Posted by My OB said WHAT?!?.
May
18
Posted by My OB said WHAT?!?.
“…You Don’t Have To Be A Martyr…”
“You know, you don’t have to be a martyr. I will order one up for you.” -L&D nurse to mother who had refused an epidural as she attempted to birth without pain medications.
There are 59 comments to this post.
I had several reasons for giving birth without drugs. Martydom was not on the list. Twinkle lights would have been cool. Martyrdom, not.
I don’t understand why people don’t get that. Pain does not always equal suffering.
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Becca Reply:
May 18th, 2010 at 5:38 am (Quote)
“I don’t understand why people don’t get that. Pain does not always equal suffering.”
Right on.
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 6:16 am (Quote)
Twinkle lights: the new “aquadural” pain relief, for those mothers who have to deal with hydrophobic health professionals. (There’s a vaccine for hydrophobia, you know – and it hasn’t been twenty shots administered directly to the stomach muscles in at least a decade. Food for thought.)
There are two types of pain. Having a brain with, shall we say, a few wires crossed in the “algolagnia” subsection of social functioning, and also a predisposition to migraines, I think I can safely say that there is a great deal of difference between them.
GOOD PAIN is what happens when you are getting something done, and pain is just part of the experience. Mountain climbing. Marathon running. BDSM. Childbirth. They are all experiences a person consents to experiencing, and generally, pain is accepted as part of the package, partly because the endorphins that kick in after enough effort get you so stoned that you really don’t care how much pain you’re in. Duuuuuuuuude. More importantly, the feeling of accomplishment after finishing the race, summiting, etc is usually more than enough reward to compensate some people for the pain they go through to get there.
Bad pain is pain we don’t want and don’t ask for and certainly don’t consent to. Like migraine headaches. Or an anvil dropping out of the sky and falling on one’s foot.
Some mothers place labour and birth pain squarely in the “bad pain” category, some don’t, and some perceive a certain grey area – for instance, I’m mostly okay with birthing pain, but when my first child was removed via c-section, it was under general anaesthesia because the epidural only worked on the left side of my body, and I draw the line at “natural surgery.” (A pity. I didn’t want that stupid c-section, but as long as I was there, it would have been a unique opportunity to see my own guts. How many chances will I get in my life for that kind of anatomy lesson? It’s really cool to see my placenta when it comes out, of course, but the placenta, for all its coolness, is only one organ.)
It is a mistake to assume that a labouring mother automatically falls in one camp or the other. Also a mistake to assume that when she says she wants one thing, she really doesn’t mean it, she wants the other.
In the circles I ran in in Life Before Parenthood, ignoring the social contract establishing parameters of intimate behaviour was tantamount to rape.
I’m pretty sure normal people think of it the same way, too, come to think of it.
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Sheva Reply:
May 18th, 2010 at 7:34 am (Quote)
You are one of the most articulate people I have EVER met.
Wow.
You definitely have something there.
The attitude that laboring women in some way lose their ability to make decisions is apalling, and very prevalent. It happened to me.
Medical professionals call the ability to make concious decisions ‘competence’.
Pain does not cause us to lose our competence.
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 9:25 am (Quote)
Thank you.
I’m articulate when I write, or follow a script or outline (as with public speaking or telemarketing). I can assure you that in ordinary communication, I am considerably less interesting, especially if I am dragged to a party. I generally advise people against doing this, because the background noise will be a song by the Police called “De Doo Doo Doo De Da Da Da,” and I’m not referring to anything that’s played on the stereo.
You can dress me up, but you can’t take me anywhere. 
It’s another reason I prefer giving birth at home. I am not unassertive, but I don’t advocate very well for myself when pressured. I am told neurotypical people also get this problem, though maybe not so dramatically.
Gosh, thinking about how badly the medicalized birth system in America works from an autistic perspective really hammers in how dysfunctional it can be for everybody, doesn’t it? For one thing, when I visit MOBSW, I am repeatedly struck by instances when a birth professional is so tactless or clueless that even I can say I would have handled the situation a little more delicately. Diplomacy has always been one of my weakest points. I am not a “people person.” I should NOT appear to have more people skills than the birth professionals that get talked about on this site. That’s just plain scary.
