info on inductions

Thats what I was thinking, Emily. What killed Amy's baby last time was
not an issue that surfaced in late pregnancy - if it HAD I would agree
that would be a reasonable incentive to induce a few weeks before
term.

Being an older mom, VBACing twice, and going to 42 plus weeks all
three pregnancies, I know when they want too, they can keep you on a
very short leash, and there ARE things they can do to monitor the
condition and functioning of the placenta with a reasonable degree of
accuracy.

It seems to me that inducing at 38 weeks is kind of a scatter gun
approach when the previous problem came to a disasterous peak a good 2
months prior to that point in pregnancy (i.e. whats magic about 38
weeks??). A more targeted and reasoned approach would seem smarter and
more to the point - to wit, starting early in the pregnancy, doing
tests and close monitoring for hints of a placental problem (including
ruling out genetic clotting issues).

Given that induction (particularly induction on an unripe cervix) is
fraught with its own set of risks for both baby and mother, you kind
of wonder if they aren't aiming the gun in the wrong direction.

I think it was really crummy of the doctors involved not to do some
better investigation for Amy at the time, to see if a cause could be
found so she'd have some idea what the problem was last time.

Mary G.

Mary Gordon wrote:

I think it was really crummy of the doctors involved not to do some
better investigation for Amy at the time, to see if a cause could be
found so she'd have some idea what the problem was last time.

I agree -- especially since some of the clotting disorders appear
to be treatable with blood thinners and/or vitamins, the later
probably preferably starting pre-conception.

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

"Add to this the position an induced mother is in, almost always on her back
in a semi-sitting position due to the continuous EFM (external fetal
monitor)..."
--Connie Banack
http://www.mother-care.ca/induction.htm

Clarification: EFM = electronic fetal-heart-rate monitoring (may be
internal or external - Williams Obstetrics 2001, p. 354)

Amy,

I found the EFM/semisitting text you quoted - thanks for the URL for the
link...

Todd

Dr. Gastaldo


PS I suspect Chotii and Circe are right - most women are semisitting for
EFM...

But even if only a FEW women are placed sitting for EFM - if they are
semisitting when they push their babies out - they are pushing their babies
out through birth canals senselessly closed up to 30%.

And semisitting BEFORE the baby reaches the pelvic outlet may neurologically
inhibit labor because semisitting torques the sacrum exactly the opposite
direction it is supposed to go. This no doubt noxiously irritates somatic
afferent nerves in the sacroiliac joint capsule - or so I say...

In any event, it makes NO sense to force the uterus to push the baby through
the outlet with the outlet senselessly closed up to 30%.

And chemically whipping the uterus to contract VIOLENTLY as a baby is forced
through an outlet senselessly closed up to 30% - well that is insanity.

FACT: By using semisitting (and dorsal) MDs are *causing* "fetopelvic
disproportion" and they themselves say (again quoting the 2001 edition of
Williams Obstetrics):

"[u]se of oxytocin...is appropriate only after assessment to exclude
fetopelvic disproportion." (p. 474)

"With an inappropriate dose of oxytocin, the pregnant uterus may contract so
violently as to kill the fetus, rupture itself, or both..." (p. 323)

MDs say they have the doses down right now - i.e. - they say they are no
longer giving inappropriate HUGE doses anymore - but it makes no sense to
give ANY oxytocin when there is iatrogenic "fetopelvic disproportion" -
i.e. - with the birth canal senselessly closed up to 30%!

Again Amy, thanks for the URL to the EFM/semisitting link.




"Amy" wrote in message
...
http://www.mother-care.ca/ind_info.htm

That Melissa Ann posted originally. Said induction = constant EFM =
semi-sitting. I quote:

"Add to this the position an induced mother is in, almost always on her
back
in a semi-sitting position due to the continuous EFM (external fetal
monitor) she needs to monitor her baby. This position often will turn an
anterior and well positioned baby posterior as the baby tries to negotiate
the pelvis that is compromised by this position."

But I've since spoken to several mothers induced for medical reasons, and
found that they walked around, crouched and delivered on all fours, so
this
is crap.

"Todd Gastaldo" wrote in message
nk.net...
Which site "said basically you will end up delivering semi-sitting due
to
the EFM"?

"Amy" wrote in message
...
Continuous EFM doesn't have to be a big deal. It doesn't have to
tie
you to the bed or to labouring on your back. I had continuous EFM
with #2 due to an induction at 38 weeks and I spent most of my
labour
walking around (albeit on a fairly tight leash) and upright until I
felt like climbing onto the bed for transition. Talk to your care
providers because they can often bend the "rules" for people who ask
and know what they are talking about.

Thanks Cheryl...this site said basically you will end up delivering
semi-sitting due to the EFM. With my son I laboured on all fours and
delivered side-lying. _No-one_ will make me lie down, it's not
comfortable
for me. This was really freaking me out, so thanks for that :-)

Todd,

I agree with you entirely. After consideration and discussion with my
midwife, I have decided at this stage to still plan towards induction at 38
weeks. She said it is usual to only be monitored for no more than the first
hour after induction begins. I plan to walk around, be on all fours and
deliver on my side as I did with my son, and she is most supportive of this
and allowed me to deliver like this without question last time. She feels
that oxytocin (rarely used here) will be unnecessary for me as I am a second
timer and responded well to induction without it last time.

I used to be completely anti-intervention, after my prior experiences now I
believe I am pro informed choice. No-one is forcing me to have an induction
(and indeed I would not permit any medical procedure to be forced on myself
or my child) but at this stage, and after careful thought I've decided it
would be the best decision for my mental health, and carry minimal risk to
the physical health of my baby or I.

