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Monday
06Jul2009

"Pit to Distress": Your Ticket to an "Emergency" Cesarean?

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Jill from Keyboard Revolutionary wrote about a new term that she recently came across— “Pit to distress.”

“Pit to distress.” How have I not heard about this? Apparently it’s quite en vogue in many hospitals these days. Googling the term brings up a number of pages discussing the practice, which entails administering the highest possible dosage of Pitocin in order to deliberately distress the fetus, so a C-section can be performed.

 

Yes folks, you read that right. All that Pit is not to coerce mom’s body into birthing ASAP so they can turn that moneymaking bed over, but to purposefully squeeze all the oxygen out of her baby so they can put on a concerned face and say, “Oh dear, looks like we’re heading to the OR!”

 

The term is found in this 2006 article in this Wall Street Journal article:

 

Oxytocin is a hormone released during labor that causes contractions of the uterus. The most common brand name is Pitocin, which is a synthetic version. It’s often used to speed or jump-start labor, but if the contractions become too strong and frequent, the uterus becomes “hyperstimulated,” which may cause tearing and slow the supply of blood and oxygen to the fetus. Though there are no precise statistics on its use, IHI says reviews of medical-malpractice claims show oxytocin is involved in more than 50 percent of situations leading to birth trauma.

 

“Pitocin is used like candy in the OB world, and that’s one of the reasons for medical and legal risk,” says Carla Provost, assistant vice president at Baystate, who notes that in many hospitals it is common practice to “pit to distress” — or use the maximum dose of Pitocin to stimulate contractions.

 

 

It’s also used on this AllNurses forum:

I agree, and call aggressive pit protocols the “pit to distress, then cut” routine. Docs who have high c/s rates and like doing them, are the same ones that like the rapid fire knock em down/drag em out pit routines.

 

 

“Pit to distress” appears on page 182 of the textbook Labor and Delivery Nursing by Michelle Murray and Gayle Huelsmann. In this example, the onus is on the nurse to defend the patient from the doctor if he or she sees the order “pit to distress” by immediately notifying the supervisor or charge nurse.

 

  

 

 

Jill asks the questions, “OBs, do you still think women are choosing not to birth at your hospitals because Ricki Lake said homebirths are cool? Do you still think we are only out for a “good experience?”

 

I imagine that all of us who have openly questioned the practices of obstetricians in the U.S. have been hit with the same backlash. We must be selfish, irrational and motivated by our own personal satisfaction. We’ve been indoctrinated into a subculture of natural birth zealots and want to force pain on other women or just feel mighty and superior. We fetishize vaginal birth and attach magical powers to a so-called natural entrance to the world.

 

Nah. It’s stuff like “pit to distress” that made me run for the nearest freestanding birth center. If I had to do it all over again, I’d stay home.

 

 

 

Have you heard this term before? What is your experience with “Pit to distress?”

 

 

Before you comment here, please go applaud Jill from Keyboard Revolutionary for blogging about this term and enjoy her brilliant and honest commentary.

 

 

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Reader Comments (80)

That is truly disgusting. And then when the woman balks, they berate her for "putting her baby in danger"

July 6, 2009 | Unregistered Commenterlorien

Wow, I can't believe I have never heard of this before. It just makes me so mad. Purposely putting your baby in distress so they can wisk you off for a cesarean. This is not right!

Yet another example of how evidence based medicine is not practiced in obstetrics.

July 6, 2009 | Unregistered CommenterKayce

Remembering George W. Bush and the Love of OB-GYNs
Posted By Christine C. On January 19, 2009 (11:23 am) In Politics

On the final day of George W. Bush's presidency, we bid farewell not only to eight years of failed policies but to gaffes like this gem:

At a rally of cheering supporters in Poplar Bluff, Missouri, Bush made his usual pitch for limiting "frivolous lawsuits" that he said drive up the cost of health care and run doctors out of business.

But then he added, "We've got an issue in America. Too many good docs are getting out of business. Too many OB-GYNs aren't able to practice their love with women all across this country."

What's your favorite Bushism?

