Calling all OB nurses

[WhoNeedsaShot?]

Hey everyone....

I am a student doing my OB rotation, and I could use some opinions for a project that I have to do.... Firstly, you will not be doing my homework for me, so please don't think that is what I am asking... I am just trying to get professional opinions from people that see this everyday...

I have to present to the class the different types of "labor coaches" Their roles, and how they are utilized, etc.

So any of you that can give me your opinions on the following, would be much appreciated.

If you don't want to publish your opinions on a public forum feel free to PM me.

1. Who make the best coach, for the patient ie: The Dad, A Friend, A Doula, A Parent, Other family member, The Nurse?

2. Do they help or hender your job? If so which ones, or All of them. At what point do they help or hender?

3. Do you see that the age of the patient makes a difference in which "coach" they should choose? ie: Perhaps Mom of teenager shouldn't be in the room?

4. What is your take on Midwives? Is your view based on Hospital setting, or Birthing Center? Is there really a difference?

5. How many people do you think should be present at a birth?

Thank you all for your replies, and if you think there is anything else you would like or need to add, to help make this an informative presentation feel free...

Thanks again

J.Q.:heartbeat

[NurseNora, BSN, RN]

1, The best coach is the one best able to help the woman with her labor. A teenaged boy is not usually a good coach even if he is the biological father (notice I said usually, there are no hard and fast rules in OB, or probably any speciality). Mom is often very good, it depends on the relationship she has with her daughter. Friends, especially those who have had children are often good coaches; sometimes able to be more objective than close family members. Some nurses are great coaches, but because of their other responsibilities on the unit, they can be called away suddenly for an emergency and leave the patient in the lurch. I think the best thing a nurse can do is model good coaching behaviors and teach whoever is with the patient to coach.

2. They help more than they hinder. I've been doing this long enough to remember the days when it was not common to have someone with the patient. Being alone in labor is not something you'd want to wish on your worst enemy. Even if a "coach" does nothing but sit there, the patient is better off than alone. The ones that hinder are the ones who want to be the center of attention themselves. They complain too much (some complaints are justified, but nothing is right for some people), bring too much of their own personal history to this birth, focus on what could go wrong and scare the laboring woman with tales of horrible things that have happened in the past.

3. I've found that the Mom of a teenager is often her best coach. Unless Mom has unresolved issures with her daughter. I have seen Mom's encourage suffering in the daughter to "punish" or "teach her a lesson" for getting pregnant in the first place. But that is not the usual situation. Again, the best person depends on so many things. I've seen teen age girls coach Mom in labor too. Some have been pretty good!

4. I'm not sure what you mean by my "take" on midwives. I've only worked with them in my current small rural hospital. In general, they are good coaches, but like the nurse, the midwife may be called to another patient, so I don't think she should be the primary coach. I've never worked in a birthing center or attended a home birth.

5. As many as the patient wants and the fire codes allow. I personally wouldn't want many people around me at that time. Other people are used to the entire extended family circling around and are comforted by it. I work with a lot of Native American families and it is usual for the extended family to be there. It drives me crazy when they keep coming in and going out and changing places, but if it's what works for the laboring woman, I just have to deal with it. When the room is very crowded, I do set boundaries at the time of delivery. I need the path between the patient and the warmer with the recussication equipment clear and I am very firm about that. After the baby's out and all is well, I let them wander where they will.

Sorry I didn't have any firm answers to your questions, but I hope this helps some.

[NurseNora, BSN, RN]

I just realized that you haven't mentioned doulas. They are people who can be hired as labor coaches. There are probably several threads in this section about doulas, read them for more information.

[WhoNeedsaShot?]

Opps I thought I mentioned them as well.....

Yes I have been reading alot of post since no one wants to reply to mine..

Thank you

[lakec4me]

Hi Whoneedsashot

1. I think the best coach for the patient is someone who has a good relationship with the patient. I've seen dads, friends, sisters, moms, etc all be good coaches. Some of the best prepared coaches are those who attend childbirth classes with their partner.

2. Coaches help me with my job. Unfortunatley, i usually have more than 1 patient, and can't spend as much time as i would like with each patient

3. i have had moms (and dads) who were great coaches for their teen age daughters. I have also had moms who were not so supportive

4. I love midwives! i have had the opportunity to work with them in a level 2 facility for deliveries and triage

5. My facility has a limit of 3 support people at delivery. I think this is appropriate, as it is difficult for me to do my job with more people than that in the room.

Hope that helps, Good Luck with school!