Doctors/ C-sections/ 1st time mamas

[indigomama]

This is a vent. You may disagree with me as you like. I do not mean any offense, just frustrated.

 

A family member is in her 39th week of pregnancy. Last week, at her dr appt. her blood pressure was 140/80. The doctors told her if she didn't have the baby over the weekend they wanted to induce. Her DH called mine (since we're family and have had a few kids), I suggested that inducing early on a first time baby would likely not go well, and cautioned that it could very well lead to a c-section. They said they understood, and that they were hesitant but drs were really pressuring them, saying BP was too high, they need to think if the health of mom and baby. Over weekend they were taking blood pressure at home, it was normal. On Monday, they go back in, blood pressure is again 14/80 so dr pressures again. They agree to a cervix softener. No progress was made.  Drs said they can go home, but babies health, yada yada. Tuesday still at hospital they agree to pitocin. Now Wednesday, mama is exhausted and they are going to do a c-section.

 

Now, I think ultimate responsibility should be with the parents. They could have said "no" to the interventions. However, there is so much pressure and guilt put on parents, especially first time parents, and it makes me so mad. Thanks for letting me vent.

[Alexigail]

Is this a JAWM?

[indigomama]

Is this a JAWM?

 

No, feel free to disagree. 

[Alexigail]

I mostly asked because I thought maybe you were just looking for support which is totally understandable.  I definitely agree that there is too much pressure on women (and couples) to induce, which often leads to unnecessary c-sections.  I also think that this pressure makes it really hard for parents to determine what constitutes a serious issue and what doesn't.  Stressful conversations with a doctor can also cause one's blood pressure to spike, so who knows how accurate those measurements are.

That said, high blood pressure at the end of pregnancy can be a pretty big deal.

 

In any event, I'm sorry you're dealing with that.  

[countrygal]

I don't think that BP is all that 'high' - but it depends on her base line and other symptoms as well - fluid retention, headaches, or non reassuring baby status. They could put her on blood pressure medication, or was that already tried? Some people feel ok doing what the doctor recommends (I'm not one of them though!) Many doctors are just afraid of bad endings and are 'cautious'. It's easy for them.

[Desert Strawberry]

140/80 is normal. Assuming that she wasn't symptomatic, her Dr. Is BSing her, and putting her and her baby at risk unnecessarily, and robbing her of a healthy, positive entry to motherhood.

This is an unfortunately all too common scenario. I am sad for her to be put in this position, and certainly the doctor will blow a lot of smoke at her about her failure and how lucky she was that he rescued her, when really it was his inability to properly assess the risk and be patient that put her in this position in the first place. 

Anyway, I agree with you, OP. This is an overwhelmingly sad trend in medical care.

 

EtA: I should have said "within the normal range" because medically, that is true. The numbers alone do not indicate a problem. As OP stated no other symptoms and reported that bp returned to normal, I assumed that she was not preeclampsic. I acknowledge that emergencies do happen. I have had one myself. From the information given, this does not appear to be one.

[sassenach]

140/80 is normal.

That's really not possible for anyone to say without knowing her baseline BP.  My husband has recently had some very serious conversations with his Dr about BP of 135/95, which is crazy high for him, since he usually runs 90/55.

 

I absolutely 100% agree that Drs are pushing induction, and ultimately c sections for all the wrong reasons.  I'm just not sure that any of us can say that this was one of those cases.

[Halftime Hope]

indigomama, as I see it, the real challenge will be for you as you follow mama and dad's lead as they process this.  I'm betting they are going to be all over the place emotionally, and it will be difficult to go through this journey with them and "be on their page", because it will be a moving page...I would lay several nickels on it! 

 

The smart money says they'll be sensitive about it and feeling grief over the way it turned out.

 

I wish you all the best in working through this with them and being there to encourage them.

[FO4UR]

Was she pre-eclamptic?  That's a major deal.  I nearly lost my 4th b/c of a deteriorated placenta...from the pre-ecl.  It was an ordeal that involved more than that, but the high bp is a huge deal.  

 

 

That said, I have done my share of eye-rolling and refusing the offer to induce over issues such as icy roads in December.  Interventions are misused too often, but there are times that they are necessary...and there are things we can't know for certain. My baby had an u/s 2 hours before the placenta abruption and everything looked perfect...had 2 Dr's (one was an OB expert) and the R-tech looking...not a hint of the disaster to come. The markers were high bp, swelling, protein levels in the urine.  

