Expecting RN- Would like suggestions - page 2

by expectant 2,422 Views | 18 Comments

Hi all- long time lurker, first time posting. I'm an RN with absolutely no experience with L+D. None, nada, zip. All I know is that boiling the water is to keep the menfolk out of the way. :) I'm pregnant for the first time... Read More


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    [QUOTE=Nurseinthemaking]I think it is normal for most moms to say, I want to do what is best for my baby, so I don't want any drugs during labor. From what I have seen, read and researched the meds they give you, won't hurt your baby, give you control of your labor and sometimes can prevent tearing. The reason for this, if your contractions start coming on pretty fast and you are going nuts because it hurts, nobody has control over anything. If they have meds hung for you, they can slow it down, its called Laboring Down, it QUOTE]

    Just wanted to point out that "laboring down" is actually the term we use if a pt has an epidural, can not or is not pushing effectively or perhaps she is still at a relatively "high" station, we do what is called "labor down" or passive descent....the body, on it's own, via the uterine contractions is going to bring the baby down....passively, meaning mom does not need to wear herself out pushing for 3hrs until babe is plus 2 or 3....then she can start pushing and usually by that time she is feeling more and is more equipped to push. Laboring down has nothing to do w/meds, slowing or shutting them off.
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    Quote from Aneroo
    Hey. Not an OB nurse, but I am starting my second trimester. Luckily, I didn't get MS that bad. How far along are you? My doc was awesome, and went ahead and prescripted Zofran. The smells of the ER (an I'm sure ICU) were too much sometimes, and she knew I needed something that wouldn't knock me out (like Phenergan). Also, Vitamin B6 is good for MS. Sucking on a mint or something like that has helped me with some of the icky smells (poo!).
    As far as delivering docs, I also will be delivering at a teaching hospital. Luckily, I go to a private practice doc, where there are three docs who take turns having call. One of them will be delivering my child, unless I have a very very quick labor! I agree with the whole residents thing- some of them freak me out!
    Best wishes! -Andrea

    Glad to hear your'e doing well! You're a few weeks ahead of me but I'll catch up in the end. My doc OK'd Vitamin B6, and gave me Zofran but I've actually felt much better the last couple days and haven't taken any of it. And it turns out that I have a private practice doc, too- and she doesn't want to deal with residents any more than I do.

    Thanks!
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    Thanks for the ideas!

    I forgot to mention in my first post that I had been snacking on little things often during the day and drinking gingerale to help. I tried ginger altoids but, well, yuck. <G.> I have ordered the PreggyPops- they should arrive tomorrow. I also cooked dinners with ginger in them the last few nights. Something is working- I've been better the last few days!

    I know a little bit about doulas and I am interested, especially since we don't live near any family that would be helpful. I think having one for immediately after birth is a great idea, but I'm not comfortable with hiring a stranger to be present at the birth as an advocate. Just a new concept for me, I'm thinking about it.

    Thanks so much for the help, though! I could never do what you all do!



    Quote from BabyRN2Be
    I can help with one of your questions for right now. I've been a labor doula for the last 8 years. I don't know if you know what a doula is, but we help with coping techniques for delivery and offer mental, emotional, and physical support. I could write a whole page on what a doula is and isn't but won't do that right now. If you'd like more information on doulas, go to www.dona.com.

    For your problem at hand, morning sickness. Have you tried using ginger? I'm talking about the actual ginger root which you can find in most grocery stores. Grate the ginger and place in cheesecloth, or just use it loose and make a hot tea out of it. Also, check out Preggypops (www.preggypops.com), they make a ginger lollipop (made with real ginger) which I've had a lot of luck with in moms who have morning sickness (refered to also as "any time of the day sickness"). You also may want to check out health food stores for other ginger products - hard candies and chrystallized ginger for cooking works well also.

    I've had a lot of luck with ginger for nausea r/t pregnancy as well as the flu. It's a good natural remedy if you're looking for something like this.

    I hope you get answers to your other questions, I just had time to help with the morning sickness one for now.

    Best of luck to you and feel free to PM me if you have any questions I can help out with!
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    Thanks for the book and other suggestions!

    I don't have strong feelings about the birth. Which may sound awful, or may just be because my mom had a general for all of hers and I don't see one type of birth as intrinsically better than others. I can see that people have strong opinions about it and I am certainly not educated enough about this yet. My preliminary feelings are that I would prefer to not NEED medical interventions or surgery. But I can accept that sometimes they are necessary, and that sometimes stepping in with a smaller intervention in a timely fashion can seriously help avoid more dramatic interventions later. I'll take the stadol or the epidural if it avoids a serious tear or a csection. It would be nice if we all had crystal balls to know what definitely would happen, though!

    I did some reading on the Bradley method and, well, they certainly feel strongly about things. At first blush, I'm concerned that any method so absolutely convinced that they have a moral high ground over other medicine makes me nervous. I'd love to hear from people who have used or taught this method in a way that isn't as absolute as what their website suggests is best.




    Quote from amber1142
    Asking about someone's practices isn't confrontational, and the way to find out what a good answer is is to do research. You could start with Henci Goer's *The Thinking Woman's Guide to a Better Birth* http://www.hencigoer.com/betterbirth/ and Marion McCartney's, *The Midwife's Pregnancy and Childbirth Book*. http://www.amazon.com/exec/obidos/tg...68615?v=glance

    In my experience people who say they are willing to "try" natural usually end up with medication and interventions. You will be more successful with a medication-free and low intervention birth if you are well prepared for it. I suggest a Bradley method class; you can adapt Bradley method to your own needs and beliefs, and they are very successful at preparing women for the births they want. I must say that you should first ask yourself, after you do some research: "What do I really want and why do I want it?" (i.e. is it because you really want to go natural or is it because you think you should or is it because you're scared).

    Morning sickness: I used ginger ale, ginger capsules, ginger tea and vitamin B6. To tell you the truth, nothing worked very well, but the nausea went away after about 12 weeks.
  5. 0
    I tried calling the L+D unit at the hospital I'd be delivering at. I asked for suggestions, saying I wasn't comfortable with the doc I had seen. They told me they don't give recommendations, but that "all our docs are great!" Umm, yeah, you all love every one... I can't blame them, though- they had no idea who was calling.

    Thankfully, my last meeting with the OB went much better and I won't have to deal with residents.

    Thank you!


    Quote from enfermeraSG
    Ginger (something that contains the real stuff) in any form worked great for me, even the capsules with ginger. I say go in with an open mind, yet informed about your options as far as meds etc. Don't feel like you are being confrontational to ask these questions ahead of time. I would wait until your third trimester to ask. It wouldn't hurt to ask some of the L&D nurses their thoughts on your doc, the residents etc. They know where you are coming from. And during your labor and delivery, you always have the right to have everything explained within reason. SG
  6. 0
    What an awesome response- thanks so much!!

    I'm not delivering at the hospital I work at- I chose one closer to home and one where I won't run in to docs and nurses I work with. Unfortunately, this does leave me without any contacts to get "the inside scoop." But then again, I've heard RNs complain about docs I really respected so I'd hate to make such an important decision without knowing the source. The hospital I'm delivering at does offer tours and that's one of the things we need to schedule.

    What is "specialing?" In my world, that means a 1:1 sitter for DT's or the like. It sounds like that means she would deliver my baby whether she is on call or not? I don't know if that's necessary-I actually wanted to work with her partner, whose practice was already closed when I was 5 weeks pregnant. There are only 2 docs in the practice so I'll meet them both. I'd love to have a midwife for prenatal care- I've heard great things about them! My OB seems good, but I wish she had more time to answer my questions. I couldn't find a practice near me that has midwives and is covered by my insurance, taking new patients, etc.

    Pain control is something I knew I didn't know enough about, and now realize I knew even less than I thought I did. I was never dead set on going without drugs. I won't ask for an epidural at 7 months, but I'm not stupid enough to think that suffering is a virtue or that I'll get a medal for having the longest or worst labor. <G> Surgery is something I'd prefer not to deal with but with my age and risk factors, it might happen. If it does, I will not see myself as having failed.

    Thanks again- you've been very helpful!



    Quote from moondancer
    Welcome, and congratulations on your pregnancy! I am a L&D/NICU nurse, practicing for about 12-13 yrs now. I think your questions are great and make sense. You're on the right track w/your reasoning. Let me address a couple of issues, 1st of all you will be delivering at a teaching hopsital, correct? Is this the hospital you work at? If so, that helps. I would, definitely, before hand, go up to L&D and get acquainted w/the unit, ask for a tour (call 1st, in case it's crazy), or perhaps you'll get this in your childbirth class. At any rate, whether you go up there on your own, know someone at work who can hook you up w/an L&D nurse, get the info on who's who in the dept...(residents, anesthesia, etc). Also, talk to your OB, does she do deliveries there? I would think so, ask if she'll "special",you....that's why it's good to have a good repoire w/your OB. Have you considered seeing a midwife....I think their care is exemplary, I can not rave enough....last 2 of mine were w/midwives: what a difference! Plus, more than willing to come in "special" and do my delivery. I have seen some really botched jobs by residents, and I can tell you, if I didn't know who they were, they wouldn't be touching me w/a 10 ft pole! LOL Also, know how you feel about students and many onlookers, teaching hopsitals use every opportunity to cram many many people in the room....if that's OK w/you, fine, if not, make sure your OB knows and your labor RN. Try and avoid being induced, unless it is medically necessary...I see this a lot (I work at a huge teaching hospital), and it is getting more common everywhere. Induced labors are always harder, and increase your chance of a c-section.
    As for pain control....I think you really need to do a lot of reading and give this a lot of thought, definitely, no matter what route you take, go to a prepared childbirth class....I teach them and there is lots of info! If you really think you want to go natural, then it is a decision you need to make ahead of time and prepare for it....it will not be easy, but most definitely can be done! But of course, the more prepared you are, the better. And ultimately, whatever you decide during labor is fine, if it just gets to be too much then there are options...IV meds, epidural, etc.
    In terms of you talking w/your OB....definitely, definitely, definitely! Ask her what her philosophy is re: inducing patients (she should say "when medically necessary, not at the whim of her schedule, etc), does she cut episiotomies, if routine, ask "why", this is not always necessary and we now know that the body heals itself better if it "tears" where it's supposed to. This can be a bit tricky, cause if it's an emergency, or it looks like you're going to get a nasty 3rd or 4th degree tear, that's different. So she should say "I only do it if it's urgent/emergent, not routinely"; ask her what her c/section rate and the hospitals is...national avg is about 25%. As far as drugs, that is your choice, but you can ask her what types of meds she likes, her philosophy on when to get an epidural, if that is the case. Remember, unless she is actually there, none of that really matters, b/c it will be whoever is in charge of your care and their philosophies....that's why it's important to know who you're dealing with. Again, I can't stress enough the value of a good midwife....they are just so receptive and are, IMO, more pt oriented...take the time to listen to you and address your needs. You need to feel free to ask your OB anything!
    Anyway, good luck, hope you have a happy, healthy pregnancy and delivery!
  7. 0
    Quote from expectant
    Hi all- long time lurker, first time posting.

    I'm an RN with absolutely no experience with L+D. None, nada, zip. All I know is that boiling the water is to keep the menfolk out of the way. I'm pregnant for the first time and would love some input from the pros!

    My goal is to have a healthy baby, keep myself as healthy and sane as possible, and (last on the list- LOL!) be a good patient. My background is critical care nursing and I know how hard having a professional for a patient can be. I at least know what I don't know. Complicated birth plans aren't my style- I think I'll try natural but will be open to some pain control if need be. I'd like to avoid a csection unless it's the safest thing but won't whine if it has to be done to protect me or the baby.

    The baby books say I should ask my OB about C Section rates, episiotomy rates, thoughts on use of drugs during pregnancy and labor, etc. That seems confrontational to me, considering that I don't even know what a "good" answer should be. Should I ask these things? If so, what kind of answers should I want?

    How do I know if I have a good OB? So far I have mixed feelings about her office staff (maybe that one witch was having a bad day... trying to keep an open mind....) The OB herself seems OK. We're not going to be friends but I want a good doc, not more friends. I don't know anyone in my area who could give me suggestions so referrals are out. What should I look for?

    Any suggestions on morning sickness? So far I've tried bland snacks and the seasickness wrist bands, but no results and I'm tired of being sick all day. I CAN put up with it if I need to and would prefer not to take meds routinely (I'm open to occasional use if they're safe) but do you experts have any suggestions?

