How do you deal with anti-OB people?

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I'm half-way to obtaining my ADN and have recently discovered that there are people out there who are not only anti-OB/GYN but are against any medical interventions at all during pregnancy. I talked to my OB/GYN for over an hour last week about some of the things that are being told to pregnant women to scare them into not trusting their OBs or L/D nurses and that not delivering naturally is an "abnormal" birth ... yadda, yadda, yadda. Dr. E called them "nature nazis" which I laughed at. But more and more I am beginning to think that she has a point.

How do you deal with lay people and over-the-top doulas that will say anything to keep a woman from considering an epidural as an option for pain management or even delivering in a hospital?

My first reaction was to set the record straight to some of these women on one mommy board, but I have not only lost my moderator status, but been basically named a "troll" for not backing down from that stance that it is no one's business how a woman opts to deliver her child (we should respect any birth plan that a mom-to-be has made and not degrade her for opting for an epidural or trusting that her OB knows best). And that no one but a MD should give out medical advice to pregnant women.

I am just shocked. I've been told that since I hope to work LDPP one day that I will have to learn to deal with the, for lack of a better name, "nature nazis" real quick.

The question is, HOW. I am just at my wit's end. Are they really that common?

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All we can do is give people the information (document our butt off) and hope for the best. Eveyone has diffrent belifes and views. We as nurses don't have to agree but have to respect everyones wishes. However I do say document your butt off. If you or a doctor tell someone they can't have a natural birth because the baby is too big and won't fit in the little pelvis and the person doesn't like your answer so they go to a midwife and try to deliver there baby gets a shoulder distocia and baby dies it can't come back on you that you never told her that could happen. Not that I'm saying scare people but give them the fact (just the facts) and let them decide. For instance we had a 22 weeker that was 5 CM + dilated. The doctor gave her all the facts, they decided to stop the magnesium (one last ditch effort to keep her pregnant) and see what happens. The nurse that had her said (to me) she didn't understand their decision it was a baby how could they do this, she thought she was taking good care of them. But according to the patient she kept saying when she had to listen for the heartbeat "your baby is really healthy" not what a parent who is making a horrible decision that they feel is right for them. Therefore she is not respecting their wishes. Our views cannot get in the way of other peoples lives. Lets just say with this couple this nurses comments changed their minds. They could keep the pregancy and everything is happy. (not ver realistic) they could keep the pregnancy another week or two just to the point of viablilty and have a physically challanged, mentally challenged child that they are not ready/willing/able to care for. I know people will say someone can adopt the child. Most people want healthy children, not kids who are blind/deaf and have cerebral palsy

Their decision may be wrong for you but right for them it is not our place or right to judge just give the facts, let people make their decisions and base our care on what they decide.

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Well, I'm not a nurse yet, and I might just be one of your "nature nazis" but here is my take...

First off, I get my pregnancy advice from a CNM, I wouldn't see an MD unless I had some kind of complication requiring a surgeon. So, although an MD is qualified to give advice, there are many others out there who are also qualified.

Secondly, it seems that many OB's lie to patients as well. I have had friends told "the baby is too big, I have to be induced/have a c-section" and deliver a 6 pound baby, my sister was told her hips were too narrow to birth lady partslly, she should just schedule a c-section, and recently my friend who does not want an epidural (didn't have one with her last birth) asked her ob/gyn (can't have cnm this time due to insurance) what options she had for pain relief and he said "You'll be getting an epidural" without even discussing it with her. To me these are far worse because the doctor is taking advantange of his "authority" and failing to educate or empower his patients.

There are many reasons to seek a low intervention birth- one of the most important being that it is safer for mom and baby. Why not encourage a woman to labor without pain meds if that eliminates all of the potential side effects from them? Why not avoid unnecesary tests and procedures, I also weighed the risks and benefits of everything else- declined AFP, had 20 week ultrasound, opted for GBS test, declined elective induction, etc.

There are also many reasons to have interventions. It's all up to the patients, not the health care providers, and just as you feel judged for your point of view, I think calling them "nature nazis" is also judgemental.

Just my .02 because we are obviously on opposite ends of the spectrum, but I don't think anyone should be judged for their choices, no matter which side they are on.

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I have seen midwives who have "lied" to their patients too, so that isn't something limited to OBs. Most providers I've worked with have been supportive and knowledgeable, that goes for docs and midwives. Despite the propaganda, there are many doctors and nurses who are all for supporting a woman's goals to have a low intervention delivery.

