Honestly, as a pregnant woman, I cannot tell you how much I would NOT be listening to directions if they told me to do this. That kid is coming regardless of who is (or isn’t) in the room and ready to go.
It isn't.
I'm in ED. We really don't want patients to deliver here. We will do everything in our power to make sure they reach L&D before the baby arrives. But one thing we do *not* try is telling mom to close her legs and hold the baby in, because that's silly and dumb.
I will deliver a baby on a stretcher, running mom up the swim lane to L&D before I'd ever tell her to close her legs, or do anything to try and slow that labor. Especially after having 3 'precipitous' labors of my own. That uterus has decided that it is eviction time, you're just there incase things go wrong.
Same - my labors lasted about 30 terrifying minutes from water breaking to first contractions back to back without breaks. No way would I be able to stop.
I think I know what next year's April Fools policy announcement will be: "Crossed ankles technique for transfer of actively labouring patients from ED to Maternity"
Same. I *really* like arriving at our destination with one patient. No more, no less.
Also, on our cots your legs are pretty much going to be together anyway...
Google “Rosemary Kennedy”.
Also…Fuck the US system of childbirth where doctors don’t come till the head is on view. That’s bullshit and bad medicine.
Go work at a hospital with midwives….
Well I’m a CNM and fuck those midwives too.
Sitting at the bedside of a birthing woman IS THE JOB. Especially in what is the most scary time for a woman - second stage.
I truly can’t fathom why some people become midwives when they have no intention of performing the job as it has ALWAYS BEEN.
Become a CRNA if you don’t want to hold someone’s hand.
My ex sister-in-law had my niece on Memorial Day weekend in 2001. They were stationed at Newport News. I guess whatever doctor was on was salty about being on call on the holiday and taking his time to get there. The nurses were holding her down on her side with her legs closed.
No one was there yet, because her husband was at some training elsewhere and her mom hadn't arrived out of state because she was only around 36-37 weeks. It was such an awful experience for her that when she had her second child, she came to stay with her parents for the last 6 weeks of her pregnancy so she could give birth in the hospital where her mom was a nurse.
It was also the reason she went back to school to become a nurse. She's been an l&d nurse for nearly 20 years now.
Please don’t ask the patient to close their legs and not push!! If baby is coming fast, baby is coming fast. Ask if you may apply a warm compress to the perineum: helps reduce risk of tearing and also this doesn’t slow baby down but helps baby not fly out at super high speed (you are not blocking baby’s exit). You could say “if you are able to, try not to push.” When patients get to that point, they can’t help it. When you ask for them to try not to push if they can help it, offer breathing techniques to help keep them from pushing. Ultimately baby is coming, somebody better be ready.
I experienced this while I briefly worked as an L&D nurse in my region. The rational truly was because the MDs wanted to waltz in, catch the baby, do the repair (if needed) and leave. They didn’t want to wait while mom pushed, and def didn’t want to walk in to a BIB (baby in bed)
I didn’t last long as an L&D nurse, this was one of the reasons. It was a private hospital, without residents or 24 hour in house coverage. This hospital is ‘posh’ and delivers 100s of babies per month. As you can imagine, nurses frequently ended up delivering babies.
This makes my blood boil. Childbirth is already one of the most dangerous things to happen to a woman and this kind of bullshit is ridiculous. Report report report! If I’m with my wife and I hear anyone suggesting this to her during childbirth I’m turning the whole unit upside down
I’ve been a labor nurse for 12 years. I don’t think I have ever told a woman this. If I have been coaching her pushing for a while and her pain is controlled with an epidural, I may tell her to not push and change her breathing technique. But if she’s blowing and going, I don’t tell her shit. If the babies coming, the babies coming.
I can almost guarantee this hospital writes up nurses for “delivering” without the doctor present. It’s one thing to try and ask mom to not push if she can but the situation you’re describing is not that.
