Breastfeeding for Professionals
With the nipple shield he was back to birth weight by day 5! I had a small 'scuff', but nothing worth messing with suture-wise. Keep doing what you are doing, and monitor the pees and poops. I have a one month old and have been using a nipple shield pretty much the whole time breastfeeding. Click here for more info Pingback: Recover your Gmail email account Pingback:
Breastfeeding for Parents
She was cuddled up with her head on my breast My son came in and asked me, "Did you get your miracle, Mommy? He got to see her, my in-laws were in the hallway looking in, and DH was walking around with my placenta in a bucket under his arm. Back up to the OB floor at 2 a. They checked me often, but basically left me alone, never asking to take her to the nursery for her admission bath, etc. I got out of bed for the first time around Kept Amy with me around the clock and nursing went well.
Went home Thursday afternoon around 3: I refused her Newborn Screen on discharge and brought her back that Saturday. OK, the last thing I wanted was a cesarean. But what I was praying for was an empowering, positive, healing birth and even though I didn't have the natural birthing center birth, that wasn't what I was praying for.
Next time I will be more specific, but I did get control in my birth experience, I was hyperaware of what I was feeling emotionally, physically, and mentally, and I feel I was so prepared for coping with pain that it has made my recovery super rapid. As far as healing, in that I feel like I can delivery vaginally without the medical need for management.
I have not had that yet, but our daughter is named for 3 very special women, 2 very dear to me. Amy's birth was healing to me in that way, a healing I didn't even know I needed, but God took care of nevertheless. Positive, a resounding yes, I have a beautiful baby girl with a perfect round head, she has dimples just like mommy and lots of dark hair.
Did I get what I wantedno, but I did have control over what I did get. Did I get what I neededdefinitely. I will no longer feel sorry inside for women who had to have a cesarean, but instead I will ask how they felt about their birth.
That is so much more important. A cesarean is not fun, it's not natural, it can be unnecessary, but it does sometimes save lives, and it is a birth of a precious little one, and an event that is no less memorable or special Sometimes we just need to be reminded of it. Amy was 6 lbs. She is a good baby, nursing well. At three weeks of age she is 8 lbs. I love the Lansinoh Ziplock bags for breastmilk storage, and the Avent pump is great. It's like "I can't believe it's not electric!
Franny went on to have a home VBAC too. This is her VBAC story. I felt like I was pregnant forever, add to this that I took off work for maternity leave at 38 weeks and I felt a little like an elephant, in more ways that one.
My midwife recommended that I see the Chiropractor and get a massage. I chose the latter and by evening Wednesday my contractions had started. I went about my normal activities, fixed supper, went to church, bathed the kids, put kids to bed, went for a walk. Contractions were regular, but not very strong, more like annoying.
Thursday AM we were to drive an hour away to see the midwife I didn't think I could handle being in the car that long, so I told her to head our way. She has 7 kids of her own, the youngest just turned 1 in November. I napped and felt like they were fading away and she said she'd just drop in to see how I was. I had gone into work for a bridal shower on Tuesday and one of my co-workers, an OBGYN Nurse Practitioner said I should just go to the hospital and have another cesarean since I was so far over my due date By 5, my doula and our friends that were going to watch our kids were present and I was starting to get uncomfortable.
Around 7pm, I was 4cm the first time my midwife ever had her hand in me. I got in the tub borrowed a spa in a box from a friend and got hot, then had to get out to cool off.
I had just attended a Michel Odent conference and had his words in my head. If a woman gets in the tub at 4 and makes no rapid progress after 2 hours, he recommended a cesarean. I kept thinking that I didn't have the urge to push, so had I made progress? I got back in the tub and was very cold, my husband found a space heater and was holding it on me next to the tub and jokingly went "oops" faking dropping it into the tub and it took me over an hour to get back into a regular pattern.
Had to get into the shower to get warmed back up and they encouraged me to drink some really salty hot broth. By 11 I was loud and hurting, they also tried to cram a peanut butter and jelly sandwich and juice down my throat PB is NOT easy to get down with 'labor mouth'. I was all over the place position-wise, remember enjoying a forward leaning position. Was in the tub when I started to push, but kept a rim of cervix and got out to the birth stool so the midwife could help hold it while I pushed.
While on the birth stool I remember saying, "I give up. Take me to the hospital, Help me" and they gave me some homeopathy. When she was crowning I got back in the tub. I remembered what It was like with Daniel and I realized that I ever got to the point where I could push past the pain and make progress I finally figured out the pushing thing this time I was on my knees in the tub, resting my head on the side of the tub, Aryn put his arm along the back of the tub so I could rest my head and I accidentally bit him I got to the point where I felt like my urethra was going to explode and I reached down to support my labia and felt her head It didn't take long from that point Once her head was out, her body followed quickly, the midwife just allowed the water to catch her.
