L&D nurses - different viewpoints on birth

Specialties Ob/Gyn

Published

  1. Your view on L&D protocols?

    • 2
      hospitals are doing things right
    • 64
      would like to see many changes
    • 25
      there are a few things that could be improved

91 members have participated

I am a future nurse trying to reconcile my beliefs about birthing with the standard of care birthing moms receive. Are there other nurses in L&D who are seeking change (or secretly hoping for change) in regards to the birth experience in hospitals for women? (i.e. reducing c-section rates, allowing women to birth in different positions, etc).

And what are your thoughts on the new organization, improvingbirth.org, and the Business of Being Born documentary? Interested in thoughts from both sides.

Can a nurse be an "out" activist for change if they disagree with the way things are done?

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

There are lots of nurses, and yes, lots of facilities, that don't do things like the "status quo" - there is plenty of room for nurses who want low intervention and choice for birthing mothers.

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It's important to remember that so many moms come in in labor having done nothing further than decide on the colors of their nursery, much less have read up on natural or alternative birthing positions, etc. Many many just want an epidural and that's it. Some have mixed feelings about the pregnancy in the first place. It's unfair to say that it's just the hospital or doctors or nurses doing it to the moms.

The business of being born, improvingbirth, etc, are all really good. I'm totally for it! I personally gave birth with a midwife's assistance and no anesthesia. I think the more this stuff goes mainstream, the more moms will approach labor with more than the ideas that they hear at their baby shower and by watching tv. But it is a slow process. And hospitals must honor mom's requests for epidurals and cope with too-busy assignments.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
It's important to remember that so many moms come in in labor having done nothing further than decide on the colors of their nursery, much less have read up on natural or alternative birthing positions, etc. Many many just want an epidural and that's it.

So true!

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I would say that if you do become a labor and delivery nurse you will find many others who came to the profession with the same beliefs you do. I know I did, I had even had a home birth. Some nurses do enter the profession and don't change any beliefs at all. Far more from what I see do start to see that there is an element of fundamentalism in the natural birth world that's far less accepting of change or evidence based than mainstream obstetrics. Also, mainstream obstetrics varies so much regionally -- there certainly are areas of the country with very dogmatic and non evidence based practices. But what I found is that in general, doctors and nurses I work with are far more open to change, research based, respectful of patient's rights to self determination and self critical than what I saw in the alternative midwifery world. So, while I still would, and did, choose and unmedicated natural birth, and I love to care for those patients, I really don't think any longer that my way of birth is superior at all to the mom who decides upon an epidural. In that way I sort of cringe at the Business of Being Born, because it presents natural birth in a sort of "we have the secret" almost religious sort of way that I have come to find is far too common. The tears of joy when a new mom with an epidural holds her baby are every bit as powerful as watching a new mom after a natural birth. Of course you didn't even say that's your belief, and it's probably not, but its a tacit message in so much of the natural birth literature, "our way is superior", and I have come to believe it's really not. However, I still am completely supportive of women who want that and good at supporting them. I just see it all with a new perspective and I think I speak for a lot of labor nurses who came to nursing with similar beliefs. Also, these alternative birth things aren't really all that new, I have been a nurse for 25 years and we have been skin to skin, no separation of mom and baby at all, no prep, no must have an IV, have who you want at your birth including siblings ... always supportive of moms who want a natural birth, at my local hospitals the entire time. My homebirth daughter is 31. These issues really aren't that new, or maybe I'm really not THAT old... yes that's it!

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The tears of joy when a new mom with an epidural holds her baby are every bit as powerful as watching a new mom after a natural birth.

^^ nicely stated!

