Consultant Wanting to Induce - I'm not so sure

cynder

Cat Melodeon wrote: »

+9 days and a different consultant again. He expressed concern that the fluid levels had dropped and that there was a risk that there was meconium in the fluid. At this, I readily agreed to being admitted (finally a medical reason!) and was induced using the gels the next morning.


There was meconium in the fluid, the last consultant was right, but there was nothing wrong with the baby or the placenta (they were not 'overcooked') and although he was quite big (9lb 6) he still got himself out with just me helping him.


.

You were fare lucky that the baby didn't swallow any of the meconium, my nephew did and he was in ICU for 2 weeks. (natural labour, he got distressed and they did an emergency c-section)

Cat Melodeon

How Strange wrote: »

Well done for knowing what you wanted and standing your ground.

I can only imagine as a first time mum it is difficult to question a doctor when all you want is your babys safety.

As a first timer, I found it really hard. My post makes it seem like I was all confident - I really wasn't. I was in tears with the nasty doctor and only for the midwives and my brilliant husband, I probably would have given in at that point. It is sooo hard to go against a doctor's wishes, even when you know that what they are telling you isn't right. That's why the second opinion is so important, you need to have that assurance from a different doctor that your gut feeling is actually right. I had also been using the Gentlebirth relaxation CDs and found them great for helping me stay in control - can't recommend them enough.

grindelwald wrote: »

You were fare lucky that the baby didn't swallow any of the meconium, my nephew did and he was in ICU for 2 weeks. (natural labour, he got distressed and they did an emergency c-section)

I know, it is rare that they actually swallow the meconium but when they do, it is very stressful for them. That's why I agreed to the induction as soon as there was a risk of this, it's not something you want to mess about with.

SanFran07

Cat - there's a very interesting thread on RC of a first time Mum who refused induction and went 20 days over. She was treated really badly for refusing to follow the hospital policy but gave birth to a healthy baby on her terms - although it was made very difficult for her.

Just on meconium in the waters - it is very rate for a healthy baby to inhale amniotic fluid during birth as their breathing movements slow down once labour kicks in. It's quite common to see meconium in the waters of an overdue baby due to the baby's gut maturing - as long as baby is healthy and remains so during the birth meconium is not always an ominous sign. Meconium can occur during pregnancy too so an induction doesn't prevent it - and if we consider that induction itself creates additional stress on the baby it could in fact be the induction that caused the meconium.... The Mum on RC had no meconium in the waters even that far over.

It's also harder for a baby to clear his airways in a caesarean section (the babies don't get the chest squeezing that's such an important part of a vaginal birth which helps drain liquid from the baby's airway).

It makes more sense to avoid interventions that can cause stress for the baby such as breaking the waters, pitocin, purple pushing and assisted births.

lynski

Saw this on RC and thought about this thread, here is an unnecessary induction leading to an ECS... how many times does this happen?

http://www.rollercoaster.ie/mumstobe/mc.asp?ID=760924&G=61&forumdb=9

Hi girls.
Was brought into hosp on Wednesday 8th at 8am for induction cos was told was having big baby and they wanted to induce me on my due date. by friday morning after 3 attempts of induction gel I hadn't even moved a milimetre so a c-section was decided. Went down for c-section at 1pm and after half an hour of trying to get local anaesthetic done it failed. my partner wasn't allowed in at this stage cos I had to be knocked out n have general anaesthetic so he panicked. it was horrible not seeing him before been knocked out.
Baby Shance was born at 14.33 weighing 7lbs8ozs (not such a big baby but very long!),

When I came around in the recovery room I was then told I was been brought to Intensive care cos my oxygen levels dropped rapidly during the section. I got to see Shane for 10 mins, he was perfect and that was the main thing. Partner was very upset, he thought I was gone when intensive care was mentioned. Spent night in ICU but got to see Shane for half an hour which was great. I eventually got hime after spending one full week in hosp which was longest week of my life. settling in now to motherhood and it's the best feeling in the world. congrats to all you mums out there and best of luck to the rest of ye. Have a great Xmas and all the very best to you, your new babies and families in the new year xxxxxx

January

lynski wrote: »

Saw this on RC and thought about this thread, here is an unnecessary induction leading to an ECS... how many times does this happen?

http://www.rollercoaster.ie/mumstobe/mc.asp?ID=760924&G=61&forumdb=9

Same experience as me, but I was not brought to ICU... They said my induction was necessary as my waters had broken, but only a small bit of my waters went and they had to break the sac anyway...

