Toilet Baby?

[apikailaa]

Hey everyone! I just had my first pp visit! I got to talking to my client and we brought up several harsh, weird, just crazy things that the nurses had said. A few of them I will never forget! Here's a list:
1) My client in January was told she was not allowed to squat because squatting causes swelling in the genitals and makes it more difficult to push the baby out.
2) Squatting is "uncivilized". We are human beings, not animals.
3) Laying on the table with people holding your legs is just like squatting, it increases the opening of the pelvis. (But you're still on your back right? I mean what about gravity?)
4) You're not allowed to go to the bathroom towards the end of labor. No one would want a "toilet baby". That's just gross!

It goes on and on!!! Anyone have any others to share? Are any of these valid? (Not in MY eyes!) Sorry if there's already a post like this. I couldn't find one!

[JerseyJess]

Let's see with reason #1 I don't know about the swelling BUT I have read that squatting makes your more likely to tear-I guess the gravity makes it harder to gradually push out baby's head?

Not even going to touch #2-that's insane! We ARE mammals-'nough said.

#3 I've heard several times-from CNMs during births. I agree with you, it's not the same, gravity is not in effect AND your putting pressure on your coccyx which makes it harder for it to move out of the way during the birth (as someone who's injured hers twice during births I can say that I much preffered being upright and off my back/butt)

#4 I've had many clients begin pushing while on the toilet-it makes it easier as we are conditioned to relax/release our pelvic floor muscles when on the toilet- and usually there's plenty of time from crowning to birth to get some distance between mom and toilet water...

[CvilleDoula]

I think the person who said those things is completely brain dead. There's nothing "gross" about pushing on the potty. Most of the time when women do that, it's to get the baby to engage, not to completely give birth. Even still, what's so gross about it? Not like there's a "floater" in the toilet that the baby will end up in lol

[earthgirl]

1. During a Cytotec induction the nurse said, (when I brought up it not being FDA approved for inducing) "It's perfectly safe, the only reason it's not approved is b/c it would cost too much money to go through the approval process.
2. Another nurse said that there are no side effects to the epidural, other than immobility!

[RosyDoula]

Yeah, they make up tons of crap. I guess its to convince the mothers to do what the doctors want them to do that is not evidence based but for their convenience. Or maybe some really do believe it.

One that I've heard three times now, at three different hospitals is that its better to birth laying on the bed at a 45 degree angle so the baby can come under the pubic bone. If you are upright, the baby may not come out because he or she will shove his or her head against the bone or won't come around the corner. *sigh*

[helpinghands]

I WISH that health (s)care providers would not spout such ignorance.. ((sigh)).. now I am going to have to go change my MOOD from Mellow to..um..Cheeky..

P.S. I DID have my own personal toilet baby..so, um.. it can happen. He just barreled out..I swear.. And it was a huge blessing that he did not fall in that cess sludge in the toilet water..sooo gross!! Most mamas won't let their babies call in the toilet..so.. no harm, no foul. If it can get the baby out with less trauma than what the hospital can do..why not let a mama push on the toilet... (??) They make up such utter crap at will and soooo many families just believe it because it comes from drs/nurses, whatever.. (it is insane!)

[UtahDoula]

I almost caught a toilet baby once. In the hospital. Mom was having her 5th baby. All 4 of her previous labors had followed the same pattern. Labor begins with water breaking. Mild contractions, nothing much happening for 5-6 hours, then BOOM! 3 cm to baby in arms in 30-45 minutes. So it had been about 6 hrs & 30 minutes since her water broke, 25 minutes since she was checked at 3 cm, and about 17 minutes since labor changed dramatically. Mom was pushing, full on pushing, on the toilet. I had called the nurse several times over the intercom, she FINALLY deigned to come in the room, but not the bathroom, and refused to believe me. The conversation went like this:
Me: Remember, she has a history of slow labors dramtically changing to fast labors. I think you should go take a look at her.
Nurse: Not today, she doesn't. She's only 3 cm. No way is she pushing. (Walks out)

I was ticked. Big time. Dad was panicking. I opted to send him for the doctor. Doc came in and yelled at mom for pushing on her undilated cervix, ("You're gonna make it swell and end up with a cesarean! You're gonna rip your cervix and I really don't want you to do that to me today") then he left. (To HIM? tearing her cervix does anything to HIM? Whatever!)

The ONLY reason there was staff there for the actual birth was a nursery nurse head mom scream "THE HEAD!" and popped her head in to see if anyone needed help. I explained baby was coming and no one would believe me. She ran to the L&D nurses station & raised a ruckus, sending half the shift into the room. Doc caught baby ungloved, there wasn't time.

Everyone blamed me & the mom. Couldn't possibly have been their own arrogance that they knew better than the lowly doula....

[DL]

3) Laying on the table with people holding your legs is just like squatting, it increases the opening of the pelvis. (But you're still on your back right? I mean what about gravity?)

I wouldn't say it's "just like squatting", but could she have been talking about the McRoberts maneuver? If baby has shoulder dystocia, it's one of the positions that can be used. Mom is put flat on her back and legs are spread really wide with knees drawn up over her abdomen towards mom's ears as much as possible. I prefer h's & k's, myself, but I've seen McRobert's work rather well a few times. Since she has probably seen it work to help free a stuck baby, she may be confusing her thinking of the pelvis widening with the pelvis actually tilting. From my understanding, McRoberts tilts the pelvis and straightens the sacrum to help free an anterior shoulder, but it does not necessarily widen it. I bet this is why she is confused, but you'd think that she would have studied that at some point, huh?

[MothertheMother]

Quote:

Originally Posted by RosyDoula Yeah, they make up tons of crap. I guess its to convince the mothers to do what the doctors want them to do that is not evidence based but for their convenience. Or maybe some really do believe it. One that I've heard three times now, at three different hospitals is that its better to birth laying on the bed at a 45 degree angle so the baby can come under the pubic bone. If you are upright, the baby may not come out because he or she will shove his or her head against the bone or won't come around the corner. *sigh*

I heard this same thing when I attended my first birth. Mom wanted to move and the doctor told her she could if she wanted to but that semi-reclined position helped get baby under the pubic bone. NUTS

[CvilleDoula]

Quote:

Originally Posted by earthgirl 1. During a Cytotec induction the nurse said, (when I brought up it not being FDA approved for inducing) "It's perfectly safe, the only reason it's not approved is b/c it would cost too much money to go through the approval process. 2. Another nurse said that there are no side effects to the epidural, other than immobility!

Id like that nurse to explain to me why I have HORRIBLE migraines (sometimes I black out) , shooting pains up my spine, and barely any memory of the delivery of my daughter....if the epi's have no side effects. Ever since then (7 years ago yesterday) I have had these problems.

TO say that a medication has NO side effects is complete BS! EVERY medication known to man has some form of possible side effects.

Nothing like being lied to by a medical professional.

[Wendy79]

OK, the nurses don't "make stuff up" or "lie" (or at least, it'd be a very unusual, horrible nurse who did this). These are all things they've been taught by people who should know better--either nursing instructors, more experienced nurses, or doctors. (OK, the squatting/animals things is just a weirdo nurse, for sure.) I know, because I've been taught and told the same things. In the few cases where I've tried and been able to convince a nurse or student nurse that what she's learned isn't true, she's hurt and sad that she's made such a mistake. But it is hard for them to believe, because aren't we trained to believe our teachers and experts? And aren't nurses supposed to be experts about childbirth?

Obstetrics is so weird. I don't know why it's so backward compared to other fields of medicine/nursing (well, I have some theories, but that's another post), but all of my other classes have taught evidence-based practice and total respect for the patient. I've had teachers who told us something one day, then the next day came back and said "Forget what I told you yesterday; new research says this". So inspiring to students! I've been on hospital floors where the nurses explained brand new procedures or policies they're instituting, so cutting-edge that the instructors haven't heard of it yet--and the instructors just explain that the nurses on the floor are the REAL experts who deal with this every day. There's no "ego" that I can detect in any area but obstetrics.

