Birth Trauma – Part 2

What can you do to prevent problems in labor, and miscommunication with your doctor? My recommendation is to follow the recommended diet for pregnancy, exercise (for pregnant women), drink a lot of water, and attend to the prenatal visits.

Never be afraid to ask questions!

Why a certain test is being done, what does that word mean, etc. Some things I can assist you with during the Childbirth Education coursework…but asking the questions of your doctor is important. You get to know your doctor, and he/she can get to know you.

Your right as a patient is to have any procedure or test explained to you, by your doctor.

Questions such as:

-Is the particular procedure / test done because it is required?
-Who requires it?
-Why is it required?
-Is it because of doctor concern? What precipitated that concern?

Your doctor is not GOD.

If the doctor is not responding to your questions or you are not comfortable with the explanation / or attitude of the doctor you still can address the issue. Sometimes just a rewording of your question is helpful.  If still you are not being listened to, the following outlines your rights…

HIPPA law outlines a patient’s rights:

To Clear Communication

The AMA’s Code of Medical Ethics clearly states that it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions.
[https://www.emedicinehealth.com/patient_rights/article_em.htm#communication ]

To Informed Consent

Informed consent involves the patient’s understanding of the following:

  • What the doctor is proposing to do
  • Whether the doctor’s proposal is a minor procedure or major surgery
  • The nature and purpose of the treatment
  • Intended effects versus possible side effects
  • The risks and anticipated benefits involved
  • All reasonable alternatives including risks and possible benefits.

[https://www.emedicinehealth.com/patient_rights/article_em.htm#informed_consent ]

Within the perimeters of informed consent, the doctor ethically understands the responsibility of:

  • The patient being told what the doctor is going to do
  • That the patient is helped to understand the medical implications
  • Whether it is a minor or major procedure
  • The risks and benefits
  • Alternatives with the information about risks and benefits

The patient rights also include:

  • Freedom from force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion
  • The right to refuse or withdraw without influencing the patient’s future healthcare
  • The right to ask questions and to negotiate aspects of treatment

    The 3rd part follows in one week…

Birth Trauma – Part 1

Many things come up during the labor and birthing of a baby. These may or may not be emergency-level events. A woman in labor is focused on the process they are involved in: birth. The woman may not be aware of what is being discussed around them, nor the things happening that may alter their ideals of the “perfect”  birth.

Here are some things that may occur:

  • Slow dilation of the cervix
  • Labor stalling
  • Movement of the baby stops
  • Blood pressure of the mother rises

Often doctors in the hospital will want to intervene. The remedies may be interventions that you really do not need.

These interventions could possibly be:

  • Monitors
  • IV insertion
  • Inducing labor (Pitocin)
  • Or even the decision to have a c-Section (read my blog post on this here: )

The first two  can be alleviated by using gravity (walking, dancing, leaning forward onto the labor bed with feet on the floor and doing squats). Usually stressors or nervousness are the cause.

With Labor stalling, if already dilated 6-7cm, it could very well be a natural stall while going into the next stage of labor or “Transition” (Balaskas 127-131). Body tension can also effect how labor progression.

Low moaning sounds are effective here, in that the vocal cords being activated relaxes the sphincter muscle group of the pelvic floor, as Ina May states ” The state of relaxation of the mouth and jaw is directly correlated with the ability of the cervix, the vagina, and the anus to open to full capacity (Ina Mays Guide, 170). The sphincter muscles will close due to stress or fear. Goer suggests that “obstetric management can obstruct progress (The Thinking Woman’s, 108)”

Remember: Babies are birthed when they are READY. Not on some sort of perceived time schedule.  This is a process that cannot be forced.

If the baby stops movement, inform your doctor. You can use “kick counts” as a method to monitor movements if you are concerned. In active labor, the baby tends to move in a spiral as baby moves into birthing position . Sometimes stopping movement for a short period of time can be an indicator of  the baby 1) shifting position 2) resting before birthing.

Blood pressure issues could be gestational diabetes, or just stress. The cause for the blood pressure rising needs to be found. High blood pressure is also a symptom of pre-eclampsia. But if you were not having signs of this condition and diagnosed in pregnancy (which is why prenatal visits are essential) then it may be something else.

Of course, water by mouth could assist in lowering the blood pressure level. Here is suggested reading for you to understand the seriousness of this condition: https://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy

So now we move onto the second part of this discussion, published one week from this page.

Women with Disabilities -The Healthcare Team- Part 1

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When do you start your Search?

The search should begin as early in the pregnancy as possible. When you do a gynecological examination is the opportune time to decide if you are able to become pregnant. Hopefully, that will occur with a doctor with whom you feel comfortable.

But if the pregnancy was unexpected, or you have not found that great doctor with whom you feel comfortable, the earliest point of time is best. It is important for the baby’s sake. It has been discovered that women who receive care late in the pregnancy or have had no prenatal care at all tend to run a higher risk of infant mortality.

Finding a doctor may be a challenge. Some will immediately advise an abortion. Other doctors will become enthused by the challenges.

You need that doctor to know you well enough to understand the way the changes of pregnancy will affect you. Health issues unrelated to the disability you have will most likely need to be addressed early.

How to Find a Doctor

You could find the doctor via those with whom you trust. You may also get recommendations from the doctor who has been working with your disability.

Evaluating the Doctor’s Practice

The recommendations of friends with whom you trust can assist you in assessing the skills of the doctor. Or listening to the impressions of the patients the doctor has had in the past.

Sometimes there may be differing experiences; it’s in this instance that the opinion of an older and well-trusted doctor in the community may come in handy. There is no singular way to assess what doctor may work for you, other than knowing what you are looking for in the care administered by a doctor.

Check the office policies, by checking with the receptionist. You can ask about fees, for normal birth and caesarian section. Ask about payment and billing, insurance the doctor will accept. You will need to know what hospital the doctor is affiliated. Also check the doctor’s flexibility with requests, such as persons allowed to attend the birth, and whether the doctor will work with you on having a natural birth. Most importantly, check accessibility, if you are using a wheelchair…are the rooms and bathrooms set-up for your ease of use. The answers to these questions may narrow the choices of whom to visit.

You could ask for only a consult, rather than a visit with a full physical examination until you have decided upon which doctor you will use. Bring with you the father-to-be or an advocate. You then will have someone to share impressions and ideas with, or who would think of questions you may have not been able to think about in your nervousness.