Labor & Delivery

For the past few years I have been reading books and blogs immersing myself in the world of natural childbirth. It seems like the right fit for my profession, working with women who share my views and opinions on not just natural childbirth, but natural living. At this point, I'm sure people are already tired of hearing the benefits of co sleeping, babywearing and cloth diapering. So, as you could expect, I went into my labor and delivery clinical rotation with anticipation. I knew hospital birth was more medical; a lot of epidurals and continuous monitoring with maybe a few unmedicated births, maybe some women laboring in the whirlpools, which were in every room, or pushing in positions other than on their back. My expectations seem so naive in retrospect. 95% of women had epidurals, and/or narcotics or came in pushing and didn't have a choice. It's not that there is a problem with epidurals or other types of pain relief. The problem is that women are not being educated or supported in other forms of pain management or really explained the risk factors of different types of pain medications. Similarly, every patient that I or my fellow students attended had Pitocin, with a nurse confirming the "pit" rate probably equaling the epidural rate at 95% and being "upped" at the maxiumum frequency of every 15 minutes, causing contractions so much more intense that an epidural is almost a requirement. Every woman had monitors wrapped around her belly, an epidurals in her back, a catheter in her bladder, an IVs in her forearm, a pulse oximeters on her finger, and a blood pressure cuff around her arm, invariably tethered to the bed.

Birth is not a medical condition. Preeclampsia and gestational diabetes are medical conditions, and require physician intervention and more extensive monitoring. Further, medical management of birth is vital in high risk women, and c-sections can be life saving in many conditions such as placenta previa, placental abruption, cord prolapse, true cephalopelvic disproportion, and other complications, but these are rare.Women are able to give birth safely at home with a midwife, in a birth center or in a hospital without constant medical intervention, and should be informed of the risks, benefits and alternatives of such interventions.

I'm not sure what specialty I will practice in following graduation, but I'm no longer certain that I will be a labor and delivery nurse. It would be unethical as a nurse to participate in medical care that I find unnecessary or even dangerous. My only hope would be for women to take the time to research, weigh the risks and benefits and choose the type of birth and medical interventions that they are comfortable with , to not be afraid to stand up for what they feel is right, and trust their bodies.

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