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Daffy2016

Birth option help

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Daffy2016

I’m currently really confused about the information I’ve been given from the hospital and would appreciate EB’s collective wisdom.

Im currently 32 weeks, booked at Flinders public in SA. This is my second and I had my first in Canberra in a very different environment.

From the beginning I’ve been designated high risk - I’m not sure why other than I had GD with my first. I have it again, diet controlled, but have been told I can’t see the midwives and have to see OBs. That’s fine, I understand each hospital has different profiles.

However the OB I saw today (my first since 20 weeks) was describing what would happen in labour and she said I’d be allowed to move around in labour but would have to be on my back in stirrups for the birth to ‘guard the perineum’. She didn’t have reasons for this other than that’s what they do. There’s also no bath/pool available as those are only for low risk women.

Part of this is moot as DS is currently breech so I will likely end up with a c section anyway, but this is the latest incident where I feel confused about what options I have, and the care I’m getting. While everyone I’ve seen is lovely I never get answers on why I’m seeing an OB or a medical registrar or whoever I need to see that day - I just get a card in the mail with an appointment time when I have to turn up, and if I call and ask the reception people say they can’t tell me.

Sorry for the very long post, but I’m hoping someone might have some advice on what I can do from here to feel more supported or at least be clearer on my options. I’d like to be active in birth if I labour, not stuck on my back!

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Dianalynch

No advice from me, there’s a lot of posters who know a lot, but when reading your post I did wonder about your age, risk goes up with age, and I thought other posters may want to know in case it’s a factor 

when I had dd I was 34, ds at 38, there were differences 

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Soontobegran

Women just do not give birth in stirrups anymore unless there is an extremely difficult birth so I would really double check what this OB has said. As for guarding the perinuem......my gosh, I have not heard that terminology used to a patient since the 70s.

Do you have the choice to go elsewhere or you could actually call the NUM of the delivery suite and tell her what you've been told. You may have just struck someone who really had no clue.

Good luck.

 

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Daffy2016

Thanks @Dianalynch and @Soontobegran. I was sort of taken aback and didn’t really know what to say. She was around my age so shouldn’t be that out of touch?

The only way I can speak to someone is to call the birthing unit - there isn’t a helpline as such, and I hate to bother them. I did call a while ago with a question and they said they couldn’t give advice specific to my case and I had to wait for my next appointment, but maybe that was because I was around 20 weeks?

Unfortunately in SA you can’t choose where you go unless you’re private.

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Soontobegran

Do not worry about calling the birthing unit. They will be well used to getting questions phoned through to them and I think it is important for them to know that this particular doctor is saying this stuff.

 

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Soontobegran

I just tried to look up maternity services to see whether they mention birthing options etc but it is such a clunky site to negotiate that I could not find anything.

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Daffy2016
6 minutes ago, Soontobegran said:

Do not worry about calling the birthing unit. They will be well used to getting questions phoned through to them and I think it is important for them to know that this particular doctor is saying this stuff.

 

Thank you, I’ll call tomorrow. I was too baffled to question her further at the time.

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Daffy2016
3 minutes ago, Soontobegran said:

I just tried to look up maternity services to see whether they mention birthing options etc but it is such a clunky site to negotiate that I could not find anything.

They don’t have anything online. When I asked today, she said the midwives give a tour but because I’m not seeing the midwives  I wouldn’t get one so she’d just describe it to me.

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Kallie88

I've had 4 "high risk" pregnancies - first designated as such because of high bmi,i did develop gd, diet controlled. So all my subsequent pregnancies were high risk because of previous gd, and well, the bmi hasn't improved either lol. so i only saw the midwives i think twice pre birth for all my pregnancies. if you get a midwife appointment before birth i'd just talk to them about what usually happens, or if you can, on the day. Sometimes the doctors are really out of touch with what happens in the birth suites. They also can't make you go in stirrups or any position if you don't want to. They might ask you to move in a certain way if the baby is showing distress, but literally even then, you need to consent (obviously not likely to not consent in that situation, but it is always your right). Good luck hun, my last is 2 months today, it's been a stressful year to be pregnant and having a baby xx

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Daffy2016

Thanks @Kallie88, I really needed to hear that! It’s been a shocker of a week so to be told this stuff today was just the sprinkles on the poo sandwich.

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PrincessPeach

I had diet controlled GD for my second pregnancy & was not classed as high risk for labour - yes my little mr had to have his blood sugars taken afterwards, but that was it.

Echoing everyone above about calling & asking answers on why you are being classified as high risk, keep pushing through departments until you get an answer.

Also I’d be telling that Ob to shove his stirrups where the sun don’t shine.

Edited by PrincessPeach
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tinselfoil hat

@Daffy2016 fingers crossed you don’t get that ob for delivery. Will you have any indication who you’ll have on the day? Or will it be midwives for the most of it? You can always always ask for someone else if you’re receiving care that you’re not comfortable with (or even better, get your partner to request someone else).

I’m sorry to derail the thread but have a question for @Soontobegran... what are some reasons stirrups are used these days? I was put into stirrups with DD. The birth was all going pear shaped but I was wondering if there was a individual reasons they were used as opposed to the baby just not coming out?

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Daffy2016

@tinselfoil hat no idea who I’ll get on the day. She said it would be midwives but the OB would also stop past, so maybe it won’t be too bad.

Of course, if DD stays breech then it will be a c section - but this whole thing means I’m less inclined to try turning him because I’d rather just get it over with and have a section and not have to fight for a reasonable labour experience.

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MadMarchMasterchef

Please give the birthing unit a call.  Unless its related to being high risk that doesnt sound right to me  ( 3 babies in SA public system, was 42 for the last).  I was not made to lie down.  I  didnt go to Flinders but I found the hospital to be really good with answering any questions I had.  They may have a social worker who can help advocate for you if you need some help getting answers. 

 

ETA I saw both midwives and OBs for appointments, mainly midwives for the births but several things were checked over by obs.  The midwives were wonderful 

Edited by MadMarchMasterchef
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Bono25

Not in sa, but I did end up giving birth on my back and my Dr agreed it contributed to my third degree tear, so I would avoid that if you can. I'd also be asking the midwives directly for a tour, you should know what you're walking into, not a description. 

 

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MadMarchMasterchef

Just had a thought, are you planning to have an epidural?   In that case they want you to stay on the bed, but usually dont make people stay on their backs, you could go on side, kneel etc. 

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Kallie88
2 hours ago, Daffy2016 said:

Thanks @Kallie88, I really needed to hear that! It’s been a shocker of a week so to be told this stuff today was just the sprinkles on the poo sandwich.

No worries hun, I hope it all goes smoothly for you either way. If you generally get a different doctor each time you can always bring any concerns up with them your next appointment too. I had one doctor take my request to have my tubes tied on the (unlikely) chance i ended up with an emergency c-sec and tell me i was much too young and might want more (i'm 31 with 4 kids, sorry mate i wouldn't be asking if i wasn't sure).  the next doctor I saw had seen in my notes that I'd asked and literally did the paperwork for me then and there, joy's of the public system i guess lol, but my birth experiences and care have all been pretty good

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Lou-bags

Gosh OP that sounds stressful. I don’t think I know anyone who birthed in stirrups- I’m as baffled as you are. I would definitely call the birth suite. It’s your right to have all the information you need for your own healthcare, and if the birth suite is the number they’ve given you then they will likely expect these kinds of calls to clarify things and ask for information.

Just on breech (I know you haven’t asked so apologies if this is an overstep), have they mention ECV to you as an option? Where they turn baby for you? I ask because I had one at 37 weeks with DS2 and it worked beautifully. Had him two weeks later, induced at 39 weeks. Was a great birth. 
 

Best of luck with getting the info you need to feel comfortable heading into birth. It’s stressful enough at the best of times ❤️

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Ozquoll

This may not be applicable as my pregnancy was high risk for a different reason, but I spent my labour either on my side or on my back. On my back was definitely more painful 😞. They had me hooked up to various monitors and I wasn't allowed to walk around at all unfortunately. I would have loved a water birth option too. As it was, it was a very short labour so I wouldn't have got much time in the water anyway! 

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Daffy2016

@Lou-bags she did tell me about an ECV, which is how the conversation started. I wanted to know what extra monitoring I would have if it was successful and I was in labour. She said none but then outlined what usually happened, including that they’d want me in stirrups. At the moment I feel like I wouldn’t bother with it if that’s my option, I’d just go for the section.

@MadMarchMasterchef We weren’t talking about epidurals at the time, although I did have one with DD and birthed on my back - it worked fine but it was at least a choice!

Thank you everyone for confirming this is odd. I’ll call in today and see what info I can get.

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QuirkyMum
14 hours ago, tinselfoil hat said:

@Daffy2016 fingers crossed you don’t get that ob for delivery. Will you have any indication who you’ll have on the day? Or will it be midwives for the most of it? You can always always ask for someone else if you’re receiving care that you’re not comfortable with (or even better, get your partner to request someone else).

I’m sorry to derail the thread but have a question for @Soontobegran... what are some reasons stirrups are used these days? I was put into stirrups with DD. The birth was all going pear shaped but I was wondering if there was a individual reasons they were used as opposed to the baby just not coming out?

I’m not Soontobegran but my friend asked her private OB this very question.

The answer was 

- if things aren’t going right and interventions are required( forceps etc)

I was asked if using stirrups was OK for quick stitching me up (2 degree tear) ( private hospital).

Previous birth in public hospital - repairs that should have been done under general on operating table ( 3rd degree tear and ruptured artery on cervix) were done without stirrups but I remember thinking there should be easier ways for a doctor( like fixing your ear and accessing it through half closed mouth).

A lot depends on a doctor I guess.

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tinselfoil hat
9 minutes ago, QuirkyMum said:

I’m not Soontobegran but my friend asked her private OB this very question.

The answer was 

- if things aren’t going right and interventions are required( forceps etc)

I was asked if using stirrups was OK for quick stitching me up (2 degree tear) ( private hospital).

Previous birth in public hospital - repairs that should have been done under general on operating table ( 3rd degree tear and ruptured artery on cervix) were done without stirrups but I remember thinking there should be easier ways for a doctor( like fixing your ear and accessing it through half closed mouth).

A lot depends on a doctor I guess.

Thank you so much @QuirkyMum!

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Lou-bags
8 hours ago, Daffy2016 said:

@Lou-bags she did tell me about an ECV, which is how the conversation started. I wanted to know what extra monitoring I would have if it was successful and I was in labour. She said none but then outlined what usually happened, including that they’d want me in stirrups. At the moment I feel like I wouldn’t bother with it if that’s my option, I’d just go for the section.

 

Oh dear!

My 2 cents/experience was that there were no differences in how my labour and delivery was treated because of the ECV. The only thing was it was one (of a few) factors in agreeing to a 39 week induction (he still had a reasonable amount of room to potentially change position again, despite being a baby elephant, due to my huge tummy and ab damage from prev pregnancy). 

I did deliver him on my back, actually, but it was largely my choice - I was oddly quite comfortable there and had no urge to change position which was a huge contrast from birth number 1. OB placed a pillow under my pelvis/lower back to help with the angle for getting him out easily (12 min of pushing and a repeat episiotomy as I don't appear to stretch well down there...). I didn't even need to have my legs held up in the air like last time (IIRC), I'm pretty sure my feet stayed on the bed.  But no stirrups until after, when I was having my epi stitched - which I wasn't actually paying much attention to by that point as I had my big boofhead to stare at. 

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Ellie bean

Yeah I definitely didn’t need stirrups after a successful ECV. 

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IamtheMumma

At 32 weeks, breech isn't an issue so put it out of your head. Bub can, and probably will, turn. 

Your consent is mandatory for everything. You choose what position you give birth in. Just because a doctor/midwife prefers something a certain way, doesn't mean it happens. Your birth is up to you. You most definitely don't need stirrups or your back as default birthing position.  If you want to birth in water, you can birth in the shower. GDM doesn't prevent that option for you. 

You can also request to see a midwife. Ring and ask to make an appointment with a midwife. Say you want to talk breastfeeding and then discuss whatever you like. 

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