Posted by My OB said WHAT?!?.
Dec
27
Posted by My OB said WHAT?!?.
“You Are Not Allowed To Push Until The Doctor Gets Here…”
“You are not allowed to push until the doctor gets here! I’m not allowed to let you have a baby without the doctor.” – L&D Nurse
There are 34 comments to this post.
I want to know what the nurse thinks she can do to prevent a birth if the woman is at the pushing phase. That wouldn’t be illegal that is….
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Alice Reply:
December 27th, 2009 at 6:06 am (Quote)
A nurse held my sister’s baby inside the birth canal until a doctor got there (and took his sweet time scrubbing up!). She was none too pleased.
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Jespren Reply:
December 27th, 2009 at 8:49 am (Quote)
and wouldn’t that be illegal/malpractice? (regardless of wether mother persued it along thos avenues) Not only can it not be healthy for a baby to be forcefully restrained, I can’t imagine a mother consenting to it!
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Amanda Reply:
December 18th, 2010 at 1:59 am (Quote)
I couldn’t help but reply to this. This very thing happened to me during the dlivery of my second child. The nurse had been a real pain all day acting as though I didn’t know what I was talking about, on anything related to my labor. So when things began to happen just like I had told her they would, she wasn’t prepared and completely flipped her lid. She ran out of the room sreaming that she needed a nurse and then she came back and proceeded to scream at me don’t push, quit pushing ! Well I use Lamaze and I was hyperventilating from the sheer effort I was putting forth to try to counteract my body’s pushing. She decides that I’m not listening so she began shoving the baby back every time I contracted. I don’t mean blocking or restraining the baby, she pushed back against my body every time. It hurt like nothing else ! When my daughter was born she was completely blue and they had to use oxygen to get her started breathing. When the nursery came later to get her for a little bit they commented on how bruised she was. Unfortunately she had the outline of my pelvis across her forehead and nose.
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i was told this for my first 3 babies… the 3rd one my grandma (who was one of my support/advocate people and a nurse for over 50 years) almost delivered because the nurses all started running around freaking out cause i went from not even close to being ready to baby crowning in about 15 minutes…
so the nurses are all scrambling around, my gma is standing at the foot of the bed watching the baby and the doc walks in puts gloves on and catches the baby…
the doc and i induced the 4th one (i brought it up due to some stuff that needed the induction) and he stayed very close to the room for the 2 hours that i was in labor, lol, i think he learned his lesson for the 4th one…
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Guggie Daly had this to say,
Dec 27, 2009 @ 9:56 am (Quote)
My mom’s cousin was held into the birth canal to wait for the doctor. She has severe developmental delays from it b/c she started breathing in the canal and was deprived of oxygen.
Browsing the curriculum required to get an RN in my state, it’s not that surprising. I’m sure some nurses are intelligent in their own right, and I’m sure some nurses pick up wisdom along the way, but the minimum requirements to graduate and start working are laughable.
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Knitted in the Womb Reply:
December 27th, 2009 at 1:05 pm (Quote)
You know, I’ve never looked at the requirements to be an RN…but sometimes I have wondered how rigorous they are.
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Wendy Reply:
December 28th, 2009 at 1:46 pm (Quote)
I wonder to. Maybe some of you nurses lurking here can help me out here, but I’ve heard that you can get your training to work L&D in as little as six weeks. I have no doubt that after years on the job, you get extremely knowledgeable. I also have a tremendous respect for how overworked and under-appreciated L&D nurses are, especially seeing as they attend all but the last few minutes of a birth and are responsible for (arguably) too many patients at once. And it’s super crappy of physicians to hold these nurses responsible because their patients had the gall (sarcasm) to undergo the uncontrollable reflex of birthing a baby.
But I have to wonder why there are so many OBs who demonize Certified Professional Midwives for their so-called lack of experience when these docs perfectly happy to hand births over almost entirely to L&D nurses.
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Judith Reply:
December 28th, 2009 at 2:39 pm (Quote)
Nurses go to school for 3-4 yrs and get some basic maternity knowledge there. After that, it really depends on the hospital what type of specialty training they offer. At my hospital, new graduates get a one year internship with many classes to go to.
as far as CPM’s go, there is no comparison to L&D nurses. OB’s are opposed to them and hostile becasue they are hostile to home birth, period. They know little or nothing about CPM’s, never having seem them in action. L&D nurses are employees of the hospital, part of the hierarchy and controllable by them. My two cents.
