RE: my story

[Vicki Chan]

I have been midwife at home to several women who have had  3rd degree
tears with previous births... All of them have had intact perineums, one
with a 4.4 kg baby! :)

Vicki

-Original Message-
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of judit
Sent: Thursday, June 06, 2002 4:19 PM
To: [EMAIL PROTECTED]
Subject: my story



> Hallo,
>
> I was recommended to tell you this story by my midwife friend, to
get
> to know so more opinions on the subject.
>
> I am a believer in "natural" birthing so I had my first baby at home 
> because I didn't trust the hospital to respect my wishes. I had a 
> wonderful midwife and a wonderful baby. I did end up in hospital 
> because of a 3rd degree tear but I wouldn't have wanted it any other 
> way if I had to do it all over again. Well that time has come. I am 
> now 33 weeks pregnant. This time we had to resort to the hospital. I 
> wrote my birthplan and they requested a meeting. It was me against
> four of them, the manager of the ward, a midwife, the obstetrician
and
> someone from administration.
> They said they respected my wishes against any interventions until
an
> emergency occurs so I thought everything would be allright. Than at 
> the end the obstetrician stated a ceasarian would be a better option 
> in my case, if I could go home and consider this scenario. I told him 
> straight away I wouldn't change my mind. He said my
pelvis
> is probably to small because my first baby was only 3.3kg so I 
> shouln't have torn so badly, and that the scar tissue is likely to 
> tear again and might not heal up as well, leaving me farthing
through
> my fanny for the rest of my life.
> So all of a sudden my wish for a natural birth changed into a 
> recommended x-ray at 36 weeks, if the baby is not to heavy I can
have
> a vaginal birth on my back with an episiotomy the size of my first 
> tear only in a different direction. I do not like my options very much

> as you can imagine so can anyone tell me if I can trust my 
> obstetricians judgement. Is this normal procedure in a case like mine 
> or shall I have a homebirth again
after
> all?
>
>  Thanks for taking your time to read my story.
>
> a worried mum
>

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Re: My Story

[Debby M]

Hi Worried Mum, 
 
You have my sympathy I have just won a battle to birth the way I want.
 
Firstly some advice - say no to the pelvimetry - you birthed your first baby there is nothing wrong with your pelvis.  It sounds like the OB is just trying to create doubts in your mind and set you up for failure.  My first was a csec for a 3.9kg baby with a 33cm head.  My OB sent me for an xray afterwards which came back with two ok and two borderline measurements.  He told me I could try VBAC next time but it would be iffy.
Two years later - new OB - my iffy pelvis let through a 3.6kg baby with a 38cm head.  My new OBs opinion (as is supported by much medical and anecdotal evidence) was pelivimetries aren't worth the film they are imaged on.
 
Stand up for what you want.  As I discovered when you go to a public hospital they cannot refuse you entry but you can certainly refuse all and any interventions offered.  You can even stipulate that you are to be attended only by a midwife (as one of my friends did at Kirwin Hosp in Townsville) and that the only reason an OB/doctor is to be admitted to the room is in the event of an emergency.
 
Opinion is also mixed on episiotomies - I am not to sure what the medical outcome is for a 3rd degree tear - but when I told my 2nd OB I rather tear than be cut he indicated to me that for 1st and 2nd degree tears (at least) that they generally heal better than a cut anyway.
 
Re they good old lay down position.  Your coycx(sp) cannot move in this position thus making your pelvid inlet and outlet smaller and less mobile.  The best positions for birthing are upright or leaning forward where the bones of the pelvis are free to move to open the pelvis and where gravity can help rather than hinder the contraction action of the uterus - see the book Active Birth.
 
Stand up for yourself definitely - go to hospital as late as you are comfortable doing so - and see if you can get a doula or private midwife who is willing to act as a support person for you.
 
Good Luck
Debby
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RE: my story

[Ward, Birthing Centre Midwives]

Dear worried Mum,
I have been with women as a midwife and they have given birth to a baby
between 3-3.5 kgs and had a third degree tear for whatever reason and all
the soul searching couldn't explain it and then have been with women with a
history of a third degree tear and have no problems next time. It is so
multifactorial as to why they happen sometimes but the research around
episiotomy and 3rd degree tears shows they increase your chance of one. 
Good luck, what a terrible time for you to be given such an inquisition.
Jackie

--
From:  judit[SMTP:[EMAIL PROTECTED]]
Sent:  Friday, 7 June 2002 08:49
To:  [EMAIL PROTECTED]
Subject:  my story


> Hallo,
>
> I was recommended to tell you this story by my midwife friend, to
get
> to know so more opinions on the subject.
>
> I am a believer in "natural" birthing so I had my first baby at
home
> because I didn't trust the hospital to respect my wishes.
> I had a wonderful midwife and a wonderful baby. I did end up in
> hospital because of a 3rd degree tear but I wouldn't have wanted
it
> any other way if I had to do it all over again.
> Well that time has come. I am now 33 weeks pregnant.
> This time we had to resort to the hospital. I wrote my birthplan
and
> they requested a meeting. It was me against
> four of them, the manager of the ward, a midwife, the obstetrician
and
> someone from administration.
> They said they respected my wishes against any interventions until
an
> emergency occurs so I thought everything would be allright. Than
at
> the end the obstetrician stated a ceasarian would be a better
option
> in my case, if I could go home and consider this scenario.
> I told him straight away I wouldn't change my mind. He said my
pelvis
> is probably to small because my first baby was only 3.3kg so I
> shouln't have torn so badly, and that the scar tissue is likely to
> tear again and might not heal up as well, leaving me farthing
through
> my fanny for the rest of my life.
> So all of a sudden my wish for a natural birth changed into a
> recommended x-ray at 36 weeks, if the baby is not to heavy I can
have
> a vaginal birth on my back with an episiotomy the size of my first
> tear only in a different direction.
> I do not like my options very much as you can imagine so can
anyone
> tell me if I can trust my obstetricians judgement. Is this normal
> procedure in a case like mine or shall I have a homebirth again
after
> all?
>
>  Thanks for taking your time to read my story.
>
> a worried mum
>