lynski

Going to also link to this thread, it is long, but it is worth reading the entire thing. Great story, but wow she had so much tenacity and gumption, i really do not think that she should have needed to fight so much.
The short version: First time Dublin Mum refuses routine induction and gives birth to a healthy 7lb 5oz baby at 43 weeks + - but not before she is harassed and bullied by the Medical profession.

http://rollercoaster.ie/boards/mc.asp?ID=369171&G=18&forumdb=1
This is how the story starts:

Posted by:- piccolo Send PM ID:- 48835 Date:- 03/12/2010 12:41

Hi ladies,

I'm currently 10 days overdue and booked into NMH next Monday for a term+13 scan to assess fluid and placental function etc.

My problem is: I really really do NOT want to be induced and I feel I will have no choice once I cross the threshold of NMH on Monday morning because they prob won't let me go home and will want to induce.

So what are my options?? Am I mad to refuse an induction because of risk of stillbirth? What if everything is fine fluid-wise and placenta-wise? How quickly can that change? My MW said she's working in NMH 6 yrs and has never seen a patient allowed to come in daily for monitoring after 42 weeks. I'm absolutely gutted because I really want a natural birth and wanted to stay at home as long as possible.

Any advice would really be appreciated as I don't want to risk the baby's wellbeing but I want to feel a bit in control too and not just being told I HAVE to be induced. Aaaah!

crazy cat lady

I think a lot of 'post dates inductions' could be avoided if there were more early scans.

In the UK it is routine to scan around 12 weeks so that the pregnancy can be assessed and dated accurately.

I think we all know how unpredicatable a womans cycle can be, and not everyone ovulates on day 14! Just ovulating a few days later may infact date the pregnancy a bit earlier and in turn lead to unnecessary induction. I know they date the pregnancy at the 20 week anomoly scan, but the gold standard is to date the pregnancy during the first 12 weeks when they can measure the sac and the fetus the most accurately.

In an ideal world, women would be given more choice and support in the decisions they make. Yes it can be risky going over 42 weeks, but with proper monitoring it doesn't have to end in disaster waiting to labour naturally. Unfortunately the resources or finances just aren't there to make this possible, and in a culture where litigation is so common, consultants do not want to take any risks. It sucks but its the way it is! I don't think its gonna change a whole lot in my lifetime either!

jimmyendless

SanFran07 wrote: »

Cat - there's a very interesting thread on RC of a first time Mum who refused induction and went 20 days over. She was treated really badly for refusing to follow the hospital policy but gave birth to a healthy baby on her terms - although it was made very difficult for her.

Just on meconium in the waters - it is very rate for a healthy baby to inhale amniotic fluid during birth as their breathing movements slow down once labour kicks in. It's quite common to see meconium in the waters of an overdue baby due to the baby's gut maturing - as long as baby is healthy and remains so during the birth meconium is not always an ominous sign. Meconium can occur during pregnancy too so an induction doesn't prevent it - and if we consider that induction itself creates additional stress on the baby it could in fact be the induction that caused the meconium.... The Mum on RC had no meconium in the waters even that far over.

It's also harder for a baby to clear his airways in a caesarean section (the babies don't get the chest squeezing that's such an important part of a vaginal birth which helps drain liquid from the baby's airway).

It makes more sense to avoid interventions that can cause stress for the baby such as breaking the waters, pitocin, purple pushing and assisted births.

I don't get how some women want an induction or c-section. If labour is let start naturally, you are saving yourself alot of trouble in the long term and could be heading home the day after.

C-section is a major operation with a considerable healing time, it is distressing for the mother and baby, the sqeezing of the babies lungs doesn't take place and that has further implications. The epidural procedure itself isn't great and causes drowsy babies which causes them to have trouble breastfeeding. Breastfeeding is made more difficult because mother can't hold baby as easily. Then mother doesn't BF and has greater likelyhood of PND, baby isn't getting breastmilk and will be more susceptible to collic. All these interventions can have negative longterm consequences. Eveer step of natural birth seems to have a purpose.

Of course all these things might not happen but once intervention starts, the chance of more interventions increases dramtically. The more natural you can keep it, the better.

PopUp

Well Jimmy very few people want to be induced, but going so far postdates is a very good medical reason to do it. The rate of stillbirths absolutely skyrockets the further past your due date you go. (That's a link to a, em, very outspoken US doctor - but the medical science is accurate and she's absolutely right about the article she's talking about - I couldn't believe the Guardian published it, so irresponsible).

