Analyzing Genres

Analyzing popular and professional genres: Views of labor induction using pitocin

Popular genre and professional genre are two opposing means of communication.  The articles of the two different genres discussed in this paper focus on the controversy of the drug Pitocin that is currently used to induce labor in women.  Two different genres, popular and professional are compared in the analysis of four different articles on labor induction.  The article entitled “Labor induction” is popular genre and was obtained online from Wikipedia encyclopedia.  The other popular genre article is called “How to prepare for labor” by contributor Laura O’Neill from the online website eHow Health.  To compare the popular genre to a professional genre, two articles were pulled to represent professional genre.  The first is titled “Modern childbirth: Failure to progress” by Sarah Blustein from The Women’s Review of Books, volume 24, number 4.  The second article is “The vanishing mother” written by Claire L. Wendland from the department of Anthropolgy at the University of Wisconsin, Madison and is featured in Medical anthropology quarterly, volume 21, issue 2.  By comparing these articles we are able to analyze the popular and professional genres that discuss labor induction and childbirth.

            The two articles in the popular genre focus on the process of labor induction with Pitocin and outline the process of labor induction and the risks associated with using Pitocin to jumpstart uterine contractions.  The articles in the professional genre link the use of modern medicine and technological interventions including using Pitocin to induce labor to a high risk of cesarean sections and other complications.  Childbirth should be a natural process and although uncontrollable does not require as much intervention as currently performed.

Although using Pitocin during labor induction can be successful in delivering a healthy baby, it is not always necessary to induce labor as the risks can outweigh the benefits in many cases.  Modern medicine and technology has taken a hold of a process that, from the beginning of the human race, has been a natural, uncontrolled process.  In the eyes of many professionals using medicine to induce labor and performing c-sections has become more of a liability issue rather than a medically necessary event.  Doctors are now more worried about being sued and if they can document that they performed all interventions available then they cannot be held accountable for the risks that come with childbirth. 

The article obtained from Wikipedia and eHow are targeted toward an audience that would like to know more about pitocin and labor induction but probably have no medical background as seen in the use of common, simple language to describe the process.  The audience may want to know a brief summary of how labor is induced and the risks that go along with the use of pitocin.  This information is targeted toward the general community and possible women that are going to be induced but do not know much about pitocin and the risks and complications that may arise.  eHow makes the labor induction process sound simple enough and is why it is targeted toward a common person that has no current knowledge of labor induction.  The audience may not spend much time reading the popular genre because it is short, simple, and straightforward with now background or insight into childbirth.  Wikipedia merely states facts.  The purpose of the two popular genre articles is to inform the reader.

In the professional genre, the audience is people that have knowledge about labor induction and that may be considering turning against the use of modern medical intervention during childbirth.  The audience is likely to have some working knowledge of the use of pitocin for labor induction and the risks that it carries.  The articles are intended for an audience that are concerned with the rise of inductions and cesarean sections that are being performed today because they basically tear down modern obstetrics and describe the downfall to labor induction and the need to control every aspect of childbirth.  The audience may want to spend more time with the scholarly articles because the authors not only state facts but give examples and describe real life scenarios about doctors that intervene for no urgent medical reason.  The purpose of the information is to inform and persuade readers about the dangers of labor induction because of high risk for complications to the fetus, the increasing need for c-sections, the painful labor it causes for a woman, and consequently, the need for pain medication. 

“Labor induction” from Wikipedia does not do well establishing the credibility of the information it discusses because there is even a disclaimer at the beginning of the article that states “This article may contain inappropriate or misinterpreted citations that do not verify the text” (Labor induction, Wikipedia).  If that does not denounce that article’s credibility, I do not know what does!  Although there are references to back up the information, the disclaimer may make the audience wonder if the information is accurate and reliable.  The article from eHow about the labor induction process does not cite references nor is there any proof to back up the discussion.  It appears as if the author is a non- health care professional by the style of writing which reduces the credibility of the information.  This article could also be persuasive along with informative because it could persuade the reader that labor induction is a quick and easy process. False!  Overall, the popular genre articles are not effective in establishing credibility. 