Once she was out, I flipped over and reached for her. Within seconds, I was pulling her up so I could see her, unlooped 2 nuchal cords and brought her out of the water to my chest. She opened her eyes and looked at me and started to whimper.
No lusty painful scream, but more like I felt between her legs and discovered she was a girl, but waited until our son came into the room to lift her out of the water for him to see and announce. I was convinced I was having a boy because my pregnancy was so much like it was with Daniel Instead I have a little girl that looks just like her big brother.
I was out of the tub about 30 minutes after her birth and we left the cord attached for about 2 hours, at that point we were able to cut without clamping and it fell off when she was 4 days old.
I had a small 'scuff', but nothing worth messing with suture-wise. My midwife had a herbal bath to soak in with Abby and it felt wonderful Abby nursed very well and my milk was in by 24 hours. She never lost weight. Was at birth, 2: Abigail has been a joy, a wonderful baby. Sleeps through the night started at about 1 month and was smiling by 6 weeks. She does have some gassy spells, but they are brief. Will definitely do it again!!! But will wait until Abby is in preschool or Kindergarten Several of the OBs in our area were really ticked and found out that I was the Childbirth Educator at the local Medicaid clinic and were not happy.
Our Medical director wanted me to assure him that I was not teaching or encouraging homebirth in my class. I replied that I simply told my story and that I did not believe that homebirth was an option for our clients for 2 reasons The results are in and saw another increase in surgical birth rates -- Some doctors cited the reason for the increase was that more women are having elective cesareans, but keep in mind that "elective" does not mean that it was the woman's choice.
I was informed that we would be forced to have a cesarean if our baby was born at their hospital simply because I had a cesarean with my second child. The cesarean rate has increased astronomically in the past 30 years: The World Health Organization states that the cesarean rate should be 10 percent to 15 percent.
Our bodies have not changed in 30 years, but medical management has. Although some babies have been saved by surgical delivery, a look at maternal and infant mortality rates show that nearly 30 countries lose fewer moms and babies than the United States and most of those countries have lower cesarean rates.
Having a vaginal birth after cesarean VBAC carries nearly half the potential complications than repeat surgery. Due to a 0.
American Academy of Family Physicians guidelines noted that there are other problems that occur more often, and they found no evidence suggesting better VBAC outcomes based on the availability of resources.
American Academy of Family Physicians went on to state that policies for VBAC "appear to be based on malpractice concerns rather than on available statistical and scientific evidence. So, how'd I do it? I found a doula -- someone trained to provide emotional and physical support during labor I ate well and read to educate myself. When labor started, my midwife came to me, and my daughter was safely born at home in water. I'll do it again with my next baby.
As long as doctors and hospitals do not allow alternatives, such as midwives, birthing centers and natural options for pain relief, more informed women who want to be able to make their own decisions will join me.
The circumstances of the labor suggests that this baby might have been posterior and gotten 'stuck'. Shawn confirms that her baby was indeed 'sunny side up' but that this was not noted in her medical records. This is not unusual; many doctors don't see posterior position as relevant and fail to note it in records or mention it to parents, yet many other providers feel that it is the cause of many c-sections.
Positioning often helps facilitate rotation, but Shawn was not able to try these. When I went to see my OB about fertility treatments, I remember one of her first comments being, "You really should try to lose some weight prior to beginning treatment MY OB was skeptical, however, and ran at least 3 progesterone tests and two ultrasounds before she was convinced.
My physician had not been derogatory in our visits, but I was concerned about her pessimistic approach to my care. What a sigh of relief! After a great 'start OB care' appointment the doctor commented "things look really good, but because of your low progesterone I don't want you to get your hopes up until after the first trimester.
Although the pregnancy had been progressing fine and all signs were good, she was treating me as though the pregnancy was a risky one. Her attitude when I visited her was usually apathetic. I remember feeling that she just couldn't believe that someone my size was having such a healthy pregnancy. False labor pains begin at 2: Contractions begin at minutes apart. I figured it was more false labor pains since I had not had a bloody show but ultimately learned that these were in fact the real thing.
I called my midwife when the office opened at 9: She thought I may be right in assessing the pain as false labor. I had not slept all night from the pain and she prescribed a sleeping pill.
She said, "If it's false labor, the pills will stop them and you'll sleep, but if it's the real thing, you won't be able to sleep through the contractions.
I didn't want to be in pain AND groggy! Once there, she confirmed that it in fact my water had broken and then informed me that the fluid was stained with meconium. She also stated that I was only 1 cm dilated and at this point I had been in labor for over 13 hours.
She recommended pitocin to get things going. I'd learned that those moms induced with pitocin had very hard labor pains and my midwife confirmed that this may be the case. We then left for the hospital. I am confined to bed with external fetal monitor.
I am told that I may be able to walk the length of the bed if the baby responds okay to the contractions. So far so good. I admit defeat and request the epidural. I breath a sigh of relief that I can't feel anything but pressure. Midwife checks and I'm still only dilated 3 cm. She waits for a contraction and stretches the cervix another 3 cm to 6! Midwife tells me there have been a few drops in the baby's heartbeat and asks to insert an internal monitor for more accurate readings.
