Change in the way we practice

Specialties Ob/Gyn

Published

I have been an OB nurse for almost 26 yrs. The one thing I can say is that change is going to happen. Babies only come out normally two ways( lady partsl and c/section). But we have found ways to change everything else surrounding the delivery. Most of these changes have been for the good. Others are a matter of opinion.

A couple of examples:

1) All babies used to stay in the nurseries at night. Most babies were bottle fed. Now most babies room-in. Most babies start out breast feeding.

2) IUPC's used to be water filled. You would have to elevate the bed to the level of the IUPC to have it work properly. Now patients can move around freely with IUPC as long as it is secured .

What changes have you seen in OB nursing? It can be from any OB department. :idea:

Specializes in Community, OB, Nursery.

Also, from what I understand, twilight sleep was horrible. Because of the scopolamine, nobody remembered anything, but they would scream and thrash and carry on. No thank you. Glad that's a thing of the past.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

My mom told me:

In the 60s and 70s (when I and my sisters were born):

they routinely were "gassed" til they passed out in the later stages of labor,(usually when the baby was emerging). She was unsure what "gas" but she did say, when she woke up MUCH later:

her babies were warehoused in the nursery, only to be brought to mom on

"nursery-set" feeding schedules, usually for an hour every 3-4 hours ONLY. And ALL babies spent the ENTIRE night in the nursery, no exceptions. How breastfeeding EVER happened, I will never know.

Oh and moms were VERY MUCH encouraged to BOTTLE feed as "formula was much superior to breast milk, and only the poor or uneducated really breastfed, after all". And ALL babies were to be on a strictly-held schedule, every 3-4 hours NO SOONER. How awful.

If permitted to be "conscious" during delivery, they often got unsolicited, un-asked-for "saddle blocks" that hurt like hell, totally not worth it to "prevent pain".

Women typically stayed in the hospital nearly a week for lady partsl delivery, and more than a week for a c/section! And they were not "permitted" out of bed for days after either delivery!

NO DADS in the delivery room!!!! NEVER! They were not "sterile" enough and "could never handle it".

The nurses and doctors smoked in the delivery room! My mom remembers a doc smoking a STOGIE during her labor!!!!! She remember how it stunk and it made her nauseous!

There are more stories, but these are formost in my mind. I am new to OB, really, only 10 years at it. We have not changed things that radically in that time, except, we no longer use peri lamps on episiotomies, lacs these days.

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

The nurses and doctors smoked in the delivery room! My mom remembers a doc smoking a STOGIE during her labor!!!!! She remember how it stunk and it made her nauseous!

THAT is gross.

Up Vote Up Vote ×

I did manage to breastfeed in the 60's in spite of the hospital stay. Not for long tho as the pediatricians added solids so fast. I remember being a new Mom, just 20 years old and crying because I had this big long list of foods to feed my baby, cereal twice a day, fruit, vegetable, juice, and even an egg yolk !!! This was at 3 months old. No wonder I dried up. Some babes were given cereal in the hospital !! Babes were weighed before and after a feeding to tell you how much they took.

Pudendal blocks were the common thing where I delivered and mediolateral episiotomies were the norm. After 3 of those episiotomies, I tried to deliver without one and had a 3rd degree tear and later a 2nd degree. Also had a huge rectocele after those tears. Don't know what I would do if I had it to do over again in that regard.

Some things have changed for the better and some for the worst.

Up Vote Up Vote ×
Specializes in L&D.

Thirty eight years in OB, I've seen a lot of changes:

No fetal monitors, listen with the heavy fetascope or the one you put on your head.

No IV pumps: Start the Pit at 5gtts/min and increase by 5gtt/min till contractions q2min. Eyeball that 5gtt/min.

All babies NPO for 8 hours after birth. Breast fed babies got to nurse 3min on each breast the first time, 4 min per breast the second time, etc. This was supposed to prevent sore nipples.

Deladumone for bottle feeding Moms.

IV alcohol for preterm labor.

My first hospital was very progressive and as early as 1967, husbands were allowed in the delivery room, but only if they'd taken childbirth classes. And only husbands. No mothers, no boyfriends. They didn't have to bring in a marriage certificate, but they did have to bring the childbirth class certificate.

Spinals, forceps, and episiotomies for most deliveries. General anesthesia for lady partsl deliveries. Leather wrist restraints on the delivery tables.

Up Vote Up Vote ×
Specializes in L&D.
Also, from what I understand, twilight sleep was horrible. Because of the scopolamine, nobody remembered anything, but they would scream and thrash and carry on. No thank you. Glad that's a thing of the past.

It wasn't always that bad. The ones who really carried on weren't usually given enough pain medication. Most of the women I saw with Scop were pretty out of it. Not everyone got the anmesia the Scop was supposed to provide. I felt badly for the ones who did get the amnesia. I think it's easier to integrate the whole experience into your life if you have some memory of it.

Also, patients who got spinals for delivery had to be flat for 12 hours post partum to avoid a spinal headache. Most couldn't manage to void on a bedpan while lying flat, so they were cathed.

Undiagnosed twins before Ultra sound was available.

TAking the patient to Xray to confirm or rule out CPD.

Up Vote Up Vote ×
Specializes in L&D.

Giving Pitocin straight IV push with the anterior shoulder or the head.

Ergotrate is the natural Methergine. It's from a fungus that grows on rye grain or flour and is closely related to LSD. I've had patients trip out on it and see the walls melting and the ceiling breathing. Is is used for anything other than migranes anymore?

Fundal pressure to "help her push the baby out".

Hand held Penthrane masks for labor pain.

Live baby when leaving the labor room (as documented by listing with a fetascope) and delivering an unexpected stillborn in the delivery room. Fetal monitors have eliminated that unpleasant situation.

Sorry I'm hogging this with so many posts, more things keep occuring to me.

Up Vote Up Vote ×

We forgot buccal pit !!

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I had a doc who gave Parlodel for non-bf moms so they would not engorge!

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

I still have moms ask me about "that shot that makes your milk dry up."

Up Vote Up Vote ×
Specializes in OBSTERTICS-POSTPARTUM,L/D AND HIGH-RISK.

I have to say that most of this is bringing back memories. I hadn't thought of Parlodel for a long time. I didn't do the alcohol gtts for PTL but I did do the Brethine gtts. I remember what a big deal it was when the Magnesium gtts were started.

Epidural before they got the pumps. The patients were so numb and difficult to turn. Then their pain would come back and they would need a redose to make them numb again.

Celestone injections- two a week 24 hrs apart. Now they get a total of two injections at our hospital.

What else do you remember?

Up Vote Up Vote ×
I still have moms ask me about "that shot that makes your milk dry up."

I had a mother-in-law of a new mom ask me that . . . . she was very angry that we didn't do that anymore.

steph

Up Vote Up Vote ×
+ Add a Comment