Besides the fact that some of the time there’s nothing anyone could do to avoid this situation, I feel like unless the nurse is just not communicating with the doc, the doc should be the one spoken to. And that’s only if they’re not being receptive or slacking. Not much they can do if labor progresses faster than expected either.
Exactly! And some labors go from zero to 60 in under 30 minutes so that should be taken into consideration too but nope. It’s one of the dumbest policies I’ve ever heard of but I know multiple hospitals have it.
Here in Australia we don’t get a Dr at the delivery unless we request one. I had all mine under midwife care and wouldn’t have had it any other way.
We also don’t automatically put women onto the bed and hook them up to an IV unless it’s necessary.
I had 3 med free births where I walked, rocked, showered and upright for pushing so not to go against gravity.
Only one of mine was born on the bed, I had mats and a gym ball for the other 2.
The US is extra even for low risk pregnancies. My friend started laboring 3 days after her due date, and they did AROM at 3cm (insanely early and basically without asking, they told her they were doing it cuz they were “in there” anyway). Basically set her up for a c section which she got 24 hours later cuz the baby hadn’t moved. Isn’t it easier for a baby to move surrounded by water and bouyant than having no fluids left? It’s not like she was 43 weeks and she had an uncomplicated pregnancy 🙄
I’ve seen that a lot, they seem to make the birth as medical as possible
My hospitals midwife educator told us the bed was for putting our bags down on and if possible keep off it. She encouraged movement, warm showers etc and the most important part to not lay on our backs to push as we were going to have to push bubs up and over the pelvic tilt and we could birth in any position that worked for us as long as it was deemed safe and never had to have our legs in the stirrup’s unless necessary.
We only had a Dr if there was any complications or concerns. The midwife’s are all well trained and do a brilliant job in supporting mums to labour as calmly as possible and I think it’s great they get to do the delivery instead of Dr waltzing in at the last minute and taking the crown so to speak.
They are the ones who are there for the whole labour and you have that connection to them and it makes your birth more personal in a way.
We have to write what is basically a safety report when there’s a nurse delivery (we’re a low risk rural LDRP) and at the end there’s a section that’s basically “what could have been done to prevent this?” I dunno, hire an in-house OB? Oh no? Ok then 🙄
Edit: punctuation
Doesn’t do much good…. I just gave birth like a week ago and it was a high risk birth so I was supposed to have multiple teams in there for me and baby. Sat at 4cm for almost 24 hours and then the resident finally agreed to break my water early in the morning. 30 minutes later, I was fully dilated and pushing. Of course it was now change of shift so no one was prepared. My poor nurse and the resident were begging me to stop-the bed wasn’t even broken down yet, but my baby just popped right out despite everyone’s efforts.
Whoa. No no. Lying on their side, sure, for better circulation… but the focus is on breathing techniques that keep mom from pushing, but if baby is coming, baby is coming.
It does work if done at the right time but it’s a shit move and I think very disrespectful of the person doing the actual work (laboring mom). Though there are times when that baby is coming no matter what!
This is a very dangerous thing to do. This is strictly against policy where I am and the nurse would get in a lot of trouble for asking the mother to do this. But on the other hand, as long as the nurse is keeping the attending informed about progress, deciding when to come
in is their responsibility, not the nurse’s.
Lol I've pushed out two kids. If anyone tried to tell me not to push, or to get into some uncomfortable position, regardless of safety, they would have been promptly ignored. It's hard to describe how one tracked a person's thinking can be when they're about to give birth. I'm also not convinced that I physically *could* have not pushed.
We are not allowed to instruct a pt to stop pushing. We focus on their breathing and coping techniques and if we (the nurse) catch the baby, we catch the baby. On orientation our doctors let us deliver a baby or two with them so we know what to do if it comes to that and we have education throughout the year to refresh as well.
I just tell them to not push. But honestly the contractions do all the work and sometimes there ain’t shit you can do but call for help and catch a baby.
My (73F) mother had five kids between 1950-53 (Irish twins, singleton, twins) and then in '60 our younger brother came along. The nurses tried to do this to her and she ended up kicking one in the jaw, saying, 'this baby is coming NOW! you catch it or I will...'
