Be Informed! Or is ignorance bliss?

[highlander]

As a first timer (well, at 35 I'm an old-timer as well, but that's another story), I've lost count of the number of web sites instructing me to be 'informed' about pregnancy.

However, I find that the information exposure raises my BP and leaves me so terrified and out of control that I immediately make a run for Hula Hoops and Snickers bars!

It particulary gets my goat when the advice proffered is a tad 'you SHOULD do this', or the information is very biased.

Examples:

1. Breastfeeding - like all new mums, I'd love to give this a go and I've found the web info very helpful for that crucial first 2 weeks when I would be likely to give up- Latching position, the fact that newborns don't need a lot in the first week, importance of professional BF support etc. However, I'm not going to beat myself up and subject myself to months of pain if I hate it/can't do it etc. I hate the way the info available akins bottles to infanticide!
   
   
2. Sections - I WANT a section. Despite the disadvantages,It's for me; it's my CHOICE. And yet I can't find a single bit of info on the web that supports me. All I can get are scary stories!
   
   I could go on ............ but I'm seething again. Now, where's the choccy......

[mears]

Grunting can be quite common, especially with babies born by C/S although it can happen to any baby. It is not necessarily connected to Pethidine.
I agree with the point that midwives should not 'force' gas and air on anyone. Pain relief should always be at the woman's request, however sometimes I do suggest it when it is obvious that the woman is not coping i.e. unable to breathe or relax at all.

[spacemonkey]

Your observations about G&A are totally correct IME pupuce. I didn't have any pain relief with my 2nd labour, but felt pressganged by the MWs into having G&A right at the end and this resulted in my feeling a loss of control and a sharp increase in pain

I had pethidine with my 1st labour and it was dreadful (administered early though so AFAIK there were no ill effects on dd). I fell asleep between each contraction only to be woken, shocked and unprepared, by the worst pain I've ever known. Bloody awful stuff IMO!

[pupuce]

Sorry for double post.... this is an additional sebtence in post number 2:

Also grunting is quite common in newborns... nothing to do with pethidine ! Mears - can you enlighten us ?

[pupuce]

HMC - if you read my post again you will see that I did say that pethidine should not be administered to close of the delivery - exactly as your Dr and MW have said.... - otherwise you often have to administer an antidote...so we are in agreement - or am I missing something?

Also grunting is quite common in newborns... nothing to do with pethidine ! Mears - can you enlighten us ?

Mears - not sure we disagree but I know what you mean,.... all I am saying is that plenty of woman around the world (and I am not talking obscure countries) but Europe and the US do not have gas and air... I also know quite a few women in the UK who didn't need G&A. Often (NOT always) good breathing and support can be enough.... When ever I had women refuse the G&A, MW were pushing them actively "it will take the edge off" but what they failed IMO to understand is that these women can cope with this pain in the rythm they are in at that moment,... constant interruption is not helpful, they feel OK! (BTW - not having a go - you know me )

[pupuce]

HMC - if you read my post again you will see that I did say that pethidine should not be administered to close of the delivery - exactly as your Dr and MW have said.... - otherwise you often have to administer an antidote...so we are in agreement - or am I missing something?

Mears - not sure we disagree but I know what you mean,.... all I am saying is that plenty of woman around the world (and I am not talking obscure countries) but Europe and the US do not have gas and air... I also know quite a few women in the UK who didn't need G&A. Often (NOT always) good breathing and support can be enough.... When ever I had women refuse the G&A, MW were pushing them actively "it will take the edge off" but what they failed IMO to understand is that these women can cope with this pain in the rythm they are in at that moment,... constant interruption is not helpful, they feel OK! (BTW - not having a go - you know me )

[mears]

I had pethidine first time and baby didn't feed for 12 hours (liked it but it made me talk rubbish). Next babies I had 'gas and air' and I loved it. Pupuce and I disagree on that one It can be very useful for women who are finding contractions too intense and, if breathed properly, can avoid the need for an injection of Pethidine or Diamorphine.

[Cam]

Re: pethidine, my own experience is that I had it twice in both labours and both my dd's were born not very long after the second injection. Both my dds fed straightaway and were not sleepy.

[dinosaur]

thanks for confirming - I thought that was the case

[handlemecarefully]

I believe that's so - yes.

[dinosaur]

thank you very much hmc!!

if the result comes back positive, does that mean you have to be on intravenous antibiotics when labour commences?

[handlemecarefully]

There is 'Group B Strep Support' a UK charity who provide an informative website : www.gbss.org.uk

Omnilabs are the lab who do the enriched culture method. Their website is: www.omnilabs.co.uk

They send a pack out to the patient with a request form which you get signed by your doctor or midwife. Then either a health professional (or yourself) can take a vaginal swab with the swab kit and transport medium that they send you or you can do this bit yourself(basically you can do it yourself because its not a complicated procedure - just rub the swab around in your nether regions). The test result takes 3 days and the result is sent back to the health care professional who signed the request form for you.

You however are required to send a cheque for £18 with the request form and swabs.

Swabs should be taken between weeks 35-37 of pregnancy. I've got my pack and I'm doing mine next week (I'll be 35 weeks next Monday)

The telephone number for requesting a pack from Omnilabs is 020 7908 7000

[dinosaur]

Could you email me through contact another talker with more info about this enriched culture thing? Or post it on here, if you don't mind?

[dinosaur]

Yes

I did insist on having a swab for strep B when pg with DS2 and will be doing the same this time around.

