Zhlake

I wondered the exact same thing about PPD. It is just very aggrivating for many of the nurses. We are so used to the women getting more and more independent before they leave. And then this culture pampers and dotes over the women so much more. Any time one of them goes to get out of bed, 3 of their friends will rush over to them to help them out. It causes a lot of eye rolling among the nurses, but I really think we need to change our perspective on that. In fact, one of the nurses was joking that the "entourage" had arrived the other day. 5 women came in to a patient's room after delivery. They were brining hot tea, food and of course an incredible amount of support. I said, "I wish I had an entourage after I had my babies!"

Oh they are very modest even with us also. And it is nearly impossible to do a fundal check. They grab our hands and say no. And I don't mean the aggressive massaging to get blood to flow, I mean just a quick check to see where it is at. I had a c/s patient the other day and we told her that the CRNA would be a man. She asked if we had a female available and we said no. She was flexible with that and it wasn't even an issue. We recieved some information from the Muslim Center in KC that they will prefer female caregivers but in emergencies or if none is available they will accept a male.

Our experience has been different than yours so far! They have kept their hijabs on but have taking off the rest of their stuff. All of them so far, (we have had quite a few) have had the female circumcision. Varying degress of such. One was very easy to get a foley in, and one was exceedingly difficult. The issues seem to be regarding infant bonding and also the mother's self cares after delivery. None of the patients we have had are interested in holding their babies. At all. In fact, they act almost angry when you ask them to hold the baby. Then, the nurses feel like the patients are very demanding and rude to them in the postpartum area. I feel like that probably relates to the language barrier, but it is leaving a very bad taste the nurses' mouths. The patients also do not want to get out of bed and very dependent on the nurses for every little thing. I have seen this with other cultures (female family members really pampering the mothers and the mothers doing very little) so I understand where this is probably coming from, but it is just opposite from our Western experience of encourage mothers to do things independently.

I am wondering if any of you have experience with Somalian culture and childbirth. I work LD/postpartum/nursery and our small town has had a huge influx of Somalian workers. This transition has been very rocky in our unit, even though we are very accustom to working with other cultures (nearly half of our deliveries are hispanic). I am trying to do some research, but am not finding much. Any input appreciated!

I was talking with a nurse on the OB floor the other day and she was telling me a story about a baby who had been in special care for bradycardia. She just kind of mentioned that when some babies are bradycardic, they check mom for RA factors and that sort of thing. They found out mom had lupus. She was telling me a rather long story and this was just sort of in passing. I didn't have a chance to ask her to expand on this. I had never heard of this, but it reminded me of my brother. His heart rate was 70's or so after birth so he was evaluated by a cariologist when he was a few weeks old. Nothing ever came of it, but mom found out she had RA 2 years later. I told her this story I had heard and she had never heard of that link either and she was intrigued. She was a labor nurse and then worked in an OB/GYN office so I was surprised that she didn't know about this. I called my sister who works in a large metro hospital in OB and she hadn't heard of this either. She thought maybe this link was more related to older babies (>3 weeks old or so) and maybe that was why none of us was familiar. Anyone else heard of a link between baby's bradycardia and RA/lupus type syndromes?

Yesterday I had an annual OB skills day and one of the things we do is review strips of interesting cases throughout the year. Every year there are a couple of stillbirths that are reviewed. Does anyone else hate doing that? I mean, I understand the learning potential that is offered, and appreciate how much I do learn from them....but it bothers my heart so bad to see them. Like I am "watching" a baby die. I literally just feel sick the whole time. I guess what I am saying is that my head likes to learn from that, but my heart just aches the whole time. Anyone else have a hard time with that?

I clocked out 20 min before I was a patient (clocked out for an appt and had to go straigt back due to bad NST) and 7 hours before I delivered. I was 6 cm dilated when I was first checked. Couldn't believe I was walking around like that all day! I had decided to not stop at all before I delivered. I delievered at exactly 41 weeks, so I was really happy I hadn't taken off early. I wanted to spend all my FMLA time with my babe!!