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RE: my story

[Jackie Doolan]

Dear worried Mum,

This is a very scary way to go about offering you information.  I would
request in writing (cc to all panel members) some research that supports
this doctors management plan. State that to make an informed choice you need
to weigh up the risks and benefits associated with vaginal birth (given your
history) and those associated with C/S (When you feel ready you may like to
visit the website below - the article is very honest about risks in general
but not to your specific case, it is written by Marsden Wagner
http://www.acegraphics.com.au/resource/papers/wagner03.html). A letter
becomes a legal document which will  be put onto your hospital file - so
keep a copy. Although I have not read any research on this matter the
following rationale comes to mind - in the event of a narrowed pubic arch
the baby's head may have to travel further down towards your coccyx before
it can slip under the arch.  This may mean the tissues in the back section
of your pelvis may have more pressure placed on them as the baby's head is
born. When a woman has a broader pubic arch the baby's head slips under the
arch after a little downward distance is travelled - this may reduce trauma
to pelvic floor and perineum.

I hope this information helps you succeed in achieving an empowered birth
experience.
Cheers
Jackie Doolan

  

-Original Message-
From: judit [mailto:[EMAIL PROTECTED]]
Sent: Friday, June 07, 2002 9:19 AM
To: [EMAIL PROTECTED]
Subject: my story



> Hallo,
>
> I was recommended to tell you this story by my midwife friend, to
get
> to know so more opinions on the subject.
>
> I am a believer in "natural" birthing so I had my first baby at home
> because I didn't trust the hospital to respect my wishes.
> I had a wonderful midwife and a wonderful baby. I did end up in
> hospital because of a 3rd degree tear but I wouldn't have wanted it
> any other way if I had to do it all over again.
> Well that time has come. I am now 33 weeks pregnant.
> This time we had to resort to the hospital. I wrote my birthplan and
> they requested a meeting. It was me against
> four of them, the manager of the ward, a midwife, the obstetrician
and
> someone from administration.
> They said they respected my wishes against any interventions until
an
> emergency occurs so I thought everything would be allright. Than at
> the end the obstetrician stated a ceasarian would be a better option
> in my case, if I could go home and consider this scenario.
> I told him straight away I wouldn't change my mind. He said my
pelvis
> is probably to small because my first baby was only 3.3kg so I
> shouln't have torn so badly, and that the scar tissue is likely to
> tear again and might not heal up as well, leaving me farthing
through
> my fanny for the rest of my life.
> So all of a sudden my wish for a natural birth changed into a
> recommended x-ray at 36 weeks, if the baby is not to heavy I can
have
> a vaginal birth on my back with an episiotomy the size of my first
> tear only in a different direction.
> I do not like my options very much as you can imagine so can anyone
> tell me if I can trust my obstetricians judgement. Is this normal
> procedure in a case like mine or shall I have a homebirth again
after
> all?
>
>  Thanks for taking your time to read my story.
>
> a worried mum
>

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RE: my story

[Sally]

I agree with Macha. What does your pelvis have to do with the tear. 

I would really recommend you get a hold of the  'PINK KIT' which has the
most fantastic perineal massage in it. (not like the perineal massage I
have seen described in most books) I have see the most amazing results
from women who do this massage.

Leaves to say that I would recommend that you find your own midwife. I
would love to know why you are not birthing at home this time. What
about a midwife support in hospital?

Good borning.

Sally

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RE: my story

[Sally]

The pink kit is found at 

http://www.commonknowledgetrust.com/index.htm

I would recommend it to all midwives and women.

Wintergreen is wonderful.

In peace and joy
Sally Westbury

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RE: my story

[Macha McDonald]

I'm not a midwife, so this is just my opinion.  What has the size of your
pelvis got to do with tearing?  Am I missing something here?  That doesnt
make any sense to me.  I think you need to change obs.  Get a mother and
baby friendly ob.  He is using scare tactics with you, telling you you'll
fart through your fanny for the rest of your life.  I think you're ob has an
underlying urge to control your birth.  It is lucky he said all of this
because it is a sign for you to change obs/hospitals.  If you must birth in
a hospital, try a birth suite at least.  Good luck!
Regards, Macha.

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re my story

[Jackie Kitschke]

I sent that story to the list as evidence that there are good 
stories around in hospitals and that we as midwives are as responsible for 
birth  outcomes as the doctors are. I do not want to use a public forum to 
judge who is good and who is not (by exculsion) as you can have the most wfo in 
the world but if they are working in systems that aren't women friendly their 
practice may change and who I think is good someone else may not. 
Jackie