I was following that Rollercoaster thread and I actually have to say, I found it shocking. I couldn't believe how many posters were dishing out medical advice without ever having met the woman, seen her charts or test results. It was actually awful. I've bumped up against the "no medical advice" rule here on Boards before, but that thread gave me new appreciation for it. Randomers on the internet SHOULD NOT be advising strangers to ignore their midwives and doctors.

I am delighted everything worked out well for that lady, and her baby was born happy and healthy and did not experience the problems that overdue babies are so prone to. Though I would point out that it sounds like the lady DID opt for an induction at 43 + 1! And in the middle of the night. So it's not exactly a sign that going to 43 weeks is perfectly safe and baby will come eventually. She gambled on the statistics, and thankfully, she (or rather her baby) won. But that doesn't mean it was a sensible thing to do. (I think crazy cat lady is right and her dates were probably off, though she insists on the thread they're not).

I think it's a shame she met some very rude doctors. But I also don't think it's correct to say she was harassed by them all. The Master of Holles Street wasn't ringing her multiple times to harass her, it was because they were really worried about her.

lonestargirl

jimmyendless wrote: »

I don't get how some women want an induction or c-section. If labour is let start naturally, you are saving yourself alot of trouble in the long term and could be heading home the day after.

Could being the inmportant part of this sentence for me. I agree that a straightforward natural birth is best for mam + baby but since there is no way to guarantee this will happen I have opted for an elective C-Section.

jimmyendless wrote: »

C-section is a major operation with a considerable healing time, it is distressing for the mother and baby, the sqeezing of the babies lungs doesn't take place and that has further implications. The epidural procedure itself isn't great and causes drowsy babies which causes them to have trouble breastfeeding.

I am prepared to put myself at extra risk to prevent some of the (very rare) risks of a natural birth to my baby. Not a chance I would have birth without an epidural either way, so this is not an issue specific to a CS.

I feel this is an issue that every woman must decide for themselves, in consultation with their doctor, and I hope everyone gets the kind of birth they would prefer.

crazy cat lady

lonestargirl wrote: »

Could being the inmportant part of this sentence for me. I agree that a straightforward natural birth is best for mam + baby but since there is no way to guarantee this will happen I have opted for an elective C-Section.


I am prepared to put myself at extra risk to prevent some of the (very rare) risks of a natural birth to my baby. Not a chance I would have birth without an epidural either way, so this is not an issue specific to a CS.

I feel this is an issue that every woman must decide for themselves, in consultation with their doctor, and I hope everyone gets the kind of birth they would prefer.

May I ask what your reasons were for choosing to have an elective section and what risks of a natural birth you are afraid of? I'm not looking to judge or try to change your mind or anything, I'm just curious

CathyMoran

I was not induced but had a c-section and I do not regret it. Our son was consistently measuring small and they were trying to keep him in as long as was safe for him - as it stood, he was delivered at 37 weeks but had not grown since week 31 and was only 4lb 11oz. A normal delivery was not an option as I was so tired from the pregnancy (have several medical issues) and had been in bed from the begining of pregnancy. I was advised that it would be better for him if he got premature baby formula though I did also express milk for the first few weeks. It did not put me off the whole experience as I am expecting again and am loving being a parent. It did help that I had(have) total trust in my obstatrician (sp?)

lonestargirl

crazy cat lady wrote: »

May I ask what your reasons were for choosing to have an elective section and what risks of a natural birth you are afraid of? I'm not looking to judge or try to change your mind or anything, I'm just curious

No problem, the thing is many of the risks that apply to me are due to my personal circumstances and won't apply to others.

• Going into labour by myself. All our family live 3500 miles away, my husband works long hours with overnight call 1/4 nights.
• Having support when I return home, again my husband's job gives him 10 days vacation and they must be booked in advance. This way I know he will have 2 weeks at home with me + baby.
• I do feel that an emergency section is riskier than an elective one (as any emergency surgery is). I like to be in control but I really don't want any kind of emergency situation.'
• I know the risk of something very bad (e.g. baby being deprived of oxygen) happening in a standard delivery is small but it is still a risk nonetheless and I'd like to avoid it if possible.
• In terms of breastfeeding my hospital is very pro-breastfeeding and brings CS babies to the mother as soon as possible. It's a bonding rather than nutritional experience anyway, newborns don't need to eat for the first day or two.

