How can one honestly determine, in advance,....

[jennyb]

I'd just like to share what just happened in my family-my sister in law was expecting her first baby on 8th December and was booked for a home birth. As the due date passed I started to worry-I spoke to the midwife who was well versed in the manouvers to resolve SD and who pointed out to me that whilst overdue babies can be at risk, induced babies are often more so. She felt that in the absence of any other risk factors the homebirth should go ahead as planned-my sister in law lives on a hill with her house only reachable down 70 steps and she wasn't going anywhere! I was reassured by this but it's always a worry.
Finally, labour started on 22nd December and 48 hours later (ouch!) baby Sebastian appeared at just before midnight on Christmas Eve, 9.5 pounds of red headed energy. So I'm an Aunty again and Catherine's firm resolve to give birth at home was vindicated-thank goodness. It is very hard to know how experienced a birth professional is and what they know about risk factors,more importantly, how they react to them. The home birth midwives group here have been very interested in having parent friendly info about risk factors available for them to discuss with parents and Karen Hillyer has provided me with some to get them started. Their view is to help parents make informed choices and I've been impressed with their attitude to me and awareness-very proactive and supportive of prevention of birth injury of all kinds. I'm hoping to continue this exchange of info and have now befriended the head of midwifery training (the majority of babies here are born with a midwife, like the UK obgyns are mainly for surgical and emergency cases) so hopefully more bpi relevant info can make its way directly into the training syllabus. She also liked the idea of regular update training, something I know the Erbs UK group have been doing with birth professionals there.
It's funny,despite being tbpi I get so much out of this preventative work for obpi and hope to get more involved as my kids grow up and need me less. Every little helps :0)
And welcome baby Sebastian from aunty Jenny!

[francine]

Jenny - congratulations on being a new auntie! and welcome littel Sebastian to the world! Thanks for reminding me to contact Karen to get copies of her stuff. I know it will be very helpful. So glad that things went well with Sebastian's birth.

-francine

[Sophie's Mom]

A few thoughts:
I trusted my doctor, but he wasn't able to make it to the hospital in time and we got a resident (we only had 20 minutes before sophie came). Educating parents is most important. Choosing a good HOSPITAL is another one.
My sister in law was pregnant with number 2. Since Sophie was born with OBPI, she asked her doctor about shoulder dystocia, and he said he knew about it and could answer her questions. Well, he really DID know about it. Her son was born without complications. While in the hospital, she looked at her chart which was hanging in her room. She found out that her first son HAD SD, but they never told her. Obviously, her first son never showed any effects from the SD. But isn't it interesting to think how many cases of SD there really might be?

Maybe one option is start with the hospital, and then find doctors who have successfully handled SD?
Tina

[francine]

Sophie's mom - I have heard midwives say that each and every birth has it's moment of shoulder dystocia - defined as difficulty birthing the shoulder. It's just a matter of what degree of difficulty.

They're all supposed to know how to disengage a shoulder using the maneuvers but I believe that many of them may panic and the rest of them are just negligent.

There's something I recently read that said that some doctors just don't realize how much traction they are using on the head until it's too late. This just makes me then want to ask why they are not retraining themselves on Shoulder Dystocia all the time - refresher courses in which they go over the maneuvers and the amount of traction that will disengage the baby without hurting it.

[big sigh] and we're having bigger and bigger babies it seems...

you are RIGHT about the hospital- it IS important to be at a good hospital. When I told my friend what hospital I was going to deliver in she said "I wouldn't take my dog there"... why didn't I listen?

-francine

[admin]

Francine,
A lot of OB nurses will protect physicians, too, from experience in working as a nurse, to cover their own rears (otherwise known in the hospital as "CYA", if you know what I mean). They won't be honest in fear for fear of retribution. Also, I have 3 very good friends who are physicians (friends outside of the hospital that we run with) and they feel it is unfair to look them up by name to see if they had any malpractice suits against them. One said, he was named just because he was in the room and not involved with the procedure. I don't particularly agree with them, I feel it should be public knowledge. Also, many people do sue for frivolous reasons and win (unlike us- who had a reason and lost- sorry, just a sore spot!!!!!!).
I am so ready for a new year for closure.
I will help join your campaign, just let me know what, where, when and how, girl!!!
Natalie

[admin]

I had an epidural and was induced, however, everytime my son's heartrate deceled, they would stop the pitocin. DO I think that this effected my outcome, YES, Yes, Yes

[marymom]

very good exchange,
not much input from me, ofcourse I lean heavily on the side of normal vaginal delivery being perfectly possible in many(not neccessarily most but many) births for women after OBPI deliveries I also remain FULLY dedicated to the choice being that of the mums-
I would hope that she would listen open mindedly to input tho-

For me, birth may be a more spiritual event with ethical values and responsibilities outweighing by far those of legal -technical ability ofcourse being the issue we are discussing-would be a prerequisite for any honerable attendant- One who is spiritually adept -in my opinion, would not freak out -and I agree that most times that is the jist of the problem-
I also believe that there are times when risking a dystocia is safer than risking a section- a fact that may be hard for OBPI mums to swallow-
I also believe that a broken collar bone is a great way to "unstick" a bebe -those pratitioners likely knew what they were doing and did so PURPOSELY, not accidently, and it takes an honerable person willing to break the baby's collar bone rather than risk a BPI- OR A SECTION, in my opinion.
Francine, your quest is an honorable one, I havent been able to think of any specifics to submit to you tho- Looking for a scale in a high risk facility however is a DUH and a great point- I will keep thinking about it tho- I also think ongoing education-for mums and birth attendants -is the best possible way to avoid OBPI-
PLease know that the above statements from me are just my POVs nothing more or less and I welcome and respect all points of view likewise or opposing that have been expressed!
HAPPY NEW YEAR !!!! WELCOME LITTLE SEBASTION!!!!!