Guest guest Posted March 24, 1999 Report Share Posted March 24, 1999 Jan, << I never heard of the saline injections before, seems alittle extrame don't ya think? >> Maybe it sounds weirder than it is. The injections are just subcutaneous so it is like a little pin prick. The (admittedly few) moms who I have seen who have had it say it works wonders. I will see if I can find some research to pass on. Anabel Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 1999 Report Share Posted March 24, 1999 This is for Lori and All Who Have experienced OP Labor, I have heard that it is the shape of the uterus, but as I had 5 children, and only one was OP, I don't think that is it. Any other guesses? Cherub Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 1999 Report Share Posted March 24, 1999 Maybe OP is caused by the shape of the pelvis. What do you think? Kathy H. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 Cherub, are you an RN or Midwife? Sorry to ask but I am interested in turning an op baby. I am an RN. Please let me know. Lynn in Ohio. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 In a message dated 3/24/99 6:03:45 PM Eastern Standard Time, RBRNUT@... writes: << Do you wonder why babies are OP? >> Ever notice that VERY physically fit women, athletic with strong abs almost always have OP babies? I bet it has to do with the muscle tone of the abs on them. What do you think? Jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 In a message dated 3/25/99 12:03:20 AM Eastern Standard Time, Lynetrn@... writes: To turn the baby, after the mother is complete and pushing, get into the vagina with your two exam fingers, feeling for the baby's head suture line. When you find the suture line, so you know what position the baby is in, then you can turn the baby with my fingers while having whoever is coaching, turn the baby in the same direction with their hands on her tummy. Depending on what position the baby is in before you start to turn, you either try to turn the baby all the way around if the baby is in a complete OP position or only 1/2 way if the suture line is sideways, LP or RP. It usually only takes a couple of times to get the baby to turn into an OA position doing this. << Cherub, are you an RN or Midwife? Sorry to ask but I am interested in turning an op baby. I am an RN. Please let me know. Lynn in Ohio. >> I guess Im just a " tad " concerned about the method of turning these babies. I do not feel that it is in the RN's scope of practice to use physical means to turn OP babies, especially when it involves physically manipulating the baby from the vagina, or the hubby pushing on her belly. What if the baby is OP because of a cord problem, i/e/ short cord or cord entanglement and then you rotate this baby and cause a cord problem, what if the placenta position is such that the baby must be in the OP position to deliver safely? I guess there are way too many unknowns to be intervening in this manner. If she is already complete and pushing then it is likely the baby will turn on its own during the process or deliver just fine OP. I believe in passive rotation, using position changes etc. in labor to assist baby into proper position on its own. Using the interventions you describe sounds way to chancy to me. Our midwifes and OB's give exercises ahead of time to help turn babies. Also the midwifes use a few herbals to help spin breech to vertex. Now ECV's are a whole nother discussion! Jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 > From: FreeMexcAF@... > > > How do you all work with the mother to relieve the pain of an OP baby? > Anyone have any other suggestions? All this movement would have NEVER flown > in the last hospital I worked in -- you walked through the door, you were *in > the bed*. Period. I tend to suggest the all fours method, rocking motion, birth balls, double hip squeeze, lunging like a swordsman, rocking chair, have mom hang all her weight on dad, saline injections if it gets really really bad. Laboring in a Jacuzzi things like that. Hot rice packs work as well. OP babies are hard, there is no doubt about that. Marna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 I agree with Jan concerning the nurse using manual rotation to turn an OP baby. We can use all the methods suggested short of this one. We don't have enough malpractice insurance for that! Kathy H. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 In a message dated 03/25/99 08:46:12 Eastern Standard Time, Zukeeper4@... writes: << Now ECV's are a whole nother discussion! >> ECV's ? Robin Ohio Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 For Jan, I suppose you have a good point. I didn't have the husbands pushing on her abdomen though, just helping me rotate them. I used this procedure about 30 to 40 times without incident. Perhaps I was just lucky! I don't see that it's any different that when the baby turns on it's own. It could wind up in it's own cord on it's own. I didn't start this procedure until the cervix was complete and the babe was engaged in the pelvis. By that time the cord situation is already in place. Haven't you delivered a baby that had a cord around it's neck? You just slip the cord over the head and deliver the baby, or as happened to me in one case I couldn't get the cord over the head, as it was too