Article taken from Our Bodies Our Blog - http://www.ourbodiesourblog.org
URL to article: http://www.ourbodiesourblog.org/blog/2009/01/remembering-george-w-bush

No offense intended to any GB fans out there.

July 6, 2009 | Unregistered CommenterAnon

I am so glad I have a bit of a choice as to where I'm going to have my baby - I plan to have her at a local birth center staffed by midwives. They will whisk me off for a c-section if the baby is breech, but so far, at 37 weeks, she's still head down... Fingers crossed!

July 7, 2009 | Unregistered CommenterCaroLyn

I am so appalled by this that I cannot even gather my thoughts enough to express how I really feel. I am a doula and soon to be childbirth educator and my husband is a bit of a birth junkie himself. When I told him about 'pit to distress' his response was 'what do they think pregnant women are?'

i am with you, I would do it at home. I unfortunately had an inverted t incision c section (for a face first presentation) and don't know if VBACing at home is the wisest choice for me but I can guarantee you this, I will NOT be having any unnecessary interventions and I am educated enough to know when it's necessary or not.

July 7, 2009 | Unregistered CommenterAmy

Lorien, I agree. Try speaking up and you'll hear why you should leave your and your baby's health decisions to the doctor.

July 7, 2009 | Registered CommenterJill--Unnecesarean

CaroLyn, I didn't know you were so far along! Congrats and fingers crossed for heads down. :)

July 7, 2009 | Registered CommenterJill--Unnecesarean

Wow - crazy stuff! Thanks for letting us know!!

July 7, 2009 | Unregistered CommenterDiana

Amy, I am really appalled, too. I guess we all knew it happened but I never knew it had a name, indicating that it's totally deliberate.

Anon, I love that Bushism. It's so funny, yet it shows how clueless people (or at least Bush) are about the reasons for litigation. Is the above VBAC case frivolous? Hardly. That's malpractice.

July 7, 2009 | Registered CommenterJill--Unnecesarean

Oh. My. Lord.

*vomits*

Jill replied: Bonnie, I'll hold your hair back.

I am so thankful to live in this high tech world so this kind of information is available to the masses. Women in the USA are coerced into so many, many procedures, and forced to comply with so many policies - most of those procedures and policies doing more harm than good for them and their babies. WAKE UP AMERICA! Birth is not an illness, and NOTHING we need to be saved from. It is a beautiful, empowering, loving, spirit-filled experience, and we need to TAKE IT BACK!

July 7, 2009 | Unregistered Commentermidwifelynda

How ironic--I posted about the exact same thing last night. I wish I had seen your post first, there is so much powerful information to share here. Well done.

July 7, 2009 | Unregistered Commenterkangaroo

Hi kangaroo... I like your blog. I'm linking to the post you mentioned.

Thanks for the comment and for stopping by.

July 7, 2009 | Registered CommenterJill--Unnecesarean

Jill asks the questions, “OBs, do you still think women are choosing not to birth at your hospitals because Ricki Lake said homebirths are cool? Do you still think we are only out for a “good experience?”

I imagine that all of us who have openly questioned the practices of obstetricians in the U.S. have been hit with the same backlash. We must be selfish, irrational and motivated by our own personal satisfaction. We’ve been indoctrinated into a subculture of natural birth zealots and want to force pain on other women or just feel mighty and superior. We fetishize vaginal birth and attach magical powers to a so-called natural entrance to the world.

Nah. It’s stuff like “pit to distress” that made me run for the nearest freestanding birth center. If I had to do it all over again, I’d stay home.

Absolutely right on!

July 7, 2009 | Unregistered Commenterpampered_mom

The reality is that there are a lot of rogue doctors (and yes, midwives) that practice to the beat of their own drummer. They give the majority of good doctors a bad name. Doctors are notoriously bad at policing themselves. Most hospitals have protocols on disciplining doctors for practicing outside of standards of practice, yet it has been my experience that all that happens to them is a slap on the wrist. MD's should not be complaining about litigation if they allow their own to use pitocin aggressively, especially with a VBAC. Nurses are the gatekeepers in protecting patients in the hospital. We are the eyes the ears, and in my case, the loud mouths. However our hands are tied in some respects. If we do not agree with the MD orders, let's say "Pit to distess" and we refuse to carry them out, we can be in big trouble. We should go up the change of command, but if the top link says, "do it," we are in a difficult situation. OK this comment is getting to long, so I guess I need to write my own post on the ethics of going against an MD order.
GREAT POST Jill. This will be posted in the break room at work.