The popular genre uses simple language that can relate to the common person reading the article.  eHow lightens the labor induction process so that someone who is reading it may lower their anxiety about being induced because the author, O’Neill makes it sound so simple and painless.  It evokes elated emotions about having a baby because it does not describe the pain and the longevity of labor with pitocin and the risks associated with it.  Its simplicity reduces fear and anxiety about labor induction which is not very realistic.  The Wikipedia article relates facts about pitocin and labor induction moreso than the article from eHow by stating many relevant facts about the makeup of the drug pitocin, how it is administered, risks such as uterine hyperstimulation, tachysystole (fast contractions), and increased risk for pain medication and c-section.  There are numerous references, but again, the disclaimer at the beginning of the article may encourage the reader to be wary of the information contained in the article, therefore making it inappropriate for research.  The popular genre is, again, not very credible and therefore not appropriate. 

The articles in the professional genre establish the information’s credibility by citing different studies that have been completed on the use of pitocin and give the reader statistics on the rates of induction, outcomes, the doubled risk of c-section, the number of babies harmed by pitocin, and so on.   The professional articles relay to the reader true stories and actual quotes from obstetricians about why they really induce and the reasons are atrocious! Along with inducing, many doctors perform c-sections for liability reasons because they want to say that they tried everything they could.  The professional articles do effectively establish credibility because they are bases one evidence-based research and include insights into the real world of childbirth and not just list facts that cannot be backed up.  The authors evoke emotions of anger, misbelieve, and awe to readers about what really takes place behind closed doors in the medical world.  There is, in many cases, no medical necessity to induce labor or to intervene in childbirth.  When doctors actually admit to this it is shocking and this is why the reader’s emotions may be evoked more so with this genre than with the popular genre.  The articles in the professional genre use scientific evidence to back up the argument by correlating the rise of induction with a rise of fetal distress, uterine hyperstimulation, uterine rupture, and cesarean sections have doubled!  This is appropriate because it is hard evidence that can back up the argument the labor induction may not be the best solution and it is still possible to give birth to a healthy baby without so much medical intervention.  Women have been doing it for centuries.

The information from Wikipedia and eHow is shaped by the popular genre because it is simple and straightforward and does not go into much detail about labor induction.  There is limited space because these are web pages not designed solely for this information and the resources do not allow for much evidence based information.  Also the information targets a general audience, therefore using technical terms may confuse the readers and would need to be explained further, but again, space is limited unlike in a professional journal that is dedicated to specific studies and is written by authors that collaborate with professionals with other fields to produce evidence based research.  Professional genres are intended to incorporate facts, research, and studies that back up the argument.  Popular genres merely give a simple summary of current views on topics.  Because labor induction is geared toward such a specific discipline, it requires more than just facts with no credibility.  In order to provide concise and accurate information, the genre must go into detail and have supporting evidence of what is being presented.  The professional articles delve more deeply into the roots of childbirth and labor and the progression over time to the use of modern interventions and the dangers they pose to the future of childbirth.  The language of the articles in the popular genre is informal.  The professional genres incorporate formal language and technical terms and pull evidence from several resources.  Medical terminology is used throughout the professional articles more so than the popular genre. The language of the popular genre is simple and geared toward a common person that may have no medical background.  This is so they can target anyone. 

In conclusion, the most significant difference between the two genres is the use of research and evidence to back up the argument and the claims of each article.  The popular genre has no credibility and although easy to read, not reliable.  The two genres barely overlap in stating some of the risks of pitocin and labor induction.  Both genres are effective at communicating the information to the audience however the audience is completely different for the two.  The popular genre is problematic in conveying the message to a professional audience, whereas if would be difficult for the professional genre to inform the general population with no knowledge labor induction. 

