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Friday
May162008

Deliver Me

Somehow, I missed the fanfare about this show. Sometimes, not watching anything but HGTV can mean I don’t see or hear about cool shows like Deliver Me.

While Deliver Me’s first season is over, you can still catch it in re-runs on the Discovery Health Channel.

Of all the “baby” shows, this one ranks next to DH’s 3-Day Live in 3 L&D’s Around the Country extravaganza. What I like about them both is they are the most real, the best example of life on the labor & delivery floor.

The 3-Day fete is cool as all get out because it shows birth in real time… in real SLOW time… and demonstrates the enormous amount of pitocin used, the vast quantities of epidurals given and ultimately the scads of cesareans done on every third woman.

Deliver Me is edited more, but watching (sometimes in horror) as woman after woman is induced, augmented, epidural’d and then “sectioned” is a study of birth reality shows at their finest.

Maybe you have to be a midwife to enjoy this kind of stuff.

Three OB’s – Drs. Bohne, Hill and Park work in a really busy Los Angeles practice together. Besides their work, they are also friends and mothers who share snippets of their personal lives with the camera. Doctors as humans. Amazing concept for television.

Not seeing the first, introductory, episode, but jumping right into their story, it was easy to decipher who had what role in the office. Later, after seeing the first episode, the doctors themselves validated what I had come up with on my own.

Dr. Allison Hill would be whom I would choose for my own personal OB – if I had to choose one of the three. Her easy-going manner and seemingly endless patience for someone who wants individuality resonates with me. Not that anyone shown has ever asked for limited monitoring, ambulation in labor or encouraged to hang in there when they initially wanted to “go natural.”

Dr. Yvonne Bohn stands in the middle of the intervention spectrum, reasonable most of the time, but dishing out annoying gems to pregnant patients like “I had my epidural at 2 centimeters! I had a few contractions and that was it.” Encouraging.

Dr. Alane Park is someone I would steer clear of if I wanted to attempt a natural birth (or even an unhindered pregnancy!). Goddess forbid a woman find herself at 40 weeks, the testing and hand-wringing concern from Dr. Park is enough to make any woman want to schedule a cesarean – or stay at home to labor and walk in complete and pushing. While I have met doctors like this, rarely is it held right in front of our faces, episode after episode… my slack-jawed emotions wanting to scream at the tv, “What the hell are you so afraid of?!” Dead babies. I already know what she’d say.

But, the interesting aspect of this series is the humorous, touching, hugging and weeping that the women do on camera. I can’t imagine they would be faking it, but never have I met an OB that was so tender with his or her clients. In fact, I don’t know many CNMs like this! But, I suppose they are out there and I just have had the opportunity to meet the cold, distant and austere obstetricians that have cared for my clients in the past. Only Dr. Wonderful comes close to these women’s warmth and love.

I like that the patients portrayed are shown in their own homes, too, and we get a glimpse of their lives outside of the prenatal and birthing “patient.” A variety of women are highlighted, including multi-cultural families, a lesbian family and loads of women with complications or serious personal or medical issues.

An LA times article offers this (pretty) flabbergasting thought:

“As a result of the show, they said they've learned that every one of their patients has an interesting story.”

You don’t say!

So, besides my nitpicking, it’s really groovy to watch pre-eclampsia, gestational diabetes, “incompetent” cervixes, cervical cancer survivors and the plethora of high-risk complications unfold on the small screen. It’s risk-free for me sitting on my couch, yet I learn a great deal from hearing how OB’s react (in a clinical and emotional way) when confronted with these situations.

Special note:

There are an inordinate number of fat women in the series. I was shocked every time I saw yet another obese pregnant woman. Baby after baby was “too big” to come out the vagina and invariably it was one of these fat women who housed giant 9-pound babies. Wow! NINE POUNDS! Can you imagine? If they allowed/encouraged the women to get up and out of the hospital beds, they might actually have a chance at a vaginal birth of their really-not-that-big kids. Over and over, women were told their babies would “never” have been born vaginally because they were so big.

(I would have a really hard time swallowing that doctors really say this so often except I heard it with my own ears when the woman at the top of my blog page delivered a 9 pound 10 ounce brow presentation via cesarean and the doctor sidled up to her post-op and said she could never deliver a baby that big, that the baby wouldn’t have possibly been born vaginally even if the baby was in the optimum position. Yeah, right.)

I find it really odd that homebirthed babies are so much bigger than these hospital cesarean babies and they make such a giant stink (pun intended) about their size. They would crap their pants if they had to vaginally deliver 10 pounders as a matter of course. My guess is they would get women UP if they were faced with this dilemma. But, instead, it’s easier to cut. For the doctor, anyway.