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L&Dnurse Reply:
December 29th, 2009 at 5:45 pm (Quote)
Speaking for myself about my training here:
I went to school for 4 years for my bachelor’s, 2 of which were pre-requisites (microbiology, pathophysiology, pharmacology etc) and 2 of which were clinical experience and training. After I graduated I got a year of experience on a general med-surg floor, then moved to labor & delivery where I had 12 weeks of training specific to L&D. I’ve been there 2 years now and have attended somewhere in the neighborhood of 700 births so far (I stopped counting at 500).
That 6 weeks mentioned above is probably a unit-specific training, but says nothing for the YEARS of experience nurses have before they get to those 6 weeks. Many L&D units won’t even hire nurses until they’ve got a year or two of experience outside of nursing school, which is intensive education all by itself.
As much as some people here might hate to hear it, nurses have a LOT of training. We have a lot of knowledge and believe it or not, whatever is going on with you we’ve probably seen it before and know the safest way to manage it. We’ve seen perfect births and we’ve seen huge trainwrecks and everything in between. We actually know a heck of a lot about having babies. Sorry if that bursts any bubbles.
(and I’ve had all 4 of my kids with midwives and no drugs. I’m anti-c-section and wouldn’t see an OB unless I absolutely had to. I am very saddened by how medicalized birth has become. Don’t judge a book by its cover).
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Wendy Reply:
December 30th, 2009 at 8:33 am (Quote)
Having married into a family of health care professionals, I am well aware of what it takes to become an RN. If you read my original post, you’ll notice that I mentioned the 6 weeks to work *in L&D*, referring to required training in addition to the other nursing credentials. I also know that if there’s hope for anybody on the L&D staff being sympathetic to natural childbirth and evidence-based practice, that hope usually rests with the right L&D nurses. So fortunately, I don’t think you’ve burst any bubbles with your post. 
The one thing that I hold to is how puzzling it is how anti-homebirth/anti-CPM docs contradict themselves. If childbirth is as inherently dangerous as they say it is, and if their credentials as surgical specialists are that vital to the birth process, you’d think they’d stick around to monitor the entire duration of a hospital birth instead of sliding into the home plate at the eleventh hour. My 2.5 cents. 
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L&Dnurse Reply:
December 29th, 2009 at 5:48 pm (Quote)
By the way, if this had been my patient I would have called the doctor to let them know they needed to come running, asked for another nurse or two in the room just in case, and then I would have gotten ready to just catch the baby myself if need be. It would not have been the first baby I’ve caught, and it probably would not have been the last.
But that’s me.
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Guggie Daly had this to say,
Dec 27, 2009 @ 9:59 am (Quote)
Oh and you know, this reminds me of PTD (pit to distress, when the doctor orders the nurse to administer pitocin until the pre-born infant is in distress and required an emegergency c-section).
What is the nurse supposed to do in this situation? They are made, from the beginning of their education and clinicals, to be submissive. Their job is to refer to the attending. If the nurse takes things into his own hands and delivers the child, he could potentially lose his job, lose his standing/ability to practice and be sued by the parents.
We might argue what he *should* do ethically and morally, as the two values (his job versus the child’s life) are uneven. But what would someone in that position really do?
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Kathy Reply:
December 27th, 2009 at 12:13 pm (Quote)
Guggie,
I think that it’s not the nurse’s fault if the baby is born before the doctor gets there (at least, if the nurse was communicating with the doctor and giving him updates). If the doc is too far away (and with some fast births, that could be out in the parking lot or even down the hall) and the baby is born, then as long as the nurse had given him updates (like calling to tell him the mom is completely dilated, and/or had been pushing X minutes and making good progress, etc.), it’s on him if he’s not there. I’ve read numerous stories of L&D nurses who have had to catch babies because the docs didn’t make it. Sometimes it’s because the docs didn’t respond quickly enough, ignored the “nurse’s intuition” that the baby would be born fast, or the doc was just too far away.
If there is another OB in the building, I think that doc would be paged, but if not, then the nurse just catches the baby. She can try to get the mom not to push, but I also think that if she holds the baby in (which I’ve heard of — the kid has mild learning disabilities [the only one of his 8 siblings who does], which may or may not be a coincidence), then that is harmful. Of course, I can see her panicking, and trying to let the doctor get there in time, but that’s not right.
