What choices did you make for L&D?

nursescar · Apr 21, 2005

What was your birth like? Did you hand pick your providers? Were you set on having a lady partsl delivery...? Would you have been ok with a section? Did you want an epidural or unmedicated birth?
I have met ob's who said they would happily take a planned section due to the horrible tears seen at vag. deliveries. So, my biggest question is, how did being a maternity nurse effect you decision making as a patient?

I have to say....having just been hired back in L&D---and having two high risk pregnancies....planned sections are/were great.....but part of me still wonders.........

camay1221_RN · Apr 22, 2005

I worked postpartum at the hospital I delivered at, and I got to know some of the residents well enough to know, I didn't want some of them touching me! So, I told my OB my reservations and since his office was in the professional building connected to the hospital, he was kind enough to come over and perform some of the things the residents would have done, ex. cervidil placement, amniotomy. I also made it a point to tell the med students they were not allowed to come into my room before 5am my second day postpartum. Sleep is rare in a hospital, especially when you have a newborn feeding every two hours!

SmilingBluEyes · Apr 22, 2005

The only real thing that I did based on my OB experience was to refuse an eversion on my baby from breech to head-down. I just saw it fail so many times and saw a placenta abrupt after one of them (on a physician was the patient, naturally, lol). I felt my baby was VERY big and so I refused, for her safety and decided to proceed with a planned csection ( I had had my son lady partslly with forceps and it was no picnic anyhow). Turned out I was right, the baby WAS big at 38 weeks--------she was 9lb---- and she was FIRMLY stuck in her position; it took them some "digging" to free her.

The funny thing was, when they cut me open her butt popped up, showing them her "attitude" (and yes, it's stuck ever since). I got to watch the whole thing in the reflection on an overhead lamp.....to see one's own csection, well is a trip. I am glad I could.

Anyhow, that is the only time I can say my being an RN truly affected an OB healthcare decision made for myself. I keep my mouth SHUT when relatives ask advice, except to say, DISCUSS THIS WITH YOUR DOCTOR please! I am not into putting relatives at risk just based on my opinions.

BETSRN · Apr 23, 2005

The only real thing that I did based on my OB experience was to refuse an eversion on my baby from breech to head-down. I just saw it fail so many times and saw a placenta abrupt after one of them (on a physician was the patient, naturally, lol). I felt my baby was VERY big and so I refused, for her safety and decided to proceed with a planned csection ( I had had my son lady partslly with forceps and it was no picnic anyhow). Turned out I was right, the baby WAS big at 38 weeks--------she was 9lb---- and she was FIRMLY stuck in her position; it took them some "digging" to free her.
The funny thing was, when they cut me open her butt popped up, showing them her "attitude" (and yes, it's stuck ever since). I got to watch the whole thing in the reflection on an overhead lamp.....to see one's own csection, well is a trip. I am glad I could.
Anyhow, that is the only time I can say my being an RN truly affected an OB healthcare decision made for myself. I keep my mouth SHUT when relatives ask advice, except to say, DISCUSS THIS WITH YOUR DOCTOR please! I am not into putting relatives at risk just based on my opinions.

I don't particularly like assisting with versions, either. Good news is that if the baby does not turn easily, then you leave well enough alone!

Littlewonder · Apr 25, 2005

I know all the doctors who deliver at our hospital and I chose the one who does the fewest epis! I had a lot of trouble with my episiotomy with my first son. Tearing just a little was so much better with my second - the doctor even managed to repair the bit of epis that retore so that it healed better the second time. My problem with working OB was that I knew I could be a real pain to my friends - and they could not keep me from eating cupcakes in labor!!! (Bad nurse, I know, I know...) :)

maxiebelle · Apr 26, 2005

I had all my children in the L&D unit where I work. I love epidurals. Not very fond of the vacuum extractor or forceps. Am terrified of c-sections--would not wish that on anyone. However, several girlfriends/relatives loved their scheduled c-sections--said it was the only way to give birth.

jdkaos · May 6, 2005

What was your birth like? Did you hand pick your providers? Were you set on having a lady partsl delivery...? Would you have been ok with a section? Did you want an epidural or unmedicated birth?
I have met ob's who said they would happily take a planned section due to the horrible tears seen at vag. deliveries. So, my biggest question is, how did being a maternity nurse effect you decision making as a patient?

With my first delivery I was not an OB nurse, and I am glad. It was an awful experience, 32 hours of labor, pit, epidural, almost a section, the a fourth degree tear. If I had the knowledge I have now back then, things would have been different. I would have requested my epidural before my pit. The epidural is what allowed me to relax and change my cervix. The only reson I had a fourth degree is because I delivered him straight posterior and then both shoulders at the same time. This experience has allowed me to talk many pts. through rough times in labor. My second labor was also an experience to behold after the first. I went from rupture and 1cm to 4cm in two hours. Then 4cm to delivered in 15 minutes. So I have done the whole natural birth as well, didn't much care for it. With my third I told my OB that I wanted and epidural before AROM. Which was a good thing because I delivered 20 minutes after they ruptured me. So what it all boils down to is pt. choice. What ever you want discuss with you OB. They should honor your requests (within reason) or find a new doc.

Zhlake · May 6, 2005

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.

mstigerlily · May 6, 2005

I had my three babies BEFORE I became a nurse (postpartum) and I'm glad because I would have worried my way through the pregnancies and births if I had done it the other way!

jdkaos · May 6, 2005

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.

Glad to hear it went well. I am all for birthing plans, as long as they are within reason. Some people just don't get it. The baby will not breast feed if it is not breathing. Theses are the parents I Fear!!

FrumDoula · May 8, 2005

What was your birth like? Did you hand pick your providers? Were you set on having a lady partsl delivery...? Would you have been ok with a section? Did you want an epidural or unmedicated birth?
I have met ob's who said they would happily take a planned section due to the horrible tears seen at vag. deliveries. So, my biggest question is, how did being a maternity nurse effect you decision making as a patient?

As a doula and as someone about to take her LVN exam, I've had the oppurtunity to see many docs and nurses in action in the cities I've lived in. For this pregnancy, I ended up choosing a homebirth with a CPM who is experienced and well respected. She has great stats, a low transfer rate (though not low enough to make me nervous that she's risking client/baby health) and a wonderful approach to prenatal care. My appointments last over an hour, and she travels to my home for prenatals. We do any blood and urine work we need to in my home as well. It's been a fascinating experience. My husband is usually the one to find the heartbeat with both the fetascope and the Doppler, and my little boy has also learned to hear the baby's heartbeat and assess fetal position (not bad for a 6 year old! :) ) We focus a LOT of nutrition, too, which is an intervention known to prevent birth and postpartum complications, as everyone here knows.

I guess I just saw enough clients with great intentions walking into hospitals and getting really poor, non-evidence based information that I got worried about what might happen for my own birth. My first was born in a hospital, however, and I had a couple of wonderful nurses. I also had a doula, and she was married to my doc, so right there you know he had an awareness of normal birth.

As for those docs who would choose a c/s over a bad tear, well, many of them have CAUSED the tears they're talking about, either through poor management of the head delivery, not insisting on upright second stage pushing or clipping an episiotomy and then being suprised when there's a fourth degree tear! (Ooops ... :angryfire )

So anyway .... those were some factors I considered when choosing a provider for my birth.

Alison