At the bottom of the book review (which was a positive review), there is a link to email the editor for MedGenMed, on Medscape, where the book review was originally posted. I urge all readers of my blog to read this book -- yet again -- and get involved in helping change our flawed maternity system.
Like the activist that I am, I responded with the following email to the editor:
Dear Dr. Blumenthal,
As a Registered Nurse in Labor and Delivery at a very large, high volume hospital, I was intrigued by the premise of the book "Born in the USA: How a broken maternity system must be fixed to put women and children first", by Dr. Marsden Wagner.
I am only several chapters into Dr. Wagner's book, and reading his words, seeing the very strong references he lists to back up his information, makes me appalled to say that I work in a L&D unit that does so much of what he discusses in his book.
I see the wide use of cytotec (misoprostil) for inductions. I see what it does to a woman's uterus and to her baby. Not to mention - it's not FDA approved for use as a labor induction agent in pregnant women! I see many, many women being induced with a "hospital made" form of prostaglandin gel to induce labor. I also see a HUGE number of pitocin inductions/augmentations, where pitocin is titrated at such high doses, so quickly, that it's like we're trying to blow the baby out of the woman's uterus.
Many of the obsetricians that I work with are eager to "get her delivered" as quickly as possible. There is also the "pit to distress" or "make the baby prove itself" - in other words, keep cranking that pitocin up until the baby crumps into fetal distress and the obstetrician does a stat c-section --- all so the doctor can be done, and get out of the hospital. Why wait 12-14 hours for a natural labor, when you can be done in less than an hour?
Our induction rates are through the roof. The nurses are rarely told the unit statistics, and when we are given them, they seem grossly understated. The L&D nurses know how many patients are induced or augmented, day after day, because we are the ones there, admitting the patient, and running their pitocin. We see them in massive amounts of pain from what is a very unnatural process designed to speed up the labor process, thus leading to increased epidural rates due to the higher levels of pain from synthetic oxytocin versus natural oxytocin.
Natural, spontaneous labor? Why, that's a thing of the past. Why wait for labor to start, when obstetricians can just induce or cut (c/s) everyone!
RN's in L&D used to have much more autonomy than we do now. Regulatory agencies are gradually taking away our ability to be autonomous, and turn us into drones that are not allowed to use our top-notch critical thinking skills to care for laboring women.
I am absolutely sickened to see much of what happens in the obstetrical "business", but I am very glad that Dr. Wagner has written this book to open my eyes to things that I did not know. I have already started to recommend his book to my fellow RN co-workers on L&D, and I will be printing the book review you wrote to post in our nurses lounge. I cannot wait to finish reading "Born in the USA" to read what Dr. Wagner has formulated for the changes needed to our maternity system.
I am a strong advocate for midwifery care, homebirth, natural labor, and VBAC, and I am strongly against unneeded inductions, elective c-sections, the intervention cascade, and using pregnant women to unknowingly "test" the non-approved FDA medications that are currently used.
I sometimes feel like I am alone, against other RN's that will rationalize what both we nurses do to pregnant women, and what obstetricians do to pregnant women and their babies. I have recently joined a Nursing Practice Group in my unit, where I hope I can start to affect change in our practices, and can help women and unborn babies be safer in the hospital system.
Feel free to use any or all of my email response to you.
Sincerely,
Xxxxxx X. Xxxxxx, RN
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10 comments:
Marsden Wagner has his act together, doesn't he? WHat do you think it will take to fix this broken, sick system?
WOmen who come into the hospital seeking a normal birth are marginalized and ridiculed. Here anyhow. At least 95% of women I know birthing in hospitals -- no kidding --are pitted.
In AL where I live, one third of counties have no one to deliver babies, infant AND MATERNAL mortality/morbidity rivals that of the third world and homebirth midwives are illegal and only 3 CNMs deliver babies in the whole state.
Sick.
