Abortion in nursing school rotations?

[caffeineRx]

Hi All,

I am soon to enter my Maternity/Peds clinical portion. I'm curious to know if you see abortion procedures during these rotations. I'm speaking of elective and medical emergencies...or would this be something that falls under OR?

Can any of you share your experience in Maternity? Did you see any sad things? I know that, realistically, I will see some depressing stuff (already have)..just want to know what to expect. Thanks

EDIT: Ps. I'm not asking anyone if they are pro-life or pro-choice. If you want to speak about that please take it to another thread. Don't be rude and mislead my topic. It's a simple question. Thanks

[Zookeeper3]

my daughter allowed nursing school students in their BSN rotation surgical clinics in. Our grandchild had died in-utero at 5 months and she didn't spontaneously abort, so we had to go to the clinic to have the baby removed to prevent complications.

As a nurse, and a grieving grandparent, I was told that nursing students in this situations are common, to help them understand..what occurs with non elective abortions. Where the nursing students fall in to abortion is not the issue, but to prepare them as to how to handle this type of patient is key and it's not about a choice issue, every patient is grieving a loss. Lynndsays students were wonderful, caring and incredible.

Whether she chose that or not, she needed those people there to give support... just remember that... and leave your beliefs at the door

[diane227, LPN, RN]

During my OB rotation I did not see any abortions. When I became a nurse and went to work in the ER I did have patients who came in with missed AB's and we would do a D&C in the ER but that was it. I have never witnessed an elective abortion.

[Purple_Scrubs, BSN, RN]

We did not see any, but we did see a very early fetal demise, I forget what week (we had the option to see it or not). It was a perfectly formed, tiny little person. One of my classmates made the comment that the baby was the same gestational age as most abortions are performed. It was very, very sad.

[07302003, ASN, RN]

No abortions - the hospital was in a poor area. Lots of teen pregnancies, drug addicted mom's and fetal demises. I could never do OB based on this rotation.

For me, the most traumatic part of the rotation was witnessing a circumcision with lidocaine cream applied 10 minutes before the procedure, I'll never forget that. Reason #2 I could not do OB.

I guess your experience will all depend on the setting. Best of luck!

[missfixit]

Abortion was not part of my OB rotation. Thankfully!!

[brizzo]

In the hospital where I worked we did pregnancy terminations in an adjacent area to OB, and nursing students typically were not assigned to this area. But as a nurse, no matter what my personal beliefs, I realized that making the decision to terminate a pregnancy is a difficult one for most. Especially if the reason for the termination is that the baby has deformities that are incompatible with life or life threateing to the mother. I realized that my role was to delivery compassionate, non-judgmental care for a family in crisis. So even though the situation was very sad and emotionally difficult I felt that I was in a situation where I could really make a difference in the outcome of the whole experience. One of those times where nurses can have a great impact.

[merrywhiterose]

You never know what's going to come through the hospital doors. Sometimes there will be an emergency abortion to save the mother's life. Babies don't always have working organs, so the mother's organs can be damaged by such a pregnancy. There are a lot of different complications that can happen during pregnancy that may require an abortion. I'm not speaking with an opinion, but with the facts. I have not witnessed any of these, but have actually experienced this myself. Usually if a woman requests an abortion they go to the clinics, where the environment is still sterile, but the doctors are more experienced. The risks are typically lower. As a student nurse I have not witnessed an abortion. I doubt most nurses have unless it's an emergency situation. This was a good question!

[honeykrown, MSN, NP]

Worst thing I witnessed was a full term baby, mother had a placenta abruption. The baby had died the day before in utero--so doc induced labor and mother knew the baby was dead (obviously). I did not witness the birth, but myself and another student helped to bathe the little girl for her pictures. She looked like she was sleeping and it was so heartbreaking.

I had an experience just like this during my OB rotation. I was actually involved in the birth process. The mother kept crying becasue that morning the doctor had told her everything was fine until she felt the belly pain and the bleeding (complete abruptio placenta). I had to hold her during the epidural and she kept crying. In the hospital, my teacher said i did great but immediately i got to the car i cried all the way home.

The pictures, with the footprints and all are for keepsake. If the mother wants to keep them she does.

[prisonnurse02]

That is awful !! I didn't have to see anything like an abortion, but I did a rotation at the Regional Medical Center in Memphis and saw lots of heart breaking things, like crack babies, fetal alcohol syndrome, abandoned babies, etc. I couldn't work OB or Peds, just so much sadness (along with joy, I'm sure).

[McBx3]

The hospital that hosted us during clinicals doesn't do elective abortions, but as others have stated, you never know what you will see... a fellow student of mine was doing her rotation on the GYN unit, and had a patient that was in for a cerclage (if I remember correctly, it's been awhile!), and the patient delivered w/o warning... from what I understand, the patient told her she felt something and when she checked her, she found the baby on the bed I was never so glad to have been assigned to a different unit in my life.

[NICU_Nurse_3986]

I didn't see many sad things during my OB rotation in nursing school, but I am a NICU nurse now so I see it quite a bit now. The difficult situation that we had to face was a mom that had IVF and ended up with triplets. Triplets are at a higher risk, but frequently delivered with little to no complications. This mom decided that she only wanted one of the babies, specifically the girl, and had to go to a different state to have the pregnancy reduced, because it was not medically necessary and because she wanted to pick which one to keep. The two boys died. One baby delivery spontaneously after that and the other was retained. She ended up delivering the living baby at 24 weeks. I happened to be the nurse at her delivery. It was a C-section, and the first baby to deliver was the demise. And I remember the doctor telling me as I waited to catch the baby "this isn't the one you want". Then the girl was delivered. She had a long stay with us, with many ups and downs (as to be expected with a 24 weeker). She is now healthy and home with her parents, but I was a very hard situation for our whole unit. As much as we know that we are not there to judge peoples choices, it is some times extremely difficult to not be upset by them. It is one of the many ethical situations that we as nurses some times have to face.

[RetiredTooSoon]

Before I go further: In this post, abortion is defined as the intentional destruction of a live fetus before viability. It does not include procedures done to treat miscarriages (sometimes called spontaneous abortion) or post-partum hemorrhage.

Like others have said, it depends on the program. The hospital I trained at was a Catholic hospital and had a policy that no 'destructive procedures on live fetuses' were performed, so abortion (D&C, D&E, D&X) was never a concern. In special cases, if a woman knew her baby was going to die shortly after birth, they may permit labour to be induced prematurely and decline to perform resuscitative measures.

Students in their first OB/Gyn rotations were not assigned to these cases; they were left for the RNs, although after the baby had died and the parents had relinquished the body to be taken to the morgue, the students may be allowed to see the body and if cause of death was obvious, be shown what was wrong and discuss how it came to cause the death.

The hospital that performs abortions (D&C, D&E, D&X) on viable pregnancies only did so if the mother's life was in clear and present danger, if severe fetal abnormality was found. Students had the option of being present during their OB or OR rotations.

That hospital also has the city's fertility program, so before the strict IVF/IVI rules were in place, they may have done selective reductions on high-order multiple pregnancies-and I believe the hospital still will do them on spontaneous higher order (3-5 fetuses) pregnancies. Students were not required to observe those procedures. Elective abortions (not ready to parent, don't want family to know, not willing to consider adoption) are only done in off-site clinics, where nursing students are not placed.

Other hospitals in this area may permit labour to be induced before viability with no attempt at resuscitation in the case of anencephaly or other genetic disorders-usually junior students were not given those patients or patients with stillbirths unless they had established a relationship with the parents ahead of time through a clinic or being with the woman in labour with death of the baby coming unexpectedly at birth due to a cord accident during labour or undiagnosed anomaly that would be incompatible with life.

When I did my OB rotation, I followed an older mom (44?) through her labour and as the baby was born, he came out blue, limp and flat. My job was to be with the mom and observe the labour, so I just stood by with her as the medical team worked on the baby. He was fine; he just came out too quickly (precipitate delivery) and needed a bit of help to get breathing.

In the OR or in OB clinics, you may have a woman come through who has had a miscarriage but her body has been unable to expel the dead fetus or who is bleeding excessively. In those cases, a D&C is performed to clear out the uterus. That usually doesn't look like anything more than blood, although occasionally if the miscarriage happened further along (14-16 weeks), the doctor may try to deliver the dead baby intact-or sometimes identifiable body parts like arms and legs can get caught on the suction apparatus or be pulled out by the curette. That can be unsettling to see.

Obviously every nursing program is different, but we had a conscience clause all the way through that if a case came up that could be considered very controversial like abortion, the student had the option of refusing to be part of the procedure *as long as* it was not an immediate life or death situation.