All you can do is give them honest, unbiased info and then support their decisions. I do think there are actual "nature nazis" that are out to lunch (people who show up at the hospital but don't want ANY "intervention" like allowing a nurse to listen to the FHR with a doppler), but most women aren't like that. Women wanting a "natural" delivery are just as entitled to it as the woman who wants a scheduled section, but I just don't think it's right that some people lie to them or pressure them to choose that.

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I completely agree that each woman should be able to deliver as she sees fit. What I am talking about are those people who scare pregnant women into a "natural" child birth.

For example:

* Telling a woman that having an epidural will harm her child, leave her paralyzed, and possibly a "spinal cord puncture." (I pointed out to one woman the the epidural is inserted well below where the spinal cord ends and she called me a "loony.")

* Telling a woman that if she has any pain medication, that the birth is abnormal because only "natural" births are normal.

* Telling a woman that all OBs and RNs are in it for the money and want to make the hospital bill as high as possible AND that having a medicated mom is better because the RNs don't really want to deal with her anyway.

* Telling women NOT to vaccinate their children at all because it'll make their child autistic.

* Telling women that giving their child formula is the same as giving them a ciagarette.

That's just the tip of the iceburg. I've heard and read so many eye-popping allegations lately that I am in utter shock. Why would I go into this field if I didn't care about each and every person placed in my care and that I'll be their advocate 100% even if I personally don't agree?

It seems like some of these people are pushing an agenda and are using horror stories to scare women into turning their backs on modern medicine.

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I witnessed an exchange between a friend and a doula on-line. Ken announced the birth of their second son by c-section. This doula had never met Ken or his wife and proceeded to denounce the c-section decision, the ob, Ken and his wife. Wow! First of all, she's never met them since they live in Australia. I have met them both. Wife is a teeny bit of a thing; Ken is probably 6'5" at the least. Their first baby was a 10+ lbs. I've always liked Ken but his handling of the criticism was wonderful! He never violated his wife's medical privacy and let the doula know it wasn't any of her business without getting into a personal attack. It was so cool. I now know why he's so successful in the business world. But it left a really bad taste for doulas in my mind. I'd been pretty neutral before that exchange. But not only has she given medical advice (not OB either) on a discussion board - BUT IT WASN'T EVEN CORRECT!

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There is always going to be two sides to every story. There is a horror story for every positive one for every procedure. Whether it be heart surgery, C-Section, Vag Birth, Hip surgery. It's alwasy a person that had a great expierence and one that person that has a horror story. I think people get too revved up about everything. People are still going to have their opinions and you'll still be sitting in neutral revving.

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Specializes in OR.
I completely agree that each woman should be able to deliver as she sees fit. What I am talking about are those people who scare pregnant women into a "natural" child birth.

For example:

* Telling a woman that having an epidural will harm her child, leave her paralyzed, and possibly a "spinal cord puncture." (I pointed out to one woman the the epidural is inserted well below where the spinal cord ends and she called me a "loony.")

* Telling a woman that if she has any pain medication, that the birth is abnormal because only "natural" births are normal.

* Telling a woman that all OBs and RNs are in it for the money and want to make the hospital bill as high as possible AND that having a medicated mom is better because the RNs don't really want to deal with her anyway.

* Telling women NOT to vaccinate their children at all because it'll make their child autistic.

* Telling women that giving their child formula is the same as giving them a ciagarette.

That's just the tip of the iceburg. I've heard and read so many eye-popping allegations lately that I am in utter shock. Why would I go into this field if I didn't care about each and every person placed in my care and that I'll be their advocate 100% even if I personally don't agree?

It seems like some of these people are pushing an agenda and are using horror stories to scare women into turning their backs on modern medicine.