July 7, 2009 | Unregistered CommenterReality Rounds

I hate how this article only paints one side of the situation. There are ligitimate reasons to use pit and yes even though I'm sure it can be overly used by some impatient doctors that is NOT always the case. Articles like this are written and put together by people who have this opinion but do not sure the con's to their own side. aka they're biased had i not had an induction my daughter would be dead. i would have waited until my contractions were 4minutes apart to go the hospital and my daughter would be dead. NOT what I want to hear. my daughter was too big for my body, it just wouldn't have happened. sometimes induction, pit, and such is the right answer for some moms. NOT all and thats fine but it is a legitimate way to go. Its up to the individual.

July 7, 2009 | Unregistered Commenterstupidness

Class. Action. Lawsuits.

Babies are being compromised. Women are loosing insurance coverage and the human right to use their vaginas in subsequent births. Divorces can be spurred by PPD and PTSD, and these diagnoses are rising. Families are forced to deal with complications of surgery and vaginal trauma. Painkillers increase the risk of SIDS. The rates of autism and ADD/ADHD keep pushing up the scale and we don't know that it's NOT attributed to obstetric drugs.

Show me a consent form which authorizes the attending to use products against manufacturer's directions. Show me a consent form which authorizes an individual or institution to disregard the health and well being of the client in order to provide a social or monetary benefit to the provider. Sheez, show me a consent form that says something other than "The material risks have been explained to me by so and so, and I consent."

The consent forms (elective cesarean/epidural) which have been recently posted on such blogs as NursingBirth contain quite long lists of possible ramifications, but how many women are given the opportunity to sign these forms? Most are self-reporting that they "had to" sign blanket consent forms allowing any procedure in order to be admitted to the hospital, and those forms do not contain the same lists of risks.

Nurses and Hospital Midwives are subject to working in hostile environments in which they either take part in sexual assaults and gross bodily harms, or loose their jobs. The "Nurse's Curse" is evidence enough that these women are also targeted for abuse during their own births. The repeat explanation is that "My hands were tied, she signed the consent form, blah, blah."

Ladies, step up and report provider abuse!

1) Being a survivor feels better than being a victim.
2) It's harder for the abuser to hurt anyone else.
3) You're protecting yourself for the future, UNGRATEFUL PATIENT, or not.
4) Nurses and Hospital Midwives are not reporting violations for you.
5) Things will not change unless clients demand it.

Sure it's hard to go up against these people and their community standing. I wonder sometimes if my own family will be targeted for the report we submitted about the abuses we lived through during our last birth. Now I know that the words I should have used at the time were "I am going to sue you if you don't cease and desist immediately. I will own you. I will own your children." would have been more effective than "No. No. No. I do not consent. I want a second opinion. I refuse to accept treatment from that doc. Let me up. etc. etc."

July 7, 2009 | Unregistered CommenterAnon

This is so disgusting but I'm really not surprised. That I'm not surprised just makes me kinda sad.

July 7, 2009 | Unregistered CommenterLindsey

In reference to stupidness...I'm not sure how inducing with pit would help get your 'too big' baby out. Unless you mean you didn't even go into labor but rather had an earlier induction. In which case there is a 99% chance that your baby was NOT too big for your body. Yes, pelvic disproportion does happen but it is VERY rare; doctors like to make women think that any baby over 8 lbs. is 'huge' and is impossible to get out which very well may be your case.
And in any case, this article wasn't about the use of pitocin, it was specifically about 'pit to distress' so what are you arguing about?

July 7, 2009 | Unregistered Commentererinfloyd101

Erin's got a point. In fact, inducing a "big" baby is probably not a good idea anyway, because a big baby's got less room to move, and Pit will very quickly cement him into what could be a bad position to try to be born. There's just not a lot of logic here.

