Any uterine ruptures?

• 04-01-2009 1:15 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682

  Re: Any uterine ruptures? Reply Contact I'm so confused. . . why does it so often come down to induction vs repeat cesarean? What about the option of just waiting for labor to start on its own? I understand that induction &/or cesareans have their proper uses & places but the vast majority of them are avoidable & unnecessary. Given time & support everything will start on its own naturally. No need to hurry things along when things are looking fine. EVERY choice has risks, especially once a scar exists on the uterus. You can never eliminate risks completely, scarred or not, but there are a number of things that can be done to minimize them. Avoiding induction & minimizing the number of scars on the uterus are two of the many things that can be done to minimize risks. No guarantees any way you choose, but it's just confusing to see women admit that doctors are human & make mistakes, & then have the evidence in front of them that says that inductions & cesareans increase risks, & then when the doctor says it's induction vs. cesarean seeing them not demand better, less risky, more evidence-based care. There are other options. Said with love & hugs.

• 04-09-2009 7:37 AM

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  Mommy2be26 Joined on 12-15-2006 Jacksonville, FL Posts 23

  Re: Any uterine ruptures? Reply Contact  lncooper, how would we know if we have a scar on our uterus?  Is this something that can be seen in the ultrasound?  My first daughter was a CS.  Not by my choice in the least bit.  I did go over the suturing beforehand with my OB and she said that she uses the double suture method, which I hear is better for VBAC's.  I am 6 weeks pregnant and going back to see this OB next Friday.  I don't like the "scare tactics" that are used to get women to keep doing CS's.  I don't want it sprung on me in my final trimester again, so I'm just trying to get as much information as possible before I see her.  That way I can determine if she will be delivering baby #2 as well.  (If she is VBAC supportive or not).   Thanks.

• 04-09-2009 9:43 AM

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  Mrs Garcia Joined on 09-03-2007 The ax forgets; the tree remembers~African proverb Posts 219

  Re: Any uterine ruptures? Reply Contact Mommy2be26:  lncooper, how would we know if we have a scar on our uterus?  Is this something that can be seen in the ultrasound?  My first daughter was a CS.  Not by my choice in the least bit.  I did go over the suturing beforehand with my OB and she said that she uses the double suture method, which I hear is better for VBAC's.  I am 6 weeks pregnant and going back to see this OB next Friday.  I don't like the "scare tactics" that are used to get women to keep doing CS's.  I don't want it sprung on me in my final trimester again, so I'm just trying to get as much information as possible before I see her.  That way I can determine if she will be delivering baby #2 as well.  (If she is VBAC supportive or not).   Thanks.  If you've had a cs then you have a scar on your uterus.

• 06-03-2009 5:12 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682

  Re: Any uterine ruptures? Reply Contact Yup, if you've had a cesarean then your uterus is considered scarred. The thickness of the scar area can be measured as your pregnancy progresses, but it's a poor indicator of whether or not you'll rupture & it's not always an accurate measurement anyways. The uterus is amazing though & has the power to heal. I've read stories of women who've had repeat cesareans & their care provider couldn't even see where the previous scar was on the uterus because it healed so well.

• 06-04-2009 8:48 AM

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  Holly2906259 Joined on 06-22-2008 GA Posts 14

  Re: Any uterine ruptures? Reply Contact Good question, and I'm about to write you a book based on my experiences seeing VBACs.... As an L&D nurse I help with many VBACs...both helping them deliver vaginally, as well as going back for further C/Ss after the trial failed. My first question is: why did you have your first c/s? Was it because the baby wasn't tolerating labor and his/her heartbeat was going down? Or was it because you got "stuck" at 4...9...even 10 cm? Sometimes our pelvises aren't big enough to allow the baby to come out. Another possibility is was the baby not positioned correctly? Where I work, if the baby is not head down, you must have a c/s. Also, even if the baby is "head down" the babies head can be positioned facing different directions. We prefer babies to come out looking towards our bottoms...sometimes babies come out "OP" aka sunny side up. You may experience a lot of back labor or difficulty getting past 9.5 cm in the end. Drs. or midwives can feel for the babies sutures on his/her head and tell the position. Sometimes turning from side to side can assist the baby in turning its head...but sometimes just because of the way the baby's head is it makes for a much more difficult vaginal delivery and sometimes needs vacuum assistance. Long story short...I think MDs are always skeptical about VBACs if they were preformed due to not progressing or "getting stuck" however, if it was due to babies position your pelvis was never "tried" so, this time around you may have a good chance! Also, babies second time around are usually bigger than the first time around (unless this is with a different partner or you go preterm, etc) Another problem is that with repeat c/s at my hospital they like you to come in around 38 weeks...for many women they do not go into labor naturally that early...so they might encourage you to go in for induction if you wanted to try vaginal ~38 weeks....and induction+VBAC is very difficult. We have to be especially delicate with medications to induce as you have a "weak" spot on your uterus which always has a possibility of rupturing if your uterus hyperstimulates (contractions coming too close or are exceptionally strong without adequate time to rest). From my experience MDs try to break your water as early as possible to place an internal monitor called a IUPC (intra uterine pressure cathetor) which will accurately measure how strong the contractions are...from there, nurses are able to monitor while we increase pitocin to help induce labor. If it looks like the baby isn't tolerating it, we slow down, change your position, give you some oxygen and a fluid bolus in your IV. If the MD deems that you are having adequate contractions that should assist you to dialate,but you aren't...they will say the "VBAC trial has failed." A uterine rupture is a extremely serious emergency, and you will be rushed back for an emergency c/s to save you and the baby. I have only seen a few, but there is always a chance of it when you VBAC...though thankfully unlikely with good monitoring. I hope this wasn't too much information...I wish you the best with your VBAC! I hope it goes smoothly for you. Just know you are considered to be "high-risk" because of having a previous c/s in your history.

• 06-05-2009 4:54 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682

  Re: Any uterine ruptures? Reply Contact Holly, this is terrible! This is one of the many reasons why I stayed home when I had my third baby- care providers in the hospital often have no idea about how birth is supposed to work normally & in their meddling, actually CAUSE problems & harm to mothers & babies. Holly2906259: Sometimes our pelvises aren't big enough to allow the baby to come out. This is very, very, VERY rare. It's often hereditary (which is hard to tell b/c of the ridiculous interventions that have been used over the past few generations), due to severe malnourishment or deficiencies, or caused by an accident to the mother's pelvis. Of course it doesn't help when in hospitals, women are usually stuck laboring & pushing in the most physiologically ABnormal positions which actually close up their pelvis, making the space for the baby to come out smaller than if mom was in upright, physiologically normal positions. Holly2906259: Another possibility is was the baby not positioned correctly? This is actually most often the case in "CPD" diagnosis. Malpositions can frequently be prevented or corrected, or they usually correct themselves. . . if the care provider & support team are patient enough. Holly2906259: Where I work, if the baby is not head down, you must have a c/s. Well then where you work, your care providers are admitting that they are lacking in skills necessary to help women & babies have safer births. With a trained care provider, vaginal breech births can be almost or just as safe as breech cesareans without the added risks of surgery. Of course, the important part is WITH A TRAINED CARE PROVIDER. OBs & even most nurse-midwives aren't taught the art of vaginal breech birth in their training. A cesarean is easier for their convenience & liability, & OBs are trained surgeons. . . when you're a hammer, every problem looks like a nail. Holly2906259: Also, even if the baby is "head down" the babies head can be positioned facing different directions. We prefer babies to come out looking towards our bottoms...sometimes babies come out "OP" aka sunny side up. Sometimes turning from side to side can assist the baby in turning its head Malpositioning is certainly an issue that deserve attention & awareness. It usually does lead to increased pain & length of labor, but luckily it can frequently be prevented or corrected. If not, the best remedy is TIME & PATIENCE. Yes, turning side to side can be helpful. . . but when you're not stuck in bed, tethered to IVs & tubes & monitors, you can be upright & active, squatting & bouncing & walking & rocking your pelvis, & your support team can be providing counter pressure on your back & hips & using a sling to help shimmy baby into a better position. There's so much more that can be done when mom isn't trapped in bed. Heck, if mom wasn't trapped in bed during most of her labor, many malpositions wouldn't happen in the first place! Holly2906259: Also, babies second time around are usually bigger than the first time around But mom's pelvis & ligaments are also prepared to spread more the second time because of the previous pregnancy. In a normal, healthy pregnancy, mom's body is not going to grow a baby that's too big for her to birth normally. Unfortunately, you don't find much support for preventing pregnancy complications & facilitating normal, healthy pregnancies in the obstetric model of care. Holly2906259: Another problem is that with repeat c/s at my hospital they like you to come in around 38 weeks...for many women they do not go into labor naturally that early... Then OBVIOUSLY they're doing them too early! Baby is not READY if most women don't go into labor naturally by then! WHY do we keep artificially lowering the length of gestation? Even the typical 40 week due date doesn't take into account a woman's cycle length or the fact that first time moms have an average gestation of 41 1/2 weeks & multips have an average gestation of 40 1/2 weeks. Holly2906259: so they might encourage you to go in for induction if you wanted to try vaginal ~38 weeks.. Yeah, that's what they'll encourage so that you have more of a chance of failing & ending in a repeat cesarean anyways. You just said that most moms aren't ready at 38 weeks- if they were ready, they'd be in labor already! Induction majorly increases your chances of cesarean. So WHY would it be a good idea to induce early when it's just going to increase your chances of another cesarean, a uterine rupture, distress in mom &/or baby, AFE, need for instrumental delivery if you do manage to deliver vaginally, ETC ETC ETC Holly2906259: ..and induction+VBAC is very difficult. Indeed. Which is why it should NEVER be done without CLEAR medical indication. That's not just for VBAC moms- that's for ANY mom. Holly2906259: We have to be especially delicate with medications to induce as you have a "weak" spot on your uterus which always has a possibility of rupturing if your uterus