Hi Nikki et al,
Thanks for the FDA reference. It confirms what I've always felt about
VE, the necessity to perform a risk benefit analysis before applying a
vacuum. It does seem that the logical response to a stalled second stage
due to an epidural, is to let the mother rest and let the epidural wear
off, not to jump to an assisted delivery, though OB's don't always use
logical thinking.
I guess what I was kind of getting at, is that women and babies have
death and near death experiences in labor every day, particularly in the
third world. And that often in L&D the near death experiences I saw were
caused by precisely the kind of thing that a VE might be used to assist
with. If vacuums were used only when absolutely indicated, to deliver a
baby who must be delivered, not just because an OB is feeling impatient,
then the statistics on bad outcomes related to VE could be greatly
reduced. I think if we have bad decisions being made we should blame the
doctors, but not necessarily the equipment. If reserved for cases of
significant fetal distress, or some other serious medical indication, the
possibility of a vacuum extraction seems a comfort rather than a threat.
It always seemed to me that the best OB's were the ones who could sit on
their hands and let nature take it's course, until that moment if and when
they were needed, at which point they could dive in with the necessary
intervention. A rare breed.
I don't for a minute doubt that a vacuum extraction could leave a baby
with a sore head or worse, which could certainly interfere with
breastfeeding, leaving a baby languishing in the birth canal who needs to
be born, seems like a worse alternative. Birth has always been accompanied
by the possibility of death, for mother or infant, but I feel that
advances in modern medicine have made birth infinitely safer not more
dangerous. I feel so lucky to live in a place where there are so few near
death experiences, in birth and life, compared to places like Somalia or
Afghanistan or 19th century America.
Okay guys, you can really let me have it now. I'm running for cover...
Kathy Lilleskov RN IBCLC
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