Saturday, February 26, 2011

Maternity Ward/Avery's birth (the nitty gritty version)

This post has been edited.

(If you don't want to read about bad things that happen and want to pretend that everything is la dee dah, then ... don't read it? That would probably be the best thing ... Hey! Consider yourself warned.)

I'd like to clarify what has me so upset about the maternity ward in our hospital. When I went in nearly 3 years ago, I was treated with disrespect but I chalked it up to me having a homebirth (is this supposed to be 2 words? It has a red squiggly but I'm doubting it)  and them just not ready to accept that women did that sort of thing. More recently, my sister had a baby, in the hospital, and I was devastated to discover that it didn't seem to matter where you had your baby, if you ended up in the hospital and you had any type of expectations about your birth experience, they are going to dash it, whether they are trying to or not.

Now that some time has passed I think I can pinpoint when the downward spiral began :  At admission, in assessment. For one thing, when a woman in labor walks in, it seems to me that she should be treated with dignity and compassion and absolute understanding. Most women walk in way too early, uncertain and feeling ridiculous as it is because I would guess about 80-90% of first time moms (and many multipara moms) have no idea when they are in labour, but that's no reason to sit behind the desk and say :

"What are you doing here?" Then proceed with, "Well ..... we don't have a room ..."

Sidenote : I didn't realize we were re-enacting Jesus' birth here. And by the way ... Jesus was born in a barn! And there were animals around him. And poop, probably lots of poop. Animal poop, not even human poop.

Of course, then the admission nurse decided she might as well get up and check out the situation (Glad she found the time for us). When we went in my sister was 1-3 minutes apart with contractions lasting over a minute. I swear that just walking into the hospital slowed her to 5 minutes apart lasting 45 seconds. It took forever to get the assessment going. It took whatever amount it takes a person to go back out to the drop off area and go park their car on the FAR side of the parking lot and come back AND talk on the phone for 5 minutes. When I came back I'd missed ... nothing.

During assessment, she was asked questions that she'd been answering throughout her whole pregnancy. This confused me because I handed those papers to the nurse and I know the answers were there and I have to presume she was literate. If this is a way for them to tell if she could 'talk' through contractions I say drop the protocol. Here's why this especially got under my skin :

By distracting my sister with redundant and extremely personal questions that are irrelevant to how her labor will go such as 'Where do you live?' 'When was your last period?', then answering her with an 'I see ....', not only did she lose focus, but she was getting irritated and upset. I agree that during early labor, it's enjoyable to be distracted ... but not while tied down by monitors and grilled about how much sex you've had and what you were doing last night around 8pm (exaggeration obviously) but she was grilled about things that were none of her business!  It seems to me that if the nurses want to complain about being overworked and understaffed they should be looking for ways to make things more efficient ... not more time consuming. If  there's time to play 100 questions, they probably would have time to use a doppler and listen to the baby during contractions instead of confining a woman to a bed with a supremely uncomfortable monitor.

During the inquisition question period, assessment, my sister was asked about if she had any special requests. She had 2. That to me seems damned MORE than convenient for them. 1. No IV She barely had time to finish the word before the nurse rushed in with why and how and if's. After smiling and nodding and standing her ground, the nurse STILL pushed my sister by saying that 99.99% of women get an IV. If that's the case, then why not smile and nod to the mom and give her tips to stay hydrated? A simple explanation that if my sister decided to get pain meds she'd need the IV would have sufficed, but no instead we all got the statistic lesson. It didn't end there. Her 2nd request wasn't really a request, just a communication of preference that she was trying to have a natural birth and would prefer no pain medication offered.

pause for the nurse to get a breath

Then we heard about how 99.99% of women get the epidural and why be in pain if you don't have to? That statement itself nearly had my jaw on the floor. How is it possible ... that I am more educated about epidurals than this nurse who seems to have been here a long time. She should know WAY more than me ... but she quite obviously has no idea what a natural/normal vaginal birth is like, nor is she aware of the serious side effects an epidural for no reason can have ... How on EARTH can you say that to someone. That statement itself makes all those natural birth seeking moms seem like show offs! To save time, and space I won't bother going into how ignorant and totally retarded that comment was. Besides, if I did I wouldn't have time to tell you that my sister ALSO got a lecture on post-birth immunizations. I thought that after she said no, they would leave her alone.