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Guggie Daly Reply:
December 27th, 2009 at 12:17 pm (Quote)
I see your point, but I was speaking on the reasons the nurse might choose to tell the woman not to push.
It might ‘be on the OB’ for not being in the room during delivery of the child, but the nurse can still face penalties for taking specific actions. And if he doesn’t face penalties from the hospital or ruling board, he can still be sued by the parents.
So in light of this litigious environment, it is clear why nurses might not choose the right path and instead tell the mom not to push.
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Jane Reply:
December 27th, 2009 at 12:30 pm (Quote)
Keep in mind that because of highly managed pushing stages, a lot of nurses may fully believe that a woman CANNOT give birth without heroic pushing, and people screaming at her or cheering her on, over an hour or so.
By forcing women to push before they’re naturally inclined to do so, these nurses may have created a situation where they’ve only seen unnatural premature pushing stages, and therefore they may think “Don’t push” is perfectly reasonable.
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Knitted in the Womb Reply:
December 27th, 2009 at 1:04 pm (Quote)
BINGO!
I actually attended a birth recently where the mom was clearly pushing–poop on the bed and all. At least it was clear to her hubby and me! This went on for 15 minutes. The OB and nurses were standing at the other end of the room staring at her as she knelt on the bed. They were busy discussing the OB’s irritation at the nurses for not informing him of the progress of another woman who was in labor.
After about 10 minutes of pushing the OB said “you are pushing are you? You can’t do that. No one has checked to see if you are completely dialated, so you might hurt yourself!” No response from the mother as she was engrossed in pushing. And the OB just kept standing there, arms folded over his chest. A few minutes later I could see she was getting much more intense, and just as I lifted her gown to see what was going on, she announced:
“F*^%! There’s the head!” and sure enough, the WHOLE head was between her legs.
The OB sprang forward and said “You were pushing?????”
Ummmm…yeah. That’s what spontaneous pushing looks like. I hope you recognize it the next time.
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S987 Reply:
December 27th, 2009 at 1:55 pm (Quote)
My OB was watching the monitors to decide when I “should” push, only the monitors completely disagreed with my body. So she was holding the head in place and telling me not to push when I most felt like pushing, and then telling me to push when my body was telling me to rest. Thankfully my daughter did not suffer any damage (that I know of) from the OB holding her in while I was pushing, but I suffered a tear that I am certain would not have happened if she’d just left me alone.
I think it should be a requirement that all OBs and L&D nurses watch a few completely intervention-free births take place before being allowed to practice. Women don’t need a machine to tell them when to push (especially if it’s going to be wrong!!) and doctors need to be able to recognize the natural process and progression of labor/childbirth.
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Wendy Reply:
December 28th, 2009 at 1:54 pm (Quote)
I agree. It should be a requirement for them to see an intervention-free birth. My doula friend was remarking that she has to pound it into the heads of OBs that they can’t dilly dally out in the hall when there’s a natural childbirth in progress. When nature supplants machinary in childbirth, birth attendants had better be ready to pounce.
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Molly Reply:
December 29th, 2009 at 5:05 pm (Quote)
When I gave birth to my son, I never consciously pushed, my body did it on its own. I would get an overwhelming feeling like I was going to throw up and my body would push. I thought thats what everyone did, are you telling me that women are forced to push when their body isn’t ready? No wonder so many women have problems when they give birth at the hospital if this is the way the OBs & nurses manage the birth.
I guess I was lucky to have my experienced homebirth midwives there who were actually familiar with the natural birth process.
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Jane Reply:
December 29th, 2009 at 5:53 pm (Quote)
yes, when I had my first, I had a nurse SCREAMING at me to push. I pushed twice through one contraction and then laid back to rest and she bellowed in my face that I needed to push. I said, “My body doesn’t want to” and she said, “push anyhow!”
