Another baby born before their time. This time because the mom insisted on being induced at 37 weeks, with immature fetal lungs. No medical reason for induction. Yes, the delivering doc was pissed that it was tossed into her lap by the admission doc who gave in and induced this mom for no medical reason.
NICU admission for respiratory distress.
Think about your babies first ladies!
27 comments:
OMG that makes me so mad!! Poor baby...I wish some mamas would be less selfish and educate themselves before doing something like that! Hope the baby does okay.
On the other side of the coin, you have the CNP at my OB's office, who told me that they "wouldn't let" me go past 41 weeks. When I asked why, she said it was due to the risks involved. When I asked if I could go past 41 weeks if I had regular BPPs and NST, she looked confused and shook her head. *sigh* I delivered at 40w3d so it was a moot point but I loathe that mindset almost as much as I loathe the mindset doctors who induce women at 37 weeks for no medical reason other than they're "term."
That's just insane. I did everything I could to keep my baby in until 37 weeks.
That just makes me angry.
Why didn't her doctor just say no? Did he know the baby's lungs weren't mature?
I have heard that before. And some do fine. But it all depends. I would be pissed, too, especially since it sounds like HER doc wasn't in favor of the decision. Selfish. Trust me, I see A LOT of those parents in my line of business. It doesn't stop with deliveries.
GRRR!!! I have 5 children and generally will go to 40+ weeks and I am normally okay with that but what makes me so mad about this is that I HAD a medically diagnosed condition (ICP)that can cause sudden neonatal death if the baby stays in past 37 weeks and the doctors flat REFUSED to do anything for my baby!!! I told them I would hold them responsible if my baby died and they said "We have every faith in our legal department". Thank the Lord for midwives who we transferred to who caught my baby at home at 37 weeks 5 days. She is a beautiful girl now but in my case they were willing to risk my child's life. It makes me so mad that they wouldn't deliver my at risk child but that they would deliver a baby early who isn't at risk.
Do you not have a 39 week induction policy?
Ugh! Another instance where I would really like to see Doctors man up and tell patients what is best for them! So tired of hearing stories like this :(
knowing babies who died at 38 wks and were stillborn for no known reason I would never judge anyone for wanting to be induced.
I know this doesn't really work in the real world, but in this kind of situation, I almost wish there would be some kind of AMA form to sign and/or a commitment on the part of the patient to bear some of the cost related to the complications.
Hmmm, mom comes to the doctor and says "I want to induce - it's my right!" The doctor says, "I'm really not comfortable with that, but OK."
Mom comes to the doctor and says "I want to VBAC." Doctor says "I'm really not comfortable with that, too bad."
Disconnect in our culture much? I think yes.
Tired of being pregnant? Irritating. I was tired of being pregnant too by the time I was 35 weeks with twins and measuring 43 weeks. But I stuck to my strict bedrest orders (due to PTL) until I was 36 weeks on the dot...I was tempted to cheat at 35w6d, but I didn't.
I finally delivered (vaginally, yay!) at 37+2 when Baby A's water broke. I was measuring 47cm. So yeah, I wanted to call it quits a couple weeks earlier because everything hurt. But I hung in there for my babies and let them decide their birthdate.
If there's no medical reason, come on ladies!
This isn't as black and white as it may seem. I know a mama who delivered her stillborn daughter at 39.5, she'd had undiagnosed velamentous cord insertion that tore at her first real (natural) contraction and baby died. SHE was induced at 37 weeks for her following pregnancy because she was just terrified to go any day past that, to an intense level that she didn't sleep, she didn't eat, she sat all day with a stethoscope pressed to her belly making sure her baby wasn't dead. Induction was the right thing to do.
So, don't judge. You really never know what the root of the issue may be.
I also chose to induce early due to stillbirth. But this history IS a medical reason to induce. My baby @ 37 weeks did just fine, but I also knew the risk of delivering early, RDS among them. But as I told my doc then, I can handle a NICU baby, I can not handle another dead baby.
No medical reason to induce, don't do it ladies. It is not worth the risk.
I'm really surprised the doc agreed to an induction without any indication what with the new ACOG guidelines and all the fuss about inducing before 39 weeks.
Hopefully, Mom will think twice with her next baby.
I had a coworker get mad at me once because I refused to give her tips on inducing herself at 36 weeks because "My doctor says the baby's ready!" If the baby was ready YOU'D BE IN LABOR. It was her first baby and she was under the impression that induction was just an easy way to know when you were going to have the baby and get things going earlier. She totally tuned me out when I tried to tell her about some of the risks of induction, especially that early and ended up having an elective induction at 37 weeks on the dot. Unfortunately, since she didn't come back to work I have no idea what happened beyond her big announcement that she was being induced the next morning and wouldn't be back to work.
If you think term pregnancy is miserable, standing next to a NICU warmer hour after hour when you are freshly PP is much worse.