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Brittany G. had this to say,
May 18, 2010 @ 4:47 am (Quote)
This sounds so much like the ridiculous nurse I had. Thinking back I quite wish I had slapped her and sent her from the room.
Nurse, in case you’ve forgotten, it is not being a martyr to birth without pain medication. Now please excuse yourself from the room and let Mom have the birth experience she desires. Thank you.
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Brittany G. had this to say,
May 18, 2010 @ 4:51 am (Quote)
You know, here’s a great idea. All the nurses and doctors who love to push pain meds so much should go work med-surg or post-op for a while. Those people are begging for pain meds. Although, then they would probably turn into the ones who say “Oh, it’s not that bad yet”.
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This wasn’t my story, but it could have been, except that it was the MIDWIFE who was saying it to me, repeatedly, during my first birth. I wanted to slug her. She backed it up with, “its only going to get worse” and “Nobody REALLY wants to be in pain”…
Mind that this was during a Pit induced birth, my first, and I was being forced to stay lying in bed and not move… and that she had already broken my water (without consent) using the excuse that if she did not, then “you can go home”.
I eventually agreed to an epidural that time, as much because she was pressuring me and scaring me as a first time mom as because my husband, not knowing better at the time, was encouraging me to get it too.
Know what? after the epi? I had all of 20 minutes pushing, and she cut me nasty deep, and I STILL have pain from those episiotomy cuts, 4 years later.
BTW, my births last 4 hours each max.
I have since gone on to have another child 2 years ago drug free with a REAL midwife, and am due any day with my 3rd, who will also be drug free. Am I a martyr? not a chance. I just don’t see any reason to put myself in more pain later on over a few minutes of pain in the present. I’d much rather feel the pushing and contractions soI can control things and not tear (didn’t tear but for a tiny one from my daughter sucking her thumb on the way out with the last one)…
OP, I hope you threw that Epi at that nurses face (figuratively)… the Epi I got with my first is my biggest regret I have when it comes to any birth… second is that I had allowed her to presure me into the induction at all, at 40+2, and all for her convenience… gah… the things first timers fall for.
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 9:33 am (Quote)
Oh great. A MEDwife. Gotta watch out for those. 
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“Actually, I refuse consent.”
There we go. The nurse can order whatever she likes and then when Dr. Anesthesia shows up, the mom can say, “I refused consent three times. She paged you anyhow. Ask her why because I don’t know.”
Many doctors would dislike such interruptions, especially because they have patients who NEED them.
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I wonder what would happen if those nurses were setting up a booth to support an athletic event.
“Now, you look really tired from this marathon. You don’t have to be a martyr you know. We can order you a sleeping pill…”
“This triathlon is going to get you all wet! There’s a nice bus here driven by Doctor C. He’s a very good surgeon and an excellent driver. You’ll get there in half the time, and you’ll be dry!”
Labor nurses: Moms who want to birth without drugs should be cheered on like a tired runner halfway through a marathon. We already KNOW we can hop on the bus, sometimes it’s not JUST about the destination, but also the journey.
Now, if the runner sprains his ankle and cannot run, order up the bus and the painkillers, sure. But don’t put out a trip line to cause a sprained ankle when the finish line is in sight!
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I ran into this attitude a lot with my last hospital birth. They wrote on the board, right outside my labor room,” patient requests no interventions”. I had nurses, student nurses AND doctors wanting to come in and see me like I was a circus freak. ALL of them asking” Why are you doing this?” Several popped off with the whole martyr bit. The nurse assigned to me kept asking me why, and I kept listing off my reasons. At one point, when I told her that as a nurse, she should know about the side effects of those interventions. She literally crossed her arms, leaned against the wall, and said” Well if you know that, then you should know that we have things to deal with those side effects.” WHen I said” Exactly- more interventions to fix the interventions- would you want your car repaired that way?”, she huffed and walked out of the room. She came back a few minutes later and said” WHy are you afraid of at least an epidural?” I told her I didn’t want to end up with my blood pressure dropping, or be supine, to which she said” Well, I had drugs and epidurals with all three of mine, and it didn’t hurt any of them”. I asked her how she knew that- did any of her kids have ADHD, or learning disabilities, or behavioral disorders. Her jaw dropped and she stomped out that time. She only came back in when she HAD to, and barely spoke another word to me until I told my husband I was feeling a lot of pressure. Then she said “there’s no way, you aren’t fully dilated yet.” My husband looked at her, and she huffed and said” Fine, I’ll check you.” Before she got the gloves out of the box, I pushed once and out shot my daughter while I was laying on my side. The nurses jaw hit the floor, and her eyes looked like saucers.She didn’t know what to do- whether to go find the doctor(who was napping)or to grab the baby. I couldn’t resist, I told her I hoped she enjoyed it, she would probably never see another birth like it.
