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 know, WVUturtle, it's a shame, but apparently hasn't changed in at least 16 years, since I had my second child. Labor is a particularly hard time to have to stand up for yourself and your desires against resistance.
And rural areas that don't have anything like a birth center I bet tend to be even more 'conservative' (read that as 'inflexible').
It's ME having MY BABY--only by necessity am I doing it in YOUR HOSPITAL. The OP doesn't seem to realize that it is not her birth. The experience belongs to the mother, not to the hospital. This is totally a control issue.
And, YES, terminology is extremely important. Mine I called 'rushes of energy' (per Ina Mae Gaskin). It is a hard wave to ride. You can't control it, you have to ride it. Riding the wave of contractions takes plenty of concentration. But nurses who work in L&D who don't really give a **** about birthing mothers, and only really care about controlling the process, won't find it in their hearts to be advocates of a mother's natural labor and delivery. Who cares if I drink Merlot? I ate beef vegetable soup and it was delicious. I needed the calories and the fluid.
My midwife prob. called them contractions, but in my mind they were rushes of energy. What she said didn't bother me, because I knew beyond a shadow of a doubt that she was our advocate. A lot of this is attitude. And statements like 'birth plans are a PIA' tell a lot about attitude.
People know when a nurse is an advocate or an adversary. Certainly birthing mothers do.
If you are truely my advocate, then maybe I will be able to be flexible without feeling like I am being run over roughshod. If my midwife had said it was time to have an IV started or something like that, I would have been totally compliant, albeit worried.
I would have hoped by now that more L&D nurses had a heart for laboring mothers.
I wanted to be a lactation consultant, got certified and everything, but realized that there was no, no, no way that I could stand to be around the hospital birth environment, day in and day out.
I thought Ina Mae had some weird terminology. She refused to use the word 'lady parts', insisting on 'puss' instead. I thought that was vulgar, personally. I also thought the term 'rush' was a result of all the acid the people on The Farm used to take.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I am not a fan of Ina May's language, but her ideals, I respect.
Can't we learn to get along? Respectful dialogue that hard? Even here, we see how polarizing misunderstandings are. This very thread could stand as a great learning experience, if we can open our minds and be more willing to see the "other" side a bit.
Contractions are called that because the work of the uterine muscle is a contraction of that muscle. No different than working your delts: contract and relax, except that you can consciously do the delts yourself. That uterus is capable of doing it on its own.
The pain thing is another whole issue. And nurses, as a requirement of JCAHO and others, are mandated to address the pain issue on a regular basis. I have read of a new way to assess pain in labor which might help how we do it, but that is a new concept. As it is, we are stuck with you, and sadly, the patients are also. The anesthesia people where I work are far more pushy about it than any of the nurses.
They wander through and will go ask a patient, without talking to the nurse first, if they want an epidural, and if so, they'd better speak up, because I'm going to be in a 2-hour case in about 10 minutes and if you don't get it now, you're not going to get it for 3 hours; blah, blah, blah That personally ticks ME off, as the RN, but I can't really do a thing about it, except do damage control for the rest of my shift, especially if, on the rare occasion we have a patient who wants no pain meds.
At our hospital, it is the rare patient who gets or wants no pain meds, rare also for one who manages on Stadol, as the vast majority want that epidural and want it as soon as they hit the floor. And those of you who think that's what all RNS also want are wrong.
Where are all these mean and nasty L&D nurses that everyone is describing?? At my hospital we try to keep people off of monitors, without IVs, etc until a true need arises. We are all very supportive of natural birth so long as the patient arrives adequately prepared and informed, and it's pretty easy to tell who is serious and who isn't.
I don't think that any nurse would start a career in L&D with the bad attitude that many of you describe, but it's probably a hospital and its protocols that ultimately changes people. When your hands are tied due to policies, and the unit is short-staffed and you end up with multiple labor patients or triages, it's very easy for your attitude to go into the mode of doing what's most efficient to keep mom and baby safe and content from your point of view, which isn't always how the patient sees it because they don't always understand why we do the interventions that we do. An example would be someone who previously insisted on no IV access wanting an epidural NOW, and not understanding why she can't have it instantly.
We all want to help our moms have good experiences, it's just that because we've seen a lot, we view the road to that good experience differently. Birth plans are useful for articulating preferences, and as long as you don't come in to the hospital looking for a battle, you can work with your nurse and physician to understand why we do the things we do, and that birth is unpredictable. Ideally that education starts in prenatal visits, not on L&D.
