Response to a Complaint
Date: May 19, 2008
To: Dolese, Jenna
From: mail@theparentreview.com
Subject: Re: mandatory pitocin and I.V.
Thank you for your information. What Ina May says is true for the most part, which is why we advise patients to stay at home as long as possible when they go into labor, unless there are medical complications with the pregnancy. This way you can eat lightly, get up and move around, etc. The contractions that you have with pitocin are no stronger that active labor contractions, it's just that your body doesn't have the luxury of contractions slowly starting out and gradually increasing. This has been documented using internal monitors to measure the accurate strength of the contractions. Being on Pitocin for long periods of time dues increase the potential for hemorrhage due to the receptor sites becoming oversaturated and fatigue of the uterine muscle. Any intervention has potential problems. We do not shave our patients, nor do we do enemas. Those practices haven't been done in many, many years. What edition is the book that you are reading, is it current?
We do not induce labor unless there is a medical indication. Pitocin is added to all IV bags after you have delivered to prevent postpartum hemorrhage. Civilian providers routinely induce their patients for almost any reason because it precludes the providers from having to go into the hospital at night, weekends, etc. We have a provider on call 24/7, so we always have someone available.
We do respect patient's spiritual and ethnic beliefs. If there is something that you would like to have included in your birth experience, I urge you to write it down and discuss it with your provider, have a copy placed in your records and when you do come into the hospital in labor, discuss it with your nurses.
I hope that some of your concerns have been addressed. Communication between you and your provider is very important. I am glad that you are trying to get as much information about what you are experiencing. That is why The Parent Review site is so vital because all of the information on the site is current evidence and research based.
Donna L. Kelly, RN
Head Nurse OB/GYN Clinic
Date: May 17, 2008
To: mail@theparentreview.com
From: Dolese, Jenna
Subject: mandatory pitocin and I.V.
I have read from various books such as Ina May's Guide to Childbirth and Spiritual Midwifery that shavings, enemas, *I.V.s, *withholding nourishment, early rupture of membranes, and *electronic fetal monitoring [* means emphasis added] (Ina May's Guide to Childbirth 326). I know that the labor and delivery department routinely give I.V.s with Pitocin.. In Ina May's Guide to Childbirth, "Pitocin induction is more apt than a spontaneous labor to result in vacuum-extractor or forceps delivery or a cesarean section because of fetal distress stemming from too strong uterine contractions." (Ina May's Guide to Childbirth 210). The abnormally strong contractions can block the flow of oxygen to the baby and cause an increase in the rate of postpartum hemorrhage and uterine rupture. You may already know this, but I thought I would share a resource and possibly this email brought to the attention of the right people that patients are concerned about their medical care and spiritual and ethnic beliefs being met then something could come from it. Thank you for your time.
My Response:
What are the medical indicators that would have you induce labor just so that I am aware, because when I spoke to a nurse during the tour and asked her why I.V.s were mandatory since the only reason I knew that hospitals had I.V.s mandatory were for easy access to interventions and so that the patient wouldn't have food in their stomachs during a cesarean section. She responded that it was so that I could have medicine and it wasn't for cesarean sections. I then asked her what medicine and she responded Pitocin, which made me alarmed that a labor inducer was thought of as being standard medicine. I then asked for the hospitals statistics on interventions used and she said that there were none. She tried to assure me that the rate was low without being able to come up with a ball park figure, but somehow I did not feel convinced. I.V.s and preventing women from eating during labor are unsound by scientific evidence and it only hurts the process in most cases I would say, because it sets women up for intervention and preventing nourishment during the most rigorous exercise a woman can endure sets her up for failure I would say since she won't have the proper nourishment and energy to keep up her strength. I.V.s are needed for cesareans only if inductions aren't routine at your facility, because of anesthesia.
To: Dolese, Jenna
From: mail@theparentreview.com
Subject: Re: mandatory pitocin and I.V.
Thank you for your information. What Ina May says is true for the most part, which is why we advise patients to stay at home as long as possible when they go into labor, unless there are medical complications with the pregnancy. This way you can eat lightly, get up and move around, etc. The contractions that you have with pitocin are no stronger that active labor contractions, it's just that your body doesn't have the luxury of contractions slowly starting out and gradually increasing. This has been documented using internal monitors to measure the accurate strength of the contractions. Being on Pitocin for long periods of time dues increase the potential for hemorrhage due to the receptor sites becoming oversaturated and fatigue of the uterine muscle. Any intervention has potential problems. We do not shave our patients, nor do we do enemas. Those practices haven't been done in many, many years. What edition is the book that you are reading, is it current?
We do not induce labor unless there is a medical indication. Pitocin is added to all IV bags after you have delivered to prevent postpartum hemorrhage. Civilian providers routinely induce their patients for almost any reason because it precludes the providers from having to go into the hospital at night, weekends, etc. We have a provider on call 24/7, so we always have someone available.
We do respect patient's spiritual and ethnic beliefs. If there is something that you would like to have included in your birth experience, I urge you to write it down and discuss it with your provider, have a copy placed in your records and when you do come into the hospital in labor, discuss it with your nurses.
I hope that some of your concerns have been addressed. Communication between you and your provider is very important. I am glad that you are trying to get as much information about what you are experiencing. That is why The Parent Review site is so vital because all of the information on the site is current evidence and research based.
Donna L. Kelly, RN
Head Nurse OB/GYN Clinic
Date: May 17, 2008
To: mail@theparentreview.com
From: Dolese, Jenna
Subject: mandatory pitocin and I.V.
I have read from various books such as Ina May's Guide to Childbirth and Spiritual Midwifery that shavings, enemas, *I.V.s, *withholding nourishment, early rupture of membranes, and *electronic fetal monitoring [* means emphasis added] (Ina May's Guide to Childbirth 326). I know that the labor and delivery department routinely give I.V.s with Pitocin.. In Ina May's Guide to Childbirth, "Pitocin induction is more apt than a spontaneous labor to result in vacuum-extractor or forceps delivery or a cesarean section because of fetal distress stemming from too strong uterine contractions." (Ina May's Guide to Childbirth 210). The abnormally strong contractions can block the flow of oxygen to the baby and cause an increase in the rate of postpartum hemorrhage and uterine rupture. You may already know this, but I thought I would share a resource and possibly this email brought to the attention of the right people that patients are concerned about their medical care and spiritual and ethnic beliefs being met then something could come from it. Thank you for your time.
My Response:
What are the medical indicators that would have you induce labor just so that I am aware, because when I spoke to a nurse during the tour and asked her why I.V.s were mandatory since the only reason I knew that hospitals had I.V.s mandatory were for easy access to interventions and so that the patient wouldn't have food in their stomachs during a cesarean section. She responded that it was so that I could have medicine and it wasn't for cesarean sections. I then asked her what medicine and she responded Pitocin, which made me alarmed that a labor inducer was thought of as being standard medicine. I then asked for the hospitals statistics on interventions used and she said that there were none. She tried to assure me that the rate was low without being able to come up with a ball park figure, but somehow I did not feel convinced. I.V.s and preventing women from eating during labor are unsound by scientific evidence and it only hurts the process in most cases I would say, because it sets women up for intervention and preventing nourishment during the most rigorous exercise a woman can endure sets her up for failure I would say since she won't have the proper nourishment and energy to keep up her strength. I.V.s are needed for cesareans only if inductions aren't routine at your facility, because of anesthesia.