Precipitous Birth care

JeanettePNP, MSN, RN, NP · Mar 2, 2006

It's a different world in the hospital, Chaya. Liability is huge and yes, NRP-trained personnel do indeed need to attend each birth, particularly from a Risk Management perspective.
Does that mean we as nurses "panic"? Hardly, no, many of us have caught quite a few babies in our years of experience-------we know birth is a natural and normal process in most every case. We know babies won't wait for the doctors, in many cases, also.
But legalities and the litigious society in which we work, make it a different and imperative event in our environment. On top of that, being licensed professionals holds us to a different standard in the eyes of the State in which we practice, as well as the public, that lay people are simply not held to. Therefore, there is a big difference there.

I was thinking more of the general attitude in society at large. So many negative things have happened because of the panic surrounding childbirth. EVERY pregnant woman should familiarize herself with emergency childbirth and know what to do if her baby starts to arrive precipitously. I had a planned homebirth so I had purchased everything in the birth kit in advance, I was mentally and emotionally prepared, etc. But most people have it ingrained that you *must* get to the hospital, even if it means leaving home in middle of a snowstorm, driving 90 MPH and putting yourself at much greater risk than if you had just delivered calmly at home.

(sigh) I'll spare you all another tirade on this subject. My only expertise in this matter is that I've had five births that ran the gamut from hospital birth with every intervention, to birthing center, to unassisted homebirth. I have experienced the difference in my flesh so I'm very passionate about this subject. And I have heard of nurses telling women in the second stage to pant rather than push until the doctor gets there. I know that none of the nurses here are that kind of nurse, but they're out there somewhere and I've met a few of them myself.

mommy2boys · Mar 2, 2006

I had a precipitous birth with my second son and the nurse did a WONDERFUL job delivering him. He was 5wks 2 days early, and thank God was healthy and had no major problems. She kept a very cool head and kept the rest of us very cool as well.

When I got up to go to the restroom (I had just been a tight 3 and they were trying to stop my labor again) I knew something was wrong. She calmed me down and checked me. He was crowing and she said that I should "do what my body tells me to do". She delivered him after 3 pushes, while calling for the other nurse to set up the room and call the nursery and doctor.

She informed me that they are trained to deliver babies on their own (if need be) and she did it better than my OB. (I LOVE my OB, but she kept me so much calmer than he did on my first birth.)

Erin

zandra · Mar 2, 2006

SmilingBluEyes

thanks for the reply and thanks for including liability issue, i am a nursing student and i wanted to see what concept or policy that most hospital have regarding "precip" birth.

Thanks all, by any chance has their been any nurse law sue regrading precip birth that went wrong in your department? And what is the the DM reaction when the baby is already delivered?ed

SmilingBluEyes · Mar 3, 2006

I was thinking more of the general attitude in society at large. So many negative things have happened because of the panic surrounding childbirth. EVERY pregnant woman should familiarize herself with emergency childbirth and know what to do if her baby starts to arrive precipitously. I had a planned homebirth so I had purchased everything in the birth kit in advance, I was mentally and emotionally prepared, etc. But most people have it ingrained that you *must* get to the hospital, even if it means leaving home in middle of a snowstorm, driving 90 MPH and putting yourself at much greater risk than if you had just delivered calmly at home.
(sigh) I'll spare you all another tirade on this subject. My only expertise in this matter is that I've had five births that ran the gamut from hospital birth with every intervention, to birthing center, to unassisted homebirth. I have experienced the difference in my flesh so I'm very passionate about this subject. And I have heard of nurses telling women in the second stage to pant rather than push until the doctor gets there. I know that none of the nurses here are that kind of nurse, but they're out there somewhere and I've met a few of them myself.

I am passionate too. There is room for all us at this table. Have a good day.

SmilingBluEyes · Mar 3, 2006

SmilingBluEyes
thanks for the reply and thanks for including liability issue, i am a nursing student and i wanted to see what concept or policy that most hospital have regarding "precip" birth.
Thanks all, by any chance has their been any nurse law sue regrading precip birth that went wrong in your department? And what is the the DM reaction when the baby is already delivered?ed

I have not seen a nurse sued after a precip birth. But I have seen nurses named in suits where bad outcomes did occur. That is all I will say.

RNnL&D · Mar 3, 2006

And I have heard of nurses telling women in the second stage to pant rather than push until the doctor gets there. I know that none of the nurses here are that kind of nurse, but they're out there somewhere and I've met a few of them myself.

Actually, I am one of those nurses, and I am sure there are others here. This is if the doc is minutes away from the room. Obviously, I'm not going to have a Mom blow for an hour. Yes, I am able to catch a baby, but in the grand scheme of things, I am not the one ultimately responsible for that delivery, or the one getting paid for it. IMO, the doc needs to earn her money too. :lol2:

Generally, with a precip delivery, baby births himself. The nurse is just there to insure a safe landing. :)

I have had a UC myself, so I understand your passion.

And for CEG, personally, I would not start a saline lock on a Mom who will imminently deliver. This happened just the other night actually. Mom came in, with SROM for fourth baby, wanting an epidural or pain med :uhoh3: She was 8 cm then. Her nurse did start an IV, although I said there was no point. She delivered 7 minutes later.

Meerkat · Mar 3, 2006

What causes a precip, anyhow? My baby was a precip. She was so fast that I didn't know I was in labour. I didn't feel much, either...I didn't feel the engagement or any of that stuff. The most I felt was a little bit of a *pop*, but I thought that was my water breaking. It was actually the baby poking out . I had a 4th degree tear thru the rectal capsule, and I seem to remember feeling an awful burning at some point in the perineum, but nothing much.

By the way, if I have another baby, does that mean the next one will be precip?

losbozos · Sep 30, 2011

So, I had a precip del the other night; ER doc got there as baby was crowning. He told her to push and I did encourage her on this direction. Baby came quickly and was healthy and parents were happy. OB walked in just after the birth and finished up.

Later, my manager "counseled" me as I should have had her pant until the OB got there. Feeling chastised and wanting to work at WalMart.

anurseatlast · Sep 30, 2011

With my second baby, I was 10cm and +4 when I got to the labor room (no, not on purpose). the nurse kept telling me not to push. At that point, I didn't care if I pushed her out on the bed and it was not possible to stop pushing. I was a point of no return - I could not wait to push. My body did it without my cooperation. A friend was with me. She tried getting me to stop but I looked at her and shook my head; she knew it was beyond that so she just started saying, "You will be holding the baby soon." Did not make the nurse happy! Nurse caught and doc got there in time for the placenta (he was already at the hospital). I was fine with that. Doc said, "Why didn't you call me?" I said, "I left a message with your answering service. I didn't think I should wait around for you to call me back." This was before cell phones. He said, "Yeah. That was obviously a good decision!"

Nurses do a fine job catching when they need to. :)

losbozos · Sep 30, 2011

Yeah, unless a person knows that feeling they have no room to talk....I suppose. Except the lawyers. No man (aka, doctor or lawyer) or a woman that has not birthed completely understands the powerful experience of birth.