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Family Forum / Pregnancy / Pregnancy / November 2004Pondering on pain relief....during labor
I am planning to start TTC in May of 2005. It really all depends on when Rachel weans so it may be a bit after that-I'm not weaning her to have a second, but at 1 year when she can have regular milk I plan to start the weaning if she hasn't already. I am not even planning on TTC before she is 1 year old. I wonder every day what it would have been like if they hadn't induced me with Pitocin (my water broke and I didn't have contractions, just hours of water pouring!) The Pitocin brought on hard and fast contractions-- I had the epidural but they kept letting it wear off so I got a good feel of those contractions. It was more pain than I wanted-- but not worse than some of the worst, endometriosis-menstrual cramps I have ever had. The Pitocin did make it miserable and prolonged. I have said before that if I DIDN'T have the Pitocin, I MIGHT have been able to have a med-free labor, IF it didn't last 18 hours. So if my second one is faster, AND my waters don't break early with no contractions-- if I go into labor naturally, I am wondering if I can (happily) make it through a natural labor. Albeit....this isn;t high on my priority list, and I liked the epidural, it offered me no side effects and total pain relief until they let it wear off- then they'd turn it up again and the pain relief would be complete again in about 5-10 minutes. And I could still move my legs and feel my toes and all that. I don't want to rush to another epidural because I honestly think it slowed my labor down-- but there are factors to consider, I got it at 2cm dilation because they started the Pitocin then, so I got it early and before I started dilating.....and also the Pitocin itself..... Anyway, I'm just wondering, I will never know till I get there, but I was wondering what the chances are of if I go into labor naturally, and have actual contractions without Pitocin....I wonder if a natural labor would feel as bad as the Pitocin-induced contractions? We really want #2! I am getting with Rachel where I am not overwhelmed and she is able to entertain herself long enough for me to get things done now (dishes, cleaning, showers). She never fusses in the car or in stores...My strong desire for a #2 has never gone away, it grows! My husband said "You don't get much free time now and you think you want another one???? And you want to go through those first few months again?" I told him' YES! and YES! Rachel IS my free time.......she's a joy. So, yeah,,,,,TTC in May hopefully........................since we changed pediatricians I would deliver in a different hospital which is equidistant from my house anyway. Since that's where the new pediatricians work. Using this hospital means I can't use the midwives or the old OBs, I'd be all new. I know the midwives bill under OBs affiliated with the old network so that they can take insurance, so I am almost sure they can't go to another hospital...right? I'll have to check on that...the new hospital is actually closer to the midwives office! > Anyway, I'm just wondering, I will never know till I get there, but I was > wondering what the chances are of if I go into labor naturally, and have > actual contractions without Pitocin....I wonder if a natural labor would > feel as bad as the Pitocin-induced contractions? I too had Pitocin and the contractions were hellashious, but as soon as I received the epidural I was fine (until it began to leak). I think that no matter what happens WITHOUT the epidural, I would have been miserable. I really wanted to give birth vaginally WITH the epidural. > We really want #2! I am getting with Rachel where I am not overwhelmed and > she is able to entertain herself long enough for me to get things done now [quoted text clipped - 3 lines] > want to go through those first few months again?" I told him' YES! and YES! > Rachel IS my free time.......she's a joy. WOW! I keep thinking back to when you first announced you were pregnant. You have come a long way, Baby!! I'm so proud of you. I really think I would like another one, too. But, I'll need to wait until Morgan is much older before I can seriously consider it. It's just a nice fantasy for now. I recently read an article about how your life changes with each child (I think in Parenting magazine). It was humourous. I'm soooooo not ready for it. Think I'll take the time to really enjoy and nurture Morgan for a few years...... ~Carol Ann > WOW! I keep thinking back to when you first announced you were pregnant. > You have come a long way, Baby!! I'm so proud of you. Thanks and the same to you!! You're a seasoned mom now!. > Think I'll take the time to really enjoy and nurture Morgan for a few > years...... That sounds ideal. I don;t know why I feel a hurry. I really think I owe ot to Rachel to let her be my center of attention for as long as possible, I just don't want too long to go by in case I have problems TTC. I don't take anything for granted, that I will conceive again so fast or have no problems. Rachel IS getting easier....she;s getting nosey and active and I have to be more watchful but she is so easy to entertain and play with. And lie I have mentioned, I never wanted to leave her to solo play but she fusses to be put in her saucer and playpen! I call the playpen the "funyard".....it's full of toys and she just loves it. She will let me know when she's had enough. Some times she stays in for 2 hours happily and other times she wants out at 20 minutes, and other times she doesn't want in at all- I never put her in when she doesn't want it (unless I need to put her in a safe place while I do something really quick)......the only thing getting harder is changing her! Her diapers are so stinky and so FULL, and she wants to roll over to her tummy in the middle of the change and I end up getting poo all over my hands etc- yuck. I blame the solids. But I am lucky- she eats well, loves her high chair, and will now entertain herself so I can take a shower if I time it right. I can most anything I need to-- I just can't neceesarily do it at the exact time I want to. Pretty cool. Rachel is a neat baby. I just think every thing she does is so cool. "Oh, look, Rachel just belched! Aw, Rachel is chewing her fist! Oh look, Rachel rolled over and is chewing the remote control! Oooh, Rachel ate 2 jars of food! She just laughed at Judge Judy!" etc. > I wonder every day what it would have been like if they hadn't > induced me with Pitocin (my water broke and I didn't have > contractions, just hours of water pouring!) First of all, how long were your waters broken before they started the induction? I have to tell you that the tendency on induction after ROM is to jump the gun quite a bit. The medical evidence suggests that, as long as you're known to GBS- and there's no cord prolapse (which would necessitate an immediate c-section), there's no risk to waiting up to 36 hours after ROM for labor to begin. Even though this evidence is well-established in the research literature, a lot of practitioners haven't caught up to it and still have the "ROM-to-baby within 24 hours" mindset. That usually means they end up putting women on pitocin within a few hours of ROM when it may well not be necessary. So the first thing I would suggest is that you may be able