Discouraged L&D RN

Published

I work in a small unit in North Louisiana and I am having a hard time with dealing with how OB pt's are handled here. My husband is in the military and I have been liscensed in 8 states and I have never seen anything like it! Probably 95% of our deliveries are by induction. we admit most of them at MN for cytotec and then pit in the am starting at 37 weeks. I read that ACOGs position is that no baby should be delivered befor 39 weeks unless medically indicated. The doctors here mostly don't give a reason but if they do the fav response is "IUGR" or "lagging AC". Needless to say they don't come out IUGR! If they don't del before 4 or 5 then they are sectioned. The goal for the doctors is to get them all delivered before Friday so their call partners don't have to deliver them over the weekend! The sad part is that the patients here think it is fine and most willingly come in to be induced. If someone refuses to be induced they are labled "granola people" and the doctors are annoyed by them! I don't know how I will be able to not get fired because I speak up to much!! I keep asking my husband when we can transfer out but it will not be soon enough! Is it this way other places?

I work in a small unit in North Louisiana and I am having a hard time with dealing with how OB pt's are handled here. My husband is in the military and I have been liscensed in 8 states and I have never seen anything like it! Probably 95% of our deliveries are by induction. we admit most of them at MN for cytotec and then pit in the am starting at 37 weeks. I read that ACOGs position is that no baby should be delivered befor 39 weeks unless medically indicated. The doctors here mostly don't give a reason but if they do the fav response is "IUGR" or "lagging AC". Needless to say they don't come out IUGR! If they don't del before 4 or 5 then they are sectioned. The goal for the doctors is to get them all delivered before Friday so their call partners don't have to deliver them over the weekend! The sad part is that the patients here think it is fine and most willingly come in to be induced. If someone refuses to be induced they are labled "granola people" and the doctors are annoyed by them! I don't know how I will be able to not get fired because I speak up to much!! I keep asking my husband when we can transfer out but it will not be soon enough! Is it this way other places?

This is one of the few reasons why I won't work in L&D. Birth has become a medical event in this country and it sucks. :sniff:

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I have a question...I'm only a student and haven't even started nursing school yet so I'm a little unaware of how it works. If I was having a baby and really wanted to avoid the pitocin route, as in I'd like to labor naturally and have the option of an epidural if I decided I needed it....would I be able to choose that method if I was low risk? What I'm asking is can they just automatically give you pitocin if you're in early labor and they want to move things along? Personally, from the experiences I keep hearing from friends who have recently delivered, they were brought in in early labor, given pitocin and an epidural which seemed to just perpetuate this vicious cycle where they needed more pitocin and eventually had a c-section. Like every single one of them had this situation!! These were not high risk women, no breech babies, nada. They didn't seem to see the issue, they were under the impression the baby was going to be in danger w/o the c-section, which at that point was probably the case....but knowing what I know about the use (overuse I think) of pitocin, I'm wondering if it's possible to have a baby without pitocin anymore??? Will I be forced to use it? Or can I say no? This is hypothetical, I'm not pregnant and it'll be a couple years before I plan to be. Just wondering about this....

As long as there's no medical need to speed things along, then it's your choice. I think the best thing for a mother to do is write up a birth plan so the staff knows ahead of time what you want and don't want. Labor has to happen in steps, inducing skips certain steps...that's why problems can happen, including needing a c-section. It's true, inducing increases the chance of having a c/s...hence the reason this country has a high rate of both. What women have to know is that it's their birth NOT the Drs. You can refuse anything you like.

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Specializes in Community, OB, Nursery.

Absolutely you can refuse the Pitocin. I wish more people would!

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Thanks for the replies! I am not saying I would refuse anything that was necessary...just like, why are all my friends who've recently had a baby telling me how they had their water broken and were given pitocin, and then eventually had the c-section? Scares me that it's going to be like that for me someday. I just want a more natural route, like go into labor and wait at home until it's appropriate to go in.

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Find a midwife provider, birth in a free standing birth center, consider birthing at home, hire a doula, become an informed, but not rigid, consumer. All the above will assist you in having as normal and natural a birth as possible.

IMO :twocents:

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you have described almost every L&D unit i've worked on, besides one in iowa and one in berkley, california. in my current hospital, our patient population is a bit 'uppity' and they LOVE the way things work, they want their delivery scheduled so that family can fly in and yada yada. people come in at 37 wks wanting to deliver, and everybody wants their epidural in the parking lot.

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