The most ridiculous birth plans you've had the pleasure of reading - page 8

I don't know when I became so jaded- I had a birth plan with my son...every single thing went the opposite of what we had wanted (induction, ITN with subsequent pukefest and finally stat section for... Read More

  1. Visit  caregiver1977 profile page
    1
    Quote from cassie77775
    I have never seen this. I thoroughly enjoy when my patients ask me questions, regardless of race, because it sows they actually cae and want to do the absolute best for their babies.
    I am glad you have never seen this and I hope you never do. It still happens.
    mamagui likes this.
  2. Visit  caregiver1977 profile page
    1
    Quote from merlinsbeard
    As somebody who has lived in the South for my entire life, this is one of the most ignorant statements I've ever read.
    Okay, I have to bite...what is so ignorant about what I said? Just because you have never seen it happen?
    mamagui likes this.
  3. Visit  SanDiegoCaliRN profile page
    3
    Quote from mamagui
    This attitude is a prime example of why hospital births can be so awful. In a hospital, giving birth is focused on what is convenient for the OB/Nurse/ hospital. Continuous fetal monitoring has not been proven by the evidence to lead to better outcomes for mom or baby- and as this nurse has pointed out, it allows him/her to "do their job," which has nothing to do with evidence based practice. It basically takes mom out of the equation, and along with her goes her personal health choices. A birth plan is designed to protect the integrity of her choices.
    Hospital births can be "so awful" because CYA is the name of the game in this litigious society. Continuous EFM and well-documented interventions with category 2 and 3 strips is the only thing that'll keep the hospital, doctors, and nurses out of hot water legally. Patients want better care but with every lawsuit, they're driving the nurse away from the bedside and to the computer for more thorough charting ("if it wasn't charted, it wasn't done."). It's a vicious cycle. They don't want an IV until a life saving transfusion can save their lives. They don't want EFM until those prolonged, late decels with loss of variability convince them their baby is in trouble. They don't want PCN until their baby exhibits signs of respiratory distress after delivery. Everyone thinks nothing bad is going to happen to them...until it does. Then I've never met one mom who wasn't so very thankful for such a skilled medical team taking care of her and her baby. We're all on the same team guys. We all want the same thing - happy and healthy mom and baby and to fulfill as many birth wishes as are reasonably possible without compromising lives.

    The unfortunate thing about this hostility towards medical intervention is it's driving women to consider delivering at home which can be very dangerous. Things can go from good to really tragic in less than a minute, and if something goes wrong, you may be too far from that medical help you've demonized for so long.

    I feel the best and safest compromise is a hospital birth with a well researched, reasonable and flexible birth plan, never losing sight of the ultimate goal of a live and healthy mom and baby when it's all said and done. Patients need to realize they have way more rights than they exercise. If they have a hostile nurse when they present their birth plan, fire her. Ask for the charge nurse and request from her a nurse who is accommodating and supportive of birth plans. As you can see from this dialogue, nurses and their opinions, attitudes, and professionalism vary widely. If the nurse you've been assigned isn't a good fit, ask for another. It could be the difference between an awful hospital birth experience and a fabulous one.
  4. Visit  uRNmyway profile page
    5
    Quote from caregiver1977
    And I don't want to be seen as someone who brings race into everything, but at some hospitals, especially in the South, black patients who want to ask intelligent questions about their healthcare and medical treatment are treated very, very badly. I'm not talking about patients who only want to argue, threaten, or curse. There are patients who merely want information and are treated badly for not just shutting up and taking whatever the hospital dishes out.
    Hate to tell you, but as a Caucasian woman and nurse who ended up with a very unpleasant AA OB, when I asked intelligent questions about my care or *gasp* refused certain treatments I knew were unnecessary at the time, I was treated like an idiot and given attitude too. So I don't know how much of it has to do with skin color and how much of it is just docs with God complexes.
    Last edit by uRNmyway on Apr 8, '14
  5. Visit  OrganizedChaos profile page
    0
    I've only been an LVN for 4 years & being an LVN not able to work in L&D. I'm pregnant with my first child & it just boggles my mind what mothers/parents request from reading this post. I don't have a birth plan, per say. But I do know what I do & don't want. I am flexible & know my baby's health comes first rather than any plan. Especially when things can go from great to horrible in the blink of an eye. I just wish I could have one of you L&D nurses as my own when I deliver.
  6. Visit  klone profile page
    3
    The unfortunate thing about this hostility towards medical intervention is it's driving women to consider delivering at home which can be very dangerous.
    See the thread in nursing news regarding homebirth. More women choosing homebirth is not a bad thing, as long as they're appropriate candidates.
    melmarie23, Baubo516, and mamagui like this.
  7. Visit  SanDiegoCaliRN profile page
    6
    Quote from klone
    See the thread in nursing news regarding homebirth. More women choosing homebirth is not a bad thing, as long as they're appropriate candidates.
    I guess that's a matter of opinion. I happen to think choosing to birth at home is extremely risky even for "low risk" women. They put themselves at the mercy of their midwife and her assessment skills and willingness to "throw in the towel" and finally admit this is a more critical situation than she can handle (and trust me, many throw in the towel way too late). But will there be time to get to medical help? Sometimes, no.

