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T_Rex View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote T_Rex Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 2:50pm
I guess the OB likes empty tums for surgery? I've had several people (MW, child birth educator) stress it was important. Mmmm danish pastry
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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 3:12pm
Originally posted by T_Rex T_Rex wrote:

I guess the OB likes empty tums for surgery? I've had several people (MW, child birth educator) stress it was important. Mmmm danish pastry


Ooooohhhh I am itching for a rant.

I loathe all these things we are supposed to do to make things easier for potential surgery - particularly when so many of them make that surgery more likely.

Labour is hard physical work, women should be encouraged to keep hydrated and fed throughout. Instead they're discouraged from eating "in case" they need surgery. It makes me wonder how surgeons manage emergency surgery where the person hasnt refrained from eating for hours beforehand.

Ditto to IV lines. If a nurse/doctor isnt able to insert an IV line under pressure in an emergency situation then I dont want him/her near me with a needle. I am certainly not going to get an IV in advance "just in case" (as an aside my DH inserted the IV before my c-sec when the nurse couldnt manage and I ended up in tears after 4 failed attempts).

My midwife tells me that I'll be contacted by the hospital for a consult with an OB and just thinking about the hospital protocols gets my back up. I am wondering if the consultant will discuss the potential risks of a repeat c-section as well as the risks of a VBAC? Or if like the previous 3 OB's I have seen (in previous pregnancy) they will stress the dreadful risks associated with a vaginal birth and not mention any of the risks associated with c-section.



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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 3:23pm
And there I go outing myself as a militant

Back to my chocolate...



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fire_engine View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote fire_engine Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 3:32pm
LOL Azza. I think it's allowed on this thread. I'm like T-Rex, bad birth but not c-s (though nearly) but yes, the not being allowed to eat (and not being offered food for 12 hours + after giving birth) really pisses me off. I also found it interesting that though I had explicitly said I would like to have the epi wear off while pushing, I was reading my MW's notes again the other day and they had actually kept ramping it up every 20 minutes during the 2nd stage.

I now take very careful mental notes of things that I want my (new) MW to know. Weegee, I like your idea of having a record of birth principles (not necessarily plan cos we know the baby doesn't always read them!).

Thanks for all sharing your stories and ideas. Like I said earlier, not a VBACer, but I am trying to avoid a traumatic 2nd birth so figure it's OK for me to read and learn!

Lurker out.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote weegee Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 3:44pm
LOL don't worry I'm a bit of a militant these days too AzzaNZ. I have my hospital OB appointment tomorrow afternoon (they rang me this morning to tell me, lucky I'm able to make it really) and I can't wait actually In fact I remember the particular OB I'm booked in to see from my last stay at Waitakere and he was nice enough. Maybe I'll just smile and nod and ambush them with birth plan stuff when I arrive, although I just spoke to my midwife and she suggested I might like to talk to him about potential post dates management (although I'm thinking since JJ arrived pretty much bang on time it's unlikely to be an issue).

ETA - I don't think anybody needs to apologise for lurking here - if this forum allowed editing of thread subjects I would consider renaming it. Different forms of intervention-led birth trauma provide us with as much opportunity to learn as c sections.

Edited by weegee

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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 4:36pm
Originally posted by weegee weegee wrote:

LOL don't worry I'm a bit of a militant these days too AzzaNZ. I have my hospital OB appointment tomorrow afternoon (they rang me this morning to tell me, lucky I'm able to make it really) and I can't wait actually In fact I remember the particular OB I'm booked in to see from my last stay at Waitakere and he was nice enough. Maybe I'll just smile and nod and ambush them with birth plan stuff when I arrive, although I just spoke to my midwife and she suggested I might like to talk to him about potential post dates management (although I'm thinking since JJ arrived pretty much bang on time it's unlikely to be an issue).


I need to try and get my "smile and nod" face ready for my appointment. I foresee it lasting about 5 seconds before I cant restrain myself and tell them exactly what I think of the hospital protocols.

Is anyone else birthing at North Shore hospital? My midwife does HBAC's so that would be preferable but never having laboured before I dont know if I will want to be home or in hospital and would like to keep my options open.

I spoke to my midwife about going post-dates as she wanted to know what my plan was. I have said that I would agree to an elective c-section at 42 weeks (which will in reality be 42w6d or thereabouts)... hoping I go into labour naturally before then, I would so hate to have another c-section where I dont even go into labour.



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T_Rex View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote T_Rex Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 5:34pm
Originally posted by AzzaNZ AzzaNZ wrote:

Originally posted by T_Rex T_Rex wrote:

I guess the OB likes empty tums for surgery? I've had several people (MW, child birth educator) stress it was important. Mmmm danish pastry


Ooooohhhh I am itching for a rant.


Whoops - distracted by a certain small someone whilst posting - I meant the MW and CBE stressed it was really important that I DID eat.

