Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

No Doula in the Name of Privacy? Oh Come On! September 26, 2009

This comment was recently left by a reader named Jessica under one of my older posts.  Since I read every comment that is posted on my blog I happened to stumble upon it this morning.  When I read it I couldn’t help but think “I Hear Ya Sister!!!”and felt that it was so well stated that it needed to be its own post!  I know that there are quite a few doulas out there that read my blog and I just wanted to take this opportunity and give a shout out to them all and say thank you for all you try to do to educate women before they get to me on L&D!  Unfortunately, they don’t all listen but I hope you know that there is at least one L&D nurse out there that appreciates your efforts, both before and during labor!!!

 

For all you expecting moms out there please check out DONA’s website to learn a bit more about what a doula is, how you can find one, the effects a doula can have on your birth outcome and experience, and how a doula can advocate for you!

 

And just for the record, there is NOTHING private about a hospital birth experience.  Even in the most well meaning hospitals with the most well meaning birth attendant and the most well meaning nurse(s).  Albeit some women’s hospital births might be more private than others and I personally have had the priviledge to be a part of a few totally amazing hospital births.  But to not hire a doula for your hospital birth (especially at a university hospital!) because you want a “private” experience is a very VERY naive and misguided idea!  I am not saying that to hurt anyone’s feelings and I am certainly not judging anyone out there who decided not to hire a doula for one reason or another.  I am just telling it like it is.  Some food for thought…

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Hi NursingBirth!

I am a certifying doula and have recently had an interview with a perspective client. She is 36wks pregnant with her first. She was strongly considering a doula, but everyone else in her family was on the fence, and pushing a “private” birth experience. However, they are planning a delivery at a university hospital, she has yet to see the same health care provider throughout her prenatal care, she has no idea which one will be at the birth, or if it will even be someone she has met. They are planning a natural birth. She assured me that the hospital she is birthing at offers a multitude of birth options, including water birth, birth ball, position changes, etc… and the childbirth education from the hospital has given them confidence in their ability to get what they want from this birth. After much “deliberation” they decided that they were not going to hire a doula, based solely on their confidence in the hospital to give them what they want, and their desire for privacy. While I can completely respect their privacy request, I fail to see how birthing in a university hospital will give her much if any privacy…AND if she doesn’t even know who will be her health care provider at the birth…how is she confident that the hospital will give her what she needs? I wish there was some way to help open her naive eyes to the reality of birth in hospitals today. Her chances of getting to work with a mother friendly doc that understands and respects natural birth have got to be low! Reading your blog was comforting (because I know there are others who struggle with this) and depressing(because we have to struggle with this). I don’t want to have her hire me for her VBAC next time around. I want her to have the birth she desires now. I realize there isn’t much I can do for her at this point, which is why I am here, leaving my frustration with a bunch of like minded individuals. I am hoping things will go well for her and in the mean time, I’ve let her know that I am and will be available until the baby is born. just in case. Thanks for the space to rant.

  

Sincerely,

Jessica

  

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Jessica, you can rant here anytime!!!  I Hear Ya Sister!  Loud and clear!!

 

And now I leave you with one of my FAVORITE Monty Python skits of all time.  I have seen it a million times but it is still as hilarious (and eerily true) each time I see it.  Notice how the doctor invites in an army of people to watch.  It often feels like that where I work no matter what I do!!!

 

 

Midwife and Author of “Silent Knife” in the News! September 25, 2009

Filed under: In The News — NursingBirth @ 8:46 AM
Tags: , , , , , ,

So first the USA Today article and now this!  Is it too good to be true?  Is the media finally starting to come around to writing about homebirth without sensationalized headlines, damning quotes from disapproving docs, and horror stories of homebirths gone wrong?  Well if I keep stumbling upon articles like this one from Wicked Local Needham (a companion website to The Needham Times) it certainly won’t be too good to be true! 

 

The article is titled simply: Needham midwife helps moms give birth at home.   Writted by journalist Steven Ryan, the piece highlights homebirth midwife and author of the book Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean(VBAC) Nancy Wainer of Birth Day Midwifery Care.  The article is absolutely fantastic, not because it is a stunning literary masterpiece, but because it is a simple, well written feature on a homebirth midwife.  Ryan gives a brief history of why Wainer is where she is today, speaks to her many years of experience and education and rounds out the piece with many great quotes from happy and satisfied home birth clients. 