    No one ever sees shoulder dystocias or thick mec coming. And yet home births are usually post term, larger babies at increased risk for both). Add to that another unforeseen, a tight nuchal and you could have a deadly situation that spirals out of control very quickly.

    I'm sorry, I just don't see the wisdom in potentially risking yours and your baby's lives and for what? To deliver in the comfort of your own bed? Apparently these women don't know how bad things can turn in the blink of an eye. Maybe I've just been in this business too long and I've seen too many bad things. Birth may be a natural part of life but it can also be deadly. Death is a natural part of life too. Why take chances?
  8. Visit  Elvish profile page
    6
    Quote from SanDiegoCaliRN
    I guess that's a matter of opinion. I happen to think choosing to birth at home is extremely risky even for "low risk" women. They put themselves at the mercy of their midwife and her assessment skills and willingness to "throw in the towel" and finally admit this is a more critical situation than she can handle (and trust me, many throw in the towel way too late). But will there be time to get to medical help? Sometimes, no.

    No one ever sees shoulder dystocias or thick mec coming. And yet home births are usually post term, larger babies at increased risk for both). Add to that another unforeseen, a tight nuchal and you could have a deadly situation that spirals out of control very quickly.

    I'm sorry, I just don't see the wisdom in potentially risking yours and your baby's lives and for what? To deliver in the comfort of your own bed? Apparently these women don't know how bad things can turn in the blink of an eye. Maybe I've just been in this business too long and I've seen too many bad things. Birth may be a natural part of life but it can also be deadly. Death is a natural part of life too. Why take chances?
    You know, women who birth in the hospital throw themselves at the mercy of whatever L&D nurse she gets, whatever OB happens to be on call, or if they aren't private, whichever resident happens to be there. There are plenty of residents who don't know when they're in over their heads, plenty of L&D nurses who rely on the monitor rather than actually hang out with their patients and labor them, and plenty of **** that happens in the hospital that's way less likely to happen at home. The numbers just don't bear out the assertion that homebirth is extremely risky for low risk women.

    Again, this is a great argument for making midwife-assisted homebirth legal in all 50 states so that women feel that they can freely choose and not be sanctioned (or risk exposing their midwife to jail time). What we have right now in my state when there is a homebirth transport is that either she dumps laboring mom at the hospital way too late and bad things happen, or she comes in pretending to be the doula. Make it legal, and it's a whole lot easier for a midwife to call an OB/hospital and say, "Look, I've got this patient and I suspect a breech, so I'm transporting to you," instead of going it alone at home ending up with entrapment. Or "She just ruptured and the fluid looks like pea soup, so we need to come to the hospital," instead of a baby with MAS on head cooling. Right now? Can't happen, and as a result there are poor outcomes that turn so many folks against home birth.

    I have two friends who between them had three home births in my state, with different CPMs attending the births (illicitly) and each time things came up that were unforeseen. All were able to be dealt with at home using emergency equipment that the midwives brought along, as they should. Two births (same patient) were postpartum hemorrhages r/t atony, managed by IM Pit and PR cytotec. Her third pregnancy was risked out because she was too anemic. My second friend's emergency was shoulder dystocia. Because she didn't have an epidural, they were able to Gaskin her, get baby out, and give him PPV when he came out depressed. He did beautifully. Ina May Gaskin, for whom the maneuver is named, reports never ever being unable to get a shoulder dystocia baby delivered when Mom is on all fours.

    It's okay to be personally uncomfortable with the idea of homebirth, but skilled birth attendants (and that is the key....skilled) do make the difference, whether at home or in hospital.
    Last edit by Elvish on Apr 10, '14
  9. Visit  ratlady profile page
    2
    Quote from SanDiegoCaliRN
    I guess that's a matter of opinion. I happen to think choosing to birth at home is extremely risky even for "low risk" women. They put themselves at the mercy of their midwife and her assessment skills and willingness to "throw in the towel" and finally admit this is a more critical situation than she can handle (and trust me, many throw in the towel way too late). But will there be time to get to medical help? Sometimes, no.

    No one ever sees shoulder dystocias or thick mec coming. And yet home births are usually post term, larger babies at increased risk for both). Add to that another unforeseen, a tight nuchal and you could have a deadly situation that spirals out of control very quickly.

