Some self loathing, some guilt, and a whole lot of venting
So, after watching BOBB (The Business of Being Born) and doing my current reading about the history of midwifery/hospitals/medicine, my eyes have been opened, yet again (still!) as to how harmful the hospital environment can be towards childbirth and women.
Yes, hospitals, medicine and nursing care can save lives. However, ever notice the trickle down effect of us *causing* some of the problems in the first place?
I have been guilty of thinking far too medically as a nurse on L&D. I feel guilt for being that medicalized thinking nurse. I'm not talking about truly sick people, I'm talking about normal labor and births.
As a new nurse, you're taught one way. You are more than likely fearful of retribution or a good scolding by other nurses or the almighty physicians if you don't do as your told. After all, those people have the experience, so they know what's correct, right? So, the new nurse will pit-pit-pit the mom til she is begging for an epidural. Or until the baby crumps. After all, the doc is bugging you, telling you to keep "upping the pit!".
Then you start to gain more experience. You realize, you have more autonomy than you thought. You need to look at the entire picture. You have control over that pitocin. You do not have to "up the pit" to distress (maternal or fetal). You assess and reassess the entire situation, continuously.
Where am I going with my rambling? I don't freaking know. All I know is, burnout is approaching. I'm doing my best to diffuse it and process it. I see so much medicalization of birth that it sickens me. I can't fix everything. I can only advocate one woman at a time.
What really goads me: a woman presents for induction of labor at term. She gets a prostaglandin gel placed for cervical ripening. It works too well, causing tetanic contractions. The baby crumps. We work to fix the horrendously long contraction and help the baby recover. The worst part of it all? She and her husband verbalize that they have *no clue!* why she was being induced. NO CLUE. She's not overdue. She's not having pregnancy complications. No medical complications. Just a normal pregnancy for a normal woman. WHY did they go along with the induction? Because the doctor told them they were going to induce her labor. Yes, full and complete trust in the physician. No informed consent on what the induction actually entails, and the risks involved. They had no clue that something like this could happen (and does happen often, especially with certain physicians).
Do you know how many times the above scenario happens where I am? All the freaking time. Sometimes several times a week - that I know about. Mind you, I'm only there 4 shifts per week. What's going on the rest of the week? Same ****, I guarantee it.
Our maternity system is broken. I'm sick to my stomach about how women and their unborn babies are subjected to such bull**** that they do not need and that actually cause negative effects.
I'm really, really trying to hang on here. I know that I can (and do!) make a difference in women's births. One woman at a time. I can't help all women, though I wish I could. I question physicians, and even midwives, on their rationale for doing this or that. I am very careful about adjusting pitocin infusions. I labor-sit my natural childbirth ladies. I give verbal and physical support and encouragement. I educate about options, pros and cons, and allow the woman to make the decision without my trying to sway her one way or another.
You don't know how tempted I am, sometimes, to put in a request to transfer to a different department in the hospital. Some place where I am not working with such a vulnerable population. But that's the easy way out folks. That's running away from the problems. That won't fix a damn thing.
So I stay. I vent. I blog. I eat chocolate. I drink alcohol from time to time. I exercise. I hug my kids. I paint. I read fiction books.
I plug away at my midwifery education, so that I can someday be a better provider than what I am and what I have witnessed.
xoxo
AtYourCervix