Realizing this would confine me to the bed but wanting to do what was best for the baby, I reluctantly agreed. Midwife discovers that my bag of waters had not completely ruptured and may have been delaying the baby's drop into the pelvis.
She breaks the sack and the baby moves to -1 station. I am exhausted and disappointed, but ask to be given more time before considering a C-section. The baby had several heartbeat decelerations after contractions and she was concerned. I am dilated 8 cm and he tells me to push although I have not yet felt the urge. It is unproductive and a C-section is recommended. I begin to cry from the exhaustion and disappointment, but after We had chosen not to learn the sex of the baby and although we both wanted a girl, we felt very strongly it was a boy.
She was suctioned well and the meconium had minimal effects on her. Apgars 8 and 9. My husband left to go video the baby for me and I was whisked off to recovery. I invested a lot of time developing my birth plan and although this is the farthest from my dream birth, my daughter far surpasses any hopes I had for my baby. I wish all of you the best in your pregnancies and pray that each of you have an uneventful labor and delivery.
This mom had a terrible birth experience the first time around. Although the birth was vaginal, it was very traumatic and the treatment very poor. Vaginal births can be very traumatic sometimes.
Nancy Wainer Cohen calls these "vaginal cesareans", and they too often need healing. It's also interesting to note that the poor treatment she received was at the hands of on-call hospital midwives who handled her birth; in her second birth she had the private OB she saw for prenatals in both pregnancies.
Proof that on occasion, midwives aren't always better! Aliza worked very proactively the second time around to change things. She used her supportive and size-friendly OB for birth too not just prenatals , hired a doula professional labor support person , worked on body trust, and actively did positive visualizations of birth, etc.
I'm originally from Melbourne, Australia, although I've been living in Israel for the past ten years. The system here is quite different from the States. You can even have a number of midwives throughout a single delivery as they change shifts every 8 hours.
One may also see a private doctor at own expense throughout one's pregnancy and may also take this same dr. My first pregnancy resulted in a miscarriage at about 10 weeks in March After that I tried naturally to conceive including losing a significant amount of weight which my dr.
When that didn't help and I was feeling desperate, I finally said I wanted help. My son was conceived on my first round of Clomid. Second Pregnancy, First Birth: From the very beginning of the pregnancy I was pessimistic. From the third week one week after conception I had severe abdominal pain which my dr. By the end of the fourth month, the pains subsided I had basically been experiencing the pains whenever I moved and had quit my job and put myself on bed rest and I then began questioning my dr.
Regarding my weight, he had said originally that I would probably put on less than thin women and he would like to see no more than a 6 kg gain. I lost steadily in the first few months and my the end of the ninth month, I'd gained a total of 8kg which was fine with him. This constant worrying and not knowing what would happen worked havoc on my sanity and by the time I was induced at 42 weeks, I was a mental mess.
The treatment in the hospital was vastly different from my private dr. They made me feel bad as if it was my fault that my BP was up, as if no thin women ever had elevated BP in late pregnancy. The labour itself was extremely traumatic in a number of respects.
Firstly, the hospital staff made me feel like they were doing me a favour and I was induced at Secondly, queries by myself, my husband or my labour coach were dismissed as bothersome. Any efforts on our part to create a different kind of labour experience were met with disdain if not direct opposition such as a desire to remove the monitor temporarily, to walk around the labour ward, to change positions etc.
Finally, I don't feel as if I received any support from the staff to boost my confidence in my ability to birth my baby. Fortunately, my son was delivered in exactly 30 minutes weighing 4. I don't know if the dr's response was due to my weight or not. The placenta took more than 40 minutes to be delivered and then the midwives were not sure if it was complete. By the time the dr. Needless to say, I was traumatized. I felt as if I'd been physically and emotionally raped.
My body had been invaded, pushed and shoved, pulled and manipulated. It took me many months to realize the extent of the trauma I'd been through. I don't know how much of my experiences with the medical staff was due to my weight but another significant factor that cannot be ignored is the fact that I am an English-speaking immigrant in a Middle Eastern country - the cultural gap is significant and the attitudes towards birth very different. I do know that they definitely did nothing to reassure me that it wasn't my fault and at my six week check-up I discussed these events with my private dr.
Third Pregnancy, Second Birth: My second baby's birth was an extremely exciting and spiritual event and this is my birth story. After my first baby 2. My son's birth was preceded by 6 weeks of medical intervention which left me feeling like my body was awful and couldn't function as it should have and that my size was the cause of all the problems. It took a long time but by the time my daughter was conceived, I had begun to like my pregnant body.
As the pregnancy continued my self-esteem grew and that confidence was boosted by a completely uneventful pregnancy. For the first time ever I felt like my body wasn't betraying me and I began to respect my body. So although as my due date approached I began to feel anxious, I tried to get in touch with my body and show respect for the process that was happening inside of me.
