07/07/2019
"Kind, Compassionate Bu****it" let me explain further and give an example.
A first time mother is 36 weeks pregnant, goes to her regular appointment. The nurse informs her that the doctor wants to do an ultrasound. She didn't expect it but she is excited about the opportunity to catch a glimpse of her baby.
During the ultrasound, the doctor says, wow, this baby is getting big! We might have to induce you at 39 weeks to avoid injury to the baby.
She is surprised and feels a little unsure because she has heard negative things about induction, but she trusts that her doctor knows what is best.
37 & 38 week appointments go the same. Baby is measuring big.
At the 39 week appointment, the doctor walks in with a chipper attitude and asks if she wants to meet her baby today. She explains that the baby is big and that she doesn't want to risk injury to the baby because her pelvis is on the smaller side.
Still trusting, she returns home to gather her things and arrives at the hospital 2 hours later. None of the risks have been explained. She is told that they will start with something to ripen her cervix for 12 hours, then begin pitocin the following day.
They are excited and can't really sleep especially with their nurse coming in every couple of hours. The next morning, her cervix is checked and she is 2-3 centimeters dilated.
They begin to administer the pitocin which initially doesn't seem to be doing much but after a couple of hours of the nurse increasing the dose every 15 mins, she begins to feel contractions.
She has an IV line leading to one machine, two more lines connected to her belly. She wasn't prepared for that. They hadn't mentioned that for induction, she must be monitored continuously. She had anticipated being able to move around more freely. She adjusts this in her mind.
Before long the contractions are coming consistently but soon they are one on top of the other, causing the nurse to come in and reduce the dose.
The contractions slow a bit but they are still very strong and requiring her full attention and strength to get through them.
Now they have slowed too much for the nurses liking, so she comes in and increases the dose. This scenario happens several times before a good pattern is finally achieved.
After several hours of working extremely hard, the nurse performs a cervical exam only to tell her that there has been little to no change. She is devastated.
She continues because really, what other choice does she have now? The pitocin drip is increased.
She has now been in the hospital for a full 24 hours. She's only seen her doctor briefly at the beginning.
She is becoming tired and hungry, she hasn't had anything to eat because again, they hadn't mentioned that they don't allow eating during an induction.
After another 12 hours and a couple of shift changes, including her doctor, she is finally 5 centimeters.
The nurse keeps coming in and looking at the monitor. They are concerned about the baby. They explain that they need a better reading on the baby and that they would like to put a monitor on the baby's head. This requires them to break her waters.
She now had an additional wire that is strapped to her leg.
Soon she gets an epidural because she can't deal with the intensity of pitocin driving contractions. Her blood pressure drops and baby's heart rate drops along with it. Alarm and concern, oxygen mask is put on mom. After a short time, everything settles down but mom and dad are pretty shook up.
The nurse is really great, she is so kind whenever she comes in. Another doctor from the same practice comes in finally and she too is compassionate and kind with her words, especially when she begins to explain that the baby must be stuck in that small pelvis of hers.
She explains that the baby is not tolerating labor very well and they think its time for a change of plans.
The doctor is thoughtful and expresses sympathy in knowing this isn't what she wanted, but sometimes, we just have to do what's right and safest for the baby.
20 mins later an 8 pound 6 ounce baby is born via surgical birth. The mother comments that the baby doesn't seem that big.
This family was never told that the risk of c-section with induction is 50% more likely or that their baby was at increased risk of fetal distress. They also weren't told that "big baby" is not a medical indication for induction or that it would take nearly 3,700 unnecessary c-sections to prevent 1 baby from having a permanent nerve injury due to shoulder dystocia. (source: evidence based birth)
The doctor and nurses were kind and compassionate at every step. They were never abusive or dismissive. They were even empathetic, but ultimately feeding her bu****it.
This specific person went home knowing clearly that something wasn't right. She was angry AT HERSELF for not knowing better and for trusting her doctor
But too many go home thinking that their provider saved them and their baby. That their body is broken. Never considering that the unnecessary interventions were the problem.
Those of us who know better, need to stand up and be loud and clear that this standard practice is not ok. Induction has its place and can be a valuable tool when medically necessary and indicated.
If you are ready, visit ImprovingBirth to find out all the ways you can do more.
Edit: I should share that this mama went on to have 3 more babies, all bigger than her first, vaginally” - Visit ImprovingBirth.org as well for more info.
Here is the video post where Dawn Thompson the author of this article mentioned "kind, compassionate bu****it" that got people fired up. https://m.facebook.com/story.php?story_fbid=10218511665759578&id=1133317211
