Where are the "normal" births?

[what2donow]

I am just starting in out in a much sought-after, much anticipated job as an L and D nurse, where I hoped to gain the foundations of a potential future career as a CNM. And.....

I am way disappointed.

From what I am seeing, this unit resembles an ICU or ER much more than I ever would have thought. Crisis situations are so frequent, I am wondering if anyone has a "normal" birth ever? I have seen a few, but (maybe it is because these ones are leaving a greater impression, at least at this point) it truly seems that more often than not, something goes wrong. If the birth doesn't end in an emergent C section or a traumatic vacuum, there is at least a significant period of time where it absolutely seems that it will. I already feel like my nerves are fried.

We work with a lot of midwives- I would say more than half of the deliveries are attended by midwives (or the labors are until the sh** hits the fan and OB has to rush in to the room), and our C section rate is actually low compared to the rest of the country. So I don't think that I work in a necessarily over-medicalized or overreactive environment. It just seems like things never go smoothly.

I asked one of the nurses who had been there for 20 years if it had always been like this, and she emphatically shook her head no. So what is the deal? And another thing it has me thinking: how are home births or even birth center births EVER safe when it seems so common for a healthy, uneventful pregnancy to turn into a code blue-like delivery?

Maybe some practicing CNMs or more experienced L and D nurses out there can give me some perspective. Thanks.

[TLAandy]

I can totally understand. I worked l&d at a baby factory in nyc and was horrified. I started wrking there versus other hospitals bc there were midwives but only medicaid pts saw the midwives. How are birhs at home or at a bithing center safe? Bc moms are allowed to walk, fewer unnecessary interventions, no inductions, intermittent monitoring etc. They have better outcomes (csection,'episiotomies) than the hospitals. Look at the stats at The Farm in kentucky'amazing. Hang in there!!

"The Farm" is in Tennessee, that is where you will find Ina May Gaskin. In Kentucky if where you will Find the Frontier School of Midwifery and Family Nursing. But wow, wouldn't it be great if they were in the same place??

What you are saying about interventions is spot on, the more interventions the more the risk of complication go up. OB/GYN's love to augment labor with Pitocin, which causes the pain to be worse (not to mention being unable to move, flat on your back) the worsening pain causes the mom to ask for an epidural, which causes the labor to slow down, which causes the OB to once again increase the Pitocin, which decreases the amount of O2 the fetus receives, TADA=Fetal distress>>>>>>>OR=C-section.

I work in a Birth Center in Florida with two CNM's, as a Birth Assistant for Births and Medical Assistant in the office. I am an RN and currently a Student Nurse Midwife at Frontier. Complications like the one described above are rare at the birth center. There are no pitocin inductions or epidurals. Our client population is the same as the local hospital, yet we don't have the same kind of complications they do. It basically comes down to something I very wise Professional Midwife told me, "If you don't break the Mom and baby, you don't have to fix the Mom and baby." It is sooooo true. Some of the countries with the lowest infant/maternal mortality statistics primarily use Midwifes for most uncomplicated pregnancies. We might get there some day, I sure hope so.

[enchantmentdis, BSN, RN]

It's all about money, lawsuits, and OBGyns not wanting midwives to do their job.