I was lying in bed the other day and something very profound that I saw in nursing school came back into my memory. I was doing a semester in the labor and delivery department and I had a really good preceptor. Now that I look back I think that she was gently- yet purposefully- allowing me to see some of the behind the scenes stuff she saw in her profession.
The first patient I saw was a young, un-married girl who was being induced that morning (she was not over-due). My nurse was telling this patient that the doctor would want to do this…this…and this…and the girl looked hesitant. The nurse bent in and quietly said, “this is your day, when he comes in you just tell him what you don’t want, he can’t make you do anything you are not comfortable with”. The girl smiled nervously. I remember she ended up yielding to what the doctor wanted, as everyone knows “doctor knows best”. It was so strange to me that she was just plugged into the system, baby out, mama gone. Surely this wasn’t the way it typically was. Maybe because she was young, unmarried and low socio-economic class…yeah maybe that was it..it wasn’t right…but something must explain her experience, or lack of experience. The glamorous labor and delivery world was not going to be knocked off its pedestal in my mind, at least not for another year or so.
The next day I was the student-nurse of a patient who was having her second baby. Her first was a C-section, I never heard why. I assumed that something disastrous must have happened for the birth to require surgery to get the baby out. It was her desire to have a vaginal birth this time, and her doctor was “open” to the notion. I wish that I could remember for sure, but I’m almost certain she was being induced that day. So anyways she was there, laboring towards a vaginal birth. While it seemed like everything was going just fine, the doctor came into her room and said something like “I think that this is just too risky for the baby, I think the best thing we can do at this point is a C-section”.
*Note on VBAC- vaginal birth after caesarean- There is an increasing number of doctors who won’t even “allow” their patients this option. Repeat C-section is extremely common. For the few docs left who do “let” their patients “try” for a vaginal birth do something called a “trial of labor”. This is a “chance” that the mother gets to progress quickly enough– and if it doesn’t “work” they will proceed to the C-section.*
The women consented in disappointment, but “doctor knows best” seemed to be her mentality. They prepped her for surgery, cut the uterus and pulled the baby out…happy happy happy…”oh and by the way”, the doctor chimed in, “your uterus was really thin, it’s a good thing you decided on the C-section”. While I didn’t know much, something made me question this assurance. I had seen some other C-sections, and the uterus looked exactly the same…hmmm… So I asked my preceptor if it was really a dangerous situation, if she really did need the C-section, and she said “oh no, it was perfectly fine, he just said that to make her feel better about surgery.”
By the way it was almost 5:00 PM.
Labor and Delivery DECEPTION 101…
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