Hi all.......just mulling over a few things here and need some feedback please! Last night was a very frustrating night at work......here's the scenario....
My patient was a G2P1, AVBAC. First baby was PCS for failure to progress and fetal intolerance/distress. According to her chart, labor arrested at 4cm? My first "hmmmm" moment......anyway, first baby was OP, second one as well.
So, mom comes in with high expectations and very clear about what she wants/doesn't want. No epi, no IV meds and wants to avoid c-section at all costs. We discuss the options and possibilities. She's very nervous, tearful. I get her calm, coping well with ctx's. She goes from 4cm to 6cm in about 2 hours, to 8 in about another hour. Getting real uncomf now and wants IV meds.....Dr barely will write order. Keeps saying "Don't you mean epi? Are you suuuuuure you don't want the epi?". Through it all, she manages to say no and we give her 1mg stadol. About 1/2 hour Dr is back in room, checks her.....still 8, -1.....then declares her! I nearly fell off my stool...mind you, baby was in no distress, mom was coping well. He tells her the baby "cannot" be delivered this way. Now, haven't we all seen them come out "sunny side up" or is it my imagination? I tried to confront this Dr....suggesting giving her a bit more time, but he was adamant....BTW, everything in the chart indicated that prognosis for SVD was good......adequate pelvis. I'm really scratching my head as to why he was so quick to jump for the c-section. Poor patient was completely devastated.
Thanks for letting me vent!