But that is another example, I had never heard of risks of Strep B when I was pregnant with DS1!! More "ignorance is not bliss"!

[handlemecarefully]

Your midwife was wrong on that count - the NHS test is known to be unreliable. That's one of the reasons they don't do universal screening (no point when the test is unreliable). It was my hospital attached midwife who gave me the leaflet for the privately available enriched culture method.

I despair alongside you re how the heck do you get reliable information!!! Its all so contradictory.

[handlemecarefully]

OOOh our posts crossed!

[handlemecarefully]

Dinosaur,

But how do you know it was the pethidine and not for example an undetected strep infection?

[dinosaur]

That's very interesting hmc.

I was told by the consultant midwife that if DS1 had had an infection it would definitely have shown up on his cultures - she never told me about the false positives!

How the hell does one get "reliable" information eh?

Well, will be trying to avoid artificial pain relief again thsi time around, one can only make one's own choices based on one's own experiences, it seems. I would just hate anyone to go through what I went through, and of courese, I was rather lcuky in that at least DS1 survived.

[dinosaur]

I don't know hercules. I asked the consultant midwife at the Homerton that, and she said that they do still use it because it's very useful for long first labours (exactly the situation I had it) and that reactions like my DSs are very unusual.

But it sounds from what Pupuce was saying that medical and midwifery opinion is swinging against the use of pethidine.

Certainly everyone who was in my antenatal classes when I had DS2 was completely put off pethidine by hearing about my experience with DS1.

[handlemecarefully]

Pupuce and Dinosaur,

I asked both my Obstetrician and 2 midwifes (my community one attached to my GP Practice, and the one at the antenatal clinic at the hospital) about pethidine and correlation with respiratory distress in the newborn and they were not of a similar opinion to yours Pupuce. So I think we have to be careful about promulgating this as established fact.....the jury is still out on this. (They did acknowledge however that it should be given too close to delivery for this reason - but in the early stages of labour, fine)

I had a grunty baby who was overnight in SCBU - but my last pethidine shot was circa 08.20 in the morning and I didn't deliver until 18.30 that night so the two were unrelated. We never established a cause - but I think it was more likely a strep infection (and although cultures from my dd came back negative for this - the NHS strep test is notoriously unreliable and gives up to 50% false negatives)...particularly since when I was given a vaginal swab 3 months post partum (before I had an IUD fitted) I was found to have a strep infection. I am paying for a strep test privately using the enriched culture method this time around (theres only the one lab in the UK offering this)

Dinosaur your experience sounds much worse than mine (i.e. my dd was in SCBU overnight for her breathing but well enough to be discharged next day)...but I think its unreasonable to automatically assume it was the pethidine that was necessarily to blame. That said, I can understand why you would want to play it safe and avoid it.

As for epidurals - I'm truly surprised Pupuce that your experience is so at odds to mine. When I was in labour the two lovely girls one fully trained midwife and one student midwife (and they were 'girls' who had never had babies themselves) kept drumming into me that I didn't need an epidural....but I was truly desperate. I was eventually saved by a doctor who came in a couple of hours later and suggested I had one (he could see that I could cope no longer and he could also see my dh weeping in a corner because he had never before seen his normally stoical wife reduced to this). I felt soooo much better after the epidural - and had I been given it sooner feel sure that I wouldn't have need the birth afterthoughts counselling that I have since had.

Plus my friends who laboured at around the same time as me report obdurate resistance to the notion of an epidural from their midwives.

I am not arguing the rights and wrongs of an epidural here - just suggesting that it seems to me that they are actively discouraged by the majority of midwives which isn't always in the interests of the labouring mum to be.

All highlander is asking for is a balanced discussion in the literature and from health care professionals about the pros and cons of intervention etc - but there doesn't seem to be one - amongst midwives at least. Doctors in my experience are more objective.

Incidentally I'm excluding Mears from this general inditement of midwifes!

[hercules]

Bloomin heckers Dinosaur! Why then is it allowed at all?

[dinosaur]

good for you hercules

I knew there was a risk that babies could be drowsy but not that they could be born blue and only score 1 on their Apgars and have a heart rate of only 40 bpm

[hercules]

I am very glad that I was not ignorant when dd was born and didnt have pethidine. DD was crying for most of her 2nd night in hospital and the mvs wanted her to have a bottle as they said I didnt have enough milk. Well I knew that was crap and had been there already with ds, they gave him the bottle and i had problems after that bf him though did succeed by speaking to a bf counsellor.
The mum in the bed next to us when dd wasa born was very worried about her baby as she'd had pethidine and her baby would barely wake up to feed and the mvs were concerned as he was barely feeding. She had to try to wake him up which is hard as when they need to sleep they need to sleep iyswim. She wished she'd known as for her ignorance was far from bliss.
It gives you far more control if you are informed rather than trusting staff who may not be informed either!

[dinosaur]

Oh don't worry I won't have it this time - I was absolutely adamant about that last time too, and in fact got through without even gas and air (which I think is greatly overrated anyway!).

I have had a chat with my doula about pain relief - she knows where I'm coming from, and I think it will be very helpful to have the extra support.

[pupuce]

Dinosaur: I would be amazed if you had pethidine AND a doula...

I am sure she will make you go through the labour with very little pain relief if any.... you will feel far more confident I reckon !

[dinosaur]

That's so interesting Pupuce.

I wish I'd known that before I had DS1, could have spared myself the most traumatic incident of my life so far.

So ignorance is not bliss, no.