I am a lactation consultant at my hospital. We did a process improvement on getting babies to the breast. After some education, our average time for vag deliveries was 28 min from birth until first freeding. For c/s it was 30 min. Only 2 min difference!! I couldn't believe it. Basically as soon as mom leaves OR and gets in the recovery room, they put baby to breast. Baby only goes to NSY if there is a problem.

Sorry to nitpick...but you can drink coke while breastfeeding. Some babies are very sensitive to caffeine, but I always advise moms to drink caffeine in moderation if desired, just like during pregnancy.

Yeah we don't have nurses who only do labor. We all do labor, special care nursery, well nursery, postpartum and gyn surgical. And if we float to all other areas of the hospital if needed. Now that is what really sucks!

Well that is what happens when you work in small hospital!! There are many many hospitals that deliver far less than that.

We never do foleys either.

We have something like 500 deliveries a year, so some times we go several days without any new babies and then of course we have other days when we have 4-5. Either feast or famine. You know how that goes.

I am a labor nurse and I doula with my second labor. She was worth her weight in gold!!! I loved the support I got from her and would highly recommend a doula to anyone. We worked together extensively during my pregnancy. She talked to me in length about my last labor and how I felt like that went. She also talked to me about comfort measures that I would like to try, and others that I wasn't interested in. We discussed the book "Birthing from within" together. I have a very supportive husband, but the doula was just that added boost of support. I got to pick which labor nurse I wanted, so I let her know I was having a doula, and we got to talk about everyone's roles beforehand. My doula told me that she would not discuss any procedures with any medical staff. If I had questions or wanted to discuss things with my doula, she would do that, but I had to be the one to talk to the medical staff.

ITA with Bets. I have seen some with reductions breastfeed with very little difficulty at all, and then others that have had to supplement quite a bit. Hook up with a good LC so that you can have regular follow up while breastfeeding. It will help put your mind at ease.

http://www.thehawaiichannel.com/news/4469470/detail.html

I had a birth preference sheet with #2 after I had worked in labor for 3 years (yes, it was a preference sheet--you can't "plan" labor!!) Some of what was on it.... *after initial NST, doppler every 30 and then every 15 in pushing *No AROM unless medically needed *no induction unless medically needed *ability to choose any position desired for laboring and delivering *No episiotomy unless medically needed *Saline lock *do not offer pain medications How it went.....I had a wonderful birth experience with #2. It was a great mixture of needed medical intervention and natural labor. At my 41 week visit, Brenna had a huge decel during the NST. I am laying there and it plumeted to the 70's after being on the monitor for like 5 sec. I was just looking at the monitor in disbelief. I jumped my naked butt off the table and swung open the door and hollered to the nurse "I need the doc in here NOW". She knows I am a labor nurse, so the doc comes running in fast. I started crying, thinking something is terribly wrong and I am going to have a section. I head over to labor (I had just clocked out!!) and they monitor me. The strip looks great and I am 5 cm dilated. The nurses just assumed I would stay, but I told them that if I wasn't in labor and the baby was fine, I was going back home. I had planned on letting her strip my membranes though at my appt, so I thought it would be a good way to evaluate how the baby was doing. She stripped my membranes and I started with some moderate ctx. She started having lots of variables, so we decided to stay and have a baby. Doc wanted to break my water and give me pit, but I asked to walk for an hour first. I started walking, but it felt so uncomfortable being barefoot. So I put on my work shoes and started walking. Like mall walking, not meandering down the hall like so many do! I was on a mission. All the nurses were laughing, but I just kept going. Doc comes back to break my water after an hour and my water breaks right as I am standing there ready to get back in bed. By that time I was 6 cm dilated but not having ctx. Well after SROM, I started ctx like there was no tomorrow. I was monitored fairly extenisvely due to the variables. I got in the tub when I was 7 or so and was there until I started bearing down with ctx. Got out, and was 9 or so. Waited a few more ctx and then started pushing. I pushed in side lying to decrease any tearing (i had extensive trauma after the first one in which I delivered on my back). I requested no direction with pushing. I just did it as my body told me. It was the natural grunty pushes. Probably 3-4 per ctx. I checked myself and said "hey, there is the baby's head." So doc goes out to scrub in. I remember thinking "she must trust my self checking ability!". I was pushing on my side, and I just got this instinct to roll over to hands and kness. (i had never wanted to deliver this way and could never fathom why anyone would). I said, "I need to roll over now". I rolled over and voila, out comes the baby. That fast. Basically just plopped right out. (she was 9#1, but so was my first and he just fell out too). It was weird, because I am facing the other way and I can't see her, but I could feel her head on my leg. They had to delee her because she was meconium, but she did great and they placed her right on my chest. She stayed there through repair and she nursed for 2 hours straight. they didn't do anything with her until she was done nursing. I knew she would be LGA, so I wanted her to get as much colostrum as possible. We went out to PP after the longest recovery EVER, and she slept on my chest that night. She was so cute. So that is basically how it happened. She needed some intervention, but I was able to keep it at a minimum. I was really happy with how it all turned out.

