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Entries in childbirth education (1)

Thursday
Feb032011

Really? REALLY?

I was talking to a childbirth educator of many years (over five), a woman teaching one of the big three methods, so it isn't some obscure type none of us have ever heard of, and she said something that made me audibly gasp.

We were talking about birth plans (common theme lately) and the one we were looking at said on one bullet point,

"No induction. No Cytotec."

I explained that putting that on a birth plan was irrelevant because the induction discussion is with the doctor in the office (or during an NST) and by the time she presented on the L&D floor, she was either in labor or being induced; induction was a moot point.

She asked about the Cytotec and I explained it was only used for inductions and hemorrhages after the birth, that if the mom presented for an induction, she absolutely needed to say NO CYTOTEC if she didn't want it -and I encouraged actually looking at what the nurse was putting in her vagina to be sure it wasn't that tiny white pill. But, this was, again, an induction question/discussion for the doctor.

She asked about Pitocin (pit) and I said yes, they do use it for induction as well, but that, from what I knew, at least 80% or more of women end up with pit sometime in their labor. If we count postpartum, too, probably 99.9%. She asked why, if a mom wasn't being induced, why she would get pit.

I said, "Because they very often augment with pit, even when they haven't induced."

She looked at me blankly.

And then this childbirth educator who has a steady stream of clients started asking questions that demonstrated she wasn't sure what the term augmentation meant. No. She didn't know what the term meant, at least with regards to birth.

"But, if her labor is going, even if it's slow, why do they need to induce?"

"They don't 'induce,' they augment."

silence

"Augment means to move it along, even if it's going well. Induce means starting from zero and pushing things, making it go."

"So, if a mom's water breaks and she doesn't have labor, when she goes into the hospital, she is going to be induced because she has no contractions. But, if she is having contractions, but labor is very slow, she will be augmented."

I could tell by her demeanor she was still baffled, but we needed to move on to other parts of the birth plan. I told Sarah it was like I was making confetti for a football game, my going through the plan. There was just so much extraneous bullet points and then, the language used was the birthing style's froo froo language.

If you don't want your birth plan laughed at, don't call your contractions "lovely gentle rivers of sparkling water splashing on the rocks" (that's not what this one said, but you get the gist); call it a contraction.

Maybe I need to do a county-wide Birth Plan In-Service for the cbe's in San Diego. I'll bring the 4x6 cards.