Yes, a lot of nurses in L&D are mean or harsh (another thing I have theories about), and I would lose respect for a nurse who actually did read the research and chose to discount it, but many nurses don't even know there's anything to research! They really do think they're giving their patients the best possible care.

Keep in mind too that some nurses may be having to uphold hospital policies or doctor's orders that they don't necessarily believe in. I had a long talk about this with my nursing clinical instructor (a different lady from my horrid OB classroom professor) who is fairly liberal in her views; she had even attempted a homebirth (but had an abruption). I told her I wanted to work in L&D but couldn't see myself giving healthy women IVs or participating in cytotec inductions, so what kind of future did I have? She said if I established a good rapport with the staff, I would be in a position to influence policy eventually, but she wouldn't advise it until I'd been working on a floor for a couple of YEARS. So for two YEARS, I'd be stuck upholding the status quo. I would HAVE to give the mothers IVs and not let them eat. There are still things I could do to make the birthing atmosphere better for mothers, and I could still give a lot of information about the interventions, but I'd have to do a lot of things I can't support. This is why I'm not sure whether I ever want to be an L&D nurse (though part of me still insists, how can I possibly do anything else?).

ANYWAY! As for the toilet-birth thing--I can tell you, I wouldn't want to deliver my baby into a hospital toilet. They're nasty, whether they look clean or not. I'm sure we all know that the baby's descending head can feel like a bowel movement, so we always encourage mothers who feel like they have to go the bathroom once they're dilated to "go ahead and go if you have to". We have a bag there for just that purpose. I understand how the toilet can be a great place to push; what about getting a commode frame? Like others have said, sometimes babies DO just slide out, and I'm sure the majority of parents would be angry if "the nurses just let me deliver in the toilet, what idiots".

[apikailaa]

Thanx Wendy, it's great to get a nurse's prespective on this! I think it's great that you're a nurse who wants to make a change for the better. I can totally see where you are coming from with what you wrote, but I have to admit that it is still so frustrating to see such false information being given to moms. I would think that if I really loved my job I would want to stay up to date and do my own research constantly, but hey, that's just me! I try not to "blame" the nurses, because I know they have policies to follow, but like I said, it's so hard from a doula standpoint!!!

[ctowndoula]

Quote:

Originally Posted by Wendy79 OK, the nurses don't "make stuff up" or "lie" (or at least, it'd be a very unusual, horrible nurse who did this). These are all things they've been taught by people who should know better--either nursing instructors, more experienced nurses, or doctors. (OK, the squatting/animals things is just a weirdo nurse, for sure.) I know, because I've been taught and told the same things. In the few cases where I've tried and been able to convince a nurse or student nurse that what she's learned isn't true, she's hurt and sad that she's made such a mistake. But it is hard for them to believe, because aren't we trained to believe our teachers and experts? And aren't nurses supposed to be experts about childbirth? Obstetrics is so weird. I don't know why it's so backward compared to other fields of medicine/nursing (well, I have some theories, but that's another post), but all of my other classes have taught evidence-based practice and total respect for the patient. I've had teachers who told us something one day, then the next day came back and said "Forget what I told you yesterday; new research says this". So inspiring to students! I've been on hospital floors where the nurses explained brand new procedures or policies they're instituting, so cutting-edge that the instructors haven't heard of it yet--and the instructors just explain that the nurses on the floor are the REAL experts who deal with this every day. There's no "ego" that I can detect in any area but obstetrics. Yes, a lot of nurses in L&D are mean or harsh (another thing I have theories about), and I would lose respect for a nurse who actually did read the research and chose to discount it, but many nurses don't even know there's anything to research! They really do think they're giving their patients the best possible care. Keep in mind too that some nurses may be having to uphold hospital policies or doctor's orders that they don't necessarily believe in. I had a long talk about this with my nursing clinical instructor (a different lady from my horrid OB classroom professor) who is fairly liberal in her views; she had even attempted a homebirth (but had an abruption). I told her I wanted to work in L&D but couldn't see myself giving healthy women IVs or participating in cytotec inductions, so what kind of future did I have? She said if I established a good rapport with the staff, I would be in a position to influence policy eventually, but she wouldn't advise it until I'd been working on a floor for a couple of YEARS. So for two YEARS, I'd be stuck upholding the status quo. I would HAVE to give the mothers IVs and not let them eat. There are still things I could do to make the birthing atmosphere better for mothers, and I could still give a lot of information about the interventions, but I'd have to do a lot of things I can't support. This is why I'm not sure whether I ever want to be an L&D nurse (though part of me still insists, how can I possibly do anything else?). ANYWAY! As for the toilet-birth thing--I can tell you, I wouldn't want to deliver my baby into a hospital toilet. They're nasty, whether they look clean or not. I'm sure we all know that the baby's descending head can feel like a bowel movement, so we always encourage mothers who feel like they have to go the bathroom once they're dilated to "go ahead and go if you have to". We have a bag there for just that purpose. I understand how the toilet can be a great place to push; what about getting a commode frame? Like others have said, sometimes babies DO just slide out, and I'm sure the majority of parents would be angry if "the nurses just let me deliver in the toilet, what idiots".

I am so glad you posted this and agree with you (I have three friends from college who are nurses on the pp floor and hear the same thing) except the part about pushing on the toliet.!

[RosyDoula]

Quote:

Originally Posted by Wendy79 the nurses don't "make stuff up" or "lie"... These are all things they've been taught by people who should know better - either nursing instructors, more experienced nurses, or doctors ... I know, because I've been taught and told the same things. In the few cases where I've tried and been able to convince a nurse or student nurse that what she's learned isn't true, she's hurt and sad that she's made such a mistake.

Thanks for sharing your experience as a nursing student, Wendy. I don't think its the nurse's fault ultimately. They've been taught this crap, and maybe they don't think theres really any reason to research anything. Maybe they don't want to research anything because they feel so powerless they just sort of numb themselves to deceiving women? Also, nurses have to follow doctor's orders, like you said. So even if they bother to educate themselves, what diference will it make? They can't influence the system overnight.

To me, though, ACTIONS speak louder than WORDS. OBs, midwives and nurses may care about these women, or say they do, but the whole system is about control and is completely messed up. I am reminded of Jock Doubleday from the book, 101 Reasons Not to Have Your Baby in a Hospital:

Quote:

NPO is yet one more example of modern medicine's century-long endeavor to convince women that their bodies are not their own and that their powerful fecundity must be manhandled if creation is to occur. Starving you to the point of pain, your hospital obstetric caregivers will cheerfully show you their concern by performing further interventions to save you from their myth-based ignorance, <b>interventions that could have been avoided with a little research and a will to care. But research requires effort, especially effort of the mind. And effort of the mind is verboten in the mindless maternity ward, where reason long ago gave way to myth. And caring requires effort, too – effort of the heart. And the heart has no place in the modern-day hospital maternity ward, where "the standard of care," not love, runs the show.</b>

But anyways, sorry to get soooo off-topic.

Quote:

Originally Posted by Wendy79 I'm sure we all know that the baby's descending head can feel like a bowel movement, so we always encourage mothers who feel like they have to go the bathroom once they're dilated to "go ahead and go if you have to". We have a bag there for just that purpose.

Have you ever read the book Ina May's Guide to Childbirth, and read the chaper on Sphincter Law? Remember the anal sphincter works just like the cervix. You can't just GO on command, you have to feel safe and I am sure alot of women just don't feel comfortable pooping in a bag on a bed in front of everyone to see. Or even if you all turned away, just being in your presence with bright lights. So the bag really isn't a good enough alternative to the toilet.

