Have any questions for a L+D nurse?

Hi ladies! My name is Shawna. I've been an active PW'er for a long time while planning my wedding and most recently on the photography boards. I thought I would swing by here to see what brides are expecting babies that I planned my wedding with :) DH and I are planning to TTC next fall so that the baby would be due just as DH graduates from pharmacy school. We have a 3 1/2 yr old son now! Hopefully I'll be active on the board next year :)


Anyway, I'm a registered nurse in labor and delivery. I work in a hospital that was built just for pregnant women this past January :) It's pretty amazing. It's called UPMC Hamot Women's Hospital in Erie, PA. If any of you are interested, here is a video on their website that shows you the interior. http://www.hamotforwomen.org/


I work on Labor and Delivery 95% of the time, doing labor inductions, natural labor, cytotec and cervidil inductions, assisting with the deliveries, I go into the OR's and scrub-in to assist the doctor's with c-sections, I monitor and assess mom and baby after vaginal and c-section deliveries. I occassionally work in the triage area for pregnant women too.


If any of you have any questions you'd like to ask, I would love to help. I know that many women are nervous about being induced or getting a c-section. I would be happy to explain it all to you, to ease your minds a little bit :)

Posted on September 13, 2011 at 12:37 pm
*slm*
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(18) Comments

alisonandjake
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03/21/2009
alisonandjake

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That is really nice of you to offer help!!! I will keep this in mind :)

Posted on September 13, 2011 at 7:16 pm
Anais_B
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05/14/2010
Anais_B

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Me me - I have a question.


I wanted to do breathing down/spontaneous pushing - that is I didn't want to do directed/coached pushing (hope I'm using the right words or this won't make sense).  


Started at home and was spontaneoussly pushing - didn't even realise I was pushing until midwife pointed it out.  Transferred to hospital due to meconium in water.  Was directed to PUSH!  At the time couldn't be bothered to ask or argue.


Just wondered - what is your oppinion on spontaneous undirected pushing compared to directed pushing?


(A friend who's a midwife in France said it doesn't usually work for first baby, but I've no idea what this is based on.)


Thank-you  :)

Posted on September 13, 2011 at 10:20 pm
FordGirl027
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10/10/2010
FordGirl027

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Anais- I can tell you my opinion :)


I had an unmedicated birth with a midwife who made no indication of how I should or should not push. She let me do my own thing and I had my baby directly skin to skin on my chest within 15 minutes of bearing down. My body kinda pushed on its own for 15 minutes prior to that. As a first time mom with my first baby, I probably would have kicked my MW in the face if she recommended purple pushing, or that I push for 10 seconds.

Posted on September 14, 2011 at 12:38 am
soon2bMRStip
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09/12/2009
soon2bMRStip

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I am going to add my opinion as well since I had the complete opposite of Ford. I had an medicated (epidural) induced (pitocin) labor... which went FANTASTICALLY.


However the ONE part I didnt love about everything was how long they wanted me to push for per contractions. I did 3 10 second intervals in a row, sometimes 4 every contraction and it was exhausting. My dr (who I loved I will mention) and nurses were ADAMENT that I pushed this way and I kind of felt bullied into pushing longer and harder than I quite frankly did not have in me every single time. I know it got the baby out faster and in the long run I was happy with how everything went but I remember thinking at one point if they make me do 4 again I am going to punch someone.


I felt EVERY single contraction since my epidural only took on one side so I KNEW when I needed to push and did so, but I felt like they were going a little overboard on the pushing and coaching me along this route...

Posted on September 14, 2011 at 12:57 am
Anais_B
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05/14/2010
Anais_B

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Thanks for sharing your experiences.  It's good to hear from people who have done both types of pushing!


At home I had got to 'just about to crown' perfectly fine without even realising I was pushing.  As soon as I got to hospital they told me to push really hard as if I was pooing etc etc - it felt really unnatural and I was scared of tearing.  BUT then DDs heart rate dropped and they said I had one more chance to push her out or they'd have to do episiotomy.  I saaw the hlint of the scalpel in the corner of my eye and I did push really hard as if I was pooing and she came out (and I tore in three places).  So I am kind of in two minds.