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Mama Mirage Reply:
May 18th, 2010 at 9:14 am (Quote)
LOL! You made my day. I think you’re my hero!
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 9:36 am (Quote)
Good for you. That’s showing them.
Do unwanted visitations from gawkers count as “interventions?” They certainly interrupt, and often interfere.
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Becky Reply:
May 18th, 2010 at 10:55 am (Quote)
You are my hero, I’m copying and pasting this so that I can use some of the combacks you did when I give birth. 
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The Deranged Housewife Reply:
May 18th, 2010 at 11:29 am (Quote)
You rock, lady!
I am convinced that we think female care providers can sympathize with us because they’ve been through it, when yet they are probably worse than males who have never experienced childbirth: they are basing everything on their own experiences, including being victimized by the system. Subconciously I bet they know this, and perpetuate the myths and fear by making us victims of it, too. Or they punish us because we’re having the birth they did not.
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Sheva Reply:
May 18th, 2010 at 11:56 am (Quote)
Now there’s a creepy thought! (But possible, I think, though no one would admit it.)
My sister had one of ‘these’ nurses once.
My sister asked her if she had any kids. When the nurse said no, my tiny little barely 5 foot, 98 pound, soft spoken sister told her, “Well, then, get out of here and find me someone who does!”
You go, girl!!
(Not that it will always help, but it’s definitely worth a try…)
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Sarah Dorrance-Minch had this to say,
May 18, 2010 @ 6:29 am (Quote)
Martyrdom: suffering torture and death for one’s deeply held beliefs, particularly those of a religious/spiritual nature, though not necessarily.
If that nurse persisted in not understanding the meaning of “martyrdom,” it would be interesting to see what would happen if she were shot full of hypodermic needles, via crossbow. Anyone familiar with the story of St Sebastian?
No, not at all a realistic scenario, but amusing to think about.
I wonder how many nurses know how their constant remarks along the lines of “I hate to see you in so much pain, are you SURE you don’t want anything for it?” sabotage a mother’s efforts at natural birthing, especially as she reaches transition and just about any suggestion sounds good because, well, it’s transition? I mean, consciously sabotage the natural birth because they don’t believe in natural birth or because they find the mother to be too much of a nuisance or inconvenience due to noise or moving around; as opposed to unconsciously sabotaging natural birth because they’ve never seen a natural birth and can’t understand it due to lack of experience.
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Mama Mirage Reply:
May 18th, 2010 at 9:26 am (Quote)
Sadly, I think that IS the purpose. A little well-placed discouragement makes the hospital staff much more likely to have it their way in the end.
It’s like going into Burger Joint and ordering a burger, which they then tell you is a disgusting combintation and proceed to order you a “better” burger instead because it’s easier for them to make than the one you ordered. We shouldn’t have to fight to have a respectful, mother-led birth experience but unfortunately we do. It’s like Moms practically have to scream at the “professionals” attending their birth, “Hello, it’s MY BIRTH and I WILL have it MY way!” I think that’s why they discourage birth plans. It’s not really because of things that could go wrong, it’s because moms with birth plans are not as easy to manipulate. Moms with birth plans are more likely to have done their homework first and to question the true need for interventions that deviate from their plan. My birth experiences were great but my second prenatal care experience was horrible. Wish I’d had a prenatal care plan! Lol!
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 9:39 am (Quote)
A birth plan is an acknowledgement that you have reason to distrust your care provider. I am pretty sure most birth plans are routinely ignored, and laughed at if hospital staff get to see them.
The only good birth I had was my third. No birth plan. Lots of open communication with my midwife beforehand, though.
