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.
How many studies need be done to demonstrate that excessive intervention does not improve outcome? We all know that increased use of inductions results in increased intervention, leading to increased c/s rate. Each c/s increases risk of many other grave complications. It has been abundantly demonstrated that more monitoring does not improve outcomes--it is prudent use of monitoring that provides the assessment tool needed to lead to intervention if concerns arise involving babe. It has been abundantly documented that a constant birth attendant at a laboring woman's side decreases risk of need for interventions and c/s rate. The problem lies in the fact that hospitals profit greatly from baby factories where women and nurses buy into a birth culture where everyone is induced at 38-39 weeks, gets her epidural, AROM by luunch---all leadinng to an unacceptable, but profitable c/s rate. I have only been reading the posts on the web site for a week, but it has become painfully clear to me that OB care in this country is primarily not evidence based. sad for child bearing families and for nurse satisfaction.
Very nicely put.....I couldn't have said it better myself!!!
Birth plans? Oh, they're just dandy, as long as they aren't INSANE!
NO you cannot burn candles or incense.
NO you cannot drink merlot to relax.
NO I will not be tailoring my language to suit you. They're called contractions, and that's what I'll refer to them as if for some reason I ned to refer to them aloud.
YES I'm going to be putting ID bands on your baby. You cut them off, guess what? You're going to have a helluva time taking that babe home.
I have no problem with PO fluids over IV if you're a healthy Mom, but if there is one--ONE--med issue? Then I need access. Just access. Oh, it's your fifth baby? Then I need IV access. Just access. Is that too much to ask? Not in a hospital, it's not.
What sux is that our U.S. attitudes toward childbirth have gotten so incredibly out of whack that Moms feel like they have no choice but to come in swinging. It's adversarial right from the get-go. it's a damn shame.
And you know what? I was raised by my Nursemommas on "Pain Is The Fifth Vital Sign" and you may not want me to offer you pain medicine but I ain't promisin' that I won't.
Birth plans? Oh, they're just dandy, as long as they aren't INSANE!
NO you cannot burn candles or incense.
NO you cannot drink merlot to relax.
NO I will not be tailoring my language to suit you. They're called contractions, and that's what I'll refer to them as if for some reason I ned to refer to them aloud.
YES I'm going to be putting ID bands on your baby. You cut them off, guess what? You're going to have a helluva time taking that babe home.
I have no problem with PO fluids over IV if you're a healthy Mom, but if there is one--ONE--med issue? Then I need access. Just access. Oh, it's your fifth baby? Then I need IV access. Just access. Is that too much to ask? Not in a hospital, it's not.
What sux is that our U.S. attitudes toward childbirth have gotten so incredibly out of whack that Moms feel like they have no choice but to come in swinging. It's adversarial right from the get-go. it's a damn shame.
And you know what? I was raised by my Nursemommas on "Pain Is The Fifth Vital Sign" and you may not want me to offer you pain medicine but I ain't promisin' that I won't.
Do you even realize how hard it is to have a pain-med free birth at a hospital? Well, I DO! I managed to be induced and chose NO PAIN MEDS at all- due to my preferences. But your attitude is really negative. Yes, I can understand that the word is "contractions" but when someone is using concentration/relaxation/hypnosis to relieve pain- all it does is hinder their efferts when they are trying to think about everything BUT pain- doing well- and the nurse interrupts saying, "How bad are you hurting. Are your contractions painful? Do you need an epidural yet?" Is it really THAT hard to understand why someone wouldn't want you to use negative words when they are trying to do the near impossible- which is a med-free childbirth? When someone is trying to AVOID pain, there is no reason to change your language. Pain is pain. But when someone sees the pain as normal and is trying to work WITH it, despite it, overcome it- it is nothing but destructive to keep bringing up the pink elephant in the room. You can ask someone how "intense" things are getting, and have a good idea of their pain level. Also, you can ask someone how they are coping or managing- and they can say good or bad. That is plenty suffiecient and respects the wishes of your patient.