My gut instinct is that if it was the best way to do it then it wouldn't feel so unnatural.


 

Posted on September 14, 2011 at 3:05 am
julie4423
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05/07/2011
julie4423

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I think it all depends on the situation. If the baby's heart rate is dropping, they need to get her out fast no matter what. If everything is going well, I don't see anything wrong with pushing however you want. I've had 3 babies, and all were a bit different.


 With baby 1, I had only stadol (I think that's what it was) which was a totally terrible experience in general. I felt totally off guard all the time as I didn't have time to prepare and be in control of the contractions and everything else. I pushed for about an hour I think at dr direction. It sucked and I tore a little, but nothing terrible.


Baby 2, I had an epi at 4 cm. Baby came about 2 hours later with 1 push. No tearing at all.


Baby 3, I had an epi at 4cm. Baby came about an hour later with no pushing. They were actually telling me not to push because the dr wasn't there, but my body was just doing it regardless. The nurse delivered. No tearing at all.


So, I think when you're not feeling the pain your body just pushes the baby out on his own which is less traumatic. If you could manage to do this with no epi I imagine the result would be the same.

Posted on September 14, 2011 at 3:27 am
Alliesauce
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08/22/2010
Alliesauce

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You rock, Shawna!! :)  So sweet of you to offer your expertise to us!!

Posted on September 14, 2011 at 3:29 am
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Anais-That's actually a very good question and I am a huge patient advocate when it comes to pushing. In my own experience, and having had a baby myself, many women choose to get an epidural to manage their pain while in the hospital. The medication in the epidural does not cross the placenta, while other IV pain medications do (such as Nubain). Sometimes, when it comes time to push, the woman does not feel that urge to push, due to the epidural. So we turn that rate down or even turn it off so she can feel that...because you need to be able to feel it.


Many women don't know how to push and and in many instances refuse to push! We are there to help them through and instruct them when and how they should push. There is a technique to pushing and many do it wrong...not moving the baby an inch. Many push with their faces, bursting every blood vessel in their eyes, etc (not effective!), many push with their chest (not effective). You have to push all in your bottom, as if you were having a bowel movement and holding that push for as long as you can will allow the baby to progress through the birth canal without being sucked back in when you stop pushing. Sounds weird, but it's sort of like a turtle's head! If you push for ajust a few seconds, you move the baby a tad and when you stop, he/she gets sucked back in. Getting the baby underneath that pelvic bone is te most difficult part and that's where you need those stronger longer pushes. Does that make sense?


Now, I NEVER make my patients push for a count of ten. I tell them to push as long as they can, then to take a couple of slow deep refreshing breaths and then go at it once again.


I hope this helps!

Posted on September 14, 2011 at 3:38 am
Alliesauce
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08/22/2010
Alliesauce

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I have a totally TMI funny question that gets brought up in here A LOT!


What percentage of women actually do poop on the table while giving birth?  (LOL)

Posted on September 14, 2011 at 3:45 am
junipertree
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10/23/2010
junipertree

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slm, I'd love to give out little gift bags to the L&D staff for being there for me.. what do you think are good gifts to give?  How many bags do you think I should prepare?


So far I am thinking:


Antibacterial hand lotion


Tic Tacs


Starbucks gift card


??


 

Posted on September 14, 2011 at 5:11 am
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Love it, Allie! Answer: 90% :) It's not a large amount (usually). It's natural and we try our best to cover it up. When the baby's head presses that hard against your rectum (for hours), from the top all the way to the bottom, it's only natural that it will happen. Plus all that pushing as if you were having a BM. We don't care at all because we see it all the time, but many women are petrified of it happening with their partners present. There's only so much you can control, ya know? :) Passing gas during the labor process happens involuntarily also, for the same reasons! Labor is not all it's cracked up to be on "The Baby Story" on TLC ;) lol

Posted on September 14, 2011 at 5:14 am
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In addition to my answer above, if you want to control this as much as possible, don't eat food high in fiber (like leafy greens, broccoli, beans etc) the day before (if you're scheduled for an induction and you know when you're going to the hospital). And after dinner the day before, eat light! (no hamburger tacos with hot sauce and sour cream for instance). Chicken broth or soup, crackers, grilled chicken, carrots, tomatoes, etc are good choices. But make sure you are getting all of the recommended calories and follow the diet your doctor has recommended.

