Finally, it's up on the web! Read my April article, 'Delivered, Safe and Sound.' http://www.kcwellnessmagazine.com/kc_wellness_magazine_april_2008_006.htm
This was a scary article for me to submit, because I could catch a lot of flak but now that it is done, I'm proud of what I wrote. - Oh, and check me out, I'm on the cover! Enjoy.
PS: Some folks are having trouble with the way the pages load: you must click NEXT in the left hand column to see the next page. My article is about 4 pages.
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The Mission
- LaborPayne
- LaborPayne has a masters in nursing education and works as a nursing instructor teaching maternal infant health. She is a lactation consultant candidate and a CNM (certified nurse midwife)student at Kansas University. Upon completion of her midwifery studies, she plans to pursue a MPH/PhD dual degree. She has been a doula and childbirth educator for 20 years, a nurse for 12 years, worked labor and delivery for 8 years, and has taught for 3 1/2 years. She owns Perinatal ReSource an education, training and consulting firm, and The CPR Lady, a safety training firm. In addition to authoring this blog, she is an editor for Clinical Lactation Journal, and sits on the board of CIMS, Coalition to Improve Maternity Services. She also sits on her local FIMR Board (fetal infant mortality review) as well as her city and state breastfeeding committees. She presents nationally on perinatal issues. Her career goals include decreasing perinatal morbidity and increasing lactation rates in the African American community through published investigative research and application of evidence based clinical practice. She also has plans to open a community based birth center in the urban core.
10 comments:
Great job! I agree with everything you have written except I have never known any nurse, midwife or MD to give pain medication without the woman's consent. Usually the mother has asked for it. Maybe it is different in other areas...
Notice I didn't say PAIN medication, I just said medication. The presence of an IV meant ANY medication could be slipped in without prior consent. As you stated pain medication was usually requested and happily given. Pit was often slipped in unnoticed and unexplained until after the fact, especially following deliver, when it was given routinely postpartum to help the uterus clamp down. Patients were almost never told of its use for this purpose.
You are right; I wasn't thinking about after the birth.
The article isn't complete on the link you sent - is it something that is only in the magazine? I love your blog and writing style so was hoping to read it today!
I tried to read your article on the link in your blog but it only loads half a page. Could you copy and paste it on your blog?
Hey everyone,
I think you just need to click NEXT in the left hand margin and it sends you to the next page to continue reading.
Thanks
Wonderful, gutsy, accurate article, Sherry! You go, girl!
Sylvia, its not just after the birth.
As a doula I was in the extremely uncomfortable situation once of seeing a client whose baby kept having decels after starting Pitocin. After about 20 minutes, when the nurse came in she turned the Pitocin down a bit rather than up. The Pitocin was finally shut off nearly 45 minutes after I started noticing decels (but what can I say about the decels without "practicing medicine"?). It was shut off only because the heart rate had dropped to 60! Then ensued 15 minutes of terror, with 3 OB in the room, whispered instructions given to a nurse to "get the OR ready." Dr. with his hand in mom, trying to stimulate baby's head. But before the OR was ready, the baby had stabilized.
20 minutes later the nurse slipped back into the room, looked at the fetal monitor, then turned the Pitocin back on...without telling the mom she was doing this. Mom was still sobbing about what had happened, and debating whether she should have a preventative cesarean before anything else went wrong--and she had already given birth vaginally without pain meds before and was not on any pain meds this time either!
So once the OB convinced her that she really didn't need a cesarean, and he left the room, I gently pointed out that the Pitocin had been turned back on. "I don't want it on!" she declared. So I went to get the medwife. Who was NOT receptive to the mom's desire, insisting that the Pitocin was necessary. But finally when the mom broke down sobbing and said "I can't do this anymore. Turn it off! And get me an epidural!" The medwife complied.
Anesthesiologist was in promptly, set up the epidural very fast. Mom later told me that she asked for the epidural not because she couldn't take the pain, but because she was scared that her baby would have problems again, and she would have to have a cesarean under general anesthesia if she didn't already have an epidural.
Well mere minutes after the anesthesiologist left the room, the medwife came back in, and without asking, turned the Pitocin back on! I told the mom about this, and I could just see the look of defeat in her face. She said "well I guess I can't do anything about it."
Predictably, the baby's heart rate again began to decel. Nurse came in and turned the Pitocin down. But then later turned it up again. None of this was communicated to the parents. Then there was a more serious decel, medwife came in with nurse, instructing nurse to turn the Pitocin off NOW! Examined the mom and told her that she was complete and should push. Mom had no urge, but tried her best. After about 15 minutes she was making no progress, and baby's heart rate had resolved, so medwife let her stop pushing. Which made me question if mom was really completely dialated, or was just "almost there," and medwife was just trying to get the baby out before decels got worse again.
Turned Pitocin back on of course...
A short while later mom was ready to push. Pushed through one contraction, and medwife had called in resident OB to do the delivery, which surprised me because it was supposed to be the medwife. But she had been harping all along about how BIG the baby was expected to be, and how dangerous that was...
So anyway...second contraction mom pushes with, baby crowns. Meanwhile without paying attention to how pushing progress was going, medwife had instructed nurse to get out a vacuum extractor because "mom was having difficulty pushing." Huh???? Nurse handed it to medwife, who ripped open the package and tossed it onto the bed (bed wasn't broken down). Before the resident could pick up the vacuum out of the packaging, a 3rd contraction came on, and mom pushed baby's head right out, followed soon by the body...with no tearing.
I'd love to have seen the bill submitted to the insurance company...did they bill for a vacuum extraction?
But anyway, long story...short bottom line. This mom was REPEATEDLY given Pitocin without her knowledge/consent or against her consent. I've had other moms on Pitocin who had trouble getting it turned down when they requested such or had trouble convincing nurses that they were serious when they said "don't turn that thing up again!"
Jenn
www.knittedinthewomb.blogspot.com
Thanks for sharing your story Jenn. I saw pit and other meds just given at will ROUTINELY. What I notice about your story Jenn at that the staff just pushes and pushes and pushes until they get their way. I remember this being legally advised by a hospital legal team once. The lawyers told us (nurses) we must use every effort to get the patient to comply with 'treatment' even if that meant repeating our appeal over and over and over again. Basically he meant we should bug the fuck out of them until we wore them down and they went along with what we wanted. I wish I had that conversation on tape. As for the resident and vacuum- I'd say someone needed a little practice time...
I remember once, the chief resident wanted all his underlings to practice forceps, so every patient that delivered that night was delivered with forceps- every single one- except mine that is- I somehow didn't manage to call them in time- oops.
I hope you don't mind, but I linked your article on my blog, in it's own post. We have to get the word out about how dangerous hospital births can be - and how we can advocate better for safer births!
Yes, I am still in the hospital setting - trying to enact change from within the system.
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