labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Monday, November 17, 2008

Another thing not to say to a woman in labor....

I was talking with a woman who told me that she was never going to have anymore children because her last birth experience was so horrifying that she can't even fathom putting herself through such anxiety again.

Her second child was born by c-section and in a different hospital than her first. It was an unplanned emergent c-section that sounds like it was a true stat situation. She had come to the labor floor in active labor, was hooked up to the monitor, an IV and put into a room. She was waiting for the preps for an epidural to be completed when several nurses came running in yelling orders at her to turn to her right, then her left, then on her hands and knees, and an oxygen mask was slapped on her face. She asked what this was all about, and a nurse answered, "You need to just do what we say- change your position because you are strangling your baby! Your baby's heartbeat is down because you are in the wrong position!" Despite the uterine resuscitative methods, the baby's heart rate never returned to a normal rate and she was rushed off to the OR and had her baby. He was vigorous and cried immediately, and she felt so relieved that what she had done did not harm her baby.

When she told me this, I was so saddened by those words. What a horrible thing to say to a woman in labor, leading her to believe that her baby was going to be harmed or even die because she was in the "wrong position". Basically, your baby is in distress because you are doing something wrong! Please!

When she was telling me this, I could see the fear and sadness still in her. Normally I leave my mouth shut when people tell me their birth stories because I don't want to have them feel like I am judging their experience, or challenging their beliefs in a negative way. But I felt so strongly that what was said to her needed to be corrected, I said, "I am so sorry that you had this experience. You didn't do anything wrong, you weren't harming your baby." I explained to her that baby's do drop their heart rates on occasion, sometimes because of a position that causes them to compress their cord, but it's not because the mother was doing something wrong. And sometimes no amount of position change, oxygen, IV fluids, or whatnot can not restore a normal fetal heart rate.

I was curious how long ago this was, since her feelings seemed so raw. "My son is 12," she answered. I would have thought maybe a couple of years at most, given her emotional memory.

7 comments:

womantowomancbe said...

Wow. Incredible. Even after all this time -- and apparently nobody had ever told her that it wasn't her fault, except you. Thanks for speaking up!

-Kathy

Prisca said...

Oh wow, that is the MOST insensitive labor utterance I have heard so far from a nurses mouth. Geez!

Myra said...

I, too, feel sad to hear that her birth memories as sad, hurtful ones. When a woman is in the labor state, she is extraordinarily sensitive to things said to her.... I still remember vividly when I had my first son, 18 years ago, the feelings of inadequacy that were laid on me by an insensitive nurse - she came in my room and saw me touching my son's little feet... I was simply amazed at every part of him... But, the nurse quickly covered up his feet and told me I had to keep him wrapped and warm. Impressionable as I was, I felt guilty and angered. I came away with a feeling that I did something wrong by unwrapping my son and touching his little feet. I do not know why she said this... this is what I felt. Perhaps she had taken his temperature earlier and it was on the low side .... Maybe she has a rough personality and that was her way of teaching? Whatever the case, I came away feeling like I did something wrong.... Her intent? Maybe not... But it was my perception.... Could it be that perhaps the mother in this situation came away with the same feeling.... The FEELING like she did something wrong because of the hasty words of a nurse in an emergent situation.... whether or not she remembered word for word what the nurse said, she certainly remembers the feeling she got from the incident...
We nurses have to remember to explain things better to the patients... Maybe we don't have time to do it right then during intra-uterine resuscitation... But certainly we can de-brief them afterwards.... and, we should remember that we not only leave words with them, but feelings as well.

Labor Nurse said...

myra, I agree with your thoughts on this. perhaps the nurse didn't say exactly what the woman said she said but how it was perceived. regardless, we need to be careful of what we say and how we say it.

LCT4J said...

When people hear you've had a baby they might ask about your labor. "Everything turned out o.k, right?" "Yes," a woman might answer. "Well, a healthy baby is all that matters." I agree with that absolutely - to a point. I've had six babies in five different hospitals with four different obstetricians over 13 years. Do you know what my advice to newly, first-time pregnant women is if they ask? Get a midwife and have your baby in a birth center if you can. My last two deliveries, with very good outcomes mind you, were very traumatic due to doctor/nurse negligence and unprofessionalism. My emotional outcome with both those labors was terrible. I've cried many tears over negligent, rude, and insensitive doctors and nurses and have worked very hard at emotional healing with God's help. I am so keenly aware that a woman's emotional experience is greatly underestimated and not talked about because people are so focused on a healthy baby. I now know BOTH matter.

womantowomancbe said...

Rebirth Nurse,

I just read the story originally printed in the Chicago Tribune about how one doctor allegedly abused a patient because he was angry at her for not calling him before going to the hospital. (You can click on the link for the allegations, but they include denying her request for an epidural for hours, not allowing her to speak [even to ask questions], making her lie in stirrups in an extremely uncomfortable position for hours, telling her in no uncertain terms that she was going to hemorrhage, and suturing her without anesthetic.)

While I am extremely upset at even the possibility of something like this happening, I wonder if there is anything that the woman or her husband could have done to stop this. Assuming all of the allegations are true, what could the woman have done while in labor to have kept this from happening? Could she have requested another doctor? Could the nurse have done something? Surely there was *something* that could have been done. While people like me can get angry at such treatment, I would like to go deeper than that and work at preventing that, rather than just "file suit afterward" if something like this happens.

-Kathy

Katie said...

I had 2 different L&D nurses tell me almost the exact same thing while I was in labor. It was excruciatingly painful for me to lay on my left side, and on more than one of the occasions when I begged to try another position, two separate nurses both told me that this is what I had to do or they were going to have to cut me open to save the baby. =\ And before that, I had on multiple occasions been told that I had to get some extra procedure or go to an extra appointment (in almost every case for things that turned out to be nothing) because it could be blah, blah, blah and the baby or I or both could die. I can't even tell you at this point how many times that argument was used to "persuade" me into doing something I wasn't sure was entirely necessary while I was pregnant and then laboring in the hospital.