Tag Archives: doctor

Monday Musing ~ Hospital Birth… I am So OVER it!

Monday Musings… Back at the beginning of February I thought it sounded catchy and I decided to start this segment on my blog.  It was intended to be a place for me to rant about something that happened in my world, in my life during the previous week/weekend.  It sounded like a good idea initially.  However… as you can see… not just from a Monday Musing stand point, but from all points in general as it relates to this blog, I have been completely M. I. A.  I have just been buried beneath life. I am sure some of you can relate. I do remain committed to my blog, and to be quite honest, while sometimes it seems like WORK, I have come to enjoy it.  And when I am away from my blog for long periods of time, I miss it.  This has been one of those times and I decided to dive back in with a Monday Musing today!

While this “Monday Musing” is not a reflection of what transpired specifically over the past week/weekend, it is a little glimpse of what work has been like for me over the past couple of months and basically… the bottom line is….

I am soooo OVER IT!!!

I am over doctors believing that they always know what’s best without ever consulting the woman(en) they are taking “care” of AND… I am over the nurses who think this is okay and are far too lazy and/or complacent to educate their patients to make informed decisions.

I am over doctors who think it’s perfectly okay to perform episiotomies and operative deliveries with forceps and vacuums without asking or even mentioning it to the patient even when it’s NOT an emergency.

I am over doctors telling a woman “You might need a c/section” BEFORE she is even in labor and convinces her to get induced for her “big” baby that weighs SEVEN pounds.

I am over doctors saying “Well we should just go ahead and admit her since she is here and she is 39 weeks. Give her cytotec and start Pitocin in the morning” THIS… for a woman pregnant for the first time who came in to be evaluated with few mild contractions who was 1cm dilated, not effaced with a healthy baby.  AND may I add… a woman who wanted to go home and lives a few blocks from the hospital.

I am over doctors telling me “Well if she doesn’t want XYZ tell her she can’t have any pain medicine” WTF!!!!….  I did have a great come back once however when I was able to say “Actually doctor she is not feeling any pain” That made me smile cause he didn’t know what to say next!! LOL

I am over nurses who think just because a woman does not speak fluent English that she does not deserve adequate explanations… Get an interpreter for goodness sakes!!

I am over family members thinking that giving birth is a spectator sport. It’s NOT and if you are not helping and she does not want or need you GO HOME!! And be clear just because she does not tell you to go home it does not mean she wants you there. She told ME she wants you to leave but she doesn’t want you to be mad. Take a clue. She is either 1. In pain or 2. Trying to rest. GO HOME.  Come back tomorrow. Or better yet… visit her once she goes home with the new baby and bring along a cooked meal! :D

I am over individuals who think “skin to skin” means swaddling the baby and putting the baby onto mom’s chest. Its SKIN to SKIN people…. NOT baby blanket to SKIN… geesh LMAO!

I am over people screaming and counting and telling my patient when and how to push when she doesn’t even have an epidural!!! Trust me… her body KNOWS when and how to push.  And even when there is a dense epidural in place there is still no need to scream and count. She can hear people!!! AND for the record… counting does NOT make the baby come faster.

And at the risk of stepping on a few toes… I am over women who ask me a MILLION questions once they are in the hospital and when I ask “What did your doctor tell you?” the response is “I never asked him… OR…   He doesn’t really give me a chance to ask questions… OR…  I don’t really like him…. Etc… ”  Now let me be clear here. I love to educate women. And I LOVE to help them make informed choices. And I LOVE working with women in labor.  However… if you make a decision to stay with a doctor for 8 months… a doctor that you don’t like… a doctor that does not talk to you or look you in the eye… a doctor that does not know your name… there is not much I can do, as your labor and delivery nurse, when you arrive to the hospital with admission and induction orders. Sure I have tried to say… “Your baby is fine, you are only 39 weeks. BEFORE I place this cytotec you can change your mind and go home” ( And trust me I have REALLY told women this. Even mid induction with Pitocin that is not working I have educated women on their right to leave the hospital and try again the next day or wait for spontaneous labor) The reality is… it never works because at this point you have already started rolling down the hill.

Sooooo I say this… and I beg of you…  Ladies, gentlemen, women, men, daughters, sisters, fathers, mothers, brothers… you have NINE months to do your homework. This is IMPORTANT!!  You HAVE to do YOUR part. Don’t be like a recent father I worked with who said to me in the labor room during my admission education… “WOW! I didn’t think there was so much that went into having a baby!” I smiled supportively and said “Yes… there is a lot, a whole lot” INSIDE… I was more like “WHAT!! What the hell did you think, we were simply baking a box cake. It’s a HUMAN life for Christ’s Sake! Geesh!!”

PLEASE….  read, and learn, and ask questions, and be informed. Don’t take the first answer, ask another question and if you feel uncomfortable find another provider. Waiting until your hospital admission is too LATE!!!

And so moving on… I must admit… I am SOOOO  OVER all of it right now…

I am OVER hospital birth.
I am OVER inductions.
I am OVER 5PM C/sections.
I am OVER continuous monitoring.
I am OVER lithotomy position.
I am OVER women being NPO (restricted from eating/drinking) in labor.
I am OVER women being stuck in bed.
I am OVER the lack of midwives in my community.
I am OVER the inability for families to have a mother/baby friendly experience.
I am OVER women feeling like they have been “saved” when the only danger in the first place is the “savior.”
I am OVER hospital birth.

Yes my friends… I am over it!! All of it!! Every piece of it!!!
And so with that I ask.… what are YOU over??

