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Thread: Using ultrasounds to determine gestational age could result in baby's death page 2

  1. #11
    lizch's Avatar
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    Quote Originally Posted by avocado View Post
    But this is opposite to the OP article. Maybe delaying delivery is a Swedish thing. I really don't know.
    Europe has better neonatal mortality stats AND lower intervention rates. Yes, Swedes would tend to err more on the side of delaying/not intervening, American docs err more on the side of inducing early.

    For anyone wanting the data, this is a great video that breaks down the US mortality stats and ultimately shows that even if we compare our most privileged, healthiest citizens with entire populations of other countries, we come fourth in world rankings for neonatal mortality. In other words, our healthiest against the rest of the developed world's average. Very sobering stuff. And we spend vastly more money on it than any other country.
    http://www.lamaze.org/OnlineCommunit...e-Numbers.aspx

    There's every bit as much ill-supported CW in birth as there is in nutrition.
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  2. #12
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    Quote Originally Posted by ZoŽ View Post
    What I meant to say, was that they are not taught about birth in a real life scenario where the mother is not in a hospital setting (and therefore they have no idea what midwifery is all about and write if off as dangerous). It is true that they do not witness a vaginal birth until residency

    I'm not trying to be argumentative, but I don't know where the heck you're getting this stuff from. Not even close to true.

    and even so, it is still in a hospital setting where the mother is in a completely unnatural position, often given an epidural which slows down the contractions and messes everything up, etc. Just because the baby came out of the vagina does not qualify it as a natural vaginal birth to me but I should have defined my opinion more clearly.
    However, I'm sure you're right they are not taught what you consider a natural birth.

  3. #13
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    Man, every time I see this thread, I cringe. Not just because of the horrible situation for births in the US (which is bad, I totally agree) but because I still take some exception to the title of the original article. They make it sound like the ultrasounds are somehow directly killing babies, yanno?

  4. #14
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    Quote Originally Posted by lizch View Post
    Oh Avocado, how I wish that were true!!! The induction rate at our local hospital is 40%. 40% of their babies are not in distress. Doctors have been routinely inducing at 37+ weeks for reasons that research does not back up, ranging from "big baby" (inducing does not give the pelvis its natural relaxing hormones that enable it to flex, so it's harder to push a baby through it....it would be better to wait for natural labor even if the baby gets a big bigger, so the pelvis can flex) to "low fluid" (tenuous evidence at best) to "why not? I'm not on call next week, so let's get the baby out now."

    I think the trend will reverse soon because induction is linked to higher c-section rates, and because inducing prior to 39 weeks greatly increases the risk that the baby will go straight to NICU instead of mom's arms
    I'd like to see the research that made you come to this conclusion. I'm a Respiratory Therapist that is there for deliveries week in and week out. The original article is correct that allowing a mom to carry a baby late is bad as many of these kids wind up with Meconium in the fluid. If the baby breathes that Meconium (baby poop is what it is) in, they usually wind up with Pneumonitis and several days in the hospital.

    Babies born in the 36 to 38 week window generally do just fine. That pelvis flex idea is also sheer nonsense. Pitocyin is given to induce labor, but the moms hormones are also in play and not damped down by it. If the baby is too big, it's just too big. Trying to force a big baby out usually results in a severe deceleration of the baby's heart rate which in turn can lead to hypoxia with a limp, blue baby being born. I know, I've seen it.

    And the idea that docs go for C-Sections as a matter of convenience is a gross overgeneralization. Every Friday night (I work 6p to 6:30a) for the last six weeks I've had a delivery between 3 and 5 a.m. when the team (including the docs) all had to be called in--four of them C-Sections from failure to progress. The docs didn't induce, the docs went home and the moms wound up not progressing and THEN the C-Section was done.

    The OP is a good article that is right in line with what I see every week.

  5. #15
    lizch's Avatar
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    I'm amazed the message about not inducing/doing c-sections prior to 39 weeks unless absolutely necessary has not reached the respiratory therapist community! You're in a position to put pressure to change this.

    http://www.ajog.org/article/S0002-93...073-6/fulltext

    The pelvis flex notion is not even remotely nonsense. Why do you think you can pour pitocin into a mom's veins at 36 weeks pregnant, and get nowhere, if pitocin is all it takes? There's a whole orchestra of hormones that precede oxytocin, including prostaglandins and relaxin.

    Pushing a big baby out "usually" results in decels? That's not the major concern with big babies. I've seen 10-11lb babies born without a single decel and 6lbers decel'ing like crazy. The concern with big babies is primarily shoulder dystocia, and even ACOG is lukewarm about induction for macrosomia as a solution to that.

    Yes, there are dangers in waiting too long for birth to happen naturally, including meconium aspiration, SGA, and stillbirth. But there are also risks to birth being forced prior to 39 weeks, whether you want to believe it or not.
    Liz.

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  6. #16
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    Quote Originally Posted by lizch View Post
    I'm amazed the message about not inducing/doing c-sections prior to 39 weeks unless absolutely necessary has not reached the respiratory therapist community! You're in a position to put pressure to change this.

    http://www.ajog.org/article/S0002-93...073-6/fulltext

    The pelvis flex notion is not even remotely nonsense. Why do you think you can pour pitocin into a mom's veins at 36 weeks pregnant, and get nowhere, if pitocin is all it takes? There's a whole orchestra of hormones that precede oxytocin, including prostaglandins and relaxin.