Quote:

The Sphincter Law recognizes the cervix as a sphincter along with the other excretory sphincters. These sphincters function best, Gaskin points out, in an atmosphere of privacy and familiarity. Obtaining privacy in the hospital is nearly impossible. If you are having a normal, healthy pregnancy and yet chose to birth your baby in a hospital you will be surrounded by at least a half a dozen people during and after the birth – most of whom you have never before met. In addition, these sphincters do not respond to commands such as "relax!" or "push!", and can close up at any time if the person becomes frightened, or humiliated.

In my opinion, I would rather my baby be born into a nasty, dirty toilet bowl than to need to be pulled out with forceps because my doctor made me lay on my back and the nurses told me it would get the baby under the pubic bone.

[MsDoula]

Quote:

Originally Posted by apikailaa 1) My client in January was told she was not allowed to squat because squatting causes swelling in the genitals and makes it more difficult to push the baby out.

Pushing with an undescending baby is what makes genitals swell. Which, if the baby is in an optimal position, pushing while squatting actually helps baby descend very well. It most certainly, again if baby is in a good position and mother's pelvis is normal (which most are), does not make the baby more difficult to push out.

Quote:

Originally Posted by apikailaa 2) Squatting is "uncivilized". We are human beings, not animals.

This one is just sad.

Quote:

Originally Posted by apikailaa 3) Laying on the table with people holding your legs is just like squatting, it increases the opening of the pelvis. (But you're still on your back right? I mean what about gravity?)

Gravity is only one reason why pushing laying down with stirrups or your legs being held is NOTHING like squatting. No matter how close your knees are to your ears this position still comes nothing close to squatting. The biggest reason, again besides gravity, is that the mother's pelvis is actually compressed by laying on her back. Laying on the table does not increase the pelvic opening, it increases the view of the vagina. Also, laying on tailbone makes it less easy for baby to move it out of the way while coming through the pelvis. This is one way tailbones get broken in chidlbirth. The last reason I'll go into, for reason of not getting onto a soapbox, is the psyche. If you are laying down spread out and exposed, you aren't feeling quite as empowered as if you are standing and squatting to get your baby out. coming from someone who has seen it and experienced it personally, it's a huge difference.

Quote:

Originally Posted by apikailaa 4) You're not allowed to go to the bathroom towards the end of labor. No one would want a "toilet baby". That's just gross!

I'm fairly sure you know this one isn't gross but I thought I'd point out why the toilet is actually great for birthing in case you don't know! The toilet is the place where when we sit, we relax. We let go and don't hold ANY tension in our pelvic muscles - vaginal, rectal, whatever - we let it all go. And when we do that, our babies descend! Also, our wonderful way of letting go on the toilet actually lessens incidence of tearing as the muscles aren't contracted and allow lots of blood flow to the perineum. I pushed an 8 lb baby out over the toilet in about 1-2 minues (literally) with not even a skid mark! Trust me, the toilet is your friend. Also, please remember that just because mom is pushing over the toilet does NOT mean baby is born into the toilet! Moms will stand enough to allow someone to catch their baby or to do it themselves on instinct at the right time! I think it's rare anyone actually chooses to let baby drop into the toilet. But, if that happens no big! Just pick baby up and wrap him in warm towels! And on the off chance that this MIGHT happen, just take the 30 seconds to wipe the toiled bowl down before mom sits on or stands over to push.

ETA: I forgot I wanted to tell you about the silliest thing I've ever heard a doctor say! Once in a prenatal with a client who was presenting her birth plan, the doctor took issue with delayed cord clamping. He told her, "The cord pluses in coorelation with the baby's heart and if we wait for the cord to stop pulsing to cut it, then the baby's heart will stop." Huh? Really doc, then why doesn't the baby's heart stop when YOU clamp and cut the cord? hehe