Ok....its been 4.5 yrs since I gave birth to my first, a boy, but I still pain over my experience all the time.
I would love to hear from you experienced L&D nurses what you think should have happened so I can finally feel validated that they didnt do right by me.
Pre-labor quicky:
Lots of preterm contractions and tons of pelvic pressure around 30 weeks. Appt. with OB at 32 weeks and she about dropped on the floor after I begged her to give me a vag exam just to see what was going on.
22 yrs old, first baby, 32 weeks, 4 centim. She looked at me in disbelief and said you are still walking around???? After checking my chart/ultrasounds (I had several from 1st tri) she said OK, Go home, do nothing, keep hydrated very well, and I will see you next week!
Delivery:
36 weeks hit and that was it....he WAS NOT staying in. Check in and find out my normal OB is on vaca....great! I get to be delivered by someone I have never seen before but o'well.
In triage the chief resident ob checks me ( I still call her superwoman....gawd her hands were huge and she was not gentle in any sense of the word) and decides they need to take a piece of cervix for exam(I am going into my first year of nursing school this semester so I dont know what thats called?) and I almost fell off my bed from the pain. Im put in a room and ready to roll. IV done etc.....voided after put in my room.
3 hrs pass im now 5 cnm, 50%, -3 station (if I remember correctly) and no change. 1st yr res comes in to break my water. After 20 minutes and alot of pain and bleeding she proclaims "I had to have gotten it by now". Yeah, those are words to live by.
2 more hrs no change. They decide to put me on pit. Im upped by 6 every 20 min. They tell me to lay down and rest and they will be back in a couple of hrs. My nurses check on me and say well your getting in a better pattern we should start seeing some change in the next few hrs. They put in internal monitors for both the baby and my contractions. I have been checked only once by the 1st yr resident and told I could no longer get up to void.
hrs pass no change and pit is still going....I was on pit for over 6 hrs with no change is this normal???
havent voided since they put in my internal monitors. Doc who delivers me comes in and does a vag exam......VIOLA.....whats that?????? someone didnt what????
My water hasnt been broken yet????? So what was the "I must have gotten it by now speel"????
After that I was in so much pain I cant explain to any of you. My internal monitor for my contractions was in the 220's and I felt like my whole body was being torn in half. The flood gates had been opened and I had gone ALL NATURAL until that point. Not because I was being "stoic"sp? but because I didnt need it.
My hubby, sister, mom, and MIL were all bawling as I writhed in pain and with each massive contraction. After 45 minutes of begging my mom in a barely there voice to please do something "Superman"(chief res ob) came in and my mom had words with her. She was not very kind to my mom and said she will be fine...women give birth maam every hour of every day. She will live. She contacted Dr. of Aneth. for my epi.
That was a whirlwind and he tried his darndest to get me that stuff fast! My absolutely wonderful and glorious L&D RN (who was Jamaican...god I loved that woman!) Spoke to me kindly as I went through it with her great accent.
He looked at me and said...roll over and I will get your meds on board. I cried and said "I am sorry but I pushed....is that ok?" He immed. looked at my RN and said page the dr. 911 and proceeded to say its too late. No meds darlin your going to have a baby. Well that epi was for naught as I never got relief. I tried to push but I couldnt. Hadnt anyone realized I needed to void???? The doc did immediately so I could proceed to push and immediately began telling me how sorry she was. They took off over 1900 cc's! The doctor told me its was almost the equivalent to a 2 liter of pop and the most she had ever seen at one time. I paid dearly for that oversight. My son came flying out in a short 15 minutes after that with his own complications for months.
I still think if they had broke my water I would have never gone through that pain or trauma. My daughter was born in 1.5 hrs very easily.
Am I justified in feeling that I was done very very wrong? And could I have done anything differently or not?
Thanks for reading my long story. I really needed educated people to read it and get it off my chest.
I plan on spending alot of time in L&D after getting my RN before going for my CRNA. I dont blame any of my nurses for the oversight....however I blame the 1st yr res. and the dr. who should have been behind her making sure my water was broken. Please tell me this doesnt happen all the time????
I'm going to be another that thought about a forebag as well. And also, having been a prima para on Pit @36 weeks, I have to tell you I was on it 15 hours before I was complete and yes, it feels like you are getting beat with a bat. If it ain't ready, it ain't gonna open that easy.It sucked. Boy can I co miserate.I was fortunate enough to have an epidural after 3 hours though.
Some births aren't what you think they are going to be. I blame, "A Baby Story". I hope you next goes as well as you hope.
Reading back I have to agree. It was your nurse's responsibility to see that you were voiding.How many hours did you go with out a void with fluid running in you?? :uhoh21:
Specializes in ER, Labor and Delivery, Infection Contro.
Just a few thoughts regarding your post:
Most OB/GYN's WILL NOT break the water if babies station is -3. Great risk for prolapsed cord (a obstetrical emergency)
Yes, I have seen woman on pit for 6 hrs without change. Not frequently, but I have seen it.
Perinatal care-question. Were you contracting? Any signs/symptoms of preterm labor? Tests done? Did you "go home and do nothing" on strict bedrest? Were you on medications?
