Do birth plans grate on your nerves?

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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 think women should choose an appropriate setting that matches their birth philosophy. It is hard to have a natural birth in a hospital and a lot of this tension gets thrown in the direction of the nurse in the form of a birth plan. It would be nice if women had more birth center options and more midwives being able to practice at home. We are working on a bill for midwives in NC right now.

I totally agree about women needing more options for birth locations!! As a nurse, I know that we are often caught in the middle between hospital "policy" and the patient's desires, which can be pretty uncomfortable. But I think a lot of the tension directed at nurses in the form of a birth plan could be avoided if some nurses were more respectful of patient autonomy and the patient perceived the nurse as her advocate. In the end, no one can force a patient to have any intervention unless she consents, whether we agree with her choices or not... and she should not have to fight tooth and nail to be shown the respect she deserves.

I know that some women aren't so nice in their approach, but I honestly think it's a result of conditioning... they've been told (accurately or inaccurately) that they will have to fight to get what they want. And too often it is an accurate portrayal.

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Specializes in Emergency Department.
We had a patient recently who did not want her baby to be bathed while in the hospital... at all. Bleh! Apparently it's a new 'thing' now. Gross.

I think they call it bonding :rolleyes: Bathing the baby scrubs away its scent and interferes with yet another primal bonding opportunity.

My clients seldom bring me a birth plan (I'm a home birth midwife, soon to be student nurse) and I go over it in detail. I want to understand their motivation behind their requests. Are they asking for certain things out of ignorance or fear? And would any of those requests interfere with my ability to provide them safe care. We both have to understand what might be a deal breaker with regard to the plan.

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Specializes in Neurology.

I work as a doula (taking prereqs for nursing school) right now and most of the time the nurses are great. The csection rate at the hospitals is terrible though. Most of the time refusing interventions ends up with us being one of the few lady partsl deliveries. Hard to fault the patient for wanting a better outcome. Personally, I had my second and third babies at home with a midwife :)

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Specializes in Emergency Department.
I heard something a few weeks ago that really bothered me. It wasn't a nurse that said it, but a second-year resident. "Normal lady partsl delivery is a retrospective diagnosis."

I heard that somewhere also.

About 6 years ago I was acting as a doula to a woman in at a teaching hospital. There was a FP doc on the unit and he was all about doing whatever the woman wanted, which amounted to laboring in the water, intermittent monitoring, and no IV so long as everything looked good. He agreed and went out of the room. A few minutes later he was in to push an IV, but was very weak with his arguments. He was turned down and left the room. This went on a couple of times while the woman labored in the jacuzzi tub and the last time he pushed it he confessed it was the nurse who really wanted it and he was fine without it. A few minutes later the nurse came busting in and announced it was time to monitor the baby. She took the waterproof doppler and applied to the mother's chest where she got an obvious

So off to the bed mother goes in a rush, first she starts the IV, then she starts the emergency monitoring for that baby who was bradycardic. What do you know? The baby was fine now that she put the monitor on the lower abdomen and not over the mother's chest. Mission accomplished: she got the IV started. She pumped her so full of fluid and restricted her to bed even after the woman complained of a bladder so full I thought I was looking at a bulging head above the public bone. When it was convenient she emptied her bladder with a catheter and got about 1L out into the foley bag. Mom was ready to push soon after and crying with relief that the ordeal was over. I started sweet talking her about all the adversity she'd overcome and how her baby was almost out and Nurse Wonderful said, "Nuh-uh honey, she's a section until the baby's on her chest." Nice! All that because mom didn't want an IV. Her FP who was precepting the other FP apologized for the nurse's behavior.

Anyway, when I get through nursing school, I'm not sure I can work L&D. I know I can be the L&D we'd all love and try to be, but will the powers that rule the world allow that to happen??

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Specializes in OB, HH, ADMIN, IC, ED, QI.
I think they call it bonding :rolleyes: Bathing the baby scrubs away its scent and interferes with yet another primal bonding opportunity.

Years ago, the decision not to bathe a newborn immediately, was to retain the vastly nutritious and protective creamy vernix. Of course the genital region was cleansed after defecation, and rinsed following micturation.

However, most babies were bathed after a day or so, but the vernix wasn't "scrubbed off". Often the axillae kept traces of it. The purpose of it is actually to preserve skin texture while the baby is in utero, emersed in amniotic fluid. If meconium has been released into the amniotic fluid, it could make the vernix irritating, and should be gently removed, with almond oil (it's the most gentle). That would be the baby's first (of I hope many) massages, that are very beneficial for bonding.

I don't know if that theory was ever researched, or the vernix analyzed for content.

Those who think it's "yucky" have developed aversions to things that are uncommon, but harmless. Really full diapers of 1-3 year olds are yucky. I remember being disgusted by excess semen following intercourse, when I was much younger, but in time it just seemed messy, and was a less loaded occurrence. As we mature, adaptation is easier.

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Specializes in Emergency Department.

A baby bath: http://www.youtube.com/watch?v=WATnDPSs3iI :bluecry1:

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Specializes in Psych, Med/Surg, LTC.

That was awful. What a "welcome" to the world. :bluecry1:

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Specializes in Community, OB, Nursery.

Oh, ugh. Who the hell in their right mind washes a baby like that?! I know we don't where I work!

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we got a birth plan the other day for a c-section!! for a c-section!! saying dad would cut the cord, the baby would go straigth to her, blah, blah, blah.... it was really pretty funny! the best part of the whole thing was dad passed out in the or. no, he didn't get to cut the cord! = )

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Specializes in Emergency Department.
we got a birth plan the other day for a c-section!! for a c-section!! saying dad would cut the cord, the baby would go straigth to her, blah, blah, blah.... it was really pretty funny! the best part of the whole thing was dad passed out in the or. no, he didn't get to cut the cord! = )

How sad you think it's so funny :(

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Specializes in Ante-Intra-Postpartum, Post Gyne.

If you can't stand smart, independent, demanding women when it comes to THEIR baby, THEIR body, and THEIR birth; then maybe you are in the wrong department. Maybe its the feminist in my speaking but, I wish more women were like the ones many people complain about in this thread, they know what they want and what is best for them and their baby and their birth and they are not going to let some dogmatic attitude get in their way. Unless it is harmful why not let them have it? Because you might be inconvenienced? While this could be the most important day of your patients life, this is just another day for you; appease them a little.

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Specializes in L& D / GI NURSE.

Birth plans aren't so bad if people research things out a little more, i mean our hospital hasn't given a routine enema for a labor pt in like thirty years why are people still writing that crap (literally) down still Please talk to your dr, hosptial... It will save time when pts write out the 4 page birth plan,, it they would be aware of current practice.. :twocents:

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