Do you guys read birth plans? - page 3

I'm putting together a birth plan to give my OB in a couple of weeks. I had one for my first, but I never had a chance to give it to my OB when I PROMed @ 36 weeks. So I'm wondering, would I be... Read More

  1. by   Jolie
    I once had a primip come in in early labor with a detailed birth plan and a militant chiropractor husband. He spent over an hour rambling on about how most of the illnesses people suffer are due to the doctor putting unnecessary traction on the spine at birth.

    She had back labor and was very uncomfortable. Her breathing and relaxation techniques were not helping. We tried the Jacuzzi and a back massage to no avail. Then I offered her some pain medication. Her hubby reamed me out for doing so " because the birth plan says that she is not to receive pain medication, EVEN IF SHE ASKS FOR IT!" I then informed him that if she refused the offer of pain medication I would respect her wishes. But I would not and could not refuse her request for an ordered pain med, as to do so would constitute poor nursing care and negligent practice on my part. I also reminded him that his wife was my patient, and I would respect HER wishes.

    I don't honestly remember ifshe received any pain meds in labor or not, but I do vividly recall the hubby hanging over the poor midwife's shoulder calling out instructions while she delivered the baby. He refused her offer to deliver the baby himself.

    At discharge, we would routinely fill and send home a pain Rx in order to save the new parents a trip to the pharmacy. When I offered the Rx to Mom, Dad grabbed it and threw it on the bed, stating that it was totally unnecessary. When he left the room to pull the car around, the mother took it and hid it in her purse. I felt sorry for her. I just do not understand how women can allow themselves to be controlled like that.

    The father also stated that their baby would never receive any immunizations, as they were just as unnecessary as pain meds. Bozo!
  2. by   mother/babyRN
    Jolie, YOURS takes the cake...I inform everyone coming through delivery that delivery is one of the only places in the world where women are in charge and that the patient is in charge as we work for her...I would have had a tough time with that couple BUT wonder if there were other issues as well...Maybe a social service consult! How can anyone accept or even condone a birth plan that refuses pain meds even if the patient asks for it..That is not only inhumane, I wonder if its illegal...Would be curious as to the position her doc took....Oh well, your story is MUCH worse than mine!
  3. by   Jolie
    This happened about 10 or 11 years ago. Our patients usually brought their birth plans in to the hospital with them, so most were not pre-approved, so to speak by the doc or midwife.

    The midwife who delivered this patient was very pro-natural birth, and also a great patient advocate. She shared my opinion of the father and his attempts to control matters. I was new to OB at the time, and it still amazes me that I had the spine to stand up to that Bozo, but I'm glad I did. I never thought about the possibility of social service intervention at the time, but it is a good suggestion to remember in the future. I think that we forget that abuse and control issues can happen even with intelligent, well-educated patients like this mom.
  4. by   shay
    God, Jolie...that movie 'Sleeping With the Enemy' just kept flashing through my head after reading that....~shudder~

    Poor woman. I bet she's had the crap knocked out of her a few thousand times since then.
  5. by   maire
    Unrealted to the main theme of this thread but sorta on track with how it's going I guess...I was watching a tv show once (don't groan) and there was this 18 or 19 yr old girl in labor and her mother was with her (no idea if the baby's father was in the picture or not). Anyway, the girl was in very early labor (maybe 3cm dilated?) and in a boatload of pain; moaning, thrashing about, crying, etc. The mother stood there like a statue and squeezed her hand and kept saying "You are doing this naturally. I did it, you can do it." Basically she told the daughter to suck it up and deal with it. The camera followed the L&D nurse out of the room and you could see she was fuming but trying to be tactful. "Noone should have to go through this torture" I believe is what she said.

    What do you do when someone other than the patient is "just saying no to drugs" and seems to want to take control of the whole labor? How do you handle that when you want to throw mom out of the room and do something for the poor girl in the bed?
  6. by   shay
    I tell them this:

    "SHE is my patient, not you, and if SHE asks me for pain medication or says that she feels the needs it, I will ignore you and give it to her as she asks. SHE is the one in pain and doing the laboring, not you, and only SHE knows when she needs medication."