to wait a *lot* longer after ROM before consenting to induction than you did. This is something it would be wise to discuss with your caregiver early on in your pregnancy. Go in armed with the research data to make your point if you feel it's necessary. > I have said before that if I DIDN'T have the Pitocin, I MIGHT have > been able to have a med-free labor, IF it didn't last 18 hours. So > if my second one is faster, AND my waters don't break early with no > contractions-- if I go into labor naturally, I am wondering if I > can (happily) make it through a natural labor. FWIW, my first labor was induced with pitocin and only lasted 8 hours, but I didn't make it without giving into the epidural. I *easily* and happily labored unmedicated throughout my second, spontaneous labor, despite the fact that it was much, much longer than the induced labor (first contraction to baby was 28+ hours, and about 6-7 hours were active, distinctly uncomfortable contractions). I attribute this to two main factors: 1. Not being in the hospital hooked up to monitors and an IV throughout the entire labor (I was actually only in the hospital for 90 minutes before she was born!). That just made an enormous difference in my *perception* of pain. 2. No pitocin. For me, pitocin seems to result in contractions that don't ever seem to completely "let go". During my spontaneous labor, I always felt like my uterus was completely relaxed between contractions, which wasn't the case during my induced labor. > Anyway, I'm just wondering, I will never know till I get there, but > I was wondering what the chances are of if I go into labor > naturally, and have actual contractions without Pitocin....I wonder > if a natural labor would feel as bad as the Pitocin-induced > contractions? As I said above, in my experience, no, they're not as bad. But it's hard to separate the degree to which they're not as bad because their non-chemical and the degree to which they're not as bad because you're not in the hospital tethered to machines with your mobility greatly decreased. I found it incredibly easy to get through spontaneous labor without pain relief; I was surprised, really, by how easy it was. Of course, YMMV, but it's certainly worth a shot! > So, yeah,,,,,TTC in May hopefully........................since we > changed pediatricians I would deliver in a different hospital which > is equidistant from my house anyway. Since that's where the new > pediatricians work. Why does changing pediatricians change your choice of OBs? That seems odd. My insurance carrier doesn't care at all whether my physician, my husband's physician, or my kids' physician are associated with the same group or not--all it cares about is whether that physician has an agreement with the insurance company. For my third birth, I used midwives not in any way affiliated with my pediatric clinic. The hospital was not in any way associated with my pediatric clinic. It was no big deal. So I don't get it. -- Be well, Barbara Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7) Tolerance, equality, and personal liberty *are* moral values! All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman >> I wonder every day what it would have been like if they hadn't >> induced me with Pitocin (my water broke and I didn't have [quoted text clipped - 16 lines] >pregnancy. Go in armed with the research data to make your point if you feel >it's necessary. ITA. I've had PROM with all 3 of my pregnancies. The last 2 were sections, but in 2000, the attitude was 24 hours to baby. This time, there was not the same pressure put on me. I was allowed to labor on my own for over 35 hours before I consented to Pit. Unfortunately it didn't do much more than make me miserable, and completely wear me out, which resulted in the second section. Nan > ITA. I've had PROM with all 3 of my pregnancies. The last 2 were > sections, but in 2000, the attitude was 24 hours to baby. This time, > there was not the same pressure put on me. I was allowed to labor on > my own for over 35 hours before I consented to Pit. Unfortunately it > didn't do much more than make me miserable, and completely wear me > out, which resulted in the second section. I'm thinking WHO recommendation is 96 hours, i.e. 4 days, which means you need to get things started within 48. For me I went for induction around 36 hours after my water broke and they told me then that they really wanted the baby out 24 hours from that point, it turned out to be 12 hours later, but only the last 5 of that was on pitocin and officially only the last 1.5 hrs was active labour (to me it felt like 4hrs 59 mins, the pitocin had instant effect on me) >> ITA. I've had PROM with all 3 of my pregnancies. The last 2 were >> sections, but in 2000, the attitude was 24 hours to baby. This time, [quoted text clipped - 5 lines] >I'm thinking WHO recommendation is 96 hours, i.e. 4 days, which means you >need to get things started within 48. NICE, not WHO. Megan -- Seoras David Montgomery, 7th May 2003, 17 hours. http://seoras.farr-montgomery.com EDD 11th March 2005 (another boy!) >>I'm thinking WHO recommendation is 96 hours, i.e. 4 days, which means you >>need to get things started within 48. > > NICE, not WHO. memory fails me, what does NICE stand for and does WHO have a reccomendation? >>>I'm thinking WHO recommendation is 96 hours, i.e. 4 days, which means you >>>need to get things started within 48. [quoted text clipped - 3 lines] > memory fails me, what does NICE stand for and does WHO have a > reccomendation? I think it's the National Institute of Clinical Excellence or something like that. I think they just give recommendations to the National Health Trust in the UK. Remember these things are just guidelines for caregivers, they don't mean the woman must actually agree to them, the decision on when to go in, if at all is up to her. And I think NICE guidelines are to offer induction OR expectant management after 37 weeks but don't quote me on that. Not sure what the WHO rec's are but here's a link to the PDF from my bookmarks that lists complications nd recommendations for management. I haven't downloaded it because it's freaking huge and I'm on dial up, but one day I'll get around to it. http://www.who.int/reproductive-health/impac/index.html Andrea >I think it's the National Institute of Clinical Excellence or something >like that. I think they just give recommendations to the National Health [quoted text clipped - 4 lines] >induction OR expectant management after 37 weeks but don't quote me on >that. Yup. There was a case locally recently where they refused induction post 37 weeks, mangled the expectant management (no swab, Mum was GBS+). Baby delivered by EMCS 60 hours later. Stillborn :( The trust concerned (no, not my local one, for once) are being dragged through the coals as they were *not* following NICE guidelines. >Not sure what the WHO rec's are but here's a link to the PDF from my >bookmarks that lists complications nd recommendations for management. I >haven't downloaded it because it's freaking huge and I'm on dial up, but >one day I'll get around to it. >http://www.who.int/reproductive-health/impac/index.html Brill, thanks for the link A. Megan -- Seoras David Montgomery, 7th May 2003, 17 hours. http://seoras.farr-montgomery.com EDD 11th March 2005 (another boy!) > Yup. There was a case locally recently where they refused induction > post 37 weeks, mangled the expectant management (no swab, Mum was > GBS+). Baby delivered by EMCS 60 hours later. Stillborn :( The > trust concerned (no, not my local one, for once) are being dragged > through the coals as they were *not* following NICE guidelines. how awful, they deserve to be dragged over the coals, the problem is don't the results for a GBS swab tak about 48 hours to come back, certainly mine hadn't come back by the time I delivered. I think I was managed very well, the swap was taken within an hour or so, though obviously by taking the swab you've introduced a foreign object into the vagina. I was warned they may not induce as I was 37 weeks and my main membranes were intact, but there was fluid coming from somewhere. >Yup. There was a case locally recently where they refused induction >post 37 weeks, mangled the expectant management (no swab, Mum was >GBS+). Baby delivered by EMCS 60 hours later. Stillborn :( The >trust concerned (no, not my local one, for once) are being dragged >through the coals as they were *not* following NICE guidelines. They are saying that the baby was stillborn due to the GBS?? That makes no sense...just doesn't make any sense. First....it is not that common for baby to contract GBS even if mother is colonized. Even if mom IS colonized, there are risk factors that increase mother's risk (one of which is delivery before 37 weeks). If baby were to become terminally colonized with GBS...it would have to be systematic, and baby would have shown signs LONG before it's demise through it's heart tones. Early onset of GBS infection in the newborn is not fatal that often. Late onset of GBS is much more likely to be fatal....and 75% of late onset GBS is not contracted from the mother but from other sources (such as hospital personnel). Let me put out some real numbers... if nobody was screened...and nothing was done...any single mother has only a .15% risk that her baby would contract early onset GBS. The odds of any single mother having a baby DIE from early GBS, without any screening or anything, is only .0225% (and that's using the worse case scenario...in other words, that's assuming that 40% of women are colonized when it's estimated that 15-40% are colonized. this is taking the worse case scenario with the statistics) So now you have to look at the odds of a baby being colonized with early onset GBS while still in utero and being stillborn because inutero warning signs weren't discovered until death had already occured. I just don't buy it. I think there HAS to be much more to the story than we know about... Stephanie Soderblom CLD CCCE CD(DONA) ICD Mesa, AZ Mommy to Mikael 5/9/95 - Kerstyn 8/6/99 - and Kevin 8/30/02 New baby due end of May 2005 Student Midwife Birth Doula / Childbirth Educator / Pregnancy and Birth Photography elfanieNOSPAM@soderblom.net http://www.birthdiaries.com - Birth Story Diaries=REAL BIRTHS = REAL PHOTOS >I just don't buy it. I think there HAS to be much more to the story >than we know about... Oh, I agree. I've been trying to find out a bit more, as it happens. I don't buy the GBS explanation either, not for a stillbirth. Cord prolapse is much more likely. Megan -- Seoras David Montgomery, 7th May 2003, 17 hours. http://seoras.farr-montgomery.com EDD 11th March 2005 (another boy!) >>>I'm thinking WHO recommendation is 96 hours, i.e. 4 days, which means you >>>need to get things started within 48. [quoted text clipped - 3 lines] >memory fails me, what does NICE stand for and does WHO have a >reccomendation? NICE is teh National Institute for Clinical Excellence and they make the recommendations that the NHS is supposed to follow. The 96 hours thing came from them (and is widely ignored, unfortunately). I don't think WHO tend to go into things like induction after SROM, but you may be getting confused with the WHO code on marketing infant formula. Megan -- Seoras David Montgomery, 7th May 2003, 17 hours. http://seoras.farr-montgomery.com EDD 11th March 2005 (another boy!) > NICE is teh National Institute for Clinical Excellence and they make > the recommendations that the NHS is supposed to follow. The 96 hours [quoted text clipped - 3 lines] > but you may be getting confused with the WHO code on marketing infant > formula. Thanks I was fairly sure there was a guideline from somewhere none british, but whether it was another country or a global organisation I'm not sure. "Nan" <nlb63@yahoo.com> wrote I was allowed to labor on > my own for over 35 hours before I consented to Pit. Unfortunately it > didn't do much more than make me miserable, and completely wear me > out, which resulted in the second section. > > Nan We did wait a bit (a couple of hours) and I was actually nervous that contractions would start- so I guess one thing going through my mind was the midwife was confident with Pitocin being the best option, and it gave me a sense of control- they said they'f go ahead and start the epidural when I gave the word, and there was NO sign of labor starting yet-- to me, and this is no excuse, I felt like I wanted to take some action-- water was pouring out of me, just flooding. So I wasn't disagreeable to getting something started. I trusted the midwife's confidence in the Pitocin and did ask her about increased risk of C-section (and also about the epidural leading to the same by slowing things down too). She didn't think it was any more likely. I don't know....the Pitocin contractions were painful, I can't imgaine a natural labor being THAT much worse.......the worst for a first-time mother giving birth was how I discovered when the pain was at its worst, THAT was when they instructed me to bear down and push! It was true, it did really make the pain better, which was unbelievable to me! But I never felt any "urge" to push at all. I pushed when told to do so, never felt an instinct to push....I was pushing when there were no contractions on the monitoring equipment and they kept telling me that was not productive, hold my energy and push when the machine indicated a contraction and I could feel my uterus tighten. I remember being in the middle of labor and saying "What? I can't just push now? Or now? I want to push this baby out!" and they kepy telling me to wait for the contractions. Lol. > I don't know....the Pitocin contractions were painful, I can't imgaine a > natural labor being THAT much worse....... Naturally occurring contractions are likely to be *less* painful than Pitocin-induced contractions. Best wishes, Ericka >> I don't know....the Pitocin contractions were painful, I can't imgaine a >> natural labor being THAT much worse....... > > Naturally occurring contractions are likely to be *less* >painful than Pitocin-induced contractions. The natural ones were less painful for a longer period, when I was in labor with ds. They came hard and fast during transition, but the pit-induced contractions hurt very early this last time. Nan >> Naturally occurring contractions are likely to be *less* >>painful than Pitocin-induced contractions. > > The natural ones were less painful for a longer period, when I was in > labor with ds. They came hard and fast during transition, but the > pit-induced contractions hurt very early this last time. I don't think my contractions got any more painful after I was hooked up to the drip, what I mean is I got contractions straight away from the drip