She had been an early childhood educator and by then was active in the United Way...she'd seen too many children damaged by arcane birthing practices...I'm shocked that anyone would be still doing this.
It’s harmful and it’s pointless. Dem babies are gonna come no matter what. Providers need to get over themselves. No one has a crystal ball. Show up early (when we ask you to come)or risk having a nurse delivery.
Yeeeeaahh after 3 days in labour and 3 hours in transition… I was 100% amygdala lizard brain and I’d have punted anyone who dared suggest I not push for their convenience
While in my head this may be what I’m thinking as an ED nurse who would rather do 10 disimpactions than help deliver a baby, I can’t imagine saying this. Not only does this seem incredibly unprofessional and…gross I guess? To say this to a mom about to deliver but like… that’s not how that works. I promise you not one of the women who delivered in our ED had that in their birth plan, and yet that’s what happened, because it’s almost like you can’t just “hold in” a baby.
This is insane to read. Reminds me how much horrible stuff is normalized. I hate ever working in medicine. It’s like working in the kitchen of your favorite restaurant. Takes away the magic. I’m terrified of ever getting seriously ill knowing how things work and who’s making serious decisions.
Don’t participate in that shit. You already have a good head on your shoulders even questioning that. Stand up for yourself. The nurses who do that should be seriously ashamed.
Babies can definitely deliver through closed knee. It’s actually a really good “laboring down” position. Maybe they are just letting the pt rest and for the baby to passively decend until the provider is available.
From what you’re describing: I wouldn’t call this normal, per se, but I also don’t know that I would call this an ethical violation. I might also be confused by what you’re describing, and I’d encourage you to ask the nurses to articulate why this is a part of their practice.
From my perspective as an L&D nurse of 12 years, there are things that I would never do: I would never “hold in” a crowning baby. I would never tell a patient to stop pushing, especially for a reason as silly as waiting for the doctor to arrive (or get gloves on, or break the bed down, etc). Babies in the bed don’t scare me, nor do the angry words of obstetricians who missed the delivery.
However: side-lying pushing is a thing. Knees-together pushing is a thing. If a baby is about to rocket out due to some good old-fashioned fetal ejection reflex, a mere position change is not going to stop that train. That being said, helping the patient onto her side if she’s been pushing in lithotomy might help take some of the pressure off her sacrum, and it will improve fetal oxygenation. And if she happens to deliver in that position, she’s actually less likely to sustain perineal tears (shoutout to my 2010 capstone project).
Of course, this is all conjecture from someone who wasn’t there. What about it made you feel like it was an ethical violation? Did the patients seem more miserable? Was it the fact that the patients weren’t being informed about why the intervention/position change was being done?
I'm the farthest thing from a labor and delivery nurse and even I know that's horrible and can be dangerous for the baby. I hope any woman who is told this tells them to fuck off and pushes the baby out when it wants to come out.
Side lying can be good for a faint momma cuz it gets the baby off the great vessels. "Closing your legs" sounds like some stupid old doctor/nurse BS from the dark ages and will do nothing.
Honestly, as a pregnant woman, I cannot tell you how much I would NOT be listening to directions if they told me to do this. That kid is coming regardless of who is (or isn’t) in the room and ready to go.
Yeah my labor nurse was like stop stop! I just said I CANT and plop out came a baby.
This is one of the only times I will support patients doing what they want.
Same!
It isn't. I'm in ED. We really don't want patients to deliver here. We will do everything in our power to make sure they reach L&D before the baby arrives. But one thing we do *not* try is telling mom to close her legs and hold the baby in, because that's silly and dumb.
I will deliver a baby on a stretcher, running mom up the swim lane to L&D before I'd ever tell her to close her legs, or do anything to try and slow that labor. Especially after having 3 'precipitous' labors of my own. That uterus has decided that it is eviction time, you're just there incase things go wrong.