My sister also mentioned she hadn't taken any prenatal classes, but she didn't elaborate that not only had she researched, but that she'd asked her doctor many questions, spoken to other mothers and her sister (moi) had two kids. There was nothing in that prenatal class that would have prepared her for her birth and we've been told by MANY moms that the prenatal class offered by the hospital is a waste of time. I saw the nurse's face when she heard 'no prenatal class' and I knew we were in for trouble.

After a horribly rough and brutal pelvic it was announced that she was at 3cm with bulging membranes.

Then they had to find room for us at the Inn hospital. There was a room, but it was being cleaned so after the nurse kicked out some kids that were playing video games in the 'patient only' lounge, we got to hang out there ... for a while. Once the room was cleaned I fully expected someone to come get us, since I could see the room I knew it was clean. Finally after ten minutes I went to find a nurse and I met a sweet nurse named Lynn.

She immediately helped us get settled into the room. Turns out she's a nurse educator (I really wanted to ask what that meant exactly, but maybe I will ask around and someone can tell me). She asked a few questions and wasn't upset or irritated when myself or my other sister Patricia answered and fully supported Gayle's wish to have a natural birth. She even asked me what my birth experiences were like and when I replied that I'd had homebirths she was absolutely supportive. If she was faking it, she totally rocked it. She reassured Gayle that everything was good then suggested a birth ball, and immediately got her set up.

I then asked her what the procedure was for getting rid of ignorant nurses. Turns out they aren't 'assigned' at the hospital, they just float. Just to file a complaint about a nurse is SUCH a pain in the ass that I was very disheartened. Then she told me where to get ice and to come get someone if we needed help and showed us the button.

During labor, most women wanting a natural birth probably want to focus on their birth and be reassured that what they are feeling/going through is normal. That certain physical things that are happening, aren't scary, but normal and that they are doing well, and offer helpful coping tips. In the middle of some particularly painful contractions, a nurse barged into the room and said (Let me get my notebook here) Ahem Ahem This was at 4:40 pm "Is it really that bad? Stop that. You're wasting your energy," (She was staring into the bathroom while Gayle was moaning through contractions.), "You're wasting all your energy that you'll need for pushing. It's not that bad!" Then she left.

Stunned silence

1. Pushing should require little to no energy if you aren't pushing against your will. In fact, you should feel energized and invigorated during the pushing stage, and actually if you've waited for that pushing urge, you really won't have to do anything at all. You're body will push the baby out regardless what you do to stop it.

2. Moaning is a highly effective way to vocalize contractions and is a lot more effective than screaming and requires less energy and generally makes a woman feel better.

3. I'm sorry ... what the *BEEP* did you come in here for anyways?

Sidenote : Why doesn't anybody introduce themselves anymore???!!!

Then, obviously since they are SO BUSY, they came in and wanted to talk to her about post-birth immunization. Now COME ON!!! How can ANYBODY defend this??? What the F??? Not only was the nurse RUDE, but Gayle's in labour. Do I need to whip out a textbook or something?? Or maybe just a common courtesy pamphlet? It was lovely how I had to basically stand in the doorway for them to leave her alone about pain medication. I'm sorry ... was she scaring the other patients??? (sarcasm)

Then later on, a nurse came in demanding to check Gayle's cervix. Gayle refused. The nurse told her she would order her an epidural and that she shouldn't be ashamed to get an epidural, which Gayle also refused and the IV ... again. Right at shift change there was a cervical check which we then got bumped into the delivery room. We grabbed what we needed and started on our way, but were met by the sweetest nurse EVAH!

She met us in the hall, and brought us to the delivery room. The first thing she did was say that she needed to be on the monitor. Gayle outright refused, but I stepped in and suggested we hold the monitors in whatever position Gayle wants to labour in. The nurse was A-Ok with that. It did drag on forever and a day and I still think that if the nurses are having time to watch a monitor they would have time to hold a doppler ... During this time the IV/Pain medication was brought up, but this nurse never brought it up again. Once she knew Gayle wanted a natural labour/birth, this nurse was very eager to assist.

Many good things happened here, we were mostly left alone and when anything needed to be done it was peacefully and very calmly and with a doppler ;). When Gayle began gravitating towards pain meds, the red headed nurse managed to divert her attention or refocus it and all those things. Gayle even asked for her cervix to be checked but the nurse told her that since her water had broken, it's not a good idea to be putting fingers where they shouldn't be (bravo!). I believe this might have been when Gayle had decided, after discussion her options with the nurse, that she wanted some phentynol, and she was getting set up for it, but ... this might have been before. Anyhoot.

