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.
The use of pain management during labor would make a good research topic.
ReplyDeleteThe induction issue points to more responsibility for the L&D nurse. Monitoring both baby and mommy at the same time. My children delivered normally, so this really hits home for me. Good luck.
ReplyDeleteI think the medications for inducation is the best topic. The use of these are happening more and more. Also, so many women are worried about the effects of these drugs.
ReplyDeleteThe use of pain management is my vote.
ReplyDeleteThe last part where you talked about epidurals was very interesting to me.
ReplyDeletemedications for inducations
ReplyDeleteI like the induction topic with medications. It seems as though a lot of responsibilities are added when these drugs are introduced for you.
ReplyDeleteI would like to hear more about use of drugs for induction.
ReplyDeleteSince I am an advocate of natural childbirth, I would like to hear more about the use of epidurals during labor.
ReplyDeleteI think inducing is a good topic. I myself was induced after 40 weeks for risk of waiting longer and having to have a c section. I agree with induction but not before 39 weeks. Babies will come out when they're ready.
ReplyDeleteI really like the 3rd topic you have. Epidurals seem like such a norm for society now. It would be interesting if you could get into different ways to handle natural births. I have heard of a couple of cases of "pleasurable" births. Strange but a natural birth would be a much better alternative.
ReplyDeleteMy vote is for the high usage of epidurals in labor. I was given one for a spinal tap, and it was administered incorrectly, so I know that it can even be life-threatening.
ReplyDeleteHaving had an epidural, a spinal for a c-section and an induction...I vote induction.
ReplyDeleteI find the topic of medicinal labor induction of the most interest.
ReplyDeleteThe oxytocin induction issue interested me because they used it on me all three times I delivered. I really wanted to go the natural route but I was young and uninformed.
ReplyDeleteMy vote is for the use of medications to induce labor. I believe, as you said, labor is supposed to be a natural process and should be allowed to go that way unless there is a medical reason. Neither of my children even waited for their due dates (they were severely preterm), but that is how I feel.
ReplyDeletemy vote is for the first one
ReplyDeleteThe use of epidurals has my vote!
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ReplyDelete