Cpd???

..IMHO? not too sure what that stands for CMCRN.. Not sure what else she could have done. And no, she was not African-American.

IMHO means "in my humble opinion"....

And in "IMHO", it seems ever so easy to for us all to sit here and "armchair quarterback" this situation and call all kinds of "foul plays" ...fact is, none of us was there, so all we can do is speculate.

Now to me, it sounds like the csection was indeed warranted if she was in adequate labor. Don't beat yourself up about "shoulda-coulda's".....Really, in days gone by, this poor lady might have been much worse-off, for all we know. I am glad she was at least safely delivered and hopefully, baby and mom will be just fine once home.

I do know, we are seeing more and more cases of CPD due to the fact, babies are getting bigger and bigger and gestational diabetes is epidemic.....

Was this the case in the particular situation?

Anyhow, I see a lot of teen moms going for csections due to small pelvises and big babies that are just TFTF (too fat to fit).

oh yea i completely agree that this is just speculation...its good to hear other feedback though. Other perspectives help to open my eyes esp. being new to l/d. and yes i do believe baby was just too big to fit as u put it. mom was pretty avg. size for teen and mayb her pelvis was just too small for babe. It was just hard bc all i heard was "why didnt u guys take her to c/s earlier?" "poor girl". etc. I thought as long as baby was fine, mom was ok..doc was contuously updated, that she was alright. i mean the doc is the one to order and finally determine if he wants a c/s or not. thanks for the input all!!

Two hours of documented adequate contractions (using an IUPC) with no cervical change usually means a C/S. But if you weren't getting adequate contractions and the baby was doing well, there is no hurry. The next shift just wanted you to have done the C/S so they didn't have to.

Thats exactly what i had thought nursenora! my preceptor didnt see any rush, md didnt either, only the next shift. sad sad sad.

I've had many patients that have labored much longer than what you are describing and had a successful vag delivery. Our docs will let pts labor for at least 48 (and sometimes 72) hours as long as they are progressing (even in the cervical change is very slow) and FHT, temps, etc all look good. If the pt/family is pushing for a c/s, our docs usually give after about 24-36hrs of labor.

In this particular case, sounds like FTP (no change for 4 hours, right? 1500-1900), but sometimes FTP can be a result of CPD. Our docs will c/s after 4 hrs of no cervical change with adq ctx unless pt wants to cont laboring.