Works Cited

Blustain, S. (2007). Review: modern childbirth: failure to progress. The Women's Review of Books, 24(4), 3-5. Retrieved from http://www.jstor.org.proxy.libraries.uc.edu/stable/20476610?&Search=yes&searchText=labor&searchText=pitocin&list=hide&searchUri=/action/doAdvancedResultsla=&wc=on&acc=on&gw=jtx&q0=pitocin&f0=all&q1=labor&f1=all&c1=AND&sd=&ed=&jo=&si=1&jtxsi=1&jcpsi=1&artsi=1&so=new&hp=25&Go.x=19&Go.y=20&prevSearch=&item=4&ttl=88&returnArticleService=showFullText

           Labor induction. (2011, September 21). Retrieved from http://en.wikipedia.org/wiki/labor_induction

O'Neill, L. (2011). How to prepare for labor induction. Retrieved from eHow.com/how_5671736_prepare_labor_induction.htm

Wendland, C. (2007). The vanishing mother: cesarean section and evidence-based obstetrics. Medical Anthropology Quarterly, 21(2), 218-233. Retrieved from http://www.jstor.org.proxy.libraries.uc.edu/stable/4499722?&Search=yes&searchText=labor&searchText=oxytocin&list=hide&searchUri=/action/doBasicResults?hp=25&la=&so=new&wc=on&acc=on&gw=jtx&jcpsi=1&artsi=1&Query=oxytocin+and+labor&sbq=oxytocin+and+labor&prq=oxytocin+AND+labor&si=26&jtxsi=26&prevSearch=&item=26&ttl=462&returnArticleService=showFullText

Professional opinions of Pitocin to induce labor

According to current research on the effects of Pitocin to induce labor, many professionals find that there are many risks associated with the effects of Pitocin.  According to the first article I found on modern childbirth, the author discusses the effects of modern medical intervention on childbirth and the risks associated with the use of Pitocin to induce labor.  Although many health care providers see a need to induce labor with Pitocin, the dangers seem to outweigh the benefits because there is usually no urgent medical need to induce labor unless both the fetus and mother are at risk (Blustain, 2007).  The second article discusses the rise of cesarean section and the effect that pitocin has on the risk of cesarean section.  The use of Pitocin greatly increases the risk of cesarean section (Wendland, 2007).

                                                                               Works Cited

Blustain, S. (2007). Review: modern childbirth: failure to progress. The Women's Review of Books, 24(4), 3-5. Retrieved from http://www.jstor.org.proxy.libraries.uc.edu/stable/20476610?&Search=yes&searchText=labor&searchText=pitocin&list=hide&searchUri=/action/doAdvancedResultsla=&wc=on&acc=on&gw=jtx&q0=pitocin&f0=all&q1=labor&f1=all&c1=AND&sd=&ed=&jo=&si=1&jtxsi=1&jcpsi=1&artsi=1&so=new&hp=25&Go.x=19&Go.y=20&prevSearch=&item=4&ttl=88&returnArticleService=showFullText

Wendland, C. (2007). The vanishing mother: cesarean section and evidence-based obstetrics. Medical Anthropology Quarterly, 21(2), 218-233. Retrieved from http://www.jstor.org.proxy.libraries.uc.edu/stable/4499722?&Search=yes&searchText=labor&searchText=oxytocin&list=hide&searchUri=/action/doBasicResults?hp=25&la=&so=new&wc=on&acc=on&gw=jtx&jcpsi=1&artsi=1&Query=oxytocin+and+labor&sbq=oxytocin+and+labor&prq=oxytocin+AND+labor&si=26&jtxsi=26&prevSearch=&item=26&ttl=462&returnArticleService=showFullText

