September 14, 2007

I was chatting with my repeat c/s patient this morning. She had a vaginal delivery with her first, c/s with her second and inquired about a VBAC but her MD advised against it so she was doing a repeat c/s. She had asked about my expanding waistline and how I delivered my 2 kids. She said "so you'll be doing this in a couple months or so then, too?" At that time, I didn't know that she had origninally wanted a VBAC. I told her "No, I plan to labor and deliver vaginally". She got this puzzled look on her face and asked "I thought they didn't want you to do that and that it was pretty dangerous?" It was at that time I realized that this issue may come up a few times before my delivery day. I didn't want to say "no, actually a repeat c/s is riskier than VBAC and that the reason your MD probably didn't want you to VBAC was because she would have to stay in the hospital during your entire labor". I just told her each individual is different and that her MD may feel she is at risk for complications. It was a bit awkward.

I also had the privledge of taking care of one of the former daycare teachers at my kids school. When Clara was a baby, this girl had a major attitude. Clara was exclusively breastfed, I came in every a.m. to feed her before going home, and I made it perfectly clear that I didn't want her given any formula and that if she ran out of breastmilk that they could call me (not enough milk was never an issue). Clara also wouldn't take a pacifier and hated bottles. She knew what the real thing was and didn't want a substitute. This girl would give me dirty looks every a.m. I came in and was pretty persistant about telling me I should give her formula, that she wanted more substance. Clara was a chubby little baby. She wasn't starving. I tolerated it for awhile and finally I told her that I was a labor/delivery nurse and that I knew what was best for my baby. Well, she came in last night with contractions at 37 weeks, thinking it was labor. I sent her home after a bit because her cervix didn't change. She was much nicer last night, probably because I was the one with the gloved hand and drawer full of needles. I was very nice and took good care of her, but I enjoyed the recognition in her face when she saw me.


Beth said...

I came across your blog when I was diligently doing my research on the pros and cons of a VBAC vs. a repeat c/s. I am facing the same decision in December too, with my second child! (actually we have a lot in common: we both have Jacobs - mine is 15 months - both live in the Midwest, both under 30, have kids that are/will be close in age, and we are due 6 days apart). I appreciate your oppenness regarding the VBAC subject (especially from a L & D nurse! This is invaluable info), b/c I too am at a loss at the moment. My kids will be 18 months apart, and my first was born via emergency c/s under GA. Not a very reassuring delivery for a first time momma. However, I would do it ALL OVER again the exact same way (with the same outcome of course) if I absolutely had to. My current thoughts are to attempt a VBAC, as my doctor is supportive of either decision. But there are definitely days that I'm unsure of that choice too. Ugh! Please keep blogging, I'll keep reading!

Brooke (CrazyRN) said...

Don't you love it when you have the power? I've been in a couple of those situations, it always amazes me how the attitude changes when they are on the receiving end.

Our hospital just got approval to start doing VBAC's again (after being a big no-no for the past 3 years) and we've had 3 wonderful & successful deliveries so far! I was scared in the beginning, but they are not as scary as everyone makes them out to be. Sure, you have to be on guard and have everything in place in case of an emergency, but don't we do that anyways? Plus, with VBAC's, it's kinda nice to know that everyone is "in house" to begin with when we have an active labor going on. We are a smaller hospital, so they are not always there, but we can have a doc there in less than 10 minutes if needed.

I enjoy reading your blog, it's great to read about other L&D nurses out there!