I look forward to next season’s show and nod knowingly that even as I write this, one of the three women is on-call, possibly helping a woman have a baby and the other two are living their lives outside of the hospital. It’s an odd concept, knowing a doctor so intimately.

But, I love it. Voyeur that I am.

References (1)

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  • Response
    Response: green Coffee beans
    - Navelgazing Midwife Blog - Deliver Me

Reader Comments (16)

Barbara, a true brow presentation CANNOT be delivered vaginally, the presenting diameter of the baby's skull CANNOT pass even the largest pelvic inlet and outlet. If the presentation is really just a deflexed head, even "military position", then the labor will be difficult, but it is possible to deliver vaginally if the head flexes.

Moreover, as you know, CPD is most often relative, not absolute. I've seen women unable to put 6 lb babies through their pelves, and other women manage babies much larger than 9 lbs. However, once you are dealing with such a large baby, there are other factors involved, including shoulder dystocia. It becomes a judgement call, and no one wants to make a choice that leads to a damaged baby.

May 16, 2008 | Unregistered CommenterAntigonos

I've tried watching the show a couple of times. I had to turn it off. It made me sick to my stomach. Yet another show helping to indoctrinate women with just how dangerous childbirth is, and just how wonderful doctors are for saving women and babies. Not that there's anything wrong with doctors saving women and babies, if they indeed need it. But sheesh, it sure seems like every other woman on the show ends up with a c/s. And the way these doctors talk to them, yes, all three of them, is so condescending. It's like they don't even give them a choice, they just say "this is what's happening, so we better just give you a c/s." Whether that's really needed or not. One time I dropped in on the show (when HGTV was on commercial break :p), one of the doctors actually suggested a c/s to a woman because the baby was too big. Without even a trial of labor. Yeah, I switched back to HGTV and watched the commercials instead. I don't know, if you can sit and watch the show without yelling at the TV, more power to you. I get too upset. :p

May 17, 2008 | Unregistered CommenterDoreen

Antigonos: I understand that brows cannot be born vaginally; it's why we went in and she had a very-warranted cesarean.

I also DO understand the fear of shoulder dystocia aspects of why women with over 9-pound babies are cut on.

However, what is frustrating is the belief that 9 pounds is giant when those of us who do vaginal births all the time routinely see babies between 9-10 pounds, withOUT sd issues.

Granted, the sd's I have contended with were with 10 and 11 pound babies, but seeing a 9 pound baby on a 41 week ultrasound wouldn't raise an eyebrow from me.

Don't you really think that immobility of the baby and pelvis because of an epidural and remaining in bed contribute to the over 9-pound fears? If women could sway and get the babies in proper positions, I really don't think they'd see sd's until around the 10 pound mark.

But, I do understand that the epidural isn't going anywhere and neither are the women getting them, so can kind of wrap my head around the severe anxiety I hear in too many OB's voices.

I don't even hear the distress coming from hospital CNMs! Is that because much of their population doesn't medicate, either?

May 17, 2008 | Unregistered CommenterNavelgazing Midwife

I can't remember which couple it was, but i chanced upon the show right when the doctor was saying out loud her fears that this woman had a huge 9lb baby and wouldn't be able to deliver vaginally.

i turned to my husband and said "wow! look honey. i birthed a "HUGE" 9lb baby vaginally. good for me... *changes channel*"

makes me upset for the women that don't know what their bodies can do soooo beautifully!

May 18, 2008 | Unregistered Commentermommymichael

I just found this show recently too and find it fascinating.

I was watching some kind of marathon before a "new" episode and was a little dismayed at how many moms were asking for c-sections.

One mom had her first as a c-section because she/he (sorry can't remember these details, LOL) was breech. Her second was breech a few weeks before delivery but turned head down. I thought for sure that since she was getting her tubes tied this time she would go for VBAC, but she still wanted the c-section.

While I am not a midwife or doula I find this show totally watchable.

P.S. I wonder what they would have said if I came in pregnant. All three of my boys were over 9 lbs and born vaginally. My middle son was 10 lbs 5 oz, came on his own at 42 weeks, no complications, and no meds. Probably would have blown their minds.

I understand that each doctor has to do what they think is right for "that" patient at that time. And that is why I will still be watching. I also like to see the home life aspect of these doctors lives. Busy ladies!

