Compelling research to persuade DH I won't die if I don't have continuous monitoring

[makemineaginandtonic]

I am due to have a VBAC in two weeks and don't want to have continuous monitoring or a cannula in my hand, both of which are standard on admission to my local hospital.

DH is convinced I am going to die because the minute they save putting the cannula in at the start is the minute that will save me should anything go wrong.

He also can't see how continuous monitoring can be anything but good, despite me explaining how active birth methods are preferable to lying on a bed.

Has anyone seen any compelling research I could show him that might make him see the reality? At the moment he is saying he won't be coming in the room at the hospital because he disagrees with my actions and we will argue.

[lulumama]

oh dear

i don;t have any compelling medical research, but mary cronk has done some good articles about this subject

CFM does not change the outcome, if anything, makes intervention more likely

signs of rupture are more than a change in the baby's heartbeat....mary cronk's article., one of many i should think

i am so sorry your DH does not feel able to support you...i imagine it is his fear of the worst case scenario...

FWIW, i had a VBAC, no canula and although i had CFM , the midwife left me to it....

you see, there are different rules from trust to trust about canula;s, CFM, hours you can labour for, so it suggests to me that there is room for manoeuvre.

so, i had a VBAC and no canula, i didn;t die! that is fairly compelling evidence


there is a really good VBAC support site, on Yahoo, and this site, caesarean.org is a great site!

[cheritongirl]

I expect someone wise like Lulumama will shortly come and dispense wisdom..
but maybe have a look on the NCT website as in my NCT antenatal classes we were well briefed that continous monitoring has as many drawbacks as plus-points and several friends of mine who are doctors definitely agreed with this. Sorry i am being vague but i think the general thinking these days is that when the monitoring doesn't work well (which often happens) then you may end up with all kinds of interventions that aren't necessary. And as you know, active birth is far preferable! Anyway.. wait for some wiser bods to come along... all the best!

[cheritongirl]

there, lulumama was already onto it!

[DaisyMOO]

There is absolutely masses of evidence that shows that in low-risk labour continous electronic fetal monitoring does not decrease the rate of perinatal mortality or cerebral palsy (main indicators of oxygen deprivation during birth) but does increase the risks of interventions such as cesarean section. Basically, interpreting the printout the monitor gives you is not an exact science and has a high rate of false positives which suggest that the fetus is in trouble when actually it is fine. You can read about it here in the Cochrane Database which is a very well-respected collection of reviews of medical research.

With VBACs the situation is less clear-cut. There is some research that has shown that the baby's heart rate sometimes dips shortly before a rupture occurs - however this does not happen consistently and there is a school of thought that if you are relying on the monitor to alert you to potential problems you may miss or pay less attention to other signs of impending rupture such as contractions stopping, pain in the scar area, and symptoms of shock in the mother such as increased pulse rate.

There is some very good stuff on the homebirth website about vbacs which is relevant whether or not you are planning a home birth (I'm guessing DH wouldn't go for that ) The vbac yahoo group that Lulu mentioned is also good. I don't know whether you have time to get it but I would also recommend The Thinking Woman's Guide to a Better Birth by Henci Goer for a good explanation of the research surrounding VBAC and common medical interventions during labour.

I don't know of any research into siting a canula on admission. There are all the downsides such as discomfort, risk of infection and the psychological feeling that you are 'at risk' which may inhibit your labour.

FWIW I had a HBA2C - no continous monitoring and no canula and I survived but could you come to some kind of compromise with your dh? Many hospitals have telemetry monitoring now so that you can move around and aren't attached to any wires, or you can try and move around with the normal belts and wires in place - many midwives will encourage and try and facilitate this. Or 20 minutes out of every hour on the monitor, 40 minutes off? Not sure how to compromise with the canula - it's either in or out!! Maybe agree to have one sited the second there are any worries?

I have to say I kinda think that if he's not happy being there and isn't going to support you, that you might get on better without him What about a doula or a female friend? I think it could be hard battling with him and possibly the medical staff at the same time, sorry if that sounds negative

Hope this helps a bit, hope I'm not just repeating what you already know

[lulumama]

makemine.....


i think it is really important that you talk this through with dh

also, was your first c.s an emergency? was it a possibility you or the baby were in grave, grave danger.? DH might well be really scared something similar will happen . and there might be memories he is reliving about the first birth?

intermittent monitoring is good, as are
the observations the midwife will make, CFM does not stop the rupture if it is going to happen....

although, the leads on the monitor should allow you a certain level of mobility, but you don;t have to agree to it.

also, staying at home as long as you can and keeping mobile and active in early labour is really positive too

have you thought about having a doula? to give you the reassurance, and DH while you labour?

[lulumama]

YAY for daisy ! x post

[DaisyMOO]

Good point about talking to your dh about any fears after the last birth. Doulas are great for supporting dads too, I think they sometimes get a bit forgotten! My dh always talks about how our doula looked after him and helped him supprt me.

[makemineaginandtonic]

Hi everyone, thanks for your messages, there is already a lot I can show DH!!

Forgot to mention that we are actually having a doula, so from my perspective the fact that he doesn't want to be there doesn't bother me that much. I would rather he was happy.

Previous section was for placenta praevia with no complications whatsoever. However, he was there when epidural was sited and even roped in to hold my shoulders steady, and then watched the op. Think it may have affected him more than he admits.

However, he is worrying himself sick in the run up and I also think he might regret not being there afterwards. He is also a retired GP's son, which doesn't help....

[lulumama]

well,there is no medical reason, your VBAC should not go smoothly, as there is no medical issue that would suggest a trial of labour is not appropriate

great you are having a doula! and if DH prefers to sit outside and you are ok with that, then why not! but definitely address his feelings about the first birth,

TBH , he might see how well you are doing in labour and want to be there for you....he just needs to get his head round the fact that yes, there is a small risk, but it is IMHO , an acceptable risk..

NICE guidelines do say a trial of labour is preferable