Goodluck for tomorrow Weegee!
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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 6:05pm
Originally posted by T_Rex T_Rex wrote:

Originally posted by AzzaNZ AzzaNZ wrote:

Originally posted by T_Rex T_Rex wrote:

I guess the OB likes empty tums for surgery? I've had several people (MW, child birth educator) stress it was important. Mmmm danish pastry


Ooooohhhh I am itching for a rant.


Whoops - distracted by a certain small someone whilst posting - I meant the MW and CBE stressed it was really important that I DID eat.


I breathed a sigh of relief at that!!



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weegee View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote weegee Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 6:18pm
Tanya there's no way I'm going anywhere near North Shore, that's where JJ was born and has the highest rate of c sections of any public hospital in NZ (27% - Waitakere is 18% but National Women's isn't much better than NSH at 25%). If my mw was comfortable doing a HBAC I'd totally be heading that way - it's not like you live in the middle of nowhere and can't be transferred if things do go pear shaped. But I do understand it's not everybody's cup of tea.

(NB before I had the discussion with my mw I did a lot of research into HBACs and can point you in the direction of lots of resources on that subject if you need.)

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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 7:11pm
Originally posted by weegee weegee wrote:

Tanya there's no way I'm going anywhere near North Shore, that's where JJ was born and has the highest rate of c sections of any public hospital in NZ (27% - Waitakere is 18% but National Women's isn't much better than NSH at 25%).


Those figures aren't great

I'm only about 4km's from the hospital and my midwife can deliver there so it would make sense to head there rather than to another hospital. Do you even have a choice or does it depend on where you live?

My midwife has had successful VBAC's at North Shore hospital but I havent asked how many.



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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 7:12pm
Originally posted by weegee weegee wrote:

(NB before I had the discussion with my mw I did a lot of research into HBACs and can point you in the direction of lots of resources on that subject if you need.)


Yes please! Any links would be great. I've looked through the ones shared previously (except the first link that didnt open for me)



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Post Options Post Options   Thanks (0) Thanks(0)   Quote mummyofprinces Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 7:38pm
To be fair NSH figures dont break down to elective versus emergency AND high risk electives are not done at Waitakere so are booked into NSH so the figures are slightly skew there.

Also the percentage of people who use private OB's as their LMC are quite high on the shore and a personal opinion that is why more electives are done at NSH (or failed inductions) as my mw says, the more unneccessary scanning the higher the chance of them picking up a potential "risk" leading to unneccessary intervention.

I birthed at NSH and it was a horrible experience, but that was due to the circumstances and certain staff (one of whom will not be alllowed to come into my room without permission due to the way she treated me unless its an emergency... bit difficult considering she is charge nurse).

I will happily go back to NSH because I have a fantastic MW whom I have had recommended to me by several people in the industry as well as the charge nurse at Birthcare as I didnt want to birth at NSH orginally and she gave me 4 names as people who are held in good esteem by the hospital staff (ie they have a fair bit of pull and can do things that push the protocol boundaries).

As for the OB's at NSH, they are pushing VBAC's at the moment because they are under very strict KPI's around reducing the section rate... though not all of them are doing it I am sure. My mw is coming to my appt (fingers crossed she isnt in a labour) as she has some questions about my previous pregnancy and as I was under the hospital and was assigned an OB i can see the same one again.

I think the most important thing is (as mentioned before ) to have someone in your corner.... I have a wonderful CBE acting as my doula and a mw who wont ask "do you want any pain relief" and I think thats the 2 most important things for me!!!!

I would love to birth at home but my mw isnt comfortable with HBAC's (although she has done a few that were meant to be at hospital but they didnt make it LOL) and DH is really anti it. If it was up to him I think I would be having an elective as he sees it as the "safer" option.... It must have been quite scarey for him watching everything unfold and having not control over it!

LOL sounds a litte PRO NSH, its not meant to!


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Post Options Post Options   Thanks (0) Thanks(0)   Quote fire_engine Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 7:39pm
I would read the ACH stats with caution given that they also are the regional fetal medicine service and do all the high risk babies incl cardiac and neuro kids where there may be good indications for c-sections.

I imagine the Waitak rates differ with the days - Tuesdays used to be the highest day b/c Dr C-Section was on. Fridays were lowest b/c Dr low-intervention was on
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mummyofprinces Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 8:08pm
LOL flissty... so true!!!!


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Post Options Post Options   Thanks (0) Thanks(0)   Quote weegee Quote  Post ReplyReply Direct Link To This Post Posted: 09 June 2010 at 9:33pm
Excellent points about the stats Fliss and Mel. My appointment tomorrow is with Dr Low Intervention which is good

Azza it depends both on where you live and who your midwife is as to what choices you have for where to birth. Mel I agree that being comfortable with your midwife is more important than where you're planning to birth, that's why I'm heading to Waitakere (assuming they agree with me that I'm low risk!) and not doing a HBAC with a different midwife.