    Then I smile with that sweet/nasty f-you smile that lets them know that the jig is up. Works every time. Heh heh. Nothing like a ballsy nurse to empower a patient and smack the family into line.
  7. by   Hardknox
    Question: How do these a$$hole , controlling men get a second date with these women, never mind marry them? Makes me wonder. I will say L&D did a lot for my marriage. Watching some of these dysfunctional couples made me realize how lucky I was to have my guy!!!!
  8. by   shay
    Originally posted by Hardknox
    I will say L&D did a lot for my marriage. Watching some of these dysfunctional couples made me realize how lucky I was to have my guy!!!!
    No husband is a prince.
  9. by   mother/babyRN
    Mine too, thank God....
  10. by   mark_LD_RN
    most nurses do fear loss of control, And I have not experience what a lot of nurses here seem to claim.i have been part of many births with plans that did not want interventions.I have seen a much better outcome with theses couples,it is a shame so many nurses claim to be caring but are so judgemental and biased.And by the way I am a L&D nurse and have experience many natural births and enjoy well prepared couples with birth plans
  11. by   mother/babyRN
    YOU are also a man and whether you like it or not (or should I say, whether WE like it or not, a man, controlling or otherwise, is going to relate to another man and his issues, if he has any)..I have read earlier that you and your wife enjoyed a good experience and that is totally wonderful. Believe it or not, no one here as far as I can determine, has said that every experience that has to do with a birth plan, is negative BUT you seem just a teensy bit defensive about it...HUMANS fear loss of control. Lets not limit it just to nurses AND one can still be judgemental and still be caring. One just has to work on the judgemental part. Reading between the lines of your last post makes me feel that you are at least a little judgemental with those of us who may disagree with your point of view on birth plans. Don't make the mistake of assuming that just because we may dread them (and men DO attempt to control female nurses in ways they usually do NOT attempt to control male nurses), we treat birth plans with less respect than not...We are allowed to talk about the experiences that don't go so well, because not all can go well. In a year with say, 30 birthplan couples, roughly half go mostly as they would like. The vast majority do not result in disaster, but when they do, they do it in a big way...I don't know that I was actually offended by your last post, but it did imply to read between the lines..I am really grateful that you are one of the only nurses in OB that I am aware of that has a great success with birth plans in general, however, losing control has nothing to do with my personal opinion of birthplans when it comes to eroneous or unreasonable ones, as when the dad speaks for the mom, or refuses to allow her to be given pain medicine. SHE is in charge of the labor and delivery deal even though he may be the dad, he is NOT going through the process anyway NEAR the same level as she is....May you forever have successful experiences with birthplans which come your way...When there is a controlling partner to the degree described in my (and others which followed), that is not a partner to a reasonable and workable care plan-that is a partner to an abusive relationship. Fortunately, those sorts of types are few and far between....(Thank God )....
  12. by   mark_LD_RN
    to mother baby rn you sound very biased(as related to gender), being a man has nothing to do with it and i highly resent that statement. a couple where the man is controlling everything would not like me, i have had some and they do not like to confront me. they usually request another nurse because i let the women have the last word during birth. I have never once refered to a man controlling the birth for the couple, it is a joint effort .you have surely seemed to forget that! I have great experience with couples and their birth plans. nurses who fear bbirth plans or go into it with the thought of failure is the problem, admittedly not all of the problem.
    i really would like you to explain how you could possible get any gender issue out of my reply! Remeber females are not always open minded or correct either.
    It is a shame many nurses feel birth plans are a joke and are unreasonable. i speak from personal experience many of the nurses i work with feel the same way. that is why i voluntarily take the couples with birth plans when possible.
    if you treat the couple with respect and gain their trust instead of prejudging them and dooming them to failure,I have found that they all will allow interventions if it would prevent harm to mother or baby. lets be a little more open minded . by the way I have had ones go bad and never had a couple refuse intervention when absolutely needed, i inform them and let them retain some feeling of control.
    I know some feel i dont have a right to speak on this because i am male ,but they are wrong. It is the hardest thing i ever had to do in my life, to help my wife with 4 pregnany for 9 months and then to watch her go through birth. you do not know what is like to watch someone you love more than life itself go through pregnancy and birth and know it is your child she is carring and birthing for you.
    our birth plan was written by her and it was her wishes, (she is by the way an rn also). at one point during the last birth i begged her to take a little something for the pain to which she refused,so i honored her wishes.
    birth plans can be a wonderful thing i just ask they be treated with respect and not laughed at, the couples mean well and do the best they can. the medical profession is not always right, america has the highest technology and interventions for birth but we still rank near the bottom in outcomes,maybe it is time to rethink some of our stratergies.
    All of what i said here is from personal experience from nurses i work with it is not to be infered to be against anyone here.
    i like birth plans in general and that is just my opinion,thanks,mark
    Last edit by mark_LD_RN on May 3, '02
  13. by   shay
    Mark, grab a big sack of granola and pull up a bean bag, honey, 'cause the church of the painful truth is now in session.

    You need to get a grip and get a clue, and please, for the sake of all of us involved here, put the incense down, extract your head from your rectum, and walk with me into the plane we all know as reality.

    While I'm sure that in happy-happy-land or wherever it is that you practice nursing, birth plans are always reasonable and natural childbirth always succeeds. I am so happy for you that you have neeeeeeever had the experience of caring for a couple so focused on 'the plan' that they couldn't see the forest for the trees. I am so happy that you have never encountered a couple who willfully and deliberately went against medical advice because to do so would deviate from 'the plan.' I am thrilled that you have the magical powers to cure such controllable things as thick meconium and cord prolapses simply with your open mind and positive thoughts. Too bad poor mother/babyrn 'doomed' her couple by thinking her evil, negative thoughts and caused that cord to prolapse and that baby to release its' bowels in such a forceful manner. It seems she is not blessed with your gift. I am so happy that you have never seen a baby get sick, injured, or die because of their parents' unwillingness to deviate from 'the plan,' like so many of us have seen. You are truly fortunate.

    However, on my planet, and on the planet of just about everyone else here, things go wrong, even with the best laid plans and the most supportive nurse. Things go wrong, without warning, without reason, without cause. Babies get into distress. Babies die. Mothers die. And no amount of positive thinking, open-mindedness, meditation, incense, granola, or what have you could stop it. That, my dear, is how things work in the real world. While we love when natural childbirth works well, what we don't love is when 'natural' childbirth is either forced on a woman by her husband or significant other, despite her crying and pleading for help, or when a baby is dying on the vine but you cannot do anything to save it because its' parents are so focused on sticking to their precious plan. What we don't love is when the couples we are trying to help approach us and labor as if it was war....mommy and daddy versus the evil nurses and doctors. What we don't love is when people speak to us as if we are stupid, like we actually enjoy having to use major interventions and technologies simply for the sake of using them.. not because they are necessary to sustain life.

    And finally....mother/babyrn came here to vent her frustrations, to talk with her peers. If her opinions of the couple she cared for offended your delicate sensibilities, that's just too da**ed bad. Suck it up and BACK OFF. She has the right to voice her opinion, and she has the right to think and feel and say whatever she wants here. It doesn't make her judgemental, it makes her human. Maybe one day we can achieve your divine level of perfection, but until then we will all have to just hope that one day we are as fabulously blessed as you.

    Church is now dismissed.