Posted on September 14, 2011 at 5:21 am
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Junipertree- AMAZING idea! That is so sweet when our patients do that...and it doesn't happen often, but when it does, it really makes us feel appreciated! We have gotten a big basket filled with snacks for all the L+D nurses and docs to dig into. It lasted the entire shift. It was filled with those small bags of chips, gum, bags of Reese cups, etc. I don't think you need to do gift cards for the whole staff. If you really want to, it would be really nice to give one to the 1 or 2 RN's that are taking direct care of you the entire 12hr shift. That would be really sweet. Many times, I am so thrilled when my patients send a thank you card to the hospital addressed to me, to thank me for the care I provided them. That alone is enough for me ;)

Posted on September 14, 2011 at 5:24 am
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Anais- I wanted to add something. If you don't want any instruction at all when it comes to pushing, I would highly suggest that you talk about this with your doctor or midwife ahead of time so that they know what you want. Like I said, many women don't know how to push and/or don't feel that urge to do it spontaneously, so we as nurses automatically coach them through it. Im sure they would be accomadating to your wants and needs as long as the baby is tolerating it in the process :)

Posted on September 14, 2011 at 5:29 am
beatie
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beatie

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Not sure if you've had a lot of twin delivery experience but I'm pregnant with twins and deathly afraid of the "double whammy"...delivering Baby A (head down) and then not being able to get Baby B out and having to have a c/s.  My doctor says that's pretty rare and that she does breech extractions for Baby B all the time.  But honestly...does the double whammy happen a lot??? :)

Posted on September 14, 2011 at 5:30 am
julie4423
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julie4423

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90% poo while pushing?! If this ever happened to me than the nurses did a good job covering it up like you said. lol It does seem almost normal that it would happen though.

Posted on September 14, 2011 at 6:11 am
*slm*
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Hi Beatie! Congrats on the twins! I know that you were trying for a long time and I'm so happy to see that you have been double-blessed :)


The 3 OB-Gyn practices that come to our hospital do not deliver twins vaginally...because the "double whammy" that you explained happens way too often and often ends in a c-section. If patients are pregnant with twins, you are scheduled for a c-section, for the safety of the babies. Now, if your doctor is great at turning a breech baby and extracting vaginally, then maybe he/she is, but I have never seen that done and it sounds painful and stressful for the baby :-/ Even if the patients are pregnant with one baby (a singleton pregnancy), and baby is breech, they get a c-section. It is way to risky to vaginally deliver a breech baby. Just my opinion based on what I've seen. I know that back in the day, twins were delivered vaginally all the time but it often ended badly because of the lack of medical equipment so doctors do what they can to prevent those things from happening. It really depends on the doctor's comfort level with doing this because if something bad happens, they are held liable. So many of them won't even risk it since it ends in a c-section most of the time anyway. I give her credit for allowing the patient the option to deliver vaginally because it is important to many women. I just find it odd that I have never seen a vaginal twin delivery at either of the two hospitals I've worked at and your doctor says he/she does it all the time. Maybe it's because we are on opposite sides of the US :) Maybe it does work but I am not at all familiar with it and there must be a reason why 5 practices between the two hospitals (22 physicians total) refuse to do them.


If I were you (and I'm not telling you to do it one way or the other), I would schedule a c-section or opt to have one if you go into labor. Especially since twins are born a early in most cases. Some go full-term but it is not common. They might not be able to handle the stresses of uterine contractions and then an extraction if breech.

Posted on September 14, 2011 at 6:29 am
andreajs3
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06/05/2010
andreajs3

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This is so sweet of you to offer advice slm!! :) I'm an ICU RN and even though we're both in nursing - OB is soooo foreign to me! I don't even like it when my patient's are on their periods lol  I know when I get pregnant I'm going to have a million questions for my OB friends that I can't think of right now :)

Posted on September 16, 2011 at 7:58 am

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