As far as her philosophy, I loved her book, but I didn't like her hippy terminology.
I visited The Farm back in '81, they were all a bunch of potheads, they all lit up together in front of their kids. I stayed with a friend of a friend who lived there. In other ways they behaved like religious fundamentalists with strict gender roles and all the women in skirts. The women would all start the morning braiding their kids' hair (boys and girls)
" The anesthesia people where I work are far more pushy about it than any of the nurses.
They wander through and will go ask a patient, without talking to the nurse first, if they want an epidural, and if so, they'd better speak up, because I'm going to be in a 2-hour case in about 10 minutes and if you don't get it now, you're not going to get it for 3 hours; blah, blah, blah That personally ticks ME off, as the RN, but I can't really do a thing about it, except do damage control for the rest of my shift,"
OY! That makes me craaaaazzzyyyyyyyy! Right around 2AM they also bumrush the unit before they go to bed!
Where are all these mean and nasty L&D nurses that everyone is describing?? At my hospital we try to keep people off of monitors, without IVs, etc until a true need arises. We are all very supportive of natural birth so long as the patient arrives adequately prepared and informed, and it's pretty easy to tell who is serious and who isn't.
I don't think that any nurse would start a career in L&D with the bad attitude that many of you describe, but it's probably a hospital and its protocols that ultimately changes people. When your hands are tied due to policies, and the unit is short-staffed and you end up with multiple labor patients or triages, it's very easy for your attitude to go into the mode of doing what's most efficient to keep mom and baby safe and content from your point of view, which isn't always how the patient sees it because they don't always understand why we do the interventions that we do. An example would be someone who previously insisted on no IV access wanting an epidural NOW, and not understanding why she can't have it instantly.
We all want to help our moms have good experiences, it's just that because we've seen a lot, we view the road to that good experience differently. Birth plans are useful for articulating preferences, and as long as you don't come in to the hospital looking for a battle, you can work with your nurse and physician to understand why we do the things we do, and that birth is unpredictable. Ideally that education starts in prenatal visits, not on L&D.
I just left a facility that was hard core intervention for the convenience of the doctors and nurses. It was done out of necessity. Too many moms/babies and not enough staff. You had to be VERY proactive with your patients, get as much done as possible as quickly as possible. Birth plans were not tolerated by the staff, they simply did not have time for it. Inductions at 37.4, epidurals at closed thick and high, AROM's when they can barely squeeze the amnio hook in. It didn't matter. There was too much going on ALL THE TIME and never enough staff, enough doctors. You had to do it to survive. I simply could not be the L&D nurse I desired to be when I worked there. I hated the way I had to become in order to survive there. I simply had to do all these interventions just to make it thru my shift.
I've since left, found my dream job and now work in a facility that is so mom/baby/nurse friendly. It's amazing when you have the staff and the doctors who have the time with the patients how much easier things are and how things just seem to flow into place. We have very few inductions, we manage our patients with very few interventions. Our patients are very educated on their choices in birth. Our doctors are very supportive of their choices and will only intervene when necessary. We have a very low c-section rate, very low epidural rate and a very high breastfeeding rate and a patient satisfaction rate of 99% for over 9 years now. Our staff is happy and all of us love our jobs to the fullest. I do work in a hospital based birthing unit but I will tell you it is simply the most amazing facility and is honestly set up more like a birthing center than a hospital based OB department.
I also have an excellent manager who simply will not back down. She would rather over staff and do 1:1 labors vs. having us resort to un-necessary interventions to "get by". She would rather fight with administration tooth and nail than have a mom/baby go bad because of inadequate staffing. She is awesome.
Wow, mom2michael.....it does sound like a dream job. I have read and re-=read these posts and I don't see anyone with a "bad attitude". The nurses who speak out are just telling it like it is. I seriously haven't taken care of a patient in MONTHS who was not induced or sectioned and MOST of the time it has been at patient request. I would love to have the luxury of helping a mom labor naturally. I can scarcely remember how to do it. I know nurses problems are not the patient's concerns but we really are between a rock and a hard place most of the time. Like I have said before, we need our jobs......no one I know works for the fun of it. We can only rock the boat so much or we will not have a job. We are advocates for our patients but in a court of law we can be fried if we did not adhere to hospital policies. I personally don't know any nurse who has ever been less than professional toward patients/clients/customers.
:yeah:
FireStarterRN, BSN, RN
3,824 Posts
Ha ha, the current definition of 'Natural Birth' in many quarters is a lady partsl birth.