Help me work through last minute questions and heebie jeebies!!....

Just writing my birth plan and a few things have come up over the last few days!

a) Internal Fetal Monitoring. In what circumstances and how often is this used? I really don't want it - didn't have it with Izzy but want to be prepared. Is it because EFM isn't picking up the HB very well? What are the alternatives - different positions? I want to stay active as possible and obviously if they recommend IFM this goes out the window as well as it increasing risk of infection.

b) Lost. One cervix. ;) Tried to feel it last night but it is nowhere to be found, which then brought back memories of Izzy's birth and them telling me my cervix was "high" etc just before I had the c/s. Is it normal for me to not be able to feel it and for it to be high at almost 38 weeks?

c)Cord. If all goes to plan as I am sure it will ;) I would like to leave the cord for a period of time to stop pulsating. Is it possible to get them to hold off on the synto for the placenta until this occurs??

d) Natural third stage - what is a reasonable amount of time to request that the placenta be delivered naturally? If haemmorage is going to occur - would it happen straight away?

I think that's it for now. The only other thing playing on my mind is the fact that it has been only 16 mths since my c/s. Surely enough time for my scar to heal - but has my mind!! Mmmmmmmm.........
Thanks for reading! :)

Hey Tan :)

Some things I can't answer - but I can tell you that my OB was going to give me an hour to get the placenta out myself before injecting drugs.

And I think I read somewhere that your scar is healed after 3 months. So it doesn't matter how long between them. Can't remember where I read that. Maybe my OB told me. Dunno. lol

(Sorry - baby brain happening here)

You have my number if you need to chat!!!

I don't think they commonly use internal monitoring in Australia. I thought I may have to have it being a little overweight but I didn't. At times it took the midwives ages to find the heartbeat but they still didn't use internal monitoring, they just perservered with the doppler.

Don't know about the other stuff.

Thanks guys - I think an hour sounds reasonable too Mel. I didn't know that about IFM so that's good to know - I will go through my birth plan on Monday with my midwife and see how we go.
Any other wisdom appreciated!

Hi.
Sometimes internal monitoring is used. DS was distressed & I haven't had it, but a friend of mine did.
I think its only in extreme circumstances though. My friend hhad it before being taken for a ceaser coz her DS couldn't fit through her pelvis.
I wouldn't worry about where your cervix is yet. I remember with DD1 it was still high in labour & the ob pulled it down under her head - Ouch! But I still had her vaginally.
I think all my placenta's were delivered with in about 30 minutes, but I had the needle with the girls. I didn't have it with DS & I'm still sure it was with in 30 mins.

Good luck hun!

Tan, I had internal monitoring with Oskar because the external was showing VERY low hb so internal gives a more accurate reading. It was VERY low so that told them they had to do something to help out. I think that he was still quite high too from what I remember.

I had the needle for the placenta cos I lost a bit of blood and they wanted to get everything done asap. I didn't need blood but had to have BT to check everything next day.

I would've left cord but wasn't able to due to his distress.

All in all I ended up getting my VBAC and drug free too. The only unpleasant thing for me was the hands being stuck up me...lol... not comfy when everything in your body is doing the opposite IYKWIM.

Good luck hun, I'm sure you'll be amazing!

Thanks for your reply Cass - when you have IFM were you able to move around? I have a fear of being stuck in bed and I so don't want that...
I have a bit of back ache today so all these fears are surfacing again and there are lots of tears around here! Im just such a control freak and hate not knowing what will happen!

I don't think you can move around, but I've never been there.
I had the external monitors with DD1 & DS & I was stuck on the bed. I could roll over with DS, but it was hard with all the cords & stuff, so I only did once.
Hope your back pain either turns into labour or goes away.
Goodluck!

Tanstar - I feel like I am stalking your threads hun :lol:

I had internal monitoring with DS cos external heartbeat kept fading/losing it and it was low - he was getting distressed - I had already had an epidural so wasn't moving anyway ;).

Re cord/placenta issues - have it in your birth preferences and you shouldn't have a problem - you have a doula too to remind you about it - just say you want to wait an hour first for placenta and if problems, happy to have the needle.

Tan they wanted me to have IFM but I refused as they said I would have to stay lying down. I also didn't think it was necessary as DD seemed to be fine and at no time was she distressed. My BP was quite high so maybe that is why they were concerned? In the end they just checked DD hearbeat externally every so often.

With the placenta I requested not to have the injection - it came out naturally after around 45 mins and I remember one nurse saying '10 more mins and you need to have the injection' . She said that after around 30 mins. And yes you can request to leave the cord until it stops pulsating.

Not sure about the high cervix, I was never aware of how high/low mine was!

YAY not long now hun!

Firstly I wanted to say

:cheer: GO TAN!! :cheer:

With IFM - your waters have to be broken for them to do it, so if they want to and you don't then dont let them break your waters! (that made way more sense in my head sorry! Lol)

Just the other day I read a book by a NZ midwife, and she was saying that the routine of clamping/cutting the cord early was to save getting blood on the hospital sheets! :rolleyes:
You are well within your right to request delayed cord clamping and natural third stage :) and actually this book said that early clamping can contribute to haemorraging (sp?)... interesting

All the best for your VBAC darl

a) Internal Fetal Monitoring.
I had IFM with Juliette mostly because the EFM machine wasn't picking up her heart rate properly & also because I was flat out refusing to lay down for them to try & get it to work properly!! I was able to wak about & even had it on (in?) when I was in the shower. When they wanted to monitor Juliette they just reconnected it to the machine for the 20 minutes & I was able to stay standing or squatting as long as I was close by the machine. I wasn't fussed about having it because it meant I could move around & my waters had already broken spontaneously so that wasn't a concern. The only concern for Juliette was that she had a tiny graze/scratch for a few days after the birth.

b) Lost. One cervix.
Don't bother trying to find it hun, there's no need really is there?

c)Cord. If all goes to plan as I am sure it will ;) I would like to leave the cord for a period of time to stop pulsating. Is it possible to get them to hold off on the synto for the placenta until this occurs??
No idea about it for a natural birth, but I was still allowed to have te cord stop pulsating for Juiette's birth even though it was a c/s so make sure you have it in there JIC you need a c/s.

