What ever happened to "mother nature"?

[im_an_honest_1]

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? I would say that less than 5% of the births we deliver were spontaneous. It is routine practice where I work to schedule an induction on the woman's 39th week. Not only that, but I have witnessed 2 failed VBAC's already - why did they fail? because it got past 5 oclock in the evening and the physician wanted to go home for the night - so after letting the poor woman labor all day long - because she didn't make it to 10 cm dialated by the time the Dr. thought his day should end - she got a c-section. :angryfire It just doesn't seem fair. Nevermind the fact that at 39 weeks you are hoping that the due date is correct (I know it is verified with ultrasound but still...).

So is this a standard practice now? I am already thinking after just a couple of weeks that I will grin and bear it for the first year and then move on to a different hospital - but if this is a standard practice in L&D now, then I think I need to find a different area of nursing because it seems just wrong to me.

Thanks for any input.

[beachmom]

Had a wonderful "mother nature" birth last evening.

We had a woman really wanted a VBAC with no meds. Her first baby was C/S d/t being ten pounds and too large to come out. This baby was supposed to be smaller, but the doctor said she was rather worried that would be a problem.

In a VBAC the baby is supposed to have continuous monitoring. The mom was a mover and moaner during labor, and we probably got good monitoring about 50% of the time.

For a VBAC, policy states that the doctor and the OR crew has to be on site throughout labor. The doctor could have come up with a reason to do a C/S, but instead she hung out with us for three hours after her office closed and missed dinner with her family. Luckily for her, the baby was born quickly. (She came to us at 6 cm.) Baby was only 7 1/2 pounds, but right before birth the doctor called extra nurses to the room as it looked like a possible shoulder dystocia.

Mom was very happy to have her natural birth. The doctor probably went home rather stressed, and she could have saved time and made more money.

Not all doctors are C/S happy.

[Sandwitch883RN]

Out of curiousity but once I do get to my clinicals in nursing school, is there any way to avoid the L&D rotation? This is just so depressing.

Please don't feel that way! There are aspects of L&D nursing that are less than perfect, but that can be said of any area of nursing. Sure the way labor and birth are managed could be very different. However, as an L&D nurse I provide the best care I can within the confines of the system. I really love my job and love working with mom's and families. Everyone is quick to point out how physicians mismanage labor, however many mother's and families choose to do things that way as well. I'm always amazed at women that would like to "just get it over with" and have a csection. Almost everyone wants an epidural, pain medication, to be in bed the whole time. It's very rare, but wonderful, when I have a pt that goes all natural. You just have to do the best you can given the circumstances you have as a L&D nurse. AS a nursing student take what you can, good or bad, from your clinical rotation and learn from it. That will help you become a good pt advocate, support person and clinician for your pt's regardless of the specialty you choose in the end.

[ElizaB]

I'm happy to see so many nurses speaking up about this horrible trend in labor and delivery.

My last child almost died because of a young OB who wanted to get a csection in before my regular Dr. was scheduled to come back from vacation. He had everyone convinced I had a horrible infection that would kill the baby and me, because I had a "fever". My temp. was only 99 which is totally normal for me.

My "emergency" csection was preformed 30 minutes before my regular OB was scheduled to arrive at the hospital. That horrible infection? Never existed. But my child will now have a lifetime of lung problems thanks to a greedy Dr. who wanted a little extra on his paycheck. (she was premature, in a hospital that was not equipped to deal with anything more than an oxygen hood for newborns)