Your granola is extra crunchy

This is going to come across as scolding or judgmental, but it’s more an observation born of years of nursing practice.

It has no bearing on the care I deliver.

No, it just makes me roll my eyes hard enough they threaten to fall out of my head sometimes.

In recent years there has been an increase in the special breed of folks I’ve labeled the crunchy granola crowd. The movement toward natural methods and care isn’t new. We all try, in some way, to forego western medicine or seek a natural way of stabilizing health. I’m a fan of yoga though at the moment I use it for its dual fitness/relaxation benefit.

Let me say this much first: when it comes to the labor process, everyone has the right to have the experience go how they feel it should go.

I stand by that fact. It’s your health and the health of your child. Ask the right questions. If you’re not sure why you’re being induced, speak up. Many people don’t and inducing a cervix that just isn’t ready means your baby is more likely to come out from above than below! If something isn’t medically necessary, ask why it’s being done. Educate yourself, ask good question, and work to understand the answers given. It’s your health here.

But leave your birth plan at home

The hospital is the Mecca of western medicine practice. While labor and delivery has moved to more hands off methods like kangaroo care, gentle c-sections, birthing centers with jacuzzi tubs, and rooming in/couplet care, it’s still big on intervention.

By coming in, having a doctor, being hooked to a monitoring system, you’re consenting to us taking steps if things appear to be going wrong.

Electronics fetal monitoring is a wonderful thing, but it’s also a double edged sword. It increases our rate of possible unnecessary intervention not decreases it! You’re walking around with low AFI (amniotic fluid index), or the baby has a cord around its neck, or contracting a ton. Not being hooked up to a monitor means you don’t know these things. They aren’t necessarily indicative of poor outcomes either. Many times you go the entire pregnancy and deliver and never know these are issues, but coming in and getting hooked up means we intervene. Just stating fact.

The trouble comes when people step in to a place ruled by western medicine and expect a natural, home birth experience. No intervention, no IV, labor in tub, walk, no medicine, no c-section, no shots, pills, nothing. They arrive with a birth plan typed up on card stock paper with a detailed description of what will happen.

To that I remind you… You are still just a layperson. I know medicine better than you do and WebMD surfing will not change that fact. I’m not saying that to offend but to remind. I don’t come to your office pretending to know how things work, do I?

I’m not the only person who see these people and shake my head. Because you’re so rigid with your expectations, you’re guaranteed to experience the exact opposite of what you wanted.

This is even more likely for the first time mommy who has never gone through the labor process. Labor pains are next level so unless your pain tolerance is amazing. Do. Not. Rule. Out. An. Epidural. Leave yourself open to it in case things become too much. Utilize your methods of pain control until that point, and ask good questions!

Epidurals are generally safe and carry no greater risk of injury than any other procedure.

I’m not saying this to discourage a detailed birth plan only to remind people that as your nurse, I have certain responsibilities.

*I must monitor you a certain amount of minutes every hour.
*I must start an IV especially if you’re GBS positive
*I must ask you about your pain level
*I have to make you sit down if your baby indicates it’s not tolerating labor

Patient advocacy is my aim, but I’m caught between obeying the patient’s wishes, following the doctor’s orders, and striving for good labor outcomes. Those who don’t come in with an open mind (and a 3 page birth plan) make the situation challenging. Don’t forget the odds of serious medical intervention increases the longer your birth plan is.

What about after delivery? There’s this movement lately with refusing shots and care for your child in order to remain natural. I’m not going to open that particular can of worms because it’s hot enough without my two cents. I will say this…

Living in a society as we do comes with a certain global responsibility. It’s very easy to believe the things we do only affect us, but we know that’s not true. We interact with others on a daily basis and that means we are responsible to each other to a degree. Immunization is a topic a feel strongly is group responsibility. We expect others to due diligence when it comes to not spreading sickness, right? We certainly rail against nurses who pass potentially deadly viruses around, but we aren’t the only people in this society with a certain responsibility to the whole. Think on that.

See? I didn’t make fun. Just observations.

I can only do one birth plan patient in a week. Bottom line: they are demanding, both medically and in general. More individual care is required to assist in the labor process and that’ll wear you out!

So have a little flexibility in your labor plan. Be as realistic as possible, ask good questions, and -most importantly- leave your birth plan at home.

Travel on, road warrior


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