I can actually understand why you want an IV access. It's obvious. I can also understand why you would need fetal heart monitoring and all of the other procedures. But the bad attitude toward LANGUAGE is just that- a bad, stubborn attitude that only hurts natural birthing moms. What does it hurt you not to say a WORD when someone asks you not to? You want MOTHERS IN LABOR to be flexible, but YOU can't even give that much? Please.
Do you even realize how hard it is to have a pain-med free birth at a hospital? Well, I DO! I managed to be induced and chose NO PAIN MEDS at all- due to my preferences. But your attitude is really negative. Yes, I can understand that the word is "contractions" but when someone is using concentration/relaxation/hypnosis to relieve pain- all it does is hinder their efferts when they are trying to think about everything BUT pain- doing well- and the nurse interrupts saying, "How bad are you hurting. Are your contractions painful? Do you need an epidural yet?" Is it really THAT hard to understand why someone wouldn't want you to use negative words when they are trying to do the near impossible- which is a med-free childbirth? When someone is trying to AVOID pain, there is no reason to change your language. Pain is pain. But when someone sees the pain as normal and is trying to work WITH it, despite it, overcome it- it is nothing but destructive to keep bringing up the pink elephant in the room. You can ask someone how "intense" things are getting, and have a good idea of their pain level. Also, you can ask someone how they are coping or managing- and they can say good or bad. That is plenty suffiecient and respects the wishes of your patient.
I can actually understand why you want an IV access. It's obvious. I can also understand why you would need fetal heart monitoring and all of the other procedures. But the bad attitude toward LANGUAGE is just that- a bad, stubborn attitude that only hurts natural birthing moms. What does it hurt you not to say a WORD when someone asks you not to? You want MOTHERS IN LABOR to be flexible, but YOU can't even give that much? Please.
And then as a country wonder why a mother comes in swinging? lol
Do you even realize how hard it is to have a pain-med free birth at a hospital? Well, I DO! I managed to be induced and chose NO PAIN MEDS at all- due to my preferences. But your attitude is really negative. Yes, I can understand that the word is "contractions" but when someone is using concentration/relaxation/hypnosis to relieve pain- all it does is hinder their efferts when they are trying to think about everything BUT pain- doing well- and the nurse interrupts saying, "How bad are you hurting. Are your contractions painful? Do you need an epidural yet?" Is it really THAT hard to understand why someone wouldn't want you to use negative words when they are trying to do the near impossible- which is a med-free childbirth? When someone is trying to AVOID pain, there is no reason to change your language. Pain is pain. But when someone sees the pain as normal and is trying to work WITH it, despite it, overcome it- it is nothing but destructive to keep bringing up the pink elephant in the room. You can ask someone how "intense" things are getting, and have a good idea of their pain level. Also, you can ask someone how they are coping or managing- and they can say good or bad. That is plenty suffiecient and respects the wishes of your patient.
I can actually understand why you want an IV access. It's obvious. I can also understand why you would need fetal heart monitoring and all of the other procedures. But the bad attitude toward LANGUAGE is just that- a bad, stubborn attitude that only hurts natural birthing moms. What does it hurt you not to say a WORD when someone asks you not to? You want MOTHERS IN LABOR to be flexible, but YOU can't even give that much? Please.
You are 100% missing my point and you are 100% over-reacting. Also, I'm not 100% certain that you actually read my post at all.
I'm far from negative, I'm as flexible as they come and I deal with pts who desire "natural" birth (natural being a subjective & relative term) all the time. I don't care if a pt calls it "strong" or "surges" or "rushes" or "pain" or whatever. I call them ctx because that what they are. I also pointed out that I'll only use the word IF I need to say it out loud at all. Funny how you can get through a labor without using a word. It IS possible, but if it needs to be said, then it needs to be said.
Sorry if YOU had an experience where a nurse interupted your chosen drug-free-birth choice with questions of "WHEN" are you getting your epidural or "Are you ready for your epidural YET" but that nurse wasn't me, and I actually don't do that. Ever. Nor did I mention that I offer epidurals mid-contraction in my post so kindly stop putting words in my mouth.
