Friday, January 11, 2013

A Different Viewpoint

If you're looking for something funny to read, you might want to keep moving. 

Cause mama's 'bout to vent.  And it probably won't be funny.  (It will probably be full of run-on sentences.  And it will contain no actual data that required research and reading articles...who's got time for that?  Just me, getting pretty damn fed up.)

I had to stop watching A Baby Story.  This used to be one of my staple shows.  I loved it.  I didn't even mind the birthing bathtubs and chanting peace mantras.  Whatever floats your boat. 

(From personal experience I can say some prettttty creepy mess comes out of the business-end before, during and after labor; the thought of soaking in those juices made me heave. So we opted out of the birthing tub.  But no judgement.  You work that tub girlfriend.)

I had to stop watching it because I just got so tired of hearing mothers talk about the "birth experience" that they wanted. 

Nay, expected. 

I got tired of hearing, "Women have given birth for centuries with no medical intervention.  Our bodies know what to do." 

While this may be true, please consider how many infants died throughout the centuries in these unassisted, squatting-in-a-barley-field births.  Probably upwards of 50%.  (Just throwing that out there.  There is NO factual data that supports that statement.  Just logic.)

Then the other day I had the misfortune of stumbling upon some "article" someone had posted on Pinterest that EVERY FUTURE MOTHER MUST READ!

Ahh, just the stuff I love (If you couldn't tell from my blog.)  Please enlighten me Pinterest!  (I am the most willing and avid student of Pinterest that has ever lived.)

THE TOP FIVE HOSPITAL INTERVENTIONS THAT WILL RUIN YOUR BIRTH, LEAD TO COMPLICATIONS AND UNNECESSARY INTERVENTIONS.

Wow. 

That's a bold statement.  Now I'm really interested. 

I love the Internet.  I love google.  I love having information at my fingertips. 

I do not love that anyone can post things on the Internet (irony?)  I do not love that people can post data, possibly out of context that can affect many peoples' important decisions.

If you are a mother doing research on giving birth, I congratulate you.  You are being proactive and trying to gain all the information possible to have a healthy birthing experience.  And most importantly, a healthy baby.

(I fear, in this day and age, the "Birth Experience" of mom has come to lie in front of "Healthy Baby" in the grand order of importance of things...) 

Oh, you want to give birth on the beach, listening to the waves and have a sea turtle lick the cheesy mess off your baby so it can become one with nature right out of the womb?  GREAT!  Go right ahead!

I'm afraid a well meaning mother may come across articles that villainize western medicine and medical intervention. They may see the statistics that tell them they are 95% (a complete shot-in-the-dark percentage, totally made up) likely to have a completely normal, uncomplicated birth with out going to the hospital and enduring the wrath of all those evil nurses and doctors. 

How dare those evil nurses stick you with a needle and start an IV!  How completely unnecessary!

Unless, of course, an emergency arises and they need to do an emergency c-section to save your baby's life.  Actually it's life and it's brain function.  Or your life. 

Your life with your new baby...who now may or may not live because they had to take two extra minutes to start an IV.  Two minutes is a long time to a fetus that isn't getting enough oxygen to its brain.  Or God forbid, you start to hemorrhage.  Two minutes is a long time when you're losing blood at an alarming rate.

How dare those bitchy nurses make you wear fetal heart rate monitors!   How dare they expect you to be tethered to a machine while you're in labor. Don't they know you need to walk and chant and bounce on your exercise ball and go to the cafeteria for frozen yogurt?  After all, intermittent monitoring is proven to be just as effective!  Yes, how dare those nurses tether you to a monitor.  It really is useless

Unless, of course, your baby isn't tolerating the contractions as well as you think he/she is.  Unless your baby has a knot in its umbilical cord, and that knot starts to tighten as it reaches zero station.  Unless your placenta abrupts. Unless any other number of things happen that affect the blood flow to your baby.

When the blood flow to your baby is affected or the baby is not tolerating labor it drops its heart rate.  It drops its heart rate and hopefully it rebounds back up.  Hopefully, your intermittent monitor catches one of those episodes.  Hopefully, that umbilical cord knot you had no way of knowing was there doesn't start to tighten right after they get done with that intermittent heart rate check.  It'll be another 30 minutes until they check again.   I wonder what that would do to your baby?

I'll tell you what that would do to your baby.

Your baby's brain would slowly be suffocated.  It would not receive enough oxygen to maintain its metabolism and it would start to die.  When they did check your baby's heart rate again, it may be 30.  It may be 56.  It may be 85.  There might not be a heart rate.

A sustained heart rate of 60 beats per minute is when we start doing chest compressions in the neonatal intensive care unit.  That is when your baby would be ventilated with a bag and mask or other resuscitator. 

That is when your baby starts to turn blue.

When your birthing team realizes that an emergency is taking place you will need a c-section.  They will get your baby out as fast as humanly possible. 

And it won't be fast enough.

His Apgar scores will be zero at one minute, zero at five minutes. 

And, just maybe, they manage to revive your baby after five minutes.  Maybe his ten minute Apgar is two. 

That means your baby was dead...dead...and then barely alive.

The baby will mostly likely go on a cooling blanket to lower its core body temperature and try to save some brain function. 

He will most likely be diagnosed with Hypoxic Ischemic Encephalopathy (HIE).   This means that the baby's brain degenerated drastically because it suffered a prolonged period of inadequate blood supply or oxygenation. 