I pushed again on that ctx, and nothing happened. My baby was born on the next (on the SECOND) pushing contraction. So clearly there was no urgent need to get the child out,and I wasn’t telling her I was too good to push at all. She just probably figured that unless she screamed at me to push until I dropped dead, the baby would just stay inside me forever. :-b
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I was told this with my 4th child, who, as it turned out, was a good 1/2-3/4 lb smaller than my previous 2 babies. I told the nurse that I had to push, and she said to wait while she got the dr. I said, “NO. NOW.” She had me sit straight up in the bed, and breathe through my mouth. And when she saw he was crowning, she yelled, “I SAID DON’T PUSH!!!!!” I wasn’t pushing. He was coming on his own. Fortunately, my DH, who had been around this block 3 times before, calmly walked to the foot of the bed and caught our son. The OB showed up about 10-15 minutes later, and my DH asked if we’d get a refund on the bill… LOL *rolls eyes*
My OB had been rather testy during my whole labor, acting as if I were there simply to annoy him… Which is why I have midwives now….
I did feel sorry for the poor nurse, who was young, and this was her first unattended birth. She was terrified, not only of having to oversee a birth on her own, but of the possible repercussions of doing things “out of order…” I *do* believe that she later went on to apply for a midwife apprenticeship, though…
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As a maternity nurse, I do hope she said this because of fear of the provider’s reaction. Unfortunately, some doctors will be very pissy, throw things, yell, etc. I have seen nurses cry. I just know that I can only do my best_ I say to a woman, try to not push if you can but do what you need to do. and yes, at times, she is not actively pushing but her uterus and baby are doing their thing. where I work, we would ask another provider to stand by or call the ER doc to stand by while we receive the infant. As nurses, we are trained in emergency childbirth and if you never catch a baby, how can you feel comfortable doing it? doctors do not understand how quickly things can change. A woman can go from 6 cm to the baby out in 2 contractions and unless the provider is in the room, she/he will never get there on time.
as always, I need to add, please fill out the birthsurvey.com, can be 3 yrs after the birth. we need to put everyone on notice that certain behavior is unacceptable.
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Sad and yet funny to me. I have had three with no doctor, one with the nurses not paying attention and she bounced on the bed. All are healthy and I was fine…so why does a doc have to be there again? If a nurse or doc held my baby in I would have a serious problem with that…what the?
I have taken to making sure the one who catches gets the credit for the birth on the birth certificate. I didn’t do it the first two non-doc births, but asked about it and made the birth certificate lady look it up and legally I could write in the nurse’s name. I will not let the doc get away with missing the birth and getting all the credit.
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My Grandmother’s sister was mentally disabled and my grandmother told me she believed it was because the nurse “held her in” until the doctor could make it for the birth. This woman required special care for her entire life and was never able to live normally. Very sad.
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Lovely Labor RN had this to say,
Dec 29, 2009 @ 9:49 pm (Quote)
I have been part of several “unattended births” at my hospital, mostly what we call “stop and drops” the ones that come up the elevator ready to deliver, those are high adrenalin moments! I “caught” my first baby not too long ago and it was amazing! Mom said that she went fast, was 6 when I checked her, called MD and update him, stated that she “went fast” and that it was her 5th baby, if he would be on his way that would be great…. his reply “call me when she is complete.” not 10 minutes later she was complete and needed to push. Called MD back and told him, she is complete and pushing, so come on up! There is not one thing in this world ANYONE can do when an unmedicated mom needs to push, let the body do what it is meant to do, and that is exactly what we told her, “if you need to push, you do whatever your body tells you to do!” I called my Charge Nurse, the Scrub Tech and the Newborn Nurse, we were there to catch the baby! The baby had a VERY tight nuchal cord that we were not able to reduce and deliver through, so we did end up clamping and cutting the cord prior to the delivery of the shoulders, but we are trained to do what needs to be done in those kinds of situations. MD casually walks in about 8 minutes later to check for lacerations, there were none, then he left. L&D RN’s on my unit are required to have 5 years nursing experience with AT LEAST 1-2 in women’s health (Maternity, GYN, etc.) prior to applying to L&D. We have a 3 month full time orientation period where we precept with another nurse, then another 3 month probabtion period before we are sent out on “our own”. The I am very lucky to work on a unit that is like family and we are never “alone” so to speak. We have quarterly education as well as biyearly skills labs, so I feel like we are continually educated and trained with up to date information. Like I have said before, the organization that I work for has really been moving toward “evidence based practice” and it has been a great movement! Yes, we have several MD’s that push back, but many are on board and are willing to change!
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Brittany had this to say,
Jan 12, 2010 @ 5:53 am (Quote)
I’m currently in a nursing program (and in mother-baby) and I’m also a mother. I see the “issue” from both sides really.
