OP babies=more pain?

[ChristyE]

Since I am not a nurse, I ask you to forgive my intrusion onto your board, but this is not something I feel like I can discuss with my OB or anyone. No one seems to understand.

A month ago, I gave birth to my fourth child. My last two babies have been born straight OP (the third baby with an epidural, the fourth with no medication).

Even though I did deliver my second child without medication, I can't seem to get over the memories of the pain I felt with these last two births.

In my third birth, I had an epidural and yet I still experienced excruciating pain in my bottom (no one knew baby was OP yet). I kept telling the nurse that I was hurting more than I ever did with my natural second birth, and all she did was keep treating me like I was weak of character, saying things like "an epidural doesn't always take away ALL the pain" and "an epidural doesn't help with the nerves in that area".

Once I was complete, the nurse had me push and then began to chide me for pushing ineffectively (even though I had pushed two babies out before with no problem!). After thirty minutes, she brought in another nurse and they started discussing the possibility of an OP presentation. Fortunately my OB came in at that time and said, "Leave her alone. An OP baby needs to come down on its own." Twenty minutes later, the baby did just that and was quickly born. When the baby emerged straight OP, everyone in the room went, "Ah ha! No wonder you were hurting so badly!" I felt like hitting all of them.

With this last birth, the baby was born 45 minutes from the time I arrived at the hospital, leaving no time for an epidural. The nurses laughed at me among themselves when I refused IV drugs (I just don't like feeling dopey.). During one contraction, my husband couldn't hold my hand because he was phoning his parents and I reached for the nurse for support. She wouldn't hold my hand--she recoiled as if I had leprosy--and only allowed me hold on to her jacket. I was hurting desperately, and they again made me feel like I just wasn't handling it well.

When my daughter was then born (to everyone's surprise) straight OP, everyone got that same look on their face, almost like, "Oh. I guess she really was hurting."

During both of these labors, I felt like I kept good control of myself physically and emotionally. In other words, it was clear that I was hurting, but I didn't climb the walls and I wasn't what I consider whiny or "difficult".

I suppose my questions are:

1) Are OP babies especially painful?

2) Why didn't the nurses support me? Why did they make me feel like I was making a big deal out of nothing?

Thanks so much for your help. Maybe I just needed to vent about this. I know that childbirth is supposed to be painful. I wasn't looking for some "romantic" childbirth experience--just some compassion and help through the pain.

I don't know why I can't seem to get over this.

Sincerely,

Christy

[keeper]

Hi Christy,

I'm not a nurse either, and these ladies have been very accomodating of my occasional posts on this board. I've found it to be a wonderful resource.

I am a doula in training and a midwife to be, and I can tell you that YES, OP hurts way more than an anterior presentation! I remember the month I was due with my last baby, my midwife told us one of the other February mommies had had her baby posterior. (Med free, at home). I still remember my midwife's exact words: "Posterior babies are why God created epidurals!" And this from a woman who wholeheartedly advocates unmedicated birth!

I don't know if you plan on having more children, but if you are and you face this situation again, there are ways to lessen the pain. A hands/knees laboring position can not only provide relief, it can actually cause a baby to flip to an anterior position if the membranes have not ruptured.

Also, counterpressure on your tailbone can help ease the pain. The woman I mentioned previously had bruises on her back from the amount of counterpressure she needed from her husband, but she couldn't make it through a contraction without it!

If your doctor and hospital are progressive enough, the hands/knees position is very effective for second stage, with the coccyx more able to move out of the way of that head and the pelvis more able to open.

I'm sorry you had such a bad experience with your nurses. I had one like that with my second birth, and we called her the "poopoo nurse." Fortunately for us, she was not in the room much. Our other nurse, Char, was absolutely wonderful, empathetic, caring, positive, everything a good nurse is!

Congratulations on your four beautiful children!

Sarah

[OBNurseShelley]

THis reply is to Canoehead, referring to the statement she made below in quotes.

YOU HAVE GOT TO BE KIDDING ME??

"I've never heard about not pushing and letting the baby move down with OP presentations, but obviously it worked. OB/GYNs get the big bucks because they know that stuff. "

are you an L&D nurse? If you are, I feel for ANYONE that has to work with you, and if you aren't, GET A REALITY CHECK!

That is the most absurb, ignorant, absolutely NOT true statement I have seen anyone make, EVER.

YOu head is obviously in the sand

I am so annoyed with that statement, I can't even see straight.

Have you even BEEN around any L&D nurses?? If you have been, you would know damn well, 99% of the time, they KNOW about positioning, laboring down, etc than the docs care to admit. Yes they have more training and know more about the technical things, but they don't sit at the bedside day in and day out, seeing patients labor, etc. Most docs think the only way a baby can come out, is a patient on her back legs in the air, ML epis, and an epidural so she's not "out of contorl" or "making too much noise"

Pardon me, but you're an ABSOLUTE IDIOT for making that statement, and an insult to L&D nurses, ALL nurses for that matter!

[SmilingBluEyes]

OUUUUUUUUUUUCH....shelly I know how you feel; I was irked a bit at this poster's words too, but.....

Maybe that was best said PM?

take care now and take a NICE deep breath, hon.:kiss

[LisaRN2B]

Originally posted by mother/babyRN

You're so welcome! Just remember that one 12 hour labor has the energy expendiature of two marathons and THEN we expect you to push!{{{}}}

My first was OP, though my OB turned her with forceps before delivery. That was almost 15 years ago, so I don't know how they do it now, or if that method is still acceptable. (I am a student with hopes of being an L/D nurse after graduation). Yes, I still remember the pain...yikes!

