May 21, 2012
Can You Recognize a Labor Room Dilemma?
I’ve just returned home after traveling over 1900 miles to attend my cousin’s baby shower and oh, what a joyous event. There was great food, laughter, a zillion gifts along with a spirit of generosity that revealed the power of true friendship. In the next 30 days my cousin will embark on a new journey called motherhood with all of its associated peaks and valleys. She clearly loves her baby and I want to make certain that she arrives safely.
My cousin appears to be receiving good prenatal care but I want to leave nothing to chance. When she is finally admitted in labor, I will be calling for updates and a status report. Why? Because obstetrics is a specialty that frequency involves the unexpected. I will inquire at least every two hours regarding her progress in labor. Is she dilating 1.2 centimeters every hour? And if not, are her contractions regular? If her contractions are not regular, and she’s less than 4 centimeters, will they encourage her to walk? If she’s more than 4 centimeters and having irregular contractions, will she receive Pitocin (a medicine that helps the uterus contract)? And if she receives Pitocin, is the baby tolerating it, meaning is the fetal heart rate between 120 to 160 beats per minute?
I will encourage my cousin to ask for pain medication because a pain-free mother progresses faster in labor than a woman writhing in pain. I will ask her about weight gain during the pregnancy not for embarrassment but because the answer has clinical significance. If she gained more than 40 pounds, it’s quite possible that the baby might be larger than expected, thus increasing the possibility of a shoulder dystocia. And if there is a shoulder dystocia, I hope the nursing staff will put my cousin’s knees to her chest and encourage her to push. I also hope her physician will be well versed in the maneuvers that are necessary to handle this type of emergency.
If the fetal tracing looks suspicious meaning, flat, or “U-shaped,” I hope the nurses will have the good sense to inform the physician immediately and not wait to the 11th hour. I also hope her hospital has 24-hour anesthesia coverage and a level 3 NICU. Lastly, I will emphasize to my cousin that a C. Section is not a failure. Iin the event of an emergency it could mean the difference between having a healthy baby or one who is brain damaged and physically disabled for the rest of its life.
Do you know how to handle a labor room dilemma? You will, if you read The Smart Mother’s Guide to a Better Pregnancy.A healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
Me said,
May 23, 2012 at 9:40 am
I hope your cousin shuts her phone off during labor and doesn’t call anyone until she is in her postpartum room.
I hope she keeps her medical information away from “helpful” family members.
I hope she realizes labor is not a spectator sport and no one is entitled to any information, pictures, or a “spot” in the delivery room.
I hope you realize how rude and intrusive you are being and leave your cousin to labor and deliver in peace.
drlindagalloway said,
May 23, 2012 at 10:48 am
I hope you realize that women and babies die unnecessarily because hospitals and labor rooms are on “automatic pilot.” I hope you realize that every month I review malpractice cases on behalf of the federal government of women and babies who have been harmed unnecessarily because of incompetence and neglect. No, labor is not a spectator sport but there are people who compromise their privacy on behalf of money and ego. I hope you realize that some women never make it to the postpartum room but the morgue, especially if they’re African American. Obviously, you’ve never experienced a labor room catastrophe and your experience is limited. I happen to be a board certified ob-gyn physician with 25 years of clinical experience and know that sometimes people won’t do the right thing unless someone is looking over their shoulder.
MaryEllen said,
May 24, 2012 at 4:11 pm
I think it is great that you can be an advocate for your cousin. I wish I had someone like you there when I was having my daughter. I ended up with pre-e and class 1 HELLP because my doctor did not really take anything seriously. I never thought I could get a hypertensive disorder because my blood pressure had always been low. Things can go from bad to worse in an instant.
Sometimes people are too sick or tired to fight for proper care. Having someone there or nearby to fight for them can be the difference between life or death. I am lucky I had my friend, an RN, there to push for proper care.
Your cousin is very lucky to have you. I hope she has a quick and easy delivery.
drlindagalloway said,
May 28, 2012 at 10:05 am
Thanks, Mary Ellen. I’m so happy that things worked out for you and you are absolutely right. I’d like to quote you for future references if you don’t mind. You would be an inspiration for the Preeclampsia Foundation. How old is your daughter?