March 17, 2009

Are you ready for a C-section?

Man, can I go one Monday night without starting out in the c-section room? Seriously, 4 out of the last 5 Monday nights, I go in, take a patient that I looks to deliver vaginally overnight, only to find out that they are heading back to the OR. Don't get me wrong, I don't have a problem with c-sections. Remember, I had 2. It just seems that it's becoming a Monday night trend for me. The first Monday night c/s in was for a failed induction - she had been stuck at 8 cm for several hours. The second and third was for a mom who had been pushing and the baby just wasn't going to fit. Last night it was for a mom who was not only not dilating, but her baby wouldn't tolerate the pitocin, and the FHR started climbing. Finally, after several calls about a FHR of 180, minimal variability and late decels, I get an order for a c/s. Okay, I guess that one wasn't right at 11:30, it was shortly after midnight. But you get my point. My co-workers told me I wasn't allowed to take labor patients anymore on Mondays - they'd give me the antepartums, that way those laboring mama's might actually deliver vaginally! Labor nurses are probably the most superstitious nurses you'll meet.

I've finally started running again, now that the weather has cooperated. My last couple runs I'm able to run a little bit farther than I did the day before. Granted, I'm probably only running 1-2 miles, but, hey, it's a start. I did get some motivation from my darling daughter. The day that I was about to loose my mind and I flung dried potatoes everywhere, Clara worked her magic. We were all at the table and she looked at me and said "Mommy! It looks like there's a baby in your belly!". Thanks, thanks for that Clara! Gotta love that 4 1/2 year old honesty! Now I know she didn't mean it to be mean, because she sees pregnant friends of ours, she remembers when I was pregnant with Isaiah and Boompa (grandpa) talks about his big belly and she talks abouthow his belly is big because there's a baby in there. And that day, the kids had said "it'd be neat if you had another baby. So she didn't mean it to be mean. But she's was right. My extra weight is concentrated around my belly (that's what 3 kids and 2 c-sections will do for your abs) and I look about 22 weeks pregnant. Really, this is a minor concern, but it was enough to get me up and running again. Oh, and I found out my cousin's wife is big into marathons and after she has her baby this month, she's going to give me tips on how to train. We'll see how it goes!

10 comments:

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pinky said...

I am a little tired of C-sections too. Does anyone go into labor any more? It seems like we induce everyone the moment they hit 40 weeks.

Morgan said...

My first baby was born via c-section after 13 hours of labor on a Monday night!

Tamrha said...

hey, maybe if these mothers were to go into labor spontaneously, be supported by doulas, not have augmented labors, were out of bed(ie not on their backs laboring) you'd see less cesareans.
And if you don't see the problem with cesareans... then you are part of the problem.

sara said...

It sounds like your unit is like the labor and delivery floor at our hospital. Mondays are known for being unscheduled C - section mornings. It seems like whenever I'm up there on a Monday, we do at least a few other than the scheduled ones. And as far as superstitions...yes, most definitely they come true up in OB!

Nurse Lochia said...
This comment has been removed by the author.
Nurse Lochia said...

Tamrha, I completely agree with you. I'm all for (as are most of my coworkers) natural labor and I love the doulas in my area. We groan when we see a "medical" induction for post-dates at 40.1 weeks, we wish the docs would give patients time to progress on their own, and I loathe continuous monitoring on healthy patients. I'm just simply talking about a trend I've been seeing as of late. But, I do think there is a time and a place for c-sections. So I'm sorry if you feel I'm part of the problem. And I don't feel women should feel like they "failed" because they have a c/s. For example, my mom had to have c/s for my sister and I, for a reason. Someone she knows said "Having a c/s is the easy way out. My wife delivered our children all natural without medications." No one should ever make someone feel like less of a woman because they didn't push their baby into the world. The ultimate goal is a healthy mom and baby. The "failure to progress" on an elective induction sucks. I wish we had more failed inductions that were just sent home instead of ending up with a surgical delivery. I always wonder "what if labor been given a chance to happen on it's own.."

Mama to Monkeys said...

I wonder if you've read the recent article about the significant drop in the number of cesareans for FTP if the women is given two hours before a decision is made to cut. I don't have the citation off hand, but I can find it if you need it. If only OB's didn't seem to think they are exempt from evidence based practice, right?

As for being part of the problem...well...nurses are not the ones walking into L&D with a smile saying "HEY, I'm going to have my baby today, I'm sooooo excited!!", but they can be a little more in depth about full informed consent before the first intervention takes place. Maybe offering the woman and her support person(s) a few minutes to discuss and think about her options before ever even inserting the IV, reporting back to the doc that the woman declined her induction and decided to go have dinner and see a movie instead and wait for a natural, spontaneous start to labor.

But that's just me dreaming out loud....

Pregnant Times said...

I think C-sections are use to quickly. It just seems sometimes they jump to quick and just think it's the only way to have a baby.

Nurse Lochia said...

Just to clarify, when I said I don't have a problem with c-sections, I wasn't actually referring to my like or dislike of doing my job for a surgical delivery. Wasn't saying that I like for moms to have c-sections. It was just I don't mind circulating in the OR. I don't loathe taking care of mom's who are having a c/s. And if giving good care to moms having a c/s means I'm "part of the problem", so be it.