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Specializes in Nurse Manager, Labor and Delivery.

and honestly the medical community is unfortunately governed by the law community. you can't turn a channel on the tv now without hearing the HAVE YOU HAD A HEADACHE AND TAKEN TYLENOL schpeel from the law offices of blah blah blah blah and blah. so many facilities, especially smaller community facilities are paralyzed by lawsuits, so the TOLAC/VBACS are put on the oh no no no list. and in my experience, it seems to me that someone told someone and they told someone that labor is not supposed to hurt. at all. in my facility, the epidural rate is well over 50% consistently and on the rise. patients are DEMANDING them. they want to wear their makeup and have great facebook shots and not expend one iota of energy. ok, breathe. my rant is over.

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Specializes in Maternal-Fetal.

Things do need to change and I plan on continuing to fight the good fight after graduating with my CNM. For now, I strive to be the best patient advocate that I can be so that my families can have the type of birth THEY desire.

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Specializes in Nurse Manager, Labor and Delivery.
Things do need to change and I plan on continuing to fight the good fight after graduating with my CNM. For now, I strive to be the best patient advocate that I can be so that my families can have the type of birth THEY desire.

you go girl

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Great responses everyone. I feel better knowing nurses can have varying viewpoints and that's okay.

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Specializes in Geriatrics, Home Health.
Things do need to change and I plan on continuing to fight the good fight after graduating with my CNM. For now, I strive to be the best patient advocate that I can be so that my families can have the type of birth THEY desire.

Does that include mothers-to-be who don't want an unmedicated birth?

I ask because I'm a pregnant RN, due in April. I've been researching local childbirth classes, and the vast majority in my area seem to be run by either non-nurse midwives or doulas who want women to "trust birth" and their bodies. My body has had enough problems that I seriously doubt its "natural wisdom." Until fairly recently, childbirth was the leading killer of women of childbearing age. Nature doesn't care if you live or die. If I want pain medication, it's not because I've been brainwashed by the medical establishment, it's because I'm in pain. I'm not aware of any other medical field where pain relief is considered a bad thing.

If a woman wants a natural drug-free birth,and there are no medical reasons against it, great. However, the desires of a woman who wants pain meds, an epidural, or other interventions should also be supported.

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Specializes in Community, OB, Nursery.
Does that include mothers-to-be who don't want an unmedicated birth?

I ask because I'm a pregnant RN, due in April. I've been researching local childbirth classes, and the vast majority in my area seem to be run by either non-nurse midwives or doulas who want women to "trust birth" and their bodies. My body has had enough problems that I seriously doubt its "natural wisdom." Until fairly recently, childbirth was the leading killer of women of childbearing age. Nature doesn't care if you live or die. If I want pain medication, it's not because I've been brainwashed by the medical establishment, it's because I'm in pain. I'm not aware of any other medical field where pain relief is considered a bad thing.

If a woman wants a natural drug-free birth,and there are no medical reasons against it, great. However, the desires of a woman who wants pain meds, an epidural, or other interventions should also be supported.

I work with many many RNs who support natural med-free childbirth who also support women's choice to get an epidural or IV pain meds if that's what she wants. I think it is awesome when women do it completely natural....but I had epidurals with both my kids.

The difference between labor pain and other pain is that labor is a normal physiologic process. The pain of arthritis, say, or appendicitis, indicates a pathology. Labor is not pathological in itself, and very rarely does pain in labor indicate complications.

So many of the reasons women died in childbirth in years past are not a big issue in the industrialized world anymore. Rickets that caused misshapen pelvis, which led to obstructed labor (and c-section not widely available). Grand multiparity. Closely spaced children. Sepsis from birth attendant's unwashed hands. Lack of decent birth attendant. Hemorrhage. Undetected preeclampsia. All these things we have ways of preventing, detecting and/or treating that were not available for a large part of human history. It's ok to want good medical help close by, and if you have a high-risk pregnancy, a good midwife will want that for you as well. It's also ok to not want more intervention than absolutely necessary. I don't know anyone who denies laboring women pain relief in the hospital setting (and keep in mind there are so many effective methods of pain relief that don't involve narcotics or epidurals).

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