kannon99

Once the baby is born you won't care about how he was born.

That's a common thought. Unfortunately, C-sections have a much higher risk for mother and baby during the birth and for some, for the long term, so they will care. Many women later suffer from post-traumatic stress disorder as a result of their C-section. Something to keep in mind.

Due date is approx 12th.

I think my wife said tonight that the baby's head isn't yet in place where it should be at this stage, because of the pelvic problem.

I'm a little worried now again about an imposed c-section...

Does anyone know if a simple feel test can determine if the pelvic inlet is too small or wrongly shaped?

That's how this and head position was determined today, not by x-ray or other method.

There is absolutely NO WAY a doctor can tell by xray or feeling that a baby is not going to fit through the pelvis. All of the bones of the pelvis MOVE during labor and birth. If the mother is pushing in an upright position (and not on her back with feet in the stirrups) the baby will come out.

The "big baby card" is played by MOST doctors in Thailand. Ultrasound at this stage can show a due date off by +/- 3 weeks! And the weight? Off by as much as +/- 1 kg.

Just because the baby has not dropped into position does not mean that it won't. You can wait until labor and see what happens. Going into labor, even if with a resulting C-section, is better because mother and baby both benefit from the birth hormones.

My neighbor's sign to rent his apartment:

"Toi Let"

Doula...

Douleur, french for pain.

That's funny! It actually comes from Greek for "servant" or "slave"

This explains more of what a doula does.

http://www.findadoula.com/Parents/Aboutdoulas/what.htm

I have the strange assumption that only foreigners opt for doulas?

Usually foreigners, yes. For one thing, the best pregnancy and birth literature that is based on evidence is in English, so Thai women have a serious lack of information. Even if they did want to be informed the info is just not there. I've browsed through the books available to women in Thai and they may have cute pictures and modern looking presentations, but so much of the info is "this is what we'll do to you when you enter the hospital" and while we're at it, here's some seriously outdated information that has been built on years of myths too.

And in a culture where the "Dr. knows best" mentality takes precedent, it's rare to have a doula. This is because they either book their C-section or are told that the hospital staff will help them so why need a doula. Also, if a woman takes a family member that person is not trained for good labor support. There is also built into the culture a big fear mentality that is supported by friends, doctors, and media.

I think the biggest reason is that many Thai women don't even know that doulas exist. My Thai neighbors and I have had long discussions about this, and most think that a doula is a wonderful idea but why have they never heard of one. Those who had vaginal births (few, sadly) wish they'd had help with pain relief, and those who had C-section question why (most question after the fact).

A burning question: I wonder if hospitals in Thailand allow doulas at all?

They do. I'm a doula. (One of 3 that I know of in BKK) BNH, Samitivej Sukhumivit, and Bumrungrad do alllow doulas. Bumrungrad's rules are that only the mother and one person are allowed, but that's not been the case any time. Sukhumvit hospital has. We tried at Vejthani but that didn't work. Also a hospital in ChiangMai that allows.

In my experience, it's either the hospital policy or more commonly, the individual doctor's preference. Most OBs do not understand what a doula's role is and feel threatened by her presence. Doula's are there for physical labor support/pain relief. Doula's don't advocate for parents... they're there for labor supposrt and the parents do the advocating. The doula is also there for information. If the doctor wants to do a procedure, the doula is not there to say if it's necessary or not... she's there to (if parents ask her) tell the reasons a procedure would be done and tell the pros and cons of the procedure. OBs don't like this (that why I do it when OB is not present) because they want to recommend and it be "obeyed" and not questioned. But this is one of the only ways a parent can make an informed decision because usually, the side-affects and pros and cons are not fully disclosed by the staff.

in hebrew the word for giving birth is literally : squatting to birth (kora'at l'ledet) as that is how beduins and ancient races did it and i think that so did the thai women as i remember in some thai movie that was supposedly accurate they have the main character birth in a squatting position (pulling herself up with ropes)

A former maid of mine and I had a discussion about this. Mother's gripping onto a rope from the ceiling during the pushing phase. She was quite embarassed that the women in her village were still birthing like this. The way they are birthing upright is actually more physiologically helpful for the mother.

Most cultures birthed upright before the invention of obstetrics with a person "delivering" a baby for a woman instead of the woman birthing a baby into someone's hands. (But that's a whole other soapbox rant for another thread on another day LOL)

I've heard from parents to be that there are benefits for a baby's immune system if they have a natural birth. Any truth to that? or are there more benefits for a baby through c-section?

More benefits through natural birth.

1. The baby gets the good bacteria from the moms vagina that colonizes in the baby's gut. Helps it fight off the bad bacteria. This can't happen with a vaginal birth.

2. Also, during a vaginal birth, the baby is squeezed. This helps force out all fluids from the baby's lungs. During a C-section, this doesn't happen (and suctioning doesn't get it all). Babies are 5x more likely to have breathing problems after C-sections because of this.