    I'm sorry, I just don't see the wisdom in potentially risking yours and your baby's lives and for what? To deliver in the comfort of your own bed? Apparently these women don't know how bad things can turn in the blink of an eye. Maybe I've just been in this business too long and I've seen too many bad things. Birth may be a natural part of life but it can also be deadly. Death is a natural part of life too. Why take chances?
    Shoulder dystocia? Maybe if women weren't stuck flat in bed with an epidural and pitocin, they'd be able to get up and move to prevent that. Not only that, but hands and knees is very very crucial to getting out of that situation, which oh by the way, can't really happen all that great when she's paralyzed from the waist down.

    Shoulder Dystocia - Spinning Babies


    BTW, you've probably seen too many bad things because you're probably in a hospital that is part of the 1 in 3 c/s epidemic. No wonder you're scared. birth isn't a medical emergency. If I ever have another I can't wait to have it in the comfort of my own home, surrounded by knowledgeable supportive people with the right qualifications to remedy that very slim chance of something going awry.
    melmarie23 and mamagui like this.
  10. Visit  SanDiegoCaliRN profile page
    5
    I am not afraid, I'm cautious. There's a difference. If I'd had my son at home as I had planned, he would have died without a doubt, and I had a picture-perfect pregnancy and labor with no risk factors. The delivery is where things got very scary, very fast. I was thankful for the NICU team who resuscitated my son and saved his life. Yes he was sick and I had to leave the hospital without him but he's alive and well today because I listened to my gut and chose to play it safe and switched my care from a midwife to an OB/GYN and delivered at a hospital with an excellent NICU.

    The link you posted is a breakdown of maneuvers already used in hospitals (by skilled staff) to resolve dystocias. If a laboring mom doesn't have a dense epidural, she can still maneuver on hands and knees with assistance and yes, we use this technique and the others in our hospital. Why so much disdain for hospitals and medical personnel? We're not looking for a reason to cut you, we're looking for reasons NOT to. We support your efforts to exclusively breastfeed and don't even stock formula except in the NICU for emergencies and HIV+ moms. We don't even have pacifiers and won't bathe your baby, instead preferring its natural vernix layer of protection. We welcome your birth plans and will sit with you and go over it line by line and do our best to make it the delivery of your dreams. We don't harass you if you decline the erythromycin and Vit K, you simply sign a waiver stating you're willing to assume the risk of declining them. You may take your placenta home with you for encapsulation if you wish. You can walk and shower with our wireless monitors, I'll get you a birthing ball, provide you with aromatherapy, turn off the lights and play music and turn on electric candles and give you counter pressure on your back when needed. If moms desire a drug-free delivery, I review her pain control options only once upon admission in case she changes her mind then never bring it up again. Most moms (the vast majority) have uncomplicated vaginal births. The preterm mom I took care of last week who was going to deliver at home until her water broke at 30 weeks said, "wow, this was an awesome experience! I don't know why I didn't plan to come here in the first place." I followed her birth plan to a T (other than the unexpected NICU admission and thus, delayed skin to skin). We're not evil or your enemy. We're here to assist and empower and advocate for you on the most special day of your life. Why demonize us? Yes, I take it personal. If you don't want our help and in the event of an emergency, our life-saving interventions, please, by all means, stay home. I prefer clients who appreciate our assistance and isn't suspicious of us like we have some self-serving motives.
  11. Visit  klone profile page
    2
    It's really NOT a matter of *opinion* that homebirth is as safe as hospital birth for low risk women. There are DOZENS and DOZENS of peer-reviewed studies over several decades that prove it. Over and over again. In Europe, most pregnancy care is given by midwives, and a good portion of them are at home. Yet...these same countries have LOWER maternal/fetal morbidity and mortality rates than the U.S.
    melmarie23 and mamagui like this.
  12. Visit  SanDiegoCaliRN profile page
    3
    Klone, low risk women have babies who crump for no reason at all at or shortly after birth. Low risk women hemorrhage, have shoulder dystocias that DON'T resolve, no matter what maneuvers you perform and develop preeclampsia in a day when the day before they were just fine. Being very close (like across the street at a birthing center) or in a hospital is the only thing that will save some of these women. Why take a chance? You or your baby could be the next statistic.

    In your downtime, read hurtbyhomebirth.blogspot.com to see real faces, real names and real stories if you don't believe me.
  13. Visit  klone profile page
    2
    I've seen it.

    Surely you know that as a professional of science who has studied evidence based practice and research, you know that anecdotal stories should not be taken into consideration when looking at statistical risk. I'm sure that for every homebirth horror story, there is a story for things that went horribly wrong due to the interventions of anxious care providers in the hospital setting.

    STATISTICALLY SPEAKING, homebirth is AS SAFE (if not safer) than hospital birth for low-risk women. Like I said, studies have proven that fact. Over and over.
    melmarie23 and mamagui like this.

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