We do this too. The first three times that someone voids after a vag deliery a nurse helps her to the bathroom and we measure the void. After those 3 times then they are free to go by themselves.

We don't do routinely do BS either. Only for babies at risk. We did do them routinely but stopped a few years ago.

You let people leave who do not have car seats?? Occasionally we will have people who do not have car seats--we just tell them they can't leave until they have one. Our health dept rents them, so we can refer the parents to their if necessary.

Another message board I am on had this post..... "when I did my maternity rotation in Nursing school one of my classmates took a new mother down to the car when she was discharged....the hosp policy was NO corificeats be brought into the hosp ...all babies were carried out.. this girl and her mother had the babies bucket in the front seat foreward facing.....did you not read the directions? and when my fellow student tried to help them fix it by explaining the problems the secuity guard had a stroke and said "we arent allowed to do that, you should ahve let them take the kid home like they had it in the first place" what idiots! both hosps I had my boys at a civilian community hospital and a Navy Hospital both made me bring the corificeat in and show the nurses I knew how to use it, tighten and loosen straps and properly strap baby in......" So it got me thinking--what is your policies for car seats? On the thread following this post.....parents had a wide variety of experiences. Many said they were NOT allowed to bring their car seats inside. I don't understand how parents can properly fit their babies in the car seats if they can't bring the seat inside?? Many said they had no nurse escort to their car, so for all the hosptial knew--they could have taken the baby home in their arms! Our hospital requires that all car seats are brought inside. The parents then get the straps adjusted as necessary to the baby. The mom then carries the carrier on her lap down to the car. The parents then secure the car seat in the car. We always make sure they are rear facing. We used to help them a lot more with the car seat in the car, until we were told that could be a liability issue. Our discharge note is something like "...parents secured rear facing car seat...."

I still have to disagree with you on this point. I am refering to: http://www.iblce.org/pathways.htm "Pathway B At least two (2) full years of post-secondary academic credit; or an Associate degree (AA), including a diploma RN; Plus a minimum of 4000 hours of practice as a breastfeeding consultant; Plus a minimum of 45-hours of education specific to breastfeeding within three (3) years immediately prior to taking the exam. " "Pathway E Exceptions based on individual cases for potential candidates who do not meet the educational background required by Pathway A or Pathway B. The total number of breastfeeding consultancy (BC) hours required is related to your post-secondary educational background. Usually 6000 to 8000 BC practice hours are required; Plus a minimum of 45-clock hours of education that reflects the exam blueprint content outline, taken within 3 years immediately prior to taking the exam. Pathway E* exceptions must be requested in a letter accompanying your completed exam application form. "

You do not have to be an RN or have a 4 year degree to become an IBCLC. Unless something drastic has happened in the last year or so.

20 years of research has demonstrated that tearing naturally reduces perineal trauma, pain, discomfort, sexual dysfuntion and urinary/stool incontince postpartum. I "absolutely" refused an episiotomy unless it was needed for fetal distress.

ITA. I think the better question is "Laying on her back??? WHY???"