"Natural" birth

JaneyW · Jul 23, 2005

Loved my epidurals!! Those of you implying there is harm to the baby, what harm? It is so much safer than IV meds. How safe is having a baby anyway??? Before all the evil medical intervention there was a 20% mortality rate. Should we go back to that?

Don't get me wrong, I think the process has become WAY to medicalized for most women. But, what is the harm of benefitting from some modern science?

RNnL&D · Jul 23, 2005

My bad attitude is reserved for those who look askance when I go in to get a medical history, consent for epidural, SAB, and/or c/s prn. "Oh, she doesn't want an epidural." I don't care. Like I said, I _cannot_ sneak up on someone and put one in while she's sleeping . . . ain't gonna happen. I get a medical history so I am aware of any unusual medical problems in case of an emergency (e.g., difficult airway, allergy, etc.). I get a consent for epidural, spinal, and general for labor or c/s as needed. If they decide later that they _do_ want an epidural, then I'm ready with a clear conscience. If we have a c/s, we don't waste time on collecting a history and doing consent paperwork. ALSO, they haven't been narc'd four ways to Sunday before I ever see and consent them! ALSO, they haven't been laboring for hours, exhausted and not hearing my words or understanding the meaning. Everything is done ahead of time and I watch happily as they labor without their epidural. Brava!
- The attitude of L&D earth mothers who want to chant and burn incense over our patients is the most irritating. Somehow, doctors and anesthesia providers really _are not_ part of their agenda. No doubt, it would be much better if a midwife did the delivery. Further, why do we need all these wires and beeping machines? PLEASE. Spare me. THAT's wear I most passionately apply my, to your mind, bad attitude. And _another_ thing: Learn how to circulate in the OR when you have to do a c/s! It's part of your job (in many places, not all, I know). If you don't like that part of your job, tough! When things have gone bad to the point of doing an emergent c/s, you better get your ducks in a row or get a new job. It can't all be chanting and breathing. Learn the science, too.

So you have to see every L&D patient, before they even request an epidural? Our CRNA's don't get a history until the patient has requested an epidural. Are you based in OB or do you cover OR too? Our CRNA's cover the whole house, so they are only up on OB when we call them.

I have never had a problem with our CRNA's. They are great with the patients and get along with the nurses fine. We do circulate and scrub for our sections with no complaints from anesthesia.

Just because I enjoy laboring with an unmedicated Mom, doesn't mean that I don't support my high risk Moms who have all the bells and whistles.... and wires and beeping machines. :chuckle I choose natural childbirth for me, but for my patients, I encourage them to do what they are most comfortable with, including getting an epidural if that's what the want.

RNnL&D · Jul 23, 2005

Loved my epidurals!! Those of you implying there is harm to the baby, what harm? It is so much safer than IV meds. How safe is having a baby anyway??? Before all the evil medical intervention there was a 20% mortality rate. Should we go back to that?
Don't get me wrong, I think the process has become WAY to medicalized for most women. But, what is the harm of benefitting from some modern science?

Uh, besides fetal distress? :uhoh21:

The most common side effect of the epidural is maternal hypotension which results in fetal bradycardia, which leads to more intervention..........

Not to mention, increased risk of maternal fever which effects baby's care, increased risk of cesearean delivery (due to malpresentation or dystocia) which has obvious risks, increased use of Pitocin which has it's own risks, increased risk of assisted delivery, forceps or vacuum which both carry their own risks.

Were you not educated about the risks before getting your epidural?

gypsyatheart · Jul 23, 2005

Well, Mr. Jzberger, I think you have me all wrong...it was one of your 1st posts saying this:

"For those who want that "natural" experience, more power to them. But, please, stay at home and have the baby. Why come to the hospital?"

that gave me a really poor impression of you. This attitude I can not tolerate. Why shouldn't a woman who desires a "natural" experience be allowed to labor and birth in the hospital w/out being "set-up"....set-up by her nurses, docs, residents, med students and yes, anesthesia. The mentality that women can not deliver w/out anesthesia in place is ludicrous! And believe me, it happens...I just had a 2nd yr the other day look on as my pt was laboring and practically complete and tell her:"I can get you a spinal, you know...." and when the pt says "no", the res says "I guess you can deliver w/out an epidural...."! OMG, yeah I guess so.... :rotfl:

Anyway, I, actually, am an advocate for my pt,...if she comes in and wanted an epidural from the minute she found out she was pregnant...fine w/me. If, on the other hand, she would like to try and have a natural birth, great, I think that option s/b given as much support as any other. Sadly, that is not the case. At least where I currently work.....to many students/residents/trainees who want a piece of the pie, the "training" pie, if you know what I mean.

