Mugwump had a great idea offering services to new grads as a mentor (thank you for that!)
So, I thought having a "sticky" for new grads, OB nurses, students, and others with questions who want to post these can do so here. We also seem to see many of the same questions over and over, so perhaps this would help serve as an ongoing discussion of common issues/questions we all seem to have on our minds. This could serve not just for those asking directly, but others who may be "lurking" and looking for information or considering a career in OB, newborn, GYN nursing, or midwifery, doula services, childbirth education, lactation consulting, or other related work.
So if any mod thinks this is a good idea, mind stickying this?
Let's give this a go and see how it works out. We have many potential "mentors" here among us who, I am sure, would LOVE to help a new nurse/midwife/doula or student on his or her way to a rewarding career. I know I would love to help out!
Ok I am having a little trouble with fetal position. I have read this & read this & looked at pictures but I am confused. To me the LOA, LOP & the LOT look pretty much alike. Same thing on the ROA, ROP & ROT. Right & left are about all I can figure out aargh! I know it's a fixed ref. point on the fetus in relation to mom's pelvis but they all look alike to me except some are on the right/some on the left.If anyone can explain this simply I would sure appreciate it. Also transverse... my book shows the fetus crosswise.... then it lists the position as ROT & shows a picture of the fetus
with it's head down like it's diving out. I am confused terribly to say the least!! Thank you CRB
Start as simply as you can. I take it you know what part of the fetal skull is the occiput. There is a right and a left side. For optimal positioning for birth, the baby should be head down and be facing the mother's back. That way, the baby's back is facing out front. If that is the case, the baby's right side of the head is facing out, then the position is ROA (or right occiput anterior). The baby's back wuill be facing more to the mother's left. If the baby just turns on it's axis and the left occiput faces front, then the baby is facing more to the mother's right side and that position is called LOA (or left opcciput anterior).
That said (I hope that wasn't too confusing), if the baby's face is facing out front and the baby's back is facing the mother's back, then the baby is said to be in a POSTERIOR position which is a much more difficult position for coming down the birth canal. Then those occiputs are possterior (LOP or ROP).
If you could put a pole right down through the baby (with baby head down), imagine that you could turn this pole with your fingers and the baby would spin around and the position would always be changing, right?
If you go to any search engine and type in right or left occiput anterior (or posterior) you should get some pictures.
Hope this isn't too confusing. I don't think I explained this too well. This was my fourth day on in a row and I am tired! Too many babies lately!
Start as simply as you can. I take it you know what part of the fetal skull is the occiput. There is a right and a left side. For optimal positioning for birth, the baby should be head down and be facing the mother's back. That way, the baby's back is facing out front. If that is the case, the baby's right side of the head is facing out, then the position is ROA (or right occiput anterior). The baby's back wuill be facing more to the mother's left. If the baby just turns on it's axis and the left occiput faces front, then the baby is facing more to the mother's right side and that position is called LOA (or left opcciput anterior).
That said (I hope that wasn't too confusing), if the baby's face is facing out front and the baby's back is facing the mother's back, then the baby is said to be in a POSTERIOR position which is a much more difficult position for coming down the birth canal. Then those occiputs are possterior (LOP or ROP).
If you could put a pole right down through the baby (with baby head down), imagine that you could turn this pole with your fingers and the baby would spin around and the position would always be changing, right?
If you go to any search engine and type in right or left occiput anterior (or posterior) you should get some pictures.
Hope this isn't too confusing. I don't think I explained this too well. This was my fourth day on in a row and I am tired! Too many babies lately!
The pole thru the baby helped!! I can imagine it turning.The anatomy I know but I am still pretty lost. I think I will get a small doll fix a pelvis & turn it until I can figure it out. I know it sounds stupid but heck if I can see it I will have it. I can usually read anything & see it in my mind but this I can't. I will also try google. Thanks for your help. Hope you are off for a few days, get some ZZZZZZZZZ's. CRB
Yahoo!! I got it. I took a doll & held it up to myself & turned it :rotfl: & now I have it. I don't know why I went so brain dead on this but...... I got it now!! Your explanation of the pole & turning did the trick! Thanks CRB
This site explains doulas and their role very clearly, I think. Doulas care for the needs of a birthing family from the late prenatal course through labor to immediate post partum care. They are versed in NON-medical labor interventions to help the birthing mother cope with pain/discomfort during labor and also assist with establishing breastfeeding after birth. The site really is a great resource for information regarding doulas and how to study to become one, if that becomes your goal.
And yes, NPs do work in OB/GYN offices/settings. Many see woman during their prenatal course as well as do well-woman checkups, pap smears, breast exams and post partum checkups.
One more question, I do not know what i want to get my masters in. I love working with mother and baby. If I get an degree in NNP, I feel that u can only work in NICU. If in women's NP only doctors offices and if CNM (maybe office also). Which degree will allow me to work in a hositpal for the experience and then later own in a office. Also, do PA delivery babies.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I understand in SOME places, PAs do deliver babies, but nowhere I work do they, except to assist in csections (in the capacity of first assistant to the surgeon). Sounds to me as if you want to pursue CNM if you want to care for birthing families in the labor/delivery area.
At my tertiary/high risk antepartum and L&D unit we have PNNPs (Perinatal Nurse Prac). They're was a program here in town but as I understand, it doesn't exist anymore. They latest one hired is a WHNP and has obtained the position through the perinatalogist group and works only at the hospital. They round on the AP pt's, manage their care, do U/Ss and other procedures on the unit for other OBs (1st assist in OR, SROM checks, AROMs, internal monitors). They do not deliver unless it's a demise. It seems like a good route to go because if you ever get tired of the hospital then you can always go do office work.
One more question, I do not know what i want to get my masters in. I love working with mother and baby. If I get an degree in NNP, I feel that u can only work in NICU. If in women's NP only doctors offices and if CNM (maybe office also). Which degree will allow me to work in a hositpal for the experience and then later own in a office. Also, do PA delivery babies.
At my tertiary/high risk antepartum and L&D unit we have PNNPs (Perinatal Nurse Prac). They're was a program here in town but as I understand, it doesn't exist anymore. They latest one hired is a WHNP and has obtained the position through the perinatalogist group and works only at the hospital. They round on the AP pt's, manage their care, do U/Ss and other procedures on the unit for other OBs (1st assist in OR, SROM checks, AROMs, internal monitors). They do not deliver unless it's a demise. It seems like a good route to go because if you ever get tired of the hospital then you can always go do office work.
BETSRN
1,378 Posts
Start as simply as you can. I take it you know what part of the fetal skull is the occiput. There is a right and a left side. For optimal positioning for birth, the baby should be head down and be facing the mother's back. That way, the baby's back is facing out front. If that is the case, the baby's right side of the head is facing out, then the position is ROA (or right occiput anterior). The baby's back wuill be facing more to the mother's left. If the baby just turns on it's axis and the left occiput faces front, then the baby is facing more to the mother's right side and that position is called LOA (or left opcciput anterior).
That said (I hope that wasn't too confusing), if the baby's face is facing out front and the baby's back is facing the mother's back, then the baby is said to be in a POSTERIOR position which is a much more difficult position for coming down the birth canal. Then those occiputs are possterior (LOP or ROP).
If you could put a pole right down through the baby (with baby head down), imagine that you could turn this pole with your fingers and the baby would spin around and the position would always be changing, right?
If you go to any search engine and type in right or left occiput anterior (or posterior) you should get some pictures.
Hope this isn't too confusing. I don't think I explained this too well. This was my fourth day on in a row and I am tired! Too many babies lately!