destova

I had all five without epidurals (my first I had the epidural for all of 5 minutes before the tubing came out and the drugs were seeping into my sheets under my back)... Yes, the pain is intense. Yes, it hurts and can be very scary. But the thing is, if you know more about labor and delivery than what is taught in "what to expect" type books, and if you prepare yourself mentally- you can live through it! I found that moving around helped a lot- being stagnant in a bed just seems to increase the pain tremendously. When I got to the point where I couldn't walk around comfortably I would sit on the edge of the bed holding onto my labor nurse's hips and we would just kind of rock together. That is one of many benefits of going to the smaller hospital for L&D- the nurses there typically have 2 laboring patients at most and give a lot of individual attention. With my last child (she was a hard back labor) the nurse stayed in the room rubbing my back for over an hour with the head of the bed up and me kneeling on the bed with my arms and head draped over the upright part of the bed. Amazing support can really help. If you think the hospital you are going to won't have that ability to give undivided attention, or if your birthing partner isn't going to be that much help, I really encourage you to find a doula, they can help you to focus and can help support you through the worst of the pain. I have so much more I could share about my deliveries, if you want to chat more feel free to email me via trishiag (!at) gmail What it comes down to is this: if you think you can, you can :)

Congratulations to you for knowing what you want to do and going for it! I just wanted to make sure you fully took in the gem in punkydoodles comment- she mentioned the NRP, PALS, & ACLS certifications. I'd say the NRP will likely make you more appealing to a L&D unit. Perhaps also pick up a course on reading fetal monitors? Just look at the specialty side of a L&D unit and learn/certify in as much of it as you can. good luck!

klone, I wasn't being judgmental of the thread or posts, just found it interesting that no one else had brought up the complication risks and drawbacks yet- I had expected to find that in one of the comments. My question is how many of those mothers who end up wanting one because "they're in too much pain and they want it gone" were given the opportunity to work through the pain in a position other than laying down on the bed hooked up to monitors? I am not in any way saying that L&D nurses don't do a good job at helping women through labor and delivery- I'm just saying that the current attitude of our culture seems to be that a woman checks into hospital, lays on bed, gets hooked up, and stays in that one position throughout. So even women who have the benefit of nurses who try to show them other ways, those women have already fully taken in the image of woman laboring in bed. Peek at any message board for expecting mamas and the perception and attitude there are unreal! It seems as though women as a culture have forgotten that we were anatomically built to give birth, and too many medical professionals help to enforce that image. I've seen myself how the attitude in general at a hospital can change the way L&D nurses work with their patients- at our more natural friendly hospital we've had L&D nurses come in from the other hospital and be in a sort of culture shock their first few months on the job... "Shouldn't mom be monitored?!!?" "You're letting her walk around at 8cm dilated? Is that safe?!?" Even as an aide (at that time LPNs on the floor were only "aide" or "tech"), I could tell the perception of birth was vastly different between the two hospitals. And those nurses were always more shocked when a patient would choose no epidural- they seemed equally shocked that the nurses on the floor felt the women were better off without them because of the risks and decreased mobility/ability to change positions and ambulate as needed. sorry so long!

I know you posted this a while back, but you might want to contact Sara Bradbury (serenityhomebirths.com) her email addy is on there. She used to work as a cnm in kansas before moving to iowa to open her own home birth practice. hope that helps!

realized I didn't answer the OP. We have two hospitals here, one very much assumes all laboring women will want/get an epidural. It is acted on without much thought and their wording shows the assumption, "here's your call light, my name is Sue, you can expect to see Dr within the hour, don't get up without help, and you can let me know when the pain is getting worse so we can get you fixed up with your epidural" is pretty much the speech given on admission. The other hospital is a bit more natural in that they use massage, counter-pressure, ambulation, breathing techniques, etc. and treat epidural more as a "maybe" than an assumed fact with each mother. This is not so much hospital policy as it is that the head nurse and the department head were good friends who worked well together and taught the nurses under them the skills they trusted, those skills are now being passed on to new floor nurses. Its more the nursing culture than the hospital policy that is different between the two hospitals I guess. I'd be very interested to see a comparison between the two hospitals in terms of c-section incidence, % of mothers being induced via pit, and use of epidurals. I'm not sure it would be statistically huge in comparison but it would be interesting...

I find it interesting that not once in this conversation has the complications issue came up... epidurals force women to stay on their back in a position that is helpful for medical procedures, but not at all helpful in the world of pushing a child out- the pelvic bones are aided by gravity and baby's position if a mom is up a bit (squatting, crouching, on hands and knees, etc). Also, epidurals have been shown to slow down labor, which can cause doctors to use the beautiful "failure to progress" (in their timeline anyway) reasoning for a c-section. I'm not saying in any way that epidurals are terrible or that they don't have a place in L&D, I understand that each individual woman needs her own methods- but I am saying that there are more issues here than just "what mom wants"- I suspect that if mom were fully educated on the possible risks and issues, she might choose differently. Also, if mom wasn't stuck in a bed on external monitors the entire labor, she would progress faster and with better means to work through the contractions. I'm speaking here from education as well as personal experience. I've had five children. The first was with epidural for all of 5 minutes before it came out and began to medicate the bed (I told the nurse "I feel a puddle on my back", she says "oh, its just amniotic fluid" when my water had not yet broke! she finally came over to check to get me quiet and stood there stunned at the fact that a silly pregnant teenager knew something was wrong). The next was without epidural but in the same hospital- again strapped to a bed with monitors and discouraged from moving around at all. The next three were without epidurals (I'd already learned that I could do it without) and in a different hospital where they encouraged mom to be up and moving, to follow her body and instincts. Very very different labors/deliveries! When looking at these types of issues we need to not only think of what a woman wants in her own birth experience, but also at what value the intervention provides versus the risks and complications it can cause. Women have every right to make their own choices for their own bodies, but should be well informed before making that choice.

I just wanted to update and to say THANK YOU to the wonderful messages of welcome! Shortly after I posted this things went haywire and my husband lost his battle with the wagon for the I-don't-know-how-many time. So I lost a lot of free time and wasn't able to come back to the boards. I've since asked for a divorce and am now a single mama of 5, which sounds like it should be more stressful but surprisingly enough my life is more peaceful now. AND... decided to finish my MSN to be a nurse midwife. Crazy, I know, but I just have to do it, this dream grew on me years ago and will not leave me alone! So I just wanted to say hello again and give very overdue thanks to all of the welcomes. And Sabby NC, your simple question has given me more clarity than anything I've heard about my grandmother in all these years. It is time to let myself be in peace and to move forward. She believed that I was meant to be in the nursing profession and always supported me no matter what I decided to do- I think I'll be making her proud in the next few years :) So I'm finishing the one class I needed to reach RN and then moving straight into masters classes with Frontier to become a Certified Nurse Midwife. Its a journey that terrifies and thrills me at the same time! Looking forward to making friends and sharing stories along the way with you all!

I am not yet off the floor (actually just now returning to the floor and school after a few years of unexpected leave) but am working towards my masters and being a CNM. I also knew that floor nursing was not for me, and wanted a more active role in patient care as far as educating, multiple visits over time, etc. And I knew it had to be with OB/GYN- particularly the pregnancy/birth side of things. So a few questions that led to me my answer of being a Certified Nurse Midwife that might help you: -What type of patients do I want to work with -How much contact do I want to have with the patients -Do I want to be involved in patient education? -Do I want to act independently or do I want the relief of having someone to answer to (this one is tricky- so many people think they must be fully independent, but when they are honest with themselves they realize they like having someone else taking on the heavy sweat work- which is not a bad thing) -What type of atmosphere do I want to be in; such as general hospital, office, college, helicopter, ER, specialized, etc -What type of co-workers do I want to work with (this one you obviously can't pick and choose, but it helps when interviewing to know what type of atmosphere you best thrive in with regards to peers and coworkers) Anyway, asking myself and then answering those questions led me to know that I wanted to be in midwifery. So I'm finishing my degree and then starting on my masters. In the meantime I'm going back to work as a float nurse and hoping to get a lot of shifts on OB until they open a full position, which I'll stay in until my CNM is done. Like you said, I'm nervous too! But if you don't have some fear in your life then you are generally in a rut. I'd prefer to keep growing and moving than to be in a settled situation. Good luck with your changes and hopefully answering those questions yourself will help you to find the nursing career that is best for you! If you go in excited to be doing it, chances are you will love it :)

in most one to one situations in hospital you are in with patients who need 24/7 monitoring. That would make it hard to pitch in and help anyone else on the floor as you can't leave just because the patient is sleeping. in home health care situations this isn't an issue as obviously there is only one patient and no one else to help.

I've worked both one to one in hospital situations as well as home health care. With home health care, I ask the patient if they mind if I study/read while they are dozing or watching tv. They almost always say yes of course- I had one sweet lady who requested that I make a batch of brownies as her grandchildren were coming to visit, which I did happily. In the hospital situation, I would usually ask the floor charge nurse if she/he had preferences on what I did during my time when the patient was sleeping. In general I only worked one to one's on general medical with patients who were detoxing so I didn't dare ask the patients preference (those patients were often in their own world and preferred me not to be there at all). Floor nurses responses varied from helping with paperwork (always from one in particular who knew me well and trusted me) to read a book or watch tv. It just depended on the charge nurse. Asking always helps, as then you can be sure you aren't crossing any lines and it instills a sense of trust and respect between yourself and your patient or charge nurse. good luck!