Yes, I'm old and rickety...but, I HATE birth plans!! Especially those that include NO vag exams unless she needs to push (wth), or NO IV access (wth), or NO fetal monitoring (WTH!!) etc.....
It just annoys me to no end that a girl comes in and tries to tell me what is best for her and her unborn baby, and totally interferes with efforts to keep her and her baby safe.
Then there is the sig other that really annoys me by being the patients mouth piece. "No, she doesn't need pain meds", or "No, she doesn't want to lay off of her back".(when having variables down to 60x60...UGGGG!!
These people need to just have their babies at home, and leave my nursing license out of it!!!
Anyone else bothered by birth plans? Maybe it's just me.
While I'll conceded that most OB residents are schooled in the method of "what can go wrong" to the point of near exclusivity, the fact is that *those* particular residents intervied in the film have, of course, seen intervention-free labors, albeit not nearly as many as they should.
Their OB residency was spent at two different hospitals: one private high-end facility where everyone was a social indx or an IVF multiple pregnancy or an elective CS or whatever, and the other a municipal facility with no private MDs at all and the midwifery clinic saw 99% of the lo-risk Moms leaving the MDs with all the rest.
I fault the hospital for that oversight. It's a big one. Those MDs didn't hone their skills on "what can go wrong" simply because that's all they were taught, it was more because that's all they were exposed to in the first place by design.
Damn shame.
If you've ever seen the documentary "The Business of Being Born", they interview several OB/GYN residents. When asked how many natural, intervention-free labors they had been involved with, all of the docs just kinda looked around at each other. Of course, their answer was "none." They are taught in med school all of the things that can go "wrong" with a delivery and they don't focus on how natural birth is.....
I guess I just don't understand why fellow nurses would have a problem with this post, especially those who work L&D.
I have worked in this area for 23 yrs. I have seen my share of bad outcomes. My job is to get a healthy newborn (and Mom) out of the deal, not a dead one, or one that is disabled for it's entire life.
I know my job and I do it well. Maybe if I put it into this perspective those who don't work L&D would see my point.
How about someone coming into the ER with chest pain,sob,pain in L arm, that has an "MI plan"? Or maybe someone coming in unable to speak, drooping on one side of their face, and unable to communicate but has their "CVA plan"? Or, a parent with a sick child that has their "menengitis plan". It's rediculous. My view is...if you come to the hospital for any reason you should expect the experts to take care of you doing what they know to do. Otherwise, stay home!
(dodging daggars)
BIG difference... Mr. MI is sick, but a birthing mama is not. A birthing woman is doing something natural that our society has twisted and turned on its axis until it's one of the most unnatural events I've seen. Her birth plan is an attempt to untwist things and keep some semblance of normalcy. Do some research. Discover how childbirth came to be what it is today. Those responsible for its downward spiral made comments comparing women to salmon, suggesting that we were meant to be used up in the process. They felt it was best to sedate women and chain them to beds, knock them out with scopalamine, and then pull out a baby with forceps. It's pretty disgusting that ANYONE feels that one of the most memorable, special moments in a woman's life should best be accomplished by making things easier for the doctors and nurses. You know, weddings are a pretty special time in women's lives too...perhaps you want to come in and tell them how they should best accomplish this task also?
Yes they absolutely do. Preferably [b']before[/b] becoming pregnant. Doctors or midwives worth their salt will start having these conversations about childbirth at their facility long before delivery day.
That being said, many women aren't lucky enough to have a lot of options. The hospital she's at may be the only one in a 25-50 mile radius. That's pretty far away if you have to travel on rural roads.
Questions for you L&D nurses: Do most of the docs in your facility have the same mentality/philosophy re: childbirth or are there some variances? The other question is: Is there a way to let the women out there know who's more "natural birth friendly" than others without causing a major rukus?
Those two things would be helpful for women to know if Hospital A is their only option other than an unattended birth.
I'm at a LARGE teaching facility very close to you that I'm sure you know of... our MDs have a very wide variance, as do our CNMs. I think it's hard for me as a nurse to get the word out, because I don't have contact with the women when they are seeking a provider. I think that patients are in the best position to let others know when they talk to others about their birth experiences. What's sad is that our largest, most popular OB groups are the ones who intervene the most.
No, I'm an Oncology nurse. I've toyed with the idea of working L&D someday, but I'm really not an adreneline junkie. I would think part of you would have to be. We have Onc. emergencies to be sure, but we get schooled in the early, seemingly insignificant S/S. Seems to really cut down on the "blow-up in your face" activity.
Are you at the "Baby Factory?" I guess it would put you in an awkward spot to recommend or not recommend a particular provider.
Yes, I'm old and rickety...but, I HATE birth plans!! Especially those that include NO vag exams unless she needs to push (wth), or NO IV access (wth), or NO fetal monitoring (WTH!!) etc.....
It just annoys me to no end that a girl comes in and tries to tell me what is best for her and her unborn baby, and totally interferes with efforts to keep her and her baby safe.
Then there is the sig other that really annoys me by being the patients mouth piece. "No, she doesn't need pain meds", or "No, she doesn't want to lay off of her back".(when having variables down to 60x60...UGGGG!!
These people need to just have their babies at home, and leave my nursing license out of it!!!
Anyone else bothered by birth plans? Maybe it's just me.
I must say I don't agree with you at all and I worry that you have some issues with wanting to be in total control. I once read a comment from a patient that I will never forget and I have thought of it often to guide my practice, the patient wrote "I felt like the staff treated me as if my baby was a gift from the hospital to me and not my baby." The birth experience is the woman's experience, not the nursing staff's. Most people have very strict birth plans because they feel they have to in order to have the experience they desire. I have found that when patients have requests that I find unreasonable, such as NO monitoring, if I explain the reason behind monitoring with them, and recognize their reason for the request, they become very reasonable. I will explain that monitoring does not necessarily mean being on the monitors continuously but that we can do intermittent monitoring or auscultation (both approved methods per AWHONN) unless there becomes a reason that we may be concerned for the baby's well-being. I have NEVER had a patient refuse after I talk to them about it. A birth plan indicates to me that the woman and her partner have considered how they want their experience to go and have done some reasearch there are some nurses that feel threatened by that.
We often forget that birth is a natural process and not a medical intervention, women need us to help them through the process, not save them from it.
Are you at the "Baby Factory?" I guess it would put you in an awkward spot to recommend or not recommend a particular provider.
Yes...that's where I'm at. It can definitely seem like a baby factory at times, but most women get the experience they desire. (Almost all women who come there WANT an epidural, etc...) If someone wants a natural, intervention-free birth, it can definitely happen there, but unfortunately her nurse won't be at her side to help her through it, so I strongly suggest a doula or a good support team.
I can definitely recommend providers. If you want info let me know. I just don't have exposure to women when they are newly pregnant and trying to find a provider. Otherwise, I think all of us nurses would steer everyone away from a few providers and they'd be run out of town. And just like some doctors being better than others, the same applies to the nurses. There are several of us who are in school to be midwives, so we usually try to take the patients who want a low-intervention, natural birth.
We often forget that birth is a natural process and not a medical intervention, women need us to help them through the process, not save them from it.
I understand what you are trying to say and I agree with you 100%... unfortunately in today's world of UNnatural childbirth that the MDs have created, women DO need saved from it. 99% of what makes childbirth "dangerous" is the needless interventions we do. If you take pitocin, misoprostol, cervidil, stadol, and epidurals out of the equation, childbirth is a very safe process.
Yes...that's where I'm at. It can definitely seem like a baby factory at times, but most women get the experience they desire. (Almost all women who come there WANT an epidural, etc...) If someone wants a natural, intervention-free birth, it can definitely happen there, but unfortunately her nurse won't be at her side to help her through it, so I strongly suggest a doula or a good support team.
