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interventions, nurses, and sibley
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Anonymous
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Hello all,
A topic came up on a separate topic I posted about an early dischrage at Sibley. I've read through the archived topics and have seen much conflicting info about Sibley but haven't been able to satisfy myself with an answer, so sorry if I'm repeating something that's already been covered. My doctor delivers at Sibley and he's very supportive of natural childbirth. I asked him specifically about fetal monitoring and whether or not I'd be able to get up and move around and he said as long as I elect not to have an epidural, I may move about as I please for as much of the labor as I want. A poster replying to another thread, however, happened to mention that Sibley was very hostile to natural birth. here's the quote: "FWIW, I too planned a natural birth at Sibley, but in my experience, it is not a supportive environment for it. Hopefully you have a doula, if this is your first. I found that once the nurses learn you want a natural birth, they pretty much leave you on your own--except for intermittedly checking monitors, which they force on you. Sorry if this bursts your bubble, but it's somewhat of a battle to have a natural childbirth at Sibley." I'm concerned to know that there is even the perception out there that nurses at Sibley will force anything on you. Isn't this for the doctor to decide? I haven't planned out my birth to the last detail, but there are certain preferences I know I already have, and moving about, as long as I'm able to and as long as it is helping me manage pain and facilitate my labor, is one I feel strongly about. I will accept any fetal monitoring my doctor recommends, but I'm certainly not going to get forced into internal or continuous fetal monitoring from a nurse if my doctor doesn't feel it's necessary. Should I expect to have a battle in the delivery room or is it possible this poster just had a bad experience? |
Anonymous
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I am the poster about the nurses at Sibley being less than receptive to a natural birth. Let me be more specific about my experience. I had a "birth plan" and my OB knew of my interest in an intervention free birth. Nonetheless, my water broke but I did not go into labor for over 24 hours, so I had to go to the hospital. The nurses reluctantly let me walk around to try to get labor going. However, they INSISTED I get a HEPlock IV put in--though it took three nurses to actually get it in (Competence is another topic altogether). They insisted on fetal monitoring, full time (hospital policy)and that is the ONLY time I saw the nurse--who seemed to care more about the monitor than my wellbeing. For example, she was visibily perturbed everytime I needed to use the restroom because it required her to come detach the monitors! While my MD was supportive of my choices, he was not there the entire time--other babies to deliver, etc. Not once did any of the nurses offer any words of support or assistance to me.
After I failed to go into labor after being at the hospital for 4 or so hours, they PUSHED pitocin on me. I finally relented on the advice of my OB. I then proceeded to have hard labor on pitocin for 12 hours with contractions 2 minutes apart and no pain meds (my choice, though they pushed drugs every chance they could) Not once during my efforts to withstand the pitocin labor did any nurse offer to stay with me so my husband could leave me to go to the bathroom or get something to eat or drink. We were very much on our own. We should have had a doula. When the nurse would examine me, she was curt and very negative--belittling any progress toward dilation--ie. comments like, I guess you could call this a start or you're barely 3 cm. Not great things to hear when you have been laboring hard for hours. After 17 hours of pitocin, I opted for an epidural so I could rest. I don't regret that decision at all--probably what saved me from a Csection since I could muster some energy to push the baby out. However, I can't help but think that if the nurses were more interested in patient care than monitors, I might have had a better time coping with the pain and might have not reached such a desperate point. This experience was 3 years ago. I know there have been alot of negative posts about Sibley in the past and hopefully the hospital has addressed some of the problems. I have heard from friends that they had good experiences (though no natural births). It is also possible that I just had a bad crew of nurses--nightime was especially bad. Who knows. It is my belief that your best bet for a natural birth there is to have your own doula. While there may be nurses supportive of it, I never met one and I was in labor for a LONG time. I plan to deliver my second child there, but have no plans for a natural birth, though I'd like to skip the pitocin this time. On a positive note, I did have one absolutely FANTASTIC L& D nurse during my three hour pushing phase ("Jane"). She was clearly a more experienced/senior nurse and had a great bedside manner and compassion. Without her and my husband, I would have had a csection. If all the nurses had been like her (trained to relate to patients as human beings, not things to be monitored, the first part of my labor might have gone differently). Sorry for the long post, but I think that first time moms wanting natural childbirth at Sibley need to be realistic about what they might face. Your OB might be supportive, but won't be at your side the whole time. |
Anonymous
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Wow, thank you for that information. Very discouraging, but at the same time I'd rather know all the experiences people have had. My OB was very clear that I would be allowed to move as freely as I want. I find it surprising that Sibley is so anti-movement, given that they have those birthing rooms with rocking chairs, massaging showers, etc, to help facilitate labor and their website is all about your birthing "choices." I am shocked that all the educated, self-advocating women on this board would stand for this.
