Dealing with Anger

Well it seems that this blog has hit a "nerve" with a reader in Denver, Colorado - a reader with some serious anger issues - and someone who obviously had a horrid birth experience. In response to the "Rules of Labor and Delivery" post, which was something simply posted as an example of "labor humor," it certainly elicted a few posts of rage from this individual. And I don't blame her. Sadly, she is of the opinion that I wrote these "rules," (which I didn't by the way - they're easily found on the web) - but in being challenged "not to post it" - I put it in the open for all to read. Her email is an example of poor nursing - but her anger needs to be directed at the hospital and medical personnel that took care of HER - not on a blog! She challenged me to post - I challenge her to not be "anonymous!"

Here's her first post to me:

Piss you off? Let me tell you about pissed. My L&D nurse gave me a drug that she SAID was pitocin. Later I found out that it wasn't pitocin at all, but Cytotec, inserted vaginally, against my will, begged her not to, she told me I didn't know what I was talking about. At the time I didn't know what cytotec was. What I did know was that the first dose started contractions so hard and so fast I couldn't breathe - and neither could my baby. The whole day all they told me was to suffer through the pain. The whole day they told me my baby was in distress and they would do nothing except tell me I was paranoid and she was fine. When I asked them how she could be in distress and be fine at the same time, they got very nasty and told me that they were the professionals and I was the patient and I had to trust them.

Not only did they give my cytotec, they gave me vistaril, demerrol, pitocin and an epidural within an eight hour period of time. I was unconscious for nine hours and they weren't the least bit concerned.

When they saw my baby was suffering bradycardia for three hours, they did nothing. When they saw that she was suffering tachycardia for two hours, they did nothing. When she was suffering shoulder dystocia upon delivery, they said nothing.

They spent AN HOUR rescusitating my baby and they never said a word.

When I asked the nurse what her Apgar scores were, she told me the one minute score was not important but her five minute score was six.

They didn't know for three days that they had broken her collar bone.

When I asked why should wouldn't wake up, they told me she was tired. When I told them she won't nurse because she can't wake up, they told me she won't let herself starve. When I asked them how it was that my baby's collar bone was broken, they told me it was NORMAL.

They told me it was NORMAL for a baby to sleep for nine days solid. They told me it was NORMAL to spike a 103-degree temperature in labor, and they told me it was normal to have to stop pushing to vomit - TWICE.

Piss you off? My baby suffered severe brain damage because of the CARE I got from nurses and a doctor who DIDN'T care enough to do their jobs, who did nothing but lie to me and tell me I was paranoid.

My next two children were born with certified nurse midwives, the BEST experiences of my life. They were caring and sensitive to my concerns, they told me everything up front and more than anything, they knew what the hell they were doing.

I thank God that my friend - who would have pissed you off - was there, because while I was unconscious for hours on end in the labor room, she was taking notes.

Difficult patients who think they know everything? Arrogant B**ch! I hope you get a nurse as careless as you. Maybe then you'll understand what it's like to have to trust someone who doesn't give a damn about your life because the only thing she's concerned with is how much time she's got left on the clock before she can go home.

I realize that you probably won't post this, but you know what? Someone needs to care about women and their health, and it's clearly not L&D nurses.

So nurses in Denver - are you reading?

Birth Plan - A Critique

One of a labor nurses worst nightmares is the patient that comes in with a birth plan. Not because we disagree with them - but because we know that most of these birth plans are created by first time parents with absolutely no clue as to what to expect during the labor and delivery process. We also know that a birth plan is a setup for disaster and that most individuals with a birth plan will end up with almost everything that they don't want!

Hospital rules were not created out of, "let's see just how many rules we can put in place to annoy our patients." Believe it or not, they are really important to the life and health of your baby (and you!) Do patients forget that? You bet.

Let's all be realistic here. The vast majority of birth plans are a setup for unrealistic expectations - for the patient and for the family. I've attended hundreds of births where the parents had a wonderful birth experience and it didn't have to be scripted out point by point.

In the grand scheme of things - isn't a birth plan more of a self-centered document so that you can attempt to control your birth experience? Isn't a birth plan more for the mother's desires than what may be best for baby?

Here's a breakdown of a recent birth plan:

No medical procedure will be allowed without my prior consent. I have not signed the general consent forms and consent only to treatment that has been fully explained and for which verbal or written consent has been given.

Okay so why bother coming to a hospital? It's not rocket science. If you don't wish to consent to be treated by a hospital - why come to one?

We are performing our own version of a hypnobirth and as such do not want any labor coaching whatsoever unless it an emergency situation that we agree is an emergency.

And just what constitutes your definition of an emergency? When your baby's heartbeat is in the 60's we'll be sure to consult with you first to make sure you agree this is an emergency before making an attempt to save your child's life.

No medications. This specifically includes oxytocics, analgesics, barbiturates, tranquilizers and antibiotics. If we feel a need arises, we will discuss our options.

Okey dokey - we'll just let that Group B Strep infection go untreated. Of course it's fatal in 5 to 15% of newborns and babies that survive can be left with speech, hearing, and vision problems as well as mental retardation. But you're the expert, right?

There will be no routine fetal monitoring, either internal nor external. If there is a medical indication for continuous monitoring, I may consent to a brief period of monitoring provided I am able to choose a position.

Let's say we come to an agreement then - we won't monitor if you won't sue!

I will not be confined to bed during labor. If the birth is happening away from the bed, say in the shower, I do not wish to be moved from this position. This includes the birth itself as well.

By all means give birth on the floor.

The father will catch the baby. This is non-negotiable. If a situation such as shoulder dystocia or nuchal cord or hand, etc., occurs, coaching and assistance is welcome but we still wish for the baby to be caught by the father unless the situation is absolutely life-threatening.

Does he require a catcher's mitt as well?

The cord will not be clamped or cut until the placenta has been birthed and the cord has stopped pulsating, however long that takes. We will decide when it is an appropriate time to cut the cord. The cord will be left long (approximately 5 inches from abdomen). This is due to our personal beliefs on nervous sensation in the cord and is non-negotiable.

There are no nerve endings in an umbilical cord - but if you want a 5-inch scab hanging from your baby's abdomen for about 2 weeks - who are we to stop you?

My vote for all parents who wish to have a birth plan is to HAVE A HOME BIRTH!