I am really curious how much your baby weighed, stupidness. I was told I could not birth a baby bigger than 6 lbs. I went on to birth my 8 lb. 4 oz. son into my own hands. Unless you have rickets or a 13-lb. baby, it's much more likely for your care provider to be feeding you a nice steaming serving of scare tactics than it is for your baby to actually be "too big for your body."

July 7, 2009 | Unregistered CommenterJill

stupidness,

I hate how this article only paints one side of the situation.
As other commenters have noted, the other side would be to show the positives of “Pit to distress.” I don’t know what positives you anyone would find in upping Pitocin to the point of causing fetal distress, whether deliberate or not.

There are ligitimate reasons to use pit and yes even though I'm sure it can be overly used by some impatient doctors that is NOT always the case.
Agreed.

Articles like this are written and put together by people who have this opinion but do not sure the con's to their own side.
See above.

aka they're biased
In this case, not really because there isn’t really a positive spin on Pit to distress. But I have plenty of biased posts if you want to take a gander. The blog format lends itself to biased writing and I readily own that in the About page.

had i not had an induction my daughter would be dead. i would have waited until my contractions were 4minutes apart to go the hospital and my daughter would be dead.
Then it sounds like a mighty good thing you were induced!


NOT what I want to hear.
That some women and their fetuses are abused in childbirth? I agree. It’s not what I ever want to hear, either.

my daughter was too big for my body, it just wouldn't have happened.
I have no reason to doubt that based on the information in this anonymous comment. Of course, we really don’t know in life what would have happened and what wouldn’t have by choosing one road instead of another. But I trust that all commenters have a grasp on their own reality. If it wouldn’t have happened, then it sounds like you’re very pleased with your baby’s birth. That’s wonderful.

sometimes induction, pit, and such is the right answer for some moms. NOT all and thats fine but it is a legitimate way to go. Its up to the individual.
Sure is. I am a fan of the judicious use of medical intervention. I am not a fan of hyperstimulating babies, whether with devious motives or not, to the point of distress.


I went point by point, but not because I want to shoot you down or anything. It was just easier and clearer. This post had nothing to do with the appropriate use of Pitocin; rather, it shows different perspectives on the abuse of Pitocin. Since it's obvious that Pitocin is something very dear to you because, as you said, it brought your daughter to you, maybe you feel inclined to speak out against the abuse of a drug that brought you so much joy. I'm not sure how long ago your birth was but congratulations.

July 7, 2009 | Registered CommenterJill--Unnecesarean

Reality Rounds, I thought of you when I posted it. I almost e-mailed you first to hear your experience (although it sounds like your hospital is pretty exemplary) but figured you would comment. Which you have. All a part of my psychic mind games.

I look forward to reading what you have to say. When I read the nursing text, I couldn't help but think what you and Anon said. Can you REALLY go to the supervisor or charge nurse and STILL have a job or respect from docs on the job? It probably depends on the environment, politics and culture of the hospital.

July 7, 2009 | Registered CommenterJill--Unnecesarean

Anon, I hope you will submit your birth story someday. How can I tempt you to write it up and let me post it?

July 7, 2009 | Registered CommenterJill--Unnecesarean

They tried to do that to me when I transferred to the hospital from the birth center with my first birth. And they kept cranking, and cranking, and cranking... and I will forever bless Nurse N, who "accidentally" unhooked the tube from my IV, and let that evil crap just drip onto the floor, instead of into me.


Laureen, that is the best birth "accident" story ever. Thank you for reading and commenting!

-Jill

July 7, 2009 | Unregistered CommenterLaureen

Women and children are subjected to horrendous abuse by the patriarchal medical profession, as outlined in Dr. R. S. Mendelsohn's book 'Mal(e)practice'. Women are mostly, but not exclusively, subjected to abuse during childbirth, while babies and children have child abuse in the form of vaccinations inflicted on them throughout childhood. Medical practice, if not humanity in general, appears to be in the grip of what can only be called insanity.


