A great website

I just found this great website!

Are you using the right type of healthcare provider for your pregnancy? Take this quiz and find out!

http://www.delivermybaby.org/

Just for FUN...

Jill at the Unnecesarean is having a contest! So, just for fun, I thought I'd throw in an entry.

Unfortunate

Well, this is the newest update in the BIRTH WORLD.

So, here is my 2 cents on the photo....

It's disgusting, and irritating. The fact that they are so out of touch with birth that they can't even spell "doula" or use the correct term for a birth plan shows that they just "decided" to do this and didn't base it on anything, let alone consider the welfare of their patients.

I also would like to know what they plan on doing if one of their patients shows up in labor, and is using The Bradley Method? I'm assuming they have heard of the Emergency Medical Treatment and Active Labor Act.

EMTALA requires hospital emergency departments (EDs) to provide any individual coming to their premises with a medical screening exam (MSE) to determine if an emergency condition or active pregnancy labor is present. If so, the hospital must supply either stabilization prior to transferring the patient or a certification (signed by the physician) that the transfer is appropriate and meets certain conditions.

Are they planning on refusing to accept the woman as a patient and pass them off to some other on call OB?

Honestly, it's GREAT that they have this posted on their wall. Pregnant women know upfront what they are getting themselves into with this practice and can feel free to run the other direction if necessary.

Someone who called the actual office for more information got this:

"I called this clinic and spoke personally to the receptionist, manager, and then doctor. The receptionist and manager were concerned over the fact that I informed them that "doula" was misspelled, and that "birth contracts" were actually birth plans. The doctor was rude and told me that he HATED doulas and didn't care what I thought and didn't care about evidence-based maternity research."

Well, if that isn't a place to end this post, I don't know what is.

Angie's List

Mainstream attention to poor OB decisions, yes.

Oligohydramnios

Oligo-wha-huh?

Oligohydramnios is the condition of having too little amniotic fluid.

What causes it?

Birth defects – Problems with the development of the kidneys or urinary tract which could cause little urine production, leading to low levels of amniotic fluid.

Placental problems – If the placenta is not providing enough blood and nutrients to the baby, then the baby may stop recycling fluid.

Leaking or rupture of membranes – This may be a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes (PROM) can also result in low amniotic fluid levels.

Post Date Pregnancy - A post date pregnancy (one that goes over 42 weeks) can have low levels of amniotic fluid, which could be a result of declining placental function.

Maternal Complications - Factors such as maternal dehydration, hypertension, preeclampsia, diabetes, and chronic hypoxia can have an effect on amniotic fluid levels.

Ok, so now for the real post - Should you be induced because your doctor performs an ultrasound and says you have low fluid? Hmmmm..

It depends (as usual). How low is low? An AFI (amniotic fluid index) that is less than 5-6 = oligohydramnios, but...

On the other hand, a low AFI (oligohydramnios) at or near term may be an indication for delivery, either by induction or C-section. If there were to turn out to be a normal amount of fluid with rupture of membranes during an induction, then the low AFI that prompted the induction was either temporary or wrong. - http://www.gynob.com/biopamfl.htm

Notice the word temporary.

Notice the word wrong.

Some interesting information:

It is important for parents to know that this is likely an inaccurate assessment. What the ultrasound technician is doing could be compared to viewing an adult in a see-through plexiglass bathtub from below the tub. In such a scenario, it would be difficult to assess how much water is in the tub above the body that is resting on the bottom of the tub. You might be able to get an idea of the water volume by measuring how much water was showing below the elbows and around the knees, but if the elbows were down at the bottom of the tub, too, you might think there was very little water. This is what the technician is trying to do in late pregnancy—find pockets of amniotic fluid in little spaces around the relatively large body of an 8 lb. baby who is stuffed tightly into an organ that is about the size of a watermelon (the uterus). If most of the amniotic fluid is near the side of the uterus closest to the woman’s spine, it can not be seen or measured. - Gloria Lemay's Blog

Now, how do you know whether is a true case of "Oligo" or not? Well, there are several things that should be taken into account.

What gestation is your pregnancy?

If you are post dates, is the fluid "low" because the baby is big and the assessment is wrong? How do you tell? Why not get some IV fluids and then get another ultrasound? If you were borderline low, is it back into a normal range now? Maybe you could go home and drink drink drink and come back in the morning for another ultrasound?

Is the baby in any distress? Are you doing kick counts and getting 10 movements in an hour?

What if you are only 38 weeks and your AFI is showing 1? Way too low. And induction is probably very necessary.

So, here's the point. If your doctor says, "Your fluid is low, we need to induce.", don't blink blindly and say, "ok". Ask some questions.

What is my AFI?
Did you do a Biophysical Profile, and what are the results?
Can I get some fluids (IV, etc.) and retest?

Can low fluid be dangerous? Of course! And for that reason you should always pay attention to any diagnosis you are given. Oligohydramnios is more dangerous in the 2nd trimester. It is sometimes associated with other dangerous pregnancy complications. True low fluid in post dates pregnancies is associated with labor complications.

The problem is that it is very often hard to determine "oligo" with certainty.

As usual, be an active participant in your pregnancy and birth. There is nothing wrong with asking questions, even if you decide to take your doctors recommendations.


**Blog Post included in the Lamaze Healthy Birth Practice Blog Carnival**
COOL!

OB Consent

So, in being the huge birth junkie that I am, I am a member of several email groups. Today, while reading through some posts, I came across this little jewel...

A Different Kind of Consent Form

Did you know that OB's love to pull out those long and horribly written consent forms when you want to use your rights as a citizen to respectfully decline a treatment, even when that treatment might be worse than declining it in the first place?

It really gives you a lot to think about. While this may not apply to every woman, it often applies to far more than is acceptable.

Don't be a sheep! It is your body, and your baby... and your birth. Do your homework! Read some good books with real research in them. Here are a few...

Think about what your doctor says to you. Does it make sense? Is it logical? Ask questions. Remember, you hired them to be your birth attendant... you are not at their mercy.