 

My favorite quote was this:

 

“Milly Ramsey described the birth as intense, but doesn’t regret her decision to have the baby naturally and at home.

 

‘I was very comfortable at home,’ Ramsey said. ‘It was intense. I was out of it when he was born but I felt very supported. I felt like I wasn’t alone … The best part was I got to hold him on my belly all slippery and wet and they didn’t take him away. He stayed with me.'”

 

Thank you Wicked Needham Local for a great pick-me-up before I head off to work!  Oh and by the way, LOVE the name of your website!

 

Thanks to Christina at the Massachusetts Friends of Midwives blog and my google reader for alerting me to this article!!

 

USA Today Weighs In On Homebirth September 17, 2009

On Monday, USA TODAY, a national American daily newspaper that has the widest circulation of any newspaper in the U.S., published an article entitled For some women, no place like home for childbirth by Rita Rubin.  As usual, I was worried when I clicked on the link as typically when mainstream media gets a hold on the “home birth debate” it gets ugly.  (Case in point: see The Perils of Midwifery.  Please don’t get me STARTED on that GARBAGE!!)  However Rubin’s article was pretty alright. 

 

First of all the couple highlighted in the piece had a beautiful homebirth experience.  (What?  You mean it wasn’t a horrible regrettable disaster!?!)  Second she actually interviews and quotes a homebirth midwife in the article .(What a novel idea!! You mean it is responsible journalism to actually interview midwives when writing an article on them!)  And thirdly she ends on a positive note with a quote from Alice Bailes, a certified nurse midwife who attends homebirths in Virginia, “We get to see one normal birth after another.”

 

Although the article didn’t get away with writing about home births without quoting ACOG’s mantra “Home deliveries are for pizza”, I think this article did a pretty good job for mainstream media.  Thanks Rubin!  You give me hope!

 

“Major” Momma: Kim Clijsters Wins U.S. Open!! September 14, 2009

Filed under: In The News — NursingBirth @ 6:45 PM
Tags: , ,

CONGRATULATIONS to tennis champion Kim Clijsters of Belgium who made history last night after an AMAZING comeback post two year hiatus to become the first unseeded woman to win the  U.S. Open!  The crazy thing is is that Clijsters didn’t even have a ranking coming into this tournament because she hadn’t played enough tournaments to get on the list.  Not only was Clijsters an underdog, but she is a mother and in fact is the first mother to win a major since 1980!

 

However seems like Google’s “Did You Mean” genie is a little bit sexist.  Hahaha!  Look what came up as a suggestion when I searched for this story to link to:

  first mom to win tennis

 

I just love reading about strong, empowered, focused, driven, successful women, and when those women happen to be moms too, it is just the icing on the cake!!  After the match ESPN quoted Clijsters as saying, “It’s the greatest feeling in the world being a mother.  I just can’t wait to spend next the few weeks with [my daughter] and have her routine schedule at home again.” 

 

Being that Clijsters is only two months older than me I have to admit that reading this story is a good kick in the pants for me to step up my workout routine!!  I mean, I know I am no “pro” but I could still stand to shave a few second off my 5K time!!

 

Just a little sprinkle of inspiration for your day!

 

Seattle Birth Photographer “Honored” To Photograph Birth September 9, 2009

Dear NursingBirth,

 

I came across your blog and I thought you might be interested in seeing the images from the recent home birth I photographed.  I am a professional photographer,  mostly I do portraiture work with mothers and newborns but occasionally I photograph birth.  I love the change of pace and the adrenaline rush : )   I am also a natural birth advocate and gave birth to my son at with a midwife at a free standing birth center.  We are planning to have our next baby at home.  The popularity of birth photography has increased dramatically over the last year – I think signaling a shift in how we think about birth.

 

Here is a link to my blog post about the birth
http://emilyweaverbrownphoto.com/blog/2009/09/birth-photography/home-birth-seattle-birth-photographer/

 

There is a slideshow with all the photos set to music linked at the bottom of the page.  Just scroll down and click the link that says >>The Birth of Waldron Dain Peterson<<.  Take care and happy blogging!

 
Sincerely,

 

Emily Weaver Brown

www.emilyweaverbrownphoto.com

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Dear Emily,

 

Your pictures are gorgeous!!!  Makes me want to move to Seattle and have a baby!!  Good luck with your home birth plans and have fun trying for #2!!!  Thank you for the link to your website as I know many of my readers love to read other women’s empowering birth stories and while a photo slideshow isn’t technically a birth story, a picture is worth a thousand words!!

 

While watching Waldron’s birthday slideshow I was so overcome with positive emotions like happiness, awe, empowerment, and especially a deep respect for our strength and abilities as women!  Some of my favorite pictures include:  (1) The one where the mother is bending over in the hallway, her husband is bracing her and her sister is rubbing her back.  I love how you can see the “family picture” in the background because you know that in just a short while they will have a new addition to the family!!,  (2)  The one where the mother is bending at her waist and then looks up with a smile.  She is either in transition or pushing but she still has a smile on her face, knowing what all of this hard work is for!!,  (3)  The “Moment” Shot where mom holds her baby for the first time and looks up at her husband with a face that says “I DID IT!” and “I LOVE YOU!”,  (4)  When “big sister” leans over the tub and is looking up like “Is that my brother!?!”,  and finally (5)  The whole family sitting on the bed together, happy and healthy!!

 

Keep up the good work!!

 

All My Best,

 

NursingBirth

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Excerpt from Birth Photography at http://emilyweaverbrownphoto.com/blog/birth-photography/

 

“The birth of a child is one of the most significant and beautiful events in life.  I am always honored when I am invited by families into these very intimate moments to document their memories.  The first moments of life are so precious…the first breath, the first cry, the first time your baby looks into your eyes.  I love documenting these moments for my clients and I know that they will treasure them forever.  The birth of a child is one of the biggest defining moments in your life and you will not regret having it photographed.  Printed images are stronger than memory can ever be and you will be so thankful that you have them to hold onto for your children, your grandchildren, and their children.”

 

In the blog section of her website, photographer Emily Weaver Brown’s writes about why she loves  photographing births, how she met her client Jessica, and why Jessica chose a home birth.  Check out her original post for more information about how Jessica’s labor went!

 

“I loved photographing this birth for many reasons. It’s so difficult to be just an observer, and though I strive to photograph the birth as though I wasn’t even in the room I still get pulled in. Before a birth I meet with my client’s to discuss their wishes and get to know them. (I don’t want to be a complete stranger showing up one of life’s most intimate and raw experiences.) This meeting and the subsequent emails usually leads to friendship and before long I know all about their previous birth stories and all of their hopes and dreams for the birth that I will photograph. So I can’t help but cheer on the moms while they work hard to birth their babies. With Jessica it was no different. Jessica is actually a former client of mine who is now also a professional photographer. I know that she really values photography as an art form and that having the birth of her second child documented in photographs was really important to her.  But even more than that, I knew that the birth of Jessica’s oldest child did not go as she had hoped. She ended up with a healthy baby girl but also a lot of interventions that she didn’t want and it made her feel like she had failed. I had no doubt in my mind that Jessica would be able to birth her second baby at home naturally as she had planed but I so wanted it to go perfectly for her so that she would have a sense of redemption over all that happened during the birth of her daughter.”

 

Please visit http://emilyweaverbrownphoto.com/blog/birth-photography/ and scroll down to the bottom of the page to see two more birth photography slideshows, both of which are hospital births.  Just curious, did any of you feel differently when watching the home birth slideshow vs. the hospital birth slide shows??  Why?

 

The WORST Idea Since Routine Continuous Fetal Monitoring for Low Risk Mothers September 7, 2009

My husband (being the techie cutie that he is) reads CNET news, a website about computers, the Internet, and groundbreaking technology as part of his morning routine.  The other day, while I was enjoying my Kashi cereal and checking out the latest blog posts on my Google Reader, my husband hollered over to me from his office and said,“Hey Melissa, have you heard of LaborPro?”  Until that moment I was having a pretty good Sunday morning.  I mean, I woke up refreshed and smiling, the sun was shining, and I was looking forward to what I felt was going to be a “good” day at work.  But my attitude quickly turned from happy-go-lucky to blinding rage when he uttered those eight little words. 

(Okay, okay, so I think I am being a bit dramatic.  Maybe blinding rage is a bit strong.  But I was pretty upset!!)

So what is LaborPro and why did it put me into such a tizzy you ask?  According to Trig Medical’s website (the Israeli company that is developing and recently won a Frost & Sullivan Technology Innovation of the Year Award for this GARBAGE), LaborPro is “a novel labor monitoring system that using ultrasound imaging measures continuously and objectively fetal position, presentation and station along with cervical dilatation. LaborPro quantitatively assesses and records vital labor parameters in real-time to enable obstetricians to make informed and accurate decisions throughout the labor process to improve both the quality and cost of obstetric care.”

 

 

 

The website lists LaborPro’s capabilities as able to:  

  • Determine continuous station & position of fetal head by ultrasound imaging,
  • Provide radiation-free pelvimetry & birth canal modeling.
  • Perform one-step computerized “non-invasive” trans-vaginal digital examination (I’ll touch on that in moment)
  • Determine intermittent or continuous accurate measurement of cervical dilatation
  • Record comprehensive labor data recording

 

It also toutes its “unique benefits” as the following: 

  • Non-invasive, precise measurement of station & position
  • Improves assessment of non-progressive labor
  • Supports decision-making before operative delivery
  • User friendly, on-screen display of all labor parameters
  • Enhances patient comfort and sense of security

 

Okay okay okay….Just HOW does it do this you ask?  Well it’s EASY!  (*rolling eyes*)  Well according to the website’s one mintute educational video (check it out here, it’s worth it).  FIRST you have to place “just four little electrodes” externally on the mother’s pelvis in order to continuously assess fetal station and position and also enables the user to “recognize CPD early”.  SECOND you just have to clip (or screw) “just a few position sensors” to the woman’s cervix to accurately and continuously measure cervical dilation.  And THIRD you just have to screw “just a small little electrode” into the baby’s head.

Fetal Scalp Electrode  (notice the little corkscrew tip)

Close up of a fetal scalp electrode, or FSE (notice the little corkscrew tip, that screws into the baby's scalp.)

According to Frost & Sullivan, the organization that awarded Trig Medical for the LaborPro technology writes, “The LaborPro is staff and mother-friendly and requires only basic training in ultrasound usage, obviating the need for an obstetric ultrasound expert,” adds Ms. Prabakar. “Moreover, the technology employs non-invasive, radiation-free pelvimetry as well as a single-step computerised digital examination. All labor progress tracking data including the fetal heart rate monitor are integrated in the LaborPro display and automatically recorded by the system, which helps reduce staff workload.”

 

Oh great!  We only need “basic ultrasound skills” to work it!  (*double eye rolling*)  Here’s a novel idea!  How about every hospital (including my own) in the United States that has a L&D floor actually provide labor support training to their nurses instead!  That would go a lot farther for us than freaking ultrasound skills!! 

(Just for the record, my hospital does NOT include labor support training as part of orientation and we are NOT alone.  At my hospital, if you want to learn how to provide labor support you have to seek out other learning opportunites on your own, like I had to.  But we do get extensive training on how to work and interpret the fetal monitor.  Oh and about 1/3 of our three month orientation is dedicated to learning how to care for a patient who is being induced.  In fact, I had to teach myself how to do intermittent auscultation and hence, I am one of the only nurses that I work with that isn’t “scared” of intermittent auscultation and will actually advocate for it!) 

The most terrifying thing is that although at this time LaborPro is not available in the United States (Oh Hallelujah!!!) there is another company called Barnev based out of Andover, MA that has developed an almost identical product they call BirthTrack™ Continuous Labor Monitoring System which they describe as “a revolutionary continuous labor monitoring technology that provides obstetric caregivers invaluable, precise, objective, real-time information about the physical progress of labor. The BirthTrack System provides tools for a more informed decision making process through which hospitals can reduce the risks and costs of childbirth and assure the safety and comfort of mothers-to-be and their babies.”  I remember hearing about this product a couple of years ago when it was still in “development.”  Well guess what?!  Development is over!!  Marketing here we come!!  (GAG me!)

 

So now there are at least TWO companies that are actively marketing this HORRIFIC, INHUMANE, and OUTRAGEOUS product.  Just wait  until LaborPro makes it to the United States (which according to their website they are actively persuing).  Then they will probably start to compete with eachother!  Now now only will labor & delivery wards around the country have to deal with Similac and Enfamil representatives competing for our money and attention in house (which already makes me sick to my stomach), but now I have to worry about this??!!  THIS IS TERRIFYING!!!

 

I’m telling you right now, I will UP AND QUIT my job and never look back if either LaborPro or BirthTrack EVER  appears in even just one, JUST ONE of my hospital’s labor rooms.  QUIT ON THE SPOT!  And I will make a Hollywood exit too!  A HUGE scene!!!  Hooting and hollering!  You just wait!!  LOL!  As if our moms aren’t already strapped down enough with the often unnecessary and sometimes downright harmful technology we already have.  This is just TOO MUCH TO BEAR!

I have taken care of MANY a laboring woman (often as a result of an induction, mind you) who are connected to:

 (1)  an IV line with IV fluids and Pitocin running through,

(2) an electronic fetal monitor to measure fetal heart rate,

(3) a tocodransducer to measure contraction pattern

(OR a fetal scalp electrode to measure fetal heart rate and an intrauterine pressure catheter to measure contraction frequency and strength),

4) an epidural catheter in the back giving a continuous flow of anethetic and narcotic medications into the spinal column,

(5) a foley catheter in the bladder since it is very rare that one can empty their bladder with an epidural,

(6)  a pulse oximeter to continuously measure blood oxygen level (necessitated by the epidural),

(7) a blood pressure cuff to record one’s blood pressure every 15 minutes since an epidural can drop your blood pressure dangerously low, and finally

(8) if the baby has shown any signs of distress, an oxygen mask for your face!

 

Well I have a message for both Trig Medical and Barnev, LABORING WOMEN DO NOT NEED ANY MORE THINGS SHOVED UP THIER VAGINA!!!!  And furthermore,  CLIPING ANYTHING TO A WOMAN’S CERVIX OR SCREWING ANYTHING INTO A BABY’S HEAD DOES NOT COUNT AS “NON-INVASIVE”!!!  LABORING WOMEN AND BABIES ARE NOT ROBOTS THAT DON’T FEEL ANY PAIN OR DISCOMFORT!!!!  RESEARCH HAS SHOWN TIME AND TIME AGAIN THAT LESS IS MORE WHEN IT COMES TO LABOR FOR HEALTHY MOMS AND BABIES!!!  CONTINUITY OF CARE IS MUCH MORE EFFECTIVE, LESS PAINFUL, LESS INVASIVE THAN ANY “COMPUTERIZED FINGER.”

Furthermore, LaborPro and BirthTrack are a slap in the face to every labor and delivery nurse that cares about giving appropriate, effective, competent, physiological, and compassionate care to childbearing families.   Unfortunately I would bet my hard earned money that at least half of the doctors I currently work with would think that this is a good idea. 

Okay, okay, now that I am all riled up again I have to go to work  😦   Please check out Rixa’s post over at Stand and Deliver about BirthTrack.  It was written about a year ago and I stumbled upon it when I was searching for a picture of a fetal scalp electrode!!

Change has GOT to come!  It’s GOT to!  For the health and wellness of our mothers and babies!!  Remember ladies, YOU actually have more power than ME and all the other L&D nurses out there!!  That’s right!  If you do not hire birth attendants that do not support evidenced based medicine and physiological birth and do not patronize hospitals that do not support a family-centered approach to maternity care then and only then will they start to listen.  You know why?  Because when the customers aren’t comin’, it hits them where it hurts… in their WALLET!!

 

NursingBirth makes TOP 50 Best Blogs List!!!

Filed under: In The News,Just For Fun — NursingBirth @ 8:28 AM
Tags: , , , ,

Good news everyone!!!  (Any Futurama fans out there?  Anyone?  Haha!)

 

Last month NursingBirth was included in NursingDegree.net’s 50 Best Blogs for Neonatal Nurses!  I am in good company too as some of my favorite blogs made the list including: At Your Cervix, Stork Stories, Birthing Beautiful Ideas, Stand and Deliver, The Unnecesarean, Our Bodies Our Blog, Pushed Birth, Enjoy Birth Blog, Woman to Woman Childbirth Education, and Science and Sensibility just to name a few!  Check out my blog roll to the right for links to any of these blogs!

 

50 Best Blogs for Neonatal Nurses

 

The cool thing is that while I don’t think the numbers actually mean anything, I was ranked #17 which happens to be my FAVORITE number!  (That’s right, I have a favorite number.  And a favorite color too!  ….it’s purple if you were wondering!!) 

 

Thanks to all my readers for reading!!  I certainly wouldn’t have made the list if it wasn’t for you!!!  Last time I checked I had 84,552 hits to my blog since I started in February.  WOW!!!!  You all amaze me on a daily basis!!

 

All My Best,

 

Melissa

aka “NursingBirth”