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How do you guys feel about pitocin?

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11 years 3 months ago #47395 by merri
Thanks for your opinions... I'm a little more reasonable today. I do realize that pitocin can be a good thing in some cases. And I have no problem taking it if I need to progress. Unfort - I do believe that our dept does have a culture of pushing it to speed things along (from my conversation with them and talking to my friends who have rotated through). I'll talk to my OB about it at my next appt. I don't want to step on her toes or upset the nursing staff - but I also don't want to be pressured to take something unless I need to. It's a difficult situation to be in being a pt and being a medical student (I know enough medicine to be dangerous! but not enough to really know what is right...). I want to trust my doc and let her do her job...but I do know that sometimes decisions are made for convenience and not necessarily for need...

I will stay home as long as I can - and hopefully will have an uneventful birth :crossfingers:

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11 years 3 months ago #47396 by TexasRose
I was just going to say what residentmom said. Tell them you don't want pitocin. They can't give you any meds you decline to have.

I wanted to have a totally natural childbirth with my daughter. Unfortunately my daughter was nearly 2 weeks late and I had to have my water broken because my labor wasn't progressing. I also wound up with pitocin, but it was discussed with me because I had discussed with the doctors ahead of time what I wanted and didn't want (in a very nice way).

I will tell you that pitocin induced contractions are very intense. I managed to deliver my daughter without pain meds, but I'm pretty sure I wouldn't try that again! My twins were by c-section for transverse position, so no natural option that time.

"All you have to decide is what to do with the time that is given to you."

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11 years 3 months ago #47397 by Doc201X
I had pitocin because my daughter was distressed but I have always thought that Docs use it primarily for convenience.

I also had a natural birth...complete with an epidural and any other pain meds I could have gotten my hands on.

I find it unfortunate that people refer to childbirth as 2 distinct processes of "natural" versus "unatural" birth as if one is "better" than another. I feel the same about the distinction made between using means other than sex to create an embryo. If an alien or test tube/incubator oven carries a baby from conception to birth, then maybe that would qualify as unatural. As we all know, surgery used to be done without meds, but I don't know anyone who today refers to the use of meds during surgery as "unatural".

Bottom line is that in the end, hopefully you get a healthy addition to your family by whatever means necessary!

My Scientist/Physician Journey
www.Doc201X.blogspot.com

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11 years 3 months ago #47398 by sahmd
Regarding the 2-person rule, maybe they would be willing to let your helpers take shifts. Your mom could be there for several hours, then your husband could be there for several hours, and the doula could be there the whole time. Maybe they have that rule because they don't want chaos, but if you are able to convince them that your plan won't be chaotic, they might agree to it.

On the other hand, if you don't get a doula, and then your husband is out of town, then you will end up with only your mom there.

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11 years 3 months ago #47399 by swissmiss

Originally posted by merri:
Thanks for your opinions... I'm a little more reasonable today. I do realize that pitocin can be a good thing in some cases. And I have no problem taking it if I need to progress. Unfort - I do believe that our dept does have a culture of pushing it to speed things along (from my conversation with them and talking to my friends who have rotated through). I'll talk to my OB about it at my next appt. I don't want to step on her toes or upset the nursing staff - but I also don't want to be pressured to take something unless I need to. It's a difficult situation to be in being a pt and being a medical student (I know enough medicine to be dangerous! but not enough to really know what is right...). I want to trust my doc and let her do her job...but I do know that sometimes decisions are made for convenience and not necessarily for need...

Trust me - people who know FAR LESS than you decline medications all the time. I know you are in a tough position being a med student where you are also a patient but in my experience, med students, residents, and docs were always given the extra benefit of the doubt when it came to preferences of management on L&D. Hopefully that will be the same for you!

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11 years 3 months ago #47400 by mamabear

Originally posted by merri:
I asked how many of the patients get pitocin - the OB (who is potentially may deliver me) and one of the nurses kind of laughed - and said - most. The nurse said more than 80%. I was shocked...

Now - I don't feel like I can contest what they are saying because I'm only a med student - I don't want to question my OB's medical judgement - but at the same time - I thought pit was to help move labor along when it was needed. They made it sound like it was always needed. They also said that they like for the moms to deliver the same day... so then I was thinking - well is this best for the mom and baby - or just best and easiest for the staff?!

Am I overreacting? Is it really not a big deal?
I feel like I am somewhere in between. I don't want to have a home birth - not totally comfortable with that - but on the other side - I don't want a totally medically overmanaged birth in which I have no say.