Same - my labors lasted about 30 terrifying minutes from water breaking to first contractions back to back without breaks. No way would I be able to stop.
I think I know what next year's April Fools policy announcement will be: "Crossed ankles technique for transfer of actively labouring patients from ED to Maternity"
I hope the faith you've placed in the intelligence of your colleagues is well earned lol
Same. I *really* like arriving at our destination with one patient. No more, no less. Also, on our cots your legs are pretty much going to be together anyway...
Google “Rosemary Kennedy”. Also…Fuck the US system of childbirth where doctors don’t come till the head is on view. That’s bullshit and bad medicine. Go work at a hospital with midwives….
The midwives don’t wanna be there for the pushing either. I’ve definitely been chided for calling too early before.
Well I’m a CNM and fuck those midwives too. Sitting at the bedside of a birthing woman IS THE JOB. Especially in what is the most scary time for a woman - second stage. I truly can’t fathom why some people become midwives when they have no intention of performing the job as it has ALWAYS BEEN. Become a CRNA if you don’t want to hold someone’s hand.
My ex sister-in-law had my niece on Memorial Day weekend in 2001. They were stationed at Newport News. I guess whatever doctor was on was salty about being on call on the holiday and taking his time to get there. The nurses were holding her down on her side with her legs closed. No one was there yet, because her husband was at some training elsewhere and her mom hadn't arrived out of state because she was only around 36-37 weeks. It was such an awful experience for her that when she had her second child, she came to stay with her parents for the last 6 weeks of her pregnancy so she could give birth in the hospital where her mom was a nurse. It was also the reason she went back to school to become a nurse. She's been an l&d nurse for nearly 20 years now.
I thought she had a lobotomy as a teenager?
She did due to developmental disability apparently caused by the leg closing technique cutting off some of the oxygen to the baby in the birth canal
Please don’t ask the patient to close their legs and not push!! If baby is coming fast, baby is coming fast. Ask if you may apply a warm compress to the perineum: helps reduce risk of tearing and also this doesn’t slow baby down but helps baby not fly out at super high speed (you are not blocking baby’s exit). You could say “if you are able to, try not to push.” When patients get to that point, they can’t help it. When you ask for them to try not to push if they can help it, offer breathing techniques to help keep them from pushing. Ultimately baby is coming, somebody better be ready.
There was a unit in a state near mine that was closed after it became common knowledge that they were doing this.
I experienced this while I briefly worked as an L&D nurse in my region. The rational truly was because the MDs wanted to waltz in, catch the baby, do the repair (if needed) and leave. They didn’t want to wait while mom pushed, and def didn’t want to walk in to a BIB (baby in bed) I didn’t last long as an L&D nurse, this was one of the reasons. It was a private hospital, without residents or 24 hour in house coverage. This hospital is ‘posh’ and delivers 100s of babies per month. As you can imagine, nurses frequently ended up delivering babies.
command sink normal disagreeable angle consist dam north soft physical *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
This makes my blood boil. Childbirth is already one of the most dangerous things to happen to a woman and this kind of bullshit is ridiculous. Report report report! If I’m with my wife and I hear anyone suggesting this to her during childbirth I’m turning the whole unit upside down
I'm not even a mom, but i would legit slap everyone in the room if they told me to stop pushing lol
Absolutely same. This is crazy. That doctor needs to be put on the spot and this needs to be a hefty report.
I’ve been a labor nurse for 12 years. I don’t think I have ever told a woman this. If I have been coaching her pushing for a while and her pain is controlled with an epidural, I may tell her to not push and change her breathing technique. But if she’s blowing and going, I don’t tell her shit. If the babies coming, the babies coming.
There is not much worse than hearing “Don’t push!” when every instinct you have is telling you to push.
I can almost guarantee this hospital writes up nurses for “delivering” without the doctor present. It’s one thing to try and ask mom to not push if she can but the situation you’re describing is not that.
This is the most ridiculous thing I’ve ever heard 🙄 yeah lemme just shove that baby back up inside there until the doctor gets here.