On Friday afternoon I took a bath in lavender oil to help me relax and continued with my visualizations which I'd been doing in the last few weeks - imagining my uterus opening up and allowing by baby to be born through it. My water broke at 4: I spent a lovely day with my family and friends until early evening when I contacted my doctor who asked me to come in. I arrived at the hospital some 16 hours after my waters broke and had managed to induce contractions using nipple stimulation for a half hour in the car on the way in.
My OB gave me a hospital room to rest in for the night and said he'd see me in the morning or when anything started happening. I sent my husband to my brother's house nearby and told him to get some sleep.
I decided to try having a shower to see if that would help move things along. By the time I got out of the shower a short time later, my contractions were strong and I was feeling shaky in between the contractions.
I was a little nervous so I called my doula who said it was time for her to come. For the next three hours I experienced strong but irregular contractions. I varied my positions and walked a lot to accelerate labor but by 4: By now, I'd been up for 24 hours so I decided to get some rest.
After sleeping for two hours, my OB returned and checked me. Since I had discussed these fears with my doula and OB during the pregnancy we had worked out how I would handle such a similar scenario and thus when my OB said he had to use pitocin to get labor going I knew I would get an epidural to help me with the pain. It was 9am by the time the pitocin was started and my epidural was already in place. The labor went very quickly from then on and although despite two attempts with the epidural, it was not working as it should.
For 25 minutes my doula worked with me to help me concentrate on not pushing and at exactly 1: Exactly 6 minutes and three contractions later my beautiful daughter was born. She was delivered straight onto my stomach and my husband cut the cord. A few minutes later the placenta was delivered and I had one stitch to repair a very minor tear. My daughter nursed immediately and we were left alone to bond and rest. A short while after the birth I hopped of the bed, freshened up and walked to the maternity ward full of energy albeit tired.
My doula had been a wonderful source of emotional support and physical help. She knew what my concerns were and was able to help me through the fear as well as rub my back between contractions and give a lot of encouragement. My OB was wonderful also in that he gave me the space to try for the type of birth I wanted. My OB treated me, throughout, like any other pregnant woman and made no comment about my weight.
At no time during the pregnancy or labor did he make me feel handicapped by my weight but rather was tremendously encouraging and positive. My husband was there the whole time and I cannot imagine going through birth without his continued presence and support.
Throughout, I felt surrounded by people who were caring and considerate of my feelings and what I was going through and they all helped me make this birth experience the best it could be. Basically a regular pregnancy Also because of my age there were concerns that the baby would have problems down's syndrome, spina bifida, etc so the clinic did test for AFP The results came back high, which led to more concerns and we were scheduled for an ultrasound.
At the ultrasound, we found out that the reason the AFP was high was because there were 2 babies, not one, which was a great relief. The pregnancy was generally uneventful, other than the fact that I was miserable through most of it because of my size and it being a twin pregnancy. I had horrible heartburn most of the time, sciatica which I have still The doctors initially suggested to me that if we made it through to 7 months that would be great and then we'd see how it was going, since twin pregnancies generally wind up being pre-term.
However 7 months came and went and I remained pregnant and miserable. Then they suggested 8 months and they would consider induction since I was so uncomfortable They tell me, "Well, lets just let nature take its course Finally since I was going in to be seen about twice a week by then I had been experiencing some liquid leaking for a couple of days and mentioned it, thinking it was a new kind of incontinence problem another side-effect of the twin pregnancy , and they checked it, found out it was amniotic fluid and decided to let me go and have my babies.
We think every once in a while about having another baby, but since the fact that we HAD twins was entirely my fault the older you get the more predisposed to having multiples and now I'm 38, I don't think we'll be having any more Two is plenty and we have a boy and a girl and they keep us pretty busy. Paula's Story gd, severe pre-eclampsia, induced premature vaginal birth.
Paula's first pregnancy was complicated by primary hypertension, which she was on medication for. Primary hypertension can often become worse in pregnancy, becoming pre-eclampsia despite medications.
This is what happened to Paula. In addition, she developed gestational diabetes diet-controlled at about weeks. Had her pre-eclampsia not worsened, she would have been induced at 38 weeks because of the gd and blood pressure concerns combined.
As it was, when her pre-eclampsia worsened, they elected to induce at 36 weeks instead. Induction probably succeeded so early because she was already partially effaced and dilated before they began, although they did nothing to ripen the cervix ahead of time. Between pregnancies she developed overt diabetes. Because her PCO is very significant, she and her doctor elected to have her take Metformin Glucophage, mg per day throughout her second pregnancy but not for nursing.
Although her blood pressure remained a concern and she was "maxed out" on 3 blood pressure medications through the pregnancy to keep it under control , she did not redevelop pre-eclampsia in the second pregnancy, which she credits to the Metformin. They did add insulin during the pregnancy later on. She felt she had a terrific doctor for her pregnancies, very size-friendly. I was induced 4 weeks early due to severe pre-eclampsia. I was given magnesium sulfate and pitocin at 6pm on Thursday.
The broke my water and I began having contractions with in an hour. I dilated quickly to 10cm by 9: Labor in all was about 6 hours. I only required one internal stitch for a small internal tear.
I did learn through this whole process to listen to my body. The labor nurse was trying to get me to push differently then what my body was telling me.
She wanted 3 shorter pushes when my body wanted 2 long ones. When I finally listened to my body I delivered very quickly. After discussing this with my OB I did what my body told me and had much better pushes then what I had been having.
I did have some problems breastfeeding at first due to the fact that she was 4 weeks early and didn't want to latch on very well. She had been tube fed, finger fed, and cup fed and like the 'instant gratification' that provided, versus having to 'work' for her food.
Our second child was conceived through an injectable cycle. I was when I conceived this child. There are so many benefits to taking Metformin during pregnancy, and I really wanted to avoid the pre-eclampsia that I had with my first pregnancy. I also did not want to risk going off of Metformin because of the dramatic decrease in miscarriage rate while on it. The fact that there are no known deformities or problems while taking Metformin in pregnancy made me feel comfortable enough to take it.
I know some doctors will not give Met in pregnancy because they are uncomfortable with the fact that no US studies have been done, but all of the information coming from other countries seems to indicate that it is safe.
The IV was started around 3 p. The Pitocin was started; they increased it every 30 minutes. I began having contractions about every 2. They were tolerable and I could breathe through them easily enough. We were waiting for the doctor who was supposed to show up around 5 p. The intern came rushing in to do 'fetal scalp stimulation' which brought her heart rate back up.
I then was told I had to lay on my side and that seemed to keep her heart rate up. The contractions while on my side were getting pretty uncomfortable and combined with the drop in heart rate I decided to get the epidural. The funny thing is that while sitting for almost an hour to get the epidural I couldn't feel the contractions at all, and even had to look at the paper to see if I was still having them.
Talk about positioning making all the difference. Once back on my side I could feel the contractions again until the epidural took full effect. I felt like I had to urinate with every contraction, but that was all I was feeling. I figured it was just the pressure form the contraction. Finally at 1 a. I asked the doctor to check me. My bladder was so full he couldn't feel the baby. I was straight cathed catheter and checked and was 7 cm.
About 10 minutes later I felt like I had to push. A full bladder can impede labor progress! It's important to pee every hour or so in labor. I waited more contractions and decided it was time to call the nurse. My nurse was gone to lunch and another nurse who waited another contractions before coming to the room told me I was only 7 cm 20 minutes ago, and I really didn't have to push; that the epidural should be working fine and I should be able to get through the contractions without any problem.
I told her my last one went from 5 cm to 10 cm in 45 minutes and I felt like I had to push. The stupid woman still wasn't going to check me. I insisted and she reluctantly checked me. I was at 10 cm and it was time to push.
The doctor got to the room and got the stirrups up. I began pushing and he was going to check to see where the baby was. He asked how long it took last time; I said 1. He commented it wasn't going to take as long this time. I could feel her head almost crowning at this point, then with the next push she was crowning and out.
I pushed for a total of maybe 5 minutes, and out she came. So much for not having to push. It was such a different experience from my first. Apparently I am 'wired' a little differently than most and with an epidural I am mostly numb except for the vaginal canal and perineal area my epidural last time did not work completely properly either.
I didn't realize this was any different from 'normal' until they went to put in a stitch I needed 2. So with one stitch left, they just put it in without any numbing agent with my permission. I figured I would get stuck once with a stitch or once that I would feel with the Novocain and either way I was going to feel it.
Not only did they fit, but the contraction monitor actually worked! I know they used an internal monitor last time as soon as possible because they did have a hard time finding a heartbeat without my laying in a very uncomfortable position and then holding the monitor there. I just figured that if they didn't get the heart rate all the time it was really no big deal, that the fading in and out which includes the rate dropping sometimes because of the monitor was just because I was moving or the baby was moving.
With my second I just assumed the same thing until they got the internal monitor on. I had one who complained every time that she saw me because they told her to measure me.
She didn't understand why they even bothered to measure me because I was so "off the charts". I may have been off the charts, but I did grow according to the curve they use, so it was useful in following the growth of the baby. I can't think of anything differently my doctor did with me that he doesn't do with every other woman.
I did see him more frequently, but that was due to the type II diabetes and insulin monitoring than anything. I am nursing; it's the only way to go for me!! I always tell everyone I am too lazy to bottle-feed; there is too much work involved. I know there is the same issue in pregnancy, but I can actually find information on Met in pregnancy but I can't find any on Met and nursing.