I love Malepractice. It's one of my favorites. I wrote about Mendelsohn's take on unnecessary hysterectomies here.

Thanks for your comment.

-Jill

July 8, 2009 | Unregistered CommenterErwin Alber

How have I not heard of this before?! How?!?

Having had a cytotec-to-distress baby a mere 2 weeks ago, I am seriously considering sending this post to my client's husband (who is a lawyer). They are still so happy about their decision, that the doctor saved the baby!, I just don't know how much they want to hear yet. What would I have done if I had known the doc said to put that second dose in even though she already had a great/huge contraction pattern? I am so, so, so upset about this, I really don't have as many words at my disposal as I want/need. I just don't know what to do.

*shaking head and wiping tears*

July 8, 2009 | Unregistered CommenterNavelgazingMidwife

@stupidness: No one here - or anywhere - can logically argue that medicine isn't amazing and sometimes needed. However, there is never EVER EVER (I can state that clearly right here) a benefit to "pit to distress." Period. A necessary induction that unfortunately leads to distress? Okay. But that's not what is being talked about here. Also, as an induced mother of a "too big" child - who was born too early - I don't know that I believe that argument anymore. My son was 8 lbs 7 oz and I was told just barely small enough. Six years later, I birthed my daughter, at home into my own hands, about a pound bigger and on her own time - and in a labor under an hour. Too big indeed.

@NGM: Oh my lord! Have you even just shown them information about cytotec itself, much less to distress? How horrid! I hope the baby and mother are okay?

July 8, 2009 | Unregistered CommenterTara

@CaroLyn
Breech is not reason for a c-section. Footling breech is, but the other breech positions are just as safe to have vaginally as to have via c. If not safer because of the future risks of c.

July 8, 2009 | Unregistered CommenterLulu

Of course I feel terrible for the uninformed, trusting women who get caught up in this system, but at this point I'm feeling more sad that this term does not come as a surprise to me.

The term I have heard of previously is "Pit to D or D." The first D is deliver, the second D is distress. The L&D nurse who told me this said that as soon as there is distress, they recommend c/s.

Seems that doctors who practice this are missing the part of their heart where anything but self-interest lies.

July 8, 2009 | Unregistered CommenterLeigh

I got a sick feeling in my stomach reading this. Can't believe I never heard of it before either! I facebooked this post because I just feel like the more we spread the word, the sooner we can put a halt to this and other shameful obstetric practices. Women and their babies deserve better.

July 8, 2009 | Unregistered Commenterjerseygirl77

Thank you! What a brilliant post!

July 8, 2009 | Unregistered CommenterJanet

Sadly, I'm with Natural Mom Loves Prada. I guess I've just been around the birth industry for too long to be surprised by anything doctors do to make their lives easier & screw the women and babies they hurt. I had a cesarean for my first & UBAC's for my second & third. I'll never go near the medpros for a baby again unless it's literally life or death. By the time it's at the point, there's not much they can do to make things worse.

July 8, 2009 | Unregistered CommenterLisa

I have never heard about this, but it really makes me wonder about my birth experience. I was induced at 40 weeks, was given the pill to 'ripen' the uterus and was started on pit. Not sure how quick it was titrated but my daughter went into distress and I had to have an emergency cesearean. Fortunately my dauughter is incredibly healthy and one of the smartest 6 year olds I have ever seen, but I am disgusted by the thought they may have done this to me.

July 8, 2009 | Unregistered CommenterCcapp22

I read that article about the lawsuit and almost lost it. Oh. My. Word. I just want to know, how do these people live with themselves?

Jill replied:I don't know. I guess they just rationalize it away as another day at the office, doing what everyone else does.

July 8, 2009 | Unregistered CommenterHerb of Grace

This has nothing to do with "pit to distress" but I was watching a show on CBS I think, its called "the Doctors" and there was a young couple trying to decide to have a c section or vag. delivery. The OB on the show was very pro c section. Is this realy an option? Do docs preform c sections at the request of mothers? I was shocked by this...Im interested in your thoughts on the subject
I just found your blog and it has brought up feelings from my own 2 childbirths. I sensed that some of the med. things that were done during my labors were not needed, but I didnt want to be difficult so I said nothing. I regret not being more informed. Im very curious as to what my pit dose was when I got into l&d. They hooked it up right away, saying that I may not progress, Im not sure what gave them that impression, I was there for less than 10 mins, and this was with both of my labors.