Can't initially think of any reason a person would take a "piece of your cervix" without having previous abnormal pap smears. Could they have done a pelvic exam and done a cervical smear (pap) or/and cultures?
Monitors and their values can vary-I know our intra-uterine pressure monitors don't go up to 200-so I can't speak to your value of 220.
There are just too many questions to really address how well care was given. Unfortunetly, it is not unusual for it to be "too late" for the epidural. It is really a bummer, but not rare.
I hope that by getting these replies/more questions etc. you will be able to come to peace about your birthing experience. And yes, it will be an experience that you can use in helping others in L&D.
First of all let me say that I am very sorry for the terrible things that happened to you. There are some things that you described that are very bad.
Second your not crazy or strange for feeling the way that you do and I'm glad you posted. The best way to put your expernaces into perspective is to talk about them and try to understand the things that happened to you.
The main problem I see is that things were not expelained to you. Pain is so much worse when you are scared. Not understanding the things that were going on had have made them very scarry. It sounds like the hospital was really bussy and becuse of this you were neglected, either that or they were just a bunch of jerks who did'nt take the time to make sure you understood the things that they were doing to you.
Even though your nurse was very nice during your epidural she neglected you. Not all OB residents are created equal some are skilled and have terbible bedside manner some vica-vera and some are just clueless in both areas. As a nurse in a teaching hospital she should have been with you whenever the resident did anything with you, to make sure they did it correctly and at the very least to expalin things to you. Explaining things and makeing sure you are comfortable is a nursing responsibility.
Also where the heck was your nurse when you were hurting enough to want an epidural? she should have offered it to you when she could tell you were ready or at the very least been there when you asked for it. It's the nurses responsiblity to advocate for you and make sure you are safe, so even though it doesnt sound like your doctors were that great your nurse sounds worse.
The sample of cervix? I'm not sure what this was for. It may just be something I have never had expernace with but I can't even imagine why they would want to take a section of your cervix with preterm labor. No matter what it was for they should have made sure you understood why before they did it to you. I have to wonder if this was some type of study and not nessasary.
The way you describe the pitocin sounds alright. policies differ from hospital to hospital but it sounds as if your solution was mixed with 20 units of pitocin in 1000cc of fluid. turning it up by 6 cc every 20 minutes would be 2 miliunits every 20 minutes which is ok and safe with close monitoring.
Is it possible that your contraction monitor was reading in the 120's? this would seem more likely, the graff paper doesnt go up to 220 and im not sure if the digital readout does or not but if it were reading that high It would most likly mean that the internal monitor was placed incorrestly as I have never seen or heard of a reading this high.
Your poor poor bladder, this in another place where your nurse failed you. I dont get patients with internal moniotors out of bed either but I would have offered you a bed pan or even placed a foley. To make you hold your urine like that while you were reciving IV fluids (which were probebly at least 2 litters over your labor) and being pregnant was poor nursing care. Having your bladder that full while in labor is not only painful but can cuase dmaage to your bladder not to mention it most likely did deley your delivery.
As for the Arom, Supperwoman was a moron, Like smiling and the others said she most likely broke a forbag but 20 minutes for an AROM? and her comment "i must have gotten it by now"? Im surprized she had the brain power to get to work that day.
As for being dilated to 4 cm at 32 weeks it's not all that common but not unheard of and it was okay that your doctor sent you home. She probebly should have xpalined things better to you but it was okay to send you home if you werent contacting.
Learn something new on this site everyday! Thank you for all of your replies. Not only did you answer the original posters questions, but you also help to educate so many of us just breaking into the field. So many of you have such a way with words, it so easy to understand. If any of you feel a call to teaching PLEASE follow it!
Attemping to (or even contemplating) breaking your water at -3 station is very foolish. You're asking for a cord prolapse. Your experience was inexcusable. That's exactly why I love working in a small hospital without interns, residents and other fools! There is rarely a need for internal monitoring (especially the one for contractions: called an IUPC). Gald your second experience was better.
There is no standard procedure to take a piece of your cervix at all. Maybe they used those words. They would routinely take cervical cultures to rule out infection but that is only a swab (like a Q-tip). That Ob thatw as covering sounds like a nightmare. I am truly sorry for your experience. I would certainly want someone to review the chart. There are a lot of highly UNSKILLED docs out there, unfortunately.
Could the "sample of the cervix" been a Fetal Fibronectin (FFN) maybe? That is something they would do if you were preterm, but I don't know about at 36 wks (that would be too late I would think).
dawngloves, BSN, RN
2,399 Posts
I'm going to be another that thought about a forebag as well. And also, having been a prima para on Pit @36 weeks, I have to tell you I was on it 15 hours before I was complete and yes, it feels like you are getting beat with a bat. If it ain't ready, it ain't gonna open that easy.It sucked. Boy can I co miserate.I was fortunate enough to have an epidural after 3 hours though.
Some births aren't what you think they are going to be. I blame, "A Baby Story". I hope you next goes as well as you hope.
Reading back I have to agree. It was your nurse's responsibility to see that you were voiding.How many hours did you go with out a void with fluid running in you?? :uhoh21: