Do you count?

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I am a pre-nursing student and l&d is a particular interest of mine. Maybe because I have had 3 little ones. Anyway, I watch these shows on the discovery channel and I hear the nurses counting. To me it is just plain annoying. And when I was delivering I think I would have told off anyone who did. Well with #1 my hubby did try to count but the CNM told him I knew when to push and for how long before I got the chance. So do you count when your moms are pushing? If so do any of your moms ask you not to? If you don't do any drs/cnm's want you to?

Just curious.

Thanks

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

i go with the mom's wishes...for some,counting is very annoying and distracting. for others, it is a way to help them stay focused...like anything else in nursing, you take your cues from your patient and her family and tailor your care and interventions based on their needs and preferences. and dont take the baby story and other tv shows too seriously or literally. it's not like that in many cases, all wrapped up neatly in a 30 minute or 1 hour package. those shows annoy me to no end.

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Specializes in Labor and Delivery.

Once again Deb has the right answer. I do count for the ones who need to focus. Some pt's are so concentrated on the pain that they can't get a grip and push effectively. If you count in a calm quiet voice, close to their ear, they have something to concentrate on. It does work. But, I would always stop if the mom asked me to.

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My nurses counted for me in all my births but it wasn't a loud counting. It was very soft and helped me to be able to push better. It was also nice to know when "10" was coming and I could stop and take another breath to start over, KWIM? I, like Deb, think it would all be up to the mom.

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As a doula, some clients like counting and some don't. It's all a personal thing and I go with their cues. Sometimes they will plan it in their birth plan (it's usually the people that say absolutely NO directed pushing), or it'll just be an in-the-moment thing. For some people it does help them keep focus.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

just a note....you do not usually have to count for UN-anesthecized women. They KNOW when to push and will usually do so very effectively once they get the URGE. I just tell them to go with their bodies and urges. If they feel the desire to push at 8 cm, you can let the grunt a bit with slight pressure to get by it. NOT ALL WOMEN who are 10cm feel the urge right away, either. You listen to their bodies and let them go with it. It really works well that way. They usually can push VERY effectively when they have the urge, needing VERY little noise and outside input from caregivers, just kind and supportive encouragement. An unmedicated labor and delivery is something to behold,when it goes as it should!

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Deb is right. It depends. I know it annoys me :rotfl:

There are some times when you need to help a woman stay focused and counting helps. Other times it is amazing . .this force takes over a woman and you just stand there and watch. No counting necessary.

Whatever gets the baby out safely, I'm all for it.

steph

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Personally, it annoys me. I don't need direction. For my pts, it annoys me when some docs insist on counting even when Mom was pushing great before they walked in the room. With some Moms, especially anethestized Moms, it takes several practice pushes before they become effective. If after several pushes, mom still seems to be struggling with pushing hard enough or long enough, I willask if she thinks itwould help if we count. I never count w/o asking, and prefer not to, at all.

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Carla! That is exactly how I feel. It can be as annoying as heck.

Actually I like a quiet focused atmosphere. No running around like chickens with their heads cut off. No distractions. Quiet voices.

Now, in an emergency I realize all heck breaks loose but that is fortunately rare for us here.

What is irritating is when one of the OB nurses who have been around for a long time and who are AWESOME nurses comes in to help and then manages the delivery her way. Just so many blankets in the warmer placed just so. Dry the baby off like this, not like that. The red bag needs to be on the counter over here. If you are gonna help, help. But don't get pushy.

We have one nurse and one doc at each delivery. So it is nice to have another nurse, don't get me wrong. But sometimes people get very set in their ways.

Having said the above, if I had another baby, I'd want the experienced nurse I described.

What were we talking about . . . .? Oh ya, counting. :chuckle

steph

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Deb...I gotta tell you I never had a problem knowing when to push. I couldn't NOT push with mine and had an epidural with all three. In fact, I had to give them heck to check me with my second because I KNEW it was time but they insisted they had just checked me. She was crowning!

I know a lot of women do have a hard time feeling when to push...but *I* never did!

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I do purely to help the mom stay focused during her pushing efforts. I've never had anyone ask me not to, but I'm pretty soft spoken so hopefully I'm not too annoying. :uhoh21: I found it to be extremely helpful when the nurses counted for me during my deliveries. But I have worked with some nurses who sound more like obnoxious sports announcers while counting, and that is irritating. :rotfl:

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I don't as a routine, only if the focus is needed. Some women get that urge and go with it. Others that pressure makes them freak and they can't focus on it. Nobody has ever told me to stop counting when I was.

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