May 18, 2008 | Unregistered CommenterJen

We don't have DH in our cheapo cable package so I can't comment on the show except that I find that the blogger discourse that arises from the (home based) midwifery -- obstetrics 'interface' is a perfect microcosm of cross-cultural interactions. Morag's treatment of that PPH; [suspected] 9 pounders in OB care... the context in which the care providers encounter them ASSIGN the meaning to these observations. Both types of settings are structured based not just on the caregivers' knowledge, assets, beliefs, and sense of control but also that of the patients. It makes about as much sense to critique one from the other's perspective as evaluating one culture with the value system of another. Case in point, medical assessments of risks of macrosomia. I'm sure that within the context doctors work in, they do the absolute most reasonable thing most of the time, based on what they know and can expect. Maternal mobility (and maternal initiative!) is not part of these expectations. Different post, same difference: did Morag and her primary advise the mom to transfer in to be checked out? Had I had an asymptomatic bleedout that was under control, I might well have declined, too. What hospital patient calls the shots like that? "No, I do not give you permission to check me for a cervical bleed"?! What OB assumes her patients would?) To me what's interesting in these dialogues across the two cultures is how ill informed both sides are of the others' values and intentions. (Hence a lot of the bad blood, IMO, no pun at all intended.)

May 19, 2008 | Unregistered CommenterJudit

Judit,

I think you make a really important point and I did sort of address this somewhat in this post - asking why they don't let women UP and then they might not have so much to fear about sd.

However, I know, because I have heard them say it, that the prospect of having a floor full of ambulating women would be a nightmare to the L&D nurses! It is far, far simpler to do nursing care, especially on more than one woman at a time, when she is immobilized and quiet. Imagine 2 women having an unmedicated birth on the same floor! Chaos, indeed. *sigh*

Good points about apples and oranges.

May 19, 2008 | Unregistered CommenterNavelgazing Midwife

OOOH Barb, you and me are both addicted to these crazy shows!

First of all, tell me you watch House of Babies. You might find that to be the best one on TV, a Miami midwife and her cool birth center. I had a little issue with the fact that EVERYone there ends up birthing in the tub in the exact same position but it is the only non medicated birth show on.

Deliver Me, arggg the ladies seem cool(ish) but damn right if they arent ALL inductions! Pit pit pit pit tucked in their beddy byes on their backs...failed to descend! Section! Yay!

So much. It gets old. I agree on the the women, I would rank them in the same order.

Basically, NOBODY in hospitals (according to television) ever ever ever gets the hell UP. Ever. they never scream they never moan they never chant and they sure do use a lot of pitocin. I knew this, but then again it is only recently that I have began to watch so much of these shows again.

Everyonce in a while Baby Story or one of the other ones has a homebirth or a midwife birth center thing. It is a whole nother event, just night and day. So so so so much pain and so much movement but so much ecstasy at the end...But we knew that ; )

May 20, 2008 | Unregistered CommenterHousefairy

I would be skeptical and cautious of an OB with a high touch and affectionate manner with a patient. What is the advice, "Ignore everything they say and watch what they do"? I've seen very nice and sympathetic OBs use saccharine sweetness & authority to push some pretty lousy courses of action. I think it is one way that female OBs interact with patients - instead of being authoritarian or bullying, they emotionally manipulate. One of the worst offenders I've seen as a doula repeatedly teared up with her clients as she told them of the absolute necessity of their c/s. After watching her pigeon-hole a half dozen of my clients into an iatrogenically "necessary" c/s, I can hardly stand to be in the same room with her anymore.

May 21, 2008 | Unregistered CommenterNorthstardoula

Barb, could you perhaps explain your comment about Cervical Cancer survivors being high risk obstetrically? I'm a survivor of cervical carcinoma with a LEEP cone biopsy who has birthed two babies at home in the water and I'm kind of wondering what the big deal is. My midwife tends to be pretty dang conservative in her protocols (without being medwife-y), so I'm surprised to hear you referring to women like me as high risk.

May 22, 2008 | Unregistered CommenterBelle

Carcinoma in situ? Or invasive cervical cancer. Very different animals.

1. Depending on how much cervical tissue was removed makes a difference in the woman's ability to reach the end of pregnancy with a term baby. The more tissue taken, the less "competent" the cervix. There is also plenty of research that says some procedures can encourage low birthweight babies, too.

2. Any procedures/trauma on the cervix causes scar tissue. Whether it's cervical tearing during birth, biopsies, or physically traumatic sexual abuse, scar tissue forms and some women make scar tissue that can be pretty tough to work through as the cervix attempts to open during labor. Many women don't have any repurcussions, but it isn't uncommon for women to have "bands" that "snap" during labor after their spending hours at the same dilation... or having the bands snapped manually - something that can save a woman hours and hours of physical pain and exhaustion.

3. Most women treated for cervical cancer (invasive) cannot get pregnant again - either because of a hysterectomy or because the chemo and radiation have damaged the ovaries, tubes, uterus, cervix and/or vagina so extensively, pregnancy without assistance can be a rarity.

I think it's great you had homebirths! I think that each woman should be evaluated individually, don't you? Not every woman who's even had more than one LEEP might not be a candidate for a home or vaginal birth. And I suspect that for some women, the capability to birth vaginally might not be known until well into labor.