and they HURT, the only change was them getting longer (and they weren't short to start off with) and the gap between them vanishing, they didn't get less painful when the drip was stopped for a while, just spaced out a bit, like 1+min on and less than 2 off even after over an hour of no drip. Is it usual for contractions to be close together with pitocin? I think the longest from the start of one to the start of the next was about 4 minutes for me and that long was a rareity. > Why does changing pediatricians change your choice of OBs? That seems odd. > My insurance carrier doesn't care at all whether my physician, my husband's > physician, or my kids' physician are associated with the same group or > not--all it cares about is whether that physician has an agreement with the > insurance company. Exactly. I had Jessica at a hospital (well, outside of it ;) that my pediatricians don't have privledges at. It didn't matter at all. I had the attending ped check her then my office wanted to see her within a week. As long as the ped is in your insurance network it doesn't matter. JennP. > > I wonder every day what it would have been like if they hadn't > > induced me with Pitocin (my water broke and I didn't have [quoted text clipped - 3 lines] > induction? I have to tell you that the tendency on induction after ROM is to > jump the gun quite a bit. I was Group B Strep negative, my waters broke at 4 am and they had me come in no later than 5:30 am and they started inducing me right away! They took it slow....using small doses of Pitocin at first, but it was not presented as an option to me- although the midwife did say it like this: "I think it best to go ahead and start the induction so we'll get you ready and start up that Pitocin, okay?" I guess you could say that was a choice, but she said she did not want it to go longer than 4 hours. ?? I don't know why or where the 4 hours came from. She just said that was her personal preference. I had no experience, and I did agree to this. I didn't think Pitocin would really be THAT painful since she said it was no big deal, but OUCHIE! With the epidural it was fine though. > I was Group B Strep negative, my waters broke at 4 am and they had me come > in no later than 5:30 am and they started inducing me right away! That is quick to get things started, you may well have gone into labour naturally within a few hours and that would have made things much easier. For me I was fairly sure I wouldn't go natural as I was in early labour, I'd had a show was having contractions about once every 3 minutes which were mildly painful, I think if things were going to happen they would have happened quite quickly after the waters broke. >>> I wonder every day what it would have been like if they hadn't >>> induced me with Pitocin (my water broke and I didn't have [quoted text clipped - 11 lines] > induction so we'll get you ready and start up that Pitocin, okay?" > I guess you could say that was a choice, That's a very aggressive treatment regimen for ROM and needlessly so. It's worth getting checked when your waters break simply to be sure there hasn't been a prolapse of the cord, but there's truly no harm in waiting at least 18 hours after ROM to start induction. If you go for more than 18 hours with your waters broken, it might not be a bad idea to start prophylactic antibiotic doses every 4 hours or so (they'll do this if your GBS status is unknown for sure; you might have more leeway with a GBS- screen, although a negative screen really just means you were negative at the time you were screened, not that you're certainly negative now), but even then, induction isn't strictly necessary. It is, however, *very* common for women to be induced within a few hours of ROM and most practitioners think nothing of it. So it's not surprising to me that it wasn't presented to you as optional. > but she said she did not > want it to go longer than 4 hours. ?? I don't know why or where the > 4 hours came from. She just said that was her personal preference. I'm not sure where it came from, either, but it probably goes back to the long-standing (but medically unsupported) preference among practitioners for mothers to give birth within 24 hours of ROM. > I had no experience, and I did agree to this. I didn't think > Pitocin would really be THAT painful since she said it was no big > deal, but OUCHIE! I have not met very many practitioners who were willing to allow that pitocin-induced contractions are more painful, on average, than spontaneous contractions. There is a very high level of denial in the medical community about this, IMO. There are piles and piles of research evidence showing that women report more painful contractions when induced with pitocin, that rates of analgesia go up with induction, and so on. Yet the people who are advising women on whether or not to be induced still claim there's no difference between spontaneous and induced labor. Makes me want to scream! > With the epidural it was fine though. Sure, but the epidural has potential problems of its own. On the whole, avoiding induction gives you a better shot at avoiding the risks of an epidural because you're less likely to *need* the epidural. And that's a statistical fact! -- Be well, Barbara Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7) Tolerance, equality, and personal liberty *are* moral values! All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman > I have not met very many practitioners who were willing to allow that > pitocin-induced contractions are more painful, on average, than [quoted text clipped - 8 lines] > advising women on whether or not to be induced still claim there's no > difference between spontaneous and induced labor. Makes me want to scream! interesting a few weeks ago I was talking to a midwife who works on the delivery unit at our local hospital, she said they offer epidurals to women who are induced before they even start the pitocin, other women have to ask! "Anne Rogers" <annekh23@yahoo.co.uk> wrote> interesting a few weeks ago I was talking to a midwife who works on the > delivery unit at our local hospital, she said they offer epidurals to women > who are induced before they even start the pitocin, other women have to ask! My midwife told me before Pitocin was started that I needed to let her know as soon as I wanted the epidural and she'd get it to me. She knew I'd want it as soon as the pain got too bad. She also knew I wanted to wait and see if it was necessary. She told me she was starting with a small amount of pitocin and having in increased very gradually to attempt to prevent the pain from hitting so hard and fast. It wasn't too bad on the beginning dose, and when she decided to increase it, she let me go ahead and get the epidural put in beforehand- I was already starting to feel like I was having bad menstrual cramps and I was pretty sure I wanted the epi before she turned up the Pitocin. I know I sat for a few hours with the Pitocin drip and with the epidural, only 2-3 cm dilated, and she went out to lunch with her son (the midwife did....this was on Mother's Day, and I told her to go ahead , it was great with me, I told her to take her time since nothing much was happening)......when she came back she checked me and I was still 2-3 cm. Just about an hour later, I was fully dilated! Pitocin must be some stuff, to do that. > My midwife