The common perception of labor induction and pitocin

       After doing some research I have found many more websites that describe labor induction by pitocin with more of a negative connotation than a positive one.  I found much more on the risks and side effects of pitocin than on anything positive about being induced.  The websites highlighted what I discussed in my previous writing about the dangers of pitocin such as hyperstimulation, C-section, etc.  Most of the material I found was that inductions are being performed in most cases without medical necessity.  Many websites and comments by common people focus on why inductions are over performed and the dangers that pitocin pose to the fetus.  Wikipedia was one of the websites that focused more on the negative side effects and the risks of pitocin and inducing labor ("Labor induction," 2011) .  Another site by a doula focused on the dangers of pitocin and the fact that there is usually no major risk to waiting to go into labor a few extra days.  Many of these websites also focus on natural ways to induce labor because of the sharp rise in pitocin induced labor (Amy , 2009) .  I also found other comments on ivillage that stated more cons than pros of being induced with pitocin and although the author did not necessarily take a side the style of writing and the information made the article seem like it leaned more toward induction as an overused and highly dangerous process ("The induction question," 2005) .  The only website which I found that described labor induction as a relatively easy process was eHow.  According to that website all that happens during an induction is getting pitocin intravenously and then you have a baby (O'Neill, 2011)! 
         All in all it seems that the common perception on labor induction using pitocin is that it is dangerous and has a bad reputation.  Many people who had never been induced discussed that they had heard horror stories and that it sounded like an awful process. 

                                                           
                                                                  Works Cited

Amy , F. (2009, June 09). The truth about pitocin and labor induction. Retrieved from http://doulamomma.wordpress.com/2009/06/09/the-truth-about-pitocin-and-labor-induction

Labor induction. (2011, September 21). Retrieved from http://en.wikipedia.org/wiki/labor_induction

O'Neill, L. (2011). How to prepare for labor induction. Retrieved from eHow.com/how_5671736_prepare_labor_induction.html

The induction question. (2005, March 03). Retrieved from http://www.ivillage.com/induction-question/6-a-144633?p=1

Hot topic in Labor and Delivery Nursing

             Based on the votes I have decided to write about the topic of medicine used to induce labor.  Within this topic I can also include the rest of my topics because I think they go together so closely.  Labor induction is a huge issue because it is on the rise and it is so controversial because there are so many opposing views on inducing labor.  It has become so popular and there are many reasons why people do not believe in it.  It is becoming more apparent just how dangerous induction medications are and the threats they pose to the fetus if not in the hands of the right skilled health personnel during labor.  I can include the issue of hyperstimulation, inducing before 39 weeks and pain management into my discussion on labor induction because those are all possible side effects of induction.

Current Issues in the World of Labor and Delivery Nursing

Current issues facing the world of labor and delivery nursing:

 Labor induction using the hormone oxytocin or pitocin to jumpstart contractions is on the rise, and in many cases for arbitrary reasons such as the doctor’s schedule or the mother being uncomfortable.  This is the first issue I came across affecting labor and delivery nurses and it is a big deal now because about one in five pregnancies now results in labor induction and even worse it is happening too early in the pregnancy.  The ACOG (American Congress of Obstetricians and Gynecologists) has recently made many recommendations to doctors and has warned against induction before 39 weeks  gestation (a normal pregnancy is about  40 weeks long) unless medically necessary because of the risk for the fetus.  The ACOG gives the reason that fetal lungs may or may not be fully developed by 37 weeks.  Inducing labor also doubles the risk of cesarean sections and increases the risk of fetal distress.  This is interesting because childbirth is supposed to be a natural process but now we are even intervening in a natural process of life, many times for no valid reason and it seems that the cons outweigh the benefits of being induced.  I was personally induced so I know how intense it was both for my daughter and me.  It makes the nurse’s job more difficult and intense as well.  The second issue I came across is uterine hyperstimulation due to oxytocin induced labor.  Hyperstimulation refers to having too many contractions too quickly and lasting too long.  Oxytocin is the hormone used to induce labor and can be  dangerous because it can cause the uterus to contract too quickly which places even more stress on the fetus and deplete oxygen to the fetus resulting in many complications and even permanent damage to the baby.  Because it is such a potent hormone, levels of oxytocin, contraction strength and duration, and fetal heart rate must be monitored VERY carefully during an induction.  This is all included in the responsibility of the labor and delivery nurse and there have even been lawsuits because babies have been injured due to hyperstimulation.  Studies have shown that hyperstimulation reduces fetal oxygen saturation and the longer the uterus is hyperstimulated, the longer it is deprived of oxygen and the worse off the baby will be.  Cases of hyperstimulation are also on the rise because inductions are on the rise and this is why it is an issue right now.  It is interesting because it makes the role of a labor and delivery nurse even more critical because they are responsible for monitoring mother and baby and must have exceptional skill in reading contractions, fetal heart rates, and fetal oxygen levels.  They must be able to intervene and recognize a problem before it is too late.  The last issue I found related to labor and delivery nursing is the high use of epidurals to control pain can slow labor down and makes it more difficult for the mother to move around to help ease contractions.  It is more difficult for labor and delivery nurses to intervene and help the mother change positions when she is numbed from an epidural.  It also increases the risk of cesarean section and it is being brought up today because of the increased interventions required during childbirth as compared to how it was before inductions and epidurals were so popular.  It is interesting because I think some people forget that it is possible to have a child without pain medication and there has been such a bad stigma placed on the natural childbirth and it is almost like we instill in women that it is not possible to have a natural childbirth when it is.