3. During a normal labor and vaginal birth, the mother and baby have several hormone reactions that help prepare the baby for it's immediate physiologic changes from living inside to being able to breathe on the outside with no attachment via placenta and umbilical cord. During a planned C-section, this does not happen, and some babies are born with shock reactions and unable to breath as well.

Doesn't matter if there's only 2 to 3 weeks left, even days, Thai doctors are just as disposable in this household as are electricians, mechanics, cable tv companies and employees that have paraded over the years, mostly because of their preference for taking short cuts, as in c-section.

During one of the births I attended, the mom fired her doctor in labor! It's never too late.

And yes, short cuts is their preference. Whatever is easier for them, not the mother.

We are changing hospital. We took naps this afternoon and I haven't heard the news yet about her call to Samitivej Sri Racha.

Regarding c-section, I forgot to mention that the doctor said yesterday that since she is 38, that it is her first child, there may very well be complications, that's apparently why he would have insisted so much on it, I had missed that part.

She looked at pictures and online videos of natural birth last night and seemed to prefer a c-section afterwards and also more as D-day approaches.

Oh great, now you've got the "over 35" myth thrown at you! Ignore it. The natural birth videos online are scary and not how birth in many countries really is. Samitivej SR is a better option though the nursing staff has less experience in labor support. If she signs up for a C-section, it doesn't matter as much which hospital you go to. When I teach childbirth classes, communication with the OB is discussed in great detail. You are doing all of the right things. Questioning, going back for info from other sources,etc. You are the consumer, and you pay for what you want.

Send me a PM if want to discuss more. I'd happily give you a call and answer more questions.

I beat him to it on our way home, I stopped at that very same hospital and we went right up to the ward. We asked the personnel there but they all agreed it is not allowed anymore, without exception. The reason given in unison? Too many lawsuits!

I almost burst out laughing! What? Do you drop slippery babies on the floor that often? Or are your doctors are so incompetent that you protect them, instead of firing them, by not allowing any witnesses into the room with a camera, or maybe the insurance costs are such a nuisance to your f$% prosperity? The place has gone downhill over the last few years anyway, dirty floors, dirty walls where people sit and rest their heads , unnecessary and overpriced medication.

You are absolutely correct. I had a great conversation with a retiring OB the other day who is disgusted with most birthing practices here. He told me that the reason no one is allowed with women when they birth is because there is no one there to observe what really goes on. From cutting unnecessary episotomies, to forcing C-sections. The gov't and teaching hospitals are the worst. There is no one there to witness it, and if the mother complains, it's nothing to change the medical records. And this is from a highly respected OB in Bangkok!

i help my goats every year, and every year i am amazed by the process... sometime we help, and sometime we are just spectators

This is how medical staff should be, but too often the interfere when unnecessary and just cause more problems.

How did this happen............?

I start reading a forum about Drs refusing entry for fathers..I used to work in the medical world in Thailand and was interested and then.

After following Kats link http://www.poopreport.com/Techniques/Conte...abor/labor.html

I find myself at some sort of middleclass scat site...... pooreport.com...

Middle-class, lower-class. upper class, we all poop, but half of us don't give birth.

I for one did not know it happened frequently while giving birth.

I've attended quite a few births (including 4 of my own) and seen only one poo (and it was not mine lol) Women rarely even notice it and the nurses just do a quick wipe.

'thai women as small'

not true as far as i know (no stats, just empiracal evidence here and we have a huge birth rate here); many if not most of us small women give birth no problem no fuss (i am really small skinner then most thai women i've seen who all seem to be petite but with wide hips, but i am 'roomy' as the ob/gyn put it...its the width of the hips inside not the size or weight of the woman and i have a small butt but my internal hip area is wide) and while i gained about 22 kilo with each pregnancy, the babes were small...and my sister in law is a huge boned finnish woman and tall and broad: all c sections due to problematic baby and then the once a c section always a c section theory...

the rise i think may be due to the fact that women are told its easier, no pain, more convenient as far as schedule go, doesnt 'rip' her down there (keeps her 'tight') and faster.... its seen as 'modern'. how many thai women nowadays breastfeed? if it 'ruins' their breasts or in inconvenient, then why bother; and formula is seen as much more 'modern' (and was pushed as such by the formula companies)...and education is also a part of it... pre birth classes really really help. the worst thing is when all the old cronies and aunties and sisters start telling birthing horror stories (i was in labour for three days in pain etc etc etc and they yanked the baby out blablabla--never underestimate the power of these stories. every old crone who see a pregnant woman here starts in on the horror stories of daughters' in law' horrible births etc; its enough to make any young mother- to- be freaked out and want a c section to get it over with)

i'm sure that home birthing, doulas, natural childbirth, etc will swing back round in thailand years after it hits its popularity in western countries...

as for amounts of births, dont think too many countries can beat us: i gave birth each time had to room with women who were on their 9th! 7th! etc...