I can definitely recommend providers. If you want info let me know. I just don't have exposure to women when they are newly pregnant and trying to find a provider. Otherwise, I think all of us nurses would steer everyone away from a few providers and they'd be run out of town. And just like some doctors being better than others, the same applies to the nurses. There are several of us who are in school to be midwives, so we usually try to take the patients who want a low-intervention, natural birth.
No, I'm good. I've been going to the midwives for the past 4-5 years and I love it. I hope we don't ever have to move where the options aren't as good or as many. When we do United Way, I always do my payroll deduction to them b/c I'm so grateful to live somewhere that has the options they offer. Just from this thread alone, I realize that sometimes we take for granted that we live live in a big healthcare center and all that comes with it.
I had my baby at home (now 16 months) and would highly recommend it. I had my first in a hospital long ago..... boy was that a horrible experience!
I am so sorry that anyone is against the birth plan. It is just so difficult for some people to have their children at home since it isn't always paid for (we had to pay out of pocket) and certainly isn't socially accepted. But the fact of the matter is, birth isn't a medical procedure. And what a WASTE of medical resources to make it one.
And please don't tell me your baby horror stories - these aren't the norm.
Until we can change birth in this country, please respect the parents' wishes. It is their child.
we had a lady with one of these and boy was she loco...Did not want an epidural but then begged for one at 5 cm. Later, claimed we forced her to have one (yeah, we bent you over the bed with restaints and made you).
Then, she wanted to get on her hands and knees to push, the nurse tried but for some reason her legs wouldn't stay up and kept sliding down the bed. She blames this nurse for her having to have a (gasp!) C-S for her 9lb 5oz baby with a 14 1/2 in head!
She told the L and D nurse, " if only you had let me get onto my hands and knees I would've had the baby naturally"...she had been pushing for over two hours.
I had my baby at home (now 16 months) and would highly recommend it. I had my first in a hospital long ago..... boy was that a horrible experience!
I am so sorry that anyone is against the birth plan. It is just so difficult for some people to have their children at home since it isn't always paid for (we had to pay out of pocket) and certainly isn't socially accepted. But the fact of the matter is, birth isn't a medical procedure. And what a WASTE of medical resources to make it one.
And please don't tell me your baby horror stories - these aren't the norm.
Until we can change birth in this country, please respect the parents' wishes. It is their child.
I don't think most people are against reasonable, well thought out birth plans. It is the unreasonable, adversarial birth plans that make the whole process difficult. I'm referring to ones in which everything is expressed in negatives "I don't want this" or "No one is to do that" rather than a positive expression of how you would like your birth experience to be. I see entirely too many that are simply downloaded from the internet, often without even "filling in the blanks" and when you ask the couple "Do you understand this term?" or do you understand that if we do this (one demand) then that (another demand) is not possible?" they have no idea what it means.
I enjoy doing deliveries with well informed mothers/couples wanting an unmedicated, low intervention birth. I generally volunteer to take thise patients. The important thing to remember though is that if you make the decisions you have to be willing to take responsibility for the outcomes - good or bad, realize that birth is unpredictable, seldom textbook, and not expect to blame the provider if the outcome is different than you expected.
I guess it would put you in an awkward spot to recommend or not recommend a particular provider.
IndigoCarmine
70 Posts
Well...yes and no.
While I'll conceded that most OB residents are schooled in the method of "what can go wrong" to the point of near exclusivity, the fact is that *those* particular residents intervied in the film have, of course, seen intervention-free labors, albeit not nearly as many as they should.
Their OB residency was spent at two different hospitals: one private high-end facility where everyone was a social indx or an IVF multiple pregnancy or an elective CS or whatever, and the other a municipal facility with no private MDs at all and the midwifery clinic saw 99% of the lo-risk Moms leaving the MDs with all the rest.
I fault the hospital for that oversight. It's a big one. Those MDs didn't hone their skills on "what can go wrong" simply because that's all they were taught, it was more because that's all they were exposed to in the first place by design.
Damn shame.