Just minutes ago, the first-born baby of friends of mine was disconnected from his ventilator after about 5 days of life. He was only slightly preterm, her water broke and just a few hours later she went to the hospital and had her baby in her arms (very easy birth, and quite fast for a primip). He was apparently healthy at birth (I saw the video - very vigorous cry while being weighed), but hours later suddenly stopped breathing. They tried everything they could over the course of several days, but the doctors said there is no hope.
What happened? Did his prematurity play some role in his death? Or would he have been stillborn if she was still pregnant? There is no way to know for sure. [[At this point, I don't know if they even know for sure why he stopped breathing.]
I understand those who would rather induce and have a baby in the NICU but outside the uterus and alive (another set of friends had a stillborn baby on her due date, so induced in the second pregnancy); but there is no guarantee that inducing/sectioning the mother to make sure the baby is born before the due date, means that the baby will live.
Can anyone elaborate on ICP and why it is dangerous to go past 37 weeks, as per PP? I don't know that abbreviation...
Nicole, I didn't know either, but googled "ICP, acronym" [love internet searches!], and think it's probably "Intrahepatic Cholestasis of Pregnancy" -- here's a wikipedia article about it.
Thank you WTWCBE about ICP. I didn't know what the other commenter was referring to re: ICP either.
Shawnicy: can you elaborate a little on what ICP is and why it necessitated an early induction?
In the linked wiki article on ICP, it says that "Delivery by 37 completed weeks is considered crucial to fetal outcome [12], though it does not completely eliminate the risks associated with the condition," so I'm guessing that's what the OP was referring to re: week 37 induction.
I went into labor naturally with my son at 36w2d (delivered him at 36w3d). My entire labor I was terrified that he'd require NICU time, but thankfully he was 6lbs 4oz and perfectly healthy. I've had other moms tell me, "Oh, you're so lucky he came early!" My response: "I'm not lucky he came early; I'm lucky he was healthy DESPITE coming early!"
I know someone whose first two sons were born at 34 weeks due to pre-term labor, did NICU time for weeks.
With her third pregnancy she called me when she was 36 weeks and tired of being pregnant to pump me on ways to self-induce (which I did not give her). Her OB would not induce her, so she ended up calling up the OB she'd had her boys with (she had moved about an hour drive away, so had a new OB), and gave him some song & dance about how she really missed him and wanted to birth with him, so he agreed to induce her at 37 weeks. Sigh. You'd think someone who had already done the NICU thing twice would realize it was important to keep the baby in, but nope.
More hospitals are starting to put policies in place to prevent elective early term (or late preterm) births. NO inductions or cesareans before 39 weeks unless there is a darn good medical reason, PERIOD.
Anyone who wants to induce a mom before 39 weeks has to get that decision approved by a doctor who acts as gatekeeper. That way the medically prudent ones still get through but the others do not.
I just heard Dr. Macones speak at the ICAN conference and this is what his hospital is doing. He spent quite a bit of time in his talk on the risks these 37-38 week babies encounter, both immediately and later in life. There's quite a bit of research to suggest that 37-38 weeks is not the most optimal delivery time for most babies.
I sympathize with the difficult place you, as nurses, are in in these situations. However, I hope some of you can start pushing your administrations to get a 39-week policy in place in your hospitals too. Then docs can't give in to moms who push for early inductions, and docs who push these earlier inductions get reined in too.
Even ACOG is on board with 39 week gatekeeper policies. Now the staff just need to advocate for them.
I see patient's daily that demand inductions for no reason other than a desire not to be pregnant. I also lose patients weekly for refuaing these demands. In many communities with stiff provider competition the last thing one needs is to have a patient telling everyone how horrible a doc/mw/cnp you are because YOU made them stay pregnant. And yes, I have been threatened with suits "If anything happens to this baby". The answer is not with new rules but with the patients. If the patient would shop for the providers with the best outcomes then the poorer stat provider would either change or be forced from practice because of a lack of patients. It is the consumers show and no I have know idea how to simulate this movement. Just like I have no idea how to get the provider stats - real performance/outcome numbers - into the hands of the public. I see early deliveries, some catastrophic, constantly, with NO documented indication for delivery. I just do not see that attemoting to add more rules to healthcare is going to help. It will just put even more work on the nurses to try and gate-keep the provider. Again, I do not have an answer. I lost a patient last tuesday to a doctor in the next building for refusing to induce her at 36 6/7 weeks. He induced her at 37 2/7 weeks and everything went fine. She saw me at the hospital and I heard her say aloud "there's the a**hole that didn't know what he was doing". See what I mean about it being the patients show? My attitude on doing what seems right is probably why I drive a truck and doctor X across the street drives a RR. Thats ok though. I can pull a horse trailer with mine.
I simply cannot understand someone being so selfish as to force baby out before reaching their due date 'just because'! So stupid! PGcy gets uncomfortable, you get huge...surely a woman should expect that and just deal with it!?
OB @10:04, I just want to say thanks for your integrity, putting patient's health first even when it is difficult. If I were pregnant I'd pick you over the competition.
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