It seems things are probably done a lot differently here in one of the
smaller cities of New Zealand than they are in the US, or even in some of
our main centres, and I've been worrying needlessly. I'm grateful, BTW that
I read one of your posts before I delivered my son. To be flat on your back
is an uncomfortable, vulnerable and undignified position for a woman in
labour anyway IMHO, and I instinctively rebelled against it when the time
came. Your posts are far too long, rambling, fanatical and repetitive for
any pregnant woman to bother reading right through, but I guess upon
skimming them at least some of what you have to say is subliminally
absorbed, and by this if you help just one woman to deliver more comfortably
it is worthwhile.

regards, Amy


'"Todd Gastaldo" wrote in message
ink.net...
"Add to this the position an induced mother is in, almost always on her
back
in a semi-sitting position due to the continuous EFM (external fetal
monitor)..."
--Connie Banack
http://www.mother-care.ca/induction.htm

Clarification: EFM = electronic fetal-heart-rate monitoring (may be
internal or external - Williams Obstetrics 2001, p. 354)

Amy,

I found the EFM/semisitting text you quoted - thanks for the URL for the
link...

Todd

Dr. Gastaldo


PS I suspect Chotii and Circe are right - most women are semisitting for
EFM...

But even if only a FEW women are placed sitting for EFM - if they are
semisitting when they push their babies out - they are pushing their
babies
out through birth canals senselessly closed up to 30%.

And semisitting BEFORE the baby reaches the pelvic outlet may
neurologically
inhibit labor because semisitting torques the sacrum exactly the opposite
direction it is supposed to go. This no doubt noxiously irritates somatic
afferent nerves in the sacroiliac joint capsule - or so I say...

In any event, it makes NO sense to force the uterus to push the baby
through
the outlet with the outlet senselessly closed up to 30%.

And chemically whipping the uterus to contract VIOLENTLY as a baby is
forced
through an outlet senselessly closed up to 30% - well that is insanity.

FACT: By using semisitting (and dorsal) MDs are *causing* "fetopelvic
disproportion" and they themselves say (again quoting the 2001 edition of
Williams Obstetrics):

"[u]se of oxytocin...is appropriate only after assessment to exclude
fetopelvic disproportion." (p. 474)

"With an inappropriate dose of oxytocin, the pregnant uterus may contract
so
violently as to kill the fetus, rupture itself, or both..." (p. 323)

MDs say they have the doses down right now - i.e. - they say they are no
longer giving inappropriate HUGE doses anymore - but it makes no sense to
give ANY oxytocin when there is iatrogenic "fetopelvic disproportion" -
i.e. - with the birth canal senselessly closed up to 30%!

Again Amy, thanks for the URL to the EFM/semisitting link.

"Emily" wrote in message
news:NVJ_b.49346$Xp.238952@attbi_s54...

Amy,

I know you posted in your earlier message that they didn't test
the placenta to see what happened last time, but perhaps there
are some tests they could run now? If you read my threads on
low amniotic fluid you'll see that I've been diagnonsed with an
inherited disorder that can *sometimes* *apparently* cause
clotting problems, leading to a poorly functioning placenta.
When they suspected that the placenta wasn't functioning well
(based on the quad screen and my 17 week u/s), they tested for
this an a bunch of other things. You could see about being tested
for such things, but even a positive result might just cause
unnecessary worry: This disorder that I have is a) common and
b) something that I've had my whole life, and I had absolutely
no problems with my first pg.

So, I guess the main thing I want to say is that having one
"overbaked" placenta doesn't mean they all will be.

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Thanks Emily :-) I have been tested for lupus & blood disorders both after
my son's death and during this pg, just in case they hadn't shown up, but
both came back clear.
My annoyance with the screw up over the placenta is that it was clearly a
placental problem (visually the placenta was abnormal) and testing might
have answered some of those 'why' questions for me. My current theory is
that GBS caused chorioamnitis (sp) and that the infection had disappeared in
me by the time he died, causing him to test + and me -.
But I've had plenty of theories over the last year :-)
Realistically, I don't think there is anything more they can test me for
now, so it's a bit of a 'wait and see' game. I'll have several U/S, but U/S
is a limited medium esp when it comes to placentas.
I'm glad they picked up your disorder so they can manage it better. All the
best with #2 :-)

Amy

"Mary Gordon" wrote in message
om...

It seems to me that inducing at 38 weeks is kind of a scatter gun
approach when the previous problem came to a disasterous peak a good 2
months prior to that point in pregnancy (i.e. whats magic about 38
weeks??). A more targeted and reasoned approach would seem smarter and
more to the point - to wit, starting early in the pregnancy, doing
tests and close monitoring for hints of a placental problem (including
ruling out genetic clotting issues).

I know what you're saying. Heck, if it were safe to do so though I'd have
this baby induced at 28 weeks, but it isn't. I guess what it comes down to
is how long I can bear to be pg with the knowledge that my baby could stop
moving and randomly die at any time like its brother, all the while knowing
if it were born it would most likely be fine. That's a very hard thing to
live with constantly, and if my baby were to die between 38-40 weeks I don't
think I could ever forgive myself. I still do have a choice on this though,
in fact I have a feeling it's been suggested more for my sanity than any
concrete medical reasons - most Dr's find from experience that most mothers
of stillborn babies don't want to be pregnant any longer than they
absolutely have to, so I guess all that's magic about 38 weeks is that it's
full term.

Amy