told me before Pitocin was started that I needed to let her > know > as soon as I wanted the epidural and she'd get it to me. She knew I'd want > it as soon as the pain got too bad. She also knew I wanted to wait and see > if it was necessary. which is the approach I chose to take and I certainly have no regrets, next time I'd rather do it without an epidural but in all honesty I think if I did have to be induced and I knew the baby was quite small and in a good position I'd just go ahead. If I was at all concerned about the size of the baby (for me that would be 7lb as I only know I can deliver <6lb), or there was any indication it was in a bad position I would be much more determine to do it without. Ultimately the best way is not to be induced and I'm reasonably confident that there is much lower risk of that happening this time round. > I have not met very many practitioners who were willing to allow that > pitocin-induced contractions are more painful, on average, than spontaneous > contractions. There is a very high level of denial in the medical community > about this, IMO. My midwife was at least honest about this. Of course, I would never say that my midwife wasn't honest about anything--- I consider her to be very upstanding. The only thing I wasn't happy about as I've said many times was just that she knew well ahead of time I wanted pain relief to be as complete as possible, and then when I was in pain she lagged around on getting them to redo my epidural when it wore off. But, everything she did, she did honestly and with the best of intentions. She wouldn't say in so many words that Pitocin makes it hurt worse, but she said that Pitocin does bring on harder and faster/cloer-together contractions, and that WOULD hurt more. Basically, the same thing, without badmouthing Pitocin. Lol. But I found what she said to be very true, I went from feeling nothing (before the epidural) to feeling harder and more frequent contrations very quickly and then you bet I asked for the epidural. I wish, in a way, I'd have sat around that day for a few more hours just to see if contractions did start on their own, but I don't regret the way it happened, it's all fine with me. It wasn't too bad and it ended well. > Anyway, I'm just wondering, I will never know till I get there, but I was > wondering what the chances are of if I go into labor naturally, and have > actual contractions without Pitocin....I wonder if a natural labor would > feel as bad as the Pitocin-induced contractions? Most people who've had both report that natural contractions are significantly easier to cope with than Pitocin-induced contractions. In addition, most people find that first labors are much longer and more challenging than subsequent labors. Obviously, there are plenty of exceptions, but it is a common pattern among multips to have a lot of early labor that is not terribly difficult to cope with (days of irregular contractions that are more irritating than terribly painful) following by an active labor that is quite short and to the point. I think that statistically, second labors tend to be about half as long as first labors, but 18 hours is longer than usual for a first labor. Of course in my case, I went from a 45 hour first labor to a 2.5 hour second labor ;-) Many more women go unmedicated in subsequent labors than in first labors. Best wishes, Ericka > I have said before that if I DIDN'T have the Pitocin, I MIGHT have > been able to have a med-free labor, IF it didn't last 18 hours. So if > my second one is faster, AND my waters don't break early with no > contractions-- if I go into labor naturally, I am wondering if I can > (happily) make it through a natural labor. I've never had pitocin so I can't compare. I found the second labor easier just because I knew what to expect, so was more mentally prepared and less panicky. 'Happily' making it through depends on how much pain you are willing to endure and how important it is to you to go med free. It still hurt but the pay off for me was worth it because I really didn't want an epidural. Had I not cared if I got an epidural it might not have been worth it because it certainly wasn't pain free. It was very tolerable though :-) since we > changed pediatricians I would deliver in a different hospital which > is equidistant from my house anyway. Since that's where the new > pediatricians work. Using this hospital means I can't use the > midwives or the old OBs, I'd be all new. You probably don't have to do it that way if you don't want to. Your new ped probably has privileges at all the area hospitals and if he doesn't there will be one there that can do the in hospital check over and then you can do all the regular follow-ups with the ped of your choice. I'd definitely pick the hospital, OB's etc. based on a good match with labor, birthing, prenatal care etc. and not on the ped.  SignatureNikki "Nikki" <kavanagh@iw.net> wrote I found the second labor easier > just because I knew what to expect, so was more mentally prepared and less > panicky. 'Happily' making it through depends on how much pain you are [quoted text clipped - 3 lines] > it because it certainly wasn't pain free. It was very tolerable though :-) It is not important to me to have a med-free labor.....I don;t mind an epidural at all, I thought it was great, and it had no side effects except pain relief. I could feel my legs and move around, and didn't feel anything but alert etc. But if I didn't need one, I could pass one up. >I am planning to start TTC in May of 2005. It really all depends on when > Rachel weans so it may be a bit after that-I'm not weaning her to have a > second, but at 1 year when she can have regular milk I plan to start the > weaning if she hasn't already. I am not even planning on TTC before she is > 1 > year old. Hi Jill, from that paragraph, I assume you are using some kind of birth control now? If it were me in your situation, I would ditch it, you are unlikely to concieve quickly whilst still breastfeeding anyway and it saves either shoving chemicals into your body or have to faff every time. You'd probably end up conceiving at around the time you want to anyway. >> I am planning to start TTC in May of 2005. It really all depends on >> when Rachel weans so it may be a bit after that-I'm not weaning her [quoted text clipped - 9 lines] > to faff every time. You'd probably end up conceiving at around the > time you want to anyway. No Way!!!! Unless you are prepared to be pregnant next month - don't give up the birth control yet ;-) I don't know what faff is but we manage with condoms to avoid the hormones and chemicals. There is also NFP but I'm not that meticulous. I was breastfeeding Hunter 10 times a day (including at night) when I conceived on the first try. SignatureNikki >> Hi Jill, from that paragraph, I assume you are using some kind of >> birth control now? If it were me in your situation, I would ditch it, [quoted text clipped - 8 lines] > not that meticulous. I was breastfeeding Hunter 10 times a day (including > at night) when I conceived on the first try. Jill hasn't mentioned that her cycle has returned, but then we don't all shout about it! I suppose what I was saying is that given that I was planning to concieve I would accept the risk. By faff I was meaning condoms, I hate them myself, so that means chemical, or even more faff by using a