My OB will stick up for me and I'm hoping he'll be there as much of the time as possible. He has a small practice and it will either be him or one other doctor delivering me. I will flat out refuse the 24/7 fetal monitoring -- if they want me to have it, then they can do their best to restrain my fat, laboring ass on my back if that is what they think good care is and then face my lawsuit or formal complaint afterwards. Otherwise I'm not having continuous monitoring and they can have fun trying. I'll be in labor and maybe a little bit out of it, but as long as my mouth is working, I will stand up for myself. Also, any nurse making rude comments during my labor will get a complaint filed against her, not that I necessarily think anything would come of that, given the nursing shortage. I'm so sorry that you had such a bad experience. It sounds like the nurses made your labor a more traumatic episode than it needed to be. I hope for my sake (and yours, this time around) that they've fixed these serious problems with the hospital. I'm going to share these concerns with my doctor and see what he says. Also, FWIW, a friend of mine who works at GW told me that Sibley is much friendlier to natural birth than GW. It does make me wonder if I"m making a mistake with a hospital birth after all, though. |
Anonymous
| My best friend had her baby at Sibley about 6 months ago and her experience was very different. She had a natural, unmedicated birth, spent most of the time on her birthing ball, and was on intermittent monitoring. The policy on monitoring may have changed in the 3 years since the 9:52 poster delivered at Sibley--my friend was not on continuous monitoring and when I took the Sibley tour last month they showed us the monitoring device and said the hospital has no policy on it (unless you get an epidural, in which case you have to be hooked up). As long as your doctor's okay with intermittent monitoring, the hospital's fine with it. There was nothing they told me on the tour that my friend didn't find to be true of her experience at Sibley. |
Anonymous
| Wow, 14:54. I think you need to take a deep breath. You're already all worked up and ready to file complaints and lawsuits and nothing's even happened to you! It sounds like you haven't even been on the tour at Sibley yet -- where they answer a lot of the questions and concerns that you raise. Relax. Definitely be an advocate for yourself, but please don't go in there expecting the worst and making all sorts of threats. That's not going to result in a positive experience. |
Anonymous
Please don't patronize me or tell me to relax, it's not helpful. I was responding to a very specific situation where someone shared an experience about having treatments forced on them, and how I would respond to that hypothetical situation if it happened to me. Yes, you're right, i have not yet gone on the tour. That's why I asked for answers (not condescention) from the board. BTW, I didn't make any threats to anyone, you just overreacted to my post. You're the one who should relax. What's with some of the bitchy women on this site? |
Anonymous
| I had two babies at Sibley and the nurses were wonderful. Let them do their jobs and all will go well. Its great to have a plan but every birth is different and if they want you monitored it is likely for good reason. My first son's birth seemed very relaxed to me but I now know after my second son was born that my first son was in some distress and monitoring was absolutely necessary. No one hid anything from me but essentially everyone wanted to keep me calm and all went great. Certainly be an advocate for yourself but don't try to control everything. They know what they are doing. |
Anonymous
Sounds to me like PP was trying to help you not be so worried and uptight. And then you start name-calling? You are the problem and the type of person who give this board a bad rep. |
Anonymous
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Anonymous
| The problem with this board is that you can't just get an answer to your question, you people who snipe. I may have called that person bitchy, but I think telling me to relax and being so dismissive of my concern was bitchy. Sorry if, for calling it like it is, I'm the one you see as giving this board its bad rap. (I'm sure it has nothing to do with a snippy poster telling someone with a valid concern that all she needs to do is "relax.") |
Anonymous
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"I'm concerned to know that there is even the perception out there that nurses at Sibley will force anything on you. Isn't this for the doctor to decide?"
