Advice for a NICU Nurse

IDreamInPink · May 2012

Hi Girls,

As you can tell from my title, I am a Neonatal Intensive Care nurse. I am due in less than 4 weeks, and have really been enjoying lurking on your board here at Natural Birth! I am planning a drug-free birth as well... I hope to be as brave as you ladies!

My biggest fear isn't about the pain, it's about the monitoring. I want to be able to walk around without being attached to monitors, but the NICU nurse in me is having a hard time figuring out "what's best". My mommy brain says "everything will be okay" and my NICU brain says "are you nuts?! you know how fast things happen in OB!!"

Do you ladies have any suggestions on how to calm my nerves about fetal monitoring? What is your plan? 20 minutes on, 40 minutes off or something of the nature?

Any additional advice you girls have will fall on appreciative ears!

Edit: I guess I should add that I have had a perfectly healthy, normal pregnancy, and have absolutely no need to worry at this point. It's just that the most "unusual of circumstances" are my norm, unfortunately, and that's what I see on a 40-hour-a-week basis... so it's hard to separate the statistics of "only 2%" or whatever the case may be!

tokenhoser · May 2012

Well, my plan was to labour at home until I felt I wanted to be at the hospital. Turned out when I got there, I was 10 cm. So the only monitoring I had was intermittent while I was pushing. It worked well for me.

I guess my advice is don't rush to the hospital if you're aiming for a med-free birth. The longer you're there, the longer there is to have to deal with monitoring, food restrictions, etc. At home, you'll feel more at ease and in control.

Jcrab · May 2012

I'm also a NICU RN and planning a HBAC. I think if you do not have the typical interventions then you need to be far less worried about monitoring for distress. Try to forget all the horror stories we are exposed to in our line of work, statistically we see many things that are very rare unusual occurrences. Trust your body and that you will know whether baby is okay or not. Good luck!!!

xnbride · May 2012

I think you have to do what makes you feel the most comfortable and at ease during the birth process and not because it is part of the natural birth protocol. If you want continuous monitoring for peace of mind then have continuous monitoring. You can still be mobile while on the monitors. You can still move around, you could still sit on a birth ball. I personally didn't mind the monitors and found them to be reassuring...to some extent. I did have to take them off to use the restroom and if you are getting into the shower or bath then you have to remove them as well (although I hear that there is actually waterproof mobile monitors available at some hospitals/birthcenters!). I would ask for approval for intermittent monitoring but if during labor you find that you like to have them on, then just leave them on. There is no right or wrong way to go about having a natural birth experience.

bloverde · May 2012

Remember the NRP stats. Less than 10% require resuscitation (including stim/suction) and less than 10% of THOSE require invasive resuscitation. Less than 1% total! I'm a pedi, so I didn't even tell my colleagues how into natural birth I am. When I'm in the NICU I just keep repeating to myself that what I'm seeing is not the norm. Just think about how we got past that 23 week hump.

kaeti_su · May 2012

Ditto tokenhoser, except I was 9 cm and was monitored the whole time I was in the hospital bed because by the time I got the monitor on for my initial strip and had my blood drawn, I was pushing. If that hadn't happened, I would have had intermittent monitoring and would have used the portable monitor in the shower/tub if I wanted to be in there.

I think I remember reading that constant fetal monitoring has not been shown to improve outcomes for babies and may even increase interventions (but please correct me if I'm wrong there, I don't want to spread misinformation!).

Celyn · May 2012

You could always bring a doppler and do your own FHTs

Do they have telemetry where you're delivering?

caralck · May 2012

I'm also a doc and I plan on staying home as long as possible/reasonable (how on earth I figure that out without accidentally delivering en route I have no clue lol!). I keep reminding myself that I'm not the people I have cared for and that majority of births are uncomplicated and normal. And then I read birth stories of natural births. I'll be asking for intermittent monitoring because research has shown that continuous monitoring did not reduce birth related injuries like cp and only increased interventions, which can cause complications themselves.

jteneback · May 2012

I had continuous, mobile monitoring and I don't think I could have done it otherwise. The initial 20 minutes in bed were the worst part of the labor and I couldn't wait to get up. It might be the best of both worlds and put your mind at ease.

jennyann28 · May 2012

Keep in mind that you also might get in there and HATE the monitoring! I found it super distracting, the telemetry unit wasn't working right, and I couldn't stand being strapped to the bed. When I WAS being monitored, baby was great, which put me at ease, and when I got in the tub, even though the telemetry was waterproof, we got to monitor intermittently before, during, and after contractions to see how baby handled it with just the Doppler. My baby was high-risk for a number of reasons, yet I never wished for more monitoring, and when the monitoring was off, I was MUCH more relaxed, which helped her come MUCH faster!

IDreamInPink · May 2012

This is all great advice, ladies... Thank you! I just love hearing everyone's positive experiences and outlooks- it all really helps!

MommyMelRN · May 2012

caralck:
I'm also a doc and I plan on staying home as long as possible/reasonable (how on earth I figure that out without accidentally delivering en route I have no clue lol!). I keep reminding myself that I'm not the people I have cared for and that majority of births are uncomplicated and normal. And then I read birth stories of natural births. I'll be asking for intermittent monitoring because research has shown that continuous monitoring did not reduce birth related injuries like cp and only increased interventions, which can cause complications themselves.

This is my rationale as well. Thanks for the post, it's nice to know I'm not the only "crazy" hopefully natural birthing NICU nurse/healthcare professional out there. I know I drive my midwives crazy with questions that no "regular" patient would ever even think to ask!

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