Do your Dr.s come for FD delivery?

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I was just wondering what other doctors do for fetal demise? We had a 16 week demise last week. When the mom began to deliver we called the doctor to come. I wasn't the nurse taking care of the pt but was the nurse to call the doctor. He was mad that I called him and asked me if the nurse had the pt push. I told him no and when he started ranting about this only being a dead fetus, I interrupted him and asked him if he was coming or not. Reluctantly he came and started lecturing a bunch of nurses at the station, I didn't listen to his lecture, I just walked away. I think what he wanted was for her to deliver and he would just come and see her in the morning. I think he needed to come and see his pt and reassure her, let alone examine her. Its not in my scope of practice to deliver his pt whether demise or not. Sure it happens, but all our other docs always come in and see the pt even if it is late at night. What do you do at other hospitals?

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

No, you are certainly not wrong. You are right on.

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Specializes in Behavioral Health.

I have to ask: Where do you typically deliver 16, 17 weekers at your places? Where I practice, they are delivered in OB. I am surprised it's done differently elsewhere.

Deb,

We deliver them in L&D as well. Had a gut wrenching one today...it took her 5 days to deliver. :crying2:

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

horrible, just awful.

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Specializes in Perinatal, Education.

At the hospital I just left, a lot of those patients would deliver in the ER with the ER doc. We would have them on the unit sometimes, but we were small and very busy and didn't always have a room. Please note that I don't agree with or endorse this, but it was the way it was. I can't believe it was the only place that did that. I no longer work there for many reasons. Where I am now, we actually have a true OBER on the unit and evaluate all pregnant women, not just those over 20 weeks.

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Specializes in Nurse Manager, Labor and Delivery.
It is very common for us to deliver a 16+ week demise. However, this is mostly due to circumstance. Since these moms tend to go from nothing to delivery in a very quick time. However, our docs always come in to deliver the placenta (which is usually stuck like glue) and to make sure everything else is ok.

I agree here. I have delivered quite a few because of the circumstances described here...and from the wee ones to almost term. Sometimes they just come too quickly. The doc does followup with post partum issues. My feeling is that the nurse, by far, gives much more support emotionally and physically during this trying time than the doc ever does. The exception is when I have a midwife delivery. They at least stay until the patient delivers. The times I have delivered the babies, the parents were extremely grateful and felt it was paramount to getting thru such a tough time. Yes, there are complications that can arise...each scenario is different and should be treated as such. I attend many many deliveries of demises being a bereavement counselor, and to be honest, having a doc around isn't always the best thing. It is a necessary evil though. The doc described in the original post exemplifies what I am trying to say here. It is a damn shame.

We deliver all of the demises in OB that are induced. If they come in with SAB thru ER, and have already delivered, they stay there.

A co-worker that is from Canada said that they were always responsible for delivering demises of any age.

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Specializes in OB, M/S, HH, Medical Imaging RN.

Any OB that is that uncaring should retire or change his discipline. "only a dead fetus". If I had heard my doctor say that I would have come up with a way to make sure he was punished. That is truely horrible. But to answer the question, when I did work OB they definately came in for FD deliveries and asap. The problem being that most go from 0 to delivery and sometimes there is not enough time for the doctor to get there until shortly after the delivery.

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A co-worker that is from Canada said that they were always responsible for delivering demises of any age.

I worked l&d at the 2 busiest hospitals in Canada and 2 smaller ones, and we never delivered fd babies unless the doc just didn't get there in time.

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Specializes in Nurse Manager, Labor and Delivery.
I worked l&d at the 2 busiest hospitals in Canada and 2 smaller ones, and we never delivered fd babies unless the doc just didn't get there in time.

Different places do different things I guess. Just relaying what I was told. She was from the northwest territories, if that makes any difference. Didn't mean to infer anything.

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Different places do different things I guess. Just relaying what I was told. She was from the northwest territories, if that makes any difference. Didn't mean to infer anything.

Just wanted to relay my experience. The NWT is definitely a whole different world from most of Canada.

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Specializes in Nurse Manager, Labor and Delivery.

:

Just wanted to relay my experience. The NWT is definitely a whole different world from most of Canada.

From the stories she tells...it is DEFINITELY a whole different world there....

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One of the worst parts about this situation with this doctor was the nurse told me when he came in to check on the pt after she delivered he yelled at the nurse asking her why she didn't call him instead of having another nurse call him. When the nurse told him she needed to stay with the pt, he said to her, in front of the pt, "why didn't you just go to the desk and call me, its not like you needed to rescucitate." I can't imagine how horrible this must have made the pt feel. I can't stand this doctor!!!!:angryfire

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Specializes in Home Health, Hospice.

I cannot believe the nerve of that doc!!!! I can only imagine what that poor woman had to be feeling and thinking at the time. :o

As for whether a nurse can deliver (this wasn't fd but still kinda relevant) When I was in labor with my daughter, I advanced very very quickly from transitional to active labor, in about 15 mins to be exact. Once the nurse realized this, she told me she had to call my doc and that I wasn't to push. Of course I had to ask "What happens if I can't stop myself from pushing?" (I mean at this point I just wanted that kid outta me :) )She told me that the nurses would then deliver, or at least start the process, till the doc got there.

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