[ER1010]

It seems to me like the experienced nurses on this board could very easily deliver the normal healthy deliveries. Just wondering if the OB nurses get frustrated with having a doc do the delivery, when all he or she did was catch? In Europe aren't all the nurses also midwives, and they only call the doc for emergencies? Do you guys think this would be a better practice?

[SmilingBluEyes]

It's all about "risk management" and lawsuit/insurance concerns. Not to mention a HUGE lobby on the part of the AMA since the turn of the 20th century to make childbirth their "own." (versus that of midwives since time began prior).

The USA, is not Europe, obviously. Things are different here. We serve an increasingly "entitled" population.

Yes, I feel the frustrations, but this is where we find ourselves in 21st century labor/delivery, where everyone wants and demands a perfect outcome and minimal effort or pain on their parts to get there. The doctors feel they can deliver this type of care to this population---and it's become their domain primarily in the USA. This is the time in which we live.

[expatnurse]

It is true that in the UK midwives deal with normal births. I have been out with them as a student nurse and if I had the chance later on I would want to train as a midwife. Over here it is not viewed as an illness, furthermore the woman is given more control of the experience This is way I will never have a child in the USA. Also the midwife does a home visit after you leave the hospital and you can still call upon her/him for up to 28 days. Afterwards a health vistor takes over. I feel that in the USA the doctors control of the labor process has been harmful to woman and made her scared.

[fergus51]

I never minded. I always had enough to do. Plus, I don't stitch up, so for any deliveries with tears, I'd need a doc anyways.

[SmilingBluEyes]

Originally Posted by fergus51

I never minded. I always had enough to do. Plus, I don't stitch up, so for any deliveries with tears, I'd need a doc anyways.

But then you get into the incidence of tearing and instrumentation. When midwives were involved, I definately noticed MUCH less tearing and need for stitching up afterward. It's like a chicken and egg situation.

[fergus51]

Sometimes, but really the majority of the OBs I worked with were great. In Canada in particular, I almost never worked with midwives, but I didn't see more tears. (the midwives were actually the ones I feared working with unfortunately). I would definitely prefer not to call the OB if he sucks, but if the OB is good I don't have any desire to catch the baby. I really had enough to do

[BETSRN]

Originally Posted by expatnurse

It is true that in the UK midwives deal with normal births. I have been out with them as a student nurse and if I had the chance later on I would want to train as a midwife. Over here it is not viewed as an illness, furthermore the woman is given more control of the experience This is way I will never have a child in the USA. Also the midwife does a home visit after you leave the hospital and you can still call upon her/him for up to 28 days. Afterwards a health vistor takes over. I feel that in the USA the doctors control of the labor process has been harmful to woman and made her scared.

I wager to say that many of us older nurses would agree with you. he younger ones have never known any differently.

[James Huffman]

I think we're leaving someone out of this equation. Perhaps the reason we have docs doing the delivery is because the mother (the patient in this situation) wants them there.

I have seen (and I'm happy that I have) a huge increase in the number of nurse-midwives practicing. However, there are mothers who want a physician to do the job. Or at least be there.

The patient is the one who calls the shots, and she has the final say in this question.

Jim Huffman, RN

[Jolie]

I had 2 high risk pregnancies which I carried to near-term. Both deliveries were expected to be normal and uncomplicated, since the prematurity issues were behind us. Both presented with unanticipated complications at the last minute. My oldest daughter had a complex presentation, with both hands up to her face. The doc had to do quite a bit of maneuvering to get her out. My youngest had an occult prolapsed cord.

I'm a perfect example of how things can get unexpectedly complicated at the last minute. Not that a CNM or experienced labor RN couldn't have handled my deliveries, but I was grateful to have a physician present.

I have known a few docs and midwives who willingly step back and allow a person of the mother's choosing to "catch" the baby when all is going well, usually Dad or a nurse with whom the mother has developed a relationship. I've always enjoyed those deliveries.

[SmilingBluEyes]

Originally Posted by James Huffman

I think we're leaving someone out of this equation. Perhaps the reason we have docs doing the delivery is because the mother (the patient in this situation) wants them there.

I have seen (and I'm happy that I have) a huge increase in the number of nurse-midwives practicing. However, there are mothers who want a physician to do the job. Or at least be there.

The patient is the one who calls the shots, and she has the final say in this question.

Jim Huffman, RN

I dont' think most of the American public is educated or prepared to question this (doctors being the primary caregivers of pregnant women), however, James. You are leaving out a huge variable/ contributing factor there. Most people I come across dont' question much of what happens to them in the hospital or what their doctors order. They are often not educated or taught to do anything but comply " for their own good". ESPECIALLY in WOMEN, this can be true.

I can't tell you how many patients I have had to explain EVERYTHING to because their doctors have not the time or patience to do so in the office. So many have come to the hospital for inductions or NSTs or other procedures that have NO clue why they are doing these and what the plan is. They just show up as told to do. Some even have NO idea WHY they are being induced, just told "it was time". That, to me, represents a HUGE lack of education out there. Contrast that situation to that of midwife patients, who can tell ME a thing or two about their bodies, pregnancies, and plan of care. They seem so much better-prepared and educated as to the whole process.

Perhaps if women as a whole were taught to take more charge of their health care and choose more carefully or discerningly their providers--- we might see some things change a bit in how and whom women choose to provide for their heathcare and in what setting. I sure plan to educate my own daughter better than I was.