tight, and the doc arrived and told me to " spin " the baby which I did and the baby delivered slick as a whistle. (I hadn't turned that baby incidently.) We attached internal fetal leads and had to know how the baby was lieing before we could apply the leads. Applying fetal leads used to be done only by the docs and then we went to classes in order to apply the fetal leads. You have to know how the baby is lieing before you start this procedure, but it's sure safer than when the docs use forceps to turn the baby, which is really the same thing, except he can crush the skull if he isn't proficient with the forceps. Sorry if I overstepped my bounds, but it worked to well for me that I thought it might help some of your moms. I know that none of you would do anything that you didn't feel comfortable with or felt was unsafe. So please ignore that advice. Cherub Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 To Everyone, Did something get the impression that I was suggesting that you try to rotate the babes from breech position to cephalic position???? Not so!!! I was refering from OP to OA. The rest I have already covered. Cherub Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 1999 Report Share Posted March 25, 1999 All of our OBs do external versions are quite frequently they are successful. Betsy CA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 Jan, my concerns as well. This is why I asked Cherub if she was an RN or what! I would not feel safe doing this and I would still like to know if Cherub is an RN and able to do this maneuver on her job. I remember when my sister was pregnant almost 12 years ago, way before I became a nurse, her baby was breech and who turned that baby around?! ME!! I was crazy and had no idea what I was doing! I am glad nothing ever seriously happened to my niece! I am still horrified that I did that! Lynn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 I agree with you, as well. Lynn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 Cherub, I would be terrified! I have only been in L & D for 15 months and I would not feel comfortable doing this, ever! What if something went wrong? I would not want to live with this on my conscience. Also, when you are in a precipitous delivery or in a situation where things are not going quite right can't you call out for help from a resident or even another doc that might be present? Lynn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 Cherub, if you have a cord that is too tight...how do you know in which direction to turn the baby?! (to turn the baby in a way to loosen the cord?!) I am glad I do not have a problem with putting my pt's call light when I am in trouble! I will be very nervous the first time I have to deliver a baby on my own and I pray it is never under any of these circumstances! I just could not do this! Lynn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 Lynn, No, we didn't have residents and the ER doc never wanted to be called as he hadn't done a delivery since he was a med student. It was a very small hospital. I still believe that you gals are getting the wrong impression of what I described. I did not, nor would I ever, try to turn a breech baby. I wouldn't know how but even if I did, I wouldn't try it. Do you know what an OP presentation is? I'm sure you do. A woman cannot deliver, at least not easily with a baby in this position. The baby just about always turns to an OA position before delivery, but sometimes that takes hours and I have seen docs take moms to the OR for a C-section, when they wouldn't turn and they couldn't deliver with them in that position. Cherub Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 I most certainly do know what an OP presentation is. I am also sure I would not try to rotate that baby on my own. I do not believe as an RN I would be aloud to do this legally. It is also very clear you are not talking about a breech presentation. Lynn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 Lynn, It only happened to me once and the doc that was supposed to deliver the baby came in just at that moment and told me to turn the baby. I turned the baby to the right and it spun around and then delivered. This sounds stupid, but I suppose if you tried to turn it the other way, the baby wouldn't turn, as the cord was too tight to slip over the head . I was in labor and delivery for almost 30 years and that was the only time I had this happen. Usually you are in the del room and the doc just reaches up, clamps the cord in two places, cuts it and gets the baby out fast. This little Mexican girl came in at 9 cm and proceeded to deliver in the bed, so there wasn't time to get any instruments. I was lucky to get gloves on. I did put the light on to get the floor nurse to come. (We only had one L & D nurse and one floor nurse and one nursery nurse. I told you it was and is still, a very small hospital.) Cherub Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 Lynn, I didn't mean you, but someone mentioned a breech presentation, so I thought that is what everyone thought I meant. Anyway lets drop the subject, OK? We all do what we feel comfortable with and I'm sure you are right. Everyone must follow their own conscious. But I wish more doctors would do what my good friend and wonderful doctor did, instead of