The Un-Labor Nurse"It doesn't matter how she has the baby, everyone's happy with a new baby in the end".As a labor and delivery nurse I had heard this and similar statements made by obstetricians many times over the years. Especially when a "failure to progress" by dinnertime cesarean section was performed. I was trained in L&D, raised as a young nurse to honor the physicians wishes and conveniences, especially in the field of obstetrics. You did not question the almighty physician. They knew best. Not the patient. As horrifying as it is to realize it now, that's the kind of nurse I was. It is a big deal. Even though its easy for the physician, its a hard recovery for the patient who now has a newborn to care for. It wasn't until after the birth of my second child that I began to see things in a different light. With my first, I had wanted a natural, uncomplicated delivery. Instead, I got an emergency cesarean section with limited anesthesia. Yes, I said that right. It was limited. But that's a whole other story in itself. After the first cesarean section I found myself pregnant again barely a year later. I decided quickly that I did not want another cesarean section. I discussed what I wanted with my doctor and midwife and they talked me out of it. I truly believed that a repeat cesarean section was the best option. It always bothered me, but I still lived by the montage of "doctor knows best".But after I returned to work, and to labor and delivery I realized something. Unnecessary cesarean sections were performed everyday. And the majority of them were performed for physician convenience, but only after they "presented" the options to the patient. I say "presented" because it was presented in such a way that the patient could ONLY choose a cesarean section. The real reason for the cesarean was discussed with nursing staff only moments before coming into the room and varied from, "I had a long night last night and I don't want to be up again tonight, we need to just go ahead and do this", "my family has been wanting me home for dinner." and my least favorite, "she's too big, this ain't gonna happen". These are all physician reasons. Convenience. A major surgery is more convenient to a physician then an unpredictable birth time. After all, its all the same as long as they get a baby in the end right?It was during one of these many situations that i had an epiphany of sorts. I un-became the typical hospital trained labor nurse. I became a labor nurse advocate. I promoted VBAC, breastfeeding, low to no intervention birth and gasp, homebirth. I stood for my patients and helped them make better decisions about their births, much to the horror of many physicians I have worked with over the years. I was the most un-labor nurse. Not that I opposed labor. I opposed the unnecessary induction and cesareans. All normal things for a hospital trained labor nurse. It was by a doula that I retained the name the un-labor nurse. Women's bodies were made to do this. We are perfectly designed to bring forth life. God knew what he was doing when he created us. There are no mistakes. That being said, He also allowed us medical advances that help increase the safety of each birth. But all these advances are not being used for their intended purposes. Inductions of labor are becoming the norm, as are the interventions that come along with them. Fetal heart rate issues, pain, epidural, vacuum or forceps assisted deliveries or even a cesarean section. All because we decided is was more convenient to have a baby when we wanted rather than when it was time. A cesarean section is a major surgery that comes with major risks. Those risks only increase every time it is repeated. Women need to be properly educated before deciding on a cesarean birth. Sometimes, cesarean sections and inductions of labor are medically and obstetrically necessary. But the necessity isn't always as apparent as the convenience. It is not my birth, or the doctors. It is the laboring woman's. It is her child. She will only give birth to that child one time. It is her and her family's experience. Yes it is my job, but it is so much more than that. I get to share in the wonder of the arrival of a true miracle. No matter how it arrives, I vow to make it as memorable experience as I can for each patient I encounter.
Author: Becki Hieneman