Written by Gloria Lemay, reprinted with permission http://www.glorialemay.com/blog/?p=98
I’m a labor and delivery RN, and have been one for 6 years. I can tell you the #1 reason why doctors (and yes, some nurses) will push patients to get an epidural — it’s much easier on us to do our jobs. What better way to manage multiple laboring patients, than by having them all comfortable with epidurals, and a pitocin drip to “manage” the labor.
UGH. I am sick of it. The unit I work at – and I have seen this at other units that have a lot of deliveries – is like a labor and delivery assembly line.
Pitocin – epidural – c/s if you don’t progress fast enough – off with you to postpartum – NEXT!
I’ve also noticed that many women that come to the hospital where I work do not go to child birth classes. Some have no clue what pregnancy, labor and delivery is all about, and just tell me right off the bat – they want their epidural. What can I do at that point? They don’t know me. I wasn’t at their prenatal appointments. I can do some very quick childbirth education, but usually by this point, they just do “whatever the doctor says to do”.
The women that come in with some education under their belt, are usually the midwife patients. They know in their mind how they would like their labor and delivery to go, and they come with coping techniques learned in class, or taught by their midwife. Even then, most women still will end up with an epidural, and chances are, many with epidurals will need pitocin to “speed up” their labor.
I am sick of the number of inductions that are done. Most for no real reason. The docs will come up with some far-fetched reason – suspected LGA (large for gestational age), suspected SGA (small for gestational age), prior macrosomic baby, advanced maternal age, maternal exhaustion, maternal request, history of shoulder dystocia (with normal growth on current baby), elevated multiple marker (blood test around 16 weeks), hmmmm… the really good ones… back pain (normal with pregnancy), hypothyroidism, tired of being pregnant (TOBP syndrome).
Doctors are inducing earlier and earlier too – even doing fetal lung maturity testing on 36-37 weekers. Those babies sometimes come out and need to be intubated and admitted to the NICU for being premature.
I could really go on and on.
Jennifer G. RN
From an OB Nurse about Hospital Birth: “Countless complications in labor and delivery are caused by the medical interventions thrust upon women by their ‘caring’ doctors. These interventions would always set off a series of further interventions (a chain reaction of interventions) to try to ‘help’ mom and baby. And ironically, after it was all over, the doctors would look like saviors to the parents!!! And the doctors caused all the problems in the first place!!!
“I’ve seen cord prolapse occur after artificial rupture of membranes. I’ve seen fetal heart tones descend rapidly immediately after the MD inserted an invasive monitor up inside the woman’s womb. Almost daily I would see fetal distress in response to synthetic oxytocin induced contractions.
“I am sorry to say that being a new nurse out of school it was very difficult to speak out against these things- even though deep inside me my instincts were shouting out ‘NO!’ And sadder still- the truth was that most women walked though the hospital doors asking for exactly what they got—inductions, epidurals, forceps, vacuum-assisted deliveries and c-sections.
“But they were never fully informed that the labor and birth choices they were making were so dangerous to their babies and to themselves.
“At least, by the end of my three years there I had developed a way to work within the medical system to help moms have their voices heard and I was always a strong patient (women’s!) advocate- but it is so hard to work within a system that is so corrupt in its view toward women and birth!
“My goal is to work as a midwife or doula in the future and to promote women’s choices and rights in childbearing. I apologize to all those women for whom I was their ‘nurse’ and for whom I assisted the obstetricians in the dehumanizing of what should have been their most sacred birth.”
-Mary Herrington, RN. (Mary gave birth to her second baby at home)
From a disillusioned obstetrical nurse
“Is it any wonder why women like me are leaving the nursing profession and why there is such a shortage when you have to work with abusive people as a bystander? My conscience won’t let me do it any longer.
“The doctors who are abusive to women are also abusive to the people who save their asses time and again… nurses. There is much talk in nursing circles about the real reasons there is a serious shortage of nurses. While low salaries and long hours are contributors, so is the abuse nurses sometimes put up with. It is everywhere. I’ve gone toe to toe with these assholes over the years and had my hand slapped by my bosses and even quit jobs because I’m not going to let them push me or any one else around.
“However, that abuse is much different than when a woman is in a vulnerable state, cold and naked in an exam room or when she is laboring. Nevertheless, their behavior is still abusive.
“And I find a lot of the language surrounding birth to be downright demeaning. For example, I was talking with a pregnant woman last week who was telling me the only problems she’s had with this pregnancy were recurrent bartholinitis (an infection of the Bartholin glands, which are just inside the vagina and provide lubrication during sexual arousal). I thought to myself, why the hell are they named after some doctor who discovered them. Why aren’t they called ‘vaginal lubricant glands’ or something like that? Arrogant, aren’t they?” -Karen
From an obstetrical nurse regarding elective inductions and cesareans
“Time & again, it’s the Mom who has requested an induction. I always tell them – when you got pregnant it was for nine months – not 8 1/2! Of course, we chuckle over the ‘disease’ of the week MD’s come up with for deciding to induce- PIH (pregnancy induced hypertension) and my personal favorite- ‘impending’ macrosomia (big baby). Fortunately, we do not use Cytotec, but Cervidil. Still, inductions definitely lead to increased epidurals and
c-sections. Even more alarming, lately we have had a few ‘elective’ c-sections. I have heard inklings from a couple of MD’s that this ‘saves’ the vagina and prevents urethral trauma and stress incontinence later in life! I said to this doc (in the middle of a c-section, I might add) ‘I’d rather pee in my pants!’