diaphragm for me. We hadn't decided to concieve, so I did end up going on the mini pill, I'm happy with how things worked out as I've had the time to make my own decisions, but if I had know I wanted to TTC in the near future when Nathanael was 6 months old I wouldn't have bothered. > By faff I > was meaning condoms, I hate them myself, so that means chemical, or [quoted text clipped - 3 lines] > decisions, but if I had know I wanted to TTC in the near future > when Nathanael was 6 months old I wouldn't have bothered. If you just want to avoid chemicals, there's always non-hormonal IUDs. I have a copper-T and have had for about 2.5 years now. It's my favorite form of birth control, hands-down. Nothing to remember, nothing to forget, no faff! And when you're ready to conceive, you can just have it removed. What could be simpler? -- Be well, Barbara Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7) Tolerance, equality, and personal liberty *are* moral values! All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman > If you just want to avoid chemicals, there's always non-hormonal IUDs. I > have a copper-T and have had for about 2.5 years now. It's my favorite [quoted text clipped - 3 lines] > What > could be simpler? sounds very simple, the problem is that each month you could concieve and then that embryo is not able to implant, which doesn't fit in with by ethical/moral standpoint and I don't think there's much chance of my opinion changing on that matter and there is zero chance that my husband would ever let me get one even if I did change my mind. >> If you just want to avoid chemicals, there's always non-hormonal >> IUDs. I have a copper-T and have had for about 2.5 years now. It's [quoted text clipped - 8 lines] > fit in with by ethical/moral standpoint and I don't think there's > much chance of my opinion changing on that matter Well, you should understand that there is *also* a chance of this happening when you're using minipills, then. Oral birth control pills work primary through suppressing ovulation and therefore preventing conception, but they aren't perfect and in quite a few cases, they secondarily by making the uterine environment hostile to the implantation of a fertilized egg. So you're not in the ethical/moral clear here if you have a problem with the idea of preventing an embryo from implanting through contraception. Moreover, the current research evidence suggests that IUDs very rarely work by this method. It was previously thought that the primary mechanism for IUDs was in preventing implantation of fertilized eggs, but recent studies seem to show that IUDs actually work primarily by preventing conception (possibly by making the sperm get "lost" and/or by increasing the mucous layer at the entrance to the cervix, thus keeping sperm out altogether or a combination of these factors). I believe one study that followed women with IUDs over a period of a year or so found no evidence that any of them conceived during that period (conception can be tentatively identified by hormone levels, even if implantation doesn't occur; none of these women had any increase at all in their HCG levels which might indicate a conception). And that really makes sense because an IUD is a tiny thing, much smaller than many fibroids, and yet women with fibroids rarely have trouble achieving pregnancy. So there must be something *else* about the IUD that's making it work! > and there is zero > chance that my husband would ever let me get one even if I did > change my mind. I'm sorry, but I truly don't get this. If you researched it and decided that an IUD would be the most effective and safest possible form of birth control, I can't imagine why your husband would object, especially given that it wouldn't affect him at all. Of course, my husband objects to the idea of any surgical form of birth control because he doesn't like the finality of it. I respect that and haven't gotten "fixed", but then, I don't really *want* to do anything permanent, either. So we see eye-to-eye. But if we *didn't* see eye-to-eye, frankly, I wouldn't let another person, even my beloved spouse, dictate to me what I could do with *my* body. -- Be well, Barbara Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7) Tolerance, equality, and personal liberty *are* moral values! All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman > Well, you should understand that there is *also* a chance of this > happening [quoted text clipped - 5 lines] > you're not in the ethical/moral clear here if you have a problem with the > idea of preventing an embryo from implanting through contraception. I was led to understand that the minipill mainly worked by thickening of cervical mucous, so we agreed that it was the best way forwards, we later realised that this wasn't the whole truth, but I didn't stop them instantly, I guess we thought it would be worse to conceive an unwanted baby, I set my limit to be the end of the current pack, before we got that far we'd decided to TTC anyway. > Moreover, the current research evidence suggests that IUDs very rarely > work [quoted text clipped - 17 lines] > that's > making it work! now that is interesting, it's not very helpful when leaflets and family planning doctors give out the wrong information is it! >> and there is zero >> chance that my husband would ever let me get one even if I did [quoted text clipped - 5 lines] > control, I can't imagine why your husband would object, especially given > that it wouldn't affect him at all. well given the information you provided above, he could well change his mind, I was a little rash, it never occured to me that IUDs didn't work this way as I've heard it in so many places. With the information he would make an informed decision. > Of course, my husband objects to the idea of any surgical form of birth > control because he doesn't like the finality of it. I respect that and [quoted text clipped - 3 lines] > frankly, I wouldn't let another person, even my beloved spouse, dictate to > me what I could do with *my* body. We've discussed surgical options, but it's not for us yet, we're both very happy that we are unlikely to want any more for several years, but we're not ready to say never. We generally do see eye-to-eye, so it's not usually an issue, but I do let DH tell me what I can and can't do if it comes to that, after all I promised to "love, honour and obey", he promised to "love, honour and cherish", he's doing a good job of cherishing me, which means I've had little need to worry that he would order me to do or not do something that wasn't the best thing for me. I currently can't think of any time when this has come up, other than in very minor ways, where he really has been right. we'll see what happens after this one arrives, we'll have to think of something, our options are quite limited as the combined pill sends me nuts and condoms are a mutual dislike > now that is interesting, it's not very helpful when leaflets and > family planning doctors give out the wrong information is it! Well, in their defense, I think this information is all pretty recent and it often takes some time for the medical field to begin disseminating new information. Here are a couple of interesting passages on the possible ways IUDs work that I thought you might like to read and/or share with your husband if at some point in the future you want to