Consider This Timeline… Choose Your Ending Story

actually happened:

  • mom has taken Birthing in Awareness childbirth preparation with her first child
  • has fast, gentle birth of first child on the day her child chose
  • mom has history of hypertension which is only exasperated with pregnancy each time
  • mom is pregnant again
  • prepares with the FEAR to FREEDOM class and a review of the Birthing in Awareness class they took the first time
  • mom has continued issues that cause her doctors to consider her high risk:  age is one issue, weight is another and her BP is the third
  • hospitalized for tests and passes with flying colors
  • threats of induction only to be dismissed by her perinatologist each time
  • finally the hypertension and fear of placental abruption after all of the physicans now show concern, causes her to enter hospital for induction nine days before her official due date
  • cervidil placed in the evening
  • cervidil removed in the morning with little change
  • baby is high, still bloatable- perhaps as high as -4, so midwife does not want to break her water yet, but pitocin started
  • although told it would be slow management, the midwife says the doctor has ordered active management of pitocin

  • mom does not agree to active – fast pitocin and it is agreed to do it slowly
  • pitocin on all day with no real change
  • doctor comes in and wants to break her water- although baby is still high- mom declines
  • midwife comes in to talk about options, doctor returns to offer his suggestion- still wanting to break the water although baby is high
  • mom and dad discuss things and decline option of breaking the baby or water
  • doctor sends word via midwife he thinks this is a big baby who does not want to enter the pelvis and suggests a cesarean
  • mom and dad decline the idea and instead go with the option of turning everything off and resting for the night
  • by morning although the cervix remains the same, the baby is much lower, now at -1 rather than-3
  • midwife pin pricks the amniotic sac and water leaks slowly out
  • pitocin started back slowly
  • baby is born within two hours of active labor starting, only four hours after pitocin started that morning
  • no pain medications needed- although offered by the midwife about an hour before the birth- mom declined
  • mom and dad ecstatic that their second baby is born without any pain medication- mom says one of the most empowering things she ever has done!

now let’s look at how this normally happens in our area without an educated consumer and perhaps without a doula:

  • mom takes a one day, six hour childbirth class with her first child, probably taught by the hospital which could be how to be a good patient class
  • mom has hypertension and agrees to an induction of her first child
  • gets an epidural due to it being an option that drops her blood pressure and since she is not allowed out of bed due to her BP
  • mom’s history of hypertension is only exasperated with pregnancy each time
  • mom is pregnant again
  • does not further preparation since her first class she found to be of little help
  • mom has continued issues that cause her doctors to consider her high risk- age is one issue, weight is another and her BP is the thrdi
  • hospitalized for tests and falls prey to the fear that her doctor shares and decides to have an induction almost three weeks early
  • cervidil placed in the evening
  • cervidil removed in the morning with little change
  • baby is high but doctor suggests pin prick to break the bag slowly although he does say it could risk breaking abruptly
  • parents do not fully understand the risk of prolapsed cord

here is where things could have drastically changed:

  • cord prolapsed when bag broken since baby was at -3 station and the gush of water carried the cord out
  • immediate cesarean under general anesthesia without her husband by her side

 

or this could have happened:

  • water trickles out and baby moved down
  • pitocin started and brings about cervical change but with increased discomfort
  • mom receives pain medication
  • mom goes on to give birth without incidence but not feeling as empowered as she would have if unmedicated
  • baby born early and needs to go to nursery for observation
  • baby does not nurse well since born 3 weeks prior to due date- officially premature since he did not complete his full 37th week of gestation

or this could have happened:

  • water trickles out
  • pitocin started and brings little or slow change
  • doctor discouraged at the progress the mom is making suggests cesarean
  • mom and dad go to the OR to have their baby

I share this to say, being full informed, knowing what your options are, knowing the questions to ask, having a doula by your side, understanding risks and dangers and knowing that a doctor can not truly predict size or outcome can really make a difference.  The baby that the ultrasound had suggested was probably close to nine pounds was only 8#5ounces, only 7 ounces larger than her first! Patience, asking the right questions, being strong in her desires, having a great support team and the preparation she and her partner did made a huge difference!