C-section #1: elective c/s offered for method of delivery. Patient accepted. (grrrrr)
C-section #2: primip who pushed for 3 hours. Failed vacuum.
C-section #3: primip who pushed for 3 hours. Failed vacuum.
Amazingly enough, the failed vacuum (both patients) did not need an extra hand from below to push the baby's head up out of the pelvis during the c-section. This is common to have to do when mom has been pushing for so long, and the baby is very low in the pelvis.
**The hand from below is the circulating nurse - pushing the head up out of the pelvis during the c/s so the surgeon can lift the baby out through the abdominal incision.
16 comments:
When I read stories like 2 and 3, I'm every so thankful for the doc I had for my kids' births. #1 I pushed for 3:20... she offered a vacuum at 3 hours and I refused, but she kept encouraging me along and never once mentioned going for a section (even though the hallway to the OR was right outside my door!).
Had I had a section for him, I would have had to have a section for #2 in a state with illegal assisted homebirth and insurance companies telling docs they'll drop them if they participate in a vbac!
(I hit enter too fast!)
So, thanks, Dr. Peters! I say a prayer of thanksgiving for you and docs like you every time I read stories like these!
I hate to hear about the #2 and #3. The #1 are so illinformed. I used to be a surgical tech and I hated so much to see those little babies that were no where near engaged. It's not like the information is not out there. They just think that they don't need it and the doctor is going to do what is best for the patient.
Whoz, you are so right. I think with the more technology we have to get access to that information, the less we know. We have become so blindly trusting in our doctors and don't even think for a second that maybe he isn't always right.
AYC, were either of those moms induced?
Aww sad. The last two were me....4 hours of pushing, failed vacuum attempt and c/section with a posterior baby.
My VBAC was 3 hours of pushing, but this time I pushed that baby out face up, using every ounce of my I had an awesome patient OB and a very supportive nurse who both had full confidence I could do it and never let on to me that the baby was in a bad position again. My dear nurse helped me and held the monitor on me when it kept falling off so that I could avoid the internal monitor.
Can I please push under 2 hours next time? LOL
*every ounce of my being.
What I don't quite get is when they decide something fails. Is it a failure because it takes x amount of time? A failure once baby shows signs of distress?
I know this is probably a silly question... but could you define "failure"?
--Steph
Steph- Don't know about other situations, but for my situation, my c/s was called when i had enough and grew too tired to push anymore. I called it, and an OB tried to help me make one last effort with a vacuum. My baby was fine the whole time.
Neither were inductions, both natural onset of labor. Both pushed for 3 hours, give or take some time. Both had physicians try a vacuum with no success. That's when it's usually decided, by both the mom and the physician, that everything that has been tried has been done, and nothing has worked. Time to go to the next step: c/s.
Interestingly enough, both babies were also posterior!
I also hate the word "failure": it implies that something is broken. It has been so ingrained in me to call things like this in L&D as a "failed induction", "failed vacuum", "failed trial of labor". Hard habit to get out of.
what is a "primip"? I wonder if I am one...
I pushed for over 3 hours and then the vaccuum popped off twice. Third time was a charm. I did NOT want to have that c-section...(I think my 11 lbs baby may have been the inhibiting factor...)
A "primip" is a first time mother, having her very first baby.
It is my understanding that they only have a certain limit as to how long they can use the vacuum? Or a certain number of 'chances,' per se? I know a few ladies who had horrible experiences with it that nearly sent them to the OR. THey were both Pitted, though. (Gee, that sounds about as bad as "failed.")
The whole vacuum thing sounds awful. Is it safe for the baby?
Oh, what does it stand for? How is it pronounced?
Primp = primiparous (literal-ish translation first birth.) Pronunciation pri (rhymes with try) mip (rhymes with tip.) Most folks use this term to refer to a woman having her first baby, although technically a woman pregnant for the first time is actually a "primigravida" and is a "nullip", a nulliparous, or never given birth, woman until she births for the first time. Once you've given birth once or more, most of the time you are referred to as a "multip" or multiparous woman.
Usually attempts at vacuum are abandoned if there is no progress after 3 pulls, or if there are 3 pop-offs (where the doc is pulling and the vacuum pops off the baby's head.) This is not a hard and fast rule, as if there were 3 pulls and baby was crowning, or 3 pop offs, and baby was nearly delivered, you may continue. With no progress, you can't just keep pulling on the baby as the risks to the baby go up with prolonged suction time and increased force, so at some point you have to say that this baby in this position doesn't fit through this pelvis at this particular time and abandon attempts to force it and proceed to cesarean section. In general, we don't go from vacuum to forceps, either, because the risks to mom and baby go up with multiple instruments.
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