sunny-side up baby

[shearernurse]

Hi guys, I am new to this thread. I work mostly nights in a small (16 bed) hospital. Tonight we had a delivery that scared the bejesus out of me. Babe was sunny-side up, maybe nothing new to you L&D nurses but very new to me. She pushed for over an hour, we tried to use the mighty-vac but that broke so we ended up using forceps. Boy did she tear even with an episotomy. I know the tearing is normal, but is the use of forceps. Even the Dr. didn't know this baby was occiput posterior. Would like to know if we could have done something different or better.

Thanks, shearernurse:

[cannoli]

Thanks.

[elleRN]

I've gotten used to the OP deliveries, but I had a mentum anterior delivery the other night now that was crazy. luckily it was her thrid so he came out quickly, but there is nothing like doing a vag exam and feeling the face and having your finger sucked on!! it was so bizarre to see just the entire face coming out surround by the labia. baby was pretty swollen in the eyes and face but otherwise okay. definitely something I won't forget!

[shearernurse]

mighty_vac, actually broke. The handle just broke right off. Thanks for all the hints. Mom was actually complaining of severe back pain. Thanks

[acuteobrn]

WOW, I have to wonder how hard the OB was pulling on that thing!! Might want to contact the mfg. and give them a lot number, as sometimes there are problems in the production..

OH RN...Must be a midwestern thing!!!!

elleRN: I would have loved to be in at that delivery. We had one with a face presentation, but was a primip and was a c/s...poor child looked like someone stuck a vacuum on the face, she only made it to about 6cm...the pressure made a perfect circle of edema where her little face was coming through the cervix.

[jansgalRN]

You guys are scaring me. I do not have any children of my own. (Three wonderful stepchildren). Can women have elective C-sections? Long, difficult labors run in my family. I am not OB, so very little of what you guys are saying means much to me. I do understand the words tear, and butt like a hamburger. I know vag delivery is best for baby, at what point do they decide that enough is enough? Most of the damage to the lower unit has been done already, right?

[BETSRN]

I did an OP with one of the midwives just the other night. The gal pushed on her left side, right side, squatting, etc. The left sided pushing really helped. The CNM also used her fingers at times to put some pressure on the baby's head. The pressure was pushing in the clockwise direction.

The baby turned completely and came out looking down. It was really nice. You don't always see good technique like that!

[BETSRN]

An elective c/section as a first timer without a documented reason is a poor choice. Get a good midwife and a skilled and sympathetic OB.

[BETSRN]

If docs would quit pushing epidurals (expecially early in labor) I am pretty sure we'd have FEWER OP babies to deal with.

[L&D_RN_OH]

Originally posted by jansgalRN

Can women have elective C-sections? Long, difficult labors run in my family.

Uh, no. Not here anyway. And just an FYI, labor patterns are not hereditary. You may have short, easy labors compared to family members. I think it has more to do with what occurs during the labor process (i.e. interventions) than family history.

Keep in mind, that in 90-95% of births, everything goes smoothly. :) I agree with Betsrn. Get a good midwife or OB and you'll do fine. :)

[acuteobrn]

I agree, most deliveries are uncomplicated. And a good skilled practitioner makes a big difference.

I am a firm believer that if you leave a laboring mother in one position for too long...you end up with problems.

Big believer in changing position every 5 contractions, even with an epidural (which given at 1/thick/high, does nothing for the patient;)).

[SmilingBluEyes]

I agree with Betsy in both her posts.

Get a good midwife for labor if you can.

MOVE ABOUT EARLY IN LABOR---no laying on your back ....

early epidural anesthesia IS linked with MUCH higher csection rates---try to hold off until in ACTIVE labor (usually 4 cm plus regular FIRM contractions).

These things alone can reduce your chances of dystocia and resulting csection.

Don't let horror stories scare you. You cannot predict for sure how labor will go for you---just give your body a chance to be smarter than we are!

[trogdor]

I think that it is scary that a OB is putting on forceps without knowing which way the baby is facing. As far as early epidurals and OP babies...My 1st was OP, and my back hurt so bad I got an epidural at 3cm, then I was able to take a nap, and have the energy to push out a 8#10 oz baby in 20min. I think early epidurals are sometimes good for that very reason...mom's getting to sleep, so they are able to push well.