    Pushing a big baby out "usually" results in decels? That's not the major concern with big babies. I've seen 10-11lb babies born without a single decel and 6lbers decel'ing like crazy. The concern with big babies is primarily shoulder dystocia, and even ACOG is lukewarm about induction for macrosomia as a solution to that.

    Yes, there are dangers in waiting too long for birth to happen naturally, including meconium aspiration, SGA, and stillbirth. But there are also risks to birth being forced prior to 39 weeks, whether you want to believe it or not.
    C-Sections, I'd agree with you on that. And as for Pit, what I said is that it doesn't damp down or eliminate the mothers natural hormones. I'm well aware of the prostaglandin cascade and relaxin, both of which still occur when labor is artificially induced which in turn means that mom is all set and ready to deliver.

    As as for the big babies and shoulder dystocia, all you're doing is trying to sidetrack the issue again. In your post, you decried having a C-section done because of the 'excuse' of a big baby. Big babies can be a real problem, and if there are decels or failure to progress, you need to take the baby by C-Section. There is also a formula for evaluating the size of the birth canal vs. the size of the baby to determine whether an elective C-section is advised. That evaluation is quite accurate, and given the low risks of a C-Section as weighed against the danger to mother and baby, most moms choose to go with a C-Section. And yes, it is a choice!

    And as for risks before 39 weeks, there are risks involved in childbirth to both mom and baby no matter how many weeks along they are! But, I've been in on the deliveries of many babies in the 36-38 week area and from my experience, it's rare to have a problem. Usually, the problems that occur in that period of time would have occurred anyway. We just had a baby born with a neoblastoma at 37 weeks---delaying for two or three more weeks wouldn't have changed the outcome.

  7. #17
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    Both my babies were delivered at 35 1/2 weeks. I was induced with pitocin for 36 hours with my first one, and finally had a C-section. Thank God my second doctor would not allow that and we just did an 'Insurance mandated" 6 hour induction before taking my daughter by C-section. Pitocin caused labor, but nothing was going to convince my cervix that it was ready to deliver! After 36 hours---with 28 of those hours considered 'active-hard labor' I was only at a 3 dialation!

    My body was done being pregnant and was going to start protesting (high blood pressure, liver, kidney, etc) I spent 4 weeks at home in bed and 18 days in the hospital in bed before my first one was born. And I really thank God for the medical team that did ultasounds every 4-5 days to measure femurs, and everything else--to come to that day when they said 'its a GO!' Neither of my kids went to NICU at all, although they were on stand by. They were small, 6 pounds and 5 pounds, but very healthy. I cannot image life if I were trying to have those children with out the ultrasound, or without the doctors and hospital---I am nearly confident that I would not have made it, and my son may not have either.

    Hats off to the medical profession!

  8. #18
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    I think that's the most retarded article I've read in a while. The whole thing makes it sound as if the dr "has" to deliver the baby right at the perfect time or it's going to die. The mom is just a machine that has to be "removed of child" when the time is right. All three of mine have been homebirths, they came out when they were ready, I didn't even have a due date for the 3rd, I figured about the general couple of weeks it would be and that was good enough for me. Meconium is a much bigger problem when you are on pitocin and your poor infant is being slammed around in your uterus under way more stress than God (or nature take your pick) planned. There are plenty of babies out there that were born way earlier than they should have been as the dr took an ultrasound and decided that the baby was too big to go to term, and then when induced it comes out tiny and premature. I chose not to have any ultrasounds with my children. I felt that it wasn't necessary and I didn't want to expose my baby to any possible risk that ultrasounds may have. I have been blessed with healthy babies and ridiculously easy labors, I know the medical profession is there for a reason and they are wonderful if they are needed, but childbirth isn't a disease and shouldn't be treated as such.

  9. #19
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    Isfahel, I'm sure homebirthing mothers that took a similar path but lost their babies have a different opinion. Its a bit naive to be so high and mighty in your opinion just because everything worked out perfectly 'for you'.

    FTR, I don't mind being overseen by medical professionals, nor do I mind ultrasounds. I also don't mind midwives and natural births without intervention of any kind. Birth is such a personal thing...every mother MUST be comfortable with their decisions as a negative outcome is possible in any situation and you have to be able to live with yourself at the end of the day, whether a squiggly baby in your arms or not.

  10. #20
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    Yes, exactly. It's always very convenient when labor and birth go according to God/Nature's plan. When that is how it works out for folks, I'm happy for them -- they got the nice birth experience they were hoping for, it was safe and easy, yay, etc.

    But personally I'm glad in our case that we had actual medical assistance available to us if needed, since as it turned out, we did end up needing it. And I'm happy for us, too. If we didn't live in this century my baby or I would've been more likely to die.

    But Bukawww, I wouldn't call that "high and mighty". High and mighty are the various women who snidely inform me that my labor went the way it did because I didn't really want it enough, or because I just didn't try hard enough. Ugh.

    I think Isfahel is in a different, far more reasonable category here -- she has a good point about the article making it sound like it's ALL due to the doctor's choices. And beyond that she's just relaying her own experience, how she felt, her priorities, etc... no generalizations there toward others. Thankfully.

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