The nurses and hospital protocal have a big impact on your birth experience. Keep in mind that no one can force you to consent to anything. There are regulations that protect against this. If a nurse tells you have to have an IV, it simply is not true. Now I don't recommend rejecting a hep lock. It doesn't hurt much, you can move around, and if you do end up being the .01% who crashes and needs an immediate IV then its good to have but it is good to understand that they can not force you to do anything. In nurses defense they sometimes have crazy shifts and it is a pain to keep coming in to do intermittent monitoring. It is much easier on staffing to keep you in bed, do CFM, and watch the monitor from the nurses station. Some moms are not prepared for natural childbirth and the nurses may not have training or the inclination to help you work through labor. Some do but some do not. A doula who has worked in the area can be a big help. My doula was great, very respectful of staff but was not a fan of Sibley. Your ob/gyn and hospital policy will be the ones who determine whether you on a clock. For example, some follow a cm dilation per hour routine and want to give Pit if you don't follow this pattern which is crazy because few people do. You are better off to labor at home as long as you can and then go to the hospital. |
Anonymous
OP here. Thank you for that straightforward reply. Very helpful. Curious -- did your doula mention any hospitals she preferred to sibley? and would you mind telling me which doula you used? I wouldn't object to the hep lock, as long as I could move around freely (get in the shower, etc). I was just a bit frightened by the previous poster saying that treatments were forced on her at Sibley. |
Anonymous
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I was (and remain) all for interventions when I had my first child at Sibley a few years back but did not find that the nurses were "pushing" any particular agenda whatsoever. They asked my preferences and followed them, and I didn't have pitocin until 12 hours into the hospital portion of my labor when my doctor ordered it. I'm not an expert, but my general understanding is that nurses cannot themselves prescribe medicine so I don't think any nurse at any hospital could "force" pitocin on a patient without a doctor's approval/consent. Obviously, I'd ask my OB but you may be worrying about a scenario that is unlikely if not impossible, so long as you're right about the OB's support for your natural childbirth plans.
Let me also say my experience was very different from the first poster's in a lot of other ways as well. My L&D nurses at Sibley were amazing - kind, supportive, cheerful and attentive. No complaints about helping me to the bathroom or anything less than great care. I delivered on a super-busy day (full moon, full house of laboring women) and the nurses were just wonderful at every turn. The post-partum nurses were another story, but I will remember the names of the two primary L&D nurses forever and if I see them when it's time to deliver #2 very soon I'll be thrilled. One final comment: there seem to be a lot of posts on DCUM from first-time pregnant women who prefer natural childbirth and appear to be incredibly hostile toward medical professionals and hospitals (as well as toward those of us who deign to offer advice or feedback.) Maybe it's all the same poster (?) or maybe it's just symptomatic of an unfortunate distrust that exists more widely. I don't know and obviously I've admitted my preferences are very different, so probably I'll just get flamed for even mentioning this. But I still think it's worth pointing out that it is not necessary, nor is it optimally effective, to go into this whole process with such combativeness (and yes, threatening lawsuits before you're anywhere near a delivery room qualifies as combative). There are good and bad in every profession, and you can find and focus on the unhappy stories if you so choose - but if you're going to have any contact with doctors/nurses/LCs/etc over the course of your pregnancy and parenting you might consider adopting a slightly more open-minded attitude about both the expertise and ethical standards of most medical professionals. |
Anonymous
| OP I used Sarah Sragg, Silver Spring, MD, U.S.A.. Phone: (301) 681-6436. I delivered at GU and at the time the department head was very supportive of doulas. Sarah knew all the docs and the hospital very well. GU has had alot of turnover in fact almost all of the ob/gyns who were there when I delivered are gone now so things may have changed alot. There have been posts on the board that sound like GU is following the other hospitals down a different path. They used to be very progressive, in the 90s they actually had a mid wife practice attached to the ob/gyns, train their residents not to do episiotomies as routine, and try to avoid c-sections. You could call Sarah and see what she thinks about other hospitals. I think she has worked at almost all of them in the area. Good luck. |
Anonymous
PP with negative natural birth exp. at Sibley: I totally agree with you. I think alot of first time moms (myself included) get a little brainwashed into the 'natural is best' mentality--I took a Bradley class, for example--which was really negative about the whole OB practice, too much so IMHO. While there may be some positive things about natural childbirth (I am no longer sure what those are....), its proponents do foster a hostility and mistrust of medical interventions/practitioners, which can be dangerous. Not all interventions are bad and some quite necessary. I think alot of first time moms (again myself included) are understandably fearful of the whole childbirth experience and want to try to control as much of it as possible. Natural childbirth, from an academic standpoint, seems to offer such a level of control. Unfortunately, it sets up expectations that often cannot be met in reality. I think if you are fortunate enough to have a fast labor, no fetal distress, without pitocin, you can probably skip the epi. Most first time moms, however, don't have fast first labors and dealing with pain over a long period of time, tires you out and can make it too hard to push the baby out at the end. Frankly, having gone without an epidural for the majority of my labor, I don't see what all the fuss is about with natural childbirth. It was really quite unpleasant, IMHO, and I have an extremely high pain tolerance. And, I had a very easy recovery, even having had an epi. I really don't know how it could have been easier, unless I had had a smaller baby.... Personally, the shock of sleeplessness and dealing with a newborn was more difficult to deal with than getting over childbirth. |