I am a relatively new Doula (the good kind, I hope
) and although I have only seen a few births, which have run the gauntlet of interventions, the last birth I witnessed was horrific for me.
Like many of the postings I have read on this site, I believed I would never see this outdated practice of fundal pressure (FP). It is giving me nightmares.
I would love to write to someone somewhere, if nothing else than to vent. I have read a post where it is recommended that I write to the risk management dept. at the hospital and the chief of OB. My concern is, as a Doula, do you think my letter will be taken seriously or will I be regarded as a birthing zealot? Nothing would make me happier than seeing this procedure eliminated or atleast minimalized at this hospital.
Here is some bkgd. info on the pt.: prim with SROM but checks into hospital next morning. 3-4 cm, 75%, -2, soft, ant. epideral and amp. for ROM. Pit given for irregular ctx, few hours later mom is complete, starting to move legs, wants to get on hands and knees, EFM belts uncomfortable, etc. (I am not sure if nurse slowed epi or not.) Mom asks nurse if gma, doula, and dad can stay for delivery...nurse says yes even though sign on door says only 2 visitors per patient.
An aside, I overheard head nurse, nurse aneth. and aneth. talking in hall (our door wouldn't latch closed) They thought I was feeding mom food since I brought lunch up to the room. I think this is why they didn't section her for fear of aspiration? She had a few bolis of epi because epi. cath. was in so deep she had a hotspot which aneth. finally fixed by pulling it out a bit.
After mom was complete, NO laboring down was allowed! Dr. comes in says only 1 person allowed in room (besides her and nurse and mom). Gma leaves, dad stays, I say, I am a Doula---OB says only if mom wants you here---mom says yes. Mom says to OB---I would like to avoid an episiotomy, if possible. OB says---verbatim---you don't want to tear, episi heal faster. OMG! I stand by her head while dad is south of the border. Mom on her back with legs up in supports in squat position.
Nurse does directed pushing count to 10 and hold breath for 2 ctx! OB says ineffective---nurse do FP! Nurse pulls up a stool, stands on it leaning over mom grabs railing across moms chest to get more leverage and proceeds to stick elbows into moms uterus! Tells mom to hold breath and push. When nurse gets off her, mom says she can't breath, wait a sec for her to catch her breath. Nurse does, but mom shrieks in pain upon subsequent FP says nurse get off me, while baby is moving all over the uterus. Nurse says she can't seem to get ahold of him. FHT are fine, from what I remember, hence my wondering why and the world FP was being done. It didn't appear to be an emergency, just an OB in a hurry.
While my mouth gapes open, OB says to me---you need to get out of here---remember I haven't said a word the whole 10 minutes this OB was in the room! As I leave room, OB says to mom ---you need to trust that we know what we are doing. (Never mind the fact that a uterus/vagina movements are involuntary! A mom can be dead and her body will still birth her baby!)
Not 10 minutes pass and Gma and I, who are standing in the hallway outside door that won't close hear baby cry and rush in to congratulate mom---OB says you need to get out---we aren't done yet, even though baby is on mom's chest.
We leave again. Nurse keeps going in and out of room (she's the only nurse in there) each time telling us to go sit in waiting area. We decline and remain there. OB leaves 10 minutes later and 30 minutes later nurse is done cleaning up battlefield from episiotomy and foreceps---for a 6 lb baby. Never have I seen so much blood on a baby's face, even after the clean up!
I am not blaming nurse for ANY of her actions, as I know she was ordered to do this procedure. I just want to learn more about why this dangerous procedure is used and when. I know mom had to be bruised from this! I was so scared that I would be witness to a rupture!
On top of all this...baby has a mandatory 4 hr minimum stay in the nursery after birth! Yes we have come along way from knock em out births...but we need to go waaaaaaaay back to when women were allowed the freedom to let their bodies perform naturally. Thanks for any input!
Feb 5, '07
I am glad the other member provided a reminder about posting too much information on a public board such as this. Please, never, ever use specifics such as hospital names, city names, staff names or even specific dates. It's amazing how quickly people can put pieces of these puzzles together and it has landed a couple members of this very board in very hot water in the past (I know of one who lost a job). I can't overstress caution when posting on this or other online boards----remember HIPAA and protect yourself and your patients/clients.
Good luck in this situation. It does sound horrific to me. Since I was not there, it's hard for me to evaluate the whole situation. It may be useful for you to carefully approach your client and ask her how she feels (now) about her birth experience. And if you do witness anything dangerous (such as fundal pressure as you state in this case), you might approach the manager/charge nurse of that unit (behind closed doors) with your concerns.
Take care and keep on being there for your clients!
Last edit by SmilingBluEyes on Feb 5, '07