Originally posted by melnel melnel wrote:

Also the percentage of people who use private OB's as their LMC are quite high on the shore and a personal opinion that is why more electives are done at NSH (or failed inductions)


I agree with this too... hire a surgeon, get surgery!

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Post Options Post Options   Thanks (0) Thanks(0)   Quote fadeless Quote  Post ReplyReply Direct Link To This Post Posted: 10 June 2010 at 8:16am
With the post-dates thing...... with my 3rd birth (1st HBAC) i went 18 days overdue from scan date! OBs were giving my midwife heat but i just said no, she did offer NST after OBs told her to and i said ok only to ring her back the day before it was supposed to be done and refused it and she said that was fine.

I credit my midwife so much with my HBACs, she was sooooo amazing, so calm and collected and didnt stress me even though she was stressed, she thought 3rd bubs might have been breech at one stage and 4th bubs shoulders got stuck.

The midwife i have with this birth (she is a partner with my old midwife who is on holiday when im due) did a big study of Tga hospital and c/s's and they are most likely to happen on a Saturday or Wednesday evening/night, my c/s was on a Wednesday, wish i was told sooner!

I never ate during any of my labours, just chugged down powerade lol.

Edited by fadeless
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weegee View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote weegee Quote  Post ReplyReply Direct Link To This Post Posted: 10 June 2010 at 8:28pm
I'm sure I'll kick myself and say duh when you give the answer fadeless, but what does NST stand for?

Warning essay ahead:

Well I am happy to report that my OB appointment today really couldn't have gone any better! I was so surprised to walk out smiling! The OB was completely lovely and didn't give me any big spiel about risk. He had obviously read through my notes and was familiar with my situation. He asked me why I had delivered at North Shore last time and I said it was just because it's a shorter travel time from home and my parents are on the Shore, but that I know that my chances of a successful VBAC are better at Waitakere so that's why I'm booked in for there this time. He suppressed a smile and said "well that's true". Instead of telling me what the risks are he asked "what do you think the risks are of a VBAC" and I couldn't resist, immediately said "well they're less than the risks of a c section" and he didn't bother to suppress his smile that time I did say "well it's the uterine rupture thing of course, but the risks of that are still very small" and he agreed with me. We had a bit of a philosophical discussion about why women don't realise that there are risks associated with c sections and that it is major abdominal surgery which was itneresting. Then he said "how do you rate your chances" and I said "90% or more, I know what I'm doing this time round, I got to 9cm last time, there's no reason why my body can't do it" and he nodded and agreed with me. He said I'm young and healthy and obviously smart and he doesn't think there's any reason why I should have any difficulty getting my VBAC. He also said they've had 3 successful VBACs there so far this week.

The only things he said that I expected to hear from an OB were something about how I may have to have more monitoring (that's when I smiled and nodded while thinking something else), and when he glanced back at my notes and said "your first was 4kg, that's quite a large baby for quite a small person". I explained I was a bit bigger when I was pregnant with JJ and that I've lost weight since then (I'm still not as heavy now as I was pre-pregnancy with JJ). He looked at the size of my belly and said "well from here it still looks like you're going to have a decent sized one" (sheesh like you can tell just from glancing at me).

I asked about post dates management and whether he would want me to have a post dates scan or how he would prefer to approach it and he said if I was older he would be suggesting a scan at 38 weeks but since I'm young (I'm 30 - it's quite nice to have a doctor tell me I'm young) he doesn't want to see me until 40 weeks at the earliest, if I haven't gone into labour by then we'll reevaluate then, he won't necessarily want a scan or to start talking about induction (I didn't say I would refuse induction anyway).

He smiled and said we probably wouldn't get that far, that a nice 3.5kg term baby would be good, and that he'll see me mid July ish.

So all in all it was very empowering and I walked out practically bouncing! My midwife was stoked to hear it went so well

Mum to JJ, 4 July 2008 & Addie, 28 July 2010
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AzzaNZ View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote AzzaNZ Quote  Post ReplyReply Direct Link To This Post Posted: 10 June 2010 at 8:30pm
Glad it went so well weegee!



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Post Options Post Options   Thanks (0) Thanks(0)   Quote fadeless Quote  Post ReplyReply Direct Link To This Post Posted: 10 June 2010 at 9:36pm
NST stands for non-stress test, when they monitor bubs for a certain amount of time to make sure baby is fine, its done at the hospital and usually offer it if you go overdue.

Thats great your OB appointment went well, makes things so much easier when the OB is on your page.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote weegee Quote  Post ReplyReply Direct Link To This Post Posted: 10 June 2010 at 10:18pm
Ah, I didn't actually know that fadeless! Makes sense though.

Thanks girls

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