I have already changed doctors and medical centers once - but now I am second guessing my decision.... Still - as a patient I don't know if this hospital will be the best for me.

Any thoughts?

I have many thoughts:

1) As a patient, you have a right and a responsibility to yourself to be informed. Asking questions and asserting your needs for the birth you ideally want - an act that women have been doing well before doctors even existed -should be something you are supported in. Now, this is far from reality for most American pregnant women, but hey, I can write out my ideal situation here!

2) Medically managed births are hard to avoid. Hospitals, insurance companies, malpractice insurance costs/fears as well as poorly informed/passive patients all play a role in this. Add the pressure to 'perform' a birth within a particular time frame and you trigger a fight or flight response -neither being particularly helpful for speeding birth along. So here comes pitocin and maybe the dose isn't quite the perfect amount so then maybe the birthing mom is in worse pain or the baby is in distress and more intervention is needed....then again, maybe the mom just really wants the baby out any way possible as soon as possible. If you don't want a medically managed birth, you really need to understand all the different potential issues and have contingency plans as well as someone who can run interference on your behalf -whether it's your doctor, a doula, your husband, your sister, etc. Whoever it is, they need to understand what you want and they (and you) also need to be prepared for last minute changes to the plan either due to your needs or your baby's needs and possibly the hospital's needs (yes, they have needs). Most women in the US are pretty comfortable just doing what their doctor recommends, but this doesn't quite sound like you. That's fine, but you need to know what kind of homework you need to do if you want to manage the outcome of your birth over the hospital's/OB's way.

My story is I started off wanting only the best western medicine could provide (mom is an RN, mom-in-law is an RN) but I had a need to question my OB's Dx and Rx as well as how he was managing my need to be informed and by asserting myself, I saved myself from taking an unnecessary prescription that two other doctors confirmed was unnecessary and, in fact, useless.

I found myself switching to a certified nurse midwife at around 30 weeks after much research and contemplation. I found an amazing OB to be my 'backup' OB in case the home birth had complications. He often was the ''supervising' OB to my midwife. Had I found this OB before the midwife, I likely would have had a hospital birth, but after leaving my original OB, I knew I needed a doctor who really liked to teach his patients as I wanted to make my own informed decisions.

Even with the decision to have a home birth, in the 11th hour (actually, the 24th hour after my water broke) I was getting pressure from my midwife to induce because she was afraid of losing her OB as her 'supervising' physician

Now I had done my homework and I knew with my water breaking 'early' that I had to watch for meconium as well as fever and to make sure not to introduce anything foreign in the birth canal. I also knew what measures to take that could naturally help the process along. I had a doula who proved invaluable as she helped me maintain my composure so that I could think calmly and rationally about choices I had to make during labor.

In the end, my OB, CNM and of course, my doula, were all on the same page and helped me have the birth I wanted - a peaceful, quiet, joyful, drug-free, pain-free, comfortable, natural childbirth! I honestly didn't think it was going to be possible, but once I was cracking jokes during the pushing, I knew it was going to be fine.

Of course, my hubby was incredibly supportive of my choices and like I said, I did my homework. I honestly felt that if I found myself stranded and alone along some deserted road about to have a baby, that I would have been prepared for all but the most dire of circumstances. I am not an advocate for home birth, but I am for an informed one.

If you can find an OB or even a CNM or licensed midwife who can meet you where you're at, I think this is key to preparing yourself for the birth you want. Of course, if yours is a high-risk pregnancy, that's a whole other can of worms and you need the proper OB trained for your needs. I do feel that a hospital's statistics are telling of what you might experience. My hospital is one of the best and also has the best NICU in the area, but they also have the highest caesarean rate. I was not a high-risk patient and I worked hard during the pregnancy to eat right (the best ever in my life!), to exercise, to do anything and everything preventative that I could including food-based vitamins, all appropriate tests, etc.

In a lot of ways, as much as I'd love to see every woman have the birth experience I've had, I honestly don't think many women want to take on so much responsibility for their well-being.

I know this is crazy long, but just HAD to throw it all up there! Hope it helps!

If you haven't read it already, please check out "Ina May's Guide to Childbirth". Her appendix of stats of some 2000+ births she/her group has attended is in itself worth the price of the book!

"To see a world in a grain of sand,<br />And a heaven in a wild flower,<br />Hold infinity in the palm of your hand,<br />And eternity in an hour." - William Blake

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