Posted by My OB said WHAT?!?.
Posted by My OB said WHAT?!?.
“…I Can See By This Monitor That Your Contractions Aren’t That Bad!”
“Oh shush! Stop making all that noise! I can see by this monitor that your contractions aren’t that bad!” -Midwife
When I gave birth a few weeks ago, my (very sweet and wonderful) nurse came in and suggested that I should get up and walk around or something to get contractions coming stronger and closer together (since they were seeing that labor wasn’t progressing very well from the monitors) — I declined. Good thing she came in the room to tell me that though, as I delivered with only her in the room 3-4 minutes later!
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That machine is UNCALIBRATED. I show students in my class two different monitor strips, one that appears to have huge contractions and the other has really small ones, and ask them to guess what stage of labor the mom is in. Of course, the “huge” ones are actually early labor ctx, and the “small” ones are late active labor, in reality far bigger than the first set. It really hammers home the point that the height of the line is meaningless, and a simple turn of a knob can change the appearance of a ctx from huge to tiny.
And even if it was calibrated….the laboring mom should make whatever damn noise she wants!
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The Deranged Housewife Reply:
July 21st, 2010 at 7:08 pm (Quote)
Wow. Just like EFM – scary to think there’s such a wide range for error when it comes to ‘technical medical gadgetry.’
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It’s time for another round of Let’s Try This Again!
“Begging your pardon, Mom-to-be, but I’m in tremendous caffeine withdrawal right now and I made a mistake by coming into your room when I did. I’m gonna go find me a huge cup of coffee, and while I’m out you just do whatever, and once I feel more like a human being I’ll be right back in and get you untied from the machine that goes Ping!”
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unless it was an internal monitor, the height of the lines on the chart don’t mean anything anyways. i had some that registered off the chart, and others that looked very small, all w/out anyone touching the machine. i barely noticed the “big” ones and was in agony for the “little” ones.
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I had telemetry on with my daughters hospital birth. (3rd baby)
I sat in the shower so long i literally drowned the one that measures my contractions. So it completely STOPPED showing how strong, and close they were. And believe me, they were pitocin induced things from Hell. lol
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How silly. Those monitors don’t pick up contractions when they’re real and pick up tiny contractions as big.
When I was 30 weeks pregnant with my first I went to the hospital with contractions that were 5 minutes apart. My words were, “Just check me out so I can go home”. My contractions didn’t feel like much but were regular. After getting hooked up to the machine that goes “Ping”, they thought my contractions were awful and I was in real labor. Five hours later ,once I got the results of the Ffn test (negative) they gave me a shot of Terb and kicked me out the door before it had a chance to take effect. The contractions were a lot less bearable when I was shaking horribly. It was blamed on me being dehydrated.
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Cmat Reply:
July 21st, 2010 at 5:47 am (Quote)
Agreed, they don’t pick up contractions when they’re real. When I went into labor they were telling me after a few hours that I wasnt having contractions anymore. Supposedly I was stalled at 3. They gave me two hours (as though I was slacking here..) to get to 6 or I’d have to start pitocin. I got to 5, but the machine showed no major contractions and they weren’t close enough together. So the doctor proceeded to manually dialate me (without consent or even telling me, it hurt like hell) and they started and IV for a pitocin drip.
I might have been going slow, but I WAS having contractions.
That sucks that they blamed it all on you then sent you out the door feeling the way you did.
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Stupid medwife, no repeat business for you! For the 20 or so min I had one of those stupid things on I was in the midst of horrible backlabor, muscels not just cramping but spasming and seizing from shoulders to buttocks so for obvious reasons the muscels in my abdomin were cramping as well, the monitor picked up on that (which started before and ended after the actual uterine contraction) as a long and sudden plateu. I’m even more convinced after the brief experiance with them that they are pointless machines.
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Yeah, they don’t mean much. I had them “spiking” really high when I was there early on and was like “Wow, that doesn’t hurt…something isn’t right.” I was happy that my nurses in L&D checked progress not only by looking at the chart, but also with a gentle cervical check to make sure things were going forward in general. They admitted that they had to have so many minutes of the strip showing up per hour, but they didn’t mind letting me do whatever I wanted for all but 15 mins an hour. They even readjusted them before I went for a walk so the things wouldn’t fall off and I could be out of bed longer.
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I never understood how those could work after my labor. I saw pics of moms with those on their abdomens and assumed that’s where I’d feel the contractions, but I didn’t feel a single contraction that high up- all of mine were really low down. Is that normal? I was never hooked up to any monitors since she was born so quickly after getting to the hossy.
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Unless it’s an internal monitor that is, without a doubt, functioning perfectly (and they never seem to), then what the monitor shows doesn’t matter one damn bit. Contractions can look massive if the monitor is positioned just so, but the mom won’t even be feeling them. Contractions can look barely there if the monitor is positioned just so, and the mom will be in that overwhelmed, ohmygodican’tdothis period of transition and need a lot of support. Contractions can show up upside down sometimes, depending on the mom’s position and shape of her belly. Does that mean she feels more pain when she’s NOT contracting? Also, even if it is a perfectly functioning internal monitor, if the mother says she is experiencing intense pain then the only appropriate response is to help her manage that pain using the method she wants to use.
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I’ve heard of certified nurse medwives (one was the senior partner of my own midwife for my first birth, if I can dignify it by calling it a birth – it still doesn’t feel like one, in retrospect).
But this particular CNM has gone far beyond that. She’s acting like she only remembers the “nurse” part of her training. Or at least, she’s certainly talking like your stereotypical bossy, oblivious, routine-obsessed maternity ward nurse…
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Health care providers who dismiss pain need to be . . . dismissed! I once went into a doc-in-the-box with a dog bite. The PA was treating it and I yelped. “Oh come on! I barely touched you!” he said. I snapped back, “I’m the patient. I’ll be the judge of how much pain I’m in!” I think that’s easily generalizable to labor.
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This is something that has really bothered me. I have read many comments on this blog about nurses telling women that they are not having “real” contractions according to the monitor.
A few months ago I read a VERY popular birth blog written by an L&D Nurse. In this specific post she was explaining how you can tell when a woman is faking contractions by how they peak on the monitor. She explained that a lot of women come in faking labor because they need attention. Many people commented making fun of these “labor fakers.” This is a very popular birth activist blog too! Right before this blog post a comment was put up on this site about a nurse telling a woman her contractions weren’t real. The woman gave birth very soon after.
After reading this mother friendly L&D nurse make fun of these women, I am not surprised one bit that a midwife said this. I think that even mother friendly care providers can get caught up in the technology and ignore the mother.
I am sure there are some “labor fakers” out there but I have seen too many women who really were in labor belittled by care providers because of those stupid monitors. Wake up people! The Monitor CAN be wrong!
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Sarah Dorrance-Minch Reply:
July 22nd, 2010 at 1:38 pm (Quote)
The blog “The Unnecesarean” had a link the other day to a series of really offensive “humour” videos made by LDRP nurses about typical maternity ward patients. The gist was that NONE of them were in hard labour, all of them were pathetic whiners and malingerers, and all of them were wimps whether they would admit to it up front or not, so of course if they wound up with a C-section or some other drastic intervention for failure to progress or something, it was all their fault, not the medical practitioner’s or the nurses’.
You really have to see this crap to believe it. Sickening.
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I am so shocked to see this from a midwife!
Those monitors are bogus. With my second, the nurse came in, looked at the monitor and said “Wow, your contractions are registering off the chart, let me fix that”, made a few adjustments to bogus-meter “there, isn’t that better?”
Oh yes, you fiddling with that stupid contraption magically made my contractions painless! Thank you for being so kind and attentive!
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Victoria Goins Reply:
July 20th, 2010 at 4:27 pm Victoria Goins(Quote)
Ha ha! that’s actually a tad bit funny!
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Jane Reply:
July 20th, 2010 at 5:36 pm Jane(Quote)
Ironic how she showed her true concern. Modern L&D nurses are very good at treating the monitors. Not so good at treating the moms.
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Sarah Dorrance-Minch Reply:
July 21st, 2010 at 1:08 pm Sarah Dorrance-Minch(Quote)
That gives me an idea. Let’s give the monitors the whole maternity ward treatment: IV hookup, starvation and ice chips, mandatory lying still in bed (well, that’s easy enough for a machine, isn’t it?), epidural drip, Pitocin if a pattern shows “dysfunctional” labour. At the end of it all, the staff can wheel the monitor into the OR, so the doctors can open it up and tinker with its inner workings.
Meanwhile, Mom can labour in peace.
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Jane Reply:
July 21st, 2010 at 1:16 pm Jane(Quote)
You starve a machine by unplugging it from its power source, at which point it ceases working. They’d NEVER NEVER NEVER do that to a machine! It would be heartless and cruel and it would also stop all normal functioning. Because, you see (and they’ll tell you this if you ask) the machine functions best when it’s allowed to work as it was designed to work.
Most labor units have been designed with that in mind, in order to give the machines the best possible atmosphere in which to do their work, and the nurses are very good at making sure that continues to happen. For example, I was not allowed to starve my machine of its data even though I offered to sign a waiver stating I accepted responsibility for anything that might happen.
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Heather P Reply:
July 20th, 2010 at 7:02 pm Heather P(Quote)
There are now bits of goldfish (crackers) on my monitor. I think that’s a first for me.
Jane’s got it right. They treat the monitors, not the mothers.
