OB-GYN-L Messages for June, 2006: Re: postdelivery bonding and baby care

Re: postdelivery bonding and baby care

From: Gail Graham

GA12L@aol.com

Sun Jun 25 02:10:25 2006

I congratulate your tenacity and determination to keep birth normal and to keep babies with their mothers at all times. I just have one question.

If women have epidurals I understand that they need to be on beds to give birth, unless it's worn off sufficiently. However, if a woman doesn't have an epidural is she also expected to give birth on a bed?

Here in the UK the custom of holding women's legs is banned because of back injuries sustained, even more so when a woman has 'dead legs' from an epi. The majority of women are also encouraged to adopt any position they like except 'stranded beetle' and if they want to be on a bed they are encouraged to lie on their sides. Although it took some doing to persuade midwives that women are not designed to labour or give birth on their backs, change is painful for some people.

As for physicians claiming that one nurse cannot care for both mother and baby, well, they'd have a fit here. Our midwives on the postnatal ward are often caring for 6 mothers and babies at one time and they might be a mixture of vaginal and 'sun roof' births. But then, when a woman has had a normal birth she isn't seen by a doctor, in fact low risk women are only seen by a midwife. Women who have had a section are seen by a doc if problems arise but once they 48 hours post section their care is all done by midwives and all women are discharged by a midwife without the need to refer to a doc. So there is no need for docs to track down anyone. By the way, nursery nurses might want the babies in the nursery but what do the mothers want? Sorry that's 2 questions!

Shaving and enema's were abandoned over 25 years ago here, and no one I work with can ever remember putting erythromycin in babies eyes.

But well done you for what you have achieved thus far.

Gail

drgent@bellsouth.net wrote: > My residence program also trained Midwives. Touchy, feely deliveries
> were standard. When I came to southern Louisiana, I just about had to
> stand next to my patients to prevent enemas, shaving and betadine
> prepping from the umbilicus to mid thigh. I can’t count the number of
> complaints made against me because of my refusal to allow the nurses to
> follow their standard practice. A review panel was called because I do
> almost all deliveries without breaking the bed apart and allow family
> members to support the mother’s legs instead of using stirrups. To
> prevent the baby from being taken by the nurses, I would not cut the cord.
>
> Eight years later, almost all the deliveries are done this way. Shaving
> is no longer done. Only one physician insists that his patients receive
> enemas on admission. Many of my patients are referred by the nursing
> staff because “it is like delivering with a midwife.” The nurses have
> become accustomed to how I do a delivery and they no longer fight it. A
> good percentage of them have also become my patients.
>
> If I do a c-section, the baby is taken to the nursery only for clear
> medical indications. Otherwise, the infant is held by a family member
> until the surgery is completed. If the mother is stable, she carries
> her infant out with her on the gurney. On the rare occasions that a
> general is done, the infant is usually kept in the operating room until
> the mother is awake and can see him/her. If at all possible, she still
> carries the infant out. The patients are very happy with this method;
> especially mothers who delivered when things were not done this way.
> Many can not believe that they will not have to wait hours to see their
> babies.
>
> The hospital has been trying for the last five years to meet the
> criteria to be certified as “Baby Friendly”. It has not happened
> because many still insist on doing things the way it has always been
> done. The hospital had to abandon couplet care because some physicians
> felt that one nurse could not take care of both the baby and the
> mother. So of course this leads to territorial behavior. The nursery
> nurses want the babies in the nursery. The nurses taking care of the
> mothers know little about the infants. It is frustrating to always have
> to track down two different nurses during rounds so that I can check on
> the mother and the infant.
>
> Charon E. Gentile, M.D. FACOG
>
> Houma, LA
>
> ------------------------------------------------------------------------

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