Your baby most likely will have lost his reflexes.  He won't suck a pacifier.  He won't suck a bottle.  He will get fed through a tube that goes directly into his stomach.  He will be sort of floppy because he doesn't have the brain function to maintain adequate muscle tone.  That means his airway will be floppy too.  He won't be able to manage his secretions by swallowing and coughing, so a nurse will have to suction his airway when they start to build up.  Or about every 15 minutes.  If he doesn't get suctioned he will go into respiratory arrest and he will die. 

This is just a snapshot. A horrifying picture.  But I paint it because it's important.  I had a completely healthy pregnancy with my son.  I was not overweight, I was not diabetic. I followed all of my prenatal instructions explicitly. 

After my son was born we saw that he had a knot the size of a nectarine in his umbilical cord. 

Thankfully, it never tightened.  It never affected him.  At least that we saw on the monitor. 

But I rest comfortably in the fact that I was monitored.  Had something gone wrong, we would have known immediately. 

He would have been out immediately.  And that still may not have been fast enough.

But I would know that he didn't suffer because I wanted to labor on the beach.

The point of this post is not to scare pregnant women or expectant parents.  Quite the opposite.  It is meant to paint a picture of reality.  While there may be a 98% chance that everything will go perfectly, I challenge you to think of the other 2%. 

What they wouldn't give to change their situation.  To have made a different decision.  To decide that maybe the ability to jaunt around freely during labor wasn't so vitally important.

I don't understand why parents make every change expected of them to keep their baby safe during pregnancy and then question every single safety measure when it comes time for the birth.  When it comes time for the birth everyone wants to hand out their laminated birthing plan, detailing which interventions are acceptable and which are not. 

Everything that happens in the hospital is designed to get your baby out as safely as possible. 

Hospital protocols are not arbitrary.  They are not designed to make you feel trapped and unnatural.  They are not designed to lessen your birth experience;

Hospital protocols are put in place because of extensive research and past experiences.  Past tragedies.

Hospital protocols exist so that the terrible thing that happened to a bunch of people before you, doesn't happen to you. 

Doesn't happen to your baby.

I am a nurse.  I am a neonatal intermediate and intensive care nurse.  I have a job because things go wrong.

I wish things always went smoothly.  I wish I wasn't needed.  I would pay good money to unsee some of the things I have seen at work.

But I can't.

If you are pregnant, congratulations!!  You have wonderful things in store for you.  The odds are in your favor that everything will go perfectly :)  I want you to have the best birth experience possible.  I just felt I had to share the view from the NICU. 

It is a place I don't want to meet you. 

(I just know this post is inviting a whole bunch of people to chew my ass out and thow statistics and midwifery text books at my head.  Have at it.  This was just one person's opinion.  One side of the story I've never seen shared, and I thought it was just high time.)

13 comments:

  1. Well said!!!!! alittle over the top but so what!;-)

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  2. Emily, This was a great post! :) It sounds like you might have had one too many sad days at work, but it's very important that people consider the things you have said.

    The safety of the infant during that transition from inside to outside is all important. I've seen first-hand the life long damage (to the child) and emotional suffering (of the parents) when things go wrong during the delivery.

    I hope people will seriously consider your concerns, take every possible action to ensure the safe arrival of their children into this world.

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  3. Having given birth both in America and in a foreign country, I can assure you that medicine in America is definitely a business. How the customer/patient can make what oftentimes boil down to superficial demands is beyond me. Great post.

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  4. A-freaking-men sister! Stumbled upon your blog from a pinterest post re: undie sundae
    I wouldn't have my sweet little Pax if it weren't for drugs, hospitals, and pretty much everything I was warned about by the 'granola moms'out there. Now 22weeks along in my second pregnancy I'm uber thankful for the ability to do whats right for my baby.

    Great post.

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  5. LOVE this post. More people need to take into account ALL of the points you have made. More NICU nurses need to tell their stories. LOVE,LOVE,LOVE!

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  6. I've had two videos so far and in both cases I'm grateful to the helpful nurses who cares about my babies and let me know the choices available, they are why my babies were safe in the hospital not my plan of action, I think the only things that a mom should decide against is an epadural if they can stand it and some hospital food. I love your rant it's amazing!

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  7. I think you just channeled every L&D nurse in the country and wrote it into a blog post O_O

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  8. Thanks for all the comments and support! I appreciate that some people are at least willing to consider another outlook :)

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  9. Well said. It appears that now that our country has had many years of most babies being born free of apparently unexpected events, we are reverting to the 'good old days' of popping a kid out on a walk in the forest. I LOVED my hospital deliveries. I especially loved my epidurals. Ah, the relief. It's been 11 years since my last vaginal delivery and I can still recall the absolute and utter peace I felt once that hit. I even proposed to the anaethesiologist who injected it. My husband didn't care; I think he was jealous. Nice post!

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  10. AMEN. I want to share this on FB but I have a midwife "granola mom" friend who might think I was being passive aggressive towards her.

    I agree: if you want to have a baby without those pesky, "out for your money" doctors, whatever. But don't look down on people with common sense who use these doctors to safely deliver their children. I don't need a special birthstory. I need a special little baby. Who didn't strangle to near death. :)

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  11. Thank you. If it weren't for the hospital, I wouldn't have either one of my gorgeous babies without it. I am thankful everyday for people like you and Dr's who care. Bless you.

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