Oh and believe me, nothing irritates me more than some failed homebirther walking in the door allready hating on the L&D staff, acting as if we are the enemy! :uhoh3: Puhleeze....the very 1st thing I do is explain that the minute they sign their "consent for tx" forms and are officially admitted that I have certain legal obligations to fulfill and if they refuse any that such will be documented and placed in their medical record. As well as,of course, re-iterating that we are there to ensure the well being of themselves and their baby.

***Oh and btw, I am an excellent circulator in the OR, could do it in my sleep, don't have a problem w/it....where in the world do you get the impression that I either a)don't like it or b) can't do it? :uhoh21:

Just because you may have had problems w/some L&D nurse, somewhere, sometime not liking to go to the OR or not knowing what to do once she got there...well, try not to generalize, OK? :rolleyes:

Oh, and please remember, not every facility utilizes their anesthesia dept the way yours is set up. I have no problem if anesthesia comes in ahead of time and prepares mom, etc, makes no difference to me;no worries, you won't see me chanting and doing a rain dance to ward you off... :rotfl:

Wrong on several points.
- I love doing OB anesthesia. I get incredible job satisfaction from it. I love my job in general, OB and otherwise.
- I do not think anesthesia is the "be all/end all." I get along great with the L&D nurses.
- I personally _do not care_ if a woman chooses not to have an epidural. As I said, more power to her. It does not affect my time, my pay, or my atttitude if a woman on the labor deck wants to "go natural." You go, girl!
- I _am_ so sick of L&D nurses who have this attitude that anesthesia is somehow unnatural, or missing the entire experience. As if a woman with an epidural somehow doesn't give birth as well or fully as those who suffer those biblical pains!
- To present an counterpoint, I _do_ disagree with unnatural use of anesthesia and surgery that has become so popular in South American hospitals, for example. There, some middle- and upper-class women think it is beneath them to deliver lady partslly -- only the peasants do that. They have their c/s whether they need one or not.
- I point out a fact: If a woman in a hospital were not monitored and cared for up to the _standard of care_ -- a legal term -- then the providers . . . including you, Ms. L&D Nurse . . . are responsible legally if something bad happens. More importantly, if I ignored my responsibility I wouldn't be able to sleep with myself at night.
- My bad attitude is reserved for those who look askance when I go in to get a medical history, consent for epidural, SAB, and/or c/s prn. "Oh, she doesn't want an epidural." I don't care. Like I said, I _cannot_ sneak up on someone and put one in while she's sleeping . . . ain't gonna happen. I get a medical history so I am aware of any unusual medical problems in case of an emergency (e.g., difficult airway, allergy, etc.). I get a consent for epidural, spinal, and general for labor or c/s as needed. If they decide later that they _do_ want an epidural, then I'm ready with a clear conscience. If we have a c/s, we don't waste time on collecting a history and doing consent paperwork. ALSO, they haven't been narc'd four ways to Sunday before I ever see and consent them! ALSO, they haven't been laboring for hours, exhausted and not hearing my words or understanding the meaning. Everything is done ahead of time and I watch happily as they labor without their epidural. Brava!
- The attitude of L&D earth mothers who want to chant and burn incense over our patients is the most irritating. Somehow, doctors and anesthesia providers really _are not_ part of their agenda. No doubt, it would be much better if a midwife did the delivery. Further, why do we need all these wires and beeping machines? PLEASE. Spare me. THAT's wear I most passionately apply my, to your mind, bad attitude. And _another_ thing: Learn how to circulate in the OR when you have to do a c/s! It's part of your job (in many places, not all, I know). If you don't like that part of your job, tough! When things have gone bad to the point of doing an emergent c/s, you better get your ducks in a row or get a new job. It can't all be chanting and breathing. Learn the science, too.
- Wow. You got me. I am male and therefore part of the problem. Good shot. I will never labor or give birth. That must mean I can't have an opinion on any female-oriented subject. I disagree, but don't have an argument that will break through your argument of the absolute.
- You're right. Anesthesia is absolutely not required to have a baby. Women have been doing it for tens of thousands of years without it. But QUIT trying to browbeat the women who do so chose into feeling like they've missed something! I'm sick of moms who berate daughters, "I didn't have an epidural! Why do you want a needle in your back?" And nurses who wear that slightly disapproving but mostly neutral expression when a mom says first thing when she rolls in, "I want my epidural." YOU get over it, lady. Give them a break! Give me a break!
Thanks for your input,
Z

JaneyW · Jul 23, 2005

Uh, besides fetal distress? :uhoh21:
The most common side effect of the epidural is maternal hypotension which results in fetal bradycardia, which leads to more intervention..........
Not to mention, increased risk of maternal fever which effects baby's care, increased risk of cesearean delivery (due to malpresentation or dystocia) which has obvious risks, increased use of Pitocin which has it's own risks, increased risk of assisted delivery, forceps or vacuum which both carry their own risks.
Were you not educated about the risks before getting your epidural?

I was trying to point out that there are risks involved with the whole process of birth. Natural or not. Harm can come to the baby with no intervention or too much intervention. Meds or no meds. There is no perfect scenario. Not everyone can do it without meds and not everyone who attempts a natural birth has a great outcome.

onehusbandsevenkids · Jul 23, 2005

Uh, besides fetal distress? :uhoh21:
The most common side effect of the epidural is maternal hypotension which results in fetal bradycardia, which leads to more intervention..........
Not to mention, increased risk of maternal fever which effects baby's care, increased risk of cesearean delivery (due to malpresentation or dystocia) which has obvious risks, increased use of Pitocin which has it's own risks, increased risk of assisted delivery, forceps or vacuum which both carry their own risks.
Were you not educated about the risks before getting your epidural?

Ummm....what risks to the baby? :uhoh3: Well, what she said here that I have quoted.

My last baby suffered needlessly and wound up in the NICU with breathing problems. Had to have countless tests, spinal tap, ect....everything checked out A-OK, and I was told by several doctors that my baby's problems were a direct result of the epidural. I went home without my child, worried sick while my child endured an unpleasant beginning to her life.

Never again. Why take the chance? No one knows which babies will have a bad outcome.

I think its mostly a cop-out. I actually think its selfish most of the time. My opinion. But I had the "so safe" epidural and it was not safe for my child. I had no problems at all, there were no problems with the delivery at all.

I had natural deliveries for my first 3 babies and felt, oh what the heck, get an epidural this time...no big deal. Wrong. I still feel guilty. And I was a very well educated / well read consumer at the time, little did I know I had much more to learn than what mainstream USA tells us women.

onehusbandsevenkids · Jul 23, 2005

Loved my epidurals!! Those of you implying there is harm to the baby, what harm? It is so much safer than IV meds.

There was harm to my baby from the epidural, she ended up in NICU.

There ARE definate risks.

RN4NICU, LPN, LVN · Jul 23, 2005

Is this routine practice.. baby in NICU after C-sec? I have never heard of this and would have thought this only applied if the infeant was in some kind of distress during labor that warranted a stat section or something of that nature. That's really ridiculous.

It takes a lot more than just being a c-section to land a baby in our NICU. I agree - totally ridiculous to admit to NICU without some other reason than just having been a c-section.

RNnL&D · Jul 23, 2005

I was trying to point out that there are risks involved with the whole process of birth.

IMO, no you weren't. You asked a specific question "Those of you implying there is harm to the baby, what harm?".

If you believe that there are inherent dangers in birth already, why add risk by asking for intervention? JMO.

I understand that many women prefer medicated pain relief for labor, but pretending like it adds no more risk than simply giving birth, is irresponsible.

This is part of the reason why elective csection is even a word. Like the risk of surgery is no big deal because birth is dangerous by itself. :uhoh3:

Any medical journal will show that there are less risks for mom and baby when little intervention is involved. Even the noninvasive external fetal monitor adds risk when it is used continuously on a low risk patient.

naturalcuriosity · Aug 4, 2006

It does seem that the patients with the longest, most detailed birth plan, with the doula, the control freaks, who hate us the minute they walk in the door because they resent the fact their insurance company won't pay for a home birth, are the ones with C-Section stamped right across their foreheads. Dunno if it's karmic retribution, or just a perception we have in L&D. I wonder if anyone's done a retrospective study on patients presenting with birth plans, doulas, &c, and C-Section rate?
(Don't get me wrong; I'm all for labor support, not intervening, homebirth, &c. Just an observation of certain personality types who come in with all the above and who seem to always get a C-Section ...)

As a birth doula, I have seen these types of couples as well. The people with the "plan" (The ones who usually have the day care picked out already as well...) are usually the type that basically think they can buy their way out of labor. I don't know if that makes sense, but they have the attitude that if they get everything ahead of time labor will be easy. Several times I have turned down clients like this and told them that I do not think that I can meet their expectations.

However, not all people who hire a doula or have a detailed birth plan are like this. But, you are right there are some and it can be hard to work with them because of their high expectations. They leave no room for any deviation from the "plan".

NHmommy · Aug 4, 2006

Natural child birth for me was I delivered to fast to get an epidural, Dammit.

Ditto!

labor1 · Aug 7, 2006

A patient told me, to her going natural meant not wearing any makeup:jester: