Feb 222013

“If she’d let us break her water, she would have had this baby already, the poor thing.” – L&D nurse at the nurses’ station in earshot of laboring mother.

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 February 22, 2013  AROM, L&D Nurse, labor  Add comments

  73 Responses to ““If She’d Let Us Break Her Water…””

  1. Or she could have a prolapsed cord and “have this baby already” by cesarean. Studies have shown it only shortens labor by 20 minutes. Leave her alone!

  2. The sad thing is, this nurse probably believes it. :-(

    • Of course she does. They probably do AROM by 5-6cm for most of their patients whether it helps or not, to the point that it’s become a thing that must be done or else the mother won’t progress anymore. Of course, they don’t realize that mothers do progress without AROM because they never see the intact membranes case because they do amniotomies for everybody. Very very sad. :(

  3. I’m really loving the passive aggresive “Poor thing” the nurse threw in there. Well, either passive-aggressive or condescending, and neither one of those is ok.

    • Wow, it has to be one or the other? The nurse couldn’t simply be compassionate but wrong?

      • I guess you could read it as compassionate. Didn’t strike me that way at all. I guess I just really dislike these types of endearments (the poor thing, sweetie, dear, etc,) when talking to or about an adult. It comes accross to me as a little disrespectful.

        • I’m from the south so those things are normal conversation.

          • Actually, I’m from the South also. And that’s where I came up with the passive-aggressive sound. Because usually when I hear something like this, it’s in those sugar-coated to hide the negativeness of the comment type tones. Now, sometimes I’ll hear it spoken in a genuine, “I feel so sorry for her!” type of way, but this one didn’t read that way to me. :shrug: Sounded more like “if the poor thing would just do what I told her to she wouldn’t still be in labor”…

          • “Poor thing” is as good as “bless her heart”. I don’t see any compassion in calling her “poor thing” for making a decision that the nurse disagrees with.

          • Hey! “Bless (your/er/his/my) heart” can be a very loving compassionate thing to say.

            Or it can be the upmost in contempt.

            Its all in the tone.

    • I would read it as compassionate but wrong, barring further context from the OP. “Poor thing” sounds like the sort of thing my late mother used to say.

    • I read the “poor thing” as being directed at the baby. If that is the case, it is definitely not a nice comment.

  4. Or you could have broken her water and this would have made her contractions suddenly unbearable, at which point she would have asked for an epidural, and birth would have taken the same amount of time in the end. For me, as soon as my water breaks contractions go from “ok, breathe and focus” to “OMG this freaking hurts!!! Ow ow ow!” And it makes sense since the baby’s head is directly on the cervix with no “cushion” of amniotic fluid. A faster labor is not always more comfortable for the mother.

  5. It makes me sad that I’m so jaded that my first thought was “at least they respected the mothers wishes enough to not do it against her will, and are just making snide comments” my (ex) ob asked to do a cervical check, then asked for the amni hook and proceeded to break my water with me screaming at her not to and trying to climb up the bed to get away, all during a transition contraction mind you. In retrospect i really regret not just kicking her in the face!

    • I’m so sorry you went through that. That sounds awful.

      My OB wanted to break my water with DD, and I didn’t object, but I asked her what exactly the process entails and how she would do that. I really wanted her to explain it to me.

      “Magic wand,” she said, and proceeded to stick the hook inside me and break my water without any further explanation.

      That response has always annoyed me. If you’re going to put something in my vagina, and I ask you what it is, I expect a real answer, not some condescending “don’t worry your pretty little head”-type tripe.

      Maybe I should submit that one.

  6. Condescending much? What a bitch!

  7. Never ever complain in front of the customer. Whether you think you know best or not the customer is always right.

    • I don’t really agree with this statement, I have meet many a customer that are dead to rights wrong. I don’t think we should foster this idea in McDonald’s much less in a hospital.

      • When it comes to Patient rights, the patient has every right to have it her way. Right, wrong or indifferent, it’s her body.

        • Its a partnership, the patient is the final decider that is true, but a patient that is utterly belligerent/impossible can be dropped and this exists for a good reason.

          • How can the doctor drop a patient in the middle of labor? That’s slightly illegal, not to mention that if the patient says they don’t consent to something, it’s doesnt mean the doctor/nurse/etc has the right to go against the patient’s wishes and do it anyway.

          • It’s not exactly a partnership if the doctor feels (s)he has the right to intimidate the client and push her into doing things she doesn’t really want.
            And when it comes to obstetrics, I feel that the customer is right more often than not since labour is treated as a “one size fits all” type of thing by ob’s. The ob is a surgeon and therefore, not the right person to assist a natural birth because he’s going to want to do things. thins mom doesn’t want or need.

          • That’s where you’re wrong: it’s not a partnership. The OB and L&B staff are delivering a service and being paid for it. Partners only pay each other when they’re buying each other out. neither will any of the staff be responsible for the child or mother’s well being in the future, or the long term consequences of anything that is done during their care. by failing to respect patient wishes you take on responsibility for their long term effects, something I know the legal department would rather avoid.

            Truth is when people are in labor they’re probably going to be highly emotional and reactive– and vulnerable! If you can’t wrap your head around that and deal with it in practice, for god sakes get out of that line of work!

          • Yeah, cause no one ever sues an OB for things that went wrong during labor, we never deal with the long term consequences.

          • First, Are you really comparing money to a long term dissability or irreversable trauma? Why dont you first imagine someone steals your car, then imagine someone rapes you (brain damages your kid to shave off 20 minutes). Both suck, but they dont compare. Second, You want to be one of the reasons a suit becomes a more likely possibily? Failure to honor patient autonomy is illegal.

          • And there you have it. You don’t care for the mother’s or the baby’s well being, you care about saving your hide. And if you used every possible intervention on me, you can shrug it off and say “I tried as hard as I could”.

          • She is comparing money and posessions to dissabilities or long term trauma. She doesn’t get it. Hey goldy, imagine having your car stolen. then imagine getting raped or your child being run over by car. How does it compare then? I’m afraid I have no sympathy for people who do things to people against their will, and then have to pay the price for it. when you take away a patient’s right to choose you take responsibility for the consequences. how do you not get that? but you know money is only an indicator of it, it is the parents who will be pushing the wheelchair or dealing with unbearable pain from uterine adhesions. If it were you for real you might take it more seriously.

      • Then you should explain using things like scientific evidence and sound logic why the mother is incorrect and what your recommendations are to proceed. You should NOT bad-mouth the mother to a colleague like this nurse did.
        I’m sure you encounter patients who are wrong all the time. Many people do not educate themselves about their healthcare. I truly truly hope you take advantage of those situations as a time to educate and inform. This nurse chose to belittle instead. Even if she her facts were right, that was the wrong approach.

        • Oh I am not saying the technique was right, I am just saying that the idea that a doctor is just someone who does whatever you tell them to doesn’t seem like a good one to me. Take that to the logical conclusion. “Doctor my pain is really bad, I want an unlimited amount of opioids” should the doctor say, your always right and write the script? Some people think anytime a doctor says no, or I won’t continue care unless you do x then they are stomping all over patient rights.

          • Oh stop being an ass. The primary comment was do not complain in front of the customer. Your little drug seeking concerns have nothing to do with this nurse being a bitch. The mother wasn’t asking for anything other than to be left alone. Stay on topic.

          • The thing is she didn’t stop with, don’t complain in front of a patient, that I am 100% behind. She extended it to, they are always right. That is where my problem lies.

          • And you went off down the rabbit hole…
            And you have no social skills and apparently hold it all in while out in public, but dump on those who don’t know you and never will on the internet… until the day when you totally lose it and take out 27 people. Breaking a woman’s waters is bad. Bitching about her behind her back is bad. Bitching about her where she can hear you but can’t do anything about it is bad. The customer/client/patient has the right to be treated with respect even if they are ill informed. Your need to correct people when you don’t have a clear understanding of the situtation in the first place is disgusting.

          • So you are on a site dedicated to complaining about people behind their backs, telling me that it is morally wrong to do so. Well that make sense.

            As for the breaking waters in the first place being bad well I frankly don’t agree. Its speeds labor up, studies show that it can speed it up just as much if not more than an epidural can slow it. No one here says the later isn’t a real thing.

            As for my social skills I’ll take your opinion with a gran of salt, since you have no real way of knowing me (and I am pretty sure you were the one who accused me of having Aspergers Syndrome at some point)

          • And who benefits most from speeding up labor? The mother? If she says no? Studies also show that it can make labour much more painful and not everyone wants an epidural because it does have side effects. Walking also speeds up labour.
            Besides that I personally feel that you should stay away from a dilating cervix. I don’t care if you soaked your hands in disinfectant for half an hour before touching my cervix I’m not giving you the chance to introduce bacteria to an otherwise sterile environment. There are other ways of finding out if a mother is dilated fully or not and letting her listen to her body is a much more effective way to have an easy and quick delivery than bullying her into all kind of procedures that make your life as an OB easier. Birth is not about you, the OB. It is about a baby and a mother and I do not believe your standard interventions and restrictions have her (and her babies’) best interest at heart.

          • As I said, if you want to talk about your customers behind their backs, call your coworkers from the privacy of your home on your free time. If you honestly think risking infection, cord prolapse, and making a woman’s labor much more intense than it has to be is worth the 20-30 minutes that breaking the water will gain you then you truly have convenience ranked over a patient’s best interest. I hope you get a dose of humility before ever seeing a patient. You can’t let go of the original posts to see my original point even after I explained it multiple times so let me simplify it as much as possible. Even if the customer is wrong, it’s unprofessional and offputting to call him wrong. It’s your job to lead him/her to being right (if necessary, this is one situation where it’s not) without telling him he’s wrong. Nobody is going to continue to use your services if you constantly tell them that they’re wrong. People don’t like that.

          • I have Aspergers… and even I can see no matter how many times you have said otherwise that you *are* an arguementative person. (You aren’t alone in that here or anywhere else… but you are arguementative.) If you can’t see that you do have some issues reading social cues.

            I also have no interest in having my labor ‘speeded up’. It moves at the rate it is meant to move. More speed is more pain…. or at least the same pain compacted into less time so that it is more greatly felt. This ‘poor thing’ would rather let labor take its own course.

          • Sorry to hear you have Aspergers. Glad you realize it. I grew up with one, and let me tell you it is so much easier to deal when you know what the problem is than when you assume the person is normal and keep getting blindsided by the limitations. And mine was darn argumentative. Nothing like telling someone they are missing the social cues, and having them tell you there is no such thing as a social cue and emotions are for wuss bunnies. That is what I’m seeing here. Whenever somebody tries to use science to argue that emotions count for nothing I suspect Aspergers.

          • Why are you sorry I have Aspergers? I’m thrilled to know I have Aspergers. I’m thrilled to finally understand why I don’t fit into society’s picture of what is ‘right’. I’m sorry that you don’t see that that does not mean that that *I* am less than you and that your ability to read social cues ‘normally’ means that you are not ‘limited’ and that I am ‘limited’.

            You are no less argumentative than Goldilocks on this board… honestly, neither am I. (Personally I think Jane and Tee have the best track record for calm, reasoned responses over all.)

            Not having Aspergers doesn’t make you better than me… your way of thinking and seeing the world is not better or more ‘correct’ than mine. Don’t feel sorry for me. Don’t go assuming you know all about Aspergers and can diagnosis it because you ‘grew up with one’. You can’t… you met one person that thinks in a similar manner to me. Do *you* think just like every other ‘NT’ (neurotypical… not ‘normal’) person out there? Then don’t thinking meeting one Aspie makes you an expert.

          • I guess I am not argumentative isn’t the right thing to say really, I am very argumentative in that I have strong opinions, but if we meet in person you would never suspect that I am. I tend to get myself into too much trouble speaking, and honestly I find social situations exhausting, so if you meet me in person you would think I am a very polite, but very reserved person. I work hard to come across that way because it keeps me out of trouble. That is why I say I am not argumentative. Its hard to be when you can go throw a whole day saying not more 200 words.

          • I understand. The internet *is* tough… particularly for those of us that do find social situations exhausting. When we can reply or not when we see fit… we reply when we *do* have the energy to be ‘social’ with our thoughts… so we can find ourselves *overstating* our point a bit much.

            While I don’t really know you… that is exactly where I catch myself here sometimes… and in *my* opinion you seem to do the same. I’d say we should work on making our point and then letting go where we can. You made your point… ‘the customer is *ALWAYS* right’ was a bit of an overstatement… however once the poster conceeded that patients *can* technically be wrong (even if a bit grudgingly) you would have been better recieved if you had let her had her point (which I believe was really more of a ‘the patient’s decisions should be respected’) from there.

            As others have said… it was an ‘idiom’. Yes, it was a bit strongly worded/not fully correct… but you were beating it to death a bit. I’m so good at that myself. I bet we would get along great in real life. Or kill each other. ;)

          • Kristy, I actually didn’t want you think I was picking on people with Asperger. I grew up with the equivalent of an art teacher who was colorblind and would critisize my color choices. That is how I see Aspergers. If you can’t see colors don’t try to come off as an expert on colors and if emotions confuse you don’t try to play shrink. People who know they have Aspergers are totally fine with me. People have it and insist that they don’t while making other people miserable need a wake up call.

          • I’m just saying you are clearly no expert on the social niceities yourself… or at least don’t think of Aspies as people they apply to. You do not refer to a deaf person as “one of those” without being considered rude… and you don’t play an ‘expert’ on *Aspergers* when you are not either.

            There is nothing wrong with the *right* Aspie for the job deciding to become a Psychiatrist/Psychologist … I know of one that decided to do so and I’m sure he did quite well. ‘Emotions’ do not confuse most people with Aspergers… we have all the same emotions that anyone else does even if we deal with them differently. *Reading facial expressions* identified with the emotions of others confuses many (arguably most) Aspies.

            In some ways Aspergers can be a *bonus* when discussing things on the internet… *there is no face/tone of voice to misread*. The ‘obsession’ aspect of not letting things like poor wording go that I and *some* other Aspies have can of course be a minus on the internet and elsewhere. Many ‘normal’ people like you do that as well.

            But you are tossing it out as a generic description/diganosis of any and all behavior you determine to be rude because “I knew one once”… and while you have graciously determined them to be “fine with me” (oh, thank you kind normal person!)… you want them to behave more like you so they don’t disturb you so much. Perhaps you should seek to be tested.

          • Wow you really need it blunt. My mother is an undiagnosed Aspie. There is no bonus to not being able to read your baby’s cue. Especially when the result is the mother blames the baby and the baby grows up believing it. There is no bonus to being the daughter of an Aspie woman who is a cold hollow shell. There is no bonus to getting caught up in your hobbies if the result is that you consider your children to be an annoying distraction. There is no advantage in the perfectionism or the favoritism. I’m sure you are a much better woman than my mother. But trust me I know what I’m talking about. Knew one once my ass!

          • Yes! You knew *one* person with Aspergers (undiagnosed… so if they are *still* undiagnosed you know one person you *think* had Aspergers) and you think that gives you the expertise (“I know what I am talking about…”) to pin your assumptions on *all* people with Aspergers? WE ARE NOT ALL THE SAME!

            You got issues with *an* Aspie… take it to your shrink. Don’t use labels that make us *all* inhuman (“one of ‘those’”) or refer to yourself as ‘normal’ and us as ‘limited’.

            Aspergers is not a disablitity! It is a different way of thinking. There are *lots* of advantages to perfectionism (even though there are many minuses as well)!! You would not have half the inventions/discovery in the world today if some Aspie hadn’t buried themselves in a topic that interested them.

            Your personal issues with an *individual* do not excuse the way you are condesending to a large group of people. You do not understand Aspergers if you think we are ‘color blind’ to emotions. If your mother was a jerk that doesn’t mean she had Aspergers or that Aspergers was the cause of her poor behavior. Although it *does* seem to explain *your* poor behavior in pretending to understand the group I am a member of *better than me* because you *knew* *one* *once*!!

          • I said that I was sorry you have Aspergers and you took it wrong. The only person I have condensed to is Goldilocks. And I will continue to do so until she recognizes that she is missing certain social cues and focusing on the wrong things.

          • Part of what Kristy was trying to say (I think) is that saying you’re sorry for someone having a condition, such as aspergers, implies that they are to be pitied for their condition. Which is not true. With pretty much ANY disability, it’s pretty rude to say “I’m sorry you have that,” because it’s typically just a part of life for those of us dealing with things like that. If someone caught a disease, or had an injury, or some major negative life event, those would be appropriate times to say I’m sorry. But Aspergers is more of a way of life, not something horrible that’s suddenly happened to a person. It doesn’t make their life “less” or something to be sorry for.

            (And I do apologize for the lecturing tone, this is something of a sore spot for me, unrelated to aspergers but having to do with other innapropriate appologies, so I kind of understand why Kristy didn’t appreciate the “I’m sorry”.)

          • If you don’t think you were condesending to me by telling all people with Aspergers in the way you presented yourself you are missing certain social cues and focusing on the wrong things yourself.

            Carrie has the “I’m sorry” part right… Aspergers is part of who I am. If you ‘cured’ me so that I didn’t face the negative aspects of it… I wouldn’t be me any more. You just don’t go around telling people “I’m sorry you are you”.

            But your ‘apology’ was just one of the places where you were rude. Saying “People who know they have Aspergers are totally fine with me. People have it and insist that they don’t while making other people miserable need a wake up call.” is like saying “People who are deaf are fine with me but they need to learn to speak or they are just rude.” or “I don’t have a problem with black people but they need to ____”. Members of a group don’t need your permission to be ‘ok’ and they don’t have to be who you want them to be to be ok.

            Being ‘fine with you’ if we behave as you feel we should is condesending… particularly when the condition you set can be one that is much more difficult for someone with Aspergers to accomplish than for someone else.

            But I’m done educating a self appointed expert in the field. You can’t teach those who think they know it all.

          • First paragraph correction:

            “f you don’t think you were condesending to all people with Aspergers in the way you presented yourself you are missing certain social cues and focusing on the wrong things yourself.”

          • Really? Come on! I don’t need you telling me you think I am a graceless lama. You told me once I heard you (don’t agree, but…) I did hear you!

          • No one ever asked women if they’d prefer a shorter and more painful labor over a longer and easier-managed labor. The assumption of most OBs is that “faster” equals “better,” and that comes from a few basic assumptions which are a little skewed.

            The first assumption is that labor is a potential train wreck that can go tragically wrong at a moment’s notice with no warning. This assumption arises from the fact that the doctors are not with the patient, and the first time they hear of something going wrong it’s via phone call, and then by the time they arrive at the hospital 20 minutes later, things are much worse. Whereas the truth is, the problem was probably developing over a long period of time.

            And secondly, the artificial 24-hours-with-ruptured-membranes timeclock, which is reinforced by OBs who perform AROM without cause. So they in effect perform AROM in order to speed up labor, but then they get panicked that the baby might not deliver fast enough because the baby has to be delivered 24 hours after ROM. Hmm.

            There’s no inherent benefit to a speedier labor.

          • I think you have to consider the hospital’s labor room turnover rates when you are trying to find the logic in a shorter and more painful labor over a longer and easier-managed labor is better for the patient even with the increased risk of infection and cord prolapse. Having 2000+ babies born each year in a hospital with just 10 labor rooms has a lot to do with “faster is always better”.

      • Do you get extra points for being argumentative? I didn’t mean that the person is really always right, I meant my first sentence. Never complain where they can hear you. Whether they are truly right or wrong doesn’t matter. Never let them hear you complain about them or any other patients. I hope you’re not as argumentative when you finish your education as you are on this site.

        • I said it once I will say it again, I am not argumentative in person, never have been never will be. I agree the nurse technique not so great, that doesn’t make her wrong or the patient right (before we get into an AROM argument I am not saying the nurse is right either). The issue I have is when you conflate, “don’t talk where others can hear you” into “the patient is always right.”

          • I hope you don’t tell a mother in labor who is refusing non-evidence based procedures she is wrong. My point of the “customer is always right” comment was that you don’t argue or complain WHERE THEY CAN HEAR YOU. Maintain professionalism and courtesy whether you think they’re right or wrong. If you want to complain to your coworkers about a patient, call them from the privacy of your home on your own time.

          • If a patient is wrong about something then their is professional responsibility to correct them. No different then telling a diabetic, that eating 30 cookies a day is probably not helping their sugar.

          • Refusing unnecessary procedures isn’t wrong. And there’s a right and wrong way to “correct” someone. Complaining to a coworker within earshot is not “correcting” someone, it’s being passive aggressive and childish.

          • You should correct a diabetic about their habit of eating 30 cookies a day because 1) that is actually wrong and 2) Correction is not complaining, it’s informing.

            The woman in this post does not need to be corrected because keeping her waters intact is NOT WRONG. And the nurse was not correcting her, she was complaining in front of her.

            Different situations.

          • “The customer is always right” (or the patient, in this case) is an *expression*. It doesn’t mean a customer can never be wrong, only that, when dealing with people who are paying their hard earned money for your services, and who could take that money elsewhere, you treat them with, get this, respect. Even if you think they are dead wrong, you still don’t act like an a-hole to them.

            It is an *idiom*. It is not meant to be taken literally. The sentiment, however, hold true in both Mickey-D’s AND L&D.

      • I agree that customers are not always right.

        But in a medical setting, the customer has the right to be wrong in the eyes of her doctor.

      • Goldilocks, have you ever once thought about the fact that your nitpicking over little things and being so argumentative might actually deter the original poster from coming back to tell the rest of the story? When you stick up for what the medical person says/does, it makes the OP not want to deal w/another person who might put her down in the same way. Discussion is one thing, but you tend to be very nitpicky about such unimportant little details. There are many times that things have been said on this site that I have wanted to say something, but this isn’t about me or my feelings about something. This is a place for women to come to find people that will listen and help her cope w/a situation that she might not have liked. It’s a place to laugh w/women over the “duh” moments……

  8. You guys who are jumping all over Goldilocks really need to untwist your panties and re-read what she wrote.

    She never said this nurse was right to say what she said, or the way she said it. NOT ONCE. In fact several times she said the nurse should not have done that.

    But because she disagreed with “the customer is always right” now you guys are getting on her case? Really? She disagrees so she is argumentative? She has no social skills? Are we really belittling her as a person instead of picking apart her arguments on their own merits? That’s called ad hominem in debates and is considered a worthless argument because instead of attacking the person’s position you’re attacking the person’s character.

    The rabid hostility toward anyone who doesn’t jump on the “bash the care provider” bandwagon with mob-like hate and lynch mentality really is sickening, just as much to me as some of the things that happen to the OPs via their care providers.

    I’ve been around for a while so it isn’t like I’ve never read Goldilocks posts. The mistake she made I think is that she declared she is a nurse. Thus, anytime she disagrees with anyone on this site about ANYTHING, she is met with hostility and antagonism and suspicion because she is part of “the establishment”, no matter the validity of her statements.

    • Goldilocks is an arrogant know-it-all who has described herself as a student doctor. I assume that means she is in medical school and not yet in residency. And doesn’t pick up on subtle social cues or even the no so subtle. What kind of a doctor do you think she is going to make? I can’t picture her as the kind who listens.
      Never once has she said if I heard a nurse or ER check in receptionist talk to a patient of mine like that I would pull her aside and explain that that wasn’t appropriate. But if she can find an idiom like the customer is always right she will hijack a thread because she doesn’t understand social cues and doesn’t see the problem there. Sounds like a horrible doctor to me. Sounds like the kind that gets quoted on here.

    • I agree, Gaevren!
      I’ve been reading this blog since the beginning, with the perspective of a woman, recipient of poor gyn care, EMT, as well as a linguist & public speaker. Over and over again the root cause of many a blog fight has been an ambiguous statement that can convey opposing sentiments depending on the resident voice inside your head (not referring to mental health issues).
      Goldilocks’ writing is appropriate and innocuous for my region, but unsettling for those living in some other regions. We all need to first question rather than jump straight to assumptions! When we’re surrounded by a strong haze (psychological, physiological, or environmental), it’s extremely difficult (and rare) to clearly “hear” the message another person is attempting to communicate.

  9. I can’t tell if my comment is in moderation or it just got eaten, lol.

    To goldilocks: The phrase, “the customer is always right” is an *idiom*. It is not meant to be taken *literally* (your insistence on doing so makes you appear argumentative, but I don’t mind argumentative people ;) I happen to be one). The phrase simply means that when people are paying their hard-earned money to buy a good/service from you, while they could have gone somewhere else for said good/service, you treat them with *respect*.

    It’s really not that complicated. Sheesh.

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