While the redheaded nurse left to get something, the other nurse came in and demanded to do a cervical check. She was horrible! Redhead came in and reassured Gayle that numbers meant nothing and that's why she didn't like doing cervical checks because she was labouring just fine. I'm not even sure why that other nurse came in!! GRR. After this, the epidural word was getting tossed around (by Gayle) and so she asked what the side effects of the epidural were. The nurse said "There are NO side effects to an epidural" ... I would love to know where this nurse has lived her sheltered life, but I love how she added 'Oh some people get a headache .... or something".

After cleverly avoiding the epidural, and getting ready to push, two things surprised and pissed me off. Why does the bed have to be so high? That seems humiliating/degrading and retarded. Why have the hold your breath pushing? Obviously, she didn't need to push, otherwise you wouldn't have to tell her. That's just a fact. And for the one person who never got a pushing urge ... are you just sure you weren't given enough time? And it hardly seems smart to just make EVERYONE push that way because ONE person didn't get a pushing urge.

Once the baby was born, she was whisked away. This is on video, so I couldn't lie if I wanted to! A perfectly healthy, perfectly vigorous baby being suctioned 3-4 times. Give me a break. All the research says that suctioning a vigorous baby is redundant. Also, how is it even possible that the warmer keeps the baby at a better temperature than the mother's skin???!! Especially a mother demanding her baby be brought back to her? This infuriates me all over again.

But believe it or not, the worst of the worst happened after the baby was born. Why is there not a nurse that is trained as a lactation consultant on at all times? Is it not true that breastfeeding right at birth is best if possible? Instead, my sister was stranded with people who either didn't want to help, couldn't help or pushed bottles.

The first morning she woke up, it was to nurses checking her and Avery. The first nurse was apparently very polite and gentle, keeping lights/disturbances to a minimal, then another nurse popped in and immediately commented rudely about the fact that the bassinet was in the bed with Gayle. That's incredibly supportive and helpful, not only was the comment unfounded, but I hate to see what she'd do when she found out people actually sleep with their kids in bed all the time.

Then, since it's not enough being a new mom, another nurse came in to talk about immunizations, to which Gayle replied she preferred to do her research before injecting something potentially harmful into her body, especially when her immune system was at a low and recovering from childbirth.

After the initial visit from the lactation consultant which left her feeling inadequate and ill prepared, she still was having trouble and no real help was around. Since the lactation consultants are only available twice a week? God forbid you have your baby on Friday because the nurse only comes on Tuesday!

During her stay, her room got so filthy (she was by herself with hardly any visitors) that she requested a broom to sweep it herself. Then after a long day of fending off nurses with immunization pushes and trying to get help with breastfeeding she was woken up at 2 am for a test. She requested they sleep another 30 minutes and the nurse was fine with that, but immediately afterwards ANOTHER nurse barged into her room, turning on lights and ordered her to take the baby to get tested and that she must be fed immediately. Gayle informed HER that she'd already talked to a nurse, where the HELL is the communication around here???

Then at 7 am they came in to have another vaccination chat. Wow. That's lovely isn't it.

For those of you who really feel like I'm holding a grudge, you seriously are deluded if you think that what happened here is 'ok.' This isn't just one crabby nurse, this is a plethora of ignorance and rudeness. It pisses me off that people don't take this seriously. I'm pretty freakin' sure that if you'd been denied your epidural because they didn't want to wake the anesthesiologist up, you'd have been just as infuriated as the mother going in there and being force fed an epidural. And I would be furious with you! It's all about choice!

And because I know some people are going to rave about how they were the exception : This doesn't include abrupt trauma or surprise problems or high risk births, but those people should still be treated like Gold after their baby is born.


Natalie said...

When I was pregnant with my first, I was so excited about everything. Even pre-natal classes. I think I had visions of some awesome earth mother imparting her wisdom and knowledge...but nothing could be further from the truth. The lady giving the class had never been pregnant and had no children. BUT..."I have a puppy, so I kind of know what it is like" with a smile. Uh, that was the end of classes for me.

When I was asked if I was attending/had attended, I explained that the health nurse giving the class was reading out of a book. So no. Not attending. I didn't usually get any static after that. :)

And yeah. Those classes are worthless. I didn't even think they did that anymore.

Corinne Linfitt said...

I actually took private classes from my doula, they were amazing. She had phenomenal resources plus 4 kids of her own.

IT makes me sad that a pregnant woman has to spend so much energy standing up for herself when she should be able to just labor and give birth in peace.