What ever happened to "mother nature"?

I have worked in many hospitals where interventional OB as you described, is practiced. The one thing they all had in common is the majority, if not all, of the births were by physicians. I now work in a hospital setting with mostly CNM's, and most of patients are "managed" in a non-interventional manner. Recently a nurse in another city was telling me how most of her patients arrive early in the morning for elective induction, receive an epidural and then "I pit the hell out of them". I guess we all are different, but I can't imagine going back to work in that sort of environment and with such a lack of respect for pregnancy and childbirth. No place is perfect, and here we still have conflicts on occasion, but are usually able to resolve them collaboratively. I love working with CNM's and hope I can stay here until I retire!

Just speaking from my point of view as a laboring mom. Induction was never talked of. I went into pre-mature labor and they stopped it with a pill. My water broke at 39 weeks and I went to the hospital. They put me on Pitocin but it was explained to me that they didn't want me to labor for a long period of time with that fluid gone. The thing that did irritate me was they continually asked me if i was ready for an epidural. My take was that I wanted to labor naturally, yet if I felt I needed pain meds then I'd ask for them, but I wanted to think it out and breathe through the pain. And I certainly didn't want to start with an epidural. To me an epidural was the very last of the pain meds. I wanted to feel the need to push! However my dreams came crashing down when baby was taken by emergency c-section (baby's heart rate dropped low) because the cord ruptured. That's just my 2 cents and I really don't know if the hospital pushes c-sections or not. I do know I can't get a VBAC, my doc said I'd be an ideal candidate but the hospital is small and they'd need a surgery team ready and waiting.

Exactly!, natural birth is so inconvenient these days...

Maybe they're medicating with THC for the morning sickness, since their HMO won't cover the meds? (Natural medicine?) hahaha, JK

I saw a true natural childbirth once, in Africa. Woman just squatted, out comes baby, not even a grimace! Oh oh, time to cook dinner. Just like nothing happened! Look ma, no bills!

Makes you want to bring back birthing chairs! No, wait too inconvenient, need to lay down in a bed so the doctor doesn't have to bend over. Amazing what gravity can do to help ladies, that's why they're up walking in circles before the birth, duh.

I think this is a problem all over! Docs dread the pts that get to 36wks and start complaining every week about awful they feel and why doesn't he do something about it! "My sister's best friend's cousin's neighbor had a baby at 36wks and it was fine." And why should their lives be interupted for a delivery after hours when they can come in at lunch and do a section and get paid more for their time...

I'm a nurse but not an L&D nurse (hopefully someday!) so my perspective is probably a little skewed but in my experience, I agree that this has been a big problem all over. However, I will say that in my neck of the woods I am starting to see the pendulum swing back the other direction. At my OB's office (all doctor led) they will do inductions but not for convenience. I got into a little discussion with my OB about evidence showing that even babies born at 38-39 weeks are showing (or at least are at increased risk for) mild deficits, and their office is really cracking down on unnecessary inductions.

I have had my MD for all 3 pregnancies and deliveries. I think he is great and would have been so disappointed not to have him there. He told me at 38 weeks that he was going to be gone for vacation my entire 39th week. Even though I was dilated to 4 and "ready to go" he flat out told me induction was not an option. He went as far as stripping my membranes but said that was as far as he would go.

In this particular office they really don't augment labor as often anymore either. They share call with another office and there are I think 8 MD's between them. Those 8 doctors rotate staying the night in the hospital so nobody is trying to get a baby out by 5 pm. Even in my relatively small circle I know of 3 people who have had successful VBAC's too - and all with different doctors.

I live in the pacific northwest and they tend to be more "progressive" so maybe that is why, or maybe I just got lucky. Either way I have been really impressed with this office.

The physician gets paid per procedure, not hourly.

In fact, adding drugs, surgery, etc to "hurry" up a labor that wasn't supposed to start in the first place is ADDING cost when labor should start naturally on it's own....which is free.

So we really hate the fact that it's 5:00 and he wants to go home, but that is why he's making 6-figures a year and we are not....that is the job they signed up for.

I have personally witnessed a physician "hang out" at the nurses station and didn't want to "be bothered" with a laboring mother until the baby actually started to crown.

To me, it is the most unnatural thing in the world to have a baby crown and then everyone in the room goes "Stop!!!!" while they run to get the doctor...and THEN TELLS MOM not to push?????????

To me....as soon as that baby has descended enough, his or her butt needs to be sitting on a stool, in front of the delivery table, waiting to catch that baby.

Oh..and I just love the physicians, that after two experienced nurses with probably 20+ years experience say that the labor is progressing after 4 hours on pit, the physician waltzes in....takes 25% off the nurse's effacement estimate and 5 centimeters off her dilation estimate, shakes his head and says, "Yeah, the labor isn't really progressing the way I would like and I sure don't want to put your baby at risk, looks like we are going to have to do a c-section."...with the nurses looking at each other with the "Say what????" look on their faces.

Happens every day.

I think it depends where you are. It seems to be a much more medicalized system in the US then in Canada. Here our section rate is about 19%, which is lower then the national average and they will not schedule an induction for convenince sake but only for a medical reason. The only time I have ever seen an induction without a medical reason was when the pt's mother was in palliative care and doing very poorly.

With only one exception our docs do not go by the clock.

Out of curiousity but once I do get to my clinicals in nursing school, is there any way to avoid the L&D rotation? This is just so depressing.

You really do not want to skip your rotation. This is just experienced nurses sounding off to people that have the same problems and understand their frustrations. I would not trade my job on L&D for anything. I will never work anywhere else and you should never let these discussions dictate how your practice is! No matter where you work, you will run into issues, challenges, and frustrations; and will want someone to talk to. That is what we are doing and hopefully are not intending to scare you!