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Tuesday
May262009

Dr. Aaron Caughey Discusses Stalled Labor and Patience

 

 

UCSF posted this video of Dr. Aaron Caughey discussing labor arrest. Here is the caption that accompanies the video:

More than 130,000 pregnant women could avoid cesarean deliveries each year in the US if they and their doctors simply wait a few hours more during labor, according to a study by researchers in the UCSF Center of Excellence in Womens Health.

Dr. Aaron Caughey, who led the research, explains how patience during active phase arrest of labor can help reduce maternal mortality in childbirth without a negative impact on the infant, and potentially reverse the trend of rising c-sections. The study was published in the Nov. 2008 issue of Obstetrics and Gynecology.

 

Note the man’s credentials. I think I just gave myself an inferiority complex.

 

Thoughts?

 

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Reader Comments (11)

WOW! That was awesome!! I'm going to post it as well. Neat!

May 26, 2009 | Unregistered CommenterDiana

That is so cool!! In some of the books I have read, they say that sometimes women stop dilating for particular reasons known to them, and others just dilate slower.

It is so cool that finally a doctor is getting it. Not all labors are the same. No one needs a cesarean just because they aren't dilating as fast as the doctors would like them to.

Thanks for posting it!!

May 26, 2009 | Unregistered CommenterKayce

Sure thing! Spread it around. It's worth watching.

May 27, 2009 | Registered CommenterJill

Definitely adding this guy to my list of favorite OBs! Thanks, Jill. You never fail to find the best stuff!

May 27, 2009 | Unregistered CommenterBuscando la Luz

Haven't watched the video as I'm at work, but I'm currently reading "Pushed" and one of the midwifes in there mentions that if you leave well enough alone, many women have a rest period, I think it's just before transition. She explained that once the head is engaged in the pelvis the uterus needs time to shrink down around the empty space before giving the final push.

It wasn't really the point of this particular midwife's profile so the author doesn't talk about it much, but it certainly crossed my mind that at best most women would be given (or upped) Pitocin at that point, or be sold on a section. This is such an uphill battle, isn't it?

May 27, 2009 | Unregistered CommenterEG

I have emailed this to all my Obstetricians!! ha! I'll let you know what feedback I get. We have a couple who do wait during a stall...but then if there is a shift change, the next Doc may not want to "wait any longer". Hope this changes some views.. Whew! Would LOVE to work with this guy!

May 28, 2009 | Unregistered CommenterBirth_Lactation

Birth_Lactation, let me know their reaction. I wonder what they'll have to say.

EG, yes. It does feel like an uphill battle.

Lani... thanks!

May 28, 2009 | Registered CommenterJill

Dr. Caughey really hit the nail on the head when he talked about the "culture" of an L&D floor. That's a big problem on the L&D floor I work on, the "culture" is that pregnancy is a disease that must be cured, getting the baby out is the only important thing about birth, and every woman is a ticking time bomb for complications. Its really frustrating! And I know that I am not alone! There is a big mistrust of nature and an OVER-trust of medical intervention and technology.

~Melissa
www.nursingbirth.com

May 29, 2009 | Unregistered CommenterMelissa

Accultuation and assimilation are really powerful forces in our lives, aren't they?

That ticking timebomb feeling is so, so counterproductive to labor. That stress is palpable when you're the one in labor!

May 29, 2009 | Registered CommenterJill

This phenomenon has actually been recognized by "The Bradley Method" for many years, if not decades as the "Natural Alignment Plateau." It was in my workbook when I took classes in 1998...who knows how long it was in there. They said that baby could be lining up, head molding, hormones could be balancing...any number of things could be going on that were "unseen progress."

Great that there is research out about it! It did disturb me though when he mentioned a 60% induction rate--was he just referring to women with an "arrest of labor," or their over-all client population? It would seem to make sense to me that induced women would be more likely to run into this issue since the baby might not be lined up & ready for labor yet, or the pelvis ready to spread enough, so initial dilation might happen, then an "arrest" occurs when the position of the baby or "flexibility" of the pelvis becomes more of an issue.

Jenn
www.knittedinthewomb.com

May 30, 2009 | Unregistered CommenterJenn
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