I did realize the other day that I was on Met while I was breastfeeding 1, but she was almost 2 years old and I was in the process of weaning her. I think once this one is eating more solid foods, I will start the Metformin again even though I will still be breastfeeding.
Ann experienced some size-phobia and hassle from a previous provider, and decided to switch mid-way through her pregnancy. Ann's story can be read on her website at www. Ann also had to have an unusual vertical incision due to the baby's presentation. Recovery at first was tough but all is well now. Breastfeeding got off to a rough start, but they persevered and are now breastfeeding exclusively. Lisa Z's Story twins, diet-only gd, vaginal birth. My story, despite the fact that I gave birth to twin boys, is actually rather boring thank God!
I did develop gestational diabetes very early on in my pregnancy, and I was expecting that to happen for many reasons family history, my weight, the fact that I was carrying twins - all increase risk. However, I was able to control my GD through diet and it proved to be not much more than a minor inconvenience during my pregnancy. I suffer from PCOS, and do not ovulate without pharmacological assistance. I did conceive once before with the help of fertility drugs, but it was an ectopic pregnancy, which we were able to abort with drugs and managed to avoid any kind of surgery.
At the beginning of my pregnancy I weighed pounds. At the end, I weighed After delivery, I was down somewhere in the 's, but alas, that was short-lived, and I am now back up to somewhere around my late pregnancy weight.
As for my labor - my water broke 2 days shy of 36 weeks. I went to the hospital and basically sat around a lot waiting for labor to start. About 12 hours after I checked into the hospital, the contractions started. A couple of hours later I had an epidural, which came out and had to be redone. Because of this, they gave me MEGA-doses of meds, which caused me to be completely paralyzed and numb from the waist down. My dh and I fell asleep until the doctor came in early in the morning to check me which required both my OB and my dh hoisting my deadweight legs into the air so that he could examine me and promptly announce that it was "showtime.
My delivery progressed very normally - Baby A arrived after not much more pushing, and Baby B, who had been breech until then, flipped his little self around to be delivered head first.
It took 23 minutes and the help of forceps, but both boys were delivered vaginally and in perfect health - 5 lbs. I took them home with me 2 days later. Just being large should not qualify you for a 'high-risk' label.
It's smart to be aware of the possibility and be proactive about it, but be careful about doctors creating self-fulfilling prophecies. My story is pretty simple. After one year of trying, my husband and I conceived our daughter.
I weighed lbs. My doctor was great and really never mentioned my weight. She did list me as high-risk and was sure that I would have blood pressure and gd problems. Everything went smoothly until the last week when my blood pressure was elevated a little and she sent me home from work to rest. One week later my water broke in the morning and 14 hours later my daughter was born.
The staff at the hospital treated me well and I never heard anyone mention my weight. The only thing at the hospital that didn't fit well was the gown and the "one size fits all" panties they give you after birth. I had an epidural after 8 hours of labor and that went pretty smoothly. The doctor had some trouble getting the needle positioned correctly, but it didn't have anything to do with my size.
I had to push for almost two hours but that is not unusual for a first-time mother. It probably would have gone faster if the nurse had asked about my flexibility earlier. Even at my size my knees can go back to my ears!
Once I changed positions she came out in under 30 minutes. She was born perfectly healthy and scored 9s on her apgars. We did have to admit her back to the hospital two days after she was released for jaundice and dehydration because my milk took some time to come in. Gina Marie was induced at 37 weeks because they suspected a 'big baby'; between 8. In most cases, ultrasounds are very inaccurate for measuring 'large' babies near term, although in this case it was accurate.
However, Gina Marie's case is complicated by her blood pressure and edema at the end of pregnancy, and the size of her baby at 37 weeks made the decision more complicated.
In most cases, inducing early for 'big baby' is clearly shown to worsen outcomes, but occasionally in selected cases can be helpful. However, her midwives did little to prepare her cervix for induction, making an induction less likely to succeed, and the induction at 37 weeks resulted in fetal distress for her baby after it was born.
Also, her baby was malpositioned, which is probably why labor did not progress. It is a difficult question whether the decision to induce helped or hurt her chances at a normal birth experience.
Waiting even one more week might have helped her body and her baby to be more ready, yet the concern over blood pressure and edema was a real one. Regardless, insult was added to injury when she encountered a very fat-phobic surgeon who was very unkind and discriminatory, and did a 'classical' up-down incision unnecessarily on her.
Most very large women can still have a low-transverse side-to-side or 'bikini' incision with careful management, or they can have an up-down or slightly higher side-to-side skin incision and a low side-to-side uterine incision. The reason given for a classical incision on very large women is to prevent infection in the moisture-prone area underneath the fat fold "apron" , yet it should be noted that this classical incision infected badlyusing a different incision didn't help!
It is Kmom's anecdotal observation that the large women she has seen with classical "up-down" incisions have tended to have more problems than those with the "bikini" incisions. Regardless, nursing techniques using a cool blowdryer on the incision, plus extremely strong antibiotics for very large women can often help avoid many cases of infection in transverse incisions, making these practical even for large women. The decision to do a classical incision on Gina Marie was dubious at best.
