Anonymous wrote:My OB recommended a heplock (his word) and intermittent monitoring when I said that I'd like to be able to get in and out of the shower during labor. There was no drama. I agreed and we moved on. I didn't find the saline lock to be all that uncomfortable. It was a little annoying, but the contractions took the focus off of my hand.

It seems like some of you are making a bigger deal of out this than it needs to be.

Or, it could be that some women feel differently about things. I'm the previous poster who had a saline lock, and it hurt and really bugged the hell out of me. If one is needed, i.e., I start labor dehydrated or tired and it looks like good preventative care, well, I'll figure it out. But if it's just hospital protocol, no.

Anonymous wrote:In the 60's, a significant number of infants were stillborn or died post partum---historically even more. The species isn't concerned with your personal survival and a significant amount of wastage takes place---do you want to be one? Close monitoring with efm can indeed pick up late decelerations or a flat heartrate that is unvarying...both signs of fetal distress. What I find most telling is that docs are frequently sued for failure to use the technology---and the women say they would have used it if they had just understood that they could be the one in one thousand.

I don't think there's any evidence that the reduction in perinatal mortality is due to electronic fetal monitoring. All the research I've seen suggests that EFM is useless, or worse, leads to uneeded c-section (which themselves are an increased risk over *normal* vaginal birth.) See, eg, http://aje.oxfordjournals.org/content/114/4/539; http://www.obgmanagement.com/article_pages.asp?AID=3270; http://www.mendeley.com/research/admission-electronic-fetal-monitoring-not-improve-neonatal-outcomes/.

But anyway, it's not like midwives (at least the ones I see at GW) NEVER monitor the heartrate. They just do it intermittently instead of continuously, so you don't have to be hooked up to equipment the whole time.

My OB recommended a heplock (his word) and intermittent monitoring when I said that I'd like to be able to get in and out of the shower during labor. There was no drama. I agreed and we moved on. I didn't find the saline lock to be all that uncomfortable. It was a little annoying, but the contractions took the focus off of my hand.

It seems like some of you are making a bigger deal of out this than it needs to be.

Anonymous wrote:In the 60's, a significant number of infants were stillborn or died post partum---historically even more. The species isn't concerned with your personal survival and a significant amount of wastage takes place---do you want to be one? Close monitoring with efm can indeed pick up late decelerations or a flat heartrate that is unvarying...both signs of fetal distress. What I find most telling is that docs are frequently sued for failure to use the technology---and the women say they would have used it if they had just understood that they could be the one in one thousand.

got something to back that up? "Significant" indicates a pretty large number. Perhaps even a majority. I find it impossible to believe that over half of the pregnancies in America resulted in either stillbirths or died shortly after birth.

One could also suggest that a number of infants that would have died after birth now survive due to better technology that means extreme premature infants live, and that those infants born with diseases, abnormalities, or genetic disorders that did not have treatments in the 1960s are treatable now. None of which has anything to do at all with continuous electronic fetal monitoring.

In the 60's, a significant number of infants were stillborn or died post partum---historically even more. The species isn't concerned with your personal survival and a significant amount of wastage takes place---do you want to be one? Close monitoring with efm can indeed pick up late decelerations or a flat heartrate that is unvarying...both signs of fetal distress. What I find most telling is that docs are frequently sued for failure to use the technology---and the women say they would have used it if they had just understood that they could be the one in one thousand.

Anonymous wrote:Ahem. Fetal monitoring does improve outcomes. There is a definite decrease in disability....and sure, there are false positives. You really want to take that chance?

You're absolutely right - how did we, as a civilization, ever survive before the advancement of fetal monitoring?!?!?! Which, by the way, was only invented in the late 60's.

Here's some actual information for those curious on either monitoring actually does anything:

Electronic fetal monitoring (EFM) can help us to observe what the heart is doing, how well oxygenated the baby is, and whether the baby appears to be struggling or happily trucking along. EFM became routine in the 80?s under the assumption that it was going to save babies. It was believed that continuous monitoring would pick up the small number of babies who show signs of hypoxia or distress and save them by cesarean section. We now know that a baby’s heart rate in labor is not great indicator of how well the baby is going to do after s/he is born. Regrettably, the technology has been applied in such an extreme manner — virtually all women in the US are attached to a fetal monitor during most or all of their labor — without consideration of whether there could be too much of a good thing.

Studies on EFM were undertaken only after it became a routine part of hospital birth. We now have decades of evidence showing that continuous EFM has no effect on neonatal mortality or morbidity; it does not help babies be born any healthier. It does however increase the risk of cesarean birth by about three times. Physicians know this, and many will even admit it. Both the US Preventive Services Task Force and the Canadian Task Force on Preventive Health Care recommend against routine EFM for low-risk women, and cannot even recommend it for high-risk women in labor. Why then are healthy, low-risk, un-medicated women still being confined to fetal monitors when we know they don’t make birth any safer?

OMG, people. Life has risks. Every time you get in a car, you take your life in your hands. Giving birth is a normal, healthy part of life, but that doesn't mean it's without risk. Want a risk-free birth? There is no such thing and no OB can promise you that. Does that mean you should live in fear of what *might* happen? No. Do your research, chose a provider with whom your comfortable, and prepare for birth. Set yourself up for success (whatever that means for you) and let it go.

