Wednesday, October 3, 2012

A VBAC and Pitocin?

I'm pretty excited at the moment.  Last night, while browsing through information about the hospital I'm supposed to be giving birth at, I found a local site that offers volunteer doula services, that include three visits before the birth and being present to assist at the the birth.  When Paul came in the room I was practically jumping up and down (or I would have been if I hadn't been so incredibly exhausted) and he quickly agreed that I should call this morning.

You see, there's this little part of my conversation with that doctor who isn't my doctor but could potentially be present at the birth of the baby that has been bouncing around in my head these past few days (I don't think it even made it into my 9 Quick Takes last week because there was just too much to remember about that particular conversation).

Towards the end of the conversation I asked him if the hospital, nurses and doctors would be pushing Pitocin on me.  From what I'd always understood, that wasn't something that was recommended for VBACs.  Besides that, I have a very, very, very bad attitude about pitocin, that comes from pushing for five hours without an epidural, with pitocin, and having it accidentally be turned up instead of off for the last hour which resulted in my OB appearing in the room, seeing what had happened, and being furious, and telling the nurse that had made the mistake that she wouldn't be in the OR.

The doctor replied that there's pitocin isn't counter-indicated for VBACs and that "we have to start labor somehow" and pitocin is usually the best way to do it.

"But," I pointed out, "I've never actually needed pitocin.  I've never been overdue.  I've gone into labor on my own, first on the day before my due date and then at 39 weeks." And honestly with the way the birthing waves are already are going, I'd be shocked if I made it to my due date.  I'll be grateful just to make it to November.

"Well," he responded, "we can't break your water until your at least four centimeters, there's no point, so we use pitocin to start things off."

Apparently the man doesn't realize that if you just wait things tend to "start off" on their own and are more likely to come to a non-slicing conclusion.

"I've been 4 centimeters at 36 weeks with both pregnancies." I pointed out, "and have always gone into labor on my own, before my due date."  I don't say, "I'm probably already at 4 now, since I've been having 'birthing waves' for over a month... real ones... I feel qualified to say, having gone through this three times now..."

"Well, the contractions you'll have with pitocin aren't any stronger than the contractions you'll have without it."  This is where, in a real moment of self control, I don't laugh at him and point out that it's very obvious that he's never had a pitocin drip.  Yes Sir, there is a difference.  A dramatic difference for many women.  And physically there is a difference between your body producing surges of oxytocin and a solid non-stop stream of pitocin entering your blood stream.  The results are not identical.

And so I left the office with the definite feeling that pitocin will very much be pushed on me.

I fully intend to say no (and you know, not to go near that hospital if I'm not having contractions on my own).  But there's a certain type of story that I've heard enough of that gives me pause that involves mom saying no and person giving pitocin giving it anyways.  And while I'm hoping to have a hep lock and not an IV, I dislike the scenario even more that has me, you know, ripping said IV out of my arm, which is what would happen if someone gave me pitocin to "speed things up" at this point (if for some reason I "have to" have an IV).

Which brings me back to my joy at the possibility of having a doula in the room as a third person to back up my decisions and say "no we're not doing that unnecessary intervention for no particular reason."

I'm definitely calling the number this morning, and hopefully setting up an appointment soon.

This whole thing seems to be infinitely more crazy than it has to be... I feel like I'm already fighting to have a natural birth... and I haven't even arrived at the hospital.  But I am excited at the prospect of having additional help that appreciates that interventions aren't always necessary...  and hopefully I'll know more soon!


  1. I have had a doula for 3 of my births and it was money well spent. I wouldn't do it any other way unless I had to.

  2. What a mess!! I'm glad you've been through this, know what you want, and will stand your ground. Hopefully the doula will help even more!!

  3. Good for you! And if it helps any... I've had 6 full term births and my pitocin labor was the absolute WORST. My body was in shock even though she was my tiny preemie. AND... it didn't even work. They had to break my water anyway. Never again!