    I'm going to deliver at a teaching hospital. My experience with residents are that some are idiots and some are awesome. In ICU I can tell the difference and stop them from doing anything stupid. In OB, I don't know enough to know what is stupid and what isn't. I don't see me being comfortable with residents no matter how good I'm told they are- I either want to tell my OB that residents can watch but not touch or that I don't want to be a teaching patient. Would that work at most hospitals?

    Thanks for your time and suggestions
    If you would like to go as "natural" as possible, I would try (if at all possible) to stay away from a teaching hospital and go to an OB practice that has certified nurse midwives (who also labor and deliver their patients). Do you have any facilities that have an LDRP (meaning labor/delivery/recovery and PP all in the same room)? That philosophy of birthing sounds more to your liking.

    Definitely ask all those questions. Run away QUICKLY from a doc with a high episiotomy rate. Most are totally unnecessary. A doc with a high C/S rate is also suspect. Remember a teaching hospital is going to have a far higher section rate because of the acuity of the patients they serve. Keep the interns and residents out of your room and away from your labor. They are far too interventive and you don't need someone learning on you. They are clueless as to what a "natural" labor is and can be. They learn that later (if they are so inclined). Often nurses in L&D's in teaching hospitals rarely see a natural labor and are probably not as good in supporting yours.

    If you can afford one, hire a doula. They are a trained labor support person. Remember, you are a nurse but during this, you are a mother-to-be, and not the nurse. Don't worry about being a "good patient."

    Best of luck!
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    Quote from BabyRN2Be
    I just wanted to mention that "laboring down" has nothing to do with meds being slowed down. It refers to letting the mom push when she has an urge to push. Usually the baby has made it's way down on it's own to the point in which mom feels an urge to push. This is what "laboring down" means, as opposed to pushing when mom is complete w/o the natural urge to push. This saves energy for the mom, however, it can lengthen the second stage of labor. Laboring down is used when mom has an epidural - maybe that's what you meant? It's not always used with an epidural, though, it can be done in any situation. But it does give your body a break, as you said, and it does prevent some tears.

    I don't know if I'm explaining this right, and please forgive me if I've misread your post.

    Also, I'd like to recommend another book - it's by Sheila Kitzinger, The Complete Book of Pregnancy and Childbirth. Here's a link to it at Barnes and Noble:
    http://search.barnesandnoble.com/boo...75710477&itm=3

    It doesn't "dumb" down pregnancy while addressing needs of those who are starting off knowing nothing about pregnancy. Yes, that's confusing... but it is a very good birth. I also second the Henci Goer book that's listed above. All very good books.
    I second the motion on Kitzinger's book. Her stuff is well written and not weird. Actually, the Bradley method book offers some very good information. You don't have to swallow everything they teach. In my opinion, what screws up some "Bradley couples" is the instructor they have and the individual's mind set as well.

    Henci Goer's stuff is a bit more confrontational, depending on how one uses it.
  9. 0
    Jamaican ginger beer is great, too. I love it just for the taste -- not the preggy thing. 8)

    John


    Quote from BabyRN2Be
    I can help with one of your questions for right now. I've been a labor doula for the last 8 years. I don't know if you know what a doula is, but we help with coping techniques for delivery and offer mental, emotional, and physical support. I could write a whole page on what a doula is and isn't but won't do that right now. If you'd like more information on doulas, go to www.dona.com.

    For your problem at hand, morning sickness. Have you tried using ginger? I'm talking about the actual ginger root which you can find in most grocery stores. Grate the ginger and place in cheesecloth, or just use it loose and make a hot tea out of it. Also, check out Preggypops (www.preggypops.com), they make a ginger lollipop (made with real ginger) which I've had a lot of luck with in moms who have morning sickness (refered to also as "any time of the day sickness"). You also may want to check out health food stores for other ginger products - hard candies and chrystallized ginger for cooking works well also.

    I've had a lot of luck with ginger for nausea r/t pregnancy as well as the flu. It's a good natural remedy if you're looking for something like this.

    I hope you get answers to your other questions, I just had time to help with the morning sickness one for now.

    Best of luck to you and feel free to PM me if you have any questions I can help out with!


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