Anonymous wrote:Ahem. Fetal monitoring does improve outcomes. There is a definite decrease in disability....and sure, there are false positives. You really want to take that chance? Here you will be sending the kid not to Harvard, but to a group home.....it is a bit more important than what color you paint the walls.

It always cracks me up that people who pay $800 for a stroller, feed their kid only organic hand made food, and breastfeed til first grade are so willing to forgo an intervention that actually has a purpose. I suppose it is because it isn't a visible sign of what a wonderful mom you are.

Seriously? Your logic is completely out of whack and you're just fear mongering. The absence of fetal monitoring does not equate to your child automatically having a disability. STOP with the hyperbole and just let people come to their own decisions without passing your judgement.

Ahem. Fetal monitoring does improve outcomes. There is a definite decrease in disability....and sure, there are false positives. You really want to take that chance? Here you will be sending the kid not to Harvard, but to a group home.....it is a bit more important than what color you paint the walls.

It always cracks me up that people who pay $800 for a stroller, feed their kid only organic hand made food, and breastfeed til first grade are so willing to forgo an intervention that actually has a purpose. I suppose it is because it isn't a visible sign of what a wonderful mom you are.

Anonymous wrote:You're right, anti-hospital PPs. It's all a conspiracy.

(GIANT EYE ROLL)

Lots of women want natural births, but aren't necessarily comfortable with birth centers or home births. No one's suggesting it's a conspiracy, just that hospital convention isn't aimed squarely at patient care like we might hope it is.

I give you hospitals that require continuous fetal monitoring, but then don't have wireless monitors so you must be in bed and can't move too much before those stupid straps slip. Fetal monitoring hasn't improved outcomes for babies, mothers, or avoiding surgery. And if you can't move as you need to, labor gets hella worse. So why do they require them?

Anonymous wrote:OK - if you don't want medical intervention such as a low risk IV lock then WHY HAVE YOUR BIRTH IN A HOSPITAL?

I agree that giving birth is totally safe. You chose to have a hospital birth. The hospital feels the risks of not having an IV outweigh are significant enough to have one.

I'm on the side of the hospital.

this is less the case in the DC area, but when I gave birth to my first, I was living in, essentially, the middle of nowhere. It was birth in the hospital, with the OBs and all that jazz, or give birth at home, without any assistance. There were no homebirth midwives anywhere close to me. And a birth center? PLEASE! don't make me laugh. This is the reality many women in this country face every day as they prepare for birth. Just because I live in DC now, where I have so many birth options, doesn't mean I shouldn't question and advocate for the birth industrial complex to engage in best practices rather than falling back on tradition and scare tactics like they do now.

I hope the original poster got her question answered. This thread has turned into a giant mess of ridiculousness, mainly thanks to the immature, ignorant posts like the one directly above.

You're right, anti-hospital PPs. It's all a conspiracy.

(GIANT EYE ROLL)

Anonymous wrote:

Anonymous wrote:
Why do those opposed to natural birth always throw out these straw-man objections? People who choose natural birth typically do so precisely because it is safer, not because we are hellbent on having some hippy-dippy sing-songy "experience." There are risks associated with every single medical intervention. Yes, if the intervention is necessary than you need to weigh the risks vs. the benefits. But since birth is a normal life process, designed to function smoothly, then there is no reason to automatically introduce ANY medical procedures - until it is actually indicated. I'm honestly not sure why this line of reasoning is so difficult to understand. Hospitals operate under the assumption that if they provide MORE services and MORE medical interventions, than at least if they get sued they can claim that they "tried everything"; completely glossing over the fact that sometimes it is because of those interventions that the mom or baby developed certain complications.

ITA.

Yes--you rock, PP!

The sad reality is hospitals now and days are essentially fast food restaurants - they want you in and out so they can fill the seats. They are concerned about your health to a degree, but the more women they can push through, the more money to be made.

Medicine is like anything, it changes over time. Babies used to solely be placed on their stomachs to sleep, but now that's one of the "most" dangerous things you can do to your child. Chloroform used to be the drug of choice for birthing mothers, but obviously we now know that's not the best option. Our current medical times are pushing for scheduled births (csections or pitocin), and less for the "natural" way of wait until the baby is ready. Let's also not forget that doctors are sued for the csections they DIDN'T perform, not the ones they do. There seems to be a motto of "When in Doubt - Cut".

Of course there are times when medical intervention is necessary, but for the "normal", healthy pregnancy no medical intervention is needed - the only issue here is most doctors seem to treat all patients like there's something wrong. They should know as well as the rest of us that labor starts and stops, could last for days, and the more calm and relaxed a woman is, the faster she will progress.

If you want a natural, unmedicated birth a hospital isn't your best choice. If that's your only choice then labor at home as long as possible, and know your body and your rights. Your birthing partner can monitor your fluid intake (my doula has me already trying a variety of "enhanced" waters to see what I like best) while you concentrate on your body and your baby. If you have a strong support system, it won't matter where you give birth.