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Mama Mirage Reply:
May 18th, 2010 at 9:51 am (Quote)
Oh I was under no illusions that a piece of paper is going to make the hospital staff any less pushy! I just meant that where there’s a birth plan, there’s a mom who was concerned enough to write it and therefore is probably at least somewhat prepared for the possibility of having to fight for the birth she wants, and therefore less likely to just accept the scare tactics at face value.
I never had a birth plan either, but like you I made good and verbally sure my midwives knew what I did and did not want beforehand.
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Sheva Reply:
May 18th, 2010 at 11:58 am (Quote)
My birth plan was definitely ignored. When I went with my sister to her birth, I asked every person who walked into her room if they had read her birth plan, and kind of quizzed them on it to make sure they were saying the truth.
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 12:28 pm (Quote)
There’s an interesting passage in Naomi Wolf’s _Misconceptions_ that describes maternity ward nurses reading through birth plans. Whenever they happen upon a birth plan that is long, has “crunchy” stuff in it (no meds, movement allowed, aquatherapy, no episiotomy, no circ if the baby is male, all newborn routines done on mother’s belly, LeBoyer birth set-up, etc) they would hoot, with relish and glee, “Another c-section!”
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Cmat Reply:
May 18th, 2010 at 1:27 pm (Quote)
I “forgot” my birth plan for every visit from 32 weeks on. Then conveniently forgot it again when I went into labor. I think its funny that they harrass you for it, but when you bring it they laugh at it essentially.
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Michelle Potter Reply:
May 18th, 2010 at 4:01 pm (Quote)
Your OB *wanted* you to have a birth plan? Mine mocked me for even having one, without even looking at it.
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Cmat Reply:
May 18th, 2010 at 4:51 pm (Quote)
I doubt they actually *wanted* me to bring it in anyway. It was a birth center so they pretended to be more pro-patient. They handed it to me at 28 weeks and every doctor after 32 weeks (I saw a different one every time)asked me if I had brought it back so they could put it in my file. Put it in my file so they can forget about it and wave it off is more like it. I had better things to worry about.
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Susan Reply:
May 19th, 2010 at 3:36 am (Quote)
Mine was definitely ignored w/ my hospital birth. I’d written that I wanted no pain meds, and at the top, in bold, was a statement that I’m allergic to the epidural meds (this was also written elsewhere in my notes). Even so, the mw said she could get me an epidural, and kept telling me I should have the drugs b/c I didn’t look like I was coping. I eventually caved, not realising I was already at transition, and ended up too drowsy to do much in the pushing stage and my son’s heartbeat became erratic.
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It’s another reason I prefer giving birth at home. I am not unassertive, but I don’t advocate very well for myself when pressured.
This is my problem- I have LOTS of strong opinions but I don’t like to be argumentative…good thing that I arrived at the hospital 15 minutes before my daughter was born because even that was long enough for them to put me in bed with my legs up and tell me when to push. ugh. no time even for looking at my carefully researched birth plan..
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Cmat Reply:
May 18th, 2010 at 1:33 pm (Quote)
That’s me as well. I’m assertive and have my opinions.. but not only do I not like to be argumentative, but I didn’t think that I was allowed to turn down interventions, directed pushing etc. I’m hoping that I can communicate with DH more of what I want (we didn’t know what to expect really, birthing classes don’t help much) and he can help me be more of an advocate for myself as well as be one for me.
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sara Reply:
May 19th, 2010 at 6:24 am (Quote)
Having your husband on board is a really good idea- mine was able to remind them that we wanted to delay cord cutting and he tried to tell them that I didn’t want to push on my back, but they were in “emergency” mode and wouldn’t even listen to him at that point. But I appreciated him speaking up because it definitely helped with the cord clamping and them remembering that we had declined Hep B and Vitamin K and eye ointment.
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Michelle Potter Reply:
May 19th, 2010 at 3:03 pm (Quote)
I agree that having your husband on board is a good idea. For one thing, the last thing you want is to have them play you against each other. But then I have also run into the problem of nurses telling my husband that it was “none of [his] business,” and acting like he had no right to say anything because he’s a man.
Worse, I know someone who was in the ER having a panic attack after her newborn daughter had just been admitted to the NICU for the second time and, when she didn’t want them to make her husband leave, the hospital called family services and accused him of being abusive.
