Response to Pregnant Friends

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Specializes in NICU.

Hi all!

I have been an NICU nurse in a large referral center for 4+ years. I do not yet have any children of my own, so I have no personal birthing experience and know that my opinions are limited by this. Obviously, though, given the nature of our job, I have developed some opinions about childbirth. I would say that I generally lean towards supporting/encouraging more natural birthing methods, but DEFINITELY in the hospital setting with the appropriate equipment and personnel available for emergencies. In fact, because of things I have seen, I'd be hard pressed to not deliver in a large hospital with a good NICU. I'm not criticizing small hospitals. I just have seen too many births end in unexpected nightmares, and I want all hands on deck so I don't have to be the anxious NICU nurse freak in labor. :)

I have lots and lots of friends in the childbearing stages of life, and more than a few of them veer toward the end of refusing interventions that are probably helpful/necessary and/or homebirths. I am NOT looking for a debate on birth interventions or home births. I know what the research says, and we don't need to rehash it. I know that there are many NICU nurses out there with similar viewpoints about the reality of birthing, both good and bad. If you have friends/acquaintances who are choosing home births, do you share any of your feelings? If they ask your opinions, what do you say? Honestly, I know that my friends who make those decisions don't make them lightly. They have done their research and feel they are making the best decision for their family. I want to respect them and their decisions, but I worry about the 1 in 10000 type of things. Plus, I find that if I tell them I'm worried about the "What ifs?," then they ask me more about them. And then there's that fine line of telling people what I mean without pouring out a horrible list of things that can happen to babies and moms. Because I'm not looking to give people nightmares or anything. :( I don't want to force my opinions on my friends, but I love and care about them. And given my profession, my opinion gets asked a lot.

So...what do you say?

p.s. Just once more, please don't make this a home birth debate. If you disagree with me, I respect that. However, that is not the question I'm asking here.

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Specializes in NICU.

If they don't ask, then just keep quiet. If they do ask, then tell them not only what you think, but why you think those things.

I know what you mean though, because I'm in the same boat ..... no kiddos of my own, but I have a lot of friends that are having babies. I also work in a big level 3 referral NICU and therefore get asked things by friends that I wish they wouldn't ask! You know, ignorance is bliss in some instances ;)

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Specializes in Community, OB, Nursery.

I work in a big teaching hospital that delivers a ton of high-risk pregnancies and has a level III/IV (depends on whom you ask) NICU. So I hear you; I see what goes wrong, because it feels like it's always me that has to ship those kids over to NICU for some freaky something. Seriously. I, and only I, have had to send two kids over there in the space of 2-3 weeks with severe congenital thrombocytopenia (platelets of 15 for no good reason!), covered in purpura and bruises. Gremlins come out to play when I'm there, it seems. That's just one example from recent memory.

But I also get to see how often it goes right. Our well-baby nursery gets the good ones and the ones who aren't sick enough to roll over to NICU....and on any given day, well-baby admits are FAR more likely to outnumber the NICU admits. (Obviously, if we're running a special on 29-weeker precips, NICU sees them and not us, but that's rare.) Ditto the moms. The ones who come the hospital, labor, and deliver and do just fine afterward FAR outnumber the ones with any sort of problem at all. Having seen how often it goes right, and how often problems are caused, rather than fixed, by stuff we do to healthy women, I am a whole lot less antsy about women who choose home births. (I just wish it were better regulated in my state, as most women who choose them have to do them 'underground', which IMO makes it a lot more unsafe.)

When all you see is what can go wrong it can kind skew the perspective - and understandably so. Please understand I'm not criticizing that. I have really strong views about some things in this field too (this not being one of them), and it's hard to keep my mouth shut when my friends decide something they may not even know I disagree with. I figure it's only my business if they ask me about it and the only kid I get to decide for is my own. So....I don't know what the best answer for you is, but I just try to provide information from several sources if they ask, and if they don't...well, I guess I have my answer as to whether or not they need my input. Don't know if this helps any.

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Specializes in NICU.

Thanks for the responses thus far. I agree...I generally keep my mouth shut if no one asks, but fortunately/unfortunately, most people ask. :confused: Like I said, although I disagree, I'm supportive and know that most kids are born healthy. The problem for me is that it's no longer just a small statistic if it happens to you. In my state, too, it's underground, so that constitutes a large part of my nervousness because some midwives are great and some not so much. I have taken care of too many kids born at home or in birthing centers when things went terribly wrong. Some of those things could have happened in the hospital, but they might have not become as serious. Others were specifically related to the homebirth scenario. So, once again, I respect people's decisions and don't go looking for a fight with my friends. I just love and care about them, so if they ask, I want to be honest. But not too honest.

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Specializes in Pediatrics, ER.
I work in a big teaching hospital that delivers a ton of high-risk pregnancies and has a level III/IV (depends on whom you ask) NICU. So I hear you; I see what goes wrong, because it feels like it's always me that has to ship those kids over to NICU for some freaky something. Seriously. I, and only I, have had to send two kids over there in the space of 2-3 weeks with severe congenital thrombocytopenia (platelets of 15 for no good reason!), covered in purpura and bruises. Gremlins come out to play when I'm there, it seems. That's just one example from recent memory.

Sorry to get off topic, but Elvish I just had to commiserate with you here. Sometimes I feel like I have a brown thumb when it comes to babies. They always find unbelievable ways to fall apart on me. At work they affectionately call me NOD (Nurse of Doom). :)

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Specializes in Nursing Professional Development.

When they don't ask ... I keep my mouth shut. But when they ask, I tell them the truth and don't mince words. I tell them that as a NICU nurse, I have seen many newborn disasters -- some really horrible things -- and that I wouldn't take any chances with my family. I tell them I would want the best care possible and that the immediate availability of the experts to handle any unexpected emergency would be more important to me that the more temporary comfort, convenience, or "prettiness" of an alternative birthing environment.

For me, as an expert in neonatal care -- I would want my birthing experience to be all about the safety of me and my baby. The immediately availability of expert care would be my #1 consideration. That's what I tell them.

If they want to know about some of the possible disasters ... I tell them. They can't make an informed decision if they don't know the whole truth. If all they see is the marketing hype and "happily ever after" on TV, they can't make an informed choice. If you're having a baby, it's time to be a grown up be fully informed of ALL the possible outcomes. Once they make their decision, I respect their right to make it.

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I do not like giving friends or family medical advice. But when I do I always tell them to ask thier own doctor. If it something dangerous I tell them frankly to go to the ER.

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Specializes in NICU, PICU, PACU.

I don't say anything...but if they ask I just say, you know, homebirth wasn't for me, and leave it at that. When they got more adamant then I laid it out and told them it was a personal choice.

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I have run into this problem. I think the important thing to remember is that most moms-to-be just want reassurance, so I make sure I validate their feelings no matter what their choice is or how I feel about it. I say things like it really sounds like you've given this a lot of thought and you feel that a home birth is the way to go.if you're having concerns you should check out (and I give them more objective resources on home births vs hospital) so that they can do the research for themselves. I always find myself flattered when people ask, and more than happy to give my biased opinion because I have strong feelings about it but then I latter regret it. Who wants to freak out happy expectant parents even though you feel like you are doing it for their good. I've learned to take the diplomatic approach of validating feelings and it has worked much better for me since.

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