Love Pregnancy, Hate Medical OB

Specialties CNM

Published

Hi! I am a senior BSN student at Saginaw Valley State University. I entered nursing because I was really interested in women's issues, especially pregnancy. I love the concept of midwifery and empowering women during pregnancy and birth. However, I find myself so frustrated with the medical system of OB. I am working as a nurse extern in OB right now and I hate it! I feel like the beauty of pregnancy and birth is overshadowed by the schedules, the meds, the aggressiveness of the doctors who are so quick to slice open women to fit their schedules. It's a rare moment when I actually see through the depressing medical shroud and actually see childbirth for what it is.

So my question to you is-what are the options for a BSN to work with mothers through the midwife model of care? I live in Michigan and there is only one free standing birth center here. I have seen a lot of CNM's who act just like medical doctors, and that is also depressing! I know that I hate hospitals, and don't want to work as a hospital nurse. So does anyone have any advice? I am seriously considering dropping out of nursing because I hate the healthcare system and I don't know how I could get involved, as a nurse, in working with women in pregnancy outside of a hospital setting. Those of you who know how I feel, PLEASE give me any advice, resources, websites, someone to just talk to to share my concerns...I am so depressed about my future because I hate the hospital so much and what it does to women...

Please help me!!

Specializes in Pulmonary med/surg/telemetry.

It sounds like OB probably isn't the best place for you to work.

My philosophy is also the same yours regarding childbirth and that's why I know I need to stay away from hospital L&D when I become a nurse.

You might want to consider working in a different area and then do something in addition to that deals with your interests such as teaching pregnancy and childbirth classes? I don't know if you have children, but The Bradley Method of childbirth is what I used for both of my deliveries and it was really wonderful. It stresses natural, low- to no-intervention childbirth. In the next few years I plan to become a Bradley instructor. You can find out more at www.bradleybirth.com

Good luck!

I agree with looking at alternatives to OB such as pregnancy/childbirth education, but I think that a BSN provides back-up. Unfortunately in this field, many people are quick to challenge educational background. Even if you don't practice full-time as a nurse, the BSN will give you more credibility. Your experience as a nurse, especically OB, will give you the info you need to make changes whether you work as a educator, policy maker, etc. Nothing will change if people with your determination and spirit leave the field althogether.

Also, you're still in school. Even though you love childbirth, you may actually find another specialty of interest. You can even work part-time as a nurse and work as a homebirth midwife or doula.

--My 2 cents

Nothing will change if people with your determination and spirit leave the field althogether.

I have to agree with this. Hospital OB practice can be very depressing at times. But I think that people who see the problems and the challenges have two choices. We can run away from the hospital - to a home birth practice, or away from OB altogether. Or we can go in and start to change the system. The system is not going to change overnight, but it needs people who see the problems and work for change, little by little. The overall picture can be bleak, but if you make a difference for one woman, to help her have a better birth experience, even in the hospital, that is huge in the eyes of that woman.

I had a woman in labor a few weeks ago. She had a baby that seemed to be malpositioned - felt OP, long dysfunctional labor. My backup doc actually came to the hospital expecting me to call a c/s for her. Her nurse and I got her up, moved her around, and she got that baby out lady partslly. Now, if I hadn't been there, would she have been sectioned? Almost certainly. But her nurse and I made a difference for her. That's what keeps me going. Not the big picture of 30% section rates and sky high induction rates.

Specializes in OB.

I have to agree with the above post. I am an OB RN, about to begin school to become a CNM, and I do get frustrated at the docs who are quick to call a CS because it's 5pm and supper is waiting... or who think every woman needs to be a scheduled induction, but the doctor is rarely there. When it's just me and the laboring patient, I can introduce different methods of relaxation, positioning, etc. to make her birth more natural. I can coach her, keep the lights low and the noise of the unit out. I can show her husband how to massage her and explain the things that are happening to keep the fear level low. It may not be perfect, but at least I feel that maybe she will have a better labor than she would've with a nurse that just comes in to check a BP and offer drugs. That's why we do need more L&D nurses who care about women.

Don't give up and quit the profession altogether. We also have 2 CNM's at our hospital who are very "natural" and they have actually had a small influence on some of our docs. The first time one of the OB's asked me to lower the lights for a birth, I almost choked!

Anyways, maybe you just need to search out a different facility. Mine is a small community hospital and although we face many of the same issues as larger hospitals, it isn't nearly as bad.

Good Luck!

I Know how you feel I am a nurse midwife from the UK - I started over 20 yrs ago and although my nursing has been excepted in the USA and I am able to workas a Nurse converting Midwifery qualifications are another story so I have to face the reality that I may never practise midwifery again - whilst I am working through the red tape I have taken a postion on OB -I was able to get a leadership postion which is still clinically based - I see practises that make my stomach churn - but I have decided to try and make a difference - and I have it may only beone woman at a time but when it happens it makes me feel its all worth while. When the nurses I lead help women and familes have the experience thay what - because I have managed to inspire tem it makes me feel really good - I am no fool its not massive changes but its change one family at a time.

I am a nursing student and seeing this post makes me think I may look into becoming a CNM. I was "radical" about the births of my two boys. Did bradly method, all natural, etc. I had to drive 1 hour to find a doctor who shared my belief system and then had to actually argue with some nurses. But I loved my births and those first few minutes. When I am on my death bed as an old woman, those times with my boys is one of the things I will remember.

More women should know this type of joy. Maybe I can make a difference.

Specializes in OB.

Absolutely, holiday2525!

Women should have access to the kind of birth they desire without having to argue or battle with nurses or doctors to get it!

It's such a wonderful, blessed event! That is why I'm becoming a CNM. Maybe you should think about it further, too!

Britte

I am a nursing student and seeing this post makes me think I may look into becoming a CNM. I was "radical" about the births of my two boys. Did bradly method, all natural, etc. I had to drive 1 hour to find a doctor who shared my belief system and then had to actually argue with some nurses. But I loved my births and those first few minutes. When I am on my death bed as an old woman, those times with my boys is one of the things I will remember.

More women should know this type of joy. Maybe I can make a difference.

I love your comment! I too had a completely unmedicated Bradley birth and found it to be the most positive and empowering experience of my life! We had a midwife and I delivered at a hospital almost an hour away. I could tell that my L&D nurse was uncomfortable with me having so few interventions. To them, a "natural birth" is a lady partsl delivery.

I just applied to midwifery school because I hope I can help other women to have positive birth experiences.

I just wanted to share my birthing/pregnancy experience: I wanted the advantages of a natural, mom and baby centered-birth, with the medical back up available if needed. Homebirth felt too risky to me, but I hated the idea of being given lots of interventions if I didn't need them.

So I went with a CNM, however once I got to the point where I was sharing my birth plan with him, I realized he was not going to do much to help me avoid an episiotomy (he actually said the reason he had a 70% epis. rate was because the scar looked nicer than a tear :angryfire) He also said he though my doula would get in the way, blah, blah, blah.... it was obvious he was not going to support me in the birth I wanted. So, literally 5 days before I had my son, I switched to a different CNM and she was awesome!

When I arrived at the hospital, the nurse I had initially told me that she had 5 kids all med free, and encouraged me not to check in (when the other nurses wanted me to) so that I could go home and labor longer. I took her advice and came back 4hrs later with my doula in tow. Again, the nurses were great and supported me, but I don't think the nurse I did have would have had much to offer in terms of positioning, pain management, etc... compared to my doula. They did a great job of working as a team, the nurses caring for the medical issues, and my doula helping me to give birth the way I wanted to. My new CNM came in about 2hrs before ds was born, and just sat quietly the whole time. She barely said a word and kept the lights down, and was very encouraging once I hit transition. She did a great job of supporting me without interventions, but I felt she would have insisted on the interventions had I needed them.

Anyway, I wound up with what I consider the perfect hospital birth: no medical intervention (not even an IV) but all the backup I felt I needed to feel safe. If everybody who didn't see birth in a strickly medical mindset, left or avoided OB altogether, then it would truly limit the choices of a person like myself. I am so greatful that there were professionals there who supported my choices, and kept my son and I safe.

I am currently working on getting into a BSN program and my plan is to become a CNM eventually. I have a question based upon my own birthing experience. I am strep B positive (I think that's what it is called) and my OB gave me an IV for this. Do CNMs follow that as well? I always wanted a birth free of IVs, etc, and although that has yet to happen, I still dream that I will one day deliver naturally. Is this an issue that will always make my dream impossible? Or is this just an example of defensive medicine?

BTW- I'm not looking for medical advice on my situation, so please don't misread my post this way. I'm actually just using my own experience as an example of a question I have regarding the basic philosophy of CNMs vs. OBs. I hope I'm making sense.

Untreated Strep B is not something any medical professional wants to take a risk on. I was tested by my CNM so that I didn't have to have the antibiotics prior to birth, but my sister is a lay-midwife and they will not do a home birth at all if a person tests positive for Strep B :nono:

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