Question for L&D nurses

[CrazziiRN913]

Sooooo I was talking with a friend at work and we were exchanging birth stories when she told me something that struck me as odd. She said when she was in labor with her 1st son the l&d nurses gave her a shot of morphine before she got and epidural!! I am only going into my second semester of nursing school but that just seemed weird so I figured I would ask you guys. And then on top of that her son's heart stopped and and the were able to bring him back but I just thought the while morphine then epidural thing was weird. Please give me some insight!!

Thanx,

~*Mesha*~

[mef06011]

I'm so sorry that your friend had to go through this stress, but stories like this are perfect examples of why you don't mess with a process that goes fine 98% of the time without any medical interventions. That said, I'm very glad to hear that mom and baby are fine now.

One intervention leads to another and to another, and soon you've got an emergency on your hands that could have been avoided if medical professionals, and our greater culture in general, believed in the amazing power of women's bodies to birth their babies

[CrazziiRN913, ADN, BSN]

Yes, I'm sorry for my verbiage (I'm only going into my second semester on NS school), she said an injection

[klone, MSN, RN]

I'm so sorry that your friend had to go through this stress, but stories like this are perfect examples of why you don't mess with a process that goes fine 98% of the time without any medical interventions.

Sounds like the only medical interventions she received were pain management. I can hardly fault a woman for that, and I think it's unfair to say she should eschew pain management if she really needs it.

[mef06011]

To clarify, I personally would not use pain management, but do not fault women for it, and absolutely believe in a woman's choice of pain management if it helps her get through her labor. I was referring to the internal fetal monitoring as a major intervention.

[klone, MSN, RN]

The internal monitor did not cause the baby to need resuscitation.

It is absolutely appropriate to put an FSE on if you've lost heart tones and are concerned about the baby's wellbeing.

[mef06011]

Sorry, from the original story it seemed unclear as to what the order of events here was. Trust me, I am grateful for the interventions that can help save lives, and I'm still learning, I'm still a student myself, but the midwives I shadow don't like to use the internal monitors. I'm still learning why, and what's appropriate when, so thank you for your input.

[klone, MSN, RN]

Internal monitors are generally not just used willy-nilly. They're used in emergency situations, or when the FHTs are just impossible to pick up on the external (such as with an obese mother, or a baby who's positioned weird or really active). Nobody LIKES having to use them, but when they're necessary, they're great to have. They're no more risky, WRT the "cascade of interventions" than an external monitor. Myself, I prefer intermittent auscultation, but there are situations where continuous fetal monitoring is necessary - such as with an induction, or after an epidural.

[mef06011]

Hi Klone,

Thanks for the info. I've never seen one used (the midwives I work with are pretty much exclusively home birth midwives, and I've never been there when they need to transfer) I'm excited to start my CNM program so that I can learn what needs to be done in such emergency situations, and I always appreciate the chance to learn. Thanks for explaining :)

[klone, MSN, RN]

No problem. Where are you doing your CNM program? I'm doing mine through Frontier. :)

[mef06011]

I know a few midwives who have gone through Frontier and absolutely loved it. I'm still waiting to hear back but hopefully Seattle University, but at this point I will go anywhere that accepts me.

[tablefor9, RN]

The only thing I can think of when the nurse said shock to the baby with the FSE was scalp stim, which will sometimes result in an increased fetal hr for a bit.

We have a few docs here that will do a Morphine sleep, they either wake up feeling better or wake up in labor. Either way, yay. Also, we have some docs that will give Morphine or Nubain or Stadol prior to epidural if anesthesia is tied up in a case and can't get there pretty quickly to do an epidural.