How do you deal with anti-OB people?

[ParasMom]

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?

[ayndim]

I'm EXTREMELY pro-midwife, but I have to wonder about those statistics citing lower mortality in western european nations as being only because of midwives. We also have a lot of women in the US who get no prenatal care, have problems with nutrition, drugs, etc. which impacts morbidity and mortality rates as well.

I don't think it is only because of the mw. One of the thing about countries that follow a midwife model of care is that prenatal care is cheap and easier to access. So using more midwives equates into more women receiving prenatal care. I remember one study (I will try to find it if anyone wants to read it), that all things being equal that MW care results in better infant and maternal outcomes, but not as significant as the US vs. Western Europe surveys. Of course, any research that does not exclude high risk pg/births, which are usually attended by doctors, will give skewed results. I think one reason for the great MW outcomes is that a good MW will empower the woman, assure her that her body knows what it is doing and educate without degrading. And many MWs stay with the pt for most of the labor/delivery when in hospital. Of course, homebirth MWs are also there the whole time. But I am partial to MWs.

[geekgolightly, BSN, RN]

No reason you couldn't breast feed a baby that size. Your other comments-the baby was on O2, and was a mag baby, may have been the reason you couldn't breast feed at first. Depending on the way a baby is given oxygen, and his condition at the time (nasal cannula and screaming or oxyhood and lethargic) you could possibly have breast fed. The mag sulfate presents a different picture. We do mag levels on all babies whose mom had been on mag, even a bolus 4 hours before delivery. If that mag level is >3.0mg/dl, the kid does not get fed until it comes down. Mostly, those babies just want to sleep. The bolus 4 hrs before? mag level in baby 4.7! That was a couple of weeks ago, mom came in with PIH high BP, systolic over 160, diastolic over 100. Baby was a 36 weeker. It did go out to mom a day and a half later.

I was pre eclamptic, bp 170's /100's, 2+ protein and baby was 35 weeker. I was on mag for about 30 hours before giving birth.

They never told me his mag level. All I know is that he was receiving o2 via NC overnight. They kept him for two weeks at which time I began to make lots of noise about wanting my baby home. They reluctantly let him go, implying that I was risking it. Risking what? I still don't understand. oh man, i wish i had made some sort of back up plan and picked a hospital more in line with what i wanted. as it was, we went to the nearest one that was in the system i worked for.

[SmilingBluEyes]

Seems to me, geekgolytely, you really were a victim here. I can't imagine treating you as you say you were at the hospital, and can fully understand your position and feelings. I think we all could take heed from your words and let them help us understand the so called "nature nazi" point of view (I HATE that term and will refrain from using it here on out).

Please, take heart in knowing not all nurses (and doctors) are this way. I personally treat my patients as if they were my sisters----I really think this guides my practices well. I think of them as real people, very individual and with needs no different than my own, not just dummies attached to a monitor.

The one thing I have found that helps people cooperate when need be, is to keep them "in the loop" and by that I mean, keeping them informed as changes or urgencies come up. Even in emergency circumstances, I will do my best to remain calm and keep them calm, too. This is critical for the health of both mom and baby (esp if mom is still pregnant as severe anxiety CAN affect both patients physically).

The whole person must always be taken into account when we are caring for our patients---and I really try to do that. Keeping people informed, LISTENING to them and their concerns----communicating clearly and compassionately, can really go a LONG way for all of us. (medical types)

I have a great respect for those choosing to labor and deliver at home, and understand this choice. However, If by chance, they do come into my care at the hospital, due to some unforseen or unfortunate circumstance, I keep in mind they are VERY disappointed, scared and may be rather mistrustful. Trying to elicit the trust of their midwife, significant others, as well as them, is only secondary to taking care of any emergent medical situation that presents when they come. I do my best to include their care provider and/or doula in my nursing plan----this helps a lot, I think. I am mindful, these folks know my new patient better than I can, and can be a wealth of information and assistance. I know most of my coworkers do this, too. That a few really rotten apples ruin the sense of security and trust on the parts of the community out there, really saddens me.

Communication, open-minded and clear, is the key, on both "sides", if you will. Hope I am making sense here. It's only 5:50 a.m. and I am on my first cup of 1/2 decaf joe......(lol)

[prinsessa]

Yes I have a problem with docs giving out false info. In all fairness though, "Well I wouldn't recommend that" and "I don't know how you ladies do it" isn't false info, it's an indication of her birth philosophy. You obviously knew what you wanted and I doubt she/he forced you to get an epidural right? Your mother's doc was wrong too, fortunately she was able to have a good birth. Like I said already I agree there are bad docs out there. That just wasn't the topic of this thread. I can probably match you bad doc story for bad doc story (and come up with many bad nurse stories, bad doula stories, bad layperson stories, bad midwife stories and stories where the parent was wrong and the hc provider was right)...

What I find offensive is the way ALL health care providers are painted with the same brush by extremists (whatever you choose to call them) who want to bully women into giving birth a certain way. I'm tired of explaining again and again and again and again and again that I will support a woman's informed decision regardless of what it is.

I agree with you, but I also find it offensive that all people who believe in natural birth are thought to be the same way (which is why I don't like the name "nature nazi"). There are people on both sides who think that their way is the only way.