Discipline Format for Labor and Delivery Nursing

Nursing uses the American Psychological Association (APA) Format

My Manifesto

                A person will never truly understand the value of a labor and delivery nurse until they are in that situation where the birth of their child lies in the hands of some very skilled and compassionate individuals.  The role of the labor and delivery nurse is crucial for having a healthy delivery both for mom and baby.  I have experienced this firsthand when I had to rely on the skill of the nurse when I gave birth.  She provided me support, encouragement, and a healthy baby!  The labor and delivery nurse is responsible for monitoring the mother to ensure that she remains healthy intrapartum (during labor) and postpartum (after birth) and monitoring the baby both intrapartum and postpartum.  The nurse must communicate with the doctor or nurse midwife, the doula (labor coach), the family of the patient and any other people involved with the birth.  The nurse is responsible for obtaining the mother’s health history, monitoring the fetal heart rate during labor and the mother’s contractions and recognizing when there is a problem and what sort of interventions are necessary to get the mother and child through labor and delivery safely.  The nurse must know when to prepare the mother and child for surgery if necessary.  They are also responsible for starting IV’s, administering medication and giving injections.  The nurse creates an effective plan of care to deliver the baby safely and care for the mother encompassing many different aspects including, but not limited to: patient safety, compassion, cultural sensitivity, knowledge, skill, experience, ethics, patient advocate, and patient education.  Only compassionate and caring individuals can become nurses; people who really want to make a difference.  Having a child is one of the most meaningful times in a person’s life and the labor and delivery nurse is there to make it even more special and make sure that everyone involved remains safe. 

                The need for labor and delivery nurses started to increase after the baby boomers of post World War II.  Doctors needed more assistance in the delivery and operating rooms as well.  Labor and delivery nurses are required to be able to make a decision in a moment’s notice because that could be the difference between life and death for a mother and newborn.  Again, the role of the labor and delivery nurse encompasses actions on many different levels.  The role of ethics in nursing is extremely important.  For example, the labor and delivery nurse, although they may know the plan of care that should be followed, must always hold of the principle of autonomy.  This means that the patient is the ultimate decision maker and should not be influenced to make a decision, only informed of the facts.  If a mother in labor does not want to follow what the health care provider suggests than they make their own decision and cannot be forced to do anything they do not want to do.  The nurse must uphold these ethical principles.  The nurse must be truthful and hones to the patient and do only what is in the best interest of the patient.  The nurse must not impose his/her beliefs upon the patient.  The nurse must also obtain consent when necessary and must inform the patient of risks and possible outcomes of certain procedures.  The nurse must also provide privacy for the patient and respect the patient’s confidentiality.  It is never acceptable for a nurse to discuss a patient or the child of a patient to anyone other than the appropriate family members and other health care personnel caring for that patient.  This can be difficult for a nurse to follow if they see something out of the norm that they just want to tell someone about.  The nurse has to be a trustworthy person because they have access to a large amount of information and they see people at their best and worst times.  There are huge consequences if a nurse breaks the code of ethics that they are taught to follow.  This includes losing their job, their nursing license, and even legal consequences.  Nurses must be very careful to remain ethical.

