Stirrups? WHY???

Rose B · Feb 6, 2005

The stirrups did not upset me as much as his routine use of FUNDAL PRESSURE. Stirrups are useful for extremely heavy people, when holding their legs for an hour or more can be taxing. I am not against their use in all cases. But fundal pressure in labor is NOT warranted, and in fact, is dangerous.

Wow! Can't believe the fundal pressure thing. The only time we ever used to used it was for shoulder dystocia (in the dark ages), and that isn't the accepted technique anymore. Maybe he needs to new info!!!!!!!!!!

BAtoLPN · Feb 6, 2005

That doctor sounds dangerous. Glad you stepped in there to advocate. But what about next time? Too bad you have to struggle w/these sorts of outdated and dangerous practices.

:nono: :angryfire OOOHHH!!! I am "just a mommy" (not a nurse... YET), but I tell you what - if any doc had put one of those damned vacuum pumps on MY Little One's head unless it was ABSOLUTELY NECESSARY, I'd have gone POSTAL on his ***!!!

Good for you! Why don't you go for Midwifery? You sound like you would be good, and I was SOOOO glad that we had a practice here so that I could avoid docs just like the one you described!

:uhoh21:

BAtoLPN · Feb 6, 2005

I have personally tried pushing with legs in stirrups and it is the most unnatural position to try to give birth to your baby. In the end I asked if I could turn on one side and deliver that way so much easier so much more comfortable.

DITTO! DITTO! DITTO!

BAtoLPN · Feb 6, 2005

The stirrups did not upset me as much as his routine use of FUNDAL PRESSURE. Stirrups are useful for extremely heavy people, when holding their legs for an hour or more can be taxing. I am not against their use in all cases. But fundal pressure in labor is NOT warranted, and in fact, is dangerous.

:smackingf OKay, as I said, student here.... I just googled "fundal pressure" - let some jerk push all on MY big old belly? I don't think so! He'd have gotten his *** a trip straight down to the ER after doing that to ME! Who IS this dinosaur, and why has someone not set him freakin' STRAIGHT? Sheesh!!!

allnurses Guide · Feb 6, 2005

DITTO! DITTO! DITTO!
DITTO! DITTO! DITTO!

But the truth for you may not be the truth for others.

I was on my back with feet in stirrups and hands on grips pushing and if anyone had made me move I would not have liked that very much.

Birth is not a one size fits all event.

steph

BAtoLPN · Feb 6, 2005

Not to be a smart alec but how is someone not able to hold their own legs?

:chuckle Um, okay, YOU were obviously not a big ole COW like myself. I don't think my arms would have reached... yes, I know, sad, but I HAVE lost the weight! :)

And yes, after 16 hours, I was a LEEEETLE tired....

BAtoLPN · Feb 6, 2005

Birth is not a one size fits all event.

:eek:

Um, I thought that was the point I was trying to make...

Ouch! Talk about nurses "eating their young" - I haven't even "hatched" yet and I am getting this kind of response.....

allnurses Guide · Feb 6, 2005

Um, I thought that was the point I was trying to make...
Ouch! Talk about nurses "eating their young" - I haven't even "hatched" yet and I am getting this kind of response.....

Sorry for the misunderstanding - not my intention. I was making the same point as you - oh well, late night and brain is fried. I'm a vegetarian anyway.

steph

RNLaborNurse4U · Feb 6, 2005

:angryfire OOOHHH!!! I am "just a mommy" (not a nurse... YET), but I tell you what - if any doc had put one of those damned vacuum pumps on MY Little One's head unless it was ABSOLUTELY NECESSARY, I'd have gone POSTAL on his ***!!!
Good for you! Why don't you go for Midwifery? You sound like you would be good, and I was SOOOO glad that we had a practice here so that I could avoid docs just like the one you described!
:uhoh21:

And this is exactly why I advocate for my patients. They would be appalled if they knew that this was "routine" for this doc to do stirrups, vacuum and fundal pressure (and oh yeah, usually a big fat episiotomy or laceration from the use of the vacuum).