 

 

There were probably other factors that led to the c/s...giving pit and then lying flat in bed.... :glare:  :grouphug:

[Mergath]

140/80 is normal. Assuming that she wasn't symptomatic, her Dr. Is BSing her, and putting her and her baby at risk unnecessarily, and robbing her of a healthy, positive entry to motherhood.

This is an unfortunately all too common scenario. I am sad for her to be put in this position, and certainly the doctor will blow a lot of smoke at her about her failure and how lucky she was that he rescued her, when really it was his inability to properly assess the risk and be patient that put her in this position in the first place. 

Anyway, I agree with you, OP. This is an overwhelmingly sad trend in medical care.

 

As others have said, that depends on the woman's normal blood pressure.  For me, that would be a jump of forty points in a very short period of time.

 

I had to have an emergency c-section because of preeclampsia, and while I wish things could have turned out differently, I don't regret it.  Preeclampsia is nothing to screw around with, and most doctors treat it fairly aggressively for good reason.

[zoobie]

I had a c-section with my first after a failed induction. She was 10 days late. I'm sure some people could look at the scant facts I shared with them IRL or online and said I didn't try hard enough or advocate for myself well enough and my doctor sucked, but... Honestly, it was the best medical decision for me and my child. It sounds like you really want the best for these family members, so try to focus on the baby and not what might have been. I felt bad enough physically and hormonally, that when I felt people's "disappointment," it really, really hurt. I hope she has an easy recovery! I wound up not being able to have a VBAC with the second (though I did try to do everything in my power to improve the likelihood), and ultimately had 4 healthy babies via c-section. :)

[LMD]

I had a huge emotional reaction when a Dr was pressuring someone I love similarly. In the end she managed to avoid the c sect he was pushing for, just. Dr did use the dead baby line on mum and grandma. I was livid. Not my baby or decision but yeah, so angry!

[LMD]

meant to add, so I can relate op and hugs!

[Arcadia]

There are obgyns that prefer caesarean for every birth because they do earn more and less time is required compared to a long labor. We rejected a obgyn recommendation because of that obgyn's fondness for caesarean.

 

That said, for her BP to go from normal to high by visiting the obgyn would be something to watch out for. A spike in BP is not safe, just the same as a sudden dip in BP is bad too. I'm guessing the BP spike is due to anxiety at the obgyn.

 

My normal BP is 80/50 or 90/60. For both pregnancies, BP was at 100/70 or 90/60. Just a little bit higher than norm. 140/80 would have given my regular doctor a fright.

 

In her case, I would look around for an obgyn that encourages VBAC for subsequent pregnancies.

[rebbyribs]

Of the moms I know, I have only heard of 1 first-time-mom induction that did not end in a C-section. It makes me wonder why induce at all instead of just going straight to a C-section if it becomes necessary.  The long induction followed by a C-section sounds awful.

[Heather in OK]

I feel ya.  I hear this kind of stuff all. the. time.

That bp is borderline but not a diagnosis for PreE, let alone a reason for early induction.  PreE is diagnosed not on high bp alone, but that plus other factors.  

 

It sounds like her dr just found a reason to frighten the patient into consenting to a scheduled delivery.  

[Mergath]

I feel ya.  I hear this kind of stuff all. the. time.

 

That bp is borderline but not a diagnosis for PreE, let alone a reason for early induction.  PreE is diagnosed not on high bp alone, but that plus other factors.  

 

It sounds like her dr just found a reason to frighten the patient into consenting to a scheduled delivery.  

 

That's quite an accusation to make based on a scant amount of information.  Not all doctors are heartless villains looking to do whatever they can to get to their next round of golf.

[Ravin]

BTDT have the scar. The "dead baby card" doctors play on first time moms is ridiculous, as is the c-section rate at most hospitals.

[Shamzanne]

I totally agree with you (the OP) that there is too often a rush to induce and too much undue pressure placed on women in an already stressful situation. Doctors have great influence. It is a shame that they can't all be trusted to give the absolute best advice. (I'm not saying it necessarily was not the best advice in this instance, but the trend is alarming). My dear friend just went through this exact scenario. I was livid while she went through it but had to remind myself that the most important thing is that her baby was delivered healthy, as I was afraid my frustration would be evident to the new parents.

 

Even my OB, whom I loved, suggested I be induced when there was no other reason other than timing on his end. I refused, and he and his wife showed up at 1:00am to deliver my daughter. Sleepy, but that's what he signed up for when he became an OB.

[Reefgazer]

I have mixed feelings on this.  On one hand, I have a general distrust of doctors and their "over-medicalizing" tendencies.  I also agree that premature induction leads to C-sections (I was a recipient of this pathway myself).  OTOH, 39 weeks is not terribly early, and between placenta degradation starting in the third trimester and the issues high BP can cause, I don't think this is the worst thing that could happen to this family.  The end goal is a healthy and safe baby and mom, and if that's what they got, then I wouldn't be complaining.  Even though I was led down this path myself, I had a very good experience overall when DD was born, and we all came out of the experience happy and healthy.  Can't ask for much more than that.

[Reefgazer]

I had a C-section because of an induction, and I had a healthy and very positive entry into motherhood.  C-sections and healthy/positive entry into motherhood are not mutually exclusive.  In fact, it was so positive, I *insisted* on a C-section with my second, at my first prenatal meeting with the OB.  A positive entry into motherhood is mainly mental; if you have a mind set that the first priority is a healthy baby and mom, and that no blue ribbons are given for a vaginal birth, you will be on your way to a positive entry into motherhood.

140/80 is normal. Assuming that she wasn't symptomatic, her Dr. Is BSing her, and putting her and her baby at risk unnecessarily, and robbing her of a healthy, positive entry to motherhood.

This is an unfortunately all too common scenario. I am sad for her to be put in this position, and certainly the doctor will blow a lot of smoke at her about her failure and how lucky she was that he rescued her, when really it was his inability to properly assess the risk and be patient that put her in this position in the first place. 

Anyway, I agree with you, OP. This is an overwhelmingly sad trend in medical care.

 

EtA: I should have said "within the normal range" because medically, that is true. The numbers alone do not indicate a problem. As OP stated no other symptoms and reported that bp returned to normal, I assumed that she was not preeclampsic. I acknowledge acknowledge that emergencies do happen. I have had one myself. From the information given, this does not appear to be one.

 

[Desert Strawberry]

I had a C-section because of an induction, and I had a healthy and very positive entry into motherhood.  C-sections and healthy/positive entry into motherhood are not mutually exclusive.  In fact, it was so positive, I *insisted* on a C-section with my second, at my first prenatal meeting with the OB.  A positive entry into motherhood is mainly mental; if you have a mind set that the first priority is a healthy baby and mom, and that no blue ribbons are given for a vaginal birth, you will be on your way to a positive entry into motherhood.

I wasn't referring to the c-section, but rather to the fear tactics and unnecessary pressure.

My first ob did this to me. He told me openly that he would prefer to do all csections because "they are easier." My birth was not pleasant. It was not positive. It was a horrible, painful, terrifying succession of threats and interventions.

I have had 3 more births, with complications and have never been treated that way again. I did have an emergent birth. My baby was in danger. But my ob was as gentle on both of us as possible. We avoided a section, and we are both healthy and happy. I had a good birth, but it was quite scary.

I don't see it as positive that doctors are so uncertain of the birthing process itself that they feel major surgery is preferable to a normal birth. The fear tactics are unforgivable. There is no need to create an emergency and put a new mother through that emotional trauma for nothing.

[indigomama]

Thank you for letting me vent. I do not have a general dislike/distrust with doctors, it's just I've seen this scenario happen so many times. And when they pressure new parents with the "your baby could die" line, I get mad.  I will not bring any of this up to them. I shared my thoughts, that they asked for, before all this started. They chose to do what they did, and now my job is just to show love and support.

 

The point is, baby is now here and healthy and beautiful. Mom is recovering, and we are all rejoicing.

 

 

 

 

 

ETA: According to the mom and dad, there were no other signs of preeclampsia, she didn't feel bad, other than end of pregnancy tired. and the bp wasn't a "problem" until this week.

 

 

 

[DawnM]

Eh, they have a baby, just be happy for them.

