too many interventions in L&D - page 4

do you think there are too many interventions in L&D. It seems lately all our patients are pitted,ruptured, induced and or augmented. Some of our docs give patients arbitrary time limits for each... Read More

  1. by   OB4ME
    Originally posted by just1rn
    I agree with NO social inductions.... the docs have increased our c/s rate up to about 40%. This because the "social" inductions have primip's, who are not ready, stressing the fetus. Also, a few prolapse cords because of arom when the patient is +3 and floating. Some of our MD's allow the patient to call the shot and be induced at 37-38 weeks....But what do you do
    Yeah, that amazes me to see docs scheduling inductions for "maternal discomfort" as the diagnosis! And, these patients seem to have no clue about the risks involved...they just want a quick fix to their aching pregnant body...
  2. by   dawngloves
    Originally posted by OB4ME
    Yeah, that amazes me to see docs scheduling inductions for "maternal discomfort" as the diagnosis! And, these patients seem to have no clue about the risks involved...they just want a quick fix to their aching pregnant body...
    Oh man! Don't get me started! I want to beat some sense into women that want an induction at 37 weeks and tell them "Ya think that hurts? Wait'll you get the Pit!"
  3. by   shoelace
    Not an OB RN here - what is a "fourth degree?"
  4. by   SmilingBluEyes
    a "4th degree" is an OB term referring to the horrendous occurence of a perineal tear extending all the way INTO the rectum.... (tear essentially creating one big gaping opening from vagina to rectum, it is ugly). Yes, it is the worst kind and if not properly repaired, can bring about lifetime problems with fecal incontinence among other things.
  5. by   wishingmary
    This discussion brings back my fears as a first and second time mother. I didn't work in L&D but I did my homework. What I found scared me to death. My choice was to get good prenatal care, hire a midwife (couldn't afford a nurse midwife), and bear my children in the hospital. Best decision I ever made. The midwife came over to my house when I called early in the morning. She came over immediately and checked me. I hung out at home, timed the contractions, getting checked until I was at least far enough along, I wouldn't stall. Got to the hospital with no time for epidural, thank God. Had both my kids different years but within 2 hours of admission. Labor pain, I say get a vibrating pillow. My first was 10 lbs 8 oz. My second was 9 lbs 15 oz. and term. My doctor wanted to induce me a week before but I said NO not unless there is something seriously wrong. There wasn't of course. I do have a L&D question. I'm not diabetic, doctor checked several times. Why is it in my OB class textbook, high normal is something like 8 lbs? Over that is always in the same sentence with diabetes? I'm 42 years old with no health problems except ADHD (found out recently and didn't take so much as a Tylenol during my pregnancies.) I'm 5'9 1/2"; my husband 6'2". Am I at a higher risk for diabetes since I bore large for gestational age and healthy children? I had them both vaginally with an episiotomy. The doctor didn't tell me he was going to cut me but I probably needed it with such big babies.
  6. by   wishingmary
    One more thought. The EFM. Once admitted to the L&D, they put that on me. I told those who were with me to ignore it. The monitor would say I was having a doosey, and I'd be like its way off. I as the patient was the best judge of when I was having a contraction. I am looking forward to my L&D rotation. Yes, I'll probably glance at it now and then to see if it works for the woman who is before me but my eyes will be on her and what she says is gospel unless there is some other factor she brings in that makes her an unreliable patient. This week, I'm going to an OB clinic to observe. Maybe I can encourage a more natural birth than the epidural-pitocin-c/s route without getting into trouble.
  7. by   mother/babyRN
    Yes, How about those patients who are convenience inductions either for themselves or the doc. Everyone knows if you aren't ready to go into labor no amount of pit is going to do anything....And if you come back more than once for a labor check then you know you are going to be admitted, ruptured, pitted and sectioned because they don't want to be bothered by us nurses calling them once again about their problem patient. Ticks me off too...
  8. by   mark_LD_RN
    wishingmary-- you know you not supposed to watch the monitor.

    the external monitor is not an acurate measure id ctx strength. i let the patient tell me
  9. by   mark_LD_RN
    social inductions and inducing the problem patients ticks me off also. just labeling them ticks me off

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