primip

For us it depends on where the doc is... I mean if they're in house we can wait til delivery is pretty close before we call... Generally if they are in surgery for example they call to check on the pt before they scrub so they are aware that they are getting close before they start a case. On the other hand if I know that our doc is at home sleeping I'd probably call and say "she's complete, we're gonna start pushing" and they can make their way in... If things go faster than usual I'd page again and then they know to make their way to the unit faster.

For multips on the other hand it's generally so much faster that I would call when 8 like you're saying, or even faster if I don't think I'll have time and things seem to be really progressing quickly. I just try to keep the docs informed. For what it's worth I've never precipt a primips baby but honestly those multips are so fast that it's been known to happen more than I'd like...

This can be a tough one. Our docs like to know when a pt. is complete, and they want them pushing right away. They are not big on laboring down. So usually with a primip, I fudge the dilation for awhile so they CAN labor down. Unless the baby is +2 or they have an urge to push, or they're unmedicated or something.

We did have a primip precip a few weeks ago. She went from 2 to 10 in 1 hour, had to wait for the doc to get there, and barely had to push. Unmedicated too...

For our multips we will call when they are 8, if we happen to catch them at 8 LOL.

This can be a tough one. Our docs like to know when a pt. is complete, and they want them pushing right away. quote]

Do they know their practice isn't based on evidence and is probably detrimental to the patients wellbeing (woman and baby)?:no::no:

I was a primip precip...I was stuck at 6cm for 4 hours...got my epidural and 10 minutes later...there was a baby...I didn't even push...he just came! Ooops! Of all the precips I have almost had (haven't had one yet Knock on wood), they've been primips, go figure...pushed forever, haven't moved the baby....and then they suddenly figure out how to push and uh oh!

It really depends on how they're pushing...I"ll call the doctor when they're pushing...just so they know they may be getting a call soon..nor not! Most of our docs can get here in about 10-15 minutes, so I just call them accordingly. If they've been pushing for 2 hours, or if the baby starts to look compromised I'll ask them to come in. Thankfully most of the time they don't push that long...although recently I've been on a LONG pushing streak! Gotta break that one...better than a crash section streak though!

I prefer to labor down.....but our docs want them pushing when they are complete. So often I fudge dilation to give them time. It's ridiculous to push when there is no urge and the baby is high. And no, not "best" practice. But it's hard when the doctors are leaning all over you to "get it done". Very frustrating. So I lie a little.