This is unethical and unprofessional, and much of her poor treatment after that may have been from the OBs attempting to punish her when she refused to have her tubes tied. She was later told that the classical incision would make it too dangerous to attempt to have another pregnancy at all, so one wonders if the doctor tried to prevent her from having more children by using this incision and accompanying scare tactics.
Many women including some large women--see other stories have had subsequent kids after a classical incision. This was pure scare tactics to frighten her out of having more kids. Gina Marie wanted to share her difficult story so that other large women can be aware of some common pitfalls to watch out for.
She says, "I didn't have a good, normal birth story. In fact, my son's birth was absolutely horrible. However, there are some important things that I learned afterwards that I think large women need to know and need to be on the lookout for, and they will be evident by the end of my story. Before I went to the hospital, I had this idea of what childbirth would be like, and it definitely did not include the experiences that I have had.
There is a happy endingI am alive, in possession of all of my faculties, and I have a gorgeous healthy baby boy. But I went through hell to bring him into this world. I started out with the local midwifery practice five midwives for a lot of reasons. Number one, they seemed to be the most size-accepting. Number two, they were the least expensive. Number three, they were the only all-female practice, although I learned during the birth that female doctor does not necessarily mean understanding, sympathetic doctor.
During labor, I was transferred to their backup OB practice. This practice consisted of eight doctors, only two of whom have a decent bedside manner. I had an easy pregnancy for 8 months, except for the heartburn and the initial nausea. I had no real problems until the last month or so. I gained about 6 lbs. I ate right and exercised and really made an effort to take care of myself.
Then, in my last month, I got really bad edema in my feet and legs, so severe that I was put on bedrest for two weeks. My blood pressure started spiking occasionallynot to the dangerous imminent stroke level, but enough to be worrisome. I felt like a sausage. I could wear one pair of shoesmy cross trainersand only if I put them on first thing in the morning. At 37 weeks I had an ultrasound to determine the baby's size and position, because it was difficult for the midwife to tell through my big belly.
The ultrasound technician determined that my baby was between 8. They were concerned that the baby would grow too large if I was pregnant for another three weeks. I went into the hospital on a Wednesday morning, and the midwives induced labor with Cervidil [ Kmom note: They applied Cervidil to my closed, hard cervix around 1 p.
My water broke around 11 p. Sometime the next morning, they gave me a pitocin drip. I asked for and got narcotic painkillers.
Finding veins has always been an ordeal for me, and it took three different phlebotomists about 10 sticks to get an IV started. I had 3 possibles, and the veins blew. I eventually dilated to 7 cm and stopped. Because of the problems with the IVs, the put in a central line on Thursday night when I was having heavy active labor. A central line is an IV in the jugular vein. It was really traumatic.
I had to have a plastic sheet over my face while they were inserting it so that the area around my jugular would be sterile, and I had to lie flat on my back, which is terribly uncomfortable for a woman in labor. So, I was on my back, I felt like I was suffocating, and I was having contractions every minute or so.
I could feel myself slipping out of reality. This was the worst physical sensation of all of it. They decided at this time that the pitocin had done all it was going to do, so they took me off of the drip. They thought it would be best if I could be sectioned with only an epidural, but after inserting the damn thing right after putting in the central line, they determined I could not breathe adequately while laying flat on my back for the epidural to be effective during surgery.
Still I had the epidural and the accompanying fluids all night Thursday night. Friday morning, I still had not dilated past 7 cm, even though I had been contracting every minute or so for 24 hours.
I think that the epidural slowed the labor further, and it didn't really do much for the pain. The fluids that accompany the epidural to keep the blood pressure from dropping inflated my feet and legs like the Michelin tire man. By morning, I could not lift my legs. One of the known risks of pitocin is to increase swelling and retention of fluids. The fluids necessary with an epidural often tend to cause significant swelling in a woman who has undergone a long induction with pitocin.
This in addition to her previous swelling made for a severe problem. His heartbeat had not wavered on the fetal monitor, but he had also not moved beyond a -2 station.
I think what happened is that instead of facing forward or facing the rear, he was facing my left, and his shoulders were hung up on my pelvis.
I could feel his little behind right below my ribcage all the way through labor. He never dropped down. A malpositioned baby could certainly have caused many of the problems she encounteredstuck at 7 cm, a high and unengaged baby that would not move down, little progress despite painful and strong contractions, etc. And being stuck in bed due to the induction meant that she could not employ other methods of turning the baby, such as position changes, etc.
This is one of the potential problems with induction. This OB was the meanest, most evil bitch I have ever met. Even though I had shopped around and shopped around for pregnancy care that was not fat-phobic and would take into account only the facts of my health and not assumptions, the OBs backing up the midwives were not nearly as enlightened as the midwives were.
