Monday, December 31, 2007

Last Post of the Year

As I rest here in a fit of laziness, I think of my coworkers who are probably battling the swarm of women determined to have the first baby of 2008 and it makes me thankful that I am safe at home. So, in the spirit of being glad I can enjoy the comforts of my own home, I will encourage all you women that want that are determined to have a home birth to do just that.

A couple of weeks ago a woman came in to L&D with her friend as a labor check. She knew her water had broken but didn't mention it, on purpose. The nurse taking care of her checked her cervix and told her she would check her again in two hours to see if she was making any change. The lady seemed agreeable and reminded the nurse it was her 5th baby and she was a pro. She also voiced that she wanted a low intervention labor and asked to be taken off the monitors. Her doc agreed and that was that.

In the meantime, my coworker checked on her several times and she said she was doing great. As the two hour deadline approached we start to hear grunting coming from the direction of her room. I joke that if someone doesn't go check on her she is going to deliver the baby herself.

The nurse taking care of rolls her eyes and gets up begrudgingly to see what in the hell she happens to be doing in there. The next thing I know the emergency light has been activated and we are all running into the room.

Her "friend" who was also coincidentally a midwife, had managed to turn the bed into a chair-like position that allows for squatting (something that is neither accidental nor figured out without knowing exactly how to do it). She is kneeling between the patients legs delivering her baby. As we run in she frantically asks for an umbilical cord clamp and some warm blankets. In the time it took me to reach into the warmer and grab a couple of blankets the baby has been delivered and is resting on mom's tummy.

At this point we are able to put together that the whole friggin time she had planned on having her friend deliver her. By the time each of us had wasted a cumulative several hours (have to stay after shift to get it done) filling out our respective incident reports I can't say she was in anyone's good graces.

You can probably figure out what the moral of the story is.


Brigit said...

Just wanted to say THANK YOU for always making me laugh and shake my head- some of the stories you tell make me feel REALLY smart! lol! I'm not an L&D nurse or anything, but I have 2 kids and I find your stories hysterical!

Jawndoejah said...

I wonder why she didn't deliver at home? I, like her, have had many babies, and want low intervention. Since I don't want all that intervention, I plan to try a birthing center next time as long as the baby looks good and I have no high risk complications.

What happens to a midwife who catches a baby but doesn't have privilages in that hospital?

l&d.rn said...

I am not sure of the answer to that one. We all filed incident reports but I am pretty sure it was more of a cover our own ass as opposed to initiating something towards her. Either way, I am going out on a limb here and guessing that "midwife" may be more of a loose general term than certified nurse midwife with current privlages to practice somewhere.

AtYourCervix said...

Very interesting....a little sneaky, but she did get the birth she wanted in the end.

I'm surprised your co-worker couldn't tell that she was already ruptured when she did a cervical check. The odor is pretty distinctive, as well as being able to feel cranial sutures pretty clearly.

Not questioning her skills, by the way. Just curious.

My personal opinion? Maybe the woman should have birthed at home with her "friend" delivering there. Or perhaps she wanted the hospital interventions available, should it be needed?

l&d.rn said...

Yeah, I didn't question her but my guess is when she answered "No" to all the questions about loss of fluid she really wasn't thinking about it. She had apparently delivered two of her other babies at home so I am not sure why she felt like sneaking this one in.

OBRNinNE said...

situations like this drive me crazy...they want a home birth like experience, but the EVIL labor and delivery staff OB/RNs alike are not privy to the plan so we all get to run around like idiots. I love the ones who go to all their prenatal appts with a lay midwife on the side and then they try to homebirth and we end up fixing their "oops" and we're treated like we're lower than the dirt on the bottom of the midwife's shoes. I have the luxury of being trained in low risk, minimal intervention labor support AND high risk labor...and I'm dirt? We had one recently who almost died because her midwife misinterpreted her labs and the pt was in DIC by the time she got to us. Great story...have a happy new year!

Donna said...

I just want to say that I love your blog. I am a nursing student that works as an aide at a hospital. I even told my CWs about your blog. I start my maternity rotation in a few weeks. Please keep it up so I have something to laugh at that will get me through nursing school.

Prisca said...

oh my--what in the owrld? why not just stay home????

Elizabeth said...

I would guess that she had insurance issues that wouldn't cover the costs of a homebirth, or that she may have been risked out from a homebirth by her midwife (or alternatively, her former midwife was no longer practicing)and so decided that a homebirth in the hospital would be an acceptable solution. Unfortunate for your colleagues.

thehbs said...

Are planned homebirths illegal in your state? They are in mine. Maybe that is why she did what she did?

Morterae said...

I may be way off base, but maybe she just wanted to push in one of your convertible beds. There's no easy way of imitating one of those at home, and I'm sure they're more comfortable than squatting on the floor.

Or maybe the other 4 kids she had at home weren't being quiet enough to give her the peaceful delivery she wanted.

Whatever her reason, it was pretty devious to use all of you like that.