                Another area that affects the principles of nursing is cultural sensitivity.  The labor and delivery nurse must be educated and aware of the practices of other cultures and how to treat individuals of other cultures.  For example certain religious cultures have customs they must follow when it comes to healthcare and the birth of children.  For example in some cultures a woman is not used to having multiple people looking at her naked or examining her.  This also may be something the husband is not comfortable with and it is the responsibility of the nurse to determine these different cultural expectations and be able to conform to the needs of the patient and her family.  Another example is pain.  Different cultures view pain in different ways and the nurse needs to be aware of a woman’s perception of pain so that she is able to make the birthing experience a positive one.  Because nurses are seeing a more diverse population in the hospital is important that we are educated on the beliefs of different cultures.  In nursing school there are several lectures that address these beliefs and if the nurse has never cared for an individual of a certain culture, it is her responsibility to do some research so she can provide the most effective care while keeping these cultural norms in mind. 

                The role of client educator and advocate is also one of the most important aspects of nursing aside from the actual skill and care.  Many clients do not understand the lingo of doctors and other healthcare professionals and the nurse should always be there to answer questions the client has.  If the nurse cannot answer the question, they are responsible for contacting the doctor so they can come back and clarify and issues the patient has.  The role of client advocate is so important in a hospital because many times clients feel pressured to go along with something they do not want to do and the nurse must be there to ensure that the client has a say in the care they are going to receive.  Specifically for a labor and delivery nurse, they must be able to provide education on topics such as newborn care, breastfeeding, nutrition for the mother, and touchy subjects such as baby abuse, particularly Shaken Baby Syndrome.  The nurse is responsible for giving the client information and resources if they need help.  For example they can refer the mother to a lactation consultant if they are having difficulty breastfeeding or a program such as WIC for women, infants, and children if they are low income and need nutritional supplementation.  The nurse can make a big difference in the life of a new mother or family with a new baby.  This is a scary time for everyone if they have never had a baby before and the nurse should be the first one to provide them with the necessary tools they need to raise a healthy child.

                In conclusion, the role of labor and delivery nurses spans across a wide range of responsibilities.  The nurse has to be a caring and compassionate individual because having a child can be the most important time in a person’s life and the nurse must truly care about each and every individual mother, newborn, and family member.  I cannot imagine having a nurse assigned to me while I was in labor that did not truly care about my safety as well as a safe delivery for my baby.  I can see how a bad nurse can make for a negative birthing experience that one may never forget.  I will never forget my labor and delivery nurses because of how outstanding, knowledgeable, and supportive they all were.  There is nothing more encouraging after twenty-six hours of labor than a change of shift and a new nurse entering the room saying “Let’s get this baby out!” And an hour later there came my daughter!   That is what I remember the most from my experience giving birth.  I was lucky enough to have a healthy child, but there are times when labor and delivery are not as successful and problems arise.  It is even more important in this case to have a skilled nurse.  It is also important that the labor and delivery nurse pick up on cues from new moms about what they are having difficulty with and to be able to support them and refer them to the right places.  If a mother is having difficulty breastfeeding she needs to get help or else she will have a hungry baby which will in turn upset and frustrate her.  It is important that the nurse can refer the mom to a nutritional program if necessary so that they child can get the adequate nutrition they need to grow because there are so many malnourished children in this world that do not have the resources to get food, milk, and iron-fortified formula for infants.  Many people are not aware of these programs and for a low income family they can be lifesavers.  The discipline of labor and delivery nurses can provide a framework or resources for new parents and prepare them for having a new baby.