Exactly, I have seen firsthand how some of the "nature nazi's" work...Yes, you should have a choice in how you deliver your baby but it is just that-your choice not someone else's. Some of the NN's can be very judgemental about other people saying things like "I can't believe she had an epidural" or "I can't believe she's not breastfeeding"(to be fair those are really "breast nazi's") One of my friends had many fellow mommy group people like that. You know, one would read a book by some "expert" and the next thing you know his/her suggestion that women should give birth out in the backyard was held as gospel. All we as nurses can do is give educate our patients and hope that they are listening. And like another poster said, document so if something happens they won't try to claim they weren't told.
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Exactly, I have seen firsthand how some of the "nature nazi's" work...Yes, you should have a choice in how you deliver your baby but it is just that-your choice not someone else's. Some of the NN's can be very judgemental about other people saying things like "I can't believe she had an epidural" or "I can't believe she's not breastfeeding"(to be fair those are really "breast nazi's") One of my friends had many fellow mommy group people like that. You know, one would read a book by some "expert" and the next thing you know his/her suggestion that women should give birth out in the backyard was held as gospel. All we as nurses can do is give educate our patients and hope that they are listening. And like another poster said, document so if something happens they won't try to claim they weren't told.

I'm dealing with the breast issue right now. Granted, I nursed my daughter and we are still working on weaning (she's over a year old...). and I am a big advocate of breast feeding. However, there is a huge push to stop forumla companies from being able to offer the free "goodie" bags to women in OB/GYN offices and in hospitals. One state has now banned the bags in hospitals all together. (No, hospitals should not be marketing places for formula companies, but like wise they are not there to attempt to force women to breast feed either.)

I just hope that I can find a way to get past the complete outrage I feel when I hear / see NN's giving medical advice and telling women what is normal and what is abnormal.

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guess i should clarify- i didn't mean to make it sound like i thought all ob's were evil liars- just wanted to show the other side of the spectrum. i think ob's in general are people who enjoy their jobs and love to support women and their families. just that like in any group there are some bad apples.

i am perhaps a starry eyed student who hasn't learned yet but i am so excited about becoming a midwife to support/educate/empower women and i find it frustrating that there are so many out there who don't.

the illustration i was given in doula training (yep...i'm one of those) is to ask your client to show your where on the spectrum she is with one extreme being an epidural in her eighth month of pregnancy and the other being an unmedicated c-section (both impossible, i get that part). whatever her answer is supporting her is your job, regardless of your own beliefs.

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I'm half-way to obtaining my ADN and have recently discovered that there are people out there who are not only anti-OB/GYN but are against any medical interventions at all during pregnancy. I talked to my OB/GYN for over an hour last week about some of the things that are being told to pregnant women to scare them into not trusting their OBs or L/D nurses and that not delivering naturally is an "abnormal" birth ... yadda, yadda, yadda. Dr. E called them "nature nazis" which I laughed at. But more and more I am beginning to think that she has a point.

How do you deal with lay people and over-the-top doulas that will say anything to keep a woman from considering an epidural as an option for pain management or even delivering in a hospital?

My first reaction was to set the record straight to some of these women on one mommy board, but I have not only lost my moderator status, but been basically named a "troll" for not backing down from that stance that it is no one's business how a woman opts to deliver her child (we should respect any birth plan that a mom-to-be has made and not degrade her for opting for an epidural or trusting that her OB knows best). And that no one but a MD should give out medical advice to pregnant women.

I am just shocked. I've been told that since I hope to work LDPP one day that I will have to learn to deal with the, for lack of a better name, "nature nazis" real quick.

The question is, HOW. I am just at my wit's end. Are they really that common?

By trying to force women to see it "your" way you are using the same tactics as those you describe as nature nazis. It is possible to have a birth without pain meds (if a woman so chooses) or other interventions (i.e., IV, continuous monitoring, etc.). And many women do successfully deliver at home with a midwife. Personally, I would never see an OB unless I had a high risk pg. I chose a midwife because she shared my own views. Although to be fair the docs that practice with the midwives do too. My view, for me personally, is that unless there are problems I don't want any interventions. If I want pain meds I will ask, please don't offer them. Drs, CNMs and nurses need to respect a patients decision. If it results in a bad outcome and you have informed the patient of the risks you have done your job. You cannot force someone to see it your way.

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I think childbirth, pregnancy,and child raising beliefs are about as strong as religion. Unfortunately, a lot of people in this world just don't know one way or the other and always feel the need to push their views. I also think some people have a tendency to use the terminology incorrectly. I.E natural=lady partsl. I have even found myself doing this before.

In the few days you will have to spend in L&D/PPwith them, it is unlikely you're going to change their mind. So, try to educate them and hope for the best. The examples you gave were extreme. But, I think calling someone a natural nazi is as bad as saying that a new mom who wants a c-sec and won't breastfeed is a bad or detached parent. It takes all kinds to make the world go round...:twocents:

Suzi

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