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.
The frustrating thing for me when it comes to birth plans is that usually the MD has not really spoken with the parents about what happens at the hospital. Or, they tell the parents what they want to hear and then when the reality doesn't match what the MD assured them would happen, we as RNs are now the enemy.
I think we are ignoring the elephant in the room--MDs. They have the most control over what is possible and have often raised the parents hopes--or not addressed them at all. I have been working registry and find that this is universal. The MDs stay the good guy and we end up with the struggle for compromise.
Excellent point, Janey. I was lucky enough when I was pregnant with ds to have an OB that had everybody at 36 weeks sit down with the RN educator of their office. We talked about what the docs preferred for labor and what I would like. Most of what they preferred I was ok with too, none of it was over the top. I would have like to eat during labor (even snuck some jello in) but had n/v anyway and didn't really care to. We were lucky to have someone sit down w/ us before we ever darkened the hospital door and go over stuff with us.
The frustrating thing for me when it comes to birth plans is that usually the MD has not really spoken with the parents about what happens at the hospital. Or, they tell the parents what they want to hear and then when the reality doesn't match what the MD assured them would happen, we as RNs are now the enemy.
I think we are ignoring the elephant in the room--MDs. They have the most control over what is possible and have often raised the parents hopes--or not addressed them at all. I have been working registry and find that this is universal. The MDs stay the good guy and we end up with the struggle for compromise.
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)
Because a MI, CVA, and meningitis are illnesses. Childbirth is not an illness. MI, CVA, and meningitis need medications and interventions for the patient to get better. Childbirth needs no medications or interventions for the patient to "get better".
I would venture to say that many people are not reasonable, especially when it comes to a bad pregnancy outcome.
I am aware of a case in which a couple presented to a new OB for prenatal care with their second child. The first baby had been delivered by C-section less than a year prior. The OB discussed with the couple from the first prenatal visit the increased risk of complications of labor (uterine rupture) due to the brief interval between pregnancies and the importance of considering and being prepared for a C-section if needed. The OB requested records from the first pregnancy, which the couple never produced.
The issue was re-visited during subsequent prenatal visits and well documented, but the couple consistently refused to consider a C-section. The OB suggested a second opinion or transfer to another OB which the couple also refused.
Fast forward to labor. The couple notified the OB that labor had begun, but refused to come into the hospital, despite the OB's reassurance that she would not and could not perform a C-section without consent. When the mother began to hemorrhage, she came into the ER and was met by the OB who was unable to save the baby or the mother's uterus.
The couple sued and prevailed in a jury trial. Upon interviewing the jurors post trial, the defense attorney learned that the jurors didn't really think that the OB was negligent, but felt that since a baby died, someone should compensate the parents.
Last I knew, the OB was seriously considering giving up her practice.
I realize that cases of this severity are rare. But they give pause to conscientious OBs and nurses who really try to do the best for their patients and their babies and fear repercussions from patients who consistently refuse recommended care.
This sounds like a legal/courts/ jury issue than a doctor issue. If they are rendering a verdict against someone who they don't believe was at fault....
That's just it, had you clarified that in the OP, I doubt you would have recieved such heated replies.
The extreme one's are annoying, but a little positive , non patronizing communication can go a long way.
I had a pregnancey loss two weeks ago, I was 25 wks.
The nurse I had treated me like I was five years old: telling me to use my "big girl words" instead of moaning when I was delivering my son! I wanted to tell her to ****, but I had other things on my mind.
Anyway, I know that most nurses are NOT like that, but this didn't exactly leave me a good image.
Sorry for the rant, I just fail to see how "horrible" birth plans are.
OMG, that's terrible! I would have thrown her out and gotten someone else in there ASAP with a follow-up to the manager. I still would folow-up with the manager in short order. I also don't think I could have been so nice. :angryfire
Sorry for your loss of your beautiful boy! :flowersfo
Unfortunately this doesn't seem to be the case as much these days. It seems a matter of the squeaky wheel getting the grease. Also, docs only have certain OR days, or deliver on certain days, or the docs (or the parents) want the baby born before they go on vacation to the golf resort. I know moms who have griped and whined that their regular OB scheduled a vacation around their delivery dates. Personally, if I'm in labor, I don't care who walks in for five minutes and catches the baby. (As long as he/she is qualified.) I really don't think you're going to want to hold it in at that point for "your" doctor.[/quote']
LOL, i did care who walked in and caught my baby. I wanted MY doctor, not one of his 2 partners. And, he did have a vacation out of state in my 39th week, lol. Still didnt get an induction and didnt have the baby while he was gone, either.
My thought, (and no, I did not have a written birth plan but I certainly will next time) about the MD that delivers. It is more than just someone who plays catch at teh end. They are the ones who decide if you've been laboring "too long" and pressure you to c/s. THey are the ones who look at your fetal monitor and decide if the baby looks stressed and needs to be cut out, or if you can wait. They decide if they are comfortable with you pushing on hands and knees or not. Sure you can refuse any of what they decide, but it certainly is easier when they agree with what you want.
However, I have read birth plans where the couple want to have intercourse in the delivery room to naturally induce labor. Ummm, no, I'm not comfortable with that. I understand from some of the birth plans that thumb sucking may also stimulate contractions and that ones no problem for me.
I also bristle a bit at the birth plan that dictates "The nurse shall not use the word "contraction" or "pain". I guess it's a "surge" and "pressure". I respect the effort by the couple to "own" the process, but insisting on vocabulary changes is just tough to remember to do.
However, I have read birth plans where the couple want to have intercourse in the delivery room to naturally induce labor. Ummm, no, I'm not comfortable with that. I understand from some of the birth plans that thumb sucking may also stimulate contractions and that ones no problem for me.
I also bristle a bit at the birth plan that dictates "The nurse shall not use the word "contraction" or "pain". I guess it's a "surge" and "pressure". I respect the effort by the couple to "own" the process, but insisting on vocabulary changes is just tough to remember to do.
However, I have read birth plans where the couple want to have intercourse in the delivery room to naturally induce labor..
Well, that tops the "post birth plan" where the father of the new babe ripped off his shirt and put the babe to his own nipple. (yes, we took turns going in to verify that was happening.)
Well, that tops the "post birth plan" where the father of the new babe ripped off his shirt and put the babe to his own nipple. (yes, we took turns going in to verify that was happening.)
All I can say is YUCK!
Oh, honey, come work at my hospital! We encourage immediate skin to skin contact between new born and either parent. Bare chested men with sticky, vernix covered little ones all snugged into the chest hair is an everyday sight around my workplace. The nurses call it a "man nest".
Skin to skin is great, and bare chests I can take. I just draw the line with naked Dads in the tub with laboring Moms. The first thing I ask if someone comes in planning a water birth is if they remembered Dad's trunks!
:flowersfo
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JaneyW
640 Posts
The frustrating thing for me when it comes to birth plans is that usually the MD has not really spoken with the parents about what happens at the hospital. Or, they tell the parents what they want to hear and then when the reality doesn't match what the MD assured them would happen, we as RNs are now the enemy.
I think we are ignoring the elephant in the room--MDs. They have the most control over what is possible and have often raised the parents hopes--or not addressed them at all. I have been working registry and find that this is universal. The MDs stay the good guy and we end up with the struggle for compromise.