So, I am a new L&D RN, and just started working at my facility and love it. We have a great set of nurses and docs. I come from a homebirth background, so hospital birth (especially at a high-risk facility) is definitely much different than what I'm used to, but I really like working with this population of mamas.
I think we are really good at trying to implement evidence-based practice. The one thing that seems universally crazy to me is that we are restricting the diets of mamas in labor. I know that it is because of risk for aspiration in the event general anesthesia would be used, but really, how often would general anesthesia be used? The benefits seem to outweigh the risks. So far I have found this article on medscape, haven't researched journal articles yet:
Seems like every mama I work with, especially inductions, c/o how hungry she is and how she can't wait to eat. Seems crazy to me to withhold food or even juice from them.
What is your hospital's policy re: nutrition in labor?
I suppose this makes the point of staying home as long as possible....
Yes! I do it so I will be less likely to be pushed into a c/s for "failure to progress" when really it is just the staff getting anxious. One time I stayed home so long that by the time I got to the hospital my child was crowning. What made it worse was that since I wasn't screaming and begging for pain meds no one thought I was in "real labor." Just think, I almost took a bath before I left for the hospital
Just wondering, is it dangerous to let a woman have a little to eat during labor? I'm talking about applesauce, yogurt, or something really light. Would that pose a danger? I am not talking about having a whole Thanksgiving dinner during labor (or even shortly before labor begins)...I think that is a bad idea for several reasons.
Yes! I do it so I will be less likely to be pushed into a c/s for "failure to progress" when really it is just the staff getting anxious. One time I stayed home so long that by the time I got to the hospital my child was crowning. What made it worse was that since I wasn't screaming and begging for pain meds no one thought I was in "real labor." Just think, I almost took a bath before I left for the hospital
Just wondering, is it dangerous to let a woman have a little to eat during labor? I'm talking about applesauce, yogurt, or something really light. Would that pose a danger? I am not talking about having a whole Thanksgiving dinner during labor (or even shortly before labor begins)...I think that is a bad idea for several reasons.
Depends on if you would want to take the small chance that that food would potentially end up in your lungs.....
Everyone handles labor differently and not every laboring patient has an easy labor. While waiting to the last second prevents someone from being coerced into a decision they didn't originally intend on it also prevents the fetal and maternal monitoring that helps make modern labor so safe.
Thank you, Wbtcrna. I wasn't for or against the food during labor, I just wanted to know if the amount would make a difference. Frankly I was too distracted, excited, or sick to even think about eating during labor. I think the most I ever had other than ice chips was a few cheetos. After my labors I ate all my snacks and everything the nurses offered. Thank you for the info.
I would still wait until the last minute (within reason) to go to the hospital during labor, and would tell any first time mother that if they were to ask.
I would still wait until the last minute (within reason) to go to the hospital during labor, and would tell any first time mother that if they were to ask.
Risking your own safety is one thing but you may want to reconsider before you risk someone else's health and their unborn childs.....just. my
Specializes in Nurse Leader specializing in Labor & Delivery.
it also prevents the fetal and maternal monitoring that helps make modern labor so safe.
THis statement is not evidence based. Continuous fetal monitoring is not associated with better outcomes compared to intermittent auscultation. It is, however, associated with increased C/S.
THis statement is not evidence based. Continuous fetal monitoring is not associated with better outcomes compared to intermittent auscultation. It is, however, associated with increased C/S.
Can't have either one without medical support of some kind and staying at home until the last minute.
THis statement is not evidence based. Continuous fetal monitoring is not associated with better outcomes compared to intermittent auscultation. It is, however, associated with increased C/S.
No one said anything about continuous monitoring. Maternal and fetal monitioring in hospital could include physical assessment, maternal vital signs, cervical assessment, intermittent monitor or auscultation, or continuous fhr monitor. Expert assessment and support without unnecessary intervention will certainly improve outcomes. Advising moms who desire a hospital birth and care to stay at home til near crowning is potentially harmful advice. Will you be there to catch the baby born on the side of the interstate?
Specializes in Nurse Leader specializing in Labor & Delivery.
Advising moms who desire a hospital birth and care to stay at home til near crowning is potentially harmful advice. Will you be there to catch the baby born on the side of the interstate?
I haven't advised any moms to stay home until near crowning.
Risking your own safety is one thing but you may want to reconsider before you risk someone else's health and their unborn childs.....just. my
If the pregnancy has been healthy I don't think I would be risking someone's health and their baby's to not go to the hospital with the first pain felt. I think doing some of the laboring at home can be good; I'm not saying you have to turn it into a home birth, LOL!
Plus, going to the hospital too early could actually stop labor. Once you get there you are hooked to IVs and monitors and at my hospital you are not allowed to walk around and you just about have to beg to be allowed out of bed to use the bathroom. Why not labor some at home so you can walk around and help your own labor?
I haven't advised any moms to stay home until near crowning.
Neither did I. I said stay at home until the last minute (which I guess could be interpreted as many things). When I stayed at home until my child was nearly crowning I didn't mean to stay at home that long. I meant to stay there until I was having strong contractions. My previous 2 deliveries before that had been induced, so really I didn't know how to time contractions and what my contractions should have been like before going to the hospital. I only knew that I didn't want my labor stalled by unnecessary interventions.
Part of the reason why the baby was crowning by the time the nurse checked me is because NO ONE believed I was in labor, not because I planned it that way. I would never tell anyone to stay home until the baby was nearly crowning (no matter how healthy the pregnancy), but I wouldn't tell them to go to the hospital with the first pain felt.
Tewdles--just asking a question. Which you didn't answer, btw... :-).
When I had my kids, way back in the stone age, they started an iv and let us walk around. Now everyone is stuck in bed hooked to machines. Fear of lawsuits. IM not-so-humble,NOT "evidenced-based" opinion, labor and delivery is much easier if you are not stuck in bed.
Specializes in Nurse Leader specializing in Labor & Delivery.
Patient1977 - I think you have a good attitude. So many in the medical profession believe that it's not safe to give birth without all the machines that go ping. Yes, occasionally monitoring the mother's vitals is important, as is intermittently listening to fetal heart tones. But those are all things that can easily be done at home with minimal technology. Cervical exams are generally not necessary, and it's quite common for women at my facility to get NO cervical exams until she's feeling like she needs to push. It's also relatively common that low-risk women don't even have IV access.
For low-risk women, homebirth is just as safe as hospital birth, and for most women, spending the majority of her time laboring at home is safer, from an intervention perspective, than going to the hospital while still in early labor or as soon as her water breaks.
caregiver1977
494 Posts
Yes! I do it so I will be less likely to be pushed into a c/s for "failure to progress" when really it is just the staff getting anxious. One time I stayed home so long that by the time I got to the hospital my child was crowning. What made it worse was that since I wasn't screaming and begging for pain meds no one thought I was in "real labor." Just think, I almost took a bath before I left for the hospital
Just wondering, is it dangerous to let a woman have a little to eat during labor? I'm talking about applesauce, yogurt, or something really light. Would that pose a danger? I am not talking about having a whole Thanksgiving dinner during labor (or even shortly before labor begins)...I think that is a bad idea for several reasons.