Vacuum Assisted Delivery... ugh.

redessa · Jul 23, 2010

I'm curious, what kind of pain management (if any) do you approve of for "smaller" repairs?

That's already a sensitive area. Add the physical trauma of having just pushed a baby out with the accompanying lacerations and see how much you'd like getting some med-free sutures! Even needle pricks for a local anesthesia are a lot to endure at that point in time. If the mom's already got an IV, why not give the meds through that?

mercuryrawks · Jul 23, 2010

My first born was done with out an epidural, and he was born OP, and weighed 9.6. I had 3rd degree tears and getting those local injections felt like they did nothing to ease the pain of the stitches, though I am sure they did. It was VERY distracting from trying to nurse my newborn-and generally just meet him, with my intermitten jumps from pain. Had I taken a minute to think big picture, I would have preferred more meds to make that less painful and intrusive. But, I didn't have an IV run either, so maybe thats why I didn't get it.

Either way, I was lucky enough to not tear with my 2nd and third, despite them being even larger, but if I have more I will opt for IV meds during that because I don't remember birth pains, but I certainly still cringe at the stitches.

Alesha

RXtech · Jul 23, 2010

I think the real solution to these problems is for more physicians to learn techniques that enable more women to deliver over intact perineums! :)

mercuryrawks · Jul 23, 2010

I think the real solution to these problems is for more physicians to learn techniques that enable more women to deliver over intact perineums! :)

It is all about education. Teach the ladies that, YES you will panic right before transition, yes, it might hurt so bad you can't see, but when the time comes, your body will bless you with hormones to make it ok. And---IT MIGHT NOT! You don't have to walk into the hospital back first. You don't have to have your baby to fit anyones schedule but the babies.

And for goodness sake Doc's---get those women OFF their backs when they are laboring! No wonder labor is taking forever, you are closing the pelvis!

Yes, I know there are exceptions to every rule. But, it should be the other way around. All of these "medical emergencies" shouldn't be happening every day, right?

HeartsOpenWide, RN · Jul 23, 2010

We are pretty natural at our hospital. I have been an OB nurse for a year and never have been to a birth that a Vac was used..knock on wood. Personally I would rather my baby be pulled out with forceps than a vac.

CNL2B · Jul 23, 2010

I had a vacuum assisted delivery with my first after 20 hours of labor, pitocin, and pushing for two hours (had an epidural as well.) It was the one thing on my birth plan I absolutely said I didn't want. I got one anyway. I haven't done enough research to know if this was the only option for me beyond C-section. Baby was crowning, I just couldn't push her out (she was 8'6".) Was there something better that would have worked for me?

My newborn daughter had a big hickey on her head for a month :crying2: . Dislike.

HeartsOpenWide, RN · Jul 23, 2010

I had a vacuum assisted delivery with my first after 20 hours of labor, pitocin, and pushing for two hours (had an epidural as well.) It was the one thing on my birth plan I absolutely said I didn't want. I got one anyway. I haven't done enough research to know if this was the only option for me beyond C-section. Baby was crowning, I just couldn't push her out (she was 8'6".) Was there something better that would have worked for me?
My newborn daughter had a big hickey on her head for a month . Dislike.

Something better? Laboring down.

CNL2B · Jul 23, 2010

Something better? Laboring down.

So ... you are saying, they should have given me more time, or coached me better? First baby -- I didn't know WTH to do.

HeartsOpenWide, RN · Jul 23, 2010

So ... you are saying, they should have given me more time, or coached me better? First baby -- I didn't know WTH to do.

If you have an epidural you do not have to push at all, you can wait until the baby is crowning. Your body will do it.

It is something UCSF is starting to recommend.

A process in which the healthcare team allows a laboring woman that has an epidural to wait to push until she is feeling the urge to push or showing other signs of being ready, other than typical cervical dilation. This allows the woman's body to push the baby out on its own, rather than forcing the baby out with forceful pushing.

jesskidding, LPN · Jul 23, 2010

If you have an epidural you do not have to push at all, you can wait until the baby is crowning. Your body will do it.
It is something UCSF is starting to recommend.

Seriously? You mean when I got my epidural for both of my deliveries I could have laid around and done nothing? That I didn't have to push for 2 1/2 hours to get my baby out? It seems like someone would have mentioned this to me. :uhoh3:

BrayaRN · Jul 23, 2010

I'm curious, what kind of pain management (if any) do you approve of for "smaller" repairs?
That's already a sensitive area. Add the physical trauma of having just pushed a baby out with the accompanying lacerations and see how much you'd like getting some med-free sutures! Even needle pricks for a local anesthesia are a lot to endure at that point in time. If the mom's already got an IV, why not give the meds through that?

I definitely agree with the OP. I was very anti-medicalized birth. However, as a nurse I did feel safety in delivering in the hospital. I did, however, arm myself with a CNM and doula to try for a "natural" un-medicalized birth. For the most part, I got what I wished for.

Unfortunately, my 8# son decided he wanted to be delivered with his hand alongside his head. Not only did this cause a larger presenting part, but when finally "free" his hand slapped back and gave me a 4th degree laceration. I do remember the pain involved and it was terrible. The lidocaine was not giving much relief. They decided to establish IV access and administer a healthy dose of Stadol.

Unfortunately, this Stadol essentially made me crazy. I could not focus my eyes to see my new son, I became extremely irritable, bordering on hysterical. I was swearing, couldn't appreciate the passage of time, and became extremely PO'd that I was not seeing my son. But then when he was brought to me, I could not focus on his face and became even more hysterical. My first BF attempt was far from magical (at least I don't think since I barely remember it).

He was delivered at 0200 and repairs continued until 0400. We had saved his gender for a surprise, but there didn't end up much fun in that at the time. Then I was too "drunk" to even choose a name. I sent him to the nursery and just told them to reintroduce him to me in the morning.

After trying so hard for a natural and bonding birth, I feel I was robbed by the medication that was administered. On the same note, though, I do not anticipate I could have handled the repairs without additional analgesic. I think the major problem was that an agonist/antagonist was chosen for the medication, which is known to have a more "drunk-like" side effect.

I had been anti-epidural for my birth, but looking back, that would have saved me from the hysteria that followed IV administration of Stadol. I will think long and hard about it next time.

So, I guess that is a different take on the situation.