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Cmat Reply:
May 21st, 2010 at 7:51 am (Quote)
None of his business?? LOL You know, usually I’m all for “Its in my body, its my business.” but in that respect, it is his business because he’s trying to help his wife and child. What is wrong with that?? I know, I know, they don’t want another person to argue with them. I also think its horrible that they pit the husband against the Mom in some situations. And that is absolutely horrible that the hospital called family services on the person you know.
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Michelle Potter had this to say,
May 18, 2010 @ 4:17 pm (Quote)
You know, I’ve been thinking. The whole epidural thing is really very simple. Mom researches (or doesn’t) and makes her decision, and then either gives consent or doesn’t. Very simple. There’s no reason for nurses to ask over and over, because our mouths aren’t broken and we are perfectly capable of saying, “Hey, I want an epidural now!” There’s no reason to grill us on our reasons because it doesn’t matter WHY we don’t want an epidural (because let’s face it, nurses don’t give women the third degree with they DO want one). There’s no reason to mock us. So I’m thinking we should reframe the conversation to address the real problem. Instead of trying to explain ourselves — Why should we? We have the right to refuse even if our reasons are stupid or even if we have no reason at all! — make the nurses explain THEMSELVES:
- Why are you trying to discourage me?
- Are you aware that you are making this more difficult for me?
- Why does it bother you that I don’t want an epidural?
- Why are you asking me this again?
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SistaC Reply:
May 18th, 2010 at 8:46 pm (Quote)
This is my view, too.
Maybe we do want to be martyrs. So what? It’s still our choice, our decision and our right.
The biggest problem we face as labouring women is the constant demands placed on us, when, in a fair world, we would be the ones making the demands. Nurses, doctors and assistants – we don’t want to be asked, hounded and forced to do anything. Just try and imagine it’s you who is giving birth, just for a moment, before you speak.
Home birth is not for everyone, but that doesn’t mean that we must accept the other extreme as a given, either.
This comment really, really rubs me the wrong way. With my VBAC, I refused all meds, not because I wanted to be a martyr, but because, amongst other reasons, I was trying to avoid the dreaded ‘cascade of interventions’ that got me a c-section the first time.
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Wendy Reply:
May 20th, 2010 at 7:00 am (Quote)
Michelle, it bothers them because epidurals make their job easier. Plain and simple. The unfortunate fact in maternity “care” is that all too often birth attendants forget that it is their job to accommodate us, the consumers, not the other way around.
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I had to fight at my last hospital birth.
My nurse asked me what I planned on taking for pain, and I said,”Nothing”. Her response? “We’ll see about that.”
Why yes we will! We’ll see that I will not let you discourage me. We’ll see that I will use that comment to get me through transition unmedicated.
We’ll see that I will tell you that I’m ready to push even though you don’t think I “should be” ready becuase you just checked me 15 minutes ago.
We’ll also see you freak the heck right on out when you pull back the sheet and see my son’s head crowning.
We’ll see my doula tell you that I do NOT want to be coached on how to push, and we’ll see you pick your jaw up off the floor because someone basically told you to shut up.
We’ll see my doctor sit back and NOT give me an episiotomy because I didn’t want one.
We’ll see my son born into this world without your interventions and your medications. We’ll see him born alert, breathing and happy.
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Sarah Dorrance-Minch Reply:
May 19th, 2010 at 12:10 pm (Quote)
Does the maternity ward just attract tyrannical, routine-daft nurses, or does it warp sensible, compassionate people into being their own evil twins?
As much as I find the mindset of the average obstetrician to be paranoid and obstinate when not outright venal, I can at least understand how that mindset is created. I’ve read accounts of what American med school students are put through, which amount to brainwashing and hazing on the part of the medical establishment, especially when they start their first internships; and the way the system is set up financially certainly exacerbates the problem. Take into account that obstetric specialty training is almost entirely focused on surgery, it’s no wonder most OBs treat birth as a medical emergency and mothers as mentally deranged and easily manipulated faddists who have to be protected from themselves.
But nurses don’t have that sort of training.
And so many nurses do go into the field with altruistic intentions.
What the bloody hell happens between the intent and the maternity ward? The worst, most idiotic, most insensitive comments I’ve read on this forum seem to come largely from the nurses. Also the worst cases of routine-worship and control-freaking.
