I’m pretty new at my job. I only worked for 6 months before I had a baby of my own (the ultimate work-related research) and went off on a year of maternity leave. I’ve been back at work for a couple of months now, and I confess, I have anxiety before every single shift. I learn something new every day, and try my best to build on my knowledge and glean wisdom from those with much more experience. I love seeing babies be born, and I love helping their mamas give birth to them. I find myself drawn to conversations, movies, news articles – really anything to do with birth stories. And in the past few years, as I have become more interested and passionate about this, I have noticed an underlying tension between the “medical” world of birth and the “natural” world of birth.
Over the weekend, I had a conversation with some fellow nurses on this topic. We lamented over the stories we had heard regarding non-hospital births in which scopes of practice were overstepped, and moments where unfortunate advice was given. In the course of this discussion we also admitted that the “other” group probably have some not great stories about us. We too are not perfect. As a coworker and I rode the elevator together at the end of our extra long night shift (thanks Daylight savings), she told me it made her sad that there wasn’t better understanding and cooperation between “us” and “them” because wouldn’t it be great if we all understood our roles, respected each other, and could work together? We wondered, what needs to happen in order to make that happen?
I’ve been thinking about that question the last few days, and I can’t help but wonder if part of the problem is just a fundamental misunderstanding of how each “group” feels and thinks about labour and birth. When I watch documentaries about the medicalization of birth, or read articles by the “other” group on hospital births, I sometimes think to myself, This isn’t how I feel about birth. This doesn’t represent my work at all.
Look, I’ll be the first to admit that I am not an expert on this topic, so I don’t want to put words into other people’s mouths. I don’t want to make assumptions or stereotype or make generalizations about groups of people. I’m just saying that sometimes the “medical” world of birth and the “natural” world of birth can clash. And I think that if we actually sat down and talked about it, we might find that we agree on a lot more than we don’t.
Why does this even matter? It matters because of all you pregnant women out there (and there seems to be a lot of you right now), who are caught in the middle of this battle, trying to make a decision about what kind of birth you want to have. So, here are a few things I want you to know about how I do my job:
- I want you to know that I care about you and your baby. Sometimes I come into your life hours before your baby’s birth, and have time to get to know you. Sometimes I come in right before you deliver and have a full view of your most intimate private places before you have even heard my name. Sometimes I have to leave before I get to meet your baby (which kills me every time, cause I hate missing out on it!). No matter what the scenario I care about what happens to you, and I’m going to work hard to make this as great an experience as it can be.
- I don’t expect you to have a baby the way I would want to have my own. If you come in with a ten page birth plan, I will read every word. If you come in and your birth plan is to get the baby out by any means necessary, I’ll do my best to guide you through that.
- If you don’t want to have an epidural, then I don’t want you to have one. I will gladly rub your back, hold the shower head on your tummy, help you keep your balance on your birthing ball, or let you squeeze the life out of my fingers while I remind you to breathe. I will do this for hours if that what it takes to help you get through a birth with no pain medications. Please understand that if I suggest an epidural at any point, it’s not because it will be less work for me, it’s because I think there may be a real benefit for you specifically in getting one. Maybe your baby’s heart rate is indicating it’s not coping well with labour, and I am worried about you needing to have a c-section. Maybe I’m concerned about you getting so exhausted that you won’t have any energy left to push when the time comes, and that could be dangerous for you and your baby. If you don’t want an epidural, I won’t suggest one unless I think it’s necessary.
- If you want to have an epidural the second you feel the slightest tinge of a contraction, I want to get you one. I will gladly start your IV, wake up a surly anesthesiologist at 4 am, monitor your blood pressure a billion times, and keep my eyes glued to your baby’s heart rate for any signs of distress. Please understand that if you are in early labour, it’s not healthy for you to have an epidural yet. On the other hand, if you are on the verge of pushing out your baby in the next three minutes, there just may not be time for an epidural to actually take effect before your baby is born. In either case, I will do whatever I can to help you get through the pain.
- I don’t want you to have to have a c-section. In fact, no one does. I feel like there is this idea out there that C-sections are easier for us. They aren’t. They require a higher nurse to patient ratio, which leaves fewer nurses to cover the labouring patients. The recovery time for a c-section patient is more work intensive for nurses. And we are all too aware that the recovery for you after a C-section is harder. We honestly think about the fact that it will be a while before you can lift anything, or sit up in bed like a normal person. No one wants for you to have to have a C-section. But the nurses I work with will unearth from inside them a superhuman speed at the first sign of trouble for you or your baby, because they know that every second counts when it comes to your baby’s life. I’ve seen a woman with a baby in trouble go from the assessment room to the OR and the baby delivered in less than 8 minutes. I don’t want you to have a c-section, but I will hand you over to the OR team in a heartbeat if it means saving your baby’s life.
- Every single shift, as I drive from my house to the hospital, I pray for you. I don’t know you yet. I haven’t yet heard how complicated or uncomplicated your pregnancy has been. I have no idea if this is going to be a breeze or if I am going to spend the next three hours before your baby is born with my heart in my throat and my mind racing. But I pray for you. I pray for health and safety for you and your baby, and I pray that God would give me and the doctors I work with wisdom to be able to make the right decision at the right time.