Thursday, October 14, 2010

Did I Choose the Right Doctor? ... on Pitocin

After taking the first 3 weeks of our Bradley Method classes, I can't help but feel concerned if I made the right choice with my obstetrician. I gave no thought to the type of childbirth I wanted when searching for a doctor, I felt rushed with what was going on at the time, and searched for one that was willing to see me that same week! But now that those risks are no longer prevalent, I wonder, did I bypass important questions and answers I should have asked and received with my hurried search for a doctor? I never had good luck with OB-Gyn's. They took one look at my history and I got a response "Oh, you're one of those..." and antagonistic, almost avoidance-type behavior followed. I finally found a doctor who did not treat me in that fashion, accepted the history as what it was, the past, and scheduled an appointment for that week. But now, especially seen as how I know how I want my baby to enter the work,  I wonder if my decision was made in haste, or by happenstance did I just get lucky with the right doctor?

One of the articles in the Student Workbook, in the first class session is titled "Parental Decisions and Neonatal Health" by Joseph William Hazell, M.P.H. and I urge those that are pregnant, plan to be pregnant and especially want a natural childbirth to read this article.You will if you wind up taking the Bradley Method Childbirth classes anyway... But the article discusses that the decisions you make in picking your doctor have an effect and play a roll in the type of child-birthing experience you will have. Granted, the hospital does as well, but mostly the choice of hospital is limited to your physician of choice. Will my doctor follow my choice in going through labor un-medicated or will he attempt to push the use of Pitocin to fit more into his busy delivery and patient schedule? Will the hospital be willing to accept the decision I have made and not attempt to push that as well? My eating habits (I admit) are not greatly healthy, and my doctor does not question the types of food that I eat, just comments on the weight I have gained. If I gain more weight during these last few weeks (9 left to go), would I be told to carefully watch my weight gain (and make it close to nothing?), or will he tell me that I am doing well?

I hope to deliver at TMC, because that was one of the only choices given to me by my doctor. They have a 24 hour rule to have the baby delivered. If I am not dilating on their schedule, they almost will make me take Pitocin. Now, will that be 24 hours from admittance or 24 hours from the rupture of the fore-water? If my water does not break, will my doctor break it for me and at what stage will he break the water? I have begun reading Pushed: The Painful Truth About Childbirth and Modern Maternity Care By Jennifer Block. Though I have not yet gotten that far into the book, having started reading it on Wednesday, she mentions this 24 hour rule having gone into effect in 1960 and increased the use of synthetic oxytocin (Pitocin) to make the labor happen within this time frame (pg 13). I am interested in reading the rest of this book, but I cannot help but question the decisions I have made on my doctor and the place I will give birth to my baby.

There are so many reasons for me to not want to have Pitocin and an epidural for during labor. I have heard from mothers that the epidural did not help remove the pain, but instead numb their lower extremities. and after the Pitocin (the pain was so much worse with the synthetic contraction creator) an epidural was necessary! I have had Morphine before, and was told to just ride it as the nurse pushed it into my bloodstream. I did not like the feeling it left. The hurting and the pain was still there, only my mind just didn't want to care. How is feeling like this supposed to help with childbirth? When am I supposed to know when to push if I am numb? With the use of an epidural, the necessity of needing Pitocin greatly increases. I can cite so many articles that state this, And that the use of epidurals and Pitocin increases the need for a cesarean (because of limited amount of time, 24 hours).  So many controversial studies, one saying one thing, the other against that. Hmm.... Can I not take any chances and just go un-medicated?

Not to mention all the problems that can arise from the use of Pitocin and/or an epidural. Who is to say that the baby will not feel the effects of the drug put into the mothers system? The baby is going to get it, just like the drugs we are not supposed to take during pregnancy. What makes the use of these drugs ok? An article in Newsweek, back in 1996 titled "Life in a Parallel World: A Bold New Approach to the Mystery of Autism", states that there may be a possibility that Pitocin mar the baby's natural oxytocin ability. I have not yet found anything to counter-argue this or refute it. Thinking about it, autism's first appearance about 60+ years ago comes about the time when Pitocin was synthesized (1953) and becoming more prevalently used! There are so many more side effects of this drug! As stated in "The Truth About Pitocin" By Elaine Stillerman, LMT:
     "Pitocin might cause a tumultuous, difficult labor and tetanic contractions, rupture of the uterus and dehiscence of a uterine scar, lacerations of the cervix, retained placenta or postpartum hemorrhage. Postpartum perineal and pelvic floor pain is increased as a result of augmented uterine contractions. Fetal complications might include fetal asphyxia and neonatal hypoxia, physical injury and neonatal jaundice. The use of pitocin also might be a factor in cerebral palsy from deprived oxygen and autism."

With all the things that can come about with the use of Pitocin, why even use it? Granted, I can understand there may be some extenuating circumstance, and if it means a matter of Life or Death for mother and/or baby, then by all means use it. Isn't that supposed to be it's purpose? So many mothers go into labor at home or with a midwife, without any medications at all and come out fine and dandy. No need for Pitocin, no need for the epidural. We women were made to give birth to a baby. Our body was built to handle and complete the activity.

So I guess now, as my questioning my choice in a doctor was spurred by the first article, I will be asking my doctor
  • where do you stand in the use of Pitocin? 
  • how many patients would you say you have given Pitocin? (like 1 out of 4?)
  • do you break the water of the patient?
  • after how much time/during what stage will you do this?
Hopefully when I talk to my doctor next week I will feel at least a slightly bit better about my decision...

Block, Jennifer.  Pushed: The Painful Truth About Childbirth and Modern Maternity Care
Hazell, Joseph William, M.P.H. "Parental Decisions and Neonatal Health"
Springen, Karen and Begley, Sharon. "Life in a Parallel World: A Bold New Approach to the Mystery of Autism"
Stillerman, Elaine LMT. "The Truth About Pitocin"