View Full Version : Labour and Delivery Question - T6 and above!
04-03-2012, 11:49 PM
I am feeling extremely discouraged and more or less categorized today. After having all of the necessary team members in place and expecting to deliver at the hospital I prefer, the anesthiology team has come back and said that because my injury is above the T6 level, and because they don't do HEMODYNAMIC MONITORING, I cannot give birth at this hospital. After reading through all of the labour and pregnancy threads I have yet to come across anyone mentioning this. I'm wondering if anyone else had run into this issue or had a doctor explain this further. I do not have a history of AD - and I have full sensation, so this seems a bit extreme of a response. Though I understand I can't force them to work outside their comfort zone.
04-04-2012, 02:31 AM
Well, if they are not comfortable delivering you, then it is probably best not to deliver there.
I don't understand their need to have full hemodynamic monitoring (i.e., putting in an arterial line to monitor your blood pressure), since AD monitoring only requires a frequent blood pressure with a regular blood pressure cuff (at least every 2-3 minutes). Invasive monitoring is not needed, and would put you at risk.
In addition, since you have full sensation, use of an epidural (which I assume they DO have available in a good labor and delivery center) would take care of both preventing any AD (which you could get in spite of never having had it before) and manage pain for you during your labor and delivery.
Unfortunately, you may need to plan on delivering somewhere else where they really know what they are doing in managing delivery for a woman with a SCI. Because women with SCI also tend to have relatively short labor, you may have to stay in a hotel close to this hospital until you go into labor if that location is some distance from your home.
kld, as usual is right. i am c7, had baby at loma linda in ca. where they determined epidural would stop AD. not only did it do that, but hours later when i had an unexpected placenta tear and hemorhaged, they sliced me open at my insistence and it didn't hurt. btw, the placenta thing was unrelated to sci.
my t4 friend, who either didn't listen to me or her dr didn't, delivered 6 months after me and had severe AD.
i insisted on loma linda, a high risk facility in 1992. the fool insurance ppl wanted me to go to a community hospital where, as it turns out, my baby and i both would likely have died.
don't be scared, many sci women (prob most) deliver no prob. but i say make sure you go to the best hospital and they are fully informed of AD AND EPIDURAL PREVENTION. oops caps.
btw, i had baby belt and bp monitoring. what really saved me, though was i felt liquid (blood) gushing and that was only cause epidural was wearing off. make sure you have someone in the room constantly looking.
04-04-2012, 10:50 AM
i agree that you need to find a place that will work with you. that seems excessive.
04-04-2012, 05:10 PM
Thanks KLD (and others). This is exactly what I thought.
04-04-2012, 06:12 PM
This makes me glad I had my children in the 60's and early 70's when there was a lot of ignorance! The "team" for my first two was one doctor. The "team" for my last was a nurse and my husband because the Dr. didn't get there in time.
04-05-2012, 08:27 PM
redros3 - where in Ontario are you located? I'm also pregnant and have had frustrations with my local hospital. I have an incomplete injury at L1 and am 38 weeks! My hospital (Woodstock) only had one anaesthesiologist who would touch my back with an epi. Then half way through the pregnancy she informed me that she wouldn't be on call ofr me and she was going on vacation for 6 days around my due date. Needless to say I promtly switched to Victoria Hospital in London. Seems odd that ehy wouldn't just transfer me to a better hospital from the begnning! I think that there just aren't many women out there with SCI and they have no idea how to handle one when they arrive in their offices/hospitals. Go to a hospital that is confident in handling our care. Chances are that things will go smoothly and you won't need extra care anyways. But if you do you'll be glad you were in the right spot!
04-07-2012, 01:40 PM
Purelife - I'm in Bowmanville and I was hoping to deliver at Cobourg, as I really don't like Oshawa. There really aren't any hospitals out my way that are confident in handling SCI but I'm hoping to find one that is willing. I really don't want to have to go all the way to Toronto. I'm not having my care handled by an OBGYN, I have midwives instead. Since none of the OB's here have experience, I'd rather have a midwife that will listen and work with me.
04-07-2012, 05:34 PM
Well you're very lucky to have gotten a midwife! I must say I'm jealous! If you need to go to toronto then you should. As heartbreaking as that would be. Is this your first?
04-07-2012, 10:18 PM
I am incredibly lucky to have two amazing midwives, now as long as I find an anesthiologist at the second and last hospital they can deliver at - then I'll get to keep my great midwives. There's really no need to go to toronto, and I just simply won't - It's to far and really isn't feasible to go and stay in a hotel. It's heartbreaking to be turned down at the hospital I wanted but regardless of which hospital it is, my midwives will take great care of me. This is our first, so lots of learning to be done.