  4. I'm so glad you found those doulas! It makes me angry beyond words that childbirth has become - in about 99% of cases, it seems - a medical event to be manipulated and managed rather than a perfectly normal, natural occurrence. Grrr.


  5. My first labor was induced with the dreaded pit drip, and it was also the worst. 4 labors after that one seemed so much better. I hope you can get what you want! I love my midwife, but if I needed to use a doctor, I would definitely get a doula. I have nothing against doctors (my brother and sister are both doctors) but they usually jump to the worst possible case scenario and don't like to wait things out. Good luck!

  6. Isn't it sad you even think you might have to "fight" for a natural birth!! How on earth did women have children for the last 6000 years without pitocin to "start things off"? lol I will keep you in my prayers that things will go smoothly and everyone at the hospital will just agree to what your wishes are so this blessed event can be full of the joy it should be ;0)

  7. I am always amazed at doctors who think that THEY need to do something to get labor to start. My son was 10 days late and my midwife was not concerned at all - just had me do a non-stress test and went over some natural induction methods that were safe to try at home if I wanted to, and.since he was healthy she wasn't going to bother worrying about him unless he went more than 14 days post-due. I did end up with Pitocin, but I trusted my midwife when she suggested it (he ended up being born fist-and-head first.)

  8. I am very wary of all those, hurry up labor methods, including breaking the waters. With my second I showed up at the hospital 6 cm dilated and the certified nurse midwife proceeded to break my waters without even asking me, or telling me until she was in there doing it. (baby had a nasty little scab on his head for many weeks). Well baby didn't like that very much and went into distress which cause the CNM to have me start pushing before I was fully dilated (still had a lip of the cervix in the way). If it had been my first I would have had a c-section. Not to mention my entire labor was 2.5hrs, why in the world do you need to hurry up that labor? The speed of the labor was scary and caused massive amount of adrenaline to enter my system which caused both me and the baby to be very shaky.(One of my mom's labors, they broke the waters to speed up labor and she still ended up laboring for 24 hours, and my brother had a hematoma the size of an egg on his head, and then had jaundice problems).

    What really gets me is that my first labor was only 7.5hrs, so it is not like I had a history of long labors. My last baby was 5.5hrs, which I thought was better than the other 2. It wasn't so fast to make me go into shock like the second but was faster than the first, which was more tiring because of the 2.5hr pushing. It probably wouldn't have been the whole 5.5hrs, except that I never got the chance to push. They weren't really ready for the sudden change of being 5cm and then being ready to give birth. Baby sort of just sort of crowned on her own. I did push the body out, but I think I pushed harder during the after birth. =)

  9. Hi Cam,

    You already know my labor stories and what I'm going to say. :) Natural contractions and Pitocin contrations = NOT REMOTELY THE SAME! I hope that you're able to secure the doula!

  10. I have used a doula for my hospital births. Frankly, I wouldn't give birth in a hospital without one. I have my babies at home now, but wouldn't hesitate to hire one if something goes wrong and I have to change my birth plan.

    I recently was the unofficial doula for one of my friends at her hospital birth with an OB. Thank goodness I was there to advocate for her, because this man was trying to push her into doing everything she didn't want to do - artifically rupture her membranes to move things along, use pitocin to speed things along (it was a Sunday and he obviously didn't want to be there all day), he tried cutting her when she didn't want an episiotomy, told her she was being too loud during pushing, etc. It was a nightmare. I cringe to think what would have happened to her if I wouldn't have been there to support her and remind her (and the OB) about her birth plan. He actually threatened a c/s when she had only been in labor for three hours simply because she hadn't progressed in an hour and she was refusing to have her water broken. But she stayed strong and positive and ended up with a beautiful, uncomplicated natural birth. Having a positive support team there is so important!

    Good luck! You are educated about your choices and strong-willed, so I'm sure your experience will be wonderful.