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Melissa RN Reply:
July 20th, 2010 at 10:28 pm Melissa RN(Quote)
While I acknowledge that there are a lot of problems in modern obstetrics, and that nurses are oftentimes a part of those problems, the first thing I tell nursing students or new nurses is “look at the patient not the monitor.” One of the first things I learned is that those external contraction monitors are only good for telling you if contractions are happening and how long they are (how high the line goes doesn’t mean jack, something I’ve expounded on more than once including on this blog), and if they’re not placed correctly they might not trace at all. I learned to listen to the mothers I care for and lay my hand on their bellies to feel what’s going on (always with permission). I learned this from other L&D nurses. So we’re not all bad, and while I recognize that this is in part a forum for expressing frustration with healthcare “professionals” (and that’s a loose term), calling us all stupid or uncaring is generally unhelpful and a little bit hurtful. Every single day I scrutinize whether my nursing practice empowers mothers or not, and I do what I can to facilitate that. One of the ways I do that is by reading this blog. I’m not saying I’m perfect, but I like to think I try to practice in a way that is supportive to mothers, babies and families. I don’t offer pain meds (unless the mother asks me to in early labor), I stay in the room and provide labor support when I can and families want me to (ie when I’m not doubled up with another mom) I advocate and practice early skin to skin contact (including in the OR), I encourage spontaneous pushing, and if I’m not tracing contractions I ask the mother if she’s having any or I feel her belly (if she’s got an epidural)
Sorry for the rant. Truly, it breaks my heart that so many nurses are so damn cruel, and it hits a little bit of a sore spot when I get lumped in with the ones who obviously don’t care, because I care about my moms so much it hurts sometimes, especially when I witness or hear about the injustices they’ve had to endure for their births.
A smart, compassionate and overall wonderful nurse told me once that my most valuable tools in our tech-saturated system would always be my eyes, my ears, my hands and my heart. I try to build my practice around that sentiment.
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Heather P Reply:
July 20th, 2010 at 11:25 pm Heather P(Quote)
Compassionate nurses are wonderful and we need more of them. I was lucky enough to have such nurses during my first baby’s birth.
Sadly though, the fact that you need to tell your students that they need to address the mothers and not the monitor tells me they’re learning it from somewhere. I’ve seen this in action before, its like the machine is giving birth and not the mother.
Keep up the good work. You are very important to many women.
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Susan Reply:
July 21st, 2010 at 2:11 am Susan(Quote)
Keep up the good work! We need all the good nurses we can get, IMO. I know the nurse or midwife with you makes a huge difference. I greatly appreciate it when I get a supportive, compassionate nurse, as you seem to be.
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Cmat Reply:
July 21st, 2010 at 5:43 am Cmat(Quote)
Actually, a nurse like you would get “lumped in” with people like the very nice nurse I had post partum. Instead of just coming in, asking how I was feeling, checking for swelling and trying to cram another pill down my throat; She pulled up a chair and sat down with me, talked to me about how breastfeeding was going, admired my son, asked me how I was feeling and if I was getting around okay. She asked if I needed help with anything. She also talked about her experiences with her own kids when I said I was having trouble with breastfeeding. Nothing she said was rude, nothing was discouraging. She was in my room for about a half hour before she said “My shift ends soon, but hopefully I’ll get a chance to stop in again before I’m done.”
On top of that, when I went in to my first prenatal appointment yesterday I met another very nice lady that is my OB’s assigned nurse. I can only hope she ends up with me when I give birth. She’s about 7 months pregnant herself, so when I come in, what she went through will be fresh in her mind and she’s been through it before. I think that, on top of the fact that she’s compassionate and listens (as does my OB so far) will make for a better experience this time.
Keep telling other nurses you train or mentor the things you’re telling them. Keep passing down what you were taught. Eventually maybe no one wil be lumped into any category.
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Jane Reply:
July 21st, 2010 at 1:20 pm Jane(Quote)
I’m sorry. I shouldn’t tar all nurses with the same brush. I’ve had some bad experiences, but that shouldn’t discolor my opinions of every one. Please forgive me.
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The Deranged Housewife Reply:
July 21st, 2010 at 7:07 pm The Deranged Housewife(Quote)
Wish you were my nurse.
Actually, the nurses I got this last time around were pretty good. One told me “Good for you!” when I said I had already had a VBAC. Another gave me a canned-but-nice “Thank you for letting us take care of you” after my c-section. Although strangely enough she is the same one who told me I could still have my baby vaginally, even though I was in a hospital that supposedly “doesn’t allow” breech births. I found that odd.
Anyway, while no, it’s not nice to paint everyone in the same light, surely you realize that you’re in a minority. But thank you for being such a kind, understanding and gentle nurse who really does go out of her way to provide the most human care to laboring moms as possible!
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