I came on to shift with the nurses talking about one particular patient and moaning and groaning about it. She was a hypnobabies birther and had come in with a birth plan. Usually those will solicit groans from nurses:) So, I immediately spoke up and said I would take her, to the surprise of all present. I think many were grateful:)
So I read through the plan, which seemed perfectly fine to me, but some of it was drawing comments from the other nurses. Here's the two things that bothered me most....one of the doctors there started talking about how some of her patients who start requesting things like what this couple was bothered her, because she didn't feel like that was her job and it shouldn't be the job of her nurses. Mostly that just bothered me because what some women request is just the right to have labor support, and move, and receive help to make it through it. I certainly think that's in my job description along with making sure the mom and baby are safe.
Another thing, though, is what really bothered me. The mom's water had broken, and so of course infection is an issue. The midwife that I was working with sat down with them and talked to them about what she felt they should do. I felt like she did a very good job with this and the decision to use pitocin was well thought out and discussed with the patient. So, we started pitocin, but the patient wanted it to be slow. I walked out of the room to tell the midwife this. When I called the midwife, she kind of balked at that. She did not want to do the pitocin slow. So she told me to just turn it up without them knowing.
And this is what bothered me....do we have the right to force a woman's body to do something against her will, without even telling her...NO! We have no right to assume that responsibility. Regardless of the reason. I choose to disregard this counsel and let the woman know everything I was doing and why, and asked her permission, but the idea that this medical professional would take a woman's trust like this and throw it out the door just tears me up inside. It tears me up the way people judged her and her decisions and it tears me up the way her decisions could have easily been tramped over without her knowledge and without her consent.
This is not the first time something like this has happened. I have seen episiotomies given without consent or knowledge until after it is done. Pitocin is started and increased without a woman understanding why, or the doctor even taking the time to discuss it with her. I think this is the first time I have been blatantly asked to do something behind a mother's back, though, and this is what is so hard for me to process.
Because what we are doing, is tearing down a sacred trust between caregivers and patients. A trust that a woman gives to us. She says I am placing myself, my body, and my baby in your hands, and we have no right to lie to them. We have no right to talk about them behind their backs or discredit them, or make fun of them. Even if we feel like their decisions are wrong and we are right. We have no right.