What ever happened to "mother nature"?

long26 · Jul 12, 2009

Good luck in your new position! Yes, hospitals vary in how "natural" the birth process plays out, so another facility might be better. However, I have found that, in general, both patients and docs, like this new, high-intervention birthing process. I think it is a shame, but all we can do is our best to support normal labor and delivery.

bluemorningglory · Jul 12, 2009

I am not an RN yet but this is the one thing that I do not look forward to...l&d nursing..and for just the reasons you mentioned, OP!

Ack_RN · Jul 12, 2009

I just finished my L&D rotation... and it's the same here! I was shocked at how many docs did a c-section just because it was easier for them.

Even lady partsl birth was unnatural- I never saw stage 4 labor, the doc just yanked on the placenta till it came out, usually less than a minute after birth.

And scheduling your birth in your free time? Disgusts me.

I though L&D was for me, but now I'm not so sure. If I can't find something like an alternative birthing center (or just a really good hospital), I'll probably just find somewhere else to work.

And as for your question about standard practice, my nursing instructor told me we'll probably never see a VBAC solely because it's so hard to find both a doctor and anesthesiologist willing to wait for the delivery.

Be_Moore · Jul 12, 2009

Like it or not, healthcare is a business. The longer it takes for a woman to give birth, the more it costs. This is the same more or less in all fields. Which is why we send people home while they are still sick but not critical anymore compared to the days of old where you stayed in the hospital until you were better. Acuity of patients is increasing mostly because of costs.

StrwbryblndRN · Jul 12, 2009

I know parents are trying to schedule just as much as the docs. Most families are two income and want to be able to plan ahead as much as possible. I would like to think that letting nature take it's course would be priority. But in this day and age medical expenses are high and people need to work and expecting parents are afraid to let things take their course. And since the md's want to be able to schedule then it is a win/win for the md/parent.

At least that is what I am seeing with my friends/family have babies. I do not agree but that is how I am seeing it.

Jolie, BSN · Jul 12, 2009

Ok, So yes, I am a new grad and very "wet behind the ears" but I have gone through the labor process 4 times over now and I am what you could say a nontraditional nurse - starting when I am 31. Needless to say, I grew up in the Northeast, where drinking, smoking, and drugs were unheard of during pregnancy. Culture shock - in TN where I am practicing lets just say I have had more than one social work consult for +THC tests. Regardless the hospital I am working in is a small rural hospital with a great family birth unit - all LDRP rooms.
My question to all the practicing L&D nurses is - does your hospital attempt to schedule ALL the births that are expected? Thanks for any input.

I can hear the frustration in your voice and have to say that it is largely justified.

I would like to caution you about one comment though, "I grew up in the Northeast, where drinking, smoking, and drugs were unheard of during pregnancy. Culture shock - in TN where I am practicing lets just say I have had more than one social work consult for +THC tests." Drug use during pregnancy may have been "unheard of in the NE, but it was happening.

Please don't misunderstand, I'm not defending the use of alcohol, tobacco or drugs during pregnancy. But it is not a problem localized to any specific area of the country, nor is it unique to less affluent or less educated patients. Nor is there an area of the country immune to it. Substance abuse occurs in expectant parents of all ages, educational levels, professions, socio-economic status, etc. To assume that a patient of a certain demographic is not using drugs is to miss a screening and treatment opportunity. To assume that a patient of another demographic is using drugs is to make an unwarranted accusation and risk losing that patient's trust, conficence and participation in care.

I once worked in a facility that had a ritzy "private" L&D unit and a bare-bones "public" L&D unit. Urine drug screens revealed an identical rate of substance abuse in both populations. Both groups needed support to be able to care for their infants, and wouldn't have received it if we operated off assumptions.

rn4babies63 · Jul 13, 2009

OK. You work on my unit, right? If not, your is EXACTLY like mine. We do a C/S almost every evening between 6-7 if a patient doesn't deliver before then (after office hours, before dinnertime). Many inductions are scheduled at 38 weeks and we get many premature infants because the docs will find a reason to deliver them even earlier. This has been addressed many, many times but our head of the OB dept is the biggest culprit! Our lives are miserable. Our unit has changed drastically since I started there 13 years ago, and not for the good. However, I still love L&D. Wouldn't consider anything else!

prmenrs, RN · Jul 13, 2009

Even w/in the same community, the amount of "granola" in L&D varies considerably. (It varies in the same hospital--one local hospital has both a traditional L&D and a "family birthing center" w/midwives.)

Mother nature doesn't always get it right, and neither do the O'Bs. You might try looking @ a different hospital, but if you're happy overall, stay put.

Whenever you go to a new situation, you'll see a "right way", a "wrong way", and (more imp't) "THE WAY WE DO IT HERE!"

Good Luck in your new career and environs.

oramar · Jul 13, 2009

I know someone that is expecting at Christmas. She told me that her ob said, "I will do everything I can to make sure you are not inconvienced by being in the hospital over the holiday". I almost gagged when the expectant mother told me that because I am fairly certain that it is the doc that doesn't want to be inconvienced by a birth over Christmas Holiday.

debRNC · Jul 13, 2009

I have worked in many hospitals where interventional OB as you described, is practiced. The one thing they all had in common is the majority, if not all, of the births were by physicians. I now work in a hospital setting with mostly CNM's, and most of patients are "managed" in a non-interventional manner. Recently a nurse in another city was telling me how most of her patients arrive early in the morning for elective induction, receive an epidural and then "I pit the hell out of them". I guess we all are different, but I can't imagine going back to work in that sort of environment and with such a lack of respect for pregnancy and childbirth. No place is perfect, and here we still have conflicts on occasion, but are usually able to resolve them collaboratively. I love working with CNM's and hope I can stay here until I retire!

Butterfliesnroses · Jul 13, 2009

Just speaking from my point of view as a laboring mom. Induction was never talked of. I went into pre-mature labor and they stopped it with a pill. My water broke at 39 weeks and I went to the hospital. They put me on Pitocin but it was explained to me that they didn't want me to labor for a long period of time with that fluid gone. The thing that did irritate me was they continually asked me if i was ready for an epidural. My take was that I wanted to labor naturally, yet if I felt I needed pain meds then I'd ask for them, but I wanted to think it out and breathe through the pain. And I certainly didn't want to start with an epidural. To me an epidural was the very last of the pain meds. I wanted to feel the need to push! However my dreams came crashing down when baby was taken by emergency c-section (baby's heart rate dropped low) because the cord ruptured. That's just my 2 cents and I really don't know if the hospital pushes c-sections or not. I do know I can't get a VBAC, my doc said I'd be an ideal candidate but the hospital is small and they'd need a surgery team ready and waiting.