In Birth and Love
Nicole

Creating a winning birth team…

So you are going to have a baby!! The time is approaching and you are beginning to think about WHO is going to be present for the big event.  Will your mother be there?  Your best friend?  Your partner/husband? Did you hire a doula?  What will your nurse be like?  What midwife/doctor will be on call?

While to some these may seem like simple questions for others they cause extreme stress and anxiety.  The wrong people can create uneasy conflict in your birth room while the right team can create harmony and peace.   There are two primary categories of people who make up your birth team; your health care providers, and your family and friends.   The ultimate goal is a winning team where Together Everyone Achieves More, and where they work together to create a conflict free birth room filled with peace, happiness and love.

Let’s quickly talk about the people on your team:

Your midwife/doctor: IF it is very important for you to KNOW the provider who will catch your baby, you want to be sure you pick someone in solo practice or choose a group with only a few providers.  Make sure you are able to meet everyone of them more than once during the prenatal period.  Keep in mind, everyone needs a day off sometimes, so even with a solo practitioner there is the off chance that your provider may be unavailable.  However, if this is VERY important to you, you can minimize the chances of having a “stranger” in your delivery room if you choose the right provider prenatally.

If it is important to have your provider present throughout your labor, providing support and encouragement, be sure to talk to them EARLY in your pregnancy about your wishes to determine if she/he is the right provider for you. Generally speaking, if you really want your provider to give you labor support you should choose a midwife.  While not every midwife provides labor support, in general a midwife is more likely to be with you in labor compared to a physician.  The bottom line about your birth attendant is knowing that you cannot wait until labor starts to choose the right provider for your labor and delivery team.  This is a process that MUST begin the moment you find out you are pregnant.  Your provider is an integral part of your birth team and you want to be sure you are happy about your choice.

Your nurse: If you will be birthing your baby in a hospital, your nurse will be a critical part of your birth team. She will likely spend more time with you than anyone else.  Not every nurse is the perfect fit for every patient but with a little patience and open communication, you can make the relationship work.  Know what you want, and be prepared to discuss it with the nurse upon admission.  Having a written birth plan is not a bad idea but it is not required.  The most important thing is to know what you want and to have a CONVERSATION.  With open communication, your nurse can become your biggest advocate and friend. There are times when regardless of communication, you and your nurse are not a good fit. When this happens, you can ask for the charge nurse on duty and request another nurse. While this is not always possible due to various staffing and time constraints, it is worth trying if all else fails and there is a definite conflict.

Your doula: Doulas are not just for women who want to “go natural.” While this is where they are primarily used, they can be a valuable asset in any birth room.  Like your prenatal provider/birth attendant, it is important that you meet your doula BEFORE labor starts. It’s important to choose someone who you feel comfortable with.  You want a doula that is going to respect what YOU want, without trying to push her values and beliefs about birth onto you.  You want a doula that has the skill to speak up for you without alienating the staff at the hospital.  Nurse/doula relationships can create some of the biggest conflicts. Be sure to communicate with both the nurse and the doula to make sure they are a part of YOUR team, not in a competition.

Your family and friends: Some women feel obligated to let anyone into their birth room who says they want to be there.  I have seen women become visibly stressed out about trying to decide who should be there and feeling some obligation to allow this one or that one in the birth room although she really doesn’t want that person present.  Some of the relationships that I have seen create the biggest conflicts for women include in-laws and friends especially friends where she was present for their labor and birth.  Birth is a special time for the mother her partner and their infant.  Just because you were invited to her birth room does not mean she has to be invited to yours. Those wedding/party “rules of etiquette” don’t have any place in labor and delivery.  This is a very different experience and should be treated as such.  It is a private event and should include only the people you REALLY want to be present. Remember that during labor and birth, much of you may literally be exposed and if you are a having a natural/unmediated birth you will be in a vulnerable state.  EVERYBODY does NOT need to be there.  Labor and birth is not a spectator sport yet when you have LOTS of visitors during the process just “waiting for the baby,” this is what your precious birth experience has the potential to turn into. When you are trying to work with your contractions or rest after an epidural, the last thing you need is your family/friends standing around “speculating, and watching.”

To avoid in labor decisions/conflicts be sure to have these discussions with your partner, mother, in-laws, friends and doula BEFORE labor ensues.   An easy way to avoid some of the conflict is to keep your “I’m in labor” phone calls to a minimum. After you have the baby and you have had time to rest, THEN you can make all the calls you want. If they don’t know you are in labor there will be no stress about uninviting them from the birth room.

If you do end up having lots of people coming to visit, I encourage my patients to send non-essential visitors HOME.  Let your nurse or your doula be the “bad guy” to send them on their way.  It’s like you are the quarter back and we are the offensive line. We protect you. Ask us and your wish is our command.

After delivery, you will want to rest and spend some private time bonding with your newborn.  Encourage your friends to come over to your house AFTER you are home. You will feel more like normal and be more open to visiting. As a side note, I also make the suggestion that you ask friends to come bearing edible gifts!! Who has time to cook with a newborn baby!  While they love us the most, family and friends are often the ones who create the most conflict.  Be careful about who you choose to invite/allow into your birth space.

When it’s all said and done, you are the captain and your partner is the co-captain of your birth team. Together you have to decide what other team members will help you win.  Be sure to Choose Wisely because your birth team can have a profound effect on your birth experience.

In Birth and Love
Nicole ~ Follow me on twitter @SistaMidwife