hyperstimulates (contractions coming too close or are exceptionally strong without adequate time to rest). Exactly. So why again is it being done without clear medical necessity? What about WAITING? There's no study that says the size of the baby increases the risk of uterine rupture, but there are COUNTLESS studies showing that induction does. The studies on whether or not being 'overdue' (which by definition is not actually until after 42 weeks; but in these studies is only after 40 weeks) leads to an increased risk of uterine rupture vary & often don't account for interventions used (which are more likely with 'overdue' moms, not always out of necessity but out of modern obstetrics' fascination with messing with the normal process & liability concerns). Again, you're not actually OVERdue until after 42 weeks, & even then in a normal, healthy pregnancy, what's the rush? The studies on this vary as well, & many times it's not being post-dates that causes problems; it's usually preexisting problems in mom &/or baby that cause the post-dates. Holly2906259: From my experience MDs try to break your water as early as possible to place an internal monitor called a IUPC (intra uterine pressure cathetor) which will accurately measure how strong the contractions are...from there, nurses are able to monitor while we increase pitocin to help induce labor. WHY break the bag of waters? This increases the risk of infection (ESPECIALLY with a constant line up into the uterus like an IUPC or internal CEFM) & solidifying a malpositioned baby, which we talked about above. Without messing with mom & breaking her waters in the first place, the mom wouldn't 'need' pitocin. Holly2906259: If it looks like the baby isn't tolerating it, we slow down, change your position, give you some oxygen and a fluid bolus in your IV. Why do all of these things knowing that it's very likely that baby will not tolerate it well???? Holly2906259: If the MD deems that you are having adequate contractions that should assist you to dialate,but you aren't...they will say the "VBAC trial has failed." This. Is. Absurd. When you leave moms alone & don't tell them they're broken, they can birth their babies normally. "Your contractions aren't adequate- we need to intervene." "Your contractions are adequate but your body still isn't working or producing the results we want to see- we need to intervene." LEAVE WOMEN ALONE & STOP TELLING THEM THEY'RE BROKEN & NOT WORKING QUICKLY ENOUGH FOR YOU. If the woman isn't 'producing' a baby quickly enough for you, then go home & let someone with patience give evidence-based care & support to the mom. She & her baby DESERVE that. Holly2906259: A uterine rupture is a extremely serious emergency, and you will be rushed back for an emergency c/s to save you and the baby. I have only seen a few, but there is always a chance of it when you VBAC.. There's always a chance of it with a repeat cesarean, too! Just being pregnant after a cesarean is a risk factor for uterine rupture! You can rupture BEFORE labor. You can rupture BEFORE a scheduled cesarean date. Many studies lump mothers who planned a repeat cesarean & ruptured, or those who ruptured prior to labor into the "VBAC" group even if that's not what they were planning or trying for at that time. Most ruptures are not catastrophic. You'd need over 7100 women to undergo repeat cesareans and all of the risks associated with them to mom, baby, & future babies to prevent ONE fetal death as a result of uterine rupture. http://www.childbirthconnection.org/article.asp?ck=10210 Holly2906259: though thankfully unlikely with good monitoring. The monitoring itself is not what PREVENTS rupture. It has the ability to help detect a rupture early, but that does not mean that mom should be stuck in bed with monitors up her vagina & screwed into her baby's head. It means she should be given one-on-one care from a knowledgeable care provider who can monitor her with a doppler or fetoscope often so that she can remain mobile which will help facilitate the normal, safe birth of her baby. I've seen it theorized that restrictive monitoring can actually lead to ruptures since it forces mom to be immobilized & laboring in physiologically abnormal ways, which makes her uterus work even harder than necessary & in ways that it wouldn't work when mom is able to labor normally. Holly2906259: Just know you are considered to be "high-risk" because of having a previous c/s in your history. A mom with previous cesareans has a LESS than 1% chance of her uterus rupturing if she is not chemically induced or augmented. An unscarred mother has a 0.5%-3%+ chance of placental abruption or cord prolapse, which would require immediate delivery by cesarean to save her or her baby. If the unscarred mom has about the same or MORE of a chance of experiencing a complication requiring an immediate cesarean, why is she not considered high risk? The question is really why is a mom with previous cesarean scars considered 'high' risk when that risk is less than 1%?

• 06-05-2009 4:56 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682	Re: Any uterine ruptures? Reply Contact VBACs don't fail. Women don't fail at giving birth. The system & model of 'care' fail to support them properly.

• 06-06-2009 7:03 AM

  In reply to

  Holly2906259 Joined on 06-22-2008 GA Posts 14

  Re: Any uterine ruptures? Reply Contact I'm glad that you've asked so many good questions. I have just been giving you information based on "my experiences" working in a big hospital L&D unit. As for the word "fail" that is not about anything the mother did or did not do, it is just the word they use in the hospital if the trial to have a vaginal birth after c/s did not work. I'm not saying the system is perfect by any means. I am saying that Labor & Delivery, though a natural experience can be a dangerous & risky at times. Why did so many women die in the old days before c-sections? I'm sure women moved a bunch prior to getting an epidural and the baby still wouldn't come down. Many women did die, and in the situation where CPI or if the baby is transverse or OP and not moving down in the pelvis despite frequent maternal positioning Drs strongly suggest c/s delivery...most patients beg for it at this point if they have been moving an pushing for hours and hours with no progress (not everyone...but most I've seen) even with an epidural at this point it is excruciating for many. The hormone relaxin helps to soften the bones. CPI is still a possibility though may be diagnosed too frequently and may also be due to babies positioning. . As for breech births, Labor and Delivery is the highest liability in the hospital with insurance, etc...so I'm sure midwives and Drs. want to be as careful as possible...not to mention practice as they feel comfortable doing so, trying to keep the patients (and baby) best interest in mind. That being said, I've seen on movies and demonstrations how some deliver breech babies with forcepts and such, there is always a risk of the head getting stuck in reverse. My understanding of this is there are some that will do this type of delivery...but due to lawsuits, I would assume certain facilities won't let them due to statistics of claims, infant deaths, and the mere fact that they haven't had enough experience birthing babies this way because of the opportunity to complete a c/s and not have to risk complications to the infant for breech birth. If c/s weren't available, I'm sure physicians and midwives would feel more comfortable, be more proficient, and have a lot better results overall. There is also another option for those who are presenting with a breech baby. With u/s the Dr. can manually try to turn the baby on the outside of your belly, it's called an "external version" In regards to your questions about breaking a VBACers water...I mentioned about that when discussing induction. In order to know that the uterus is not experiencing exceptionally hard contractions too close together they will place an IUPC...these monitors can only be put in after the bag of water is broken. The risk for infection increases after this has been broken 12+ hours, and if you are still laboring at this point they may give you some antibiotics. Medical staff also usually checks your temperature every 2 hours after your water is broken to monitor for infection. I'm not saying I agree with this, I'm only informing you that this is why they do these things. As for babies heartbeat....there are different reasons why is goes down, hence why I listed those interventions. It can be due to head compression, baby laying on his/her cord, maternal BP going down (like post epidural placement), or if there is not enough oxygen or blood reaching the baby like in placental insufficiency, or sometimes because the cervix is changing rapidly. Slowing down or stopping the induction medication, changing mother's position to the other side, giving extra oxygen, giving a fluid bolus, also the cervix would help us discover what might be going on. If the baby's heartbeat is going down no matter what position mom is in, even if she has an 02 mask on, blood pressure is fine, cervix still the same...the baby might have some reason that he/she is not tolerating the contractions, or some reason that the baby is stressed. Depending on how long this has been going on and if there are decelerations with the majority of contractions, the Dr. will decide in his or her opinion if you should have a c/s or proceed. The goal is to have a healthy happy baby, obviously we would all want vaginal deliveries if possible...but for some, unfortunately their plans get changed. About the comment about moms being stuck in bed, many moms want epidurals...and if you are going to have one...you aren't going to be up walking. If you decide you want to go natural and there aren't any contraindications, the baby has been looking good on the monitor and it is ok with your Dr, many women do get up and go walking.... (those who decide not to get epidurals until later or not at all). I'm sorry if what I said upset you, I'm just trying to help answer some questions based on what I've seen or learned about. I think it's wonderful when women are involved in their care and are understanding of what is going on in their bodies and with their babies. I think it's terrible if someone has had to have a c/s and has no idea why. Keep up the good work! May all you ladies have healthy, happy deliveries!

• 06-07-2009 4:59 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682

  Re: Any uterine ruptures? Reply Contact Holly2906259: IAs for the word "fail" that is not about anything the mother did or did not do, it is just the word they use in the hospital if the trial to have a vaginal birth after c/s did not work. I know it wasn't you using this term. It's just the term they use in the hospital. . . & it's a terrible, damaging term. Holly2906259: I am saying that Labor & Delivery, though a natural experience can be a dangerous & risky at times. I completely agree. This is why it's so important to minimize the risks. Many interventions cause more risks than they prevent. Holly2906259: Why did so many women die in the old days before c-sections? It had hardly anything to do with cesareans & modern medicine. Of course there are some that would have lived with access to cesareans, but most maternal & fetal deaths had to do with the overall standards of living! The lack of access to sufficient food & clean water. Poor sanitation. No knowledge about how germs & sickness were spread. In fact, when birth started moving out of the home & into hospital, significantly more moms & babies were dying at the hospital because of the doctors going from cadavers to laboring women to sick people without hand washing. Think about it this way: 'back in the ol' days' many people would die from the common flu just because due to their standards of living, their bodies couldn't handle it & the risks were high. Now, most people get the flu once a year or every other year & are down for a day or two but survive it just fine! This is because we have access to mostly clean water, better availability of food, better sanitation, & more general knowledge about how to help prevent the spread of germs. Holly2906259: As for breech births, Labor and Delivery is the highest liability in the hospital with insurance, etc...so I'm sure midwives and Drs. want to be as careful as possible...not to mention practice as they feel comfortable doing so, trying to keep the patients (and baby) best interest in mind. Keeping the patient's & the baby's best interest in mind are not what most care providers have as their top priority. It's sad but true. Look at most care provider's intervention statistics in comparison to what the evidence says they should be. According to the World Health Organization, cesarean rates above 10-15% & inductions above 10% are unjustifiable & cause more harm than good. How many care providers do you know that practice within these standards? Not many exist, because they are more worried about their liability (liability & safety are NOT the same thing) & convenience. Holly2906259: That being said, I've seen on movies and demonstrations how some deliver breech babies with forcepts and such, there is always a risk of the head getting stuck in reverse. There are certain kinds of breech presentation that carry a higher risk than other types of breech. Yes, that is a concern, but forceps are not a necessity for breech birth. In medical or nursing school, when they show videos of breech vaginal birth, they're of the mom in bed in stirrups & the baby being dragged out by forceps. This also usually involves a hefty episiotomy. Ouch :( When mom is laboring & pushing upright, her pelvis opens up ~30% more, making way more room for for the baby to come out whether baby is vertex or breech. If she's unmedicated & pushing upright, she can also quickly change position if baby gets stuck which often helps baby pop right out. A medicated mom stuck in stirrups can't move to help dislodge her baby, breech or vertex. Besides, with a breech birth, depending on the size & gestation of the baby, the circumference of the baby's butt with legs bent up &/or shoulders are usually equal to or greater than the circumference of the head. If the baby makes it down that far to where the butt is out or the shoulders have made it out, then that baby has usually loosened up mom's pelvis adequately for the head to be born. Holly2906259: My understanding of this is there are some that will do this type of delivery...but due to lawsuits, I would assume certain facilities won't let them due to statistics of claims, infant deaths, and the mere fact that they haven't had enough experience birthing babies this way because of the opportunity to complete a c/s and not have to risk complications to the infant for breech birth. If a facility doesn't feel they are capable of handling an emergency like a uterine rupture in a VBAC or a cord prolapse in a breech vaginal birth, then they shouldn't be handling any births, period. ANY mom/baby could have an emergency arise at any time. Maybe I shouldn't say they shouldn't be handling births at all; I understand that for many women, there aren't facilities close to them that have these capabilities. What I'm saying is that this should not be grounds to refuse women their right to options. If a care provider isn't trained in breech, then darnit they should LEARN. What if a mom comes in pushing & her baby is half out of her & breech? How can that care provider help prevent injury at that time instead of interfering & making it worse? Holly2906259: If c/s weren't available, I'm sure physicians and midwives would feel more comfortable, be more proficient, and have a lot better results overall. I completely agree. The art of supporting a normal, natural birth is almost dead because it's just easier & more interesting to them to use their surgical skills. Meanwhile, this puts moms & babies under additional risks. I'm thankful that cesareans exist for when they are truly necessary, but they certainly don't fix everything. Holly2906259: There is also another option for those who are presenting with a breech baby. With u/s the Dr. can manually try to turn the baby on the outside of your belly, it's called an "external version" Yes, this is an option, but it's also another art that's being lost. Moms are usually told that they can't have an external version because it's her first baby & her uterus isn't stretched out enough, or there's not enough amniotic fluid, or the baby is too big, or she's had a previous cesarean, or any number of reasons. . . sometimes with reason, other times without. It's also often done so roughly in the hospital setting! I know someone who went & saw an Amish midwife at around 38 weeks pregnant & had a version done (two previous cesareans; baby was over 9 lbs at the time of version). She said it was so gentle. Many women who have a version in a hospital are in excruciating