July 8, 2009 | Unregistered CommenterAmy

Just had to reply... here in New Zealand, we son't have "pit" we have "synt" and the line is "get the baby to declare itself". This basically means, keep upping the synt untill the baby either is born, OR, the baby is in distress "proving" that it cannot "cope" with "Labour". the fact that it is not LABOUR the baby isn't coping with, but in fact, artificial suffocation due to oxygen depletion through the mechanism of hyperstimulation of the uterus, not withstanding (do you like my very special made up medical term, there?), the baby obviously can't "cope" and therefore needs to be "helped out". Now, thankfully, I CAN say "No, I won't do that" because I am an independent midwife, and can councel my clients not to become patients... but, that is why I stopped working on L&D, because, there, i could not. Not all docs do this, not by a long shot, but the ones that do.... Ah, they think they are Godlike saviours of womankind.

July 8, 2009 | Unregistered CommenterAnna

Ccapp22, have you thought about requesting your prenatal, L&D and postpartum medical records? The pill was probably Cytotec (Misoprostol). It sounds like maybe you weren't full informed of the risks associated with what many doctors tell their patients is "just a little pill to get things moving." If that's the case, you definitely are not alone.

If researching your birth interests you, go for it!

Thanks for your comment.

July 9, 2009 | Registered CommenterJill--Unnecesarean

I just read that bulletin you referenced by Alexian Brothers as that is one of my neighborhood hospitals. While they do seem to be one of the most natural childbirth friendly hospital in our area (I'd still choose a home birth for myself) I don't think they realized exactly what they were communicating when they wrote that their "focus was to reduce harm to both mothers and babies by redesigning maternity care using a cutting edge approach."

I think maternity care that is designed to avoid the cutting edge is exactly what we need.

July 9, 2009 | Unregistered CommenterLori

Lori, I agree with you 100%. At the end of the bulletin, they boast that they are "there."

From the bulletin:
When you practice daily, you may not see how you moved from point A to point B. Working with IHI to implement their perinatal care measures and collect data on these measures, provided the means to have our department look back and reflect upon where we were and where we are now.

Are we there yet? Oh, yes, we are there!

It's a little hard for me to see an institution bragging about no longer being irresponisble with the lives of their patients through the abuse of Pitocin. But... thumbs up? I guess?

July 9, 2009 | Registered CommenterJill--Unnecesarean

This kind of stuff is hard to read about, but it's so important that women know this stuff actually happens! How I wish these doctors would be sued and put out of practice.

Thank you for this, I am going to link to it on my blog.

MJ

July 9, 2009 | Unregistered CommenterMJ

I liked this article. I am a mom to 3, having had 2VBA1C and was induced for both. I have a great dr though who know when to say when. Would I prefer to go without the pit, sure, but I also know with my gest. diabetes and now type 2 diabetes that while I can go to term it isn't always safe for the baby. For me it comes down to being induced or having another section - it's the easiest choice, I am induced. Granted I believe there is too much pit and to distress the uterus is completely wrong and neglectful.

July 9, 2009 | Unregistered CommenterSarah

Sarah, I just had my second baby, born 42w1d--I've had type 1 diabetes for 10 years now, and let me tell you, that line about not letting babies of diabetic mums go to term? that's a load of crap. I'm including the URL to Gloria Lemay's blog, a midwife in Vancouver, who posted the latest study on induction of labor, and it specifically lists diabetes and gest. diabetes as not being reasons to induce.
The key to having a healthy baby as a diabetic is not to induce at 39 weeks, but to keep very tight control of your glucose levels (I tried to keep my A1Cs in the 5's).

July 9, 2009 | Unregistered CommenterKari

Oops, forgot to add the url:
http://www.glorialemay.com/blog/?m=200906


Kari... thank you!

