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October 17, 2006

Comments

Ninotchka

Hey Rebekah, I didn't have *any* monitoring with Elle's birth because I labored at home so long, she was born 24 minutes after arriving at the hospital. So, there's definitely something to be said for that. I had my doula (who's also a midwife) with me, though -- so I was definitely in good hands. I don't know if I'd do that on my own because, yikes, 24 minutes? That was kind of close. Which is why we went to the hospital earlier with Anna Sofia. (She was born within 2 hours of arriving at the hospital) I didn't have continual monitoring with her birth but when they *did* monitor me, they allowed me to sit on the birthing ball or in whatever position I wanted to on the bed or standing next to the bed, etc. So yes, it limits your movements but you know what? I spent those two hours of labor very close to bed anyway because I kept having to change positions to get through the contractions. So, something to think about. You can work around that monitoring thing. As long as they don't insist you stay in bed, I think you should be OK.

And yes! Make sure to have a birthing ball and I can't stress enough the importance of those wonderful, warm, soothing rice socks. (Just make sure they have a microwave available for your use -- Guy kept running back and forth warming them up for me, BUT OH MY GOD, did they help!)

Ninotchka

Shit. Sorry that comment was so long. I should have emailed you instead.

Sherry

Hey there,

Do you have the option of a monitrice or a doula? I do this for quite a few of my clients (check fetal heart tones and check dilation if they want). Just an option for staying at home a long time.

When you go into the hospital, you do need to go to the bathroom at times, so unhook yourself and spend some time in the bathroom or walk around your room a little. Women tend to get away with this for 15-30 minutes at a time. And if you are continuously monitored, you still do not have to lay in the bed, you do have some maneuverability (did I just make up a word).

Also, we have a homebirth client who had factor v (of the worst variety, as she puts it), but found an ob who would support her in her homebirth desire. He is monitoring her prenatally (as well as us too) and providing her with her medications (either lovenox or heparin) and everyone will expect a homebirth. Is there this kind of arrangement you can find in your area?

Good luck with your birth plan discussions.
sherry

Bev

First off, I would be firm in telling your doctors what you want. In the end, it is your body and your child. Being flat on my back sucked big time. Course then I ended up with a c-section, so overall my first birth did NOT go as I would have liked. With my second, I had EVERYTHING written down in a notebook so I would not forget what to go over with the doctor. I chose a c-section, however there were many things which happened the first time which better not have happened the second in terms of meds., when I saw the baby, how we were cared for in general. My hubby laughed when I pulled it out for the doctor, but I am so happy that i stuck firm to what I wanted. I had a wonderful experience this time! BTW, if you end up with a c-section again, I am being totally honest here when I tell you my second c-section was so much easier than my first. Oh, what pain I was in the first time! This time I only took 4 pain pills at home, and then only took Advil after that. I was walking up and down the stairs freely in the first week, and was at the mall a week to the day after I had my son.
I guess my point is if you want to not be monitored as closely, say it. If like Nino suggested, you can use a birthing ball close to the bed while being monitored and you'd be okay with that, do it. We all know you are thinking of what's best for the baby too, so just be firm in what you want. It's your birth after all.

Moxie

I would see if you can find stats on continuous fetal monitoring specifically for VBACs. I know there are a bunch of studies out there showing absolutely no difference in safety of continuous vs. intermittant for births in general (but a much higher rate of interventions with continuous, duh, because it hurts like hell to be on your back the whole time). But if you could find any info about outcomes specifically with VBACs, you'd have one of two things 1) stats to show your doctor what the research shows, inviting her to practice evidence-based medicine, or 2) assurance that continuous is safer for a VBAC situation and an eased mind about using continuous.

I wish I knew how to help you look for this info. Maybe email someone at ICAN to see if they know where to start.

Lil Liberal

Ouch. Sorry your doctor isn't too receptive to your birth plan. Can you see if any information exists on how being unable to move around freely actually contributes to uterine rupture or complications in a VBAC? If you could find any information on that at all- it might make for good ammo.

Also, how can continuous monitoring prevent or predict rupture? My untrained mind is having difficulty picturing how that would work.

Or how about an "AMA"- are you able to sign an against-medical-advice form and refuse the monitoring?

I hate it when our health care practitioners give us no choices and no information while simultaneously refusing to honor our wishes.

Jeanette

If the monitoring seems to be a non-negotiable issue (and I say that meaning you decide it is not worth the stress to negotiate it - grin) then find out if the hospital has telemetry units, or if they/you could obtain one. With a telemetry unit you can be continually monitored but not tethererd to anything (no wires). With the ones I've seen here, you can also get into the bathtub or shower while being monitored (I have a VBAC client in Jan whose doc just told her that she'd be able to be in the tub as much as she wants because of these monitors - that hospital has a CEFM policy for VBACs too). Make sure you ask and ask again though, because I was also told by a nurse at the same hospital that they didn't exist:)

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