{we, btw, have a huge lack of anesthesiologists since its not an attractive profession, so natural childbirth and c section takes on a whole new aspect (for those wanting to give birth in israel there is a huge lack of anesthesiologists, and medical is not private so what u get when u go in is what there is... grin and bear it...}

the general rise in c sections may also be related to the rising age of first time mothers in western countries where c sections are recommended ... and to the multiple fetus pregnancies again due to use of artificial means of conception with more then one viable fetus; late pregnancies, more over weight women with pregnancy related problems making a natural birth difficult... the list can go on

Very interesting post bina! I'm a doula!

I think that it's rare for a baby not to fit. When mixing races (here it's the small Asian woman + falang guy) it can happen. But what women are not taught is that all the bones of the pelvis move during birth and that being forced to birth in the most unnatural position (on the back with legs in stirrups) work against that movement.

That may very well be the reason c-sections are so popular when some hospitals have to deal with an average of 15 women lining up for labor every day. Natural birth must be very time consuming regarding staff and resources.

I don't think C-sections are popular in regard to the # of women birthing because it takes so much more staff and resources.

I do labor support for women in hospitals and you're right about natural birth being time consuming. I've seen OBs "suggest" (coerce) women into unnecessary labor augmentation to ge it over with when all they really want to do is just go home and not wait. I've overheard one OB telling staff to give the mom something so she wouldn't make so much noise... never mind the woman was the only one in the birthing ward.

Tony - my wife and I also wanted a natural birth - but 12 hours with not enough dilation after her water broke essentially made the decision for us.

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Whatever you choose will not affect breastfeeding.

onethailand, that's so sad! 24 hours is the new protocol.

As for breastfeeding, vaginal birth with meds or C-section can affect breastfeeding. Not for all, but for quite a few.

Since natural childbirth is somewhat rare in LOS, Thai medical teams may not be prepared for the full range of complications in a natural birth.

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As far as I know, there can be complications to epidurals (sp) as well.

Usually the complications in natural birth here are from unnecessary interventions by the medical staff. OBGYN here is usually rarely practiced here looking at the research that is out there.

And yes, there are many epidural complications.

One other question: For natural childbirth in Thailand, is the mother and father-to-be taking birthing classes to prepare them for natural birth?

There are only a few classes offered, and most are biased. The teachers pretty much have to teach hospital policy. "Here's what the staff will do when you ... "

In my opinion, the best classes offered are at BNH (taught by independent teachers and you can take the classes if you're not birthing at BNH). I teach private classes but am on maternity leave. The best classes are the ones that teach evidence/research-based information.

As the birth gets closer, she now admits being more and more afraid of the pain and is seriously considering a c-section. If it involves less pain then and afterwards, I am all for it but I am concerned about medication prescribed during and following the surgery and it's effects on the baby while still in the womb and through breastfeeding afterwards. I think the epidural doesn't affect the baby, any sedatives or other drugs administered? Same goes for the mother, which heals faster and has less chance of complications? C-section or natural?

A woman as 3x the chance of dying with a C-section. It is major abdominal surgery. There can be life-long consequences for the mother and there can be side affects for the baby as well. C-sections also cause more pain after the birth and healing time is much much longer. Less mobility, more difficulty breastfeeding. Epidurals do have side affects for both mother and baby. Epidurals are often the cause of C-sections (look up cascade of interventions). Vaginal birth is by far less risky. The World Health Organization states that C-sections should account for 15% of births max. When I last checked, the "best" international hositals had very high rates... Bumrungrad was 90%!!! Yes, many Thai women opt for C-section, but a huge proportion of those C-sections was also "emergency".

I'm a childbirth educator and a doula (labor assistant). I've lived in Bangkok for 6 yr now and know quite a bit about the main international hospitals, birthing options, doctors, etc.. It's very hard to the get the birth you want like you'd have at "home", especially here. PM me if you need info on a specific doctor or policies at a hospital.

Thank you for that info! Next question then, does the MFA require the translation done by specific translators, or do they not care? I'd hate to pay and wait for a translation office around the corner and then take it to the MFA and them not accept it.

My son was born at home here in Bangkok. The district office had no problems issues a Thai birth certificate in just a day. (Amazing considering the run-around we got at first)

I got a birth packet from the US Embassy and the social security application says we need the Thai certificate translated by the Ministry Foreign Affairs. We did not have to do this when our daughter was born here... maybe the hospital did it for us. But this time with son born at home, there's no hospital to do it for us.

So, where is the MFA? I'm finding 2 locations and don't know which it is. Any specific office? How much will it cost? How much time does it take to do the translation?

Thanks!