I'm not much help but anyway! My placenta took 43 minutes to arrive. I breasfed straight away so that would have helped.

Good luck !

Hi Tan!

My midwife said they would give me the injection after an hour if the placenta hadn't come.

And as for the cervix.....I have NO idea what I am looking for! :redface: Should I know? Or should I be checking??

Have no advice Tan, but wanted to wish you all the best for your vbac! I'll be learning from you so that I am prepared when it's (eventually) my turn.

Good luck hun!!! Sending plenty of cervix ripening vibes your way!

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Have no advice Tan, but wanted to wish you all the best for your vbac!

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Ditto here, mate. You're going to be great. I do understand about the control issue, but we just can't control something that's so instinctive, KWIM? When the time comes, you're going to handle it beautifully, and be wonderfully supported. Try to trust in that as much as you can.
All the very best for these last few weeks! :hug:

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a) Internal Fetal Monitoring. In what circumstances and how often is this used? I really don't want it - didn't have it with Izzy but want to be prepared. Is it because EFM isn't picking up the HB very well? What are the alternatives - different positions? I want to stay active as possible and obviously if they recommend IFM this goes out the window as well as it increasing risk of infection.

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I can't find the source at the moment, I'll keep looking, but I have read several studies recently that show there is NO improved outcomes with continuous monitoring. You've probably read that, so not sure if it helps, but I thought it might be useful to have that evidence up your sleeve if there is talk of IFM.

Wishing you the best for your VBAC!! :hug:

Sarah - That's good to know hun, I had visions of it being in/on ;) and having to stay on the bed. Hoping we can avoid it anyway but it's good to know that if I do need it I can stay active!

I've stopped looking for my cervix now too! I figure it's there somewhere and hopefully getting ready as I am!

My back pain has eased a little - DH gave me a wonderful massage before and I had a little nap. Off to do a bit of shopping soon so will see if it flares up again with walking I would say I overdid things stretching last night!

Thanks for all yoru wonderful advice and support ladies! I'm sure you will be the only things keep me sane in the coming weeks with all my silly questions!

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The only concern for Juliette was that she had a tiny graze/scratch for a few days after the birth.

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My DD2 had a little scratch on her head as well from them breaking my waters at the last minute. Not real important, but just so you know. I felt at the time like they could've been more careful, but these things happen sometimes.:)

I complained about having constant efm and so they said they could just attach this thing to bubs head and then I would have more freedom to move etc. So easy, sounds great...
Problem is that by the time this sunk in and they have done it I realise the little cord coming out of myvagina is attached to my baby's head - TALK ABOUT MAKING YOU WANT TO KEEP STILL!!!!
I also had to pee later and was terrified to walk to the loo!

NO ifm, no constant efm - let them use the doppler every 10-15 mins or so, no reason they can't.

As for your placenta injection you don't have to have it at all if you don't want it, just make sure that you let them know in writing and very clearly beforehand 'cause you'll be pre occupied pushing a baby head out and it'll be in your leg before you know it!

Sarah :D

Tan, I'm glad that Sarah replied with her experience with the IFM as with Oskar he was born in less than an hour after I got to hospital and that was partly due to them picking up that he was in distress with HB dropping to 40 BPM every contraction so I didn't have time to walk around and he was helped out into the world via vacuum.

Honey, it's totally normal for old fears to arise as you get closer. This is when it is really important to keep up with your affirmations and relaxation techniques. I had my affirmations on my fridge so I saw them all the time (actually they're still there...lol) ... good thing cos I'll need them again! Oh and re: control freak... you need to give into your body hun ;) Your body and baby know what to do :) :hug:

IFM - it's still atached to the EFM and you will have limited movement, just as much as normal monitoring, you can sit on the fitball and all that, but unless there is a medical reason why, do you really want a clip in your bubba's head?

Yes, the studies show no improved outcomes for having continuous monitoring, only increased c/s rates!!!

Cervix - yup don't stress, it's doing it's job and will continue to do so!

Third stage - most placentas come out pretty soon after the birth, I have only ever been with one client where it was stubborn, it was a normal waterbirth too. But the majority come away well and it's a much better option than a managed third stage which requires active management where they need to manually get the placenta out, possibly pulling off the cord (yes it does happen) or other issues. If you start bleeding too much and need Syntometrine, then it is much more concentrated than Syntocinon and works very quickly intramuscularly. Blood loss is hard to measure and estimate though.

Thanks so much everyone! :hug: It has put things in perspective in my head much more clearly now and I have a midwife appointment tomorrow so will have a chat to suss out the waters (no pun intended :)) and see how we go!
Kelly - that is exactly it, I don't want anything attached to his head, and just am keeping positive that it won't even be an issue.

Cass - CONGRATULATIONS! I think I missed something along the way or else it's my baby brain but how exciting hun! :hooray: