Could I like OB even if I'm an "all natural" kind of girl?

delilas · May 28, 2010

Tread carefully. If having to take part in those types of birth on a very, very regular basis is going to make you unhappy in your job, then steer clear.

The last place (some) mothers want advice is the labor room. For every one that will hang on to everything you say, there are one that would like to schedule their labor for their lifestyle and are perfectly happy with pit and scheduled c-sections.

If you think you'd like L&D but want to avoid medicated births, you may want to look into local birth centers - the majority of the ones near me focus on non-pharmacologic births and use a wider variety of relief than most hospitals do.

Orna01 · May 28, 2010

When I delivered my second child I wanted her birth to be as natural as possible. My first birth was not a wonderful experience and I did not want a repeat of that birth. I had the best nurse ever for my second delivery. She was pro natural and she was the reason I had such a wonderful birth. She was my champion, gently reminding of what I wanted when it got tough. She fought for me each step of the way and made sure my wishes were heard. I cannot say enough about her, she was even more supportive than my husband was! You may get frustrated with many of the births but you also may be able to help so many women have the birth they want.

anon456, BSN, RN · May 28, 2010

If you can focus on the patient's wishes-- to be in control, happy, etc-- instead of on *how* she is made to have those wishes, I think it could work.

Even though I'm pro-natural on many things, I had two wonderful epidural births. I felt very much in control of my situation, and still was able to delivery my baby into my own hands with assistance, had delayed cord cutting, delayed vaccinations, etc. Each woman will have an idea what is the ideal birth for her.

Of course many births don't go as expected and the mother loses control-- and that's where you get into your supportive role. Some natural mamas may not be able to cope with pain as well as they thought, or they may encounter an emergency situation where they need medical intervention. Other "medical" minded mamas may not get their epidural in time and face a natural birth that they are not emotionally prepared for.

In OB anything goes, but just try to remember to support the patient in whatever mental/emotional/physical state of mind she's in at the time.

(I have some experience in doula work to be able to give this input-- I'm still a student nurse)

jillyjb · May 28, 2010

I think if you don't think you can get passed your own hangups about this, then you shouldn't take the job. The patients deserve to be respected no matter which choice they make.

Pitocin in necessary and life saving in certain situations, and though I agree its over used, its existence is needed. I do find some OBs do try to "schedule" these things, but I'd like to think it isn't the norm.

I think it comes down to you. Can you be the nurse these laboring woman and families deserve, or are you going to be too hung up on your own views? That's the bigger question here.

BluegrassRN · May 28, 2010

I thought I could, but I couldn't. Yes, I believe in a woman's right to choose whatever birth she wishes. Yes, I understand that interventions have their place.

Even though I understood this, I was still sickened by the entire unit. Convenience sections absolutely were the norm, as well as "That baby is too big for a lady partsl birth, we need to section" with the result of a 7#er. Over 95% of women had epidurals; it was pushed on them, and they were asked to sign the consent at the preadmission clinic. When I birthed there myself, I refused to sign the consent, and the woman actually told me, well, if you don't sign it now, you won't get one, even if you are begging for one, or need one for a c-section." I told her I was a hospital employee and I knew that was absolutely not true, and I couldn't believe she was saying that. She back-peddled and said that the anesthesia doc REALLY wanted all the women to sign the consent prior to labor. Fine, but don't threaten.

I'm sure there are some OB units that are fine. The several I experienced were not. I worked OB as a nurse, and previously I worked for several years as a doula. The cattiness is to the extreme, the disrespect for women was so sad to see, and god forbid a woman wanted something out of the ordinary. A birth plan? Ha, the nurses took turns tearing it apart and making fun of it at the desk. Want your three year old in the room? The nurses did everything in their power to prevent that. Want your husband to catch? Are you kidding me? Want to leave within 24 hours of birth? Do you want you or your baby to die, because that's what can happen. You want to birth in the tub? Why do you want to drown your baby?

It was awful. If you want to support natural birth, work at a birth center. If that isn't an option for you, check your hospital's epidural rate. If it's above 50-60%, they aren't supportive of natural birth, and have no intention of wanting to be. Do they allow midwives? Do they encourage doulas? If so, that might be the hospital for you. I'm sure there are hospitals that are not so intervention crazy, but not in my area.

I did it for six months, couldn't hack it, and transferred to the medical floor. If I'm going to be intervening, I want there to be a good reason for it, not for the convenience of staff or physician, or because no one thinks outside the box. Maybe you are up to fighting every freakin day for those moms who want a natural birth, but I wasn't. I would come home from work, so sad about the complications I witnessed from fluid overload, epidurals, pit, removing baby from mom for extended periods of time, etc. In my experience, lip service is given to evidence based practice in OB, when the reality is that convenience and "this is how we do it" reign.

Again, I'm sure there are hospitals that have wonderful OB units; but I never saw one, and I wasn't willing to job hop to keep seeking one out, nor was I willing to relocate my family in the event that I found a wonderful hospital outside of my area. Perhaps if you are much more selective than I was, and if you have the ability to relocate for a good hospital, you might have better luck.

chiapet · May 28, 2010

I'm with you Bluegrass. I went to nursing school to become an L&D nurse. I precepted at my local hospital here in the Bay Area and was hired. I lasted 3 months. For all of the same reasons you mentioned. Now I am in oncology -- I know what a switch, but I love it.

Jules A, MSN · May 28, 2010

Wow, maybe I missed my calling. I'm all about meds for pain control and after seeing the physical condition of babies born lady partslly vs. C-section I'd prefer the later. I'm also cool if someone isn't interested in breast feeding.

lifelearningrn, BSN, RN · May 28, 2010

Wow, maybe I missed my calling. I'm all about meds for pain control and after seeing the physical condition of babies born lady partslly vs. C-section I'd prefer the later. I'm also cool if someone isn't interested in breast feeding.

I second that! :) I think I'd like L&D and all the different types of births I might encounter.

JP2011 · May 28, 2010

Well, I think if you could find another job you should. I'm not a nurse but at the facility I work at of the 24 beds we have almost everybody is on pitocin, with a IUPC, they want an epidural, or need to be induced for preeclampsia or such reasons. Maybe a natural birthing center would be better. Not being a woman or a nurse I believe that there are valid reasons for everything that is done, even though they are not always used at the right time. ISLs and IUPCs need to be used unless you as the nurse want to run in the room every 15 minutes on a pt that is difficult to monitor. I really think you would be unhappy. Yes - MDs do some dispicable things, but just like with nurses you have people who really care for their craft and those who just do it to get paid. Usually all of these calls are made by the attending physician and the residents just have to follow orders.

I hope everything works out for you. I only think you wouldn't like it because at the end of the day you have little control as the nurse. If an IUPC or ISL is ordered or Pitocin is ordered you pretty much have to do it.

Good luck!

TDCHIM · May 28, 2010

If you firmly believe you can separate your views from your work and you've had success doing so in other arenas, perhaps this position would work out well. But if there's the slightest chance you're going to directly or even indirectly project your views onto a patient, then for everyone's sake, pass up the job. As a mother who had no choice about a VERY medically necessary c-section, if I'd had a nurse prepping me who was frowning or harrumphing at me - or god forbid, one who tried to talk me into birthing "naturally" before going with a c-section - I would have been strongly tempted to stuff one of my crutches up her nose. I agree with some of the other posters that it might be better for both you and your potential patients to seek out a birthing center or something along those lines. You won't be miserable having to support practices you find unnecessary or unethical that way. Everyone has their own likes, dislikes, and firm beliefs, and it's best to find jobs that complement them as much as possible! Best of luck to you.

klone, MSN, RN · May 28, 2010

OB NEEDS more nurses who believe in natural childbirth!

If nothing else, it will get your foot in the door, gain you some experience, and then you can move onto a facility that is less interventionist and employs midwives.

Even though the majority of births I see are highly managed with Pit or Cyto and an epidural, I still see enough natural births with midwives, or even waterbirths, that make dealing with everything else totally worth it.

There are enough women out there that desire a more natural birth, and will appreciate having a nurse who respects and will help her achieve those desires, and they will appreciate you and always remember you for it.