Enacting change in OB

I finally started reading "Pushed" by Jennifer Block. I've had this book in my library of books to be read for a few months now. Like Marsden Wagner's book, "Born in the USA", this book looks at the medical mis-management and downward slope that our healthcare system is doing all in the name of progress in obstetrics. I found myself nodding my head, once again (like when I read "Born in the USA"), at what I'm seeing in the OB field.

• Active management of labor
• Overuse of induction agents
• Overuse of c-sections
• Denial of a woman's right to VBAC
• Use of cytotec without true informed consent
• Lack of true informed consent about ANYTHING in obstetrics
• "Pushing the pit" to the point of fetal distress
• OB's "saving the day" by performing emergent c-sections - caused by their own mis-management of care and messing with mother nature
• Non-baby friendly hospital care
• Separation of mother and baby
• Putting hospital policies above all else
• Fear of litigation
• Not listening to what women want
• Not asking what women want
• High epidural rates
• Non-support of laboring women by competent birth attendants
• Doulas being laughed/forced out of the labor ward

I could go on and on, but I think I'll stop for now.

I was chit-chatting last night with a fellow nurse who believes in the power of a woman's body, natural childbirth, birthing without fear, etc. We both feel sometimes that we are powerless in our position as L&D nurses to enact change to the flawed "baby factory" system that we work in. But, it's not always true - we CAN enact and enable change - one mother at a time. One baby at a time. One birth at a time.

We can speak up for what our patient (mother-to-be) wants and desires for her birth experience - because it truly is HER BIRTH EXPERIENCE. We educate women on the fact that cytotec is not FDA approved for induction of labor, when we have them read and sign the consent prior to it's administration. Yes, sometimes (more often than not) the woman says she doesn't care about it - she just wants her baby delivered NOW. But it's our position, as L&D nurses, to educate women to the best extent that we can, about what their doctor/midwife wants to do to them. They have every right to know.

We advocate on behalf of women, to prevent them from falling victim to the cascade of labor interventions. We refuse to "up the pit" to the point of fetal distress. We provide as best as we can, one on one physical and emotional support during the labor process. We encourage women by telling them "you ARE doing it!" when women say "I can't do it".

We work directly in the "baby factory" and help women, one woman at a time.

We join councils at work to enact changes to policies and procedures.

We review literature and studies for the best care of women and their babies.

We work our asses off, to the point of physical exhaustion, to help a woman birth her baby in the way she wants it to happen.

We shoo the obstetrician from the room, when he/she brings negativity into the room by saying things to us like "she won't be able to do this, she's going to be a c-section." Then we turn around to the woman and tell her, "you CAN and WILL do this - let's prove your doctor WRONG!"