Labor and Delivery is one of those places and words that most people are trying to quickly backtrack their way out of. But, for most of you there will be a day that you’ll feel it is your duty to learn as much as you can about this area in a quick timeframe because the due date is soon upon you! Most of us in this world of technology know how to google and search for keywords that will generally obtain the information that we are looking for; however, most of what is on the internet is personal opinion or research that has not been supported by an accurate source. So beware of the words epidural, fetal monitoring, water birth, etc. because you just never know who is on the other side writing what their experience was or the experience of a friend of a friend who has distorted the story a little too many times. We all know it is a more interesting read if something dramatic has happened! However, when it’s going to happen to you or your loved on, little drama is desired!
If you have found this blog I hope you will stay tuned to learn a little more about what a Labor and Delivery Unit is and how you can answer some questions that may prepare you for the most important day of your life. As a Labor and Delivery Nurse, I am constantly confronted with couples who are scared because they have no information or have been given inaccurate information. I would like to somehow bridge the gap between the excitement of seeing “pregnant” on your pee stick and the fear that comes with the day of the “birthday.” I am going to provide you with just a few websites and data sites that has been searched for accuracy and has good credentials behind these topics so that you will feel confident in the information you are reading, but also be prepared to have educated questions to ask your physicians or anesthesiologist. Remember each facility is different and this information provided should prompt you to ask questions of your facility to get the most beneficial answers to put you at ease through the most wonderful day of your life.
The sites provided here have been evaluated for accuracy and objectivity. I, as a Labor and Delivery nurse, also come with my own biassed opinion on some of these topics; but you will not hear them in this blog unless you ask. I am a true believer in making educated decisions for yourself. I was part of a health care initiative in our Labor and Delivery Unit that also researched and brought positive change and increased patient safety to our own facility because I wanted to be educated in my job as your nurse. This blog will provide you with a just a few pages that I feel have good current information and are supported by those who you can contact yourself for further information and have the credentials to prove it.
We will be looking at just a few common questions in Labor and Delivery at this time, but continue to check back as I hope to update this information to be more specific to my own facility as I gather feedback from you, my readers, and my patients in my own unit and childbirth classes. We will briefly look at labor inductions, iv’s in labor, electronic fetal monitoring in labor, and epidurals. These seem to be the most common questions to address first and I will add more as the questions come.
ACOG Education Pamphlet
–Labor Induction
http://www.acog.org/publications/patient_education/bp154.cfm
ACOG is the American College of Obstetricians and Gynecologists that provides guidelines for clinicians. It is a nonprofit organization of women’s health care physicians that advocate the highest standards of practice and provide public awareness. This is an educational pamphlet that outlines stages of labor, reasons for inductions (medical or elective), why inductions may not be done, and how it is done and a brief overview of the risks.
Nursing Center-The American Journal of Maternal/Child Nursing
–Trends and Controversies in Labor Induction
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=835068
This is from the American Journal of Maternal/Child Nursing Jan/Feb 2009. This article goes through triggers of onset of labor, indications for induction, costs, preparations, controversies, and more natural induction methods. This goes into detail about the topics listed above and also recognizes self-induction methods that are rarely discussed and how all types hold risk that may be minor or major. The data collected in this journal is also helpful for looking at the statistics through the years.
AHRQ- Agency for Healthcare Research and Quality
–Thinking About Inducing Your Labor: A Guide for Pregnant Women
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?
pageaction=displayproduct&productID=353
This is a wonderful guide that is an easy read for a patient to move through this with ease and accuracy. It was written by Stanford University-UCSF Evidence-based Practice Center in 2008. This guide is simply for elective inductions which is mostly where the questions come from. This guide goes through the changes in your body that are necessary for elective inductions, problems that may occur, answers that we still don’t know, and the part I loved was the section titled “Questions to ask Your Doctor or Midwife.”
Suite 101
–Pregnancy and Childbirth, IV’s During Labor
http://birthing-options.suite101.com/article.cfm/ivs_during_labor
This article was written by Brenda Lane, a childbirth educator and doula who has served on Board of Directors for DONA. Many of our information for Childbirth/Lamaze classes come from this organization, so I feel it is good to use the resources that they are sharing in the classes. This short article tells the uses of IVs in Labor, the Disadvantages, and Alternatives to ask your health care provider.
ACOG- American College of Obstetrics and Gynecology
–Fetal Hearth Rate Monitoring During Labor
http://www.acog.org/publications/patient_education/bp015.cfm
This pamphlet was designed for allowing patients to receive current information and opinions related to women’s health. This educational pamphlet describes the types of monitoring, electronic and internal monitoring, and a very basic overview of what fetal heart rate patterns mean. This like many other articles should allow you to read, be more informed, and then ask what is available at your facility and in your situation. Fetal monitoring is a way to check for fetal well-being and should be discussed with your health care provider.
American Society of Anesthesiologists
–Planning Your Childbirth: Pain Relief During Labor and Delivery
http://www.asahq.org/patientEducation/labordelivery.pdf
This tool is one from the source of those placing your epidural/spinals for labor. I feel that when in labor and have questions, ask those who will be doing the procedure to get the most accurate and beneficial information. This article is a good start to have an overview of types of pain relief in labor, how it works, and what are common side effects and what are risks. Again, these are great to have a base to then go forth and ask questions of your anesthesiologist.
ACOG- American College of Obstetrics and Gynecology
–Pain Relief During Labor and Delivery
http://www.acog.org/publications/patient_education/bp086.cfm
This pamphlet is another educational tool put out by ACOG, it mimics the words of the American Society of Anesthesiologists as well but gives a little more detail about easing discomforts without medications.
OMNINERD
– Pros and Cons of Epidural Analgesia During Labor: Recent Research
http://www.omninerd.com/articles/Pros_and_Cons_of_Epidural_Analgesia_During_Labor_Recent_Research
This database research does just as the site states, it shows the pros and cons of epidural analgesia throughout the years of research starting in 1996 to 2007 with a summary at the end detailing the risks and benefits and a good conclusion. There is also a brief study at the end on other pain relief options.
PUBMED.gov
–Maternal and neonatal outcomes of elective induction of labor
http://www.ncbi.nlm.nih.gov/sites/entrez
This brief overview looks at the rising increase of elective inductions and the outcome of the maternal experience and neonatal outcomes.
