelings before labor. Your Hypnobabies instructor probably has some community contacts you can go to.

Best wishes for a healthy pregnancy and wonderful healing Birth!

[brittone2]

I would definitely interview OBs and Midwives in your area that support noninterventional birth. With our third baby, I bounced through 3 different providers until I found a group of CNM's that did homebirth and chose that route. When you interview, make sure you get a chance to meet ALL of the providers. They WANT your business so they should be able to find time to meet with you.

I suggest that you find a Doula who will be able to help you achieve the kind of birth you and your partner desire. Most Doulas are really good at gently advocating for their client so as not to step on your healthcare providers toes and still getting you what you want. Doctors and Nurses are not bad, but they know what they know and it's hard for them to understand when they have a Mom who trusts enough in her body to do what is normal and natural and not follow the typical medical model practiced in most hospitals here in the US.

I also suggest you get in touch with a local birth circle or meeting of local doulas and childbirth educators and see if you can work through some of your feelings from your last birth. You need to resolve those feelings before labor. Your Hypnobabies instructor probably has some community contacts you can go to.

Best wishes for a healthy pregnancy and wonderful healing Birth!

Find a care provider who has an approach that you are comfortable with. Talk to other moms, talk to doulas (even if you don't want to use one), etc. about their experiences with different hospitals and practitioners in your area. Even some midwives are more intervention happy, so it can take some teasing out to find someone who practices more in line with what you are looking for vs. giving lip service to it. Get networked with the natural birth community, etc. and see if there are a few names that come up as practitioners that other people have been happy with.

Consider a doula.

DO NOT beat yourself up. At all! With my ds1, I had an unmedicated labor w/ a CNM in a hospital. It was an easy labor, and was great overall. Despite my requests to not have coached pushing, etc. my midwife went into Medwife mode and had the nurse pull my leg back, everyone started counting, etc. and I didn't like it at all. With my 2nd pregnancy I was in a different state and using a FSBC and I just emphasized that I really didn't want to repeat that experience. They were *great* at letting me follow my own urges, and I found that far more enjoyable in the "pushing" stage. I showed up 10 cm dilated (no idea I was that far) and my membranes were still in tact, so I didn't feel pushy at all. They let me just do my thing and hang out (no pressure to allow them to break my water, etc.) until I felt pushy, which was like an hour later. With DS2 I didn't push until I couldn't *not* push (homebirth/waterbirth). I started feeling a little grunty, and just went with that, and then with two pushes with one contraction, he came out. No one checked to see if I was "ready to push" or complete, etc. So yes, I think some moms don't feel ready to push when they are 10 cm, and may exhaust themselves if they aren't allowed to follow their body.

THe great thing is after that first birth, I had a better idea of how to advocate for myself and what I wanted the next time around, and I was *very* clear about it. I had a birthplan etc. with DS1, but I was a little afraid to stir the pot too much at the same time. We all know you don't always get what you want in labor obviously, but anything you can do to stack the deck in your favor is a help. It sounds like you are working on stacking your deck this time, and that's wonderful.

My doula was great overall. I wish she had run more interference when we ran into the coached pushing situation. I didn't need her for 95% of my labor, but she was worth her weight in gold in transition.

You may also want to look into EFM and consider whether it would be reasonable in your situation to look for someone who does not do routine EFM but maybe does intermittent doppler checks instead (I opted for that with DD and DS2 vs. EFM with DS1)and include that as a concern when you are looking for a care provider and in writing a birth plan.

do not beat yourself up!