WOW! I did not realize that a 12 hour labor was equal to the energy expenditure of 2 marathons (BUT I can BELIEVE it!). My first labor was 23 hours, second 6 and the last one 22 1/2. And to think, I didn't know I was such an athlete! lol :chuckle

[BETSRN]

I did a completely posterior labor with one of or midwives laterly. We had the woman push on her side and while doing so, the CNM was often putting gentle pressure on the side of the baby's head in the direction she was trying to turn her. It worked like a charm. Side lying is a miracle for many problems called by poor positioning.

A for the nurse not allowing you to touch her. All she had to do would have been to reposition your hand in hers and just remind you to not grasp her so tightly. I find that my patients respond very quickly if they are hurting me and are more than willing to make adjustments with me.

Again, I would say that I am sorry you had such a lousy experience with that labor nurse. She needs to take a step back and change her specialty or get out of nursing altogether. As I said before, please send your patient satisfaction survery back and mention her name (or write the nurse manager a personal note). She needs to realize that her actions do effect others; especially in such a vulnerable time in a person's life. That manager has 24 hour accountability and would want to know how her staff are effecting their mothers.

[BETSRN]

Canoehead: do you ever just let your patients alone and just let the baby come down without the aid of pushing? The uterus WILL bring that baby down without cheerleading and pushing until the mother feels enough rectal pressure to WANT to push. It's called "laboring down" and it keeps the doc out of the room and hands out of the lady parts until the baby is crowning.

Just curious, canoehead, are you a nurse?

It is sad to say but often, nurses do NOT "think outside the box" as they should.

[Hellllllo Nurse, BSN, RN]

Here I was reading this lovely, touching thread, then the insults and name-calling started. As another poster said, that would have been better to send in a PM. (wincing over those words, here).

I do not know why I am still surprised to see a nice thread here turn ugly.

[mother/babyRN, RN]

Oh for goodness sakes! We all have different experiences and different styles...Then too, when we are in labor we perceive differently...I just think that we should take what helps and use it..Share share share....Passive decent and no pushing as long as mom and baby are fine at fully WITH an epidural is a great thing, but if there is no epidural and mom hurts then one cannot delay pushing really....

I have used pushing on the side and sometimes it works, sometimes it doesn't....Knee chest also, or squatting, or in the bathtub if that helps....I have also lubed up the old glove with either mineral oil, astroglide or castile soap with excellent results.

The bottom line is that it isn't easy and until we are actually in such an experience, we can't know how we feel....Even imaginary pain still hurts and I remind patients who wonder how they will be that labor and delivery is the only place in the world where women are in charge and allowed to be crabby and we will never hold anything against them. I also take the time to mention that they are in charge (since they often feel so out of control from the get go), and temper my comments with humor....Usually I may even mention to someone who is concerned about "being a wimp" or "bothering the nurse" that those two things are just not so and that they are there because they have to be and I am there because I want to be....Sometimes coaching can seem like bullying, and I take time to remind people of that...Positive reinforcement is a beautiful thing...The lovely person starting this thread merely desired to be validated....We all hope we would be perfect every time but sometimes we don't even realize that we may have negatively impacted a patient.....

All we can do is learn learn learn from our patients and each other..

[canoehead, BSN, RN]

We rarely use epidurals at my hospital, so just letting the baby labor down is not usually an option as mum wants to PUSH. But yes I have gotten great results with just letting baby come down while mom rests. I just hadn't heard about OP babies coming down more effectively if mom doesn't push. Obviously this woman was in a lot of pain so I would have encouraged her to push if she felt the urge and was fully dilated thinking she would birth sooner. From what she said the opposite is true.

I'm awfully glad we have this forum so we can exchange tidbits like that, and probably in a larger hospital once the doc mentioned it, it would be common knowledge for all the nurses. Nursing staff here are soooo much better than docs at position changes and comfort measures that it's sometimes embarassing to have to tell the doc to take down the drapes and let the woman squat, or turn, without making it obvious that they are holding up the show.

And, just to clarify, just because I admit to being stupid and not knowing something doesn't mean I think all the nurses on this board are equally dumb. If anyone has any other good tips throw them out- I'll be happy to take some flak if it means I can help our laboring patients get through the birth with a little less pain.

[BETSRN]

I would wager that at nmost places, the nurses are much better than docs at all of this labor stuff. That's why we all keep docs out of the room as long as possible! HA!!!!!!!!!!!!!!:chuckle

[sbic56, BSN, RN]

Originally posted by BETSRN

I would wager that at nmost places, the nurses are much better than docs at all of this labor stuff. That's why we all keep docs out of the room as long as possible! HA!!!!!!!!!!!!!!:chuckle

ITA with that!! When she asks, "When will you call the doctor?", I sometimes want to say, "When I know he doesn't have time to undermine all of our hard work!" No disrespect to the docs at all on this, either. I sure don't want to be alone and responsible for that shoulder dystocia or PP hemorrhage, but please leave the laboring/pushing to me. I'll be sure to call you when I need you. Most laboring mom's don't realize that doctors are there for delivery, it is their expertise, but the nurses are the experts, when it comes to getting them through the labor process itself. Furthermore, I find most docs truly appreciate the nurse who doesn't summons them until delivery is imminent.

[OBNurseShelley]

EXACTLY

My response was to the fact that canoehead, said

"the docs really know their stuff this is why they get paid the big bucks"

This is exactly the kind of ignorance that gets passed on to the public. Don't get my wrong, I appreciate the doctors, but that is something an uneducated NON-health professional says, NOT an experienced Nurse working on ANY unit

I was not out of line, and I was offended, so if you don't like my response, get over it

Ya'all can stop with the flaming now