OB Nurse's View on Natural Childbirth

DroogieRN · Mar 26, 2012

I had natural childbirth with CNMs both times. I was in a birthing room in a hosptal setting, and I wouldn't have changed a thing, except possibly to have provided more education to the nursng staff. The nurses were bound and determined that I be hooked up to the monitor, and because I and the midwife refused, came in constantly with the portable. It really interrupted my concentration, especially when I was in transition.With my first child, in 1992, my nurse came into my room after I left the birthing area and said, "Has the feeling returned to your legs?". I guess natural wasn't the norm then. I told her I hadn't had an epidural and she didn't believe me until she looked at my chart!

LexiRN2 · Mar 26, 2012

For the record, if you're into the idea of a natural childbirth, the lithotomy position (legs up in the stirrups) is nearly the farthest thing from "natural".

I said I want to use methods other than the lithotomy position in my original posting

LexiRN2 · Mar 26, 2012

You may want to look into a birth center with midwives as another poster said. You will certainly be fighting against policies especially if you are going to end up (or start with) pitocin. Birthing centers are excellent for very low risk pregnancies and allow for all the freedom. I know I have to fight some providers to allow women to walk and be intermittently monitored. I have had great outcomes and they are "coming around" but still have to plead my case each and every time. You certainly should talk to your provider about their "views" on what you want and find out how the hospital where you plan to deliver looks at the 'au naturale'...

My city doesn't have any birthing centers. My OB practice typically has the midwives do deliveries as long as everything is going fine. I'll need to look up hospital policies and find out how much I'll be able to try and dictate some of these things. I've read up on the continuous monitoring and it definitely is not necessary, and as another person said, often leads to intervention that is not necessary. I'll be making a list of questions for my next dr appt.

allforthekidds · Mar 26, 2012

I'm not a nurse yet, but I have 5 children myself and although thankfully I did not ever have a c-section, each birth was totally different. I was only 21 when I had my first baby, I tried the "natural" route, but after 24 hours of labor I caved and got the epidural, no regrets, but I did ask myself why I hadn't done it sooner:rolleyes:. My 2nd baby I tried natural again and again I couldn't deal with the pain, but this time the doc had a hard time finding my epidural space and kept putting it in a blood vessel. About 10 tries later, they finally got it, only to have the baby about a half hour later. My 3rd baby I had at a birthing center, no epidural and had her in 2 hours. My fourth I went for natural again at the birthing center, midwife found baby to be in distress, so I was sent down the hall to L&D. My son came out with cord around his neck and a broken clavicle(poor guy, felt so bad), he was big. My 5th child I didn't want to go natural, I didn't want to bear the pain again, however, this time the anesthesiologist could not find the epidural space(apparently my spine is overly vascular, don't let this scare you, the anesthesiologist said after all his years he had never had that happen, go figure:confused:) and refused to try anymore. Thankfully she came out in only 2 hours.

After all of this, I have to say that every L&D nurse that I ever had was awesome. I didn't ever have a nurse I did not like, and they always supported me with whatever choice I made. If I wanted an epi, if I didn't want an epi, if I was screaming at the top of my lungs, they were there to support me and to take care of me and my baby.

Sorry for the long post, I just wanted to let you know that L&D nurses will be there for you no matter what choice you make and they will also be there for you if plans change. Congrats and good luck with your delivery:)

nurseprnRN, BSN, RN · Mar 26, 2012

i had my 2nd kid in a birthing center, no epidural, no lithotomy, midwife, and i got to cut the cord. hint: it's really tough. i meant the cord, not the unmedicated birth!

if that's what you want, look around. my daughter did that for her second, too, after her 1st in the hospital turned out to be no so great. i got to meet her midwife for the 2nd; she was wonderful. it's worth the drive to get care you feel good about.

and as for "hospital policies," and who "dictates," well, they taught us all in nursing school that the patient has the right to refuse anything. go for a visit to the unit and make friends with the nurses. in this day and age, they are sure to have heard of unmedicated births.

allforthekidds · Mar 26, 2012

Oh and as far as having to be hooked up to anything, the only time I was required to be hooked up was when I requested an epidural, otherwise I was free to do whatever and the baby didn't need to be constantly monitored unless distress was found. I'm sure each hospital is different, so definitely check policies:)

eden · Mar 27, 2012

I enjoy the natural births, we have so many things they can try. Luckily I work in a very low intervention hopital so we see lots of natural births. That being said if a mom wants an epidural I am okay with that too.

Vespertinas · Mar 27, 2012

I said I want to use methods other than the lithotomy position in my original posting

Ohh yes, you did. My mistake.

melmarie23, MSN, RN · Mar 27, 2012

Please don't ask for a reference but I remember reading recently something about how constant fetal monitoring is now considered unnecessary in most cases and even harmful because it precipitates more interventions that should have been left undone

there is actually a lot of research that supports this. Not that continuous EFM is harmful per se, but that it can lead to increased, and sometimes unnecessary interventions.

melmarie23, MSN, RN · Mar 27, 2012

with regard to the original ?, I am all for it. I am a natural birth momma myself. I went med free and had relitively intervention free birth with my son (intermittent monitoring, no IV, only one cervical check my whole pregnancy...while I was in labor and in transition). Had a waterbirth too! Granted............I went the birth center route with midwives. But I knew for myself, I had to remove myself from temptation in order to do it. So thats what I did.

That said, where I work, we are very supportive to natural birth and routinely attend many! Some docs (usually family practice physicians who deliver where I work) and the midwives are more open to intermittent auscultation than the OBs, but that can be accommodated provided they are not being induced or augmented for any reason. I've had many mom's without IV access. I have yet to see stirrups used for a delivery. I've had docs who've caught babies where the momma's have been on on their hands and knees or on the birthing stool. If mom and baby look good, we almost always accommodate mom's wishes.

beachmom · Mar 27, 2012

I've had a C/S, an epidural/episiotomy and a natural - in that order. (Back when VBAC's weren't "dangerous" ). I tell my patients I'll support them in whatever they choose, and I mean it. There are pros and cons to each. My episiotomy gave me more pain than my C/S. My favorite was my last - I stayed in the shower until they made me get out. Then got in bed and pushed my baby out with only a small tear.

I used to be more pro-natural. However, I've had lots of women try natural, then by 6 cm change their mind and get an epidural. They are sooooo happy for the epidural, I've become more pro-epidural. Also, some women, once they get the epidural, they relax, and labor goes quickly to complete. The majority of women come in planning on epidurals. Last night had a woman with a really good one. Baby was crowning, and mom was laughing. The baby's head bobbed in an out of the birth canal. Precious.

We can do intermittent auscultation unless they are high risk or on pit. Everyone gets at least a SL. I do get upset with doctors who only want the semi-fowler's position. Usually we have family members help hold legs in pushing. If a woman is large, we may use stirrups. Some doctors and both midwives will use the squat bar or hands and knees.

One of our doctors only does the back position. The pt. was pushing, and baby wasn't moving. The nurse asked if we could try side lying. Doctor said no. Doctor left the room, and nurse put pt. on her side. Then had to yell for the doctor quickly to not miss the birth. Dr. had an irritated look, but she couldn't argue with success.

Nurse2b7337 · Mar 28, 2012

I have four children. The first child I had a epidural I was young and couldn't bear the pain. When I delivered my two middle children I wanted to have them naturally and I did. I told my doctor my wishes and I carried them out. Was it hardwork, absolutely but it also was worth it!! My last child I had an epidural it's totally up to you!!