Is it proper for a nurse to tell a patient who has gone to the hospital in labor to "go home and come back when you can't talk through your labor discomfort"
What is that all about. If you are in labor, in this case every 3-5 minutes documented but do NOT need pain meds just yet, this does not sound proper to me, especially since what is the point of "controlled labor"
That is my rant----happended to my daughter who did agree to go home but had to come back after 3 hours when she absolutely needed pain med control and did deliver 11 hours later
Oh and by the way-----the nurse discharged the patient, never seen by the MD----but supposedly did talk with the MD
I was due June 21st with my 1st baby...still preggers now. I am glad I read all the responses from the RNs. I feel better about when to actually go into the hospital now. Thanks everyone!!
On a side note: I have been told on numerous OBGYN visits that my pelvic bones are close together (even before I ever got preggers) Just recently at one of my last appts, my MD stated that she did not want to induce me due to the high-probability of ending up with a c-section anyway. Then I go into the drs this week and she mentions that if I don't go into labor by July 5th, then they will induce. Can someone tell me why one week she would mention that she does not want to induce and then mention the opposite at the next week appt? I am ok with having a c-section if that is what it takes. ANY INFO?
:balloons: (((((((Deb)))))))) You sound like a darn good ob nurse -- one I would have loved to have when I was pregnant with my three girls. I LOVE reading your ob/gyn comments all the time. Your comments are professionally put, thoughtful, sensitive to the need being presented, compassionate, caring, and they just plain ol' bring a smile to my face when I read what a great ob nurse you are. Don't mean to make you blush or anything, but I've read numerous comments on this forum from you, and I'm super impressed all the time. If the Lord blesses me with enough money to build and run my own health center one day, I'd want nurses just like you to work for me. :icon_hug:
Amen, sister!!!! If I have to transfer to the hospital during my birth, SBE is just the kind of nurse I would want greeting me at the door!
I was due June 21st with my 1st baby...still preggers now. I am glad I read all the responses from the RNs. I feel better about when to actually go into the hospital now. Thanks everyone!!
On a side note: I have been told on numerous OBGYN visits that my pelvic bones are close together (even before I ever got preggers) Just recently at one of my last appts, my MD stated that she did not want to induce me due to the high-probability of ending up with a c-section anyway. Then I go into the drs this week and she mentions that if I don't go into labor by July 5th, then they will induce. Can someone tell me why one week she would mention that she does not want to induce and then mention the opposite at the next week appt? I am ok with having a c-section if that is what it takes. ANY INFO?
Though I have obviously not looked at your medical record or your body, it's these kind of comments from docs that make me absolutely want to bang my head against the wall!!!!! Why a practitioner would feel the need to put all of this fear and doubt into a patients mind is beyond me. It can make a woman feel as if her body is deficient for the job of birthing a baby!!!! And this is before she's even had a single contraction!!
The body produced relaxin, which (suprise suprise) RELAXES the pelvis in preparation for labor. It's part of the physiology of pregnancy and birth.
TweetiePieRN, let me tell ya: my midwife during my first pregnancy tried to feed me a line about how I had a small pelvic outlet, and a C-section would be more likely. And trust me, no matter WHAT your body looks like, if your care provider is intent on a certain mindset, that's what they're going to follow. However, I chose to leave my midwife and find a doc who really believed in a woman's ability to have a baby.
And guess what? Me, little ol' 5'0 me, with my narrow pelvic outlet, gave birth to a 10 lb. 1 oz, 22 inch long baby. I credit my doctor, my doulas and a couple of fantastic L&D nurses, as well as my own strength in persevering despite hearing those creepy messages. I know I would have had a c-sec with that midwife. And it would have been unecessary. She can take her beliefs and shove 'em where the sun don't shine.
So while you may not oppose a c-sec if that's what it takes (and for sure, there are instances where c-section is lifesaving and a true godsend), you're also right to wonder about the mixed messages. They're a bit confusing.
I just wanted to give you a little inspiration - us girls with small pelvises need to give each other encouragement! :) :)
Also remember that you're the result of perfection in childbearing - all the generations of women before you gave birth and lived - that's a legacy to think about. Still, if you ultimately need a c-section, know that it's still a birth and you can feel so incredibly proud of yourself.
Consider hiring a doula, by the way. They can make all the difference - for both you and your baby. Good luck!!!!!!
Alison
(Whose small pelvic outlet is due to have another baby around the middle of July)
Is it proper for a nurse to tell a patient who has gone to the hospital in labor to "go home and come back when you can't talk through your labor discomfort"
What is that all about. If you are in labor, in this case every 3-5 minutes documented but do NOT need pain meds just yet, this does not sound proper to me, especially since what is the point of "controlled labor"
That is my rant----happended to my daughter who did agree to go home but had to come back after 3 hours when she absolutely needed pain med control and did deliver 11 hours later
Oh and by the way-----the nurse discharged the patient, never seen by the MD----but supposedly did talk with the MD
Also only 1-2 cm at that particular time
Given a normal labor it is definitely better for a mom in early labor to labor at home. We send people home after a labor check frequently. We evaluate them, monitor Mom and baby, do a vag exam, and let them walk around after we get a good strip. Then we would recheck her in an hour or two and if there is no cervical change (and everything else is normal), we would send them home. Sometimes we give them sleeping medication to help them relax. That will sometimes speed labor along or knock it out, especially if it is not good labor. We do not have to have a doctor (or nurse midwife) present to do this. We labor nurses are perfectly capable of evaluating a laboring mother and discharge patients frequently.
So, your daughter did three extra hours at home. It was probably better for her. The longer one is in a hospital, the more likely it is to have unnecessary interventions and ones risk of infection increases as well. If she was only 1-2 cm at that time and did not change, there was no reason to keep her at that time. Everyone's need for pain meds is different.
I was 37 weeks pregnant with my first child, and was having non-painful, close, but somewhat irregular contractions (5 minutes here, 2 minutes here, then 3 minutes, etc). I called the doc on call, and when he found out I was 37 weeks, he said, rather rudely, "37 weeks..come on the hospital so I can send you back home." Yup--my son was born less than 3 hours later!!
Just last evening, I traiged a lady who was contracting regularly. As I was evaluating her, I mentioned that she might be sent home if she was not dilating etc.,. She had only been 2cm with a thick cervix the day before. I often mention that as we do a lot of sending home if there is no true labor or it is very early. She was obviously very uncomfortable but many often are even in the presence of no cervical dilitation.
Well...................I checked her and she was 8cm with a big bulging bag and delivered about 45 minutes later. She never did get her epidural (or any pain meds actually). I was lucky to get a doc and a midwife there! All was well. That kind of quick labor is often harder for women to cope with than a longer more drawn out one.
It was the perfect end to an already very cool evening!
Well...................I checked her and she was 8cm with a big bulging bag and delivered about 45 minutes later. She never did get her epidural (or any pain meds actually). I was lucky to get a doc and a midwife there! All was well. That kind of quick labor is often harder for women to cope with than a longer more drawn out one.
As often as you hear about women experiencing trauma because of an unintended c-section, you don't as often hear about women who go through trauma due to unintended NATURAL childbirth. The RN's here probably have a lot of experience with this.
There are those women who have their hearts so set on a painless childbirth with an epidural, that to not have it due to precip labor is very traumatizing for them. It's all about expectations, and helping mom to reframe her birth experience postpartum. Unfortunately, these are often women who, instead of being wowed by their accomplishment, will simply induce labor earlier next time so they can be assured of their epidural. *sigh* Ah well.
My doula mentor once told me about the story of a woman who told her doula that her whole life had been one of pain and abuse, and she was going to insist on an epidural during labor to make sure that pain was not a part of this special day. The doula practically tattoo'ed anesthesias' phone # to her forehead to make sure to accomodate her wishes. I would have done the same exact thing!!!!! For some women, pain meds are an act of lovingkindness, pure and simple.
Boy am I rambling!!! Ya think maybe it's the combo of pregnancy hormones and a complete and utter lack of sleep?!?!
Though I have obviously not looked at your medical record or your body, it's these kind of comments from docs that make me absolutely want to bang my head against the wall!!!!! Why a practitioner would feel the need to put all of this fear and doubt into a patients mind is beyond me. It can make a woman feel as if her body is deficient for the job of birthing a baby!!!! And this is before she's even had a single contraction!!
The body produced relaxin, which (suprise suprise) RELAXES the pelvis in preparation for labor. It's part of the physiology of pregnancy and birth.
TweetiePieRN, let me tell ya: my midwife during my first pregnancy tried to feed me a line about how I had a small pelvic outlet, and a C-section would be more likely. And trust me, no matter WHAT your body looks like, if your care provider is intent on a certain mindset, that's what they're going to follow. However, I chose to leave my midwife and find a doc who really believed in a woman's ability to have a baby.
And guess what? Me, little ol' 5'0 me, with my narrow pelvic outlet, gave birth to a 10 lb. 1 oz, 22 inch long baby. I credit my doctor, my doulas and a couple of fantastic L&D nurses, as well as my own strength in persevering despite hearing those creepy messages. I know I would have had a c-sec with that midwife. And it would have been unecessary. She can take her beliefs and shove 'em where the sun don't shine.
So while you may not oppose a c-sec if that's what it takes (and for sure, there are instances where c-section is lifesaving and a true godsend), you're also right to wonder about the mixed messages. They're a bit confusing.
I just wanted to give you a little inspiration - us girls with small pelvises need to give each other encouragement! :) :)
Also remember that you're the result of perfection in childbearing - all the generations of women before you gave birth and lived - that's a legacy to think about. Still, if you ultimately need a c-section, know that it's still a birth and you can feel so incredibly proud of yourself.
Consider hiring a doula, by the way. They can make all the difference - for both you and your baby. Good luck!!!!!!
Alison
(Whose small pelvic outlet is due to have another baby around the middle of July)
Thanks so much for your response! You are absolutely right about them making me feel deficient about my body's ability to give birth! I am going to try to just calm down and have confidence in whatever my body can do.
I am also short...4'11" and hubby is 6'1"!! Thanks again!
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I think Alison gave you great advice. Trust your body. My cousins are teeny-tiny (4 feet 10 and 85 pounds) and delivered 8.5 pound babies, both of them. TRUST YOUR BODY -----but also your staff. Make sure all interventions are explained as they are done. I wish all the expectant moms here peaceful, safe and joyous deliveries.
wow Judy and Renee, I am blown away by your compliments. THANK YOU from the bottom of my heart.
I needed that today.....just had a kinda rough day in OB. I have my days when I wonder if I even BELONG In OB. (we all have challenging days right?). I really thank you, it meant a lot to hear all this.
see smiling........ i said a while ago you were a very good ob nurse. i will never forget the helpful and good advice you gave me in my troubled pregnancy. my daughter is now a happy, healthy 5 mth old. you are a credit to the profession. take care now. xx
awww uk, thank you. I am glad I was able to help you. ALREADY the baby---5 months old ---wow!!! How are you doing????
im fine thanks. i go back to work in sept but only going to do fri, sat, sun nights. i think that is enough with 4 children, house and hubby....lol. we r in process of moving to a bigger house too. its all go here........lol. thanks for all advice you gave me. take care. hope you ok x
TweetiePieRN
582 Posts
I was due June 21st with my 1st baby...still preggers now. I am glad I read all the responses from the RNs. I feel better about when to actually go into the hospital now. Thanks everyone!!
On a side note: I have been told on numerous OBGYN visits that my pelvic bones are close together (even before I ever got preggers) Just recently at one of my last appts, my MD stated that she did not want to induce me due to the high-probability of ending up with a c-section anyway. Then I go into the drs this week and she mentions that if I don't go into labor by July 5th, then they will induce. Can someone tell me why one week she would mention that she does not want to induce and then mention the opposite at the next week appt? I am ok with having a c-section if that is what it takes. ANY INFO?