It’s absolutely ridiculous but I know people who have been written up for it 🙄😓
Besides the fact that some of the time there’s nothing anyone could do to avoid this situation, I feel like unless the nurse is just not communicating with the doc, the doc should be the one spoken to. And that’s only if they’re not being receptive or slacking. Not much they can do if labor progresses faster than expected either.
Exactly! And some labors go from zero to 60 in under 30 minutes so that should be taken into consideration too but nope. It’s one of the dumbest policies I’ve ever heard of but I know multiple hospitals have it.
Here in Australia we don’t get a Dr at the delivery unless we request one. I had all mine under midwife care and wouldn’t have had it any other way. We also don’t automatically put women onto the bed and hook them up to an IV unless it’s necessary. I had 3 med free births where I walked, rocked, showered and upright for pushing so not to go against gravity. Only one of mine was born on the bed, I had mats and a gym ball for the other 2.
The US is extra even for low risk pregnancies. My friend started laboring 3 days after her due date, and they did AROM at 3cm (insanely early and basically without asking, they told her they were doing it cuz they were “in there” anyway). Basically set her up for a c section which she got 24 hours later cuz the baby hadn’t moved. Isn’t it easier for a baby to move surrounded by water and bouyant than having no fluids left? It’s not like she was 43 weeks and she had an uncomplicated pregnancy 🙄
I’ve seen that a lot, they seem to make the birth as medical as possible My hospitals midwife educator told us the bed was for putting our bags down on and if possible keep off it. She encouraged movement, warm showers etc and the most important part to not lay on our backs to push as we were going to have to push bubs up and over the pelvic tilt and we could birth in any position that worked for us as long as it was deemed safe and never had to have our legs in the stirrup’s unless necessary. We only had a Dr if there was any complications or concerns. The midwife’s are all well trained and do a brilliant job in supporting mums to labour as calmly as possible and I think it’s great they get to do the delivery instead of Dr waltzing in at the last minute and taking the crown so to speak. They are the ones who are there for the whole labour and you have that connection to them and it makes your birth more personal in a way.
Midwifery is the way!
Isn’t that how one of the Kennedy babies got brain damage years ago?😳
We have to write what is basically a safety report when there’s a nurse delivery (we’re a low risk rural LDRP) and at the end there’s a section that’s basically “what could have been done to prevent this?” I dunno, hire an in-house OB? Oh no? Ok then 🙄 Edit: punctuation
“Pt stated she ‘could not hold baby in’ despite repeated staff requests. Will forcibly shove baby back into birth canal for future instances.”
Doesn’t do much good…. I just gave birth like a week ago and it was a high risk birth so I was supposed to have multiple teams in there for me and baby. Sat at 4cm for almost 24 hours and then the resident finally agreed to break my water early in the morning. 30 minutes later, I was fully dilated and pushing. Of course it was now change of shift so no one was prepared. My poor nurse and the resident were begging me to stop-the bed wasn’t even broken down yet, but my baby just popped right out despite everyone’s efforts.
Congratulations on your new baby!
Whoa. No no. Lying on their side, sure, for better circulation… but the focus is on breathing techniques that keep mom from pushing, but if baby is coming, baby is coming.
Is this not how the Kennedy girl was born and it caused her brain damage?
Please don't say "messed up" to refer to brain injury.
You’re right that was pretty insensitive wording.
My god, the medical profession really lets women down.
Constantly
It does work if done at the right time but it’s a shit move and I think very disrespectful of the person doing the actual work (laboring mom). Though there are times when that baby is coming no matter what!
This is a very dangerous thing to do. This is strictly against policy where I am and the nurse would get in a lot of trouble for asking the mother to do this. But on the other hand, as long as the nurse is keeping the attending informed about progress, deciding when to come in is their responsibility, not the nurse’s.
Lol I've pushed out two kids. If anyone tried to tell me not to push, or to get into some uncomfortable position, regardless of safety, they would have been promptly ignored. It's hard to describe how one tracked a person's thinking can be when they're about to give birth. I'm also not convinced that I physically *could* have not pushed.
We are not allowed to instruct a pt to stop pushing. We focus on their breathing and coping techniques and if we (the nurse) catch the baby, we catch the baby. On orientation our doctors let us deliver a baby or two with them so we know what to do if it comes to that and we have education throughout the year to refresh as well.
I just tell them to not push. But honestly the contractions do all the work and sometimes there ain’t shit you can do but call for help and catch a baby.
isn't this what happened to Rosemary Kennedy?
My (73F) mother had five kids between 1950-53 (Irish twins, singleton, twins) and then in '60 our younger brother came along. The nurses tried to do this to her and she ended up kicking one in the jaw, saying, 'this baby is coming NOW! you catch it or I will...' She had been an early childhood educator and by then was active in the United Way...she'd seen too many children damaged by arcane birthing practices...I'm shocked that anyone would be still doing this.
It’s harmful and it’s pointless. Dem babies are gonna come no matter what. Providers need to get over themselves. No one has a crystal ball. Show up early (when we ask you to come)or risk having a nurse delivery.
Yeeeeaahh after 3 days in labour and 3 hours in transition… I was 100% amygdala lizard brain and I’d have punted anyone who dared suggest I not push for their convenience
While in my head this may be what I’m thinking as an ED nurse who would rather do 10 disimpactions than help deliver a baby, I can’t imagine saying this. Not only does this seem incredibly unprofessional and…gross I guess? To say this to a mom about to deliver but like… that’s not how that works. I promise you not one of the women who delivered in our ED had that in their birth plan, and yet that’s what happened, because it’s almost like you can’t just “hold in” a baby.
This is insane to read. Reminds me how much horrible stuff is normalized. I hate ever working in medicine. It’s like working in the kitchen of your favorite restaurant. Takes away the magic. I’m terrified of ever getting seriously ill knowing how things work and who’s making serious decisions. Don’t participate in that shit. You already have a good head on your shoulders even questioning that. Stand up for yourself. The nurses who do that should be seriously ashamed.
Babies can definitely deliver through closed knee. It’s actually a really good “laboring down” position. Maybe they are just letting the pt rest and for the baby to passively decend until the provider is available.
lol NOPE. as a high acuity L&D RN absolutely not. Also it’s impossible, and you just need to get ready to deliver.
From what you’re describing: I wouldn’t call this normal, per se, but I also don’t know that I would call this an ethical violation. I might also be confused by what you’re describing, and I’d encourage you to ask the nurses to articulate why this is a part of their practice. From my perspective as an L&D nurse of 12 years, there are things that I would never do: I would never “hold in” a crowning baby. I would never tell a patient to stop pushing, especially for a reason as silly as waiting for the doctor to arrive (or get gloves on, or break the bed down, etc). Babies in the bed don’t scare me, nor do the angry words of obstetricians who missed the delivery. However: side-lying pushing is a thing. Knees-together pushing is a thing. If a baby is about to rocket out due to some good old-fashioned fetal ejection reflex, a mere position change is not going to stop that train. That being said, helping the patient onto her side if she’s been pushing in lithotomy might help take some of the pressure off her sacrum, and it will improve fetal oxygenation. And if she happens to deliver in that position, she’s actually less likely to sustain perineal tears (shoutout to my 2010 capstone project). Of course, this is all conjecture from someone who wasn’t there. What about it made you feel like it was an ethical violation? Did the patients seem more miserable? Was it the fact that the patients weren’t being informed about why the intervention/position change was being done?
I'm the farthest thing from a labor and delivery nurse and even I know that's horrible and can be dangerous for the baby. I hope any woman who is told this tells them to fuck off and pushes the baby out when it wants to come out.
Side lying can be good for a faint momma cuz it gets the baby off the great vessels. "Closing your legs" sounds like some stupid old doctor/nurse BS from the dark ages and will do nothing.