get away from hormonal/chemical contraceptives: From http://www.fhi.org/en/RH/Pubs/factsheets/mechact.htm: "Despite years of study, the precise mechanism of contraceptive action of intrauterine devices (IUDs) remains somewhat unclear. Relevant investigations in humans are difficult to conduct, and extrapolating from animal studies is not always meaningful. The high efficacy of IUDs in humans may stem from more than one mechanism of action. This section will summarize the evidence concerning potential mechanisms of action in humans and describe the conclusions of expert panels on this issue. IUDs, especially the now most widely used copper containing IUDs (TCu-380A and Multiload) hinder ascent of sperm to the fallopian tubes (where fertilization occurs) or reduce the ability of sperm to fertilize an egg. Several studies have shown that IUDs influence the number of sperm reaching the uterine cavity and the fallopian tubes. The sterile foreign-body reaction in the uterine cavity causes both cellular and biochemical changes that may be toxic to sperm. There is also evidence that the copper released from the IUDs may have a toxic effect on the sperm. Investigators have done flushing studies of the uterine cavity and fallopian tubes after exposure to semen. Women using IUDs had lower concentrations of sperm in the uterus and tubes than did women not using IUDs. In addition, the sperm found in women using copper IUDs were likely to be damaged and not able to fertilize. Thus, the evidence suggests that fewer sperm reach the site of fertilization in women using IUDs than in women who are not using the device, and, for women using copper devices, the sperm may not be able to fertilize the egg. This effect on the sperm is considered the main mechanism of the IUD's contraceptive action." And from http://www.wdxcyber.com/ncontr07.htm: "A popular idea about IUCDs that has limited their acceptance by many women is that the way in which they prevent pregnancies is by acting as an abortifacient. That is, they prevent fertilized eggs from implanting in the endometrial lining. More recent studies, however, suggest that the copper IUD prevents fertilization of the egg. It somehow blocks the sperm from getting to the faloppian tube and those that do are damaged and thought not capable of fertilization. Also supporting the concept of not being an abortifacient is that super sensitive pregnancy tests show that women without any contraception have much higher rates of slightly positive HCG levels and do not end up being clinically pregnant. Women with IUDs have very low rates of low level positive pregnancy tests. No one could ever say for certainty that IUDs do not cause early abortion but the best evidence suggests that is not the primary mechanism by which they work." -- Be well, Barbara Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7) Tolerance, equality, and personal liberty *are* moral values! All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman "Circe" <guavaln@yahoo.com> wrote But if we *didn't* see eye-to-eye, > frankly, I wouldn't let another person, even my beloved spouse, dictate to > me what I could do with *my* body. I don't see eye to eye with the midwives and OB's. The OBs: don;t seem to understand the caliber of headaches I get with ALL pills (I am a migraine sufferer). And they dont get that I wouldn't want to wean anyway for the Pill, and the minipill is one of the most headache-inducing for me. The midwives really push the diaphragm! I was surprised. I am NOT interested in that. Also they push IUDs. I just don't want anything inserted into me. I don't like the idea of it. And that's that. Condoms with spermicidal jelly work for me and my husband. > If you just want to avoid chemicals, there's always non-hormonal IUDs. I > have a copper-T and have had for about 2.5 years now. It's my favorite [quoted text clipped - 3 lines] > What > could be simpler? the slight side issue is that the family planning people here get very cross with you if you want it removed in less than 2 (or maybe it's even more than that) years, and though when Nathanael was 6 months old we wanted to delay things we didn't want to delay things that much, so none of the longer term chemical options were available either. >> If you just want to avoid chemicals, there's always non-hormonal IUDs. I >> have a copper-T and have had for about 2.5 years now. It's my favorite [quoted text clipped - 7 lines] >with you if you want it removed in less than 2 (or maybe it's even more than >that) years Are you kidding me?? I can understand that with the Mirena IUCD (the hormonal one), as that's very pricey & hence not a terribly cost-effective option if a woman has it taken out too quickly (although even then, two years sounds like reasonable value for money to me - and, besides, it should ultimately be your decision anyway!). But the non-hormonal IUCD is cheap as chips, and even our cash-strapped NHS should be able to deal with women using it for a relatively short-term method of contraception. All the best, Sarah Signature"I once requested an urgent admission for a homeopath who had become depressed and taken a massive underdose" - Phil Peverley >>the slight side issue is that the family planning people here get very >>cross [quoted text clipped - 9 lines] > cheap as chips, and even our cash-strapped NHS should be able to deal with > women using it for a relatively short-term method of contraception. I may be confused, but that was certainly the impression I got when talking to the family planning people. > If you just want to avoid chemicals, there's always non-hormonal IUDs. I still go 'huh' when I see IUD written in reference to the contraceptive device. I've always been taught an IUD is an Intrauterine Death, the contraceptive is a IUCD, intrauterine contraceptive device. What does the IUD stand for there? Just Intrauterine Device? Andrea >> If you just want to avoid chemicals, there's always non-hormonal >> IUDs. [quoted text clipped - 4 lines] > contraceptive device. What does the IUD stand for there? Just > Intrauterine Device? <Grin> Yeah. In the States, they've always been called Intrauterine Devices, not Intrauterine Contraceptive Devices. -- Be well, Barbara Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 7) Tolerance, equality, and personal liberty *are* moral values! All opinions expressed in this post are well-reasoned and insightful. Needless to say, they are not those of my Internet Service Provider, its other subscribers or lackeys. Anyone who says otherwise is itchin' for a fight. -- with apologies to Michael Feldman *Unadulterated Me wrote: *>> If you just want to avoid chemicals, there's always non-hormonal *>> IUDs. *> *> I still go 'huh ' when I see IUD written in reference to the *> contraceptive device. I've always been taught an IUD is an *> Intrauterine Death, the contraceptive is a IUCD, intrauterine *> contraceptive device. What does the IUD stand for there? Just *> Intrauterine Device? * *<Grin> Yeah. In the States, they've always been called Intrauterine Devices, *not Intrauterine Contraceptive Devices. and I've usually seen "intrauterine death" charted as "fetal demise" or FD. FWIW. SignatureHillary Israeli, VMD Lafayette Hill/PA/USA/Earth "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." --Groucho Marx >By faff I was meaning condoms In the interests of avoiding