using forceps. Cherub Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 In a message dated 3/25/99 1:36:29 PM Eastern Standard Time, RLPasquale@... writes: << ECV's ? >> External Cephalic Version Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 In a message dated 3/25/99 2:43:29 PM Eastern Standard Time, Diane@... writes: << External Cephalic Version they stopped them a long time ago and restarted a couple of years ago, not very popular and not too successful either, >> We have a pretty good success rate. The old way of doing them required us giving MgSO4 prior! It was awful. Now in the birth center, the OB's do an NST, bedside US to check position, cord, placenta etc., then they attempt, if the baby's going to turn it usually does so easily and in less than 4 attempts. After each attempt, they US again, then when done they get another NST, then home. Several of our midwives use Homeopathic Pulsatilla 200c 1xday; repeat one more day if baby hasn't turned yet or Pulsatilla 30C (homeopathic; dosage 3-5 pellets under the tongue twice daily for 2 weeks) which encourages position change. or homeopathic Pulsatilla 6X, one tablet under the tongue four times a day. Combine this with the breech tilt exercise at least twice a day for 10 minutes each time. The mom takes one Pulsatilla tab before beginning the breech tilt. exercises. Also for further info, it can be used in for any malpresentation, including posterior. ( It is most effective if used in conjunction with a slant board, crawling, pelvic rocking, etc.) The books I have read say not to take it for more than one day. The midwives don't talk about it use very often in front of the docs because they get boo- hood but it seems to work. Jan ------------------------------------------------------------------------------ -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 In a message dated 3/25/99 5:46:14 PM Eastern Standard Time, CherubJoen@... writes: << My scariest delivery was one where the head and one hand emerged through the vagina. >> My scariest was a very preterm patient being treated in ER for something, I can't even remember what. But they sent her to US and the US tech called panicking saying she was doing the US and the foot was in the birth canal. Of course it was middle of the night, no docs around anywhere but some ER doc, who had no clue, they rushed the pt to us and as she was coming through the door, the BOW was extended about 2 inches out of vagina with little foot wiggling below, the ER doc didn't know what to do, I felt for the head/cervix was only about 5-6 cm, delivered the foot/breech, manually dilated the rest of the cervix to get the head out. We would not have started to resuscitate but the ER doc would not take a stand and started ordering all kinds of things, lines, meds etc. It was horrible, all I wanted to do was snuggle them up together and let this little one pass on in peace. Finally the ped arrived and called it. The baby was placed on Mom with warm blankets, it was hours before she finally died. Occasional gasping and Mom saying " She's trying so hard to live " , broke my heart. I was thankful for my Resolve Through Sharing training on that one! They wound up suing the hospital and the ER doc for missing the signs of preterm labor, they lost. I still keep in touch with them through Resolve but it was difficult during the time the suit was in place as I had to assign another counselor since I could not talk about the events that took place. And thats my worst delivery.... Glad to say I've had many more nice ones than bad ones! Jan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 In a message dated 3/25/99 6:06:13 PM Eastern Standard Time, CherubJoen@... writes: << I don't see that it's any different that when the baby turns on it's own. It could wind up in it's own cord on it's own. The difference being that the baby " did it on its own " and nothing that YOU did created the problem. < Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 1999 Report Share Posted March 26, 1999 In a message dated 3/26/99 2:06:25 AM Eastern Standard Time, CherubJoen@... writes: << A woman cannot deliver, at least not easily with a baby in this position. The baby just about always turns to an OA position before delivery, but sometimes that takes hours and I have seen docs take moms to the OR for a C-section, when they wouldn't turn and they couldn't deliver with them in that position. >> I disagree, we have a good number of babies that start out OP and turn - on their own- with passive intervention. Many of these babies are found to be OP prior to labor and these Mom's are given specific exercises to do prior to labor to assist in positioning. Babies who are OP require more nursing care and more nursing patience, and NO EPIDURALS. Relaxation of the pelvic floor will almost certainly " sentence " that baby to delivering in a poor position and hinder rotation. If you must use pain mgmt, select non-pharmaceutical, IV stadol, nubain, or Intrathecal. We rarely deliver by C/S for OP. The other problems I've seen with OP deliveries result from induction of labor on a patient that is a known OP or premature or artificial ROM. Again, on the granola soapbox,' Jan Quote Link to comment Share on other sites More sharing options...
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