Woah,
No wonder the nurses looked at me straange last time I delvered. My 5th baby was like the rest, no pit, no epidural, no meds of any kind. No IV (this occurred in three of my deliveries), just me, my husband, and the baby. Sure, I had massive mec and baby had to be sucked and get O2. Sure, baby had an apgar of 1 and then finally 7 then 8 (she's so healthy now). But, I was an alien. I am a meds virgin, a pit virgin, an induction virgin. I did let them break my water with #1, but the rest broke on their own. I did get an episiotomy with #1 (not my choice) but it only neede one stitch. Sure, I've had scary deliveries because two came without a dr. attending, one without anyone paying attention. Still, all my born babies are healthy. (I go to the hospital because of the mec mostly, I've had it every time). I see reasons for medical intervention...and plan to use it if I need to. I also see the beauty of the natural process. No pit, no pit, no pit (unless we're truly stuck or have pre-e or something)....
Nice letter. Saw the same practices on L&D units here in Portland, OR as well.
Howdy! I'd love for you to join the new yahoo group "Born in the USA" based upon Marsden Wagner's book. Its been up for a few months now and Marsden is a co-moderator of the group. I'm the owner and we need as many folks like you nationwide to join the group. go here: http://health.groups.yahoo.com/group/Bornintheusa/
I can't WAIT to read this book!
I enjoy reading your blog, and I am planning on reading this book! I work in a small hospital in the northeast, we use our share of interventions. But sometimes, it is great, like this weekend when I had 2 patients that came in with spontaneous labor. There was NO pitocin, NO pain medication, minimal EFM, mostly auscultation, and whirlpool use. These kinds of births remind me why I do this work and why I am in school for midwifery.
You are not alone, my friend. I think there are more RN's who think like us and have the same beliefs but just don't speak out because it's not the norm in the hospital.
I have yet to read that book because I think it will piss me off way too much.
I unfortunately had to be induced twice for medical reasons. The first time I was very niave and didn't realize the risks or that there was such a thing as "pit to distress." I wish I had known because I would have fought like hell against it. I could go into long detail, believe me. But let me just say that for my first pit delivery I had a massive postpartum hemorrhage and there's a good change I have pituitary damage from it. I now have a secondary hypothyroid condition which only developed after the hemorrhage (probably because of pit gland damage from the hemorrhage) and I am waiting to go for further testing to see if I have other hormone deficiencies. It is quite possible, that I will live with the effects of "doctor convenience" for the rest of my life. Hopefully only my thyroid function was compromised and not other hormones. Luckily both children are fine and my fertility was spared from the hemorrhage. But, I am not the mother I would have wanted to be as I suffer frequently from fatigue that keeps me from a lot of activities I would otherwise have done. For my second delivery, the doctor had ordered the pitocin to be increased at twice the rate it had been the first time despite the fact that we had discussed using as little as possible. I fought that and won - sort of - I was still up to 28 in dose by the end, but overall we used less than 1 bag for the whole day instead of 3 like the first time. I was told by two different doctors at that practice that pitocin can't cause a postpartum hemorrhage - I directed them to the package insert for the drug - how stupid. And, they couldn't understand exactly why I would want to avoid having a second postpartum hemorrhage and further possible damage to my pituitary gland. And, of course, the doctor was very upset that I delivered at 11pm instead of 4 or 5 pm as she would have liked. I swear, I don't ever want to have another child again. And, btw, they would have given me cytotec for this second delivery, but I said no to that since I had educated myself more for this second delivery. Sorry about the length, but I'm very passionate, and I have to say, somewhat bitter about the whole thing.
Its a great book here is his web site: www.bornintheusahome.org and I think you all should check this out:
www.birthconference.org (not your run of the mill birth conference this time around - watch out!)
Also check out Tammey Dickerson, a legal nurse. Tammey was able to get cytotec regulated at one hospital and she's a good person to start with to begin curbing and abolish use of cytotec.
http://dickersonlegalnurseassociates.com/id1.html
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