July 9, 2009 | Unregistered CommenterKari

Wow...I guess I should consider myself lucky! I transfered to the hospital from a homebirth and they tried to force pit on me. I refused, because they informed me that I could not have it without an epidural (lie #1). They continued to try and force it on me and I continued to refuse it. They really hated me asI was totally non compliant. Long story short, they punished me by threatening another court order (they had already gotten one for internal monitoring) if I didn't consent to a section. I ended up butchered anyway, but at least they didn't try to kill my daughter first.

July 9, 2009 | Unregistered CommenterFyrestorm

oh...BTW I sued them and won!

July 9, 2009 | Unregistered CommenterFyrestorm

Fyrestorm, I am familiar with your story. About six months ago, I wrote down your email address and intended to contact you. I think you are amazing. And so now? I'm going to finally e-mail you. I'm glad you stopped by.

July 10, 2009 | Registered CommenterJill--Unnecesarean

Navelgazing Midwife,

To hear that you, the writer that you are, are beyond words tells me that you were deeply impacted by this birth. Maybe with time, the vicarious trauma of the experience will serve as a catalyst for you in... changing the world as we know it?

She was lucky to have you there, no matter how disenfranchised or useless you felt.

Jill

July 10, 2009 | Registered CommenterJill--Unnecesarean

Lisa and Natural Mom Loves Prada...

I keep reading the same sentiment over and over-- that people want to be shocked by the idea of knowing that it's a real practice, but aren't.

July 10, 2009 | Registered CommenterJill--Unnecesarean

Amy said: This has nothing to do with "pit to distress" but I was watching a show on CBS I think, its called "the Doctors" and there was a young couple trying to decide to have a c section or vag. delivery. The OB on the show was very pro c section. Is this realy an option? Do docs preform c sections at the request of mothers? I was shocked by this...Im interested in your thoughts on the subject.

I believe I know the show you're talking about. I *think* it was Jennifer Berman who was quipping about wasting a perfectly good vagina. Does that ring a bell? Yes, it's increasingly becoming offered to healthy women in the absence of any medical indication like it's a choice between Coke or Pepsi, which is dishonest, unethical and dangerous. True maternal request cesarean remains rare and I address some of my thoughts on it on my About page. I keep getting asked to write more about it, so I will soon. I've heard people go berserk over the concept, calling women who want c-sections crazy. I don't believe it's crazy at all, but it doesn't make it a healthy (or healthier) option to a normal, spontaneous vaginal delivery. Doctors should have he right to refuse to perform a planned unnecesarean and lovingly refer them to another doctor.

I just found your blog and it has brought up feelings from my own 2 childbirths. I sensed that some of the med. things that were done during my labors were not needed, but I didnt want to be difficult so I said nothing. I regret not being more informed. Im very curious as to what my pit dose was when I got into l&d. They hooked it up right away, saying that I may not progress, Im not sure what gave them that impression, I was there for less than 10 mins, and this was with both of my labors.
Not being there, I don't know. I can take a guess and say that over the years, obstetricians have tried to standardize the practice of medicine in childbirth. People have a lot of theories on why that is. If it helps, you are not alone in not questioning in the moment why things were being done to you during labor. The message that telling a woman she needs prophylactic Pitocin because she won't progress has a lot to do with control and authority. Plus, once a woman is on Pit, she will most likely need an epidural, making her a more manageable and less needy patient. Then, once she has an epidural, she's basically ready in case she needs surgery. Of course, the question is whether the Pit, epidural, lack of mobility, etc., actually produced an iatrogenic "need" for the cesarean or operative delivery.

The other message that women get from being told their labor will go poorly without induction (as if they could possibly KNOW that without a crystal ball) is that women walk away with the mindset that something is defective and not trustworthy about their body. I had someone tell me not long ago, "I'm just not very good at giving birth." Under those conditions, who would feel extra good?

Sorry... long answer. Thank you for your comment. Hope to see you here again.

July 10, 2009 | Registered CommenterJill--Unnecesarean

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