While I'm here, I'd like to also say that "Pain is pain" isn't remotely accurate. Pain is what you make of it. Pain is whatever you create it to be. Pain isn't something else simply because you give it another name. It is MY JOB to offer relief from pain no matter what it's called. Case closed. It would be my job whether I worked on med-surg or labor or onc or a burn unit. Everyone gets The Offer upon admission.
Did you not see my point about what the culture has done to expecting women? Coming out swinging? And what a shame it is?
You are 100% missing my point and you are 100% over-reacting. Also, I'm not 100% certain that you actually read my post at all.
I'm far from negative, I'm as flexible as they come and I deal with pts who desire "natural" birth (natural being a subjective & relative term) all the time. I don't care if a pt calls it "strong" or "surges" or "rushes" or "pain" or whatever. I call them ctx because that what they are. I also pointed out that I'll only use the word IF I need to say it out loud at all. Funny how you can get through a labor without using a word. It IS possible, but if it needs to be said, then it needs to be said.
Sorry if YOU had an experience where a nurse interupted your chosen drug-free-birth choice with questions of "WHEN" are you getting your epidural or "Are you ready for your epidural YET" but that nurse wasn't me, and I actually don't do that. Ever. Nor did I mention that I offer epidurals mid-contraction in my post so kindly stop putting words in my mouth.
While I'm here, I'd like to also say that "Pain is pain" isn't remotely accurate. Pain is what you make of it. Pain is whatever you create it to be. Pain isn't something else simply because you give it another name. It is MY JOB to offer relief from pain no matter what it's called. Case closed. It would be my job whether I worked on med-surg or labor or onc or a burn unit. Everyone gets The Offer upon admission.
Did you not see my point about what the culture has done to expecting women? Coming out swinging? And what a shame it is?
You just proved my point. Thanks!
I have a question:
Is contraction a medical term of art? In other words, is it like a dx? If not, then why do you have to use it? Ever?
(Please read that as a sincere question. I haven't had OB yet.)
I agree that it is a requirement to offer pain medications to patients. My limited clinical and educational experiences have drilled that fact into my head. I think it really depends on how you present it. It sounds like some people feel meds are being pushed on them and let's not pretend like there aren't some folks who seem to have their own agenda when it comes to medicated birth.
I think that what we can all agree on is that there are some practices that are used by SOME people that could use some uh, updating! I also think all of us who have birthed and had negative experiences would appreciate knowing that you can understand why we come out swinging the way we do.
After all, it seems we agree that there is a lot of unnecessary interventions and an emphasis on policies and accepted practices rather than on well, giving birth!
If someone resolves not to use pain medication, then to continue to offer it is inconsiderate. They don't want to be asked because they don't want to be tempted when they are vulnerable. They want to protect their children from being born on drugs.
Why can't OB nurses recognize and support the sacrifice these women are making for the sake of their babes?
I had my second child in a birthing center and it was wonderful. It's too hard to want things a certain way while delivering in a hospital. So many of the nurses see you as a PIA and don't know how to give life-affirming support to natural-birthing mothers. After all, their norm is NOT natural birth.
If you have a high-risk pregnancy, go to a hospital. If you don't care at all about tech things and crave an epidural, go to a hospital. If you want to walk, eat, choose your own position, have a doula, get expert midwifery care, and have access to a hospital if needed, go to a birthing center.
If you want to walk, eat, choose your own position, have a doula, get expert midwifery care, and have access to a hospital if needed, go to a birthing center.
Unfortunately many women don't have this option. I am lucky that I live 5 minutes from the birth center where I will be delivering (granted this baby doesn't get too comfy in there and go extremely overdue). However, it is the only birth center in the ENTIRE STATE where I live. In many states, especially those with very rural areas, birth centers are few and far between....and in several states homebirth with a midwife is actually illegal and/or there are no midwives in their area who perform homebirths. So basically these women have no choice but to deliver in the hospital.....even when a natural birth is desired. And then they run into attitudes like some of the posters on here have displayed......because let's face it, most hospitals do not in any way cater to "natural birth"....
FireStarterRN, BSN, RN
3,824 Posts
Excessive intervention is mainly legally motivated, since if something happens and you didn't intervene, people will sue.