The last reason I can imagine a pregnant cancer survivor would be higher risk is because cancer seems to adore the hormones of pregnancy and even women in remission/cured for ages can have cells kick back up and become active again.

As a midwife, I am not equipped to give proper care to a woman with cancer. In fact, I don't even think I have enough knowledge to monitor a survivor in pregnancy! Maybe some midwives would, but I would have to defer to others (OBs) who could do much more than I.

May 22, 2008 | Unregistered CommenterNavelgazing Midwife

Here in Good old New Zealand, this show has not made an arrival, so cannot comment on it but: On the issue of obs vs midwifery models: The knowing and valuing of knowledge is SOOOOOO different between these two models. I walked out of the room of one of my labouring mommas the other day, mooing like a cow to get through her late first stage contractions, and walked into one of the oncall docs. "When will you be calling me in to fix things in there" she joked. "I won't be, she is doing fine" I said. "You should get her an eidural, you midwives are positively saddistic and cruel, you know that" she responded. This is a doc I get on with really well, with whom I have had a couple of really intensive emergencies, and had coffee and sandwhiches with occassionally. She has hugged me for my birthday, and she has laughed at my funny stories about my kids.

BUT she seriously thinks that I am a saddist, and that I enjoy seeing women in pain. She thinks that midwives in general are cavaleir about risks, and too willing to risk safety for the experience.

I think she is too quick to pull out her scalpel, and does not support womens choices: But then we are not looking at things from the same perspective. My page says that women are experiencing something natural and amazing. heers says they are suffering needlessly.

And on big babies: My little sister (an absolute rockstar) just had her fourth baby. She is 5ft6inches tall and weighs about 68kgs at full term pregnant. One of the midwives on the postnatal ward went into see her, and had obviously mixed up her rooms: cause the conversation went like this:

Midwife: Wow, he is a whopper, isn't he!
Sister: Yup, he is huge
M: How much does he weigh then?
S: 9lb51/2oz.
M: Wow! Bet you are glad you didn't have to push that out! No way he would have fit!
S: ummm....
M: Just as well you were booked in for the section anyway...
S: ummmmm......
M: For previous section, wasn't it?
S:Ummm, I am not sure who you are thinking of: He was born normally, this morning, like all o my other babies, and i didn't even get a tear!


Hahahaahahaahahahahaa! honestly, wish I had been there!

May 29, 2008 | Unregistered CommenterTrin RM

PLEASE GET OVER YOURSELF!!!! BEFORE YOU JUDGE THE PATIENTS ON THIS SHOW, PERHAPS YOU SHOULD GET TO KNOW THEM MORE PERSONALLY TO FULLY UNDERSTAND THE CIRCUMSTANCES IN WHICH THEY FIND THEMSELVES!!! YOU ONLY SEE A SMALL GLIMPSE OF THEIR LIVES IN THESE EPISODES. BELIEVE IT OR NOT, MAKING THE DECISION TO HAVE A C-SECTION, REGARDLESS OF A BABY'S SIZE, IS A WOMAN'S RIGHT AND SOMETIMES, THEIR ONLY OPTION. IT HAS MORE TO DO WITH A WOMAN'S CHOICE, GIVEN HER MEDICAL CONDITION, THAN IT DOES WITH THE DOCTORS. YOU HAVE NO IDEA WHAT THIS SHOW IS REALLY ABOUT!! AND AS FAR AS MAKING REMARKS ABOUT THE "NUMBER OF FAT WOMEN" ON THIS SHOW...WHAT GIVES YOU THE RIGHT TO PASS ANY JUDGEMENT ON SOMEONE YOU DO NOT PERSONALLY KNOW?? YOU'RE AN EMBARASSMENT TO MOTHERS, OF ALL SIZES, WHO DELIVER HEALTHY BABIES EVERYDAY ... VAGINALLY OR BY CSECTION.

PS I LOVE HOW WE NEED YOUR PERMISSON TO POST A RESPONSE TO YOUR BLOG...YOU'RE REALLY SOMETHING!!!

August 14, 2008 | Unregistered CommenterAnonymous

Classy.

August 14, 2008 | Unregistered CommenterNavelgazing Midwife

And I suppose you are???

August 14, 2008 | Unregistered CommenterAnonymous

SCREAMING IN CAPS is so gauche, in the first place. Not even understanding what I wrote in the second (I love the show!) and then a smart ass comment about moderation. Not that I owe you *any* explanation (and if you read more than one post by me you would already know this), but people write me in my comments and ask that they not be published because they are asking private questions. I moderate to honor their requests.

Perhaps if you weren't so hyped up hostile you might get your message across. As you "speak" now, who can hear anything but anger?

Oh, and hiding behind "anonymous" doesn't buy you any brownie points either.

August 14, 2008 | Unregistered CommenterNavelgazing Midwife

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