Why so many interventions ??????

At our hospital we don't usually induce without a good reason. Same for C-Sections. Regarding the epidurals, I think its great that women have this and other choices (including no pain meds) in their pain control management. (It's much better than what used to be done: being strapped down in four-point restraints and being given 'knock-out' drugs and not being able to remember the entire labor).

Regarding the IV's, I guess I have to disagree...I feel it's better to have a line in because you never know who's gonna bleed or need pit post partum. Better to be safe than sorry in my mind.

Ironically, you'd put up this post prior to Super Bowl....oh yeah, ten and touchdown, but wait....induce labor now! "Waaah, waahhhhhh!" touch down and baby scores the extra point!!!!

Oh, I also forgot to add our pt's do get clear liquids, can walk around (not epidurals obviously) and if there are no problems can be monitored intermittently.

I don't think rural has anything to do with it. I work in a large urban center, where we use lots of IA, no routine IV's and less the half our patients have epidurals. Most of our IV's are in pt's being induced or are those who are GBS pos and they are allowed to have clear fluids. I think alot of it has to do with policy and if you a good committee who are up on the latest studies/practices they can do great things so that not everyone needs all these interventions.

The rural hospital in which I worked was VERY pro-intervention. It was not til I left the state that I realized birth need not be so medical-ized in the hospital setting (and in a place where we had midwives). I agree; rural may not be the key so much as attitude of the health care providers in a given setting. One of the biggest hospitals in a major metro area here has a whole wing of suites dedicated to tub and natural birthing.

Steph, your hospital sounds great-----I am sure you give wonderful care there too.

This is why I'm nervous about working L&D. I don't understand the reason for so many routine interventions. I think I'll just do my best to get through those few years until I can apply to the CNM program.

I know not all hospitals are like that, though. When I had my 2nd, I picked a different hospital because I wanted a natural VBAC. The hospital was an hour away (and I passed 4 others on the way), but it was so worth it. Jacuzzi tub to labor in, aromatherapy kits in the rooms.. some of the nurses were also trained as doulas. A few of the nurses were also lactation educators, which proved to be very helpful. They didn't bat an eyelash about my very specific wishes for the birth and for our newborn & really respected birth as a natural process. I wish more hospitals were like that.

In my experience, many women demand induction. They are "tired, can't sleep, their backs hurt, they have a babysitter, yadda, yadda." In this litigious climate, their demands are caved in to. We have many c-sections "on demand"........which I believe I wrote in another thread. Some are primary c-sections in which the mothers refuse to labor. I did see one chart where the doc wrote "repeat C-section" when it was really a primary and I was tempted to report him for insurance fraud. He would have made up a reason for it. IUGR, decreased FM, I have seen them all. A birth without unnecessary intervention is a very RARE thing where I work.

I stand corrected -

steph

I was going to echo the same sentiment about rural setting - we are a pretty rural community hospital and I think we're pretty interventionist.

For just one example, I walked an early labor pt the other day for the FIRST time since I started in July, (no ROM, no risk factors at all, her ctx were spacing apart to about 7-8 mins instead of getting closer, etc. etc.) and I think the MD was pretty taken aback when I told her. She was like "yeah but don't we usually only walk r/o labors?" (me thinking: "ummm yeah.. and therein lies the problem..." and btw, we don't even walk the r/o labors very often) ... but I said "it's on your routine orders so I thought it was ok" ... she didn't even KNOW it was on there. She'll probably remove it now! LOL (or cry).

but I said "it's on your routine orders so I thought it was ok" ... she didn't even KNOW it was on there.

we had an attending physician who supervises residents not know that 10L 02 by mask was a standing order for decels. when we told him it was a standing order, he goes "for everyone? you dont have everyone on O2" and we're like, no, for decels.

he thought maybe it was 2L. lol.