As you can see my major influencing factors are logistical but I don't think that means they should be ignored, I'm not doing it just to be convenient, the idea of possibly being by myself going into to labour or going home from the hospital by myself really does scare me.

crazy cat lady

lonestargirl wrote: »

• newborns don't need to eat for the first day or two.

Lets see if you're saying that when you have a newborn

Thanks for sharing your reasons. Its very easy to assume that someone who elects to have a section is 'too posh to push', nobody ever really asks what reasons someone might have for wanting a section. I hope it goes well for you. When is the big day?

cynder

When i said 'too post to push' i was on about the likes of Victoria beckham.

Lonestargirl

Best of luck with the c-section I know a few that have had planed c-sections and they all went as expected, im sure you will be the same.

lonestargirl

crazy cat lady wrote: »

Lets see if you're saying that when you have a newborn

Lol , I'm sure I'll be exhausted trying to feed for the first few days. But I meant that a mother need not worry if it doesn't work immediately, you are not harming your baby nutritionally.

crazy cat lady wrote: »

Thanks for sharing your reasons. Its very easy to assume that someone who elects to have a section is 'too posh to push', nobody ever really asks what reasons someone might have for wanting a section. I hope it goes well for you. When is the big day?

grindelwald wrote: »

When i said 'too post to push' i was on about the likes of Victoria beckham.

Lonestargirl

Best of luck with the c-section I know a few that have had planed c-sections and they all went as expected, im sure you will be the same.

Thanks girls, I'd didn't take the 'too posh to push' comments personally I know the types of situation you were describing. As I said everyone's situation is different and each case needs to be decided on its own merits and maybe if I had a crystal ball I would make a different decision, but I don't.

Junior is scheduled to arrive 7.30 am Jan 7th, I'm kinda in work this week (just showing my face really) and I have a nice stack of books waiting for me next week.

lynski

PopUp wrote: »

Well Jimmy very few people want to be induced, but going so far postdates is a very good medical reason to do it. The rate of stillbirths absolutely skyrockets the further past your due date you go. (That's a link to a, em, very outspoken US doctor - but the medical science is accurate and she's absolutely right about the article she's talking about - I couldn't believe the Guardian published it, so irresponsible).

I was following that Rollercoaster thread and I actually have to say, I found it shocking. I couldn't believe how many posters were dishing out medical advice without ever having met the woman, seen her charts or test results. It was actually awful. Randomers on the internet SHOULD NOT be advising strangers to ignore their midwives and doctors.

I am delighted everything worked out well for that lady, and her baby was born happy and healthy and did not experience the problems that overdue babies are so prone to. Though I would point out that it sounds like the lady DID opt for an induction at 43 + 1! And in the middle of the night.

I think it's a shame she met some very rude doctors. But I also don't think it's correct to say she was harassed by them all. The Master of Holles Street wasn't ringing her multiple times to harass her, it was because they were really worried about her.

I also read the thread. I have to disagree with you on some of these points:
* the thread was very supportive, and no one, to my recollection, told her to ignore her doctors advice. The posters offered her links to research, their experiences, their opinions, their support. and some of them were not randomers - at least one of the posters works exclusively in the pregnancy and birth area.
* the lady was so obviously paying close attention to her body and her babies signs, her bishop score never rose high enough to justify an induction and had she acquiesced to the docs demands on her she would probably have had a terrible experience.
* she did not opt for induction, she did agree to it but did not get it she got an epi and the relaxation it brought to her made labor faster.
* i am sorry to also disagree that calls from the masters of a hospital are not harassment: when you are overdue every call is harassment, calls from senior doctors when you have made informed decisions and are articulating your desires clearly to your team could be considered harassment, calls from the masters of the hospital you are attending to try to persuade you to change your mind on a procedure that there are no indications you need could be considered harassment.
* in many cases the medical professionals she encountered supported her decisions.
I wish i had read a story like hers 4 yrs ago, i might not have agreed to a painful, long induction which led to an emergency cs followed by a dreadful infection. I have not personally spoken to anyone who has had a good induction experience and can honestly say that more then half the women i know have inductions which led to difficult, long, painful labors ending in complications such as ecs, tears, and problems with the baby.

PopUp

I think we'll just have to agree to disagree. I am 39 weeks myself and no, I wouldn't like to be called at home by any doctor - but if the Master of the hospital was so concerned about my treatment that he had to, I would assume it was because he had cause to be, not because he was looking to annoy me.

I'm really sorry you had an awful induction. I think it's true most inductions are really tough. However, while they carry risks, often the risks of doing nothing can be even greater. That's my big problem with that board - there are no end of comments about the risks of inductions/epidurals/C-sections - but not as much acknowledgement that these procedures are not done for fun but because the risks of not doing them are even higher.

I think that the advice and "research" handed out on that particular board is often seriously misguided and misinformed. The only "professional" on that thread is someone who makes money from natural birth - they aren't a medical professional and even if they were, they aren't that woman's medical professional.

I am very, very glad of the approach here on Boards which is much more responsible IMO. We have no way of knowing how big a risk that poster took, because we aren't her doctors and we can't see her tests and files.

January

PopUp wrote: »

I think we'll just have to agree to disagree. I am 39 weeks myself and no, I wouldn't like to be called at home by any doctor - but if the Master of the hospital was so concerned about my treatment that he had to, I would assume it was because he had cause to be, not because he was looking to annoy me.

I'm really sorry you had an awful induction. I think it's true most inductions are really tough. However, while they carry risks, often the risks of doing nothing can be even greater. That's my big problem with that board - there are no end of comments about the risks of inductions/epidurals/C-sections - but not as much acknowledgement that these procedures are not done for fun but because the risks of not doing them are even higher.

I think that the advice and "research" handed out on that particular board is often seriously misguided and misinformed. The only "professional" on that thread is someone who makes money from natural birth - they aren't a medical professional and even if they were, they aren't that woman's medical professional.

I am very, very glad of the approach here on Boards which is much more responsible IMO. We have no way of knowing how big a risk that poster took, because we aren't her doctors and we can't see her tests and files.

CalmBirth also posts here under a different name, not as often though!

Nevyn

The content of discussion other sites really aren't the concern of this one.

lynski

I did not claim any of the posters on that thread were professionals, i said they worked in the area, ie were experienced.
The professionals i referred to were the ones she encountered at the hospital, at least 2 doctors and 2 midwives if i recall correctly supported her decisions.
It is interesting to note that over 2700 births occurred at 42 wks + in Ireland in 2008.
I also think that that person in particular was especially supportive of any of the decisions that the woman was making, for induction and against induction. she provided plenty of info as well.
There was plenty of discussion of the dangers of going over also, and they were not dismissed.
The intervention rates in Ireland is appalling - 43% of births have interventions of some sort, with 26% being CS. The rates for induction are not recorded, but i would bet that of that 43% the induction rate would be pretty high. http://www.esri.ie/UserFiles/publications/jacb201066/SUSTAT35.pdf
I think women have the right to ask questions and make informed decisions, and the source for that information is not *just* the team in the hospital who have other agendas to address too.
apologies mod i think we cross posted.

lonestargirl

lynski wrote: »

The intervention rates in Ireland is appalling - 43% of births have interventions of some sort, with 26% being CS.

And yet Ireland is one of the safest places in the world to give birth, how do you reconcile that with the intervention rates being 'appalling'?

How Strange

lonestargirl wrote: »

And yet Ireland is one of the safest places in the world to give birth, how do you reconcile that with the intervention rates being 'appalling'?

IM(very inexperienced)O, ironically enough maybe because of the interventions. I'd say interventions make for safer delivery of babies in general but lead to more stressful and negative birthing experiences for mum.

I'm on my first pregnancy so that's just my opinion and not based on medical evidence etc.

cynder

Just wondering on average how long is a natural labour?


anglefire9 was in labour for a few days with her 2nd, with my first i was in labour for 30+ hours, my mother was in labour for a whole week with her first (who was 2 months early).

So how long is an induced labour? does it beat a week?

Tears happen regardless, i tore with all 3 and i wasn't induced and i got one of the worse tears out there. I also got an infection after my first was born and that lasted 3 weeks.


You never know whats going to happen, With all the scare stories one might hold off being induced and it might work out fine, but then again it might not. I personally would not put the baby at risk of the placenta failing and would opt for an induction.

Nevyn

Depends on the type of induction used and how urgently the baby has to come out.
I was 10 days over on my second, 41+3 and had labour start and stop when I was booked in and I was told that once I booked in the next morning the baby would be born that day.

