I apologize in
advance for rehashing an old topic of discussion, but I need to get this off
my chest.
I had a 36 week ANC
appointment with one of the hospital OB�s yesterday and I
left the appointment shaking with anger. I also left questioning my own
wishes and plans. I was asked if I realized the risks of a VB due to my
tear. I answered to the affirmative. I was asked if I truly appreciated the
�great� possibilities of incontinence if I had a VB. I answered yes, but
didn�t engage in a debate over the actual research done and what may cause
the incontinence.. I was then asked how I felt in the event of a successful
VB, with no tear, still meaning that 10-20-30-40 years down the track I
would most likely still need a colostomy bag due to the damage to the
perineal nerves/muscles- all linking back to my �ungiving� scar tissue and
my adamant wish to have a VB. How does he expect me to feel, with this doom
and gloom prediction being spouted in an extremely patronizing tone of
voice? He went on and on for about 6-7 minutes about how I must
realize the risks that my choices could entail. I felt my face getting hot,
I felt sweat beading on my upper lip, I started shaking. The only part of my
wishes that he actually �approved� was the possibility of an
episiotomy.. Then he started on my wish for a physiological
3rd stage- again predicting doom and gloom. His exact wording was
�Sure it is great to have a natural delivery of the placenta, but you can
also die naturally from massive blood loss. Did you know that a PPH can mean
that blood is running with the speed of a household tap and before you know
it you have lost 3000cc of blood?� I just nodded dumbly in shock and
disbelief..
Today I doubt
myself, my abilities, my wishes, my knowledge, my body. I feel physically
sick, thinking of all the women who go to see a doctor and end up being
scared into submission. No wonder the rates of intervention are so high, no
wonder the concept of a normal, natural birth doesn�t actually mean what it
sounds like..
I am scared of this
birth, I am wavering in my resolve to not have a c-section just in case. I
feel empty.
-----Original
Message-----
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Lois Wattis
Sent: Friday, 6 June
2003 10:15
AM
To:
[EMAIL PROTECTED]
Subject: Re: [ozmidwifery] vaginal wall
tearing
Dear Isis -
I am impressed with your response to Jo, and the way you have worked through
your own experiences. Congratulations. You display courage and
wisdom in your choice to birth (again) as naturally as possible.
I applaud and endorse the advice given by the private OB. Being
upright through labour and especially the use of water immersion which
assists the process of softening and stretching the perineum, and
'feeling' your own progress in the expulsive stage. Most importantly,
allowing the time for the crowning and birth of the baby's
head and body to be SLOW, and not forced in any way - YOU WILL PROBABLY
NOT NEED AN EPISIOTOMY!! Many birth
practitioners (midwives AND ob's) get very anxious when the birth is slow,
and feel compelled to intervene, especially if the birth is in
water. Birth in water is gentle on baby and on you...Be guided by your
instincts. Best wishes, and let us know how it goes. Kind
regards, Lois
----- Original Message -----
Sent:
Wednesday, June 04, 2003 6:19 AM
Subject: RE:
[ozmidwifery] vaginal wall tearing
Hi
Jo,
I
tore to the 4th degree with my daughters birth. A mix of
factors caused it- very fast labour, compound hand and forced pushing
while on my back with my legs braced on midwives hips.. My poor perineum
didn�t stand a chance.. Unlike your lady, I have had no problems healing,
with incontinence or sexual dysfunction.
This
birth I have been advised by hospital OB�s to have a c-section. Any
midwife I speak to disagrees with that recommendation. A private OB agreed
that a VB was indeed possible, but to keep upright, active during first
stage. During second stage, no forced pushing as such. Follow my urges and
to breathe/grunt with the uncontrollable urges. An episiotomy may be
advisable while babe�s head is crowning to �take the pressure off� the
peri scar tissue. This same OB mentioned being in a bath, peri massage,
hot compresses, having my hands on my peri to �feel� what is happening-
but most important, stay off my back J
I
wish your lady luck and strength. It is a hard decision to make and only
one that we (as the mother) can make. We are the ones that have to stick
up for ourselves and take the bit between our teeth.. Then we have to be
the one to climb back on the horse and ride again if we fall
off..
I
shall keep you all posted as to how this birth goes. Less then 10 weeks
till birth time finds this family again J
Cheers-
Isis
-----Original
Message-----
From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of M & T
Holroyd
Sent: Thursday,
29 May 2003 10:35 PM
To:
[EMAIL PROTECTED]
Subject: Re: [ozmidwifery] vaginal
wall tearing
I don't know if this will
help, but as a midwifery student I cared for a woman who had had a
previous 3rd degree tear (I think... can't remember all the details as it
was 5 years ago). She had to have it repared in OT at the time &
I think maybe one more op later down the track... as you can imagine she
was very worried this time around. The Dr's notes stated that she
was to have an episiotomy at even the slightest indication that she might
tear. Looking at her perineum the scar was large & there was a
dint in it like someone had removed a piece. Anyway, from
memory she stayed mostly active & only just made it back onto the bed
in time for me to catch the baby (I know better now with regards to the
bed thing) & I didn't even have time to call the registered midwife
until the baby was almost all the way out. The woman did not have
even a graze to her perineum / vulva. She was absoulutly happy
(& so was I ). She followed her own instincts & no coaching
from me or her husband. Good luck to this woman for
whatever she chooses.
----- Original
Message -----
Sent:
Thursday, May 29, 2003 11:07 AM
Subject:
[ozmidwifery] vaginal wall tearing
I know there
has been discussion in the past about this but I am in a hurry to get
some information for a woman whom had a positive vaginal birth that
turned ugly when she "tore badly inside and out" (in quotes because that
is what she said and I have no further knowledge of what sort of tearing
it was.) She has had incontinence problems and sexual dysfunction for
the last 16 months. Her first OB said to have a cs (of course) and
then yesterday she was told that she should not have a cs and that a vag
birth would be the best option. She is now very confused and
scarred as hubby wants her to have cs and her fear is that a vag birth
will increase problems they already have.
She is willing
to have a vag birth if she can optimise her chance of reducing the
damage if a tear happens again.
Can anyone
offer midwifery woman focused care and positions etc that she could use
during a vag birth? She would have a home birth but she can not
afford it. I suggested an independent mw to take with her to
hospital but that was dismissed without reason. She is an
intelligent woman and if she can read evidence to support the chance of
her not having further damage caused then she will opt for a vag birth I
think. She wants to make her choice in three weeks so I would
appreciate some help in gaining information and not waste time surfing
around
cheers
wonderful women! Hope you can help me help a woman
avoid putting herself and her baby through a cs.
