Notes on period obstetrics

[bunnyjadwiga]

The first recorded case of a C-Section operation survived by the mother appears to have been in Germany in 1500, performed by the desperate father-- Jacob Nufer, a pig gelder.

Rectovaginal fistulas (which is one of the complications that episiotomies were developed to combat) were common and long-term complications of birth in the 19th century. Between 1845 and 1850, James Marion Sims came up with a speculum that allowed repairs to be made and perfected a method by operating on a number of African-American slave women who had such fistulas. He later made his fortune performing the surgery on upper-class women who also demanded the now-fashionable anesthesia for the operation.

The 16th century Rosegarden for Pregnant Women and Midwives recommends that overweight women deliver in a hands and knees position that is widely mentioned in the current delivery/midwifery literature as a method for reducing shoulder dystochia (where the child is trapped in the birth canal because the posterior shoulder cannot be delivered). This manuever, however, is not easily executed in a modern standard delivery room due to the presence of monitoring equipment.

Comments

[bunnyjadwiga.livejournal.com]

I know perfectly well that I'm being dragged through this medical supervision hell-- and will be badgered to have C-section and/or induction-- for the comfort of the doctors. They are terrified that something will go wrong and someone will sue. In particular, fat mothers and GDM are heavily associated with macrosomia-- big babies-- which is associated with shoulder dystochia which is one of if not the biggest cause of obstetrical malpractice suits. Of course, I will probably have to be completely honest with my doctor and say: "If you force me into a C-section, and something goes wrong, I'm much more likely to find a lawyer than if we do this the normal way and something goes wrong."

[paquerette.livejournal.com]

Shoulder dystocia is somewhat more random than that. About half of all cases are large babies (and not all large babies are macrosomic; there have to be inappropriate proportions that I don't know the specifics of for that). So half of shoulder dystocias are babies about 8 lbs and under. And true dystocia is probably rarer than the stats would indicate. Many cases that get chalked up to it are probably just "sticky shoulders", not stuck long or hard enough to be dystocia.

If you do end up with the scalp electrode, it is possible to move around. Possibly moreso than the belly band. They should tape it to your thigh. A support person can hold and guide the wires while you change positions, walk around even. Some doulas have reported that some patients have had better mobility when switched to internal monitoring.

Of course, intermittent monitoring is the gold standard. But I know that you might end up wanting to pick your battles and that might not be one.