“And would you believe that a female ob/gyn is giving seminars to docs touting this baloney? I don’t mean to get down on all MD’s- most of the ones I work with are wonderful, but some…? So again, I stress that these women MUST educate themselves (and we RN’s must assist in educating them) on just what the consequences of their decisions could be. First and foremost WE MUST REMEMBER that we are their advocates! We have the knowledge- use it!” -Jana
Flashbacks, and grim reality
“I am a nurse in the Special Care Nursery at the hospital where I had my c-section so I am confronted with flashbacks and bad feelings on a constant basis. It is awful!
“We were called to a ‘stat’ c-section the other night for ‘severe fetal distress’ and the sOB’s started cutting this woman before the anesthesia was effective… and they did the old pull and tear maneuver while she could still feel it also. (It was in the same OR as I was in to have Alexandra.) I started sweating and got really anxious, scared, and thought I was going to throw-up and faint at the same time. But then I said, ‘OK PEOPLE YOU HAVE TO
STOP!! THIS MOM IS SCREAMING AT THE TOP OF HER LUNGS!!!’ They did stop and then gave her a general… but I felt terrorized all over again… and that poor mother!!”
Mama to Alexandra
Jan 6, 2008
In response to a news item “2 N. J. Moms who died… hospital situation” Jan 6, 2008 8:06 am (PST): I am a registered nurse, and have no intention of ever working within a hospital setting again. It really is all about the business and not about the patient. The human life we are caring for. In NJ, where I reside, there is a nursing shortage. In addition to a nursing shortage, there are very poor unregulated nurse patient ratios, making quality care hard to provide when the nurse is spread thin. I don’t know what the mother baby ratio was at Underwood, but I do believe that with the appropriate monitoring, these cases if truly resulting in hemorrhage and a clot perhaps may have been prevented. But there are a lot of questions that need to be asked. At what point in their stay did the episodes occur? Where was the clot? Was it a pulmonary embolism? Clot went to the lungs. A myocardial infarction? Clot went to the heart. A stroke? Clot went to the brain. Was her PT/PTT time measured before or after the surgery? Bleeding time. What were her platelets? Clotting component. These measure clotting predictability. Was she wearing compression boots on her legs and if so, for how long. This is to prevent clot formation, which is very often where clots form s/p surgeries due to venous stasis, and platelet formation at the incision site. How often was the nursing staff in the room? How often were her vitals measured? Did she complain of any DVT (deep vein thrombosis) pain? Leg pain, heat, swelling of the leg at the location of the clot? There is clot busting medication available IV for emergency situations. But if no one was in her room for hours upon hours, no one would have seen the signs. I know from my 4 c/s that nurses don’t frequent the room as often as they should and they don’t respond quickly to your calls on the call bell. Was her vitals monitored? If so, how often? what was her PT/PTT pre-operatively & postoperatively? Was something nicked? Was it vaginally? Did they attempt a blood transfusion? Did they attempt to stop the cause of the bleed? There are so many unanswered questions here.
My horror story: They medicated me and took my baby back to the nursery. They told me they would bring him back at one am to breastfeed. They did not. I awoke at 6am when they did my vitals, which was done by a tech, at the beginning of each 12 hour shift. Q 12 hour vitals are not enough to detect a potential postoperative problem. They never brought my baby back. I asked for him, and was told, soon. I called again at 7 and they were in the middle of a shift change. I called again at 7:45 and was told the babies were being seen by the docs and he would be brought to me after. 8:30 I called down and was told that he was being seen by the doc. 9 am, the doc came into my room, no baby. No nurse. It had not even been 24 hours since his c/s birth. I was still medicated, still could not feel my legs, I was in compression boots, still had the foley catheter, still had the IV. The doc sat at the foot of my bed and proceeded to tell me that my baby had stopped breathing, needed resuscitation. There were other details but all I could here was my baby stopped breathing. He WAS fine when he was with me. He left me there, by myself. I called down to the nurse, that I needed her NOW. No one came for the 15 minutes that I was on the phone with my mother and my husband telling them what had happened and to come down. I had to call the nurses station again, this time, demanding that a nurse come and release me from everything or I would do it myself. for God Sake my baby nearly died. One came, and an hour later I was being wheeled down to see my baby… nothing urgent to them. Not enough staff to meet the needs of the patients. My son is wonderful, thank GOD, he is 16 mo old! But if I could not get nursing support, and I was calling for it, who is to say that this was not part of the problems in these Underwood cases? Tiffani
In response to: 2 NJ Moms who died after CS – cause of death?
Well, last I heard, “they” had investigated and found no liability on the part of the hospital — which can be looked at 2 ways — sometimes women die from “known” risks of surgery and there really isn’t anyone “at fault” per se. Or, if you believe that you can always find fault somewhere, then basically a deal was made with the families and no one
is talking about it. I’d heard that one death was due to hemorrhage and one due to a clot. Being a surgeon, I could see both of those things happening even if everything was done “right”, though the risk of them could be increased if things weren’t done the best way possible.
Gretchen (Veterinary surgeon)
This item made the rounds a while back after it was posted on Cafepress. It’s pretty horrifying but, somehow, it is good to have spoken out in words the attitude that I have seen on the faces of so many of the burned out obstetric nurses. The truth shall set you free but first it will upset you.
Rules of the Labor and Delivery area
1. Don’t ask me if my wheel can tell you if you got knocked up on the 15th or the 16th. That’s too damn close to have 2 different partners anyway… Just suffer for 8 more months, assuming the father is not the one it should be.
2. Bed rest does not include walking around Walmart, or running by the mall to pick up something.
3. Don’t come in the middle of the night because you’ve been throwing up for a week… and then ask me to get you something to eat..
4. Breathing hard, and faking to your family like you’re having contractions, WON’T open up your cervix.
5. Tears, and rolling around in the bed also will NOT open your cervix.
6. Doing sit ups while in the bed to make the monitor “go up” also WILL NOT open your cervix.
7. Until your cervix is opening… don’t plan on staying.
8. If you fight with your boyfriend and need a little TLC… go to his mother’s house, not the labor room.
9. If you are there with someone in labor, don’t try to read the strip and tell me what’s going on. You don’t know the difference between a fart and a contraction and you’ll likely just piss me off and delay your loved one getting pain medication or her epidural.
10. When I ask the patient a question, that’s who I want the answer from… OK? I don’t need her mother to tell me when she had sex last.
11. This day and time, if a patient is between the ages of 37 and 42… she has had approximately 2-5 partners. If she is between the ages of 28-36, the average is 7. If she is in her early to mid twenties, then her age is how many partners she’s had… If she is a teenager, then “too numerous to count” applies. (and she has had, or currently has chlamydia or trich)
12. Open your damn legs. If you were a virgin, you wouldn’t be here.
13. Shave that shit. If we wanted a trip to the jungle, we’d go there.
14. Clean your ass before you come in. Unless you have the umbilical cord hanging out, are in a serious accident, or are bleeding profusely, take time to wash it up a bit… it’s going to be on display.
15. You’d better be nice to your nurse. She, not the physician, decides when you get pain medication… There is such a thing as placebo. We can also make you wait the entire 2 hours… adding 45 minutes for our convenience… or we can give it to you 15 minutes early… it’s all in your attitude.
16. The fewer visitors you have in with you… the better mood your nurse will be in.
17. Get rid of that one “know it all” visitor before it’s too late. She can ruin the entire experience for you by pissing me off.
18. If this is your 6th baby, either get the epidural before you come in, or don’t plan on one.
19. Don’t blame us when you’re baby can’t say it’s own name when it’s 5. Chances are, it was the cocaine you snorted in the parking lot, just before you were rushed in abrupting.
20. If your pulse is 50 when you come in from all the downers you’ve been downing… chances are your baby will be several bricks shy of a full load. It’s your fault, not ours.
21. When I ask you if you smoke, you should include marijuana in that answer. Other things that should be included are, hashish, crack, meth, and any other illegal drug that you may have smoked. Nicotine is the least harmful of all the crap you could smoke… dummy.
22. Don’t b**** at us because your baby has to stay in the hospital until it’s 2 months old, weaning off of Methadone or Morphine. Regardless of what the bulls*** clinic says to you, Methadone is NOT healthy for babies.
23. If you call us and say you’re bleeding profusely, then I’d better see some blood when you come in. Do you know how many people we notify for s*** like that!
24. Hard labor doesn’t just stop with 1 bag of IV fluids. We know a faker when we hydrate one.
25. If you’re an addict, we already have a preconceived notion about you, and we probably don’t like you. Nothing personal… it’s just the way it is. You chose that life… now live it.
26. Regardless of the fact that your neighbor’s sister’s aunt had a baby at 30 weeks and it is perfect, that does NOT mean we’re going to let you have yours at 30 weeks.
27. Your neighbor’s sister’s aunt’s baby likely had to stay in the hospital for 6 weeks, and could possibly have problems that you’re not aware of… dumb dumb.
28. You’d better tell us if you’re on narcotics… trust me, we’ll know soon enough, because our drug of choice is Stadol… HA HA.
29. If you have track marks on your arm, “NO YOU CAN NOT GO OUT AND SMOKE” with your IV. What do you think we are, Stupid?
30. Don’t scream. We hate screamers. It gets on our nerves and we just sit at the desk looking at each other and grinning and making faces. It’s not to your advantage.
31. If you don’t have custody of your 3 other kids, chances are you won’t go home with this one either. We ARE calling Social Services. That’s our job.
32. If the baby’s dad is in jail, and he’s still your boyfriend, we automatically assume “birds of a feather flock together”.