It kicked of at 9:30 am when I had the gel applied to the mucus plug and when there was no movement by 11am I had my waters broken but not even a twinge. By 1pm I was on the oxy drip which by 2:30pm had me sore with contractions, 3pm I was brought to the labour suite and she was delivered at 4:15pm.

January

I didn't need the gel but they broke my waters at 11.30am and by 12 they had me hooked up to a syntocin drip, contractions were coming thick and fast but by 6pm I was still only 2cms and baby was getting distressed so they done the section.

crazy cat lady

grindelwald wrote: »

Just wondering on average how long is a natural labour?


anglefire9 was in labour for a few days with her 2nd, with my first i was in labour for 30+ hours, my mother was in labour for a whole week with her first (who was 2 months early).

So how long is an induced labour? does it beat a week?

Tears happen regardless, i tore with all 3 and i wasn't induced and i got one of the worse tears out there. I also got an infection after my first was born and that lasted 3 weeks.


You never know whats going to happen, With all the scare stories one might hold off being induced and it might work out fine, but then again it might not. I personally would not put the baby at risk of the placenta failing and would opt for an induction.

An average natural labour will last about 8 hours. Obviously there are those that will be shorter and those that are longer. And this is working from the definition of active labour having commenced as soon as the cervix is 1cm dilated. 30 hour labours do not 'exist' here in Ireland as 'pre-labour' is not considered labour. It doesn't matter how much pain you are in or for how long, they are not considered labour pains until that pesky cervix starts to dilate. Who would have guessed that obstetrics is a male dominated discipline :rolleyes:

As labour and birth is very medicalised and managed here in Ireland, a labour will not last longer than 12 hours as a rule. The Active Management of Labour was establised in the 60's I think by the Master of the NMH at the time (O'Driscoll) and I think in partnership with the masters of the other Dublin maternity hospitals. It was set up to manage labour supposedly with the purpose of delivering a better birthing experience. The only positive thing in my opinion that has come out of AML is the 1-1 support of a midwife throughout labour.

The AML supports the use of interventions to sped up labour if a woman does not dilate naturally at a rate of 1cm per hour. In the past women were too reserved to question AML, and things such as the internet did not exist as it does today to gain information. Women are attracted by the prospect of labour not lasting longer than 12 hours, without really questioning how this would be achieved or what the possible adverse outcomes of all the interventions may be.

AML has completely medicalised a very natural human process. If it were that great I'm sure other countries would adopt its use, but as far as I'm aware, any countries that did use AML have now stopped in favour of a more 'woman centred' approach to childbirth. One day Ireland might catch up with the rest of the developed world, but while there is such high demand on maternity services here, I think to keep using AML is convenient

SanFran07

lonestargirl wrote: »

Could being the inmportant part of this sentence for me. I agree that a straightforward natural birth is best for mam + baby but since there is no way to guarantee this will happen I have opted for an elective C-Section.


I am prepared to put myself at extra risk to prevent some of the (very rare) risks of a natural birth to my baby. Not a chance I would have birth without an epidural either way, so this is not an issue specific to a CS.

I feel this is an issue that every woman must decide for themselves, in consultation with their doctor, and I hope everyone gets the kind of birth they would prefer.

Just looking at the bigger picture here in that having an elective caesarean is not risk free for your baby. It's a case of swapping one set of risks for another (surgical cuts, forcep bruising, lung immaturity are a few).

Routine interventions don't make for safer births for babies. Midwife Led Units in Ireland and Midwife Led care in other countries have similar if not better outcomes for babies without all of the routine interventions...

http://www.hse.ie/eng/services/newscentre/2009_Archive/dec09/MidUstudy.html

cynder

crazy cat lady wrote: »

An average natural labour will last about 8 hours. Obviously there are those that will be shorter and those that are longer. And this is working from the definition of active labour having commenced as soon as the cervix is 1cm dilated. 30 hour labours do not 'exist' here in Ireland as 'pre-labour' is not considered labour. It doesn't matter how much pain you are in or for how long, they are not considered labour pains until that pesky cervix starts to dilate. Who would have guessed that obstetrics is a male dominated discipline :rolleyes:

With my first i was in the clinic and my bp was very high so they sent me to limerick i went home picked up my bag and was driven in by my father in law.

My contractions started on the way in every 5 mins, when i got there i was 1cm dilated and that was the start, it was between 1pm and 3pm that i arrived at the hospital on the Wednesday (no later than 3). 5 mins contractions all through the day and night had no sleep at all.

I was sent to the labour ward at 9am on thursday morning, i was 4cm dilated (already done 18hours -20 hours of 5 min's contractions and walked the corridors all night)

At 4pm on the Thursday i was only 5cm dilated so they put me on a drip and broke my waters to speed up things, i got contraction upon contraction one was half way through when the other started, i refused the epidural all along but at that point i agreed approx 5pm (i was in tears over it as i really didn't want it, but was in so much pain i needed it) also i was vomiting (thanks to my ever continuing morning sickness).

I started pushing at around 8pm and she arrived at 8.51 pm to me that is a 30hour+ labour as i was already dilated when i arrived at the hospital. (i spent just under 12 hours in the labour ward)

As far as im am aware anglefire9 was 2cm dilated but contractions were far apart.


Thankfully my 2nd was premature and that was quick my waters broke while i was asleep ( 2am), my bp spiked and contractions were 20 mins apart they were down to 5 mins apart at 5am so off to the hospital and i was 4m when i got there and contractions 2 mins apart, the contractions stayed at 2 mins apart so when it came to push him out i had to wait for the contractions so he arrived after 5 pushes (but that was still 20 mins) at 10.15 am he was born (8 hours of labour). i had the epidural at 9 and it never kicked in so i felt everything.

3rd guy i woke at 3am with contractions every 20 mins left for the hospital at 5am bp spiked again, had the epidural at 8 and it kicked in just before i started to push, he was born at 9.20am, they didnt want to give me the epidural because they thought it wasnt going to kick in on time and the guy who administers it was going home. But he stayed around just for me. (labour just over 6 hours)

Cat Melodeon

crazy cat lady wrote: »

... this is working from the definition of active labour having commenced as soon as the cervix is 1cm dilated. 30 hour labours do not 'exist' here in Ireland as 'pre-labour' is not considered labour.

How does this work with regard to women on a second or subsequent birth who may be 1-2 cm dilated a number of weeks before labour begins? As far as I'm aware, it is quite common for the cervix to remain wider once a woman has had a baby - does this affect how her labour is managed?

angelfire9

crazy cat lady wrote: »

An average natural labour will last about 8 hours. Obviously there are those that will be shorter and those that are longer. And this is working from the definition of active labour having commenced as soon as the cervix is 1cm dilated. 30 hour labours do not 'exist' here in Ireland as 'pre-labour' is not considered labour. It doesn't matter how much pain you are in or for how long, they are not considered labour pains until that pesky cervix starts to dilate. Who would have guessed that obstetrics is a male dominated discipline :rolleyes:

As labour and birth is very medicalised and managed here in Ireland, a labour will not last longer than 12 hours as a rule. The Active Management of Labour was establised in the 60's I think by the Master of the NMH at the time (O'Driscoll) and I think in partnership with the masters of the other Dublin maternity hospitals. It was set up to manage labour supposedly with the purpose of delivering a better birthing experience. The only positive thing in my opinion that has come out of AML is the 1-1 support of a midwife throughout labour.

Funnily enough, as I think grindelwald said, I was 2cm dilated when I was examined on the 16th of December and the babs wasn't born til the morning of the 20th which is circa 96 hours of labour according to your definition
Which is well over the 12 hour "rule" :eek:

For the record when they discovered I was already dilated they did a sweep but I was REFUSED a full induction and was told that I couldn't be induced until EDD+10 days if things didn't progress naturally! :rolleyes:

crazy cat lady

Ok '1cm dilated' is a very basic definition, but a very important factor in determining active labour.

Obviously a doctor/midwife looks at the bigger picture before diagnosing labour. Is the woman having contractions? If so are they regular? Are they close? Are they lasting 40-50 seconds? Do the pains stop her dead in her tracks? You could answer yes to all of these questions but if the cervix hasn't started to dilate then labour isn't considered 'active'. However you could answer no to all of these questions and the cervix may be starting to dilate. The way a woman looks and sounds in labour is also quite distinctive.

If a woman has already had a baby, the cervix does remain open slightly. But it still needs to migrate forward and efface with each labour, and the cervix would be assessed in conjunction with the questions above and also considering the last labour and how fast/slow etc... it was.

Also, vaginal examinations are very subjective. What I might assess as 3cm another midwife might say is 5. That is why its always best to try and keep the same midwife.

Honestly the dignosis of labour is something that can't really be done on a forum on the internet. Its something that comes with training and experience. Every woman is different, as is every labour, that is why there are always exceptions to the rule!