I do have a goal to become a midwife, it's just a very long road getting there when you have small children, a fulltime job, etc. Right now, I'm working on finding a BSN program that I can fit into my schedule, so that I may at least finish my BSN first.

In the meanwhile, as a nurse, I do the absolute best job I can to make each birth safe. :)

Jen

L&D RN

tasharn · Feb 6, 2005

There is a doctor that I work with....he likes to break the bed, use stirrups, vacuum and fundal pressure (ugh) on every single delivery. No matter if she's a primip or grand multip.
Well....hehe....good patient advocate that I am...I had one of his patients yesterday. She wasn't too fond of him (going to him by default, he was the closest OB, she lost her previous OB). She had a prior SVD with no comps.
Well well well, while Mr Stirrup man went looking for his infamous stirrups to add to the bed (we don't have them on most of our birthing beds, or in the rooms - they are RARELY used), I had her pushing. I mean, vigorously pushing. I wanted to get this baby to crowning+ before he came back in the room, carting his darn stirrups. Back in the room he comes - complaining that he couldn't find his darn stirrups, and no one knows what he was talking about (the type he wanted), and here I have the patient crowning with pushes. Bed is not broken - why bother? She can easily pass this baby out, not anticipating shoulder problems, etc. With his back turned to the patient while she's pushing, here comes the head....I tell him - "hey, no need for those stirrups here....and you wanna get some gloves on?" ..... while I'm starting to deliver the head. He quickly dons gloves, acting flustered because he has an unbroken bed, no stirrups, and god-forbid no vacuum or fundal pressure (cause I sure as heck am NOT doing it for him), and a normal delivery occurring right before his eyes!
In the end....no epis, no vaccum to this little one's head, no lacs even!
Hehe....score one for the nurse who advocated for her patient.
Afterwards....he complains to me "what if I needed forceps? or a vaccum? You're not going to be able to hold her legs up." Wanna bet buddy? I do it all the time for the other docs. And if we have an operative delivery like that, there is always a 2nd RN in the room.
:balloons: It was an excellent birth, and I hope I can help this doc see the light of a non-operative delivery, and how wonderful it can be.
Jen
L&D RN

I work in l&d and have never done a delivery without stirrups, a broke down bed, and with out vaccum (with one doctor) every delivery is an emergancy situation and he gears up and gears my patients up.

BETSRN · Feb 6, 2005

I work in l&d and have never done a delivery without stirrups, a broke down bed, and with out vaccum (with one doctor) every delivery is an emergancy situation and he gears up and gears my patients up.

Well, let it be known that stirrups do NOT have to be used at all (use the footplates or the squat bar as a foot rest). Try these things and you will see how easy is it.

Secondly, the bed does NOT need to be broken either, but that's a far more common practice and the footplates can still be used. Just drop the foot of the bed down a bit and it is out of the doc's way. It is far SAFER to have the bed intact. I saw a baby go right in the underbed bucket once (because the doc dropped the slippery baby).

As far as a vacuum at every delivery......that's bad practice. It sounds like that doc either has places to go or has made the delivery emergent because of his interventions (probably some unnecessary). Of course if he is using a vacuum all the time, he probably causes some of the problems that then become emergent!! My thoughts on that would be to keep this specific doc out of the room until you have the head crowning in your hands. That way, he won't need (or have time) to use the vacuum. For your own benefit......if at all possible, I would try NOT to have my name anywhere on his charts!!

BETSRN · Feb 6, 2005

:smackingf OKay, as I said, student here.... I just googled "fundal pressure" - let some jerk push all on MY big old belly? I don't think so! He'd have gotten his *** a trip straight down to the ER after doing that to ME! Who IS this dinosaur, and why has someone not set him freakin' STRAIGHT? Sheesh!!!

Until you are a nurse, you cannot understand how difficult it is to set a doc straight. Some of them have egos that are huge not to mention the idea that nurses are mindless handmaidens. Thank God those are getting farther and fewer between nowadays.