So when she came in to discuss my surgery, the OB sat down and asked me if I wanted my tubes tied while she was in there. I was shocked and told her no, that this was my first child, and I didn't want to make decisions like that at the moment. And she countered with a speech that boiled down to "you are too fat to have any more children, you shouldn't even be having this one, and if I had anything to do with it, you wouldn't be.
Granted, fat people do sometimes have problems with general anesthesia. However, it was a little heavy-handed for her to instruct me to discuss funeral arrangements with my husband before I went into surgery. She asked me if I was an organ donor, and then said it didn't really matter. I don't know what the hell this was supposed to mean. I guess she was implying that my organs were probably not acceptable or something. It is unethical to pressure a woman to have her tubes tied while in labor.
In fact, in many places it is forbidden, deemed a decision made under duress. However, OBs have had a history of doing this to women they don't approve of having children, from welfare mothers to minority women, etc.
This is supposed to be totally unacceptable now, but it is still done to some women including fat ones at times.
The other remarks and treatment she received were extremely unprofessional. This may have been a case of the doctors 'punishing' her for not going along with them. I was given the prognosis of 'guarded'.
It was my impression that she had never dealt with a patient my size before and that she didn't like fat people to begin with. This kind of incision precludes a VBAC.
Later I learned that a bikini incision could have been done if I'd had a more experienced doctor [ i. Part of me still feels like she did this kind of incision to punish me for being such a fat pig. Even very large women can usually have a bikini cut or a modified version thereof. Only rarely is a classical incision necessary, but some doctors persist in using a classical incision on fat women anyhow.
The concern is for infection, but with proper nursing techniques and special attention to prevention, infection can usually be avoided even in very large women, as noted. My legs were so swollen from the epidural fluid and the previous edema that they were worried about blood clots in my legs.
They wrapped up my feet and legs in ace bandages up to my thighs. They wheeled me down to the prep area for the Operating Room and the team of anesthetists gave me an arterial line yet another big traumatic stick. My husband was there while they were prepping me for surgery, but the poor guy was as overwhelmed by the fatigue of being awake so long and the shock of the guarded prognosis and the business about funeral plans. He was sobbing loudly and disturbing the doctors. A nurse led him away.
I could hear my baby's heartbeat on the fetal monitor until they took it out a couple of minutes before they wheeled me into the operating room.
He was strong and steady and never wavered, and I was grateful for that. I was halfway convinced that I was going to die. I remember thinking that it would be all right as long as my baby was OK.
While they were strapping me down for the surgery, the 15 or so people in the room introduced themselves to me. The pediatrician and her staff came over and I told them to be sure and take care of my baby, no matter what happened to me. The nurses swabbed my belly with betadine and put the anesthesia mask over my face and I went out. When I woke up there was a greenish light over my head and people were calling my name and telling me not to cough while they removed my ventilator tube.
I don't even know how long I was in surgery. I found out later that I lost 2 liters of blood during the surgery. The first time I saw the stitches, I thought they had sewn my navel shut. They told me later that they were prepared to keep me on the ventilator for 12 hours after the surgery, but I was up in the operating room on the first attempt at waking me. Basically, I handled the anesthesia like a normal person would, despite their dire predictions.
As soon as they took me to the recovery room, they told me that my beautiful son was born at We named him Jacob Baruch after two of his great-grandfathers. Baruch means Blessing in Hebrew, and he is a blessing in my life.
They took me to the ICU. He was born in respiratory distress because of the narcotics, and he was also getting antibiotics because my water had been broken for so long.
Late on Saturday afternoon, the neonatal nursing staff bent rules and rolled my boy up to see me in an isolette and let me hold him for a few minutes.
I cried and cried. He had been screaming until I held him, and he immediately soothed and looked up at me. I swear he knew me. It was hard to hold him because I had wires and tubes everywhere, and so did he. I wanted so badly to breastfeed, but I couldn't because of all the stuff I was getting in my IV. A lactation consultant came and brought me a breast pump and I diligently tried to establish a milk supply, but the most I could manage was getting the inside of the breast shell wet.
I was told that I would have to pump and dump for 3 days because of all the drugs in my system. I was getting some very strong antibiotics through my IV, so they figured it wasn't an infection. The fever didn't go away within 24 hours. Monday morning they decided that I might have had a pulmonary embolism, and sent me to nuclear medicine for tests on that.
They injected some kind of radioactive dye so they could see an embolism, and this made my hypothetical milk unusable for another 2 days. Well, I didn't have a pulmonary embolism.
The OB said that i was was possibly microscopic blood clots from the surgery causing the fever. I was also having difficulty breathing when I wasn't sitting straight up. They determined my oxygen saturation level was low, and the bad OB who had been so mean to me said it was because of sleep apnea which I had never had a problem with before or since. The next OB to come on shift after her did a blood count and determined that my hemoglobin was low, and I had a transfusion of two units of blood.
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