pain because it's done so forcefully. Holly2906259: In order to know that the uterus is not experiencing exceptionally hard contractions too close together they will place an IUPC...these monitors can only be put in after the bag of water is broken. But without the chemicals, the uterus almost always won't contract too hard. The IUPC is most often used to place the seed of failure in the mom's mind. Contractions too strong. . . contractions not strong enough. . . contractions adequate but not changing cervix. . . Holly2906259: The risk for infection increases after this has been broken 12+ hours, and if you are still laboring at this point they may give you some antibiotics. The risk of infection raises so much after that point because of the frequent dilation checks & internal monitors that provide a continuous line of infection into the baby's head & mom's uterus. In order to minimize the risk of infection, don't artificially break the bag of waters & keep anything & everything OUT of the vagina! Dilation checks & monitors push bacteria up into the uterus where it doesn't belong, whereas when the bag of waters releases on its own, it naturally flushes bacteria down & out, thus preventing infection when not tampered with. Holly2906259: I'm not saying I agree with this, I'm only informing you that this is why they do these things. I know Holly. It's not a personal thing against you; I'm just so fed up with seeing women made to feel broken & saved by these interventions when these interventions are what 'broke' them or made them 'need' to be 'saved' in the first place. It's all very misleading. I appreciate your insight as someone 'on the inside,' & I think it's very valuable for women to see just what harm these interventions are causing. It's about time for women & knowledgeable care providers, nurses, & support persons to stand up against these things that are NOT evidence-based & have been proven to do more harm than good. We're losing too many moms & babies because of this. Holly2906259: As for babies heartbeat....there are different reasons why is goes down, hence why I listed those interventions. It's the interventions that often cause distress. To keep an eye on baby's heartbeat, why not monitor mom with a doppler or fetoscope? One-on-one care & support is what's safest for moms & babies, but again, our modern model of maternity care is not based on safety, it's based on fear & convenience. Holly2906259: Slowing down or stopping the induction medication, changing mother's position to the other side, giving extra oxygen, giving a fluid bolus, also the cervix would help us discover what might be going on. Yeah, but once the bag of waters has been artificially broken, there's no turning back!!!! Holly2906259: The goal is to have a healthy happy baby, Exactly. Then why are we allowing so many babies to be placed under avoidable risks? Different people define healthy in different ways. Apparently, in modern obstetrics, a healthy baby= a live baby. What about the baby who was born earlier than he was ready due to induction or planned cesarean? Or pulled out with instruments because of interventions? Or separated from mom in that important first hour of bonding because she was hemorrhaging or being stitched up from an extensive tear or episiotomy that was caused by the interventions? Is that baby healthy & being given the best chance at an optimal start in extra-uterine life? Another important goal is to have a healthy mother who is capable of taking care of & bonding with her new baby & other children she may have as well. A mom who is post-op from major abdominal surgery is not healthy or capable. A mom who is traumatized due to feeling violated by the modern model of maternity care is not healthy. Holly2906259: obviously we would all want vaginal deliveries if possible... Eh, I don't know about that. Not in the way most women are treated during vaginal births, anyways. Many women think cesareans would be 'the easy way out' or at least feel they MUST have the epidural mostly because they are uncomfortable with what is usually done to women in a typical hospital vaginal birth. It's no wonder so many women opt to become as distanced from birthing as possible (not that maternal request cesareans are high, because they really are very low, but it's no wonder that so many see cesareans as 'the easy way out,' no pun intended). I think that if women knew the truth about birth & were given evidence-based care & support, they'd be more likely to assert themselves & take the steps necessary to facilitate a safe, normal birth. Holly2906259: but for some, unfortunately their plans get changed. Yes. Their plans get changed by the interventions. Holly2906259: If you decide you want to go natural and there aren't any contraindications, the baby has been looking good on the monitor and it is ok with your Dr, many women do get up and go walking.... Ah yes, but how easy is it for a doctor to create a reason that would be contradictory to 'allowing' the woman to birth naturally? Baby is too big, baby is too small, your pelvis is too small, you're overdue, you're taking too long, you had a previous cesarean, we need to keep an eye on the baby, this is for your baby, you want a healthy baby, don't you? Many babies don't look good on the monitor because mom is stuck in bed! It's pretty rare to find a care provider who is truly supportive of natural, normal birth. There are liability concerns with it. Holly2906259: I'm sorry if what I said upset you, I'm just trying to help answer some questions based on what I've seen or learned about. Holly, I'm sorry, I'm not taking it out on *you* personally, & I know this might not be necessarily how *you* feel. I'm just expressing frustration with the fact that this is how most care providers, nurses, & support persons feel, & it's doing more harm that good. Women deserve to know the effects of what they're agreeing to. In your experience, when a woman is told "You must be induced, get in bed, & have your waters artificially broken so we can continuously monitor you, your contractions, & your baby so we can keep your baby safe," are the women told the risks, limitations, & high chance of inaccuracy with this? If the doctors aren't going to tell them because it would put their liability at risk, & the women don't know that they have to ask these things because it's already so ingrained in their head that "it's for the baby" & "the doctor wouldn't do anything that wasn't necessary or would cause harm!" then who's going to tell them the truth?