potential future embarrassing American-British misunderstandings, I would like to point out that 'faff around' is a general term meaning 'mess around, go to the trouble of', and, although used to discuss condoms in this instance, has nothing specifically to do with them when used in other contexts. ;-) All the best, Sarah Signature"I once requested an urgent admission for a homeopath who had become depressed and taken a massive underdose" - Phil Peverley > >By faff I was meaning condoms > [quoted text clipped - 7 lines] > > Sarah Thanks for the explanation - Anne's posts seemed to imply otherwise, but also make perfect sense with that explanation! Irene >> By faff I was meaning condoms > [quoted text clipped - 7 lines] > > Sarah And us Aussies use the term "piss-fart arount" for the same thing ;) Jo (RM) > And us Aussies use the term "piss-fart arount" for the same thing ;) And the NZ equivilant to this would be 'piss-arsing around', although 'faffing around' is quite often used as well. Andrea > Jill hasn't mentioned that her cycle has returned, but then we don't all > shout about it! You must have missed it. it was buried in some long diatribe I wrote. Lol. AF did come back at *4 month postpartum*, I have had 2 periods and am expecting a 3rd any day now. It sucks! Cramps are back and everything, really even as bad or worse than before. I get really tender so nursing feels yucky, but I suffer through it. It is not really suffering, just mild moodiness and not feeling 100% to nurse. I use Lanolin when I never needed it before- it really helps with the tenderness. Unlike what I was told by a lactation consultant to expect, Rachel doesn't seem to notice and lose interest at all for those few days, and my supply doesn't seem to dip. She said it would be saltier and rachel may get fussy but so far I don't notice anything except-- the PMS beforehand is NOT fun, and nursing through AF isn't fun either- but it's not bad- Just feel tired, a little sore , and just want to nap (alone). I was horrified and griped when AF came back so soon while I was nursing exclusively, just because I get bad PMS. Moody, tired..... > AF did come back at *4 month postpartum*, I have had 2 periods and am > expecting a 3rd any day now. bad luck! mine came back quite early too, 4.5 months, but at least my cycles were really long, like 8 weeks for the first few. *either shoving chemicals into your body or have to faff every time. You'd "faff" ?? SignatureHillary Israeli, VMD Lafayette Hill/PA/USA/Earth "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." --Groucho Marx > *either shoving chemicals into your body or have to faff every time. You'd > > "faff" ?? sorry I'm fairly good at "American" but I didn't know that "faff" was English not American! faff is a verb used to describe a sort of unnecessary/unwanted/disruptive activity, so I might say "It's such a faff having to sterilise bottles every day", in this case I meant that using a condom or a diaphragm was just awkward, time consuming, has to be in the right place at the right time etc. >> *either shoving chemicals into your body or have to faff every time. You'd >> [quoted text clipped - 7 lines] >day", in this case I meant that using a condom or a diaphragm was just >awkward, time consuming, has to be in the right place at the right time etc. Cool word. I might have to use it on dh and see if he notices ;-) Nan > Cool word. I might have to use it on dh and see if he notices ;-) it's useful if someone is being slow getting ready to go out, doing things that don't really need doing, but not doing the things that do, just yell "oi, stop faffing" >> Cool word. I might have to use it on dh and see if he notices ;-) > >it's useful if someone is being slow getting ready to go out, doing things >that don't really need doing, but not doing the things that do, just yell >"oi, stop faffing" Hah, perfect for the days I'm trying to get the 4 year old out the door and on to school ;-) Nan > "oi, stop faffing" In our house the phrase is 'Stop faffing around or you'll miss that bloody bus' heard almost every weekday at 5 minutes before 8. Andrea > Hi Jill, from that paragraph, I assume you are using some kind of birth > control now? Yeah, but not pills. I don;t do well with ANY kind of pill I have tried, I can't tolerate them. They all give me headaches. I don't know what the brand names would be outside the U.S., but I have tried several brand incuding progestin-only (the minipill-Micronor) and it gives me the worst migraines. So does OrthoTriCyclen, Lo-Ovral, Alesse etc. I had the least bad side effects from Mircette but, still, it increased my headaches. So for me, birth control isn;t the Pill. :) > I wonder every day what it would have been like if they hadn't induced me > with Pitocin (my water broke and I didn't have contractions, just hours of [quoted text clipped - 3 lines] > the worst, endometriosis-menstrual cramps I have ever had. The Pitocin did > make it miserable and prolonged. I was induced with Pitocin for the same reason, but I refused an epidural. I found that having my doula squeeze a spot on my feet during each contraction really helped reduce the pain. I also was encouraged to scream. Hopefully, I won't need to be induced with this pregnancy (or end up with an emergency c-section). *So, yeah,,,,,TTC in May hopefully........................since we changed *pediatricians I would deliver in a different hospital which is equidistant *from my house anyway. Since that's where the new pediatricians work. Using *this hospital means I can't use the midwives or the old OBs, I'd be all new. You would switch your OB/midwife and chosen hospital for delivery just because your pediatrician doesn't have privileges at a particular place??? Is that typical in your neighborhood? It seems to me almost everyone I know delivers at one of two local/regional hospitals, yet uses pediatricians who do not have privileges there. There is no reason (IMO) for a baby to see his/her own pediatrician within 48 hrs of birth, as long as there is a qualified ped available for an initial assessment -- and frankly I'd rather choose a hospital based on other factors (like presence or absence of a high quality NICU, presence or absence of amenities, presence or absence of my chosen obstetric caregiver...) -h. SignatureHillary Israeli, VMD Lafayette Hill/PA/USA/Earth "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." --Groucho Marx >*So, yeah,,,,,TTC in May hopefully........................since we changed >*pediatricians I would deliver in a different hospital which is equidistant [quoted text clipped - 11 lines] >or absence of a high quality NICU, presence or absence of amenities, >presence or absence of my chosen obstetric caregiver...) I chose the hospital I delivered both girls at, partially based on the fact that I try to avoid the more local hospital at all costs. The standard of care is too low for my taste, among other things. My GP didn't have privileges at the hospital I delivered at, but the staff ped. was good, and I was able to take dd1 to see the GP for her care once she was released. This time around my OB team are our GP docs, so we're able to keep it all in one place which is handy. But I'd prefer using the hospital my OB team would practice at over the ped, if I had a decision to make in that regard. Nan |
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