At least from my experiences so far, nurses are told not to do anything but check mom for dilation and call the doctor. Most births in the hospital are pit induced, epidural “managed”, and many turn into C-sections. Most nurses I’ve spoken to have never seen a natural labor, much less a natural delivery. That’s not their fault. So, other than from the textbook, they have no idea what to expect when mom-of-five on her sixth comes in wanting to do it naturally. And since they are so intimidated by the OB, they say stupid things and make stupid decisions in fear of being reprimanded or fired. That doesn’t make it right, but they don’t know what else to do.
I knew most of this before I gave birth to DD, which is why she was born in another hospital and caught by a midwife. Lol
I know this may be hard, but instead of being demeaning to the stupid young nurse you encounter, try to encourage and educate her on natural labors and deliveries. Yours may be the only one she ever gets to see.
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NICU Nurse had this to say,
Jan 24, 2010 @ 8:32 am (Quote)
This is awful. But it sums up why I don’t think I could ever return to the US and nurse there. (I’m American and trained as a children’s nurse here in the UK, although I would only have to complete a surgical placement in order to take the N-CLEX.) Just like American nurses, our nurses and midwives are trained, professional, clever and all about evidence-based practice, but the autonomy we enjoy here is amazing. We call our doctors by their first names, and I’ve lost count of the amount of times a doctor has deferred the decision to me when a junior doctor asked them what they as doctors should do, saying that the nursing staff are more knowledgeable in that area.
I’m 35 weeks pregnant with my first baby and have yet to see an obstetrician – we only see them if we’re considered high risk. My midwife has looked after me throughout my pregnancy (we don’t have L&D nurses, but midwives have 3+ year degrees like us nurses do), and she actually seemed a bit excited when I told her at my last appointment that I’d like to plan a home birth.
I’m really worried that nurses will never experience true career satisfaction and patients will never get to enjoy the benefits of a nurse that can put their all into looking after them if these US doctors (and I know it must be similar in other countries) don’t start to let go of some of their power.
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Kelaiah Lynn had this to say,
Feb 6, 2010 @ 5:15 pm (Quote)
(2006) I saw a several midwives during my pregnancy, all from the same office and had reviewed with ALL OF THEM my birth plan, they were SUPPOSEDLY in agreement with ME as to how I WANTED THINGS and I chose to labor at home until a half hour before my baby was born despite most of their discouraging comments during the prenatal visits. The hospital waited so long to get me into a labor room, that my water broke in the hallway while we were waiting. I could feel my baby slipping down my birth canal, and the nurse looked at me and said, “No pushing! Wait for the Midwife” to which I repeated, “My baby is coming now, and I don’t even need to push because she is already in my birth canal and will come out any moment, and even if I did need to push, I would push when or if I felt my body was telling me to.” Not 5 minutes after they got me a room, the midwife arrived and basically said “very good, you don’t even need me here” (in a joking manner as my baby was crowning)My baby was delivered a few moments later all on her own and I was able to reach down and pull her up to me without anyone interfering, and put her immediately to my breast. They waited an hour and a half before they took her to “clean her up and give her a bath” I wish I had known that I could have requested they not even do that…at least next time, (if I do have another one) I will be even more aware next time. All in all it was my best birth out of all 3 of my children’s births. Completely natural and with little interference.
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JulietsButterfly had this to say,
May 11, 2010 @ 6:18 am (Quote)
One of my nurses said something like that, but it was more “Hang on, he was just checking on another patient!” They were going to check me in half an hour and I said it was time and they needed to get him there ASAP! No one held him in, but as soon as they checked me after the next contraction, the bed was being broken down and everyone was scrubbed up.
I can understand them requesting a mom to wait, but if the baby’s coming, it’s coming!
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LOL! My mom’s nurse said that to my mom when she felt the urge to push (or rather, her body started pushing) with her second. The doctor barely made it in time–mask dangling over one ear, scrubs not on properly, still putting on his gloves as he arrived! After feeling the sensation of my body determined to push something out with my second, I think that nurse has probably not had more than one kid, or else had epidurals or something!!!
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Then the hospital darn well should have been had a doctor in the maternity unit instead of in an office five minutes away, in his bed, on the golf course, or at the shopping mall. No?
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