  11. Make sure you are very clear with the doula about what you do and don't want her to do. I had a doula with my first daughter and while she was very nice, she was pushy and had me labor her way and not mine. I skipped the doula on my last two labors and it was a much better experience and easier labor for me.

    Oh and they don't have to break your water all all. With my first two the midwife broke my water when it was at 3-4 cm and after that contractions became much stronger. WIth my last baby the midwife wouldn't break my water. It didn't rupture until I had started pushing.

  12. I find it interesting that the doc feels pitocin is ok and yet I have friends who planned vbacs and were told castor oil was a no no. You'd think pitocin would be worse. I've never had a section but had waters leaking all three times and used castor oil with the the last two. It's a bit unpleasant but not unbearable and I sure had fast labours. PS I had pitocin with #2 and honestly it didn't feel any different than the other labours. (but I have very fast short active labours and killer afterpains) Anyway I'll keep you in my prayers that it all works out for the best. I have a friend who tried for a VBA3C and it didn't go but she did end up with a very "natural" csec. (ie delayed cord clamping/skin to skin/ etc)so she did feel resolved. (the word natural was her phrasing)

  13. Hooray for the free doula possibility! That's awesome! The presence of a doula should definitely help you be able to stave off any unnecessary interventions like pitocin (which I call Satan's brew).

    I have also had 2 c-sections and am anxious to see how things will go the next time around. I know it's going to be a fight, but one that's well worth it.

    Just remember that you can do this, your body can do this! I'll be praying.

  14. *raises hand* Another woman here who can assure your doctor that Pitocin contractions are much, much stronger than regular contractions. I'm infuriated for you, but very glad that you will be having a doula at your birth. I recently switched from an increasingly intervention-happy, slice-and-dice OB to a midwife at a birthing center. (That being said, I'm a low risk pregnancy. I know that probably wouldn't be an option for you since you're trying for a VBAC). Even though I know I won't have to fight off unnecessary interventions, I'm still going to have a doula to help me with labor/delivery positions, light touch massage, etc. Best of luck to you!

  15. I wish I had more time, but since I do not: I believe you have my email via my etsy purchase (LOVE my sacrifice beads!). My last delivery was a VBAC, and if you have questions, including about pitocin use, I'd be happy to share. It sounds like your biggest dilemma is the nasty, ignorant doctor. Is your hospital the same way? I would STRONGLY recommend a doula, but it doesn't sound like you need anyone to tell you that! ;-)

  16. Just make sure the doulas are not trained by the hospital itself. There is a move to provide "support" that has been trained to back the doctors and manipulate the woman to go along with it.

    I've heard the best results come from refraining from going to the hospital until you begin to transition.

    The more "help" the doctor applies to get the labor going, the higher the likelihood you will end up with another c-section from what I have read.

    You are in my prayers.

  17. I tried for a VBAC after my twins were delivered via c-section and it was against hospital for them to give me pitocin. The one requirement for my VBAC was I had to go into labor naturally and progress naturally. I would be concerned that your doctor doesn't seem to understand the risks associated with pitocin and VBACs

  18. Lol. Ann, if I waited until I hit transition to go to the hospital, I'd never deliver in a hospital! I skip transition faster than you can blink. My poor OB has made it to exactly one of my last three births (the first was a different doctor), and he barely made that one! I actually told them with my last to call him when I hit 7 cm rather than waiting for 10--they missed 7 but called him at 8--he still didn't make it. :) That pointless anecdote aside, unless it actually becomes a necessary intervention, stay AWAY from the pitocin. It's particularly dangerous for VBAC mothers. I can't believe that doctor's sitting there basically telling you you're GOING to have pit. Ugh.

  19. I'm praying for you sister! We're on the same baby schedule it seems (4.5 Daughter, 2.5 son, 10 month old baby in heaven), miscarriages and all! I'm due 11/13 or 16 depending on who you ask. I had Pitocin for my first and would advise avoiding it like the plague! Do you have Certified Nurse Midwives you can go to? I love mine and I know that they'd recommend and assist a VBAC!


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