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GranolRN Reply:
May 19th, 2010 at 12:58 pm (Quote)
Actually nurses do have that kind of training. Nursing school teaches pathology after pathology after pathology. I was very, very lucky. My maternity rotation was taught by a former CNM. And, I’ve had natural births of my own, so I know how simple and beautiful they are. But maternity nursing education often centers on all the horrible pathologies and complications, the unbelievable physiological changes that occur with childbirth, and the different interventions that can be necessary.
Nursing school often also hammers in the idea that “you must treat the patient’s pain!!!1!!!1!!eleven!!!” We’re taught almost daily that pain is bad and that we are not good nurses if we don’t manage and treat that pain. Not specifically in maternity care, but throughout nursing school the management and treatment of pain is emphasized as really, really important and a HUGE cornerstone of being an effective and empathetic nurse.
Add that education to a group of people who tend to be very Type A and control-freak-ish, and you get the people who come up with these comments. I bet you if that nurse was posting on a blog, she’d be lamenting about this poor patient she had who was suffering so much but had these unfounded fears about epidurals, and how badly she had wanted to help the patient not be in so much pain and nothing had worked. I bet you she truly felt she was helping by making the decision to call the anesthesiologist.
She was wrong, she was offensive, she was dismissive and rude and out of touch. But I bet you anything, she was actually trying to help. She was just trying in all the wrong ways.
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Michelle Potter Reply:
May 19th, 2010 at 3:17 pm (Quote)
That makes so much sense. For one thing, it makes a ton of sense that pain management would be considered so important in nursing school, because it seems to me that a lot of what nurses do is making people comfortable and watching out for problems that need a doctor’s attention. That’s a really important job, and for someone who is sick, injured, or post-op, pain management is going to be one of their main requirements.
But birth is so different from the other reasons that people go to the hospital that it doesn’t make much sense to teach maternity care as a subsection of other medical training. Being a good L&D nurse seems to require a completely different approach than being a nurse in any other part of the hospital — it ought to require completely different training.
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I’ve said this in past threads, but it bears repeating. If a man does something to prove his strength, he is brave and a bada$$. If a woman proves her strength through labor, she’s “just being a martyr.” The double standard fascinates me.
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Sarah Dorrance-Minch Reply:
May 21st, 2010 at 12:14 pm (Quote)
Either that, or she’s a bitch.
I get the “b” word thrown at me a lot more than the “m” word.
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I was so glad that I got to the hospital already at an 8. It made my decision to go med-free that much easier since I was too far dilated for an epidural. Nothing like arriving during transition to give the nurses a great opportunity to try and rope you in. First thing “Are you getting an epidural? You’ll have to decide before the anesthesiologist leaves.” But, the doc said no epi, just IV meds, and my decision was re-made for me 
Totally worth it. Frankly, by the time I got to the hospital, the worst was over. I think the stitches (from my natural tear) hurt more than the tear itself.
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Add Your Comment.
I hate this attitude. I run into it with my family any time I’m in pain. They cannot understand why I refuse to take pain meds unless it’s killing my ability to stay still or sleep. It’s just how I am. And with birth… ugh. What part of “no thank you” doesn’t translate to “I don’t consent”? You can’t just order an epidural for someone like a burger at a restaurant.
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Heather P Reply:
May 18th, 2010 at 4:44 am Heather P(Quote)
Yeah, I hope they didn’t try to charge her for this epidural if she didn’t get it.
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Sarah Dorrance-Minch Reply:
May 18th, 2010 at 6:00 am Sarah Dorrance-Minch(Quote)
I find the intrusion of well-meaning idiots like these to be FAR more painful than any actual labour pains. Given the pattern of my labours to date, that’s saying a lot, too.
I wonder what part of “No, you’re not. I do not consent to your meddling. I request that I be assigned a new nurse” this person would not understand?
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Kristen Reply:
May 18th, 2010 at 8:45 pm Kristen(Quote)
Exactly why I chose home birth – I didn’t want the intrusions (like this one) to distract me. Why should I have to say NO if I’ve already made it clear? I wanted total clarity. I feel bad for people that have to mess with this junk while they’re working so hard. I mean, c’mon, we wouldn’t ask a runner to sign legal documents while participating in a marathon, would we?
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