 

I had two C-sections.  I am not going to debate with anyone about my labor and delivery, that was a personal issue.  

[AimeeM]

That would be a seriously high bp for me - it completely depends, as others have said, on that single person's baseline.

 

I also want to note that I've had 3 sections, all classified as emergencies because I went into labor before my orginal date; while rushed, I definitely still had a healthy, positive entry to motherhood.

140/80 is normal. Assuming that she wasn't symptomatic, her Dr. Is BSing her, and putting her and her baby at risk unnecessarily, and robbing her of a healthy, positive entry to motherhood.

This is an unfortunately all too common scenario. I am sad for her to be put in this position, and certainly the doctor will blow a lot of smoke at her about her failure and how lucky she was that he rescued her, when really it was his inability to properly assess the risk and be patient that put her in this position in the first place. 

Anyway, I agree with you, OP. This is an overwhelmingly sad trend in medical care.

 

EtA: I should have said "within the normal range" because medically, that is true. The numbers alone do not indicate a problem. As OP stated no other symptoms and reported that bp returned to normal, I assumed that she was not preeclampsic. I acknowledge acknowledge that emergencies do happen. I have had one myself. From the information given, this does not appear to be one.

 

[Wheres Toto]

I had an induction with my first (water broke, no contractions) that did NOT result in a c-section but looking back on it, probably should have.

 

I had an induction that did lead to a extremely rushed, emergency c-section with my second.

 

Third was a scheduled c-section and the first time I went into labor on my own- 5 days before the schedule.

 

My normal bp is 90/60 so 140/80 would be extremely high for me.

[Heather in OK]

That's quite an accusation to make based on a scant amount of information.  Not all doctors are heartless villains looking to do whatever they can to get to their next round of golf.

No where in my post did I say anything about "all doctors" being heartless villains.  I said "it sounds like….".  I didn't say it was a fact.  And based on the information given and what I know about the majority of OBs, it's probably a true statement.  

 

I've been doing birth work for eight years.  The number OBs that do the thing that the OP mentioned is quite high.  It's not uncommon.  There are wonderful doctors out there who are practicing evidence-based OB.  Unfortunately they are few and far between.  

[LizzyBee]

Of the moms I know, I have only heard of 1 first-time-mom induction that did not end in a C-section. It makes me wonder why induce at all instead of just going straight to a C-section if it becomes necessary.  The long induction followed by a C-section sounds awful.

 

I had an induction with my first baby and didn't have a c-section. I thought it was headed that way because I was only 2 cm after 12 hours of labor, so I agreed to an epidural. The epidural was what kept us from a c-section. I finally relaxed and took a nap, and when I woke up I was 9 cm and ready to push.

 

But I was induced with my 3rd for the same reason (HELLP syndrome), and that one did end in an emergency c-section at 4:30 am. The cord was wrapped around her neck and she was in distress.  Dr re-infused fluid into my uterus to try to break the cycle that was causing her distress to prevent a c-section, but it didn't work.  The OR staff was giving him grief because he had an OR reserved for me in case we needed it, but in the meantime he was trying to avoid using it. I was pretty impressed at how hard he worked to avoid a c-section.

 

OP, I have a friend who had the same thing happen to a friend, except she didn't even have high bp. OB just decided that since her due date was here, they should induce. After 12 hrs of labor 3 days in a row, they finally did a c-section at the end of the 3rd day. She was one exhausted new mom.

 

[AnnE-girl]

This is frustrating because if a woman is hoping to have more than two or three children, each c-section becomes more dangerous for mom and baby.  I was induced with my first, but it was after two weeks of watchful waiting and bedrest with PIH before I starting spilling protein during a second 24 urine catch at 40 weeks (not to grossly over-share or anything).  I did have strict orders to call immediately and go to the ER if I started experiencing other pre-eclampsia symptoms.  I had my babies with midwives and the obs they worked with respected their judgment.  If they had said I needed a c-section or to be induced earlier, I would have absolutely trusted their assessment.  While the induction wasn't fun, I had as close to the natural birth I was hoping for as possible.  

 

I agree that having a place to vent your own feelings on the matter is helpful, and to be as supportive of the parents as possible.  If the mom is having trouble dealing with how the birth went, she may look for an ICAN chapter in her area to talk to other moms with similar experiences.