Laurie,
I can identify with the mom who felt the staff was considering her a
"freak" for having a birth plan and insisting on no separation from
her baby.  I have seen L&D nurses roll their eyes when a mom comes
in with a birth plan.  In many cases these are nurses I know to be
very supportive of momsin labor.  Why the reaction?  There seems to
be a belief that the stronger the birth plan, the more likely the
mom is to have problems that interfere with her meeting that plan.
It's kind of a "Murphy's Law" attitude (the more a mom wants her
birth to go a certain way the less likely it is to happen that way).

This leads me to several questions.  Does the nurse's belief that
the mom is more likely to have difficulties affect the way that
nurse cares for the mom?  Not in a conscious way, but
subconsciously.  Does the nurses subconscious anticipation of
problems affect how the mom percieves the support she recieves?  If
the mom senses the nurse's subconscious beliefs, is she less able to
use the techniques she has learned for working with her labor?
Any thoughts?
I, too am frustrated by the number of inductions without a medical
indication.  I can understand why some moms might want to be sure
their favorite doc is available for the delivery.  In some
practices, the approach to a laboring woman can vary widely from one
doc to another.  In scheduling inductions at our hospital, there is
a priority list (since I don't work L&D I'm not sure of all the
categories, but the first priority is where there is an indication
that the baby is in some distress and would do better outside mom
than inside and the last is the "convenience" incuction).
Nevertheless, doctors are not happy when one of "their" inductions
has to be postponed because there are already as many patients in
labor as the staff can handle. There are definitely some docs that
tend to have far more inductions than others.  The same ones are
more likely to use interventions such as vacuum!   The inductions
don't only have an impact on how the baby nurses, but if a vacuum or
forceps is used, mom is more likely to have an episiotomy and/or
extensive bruising which makes it difficult for her to sit up very
straight or move.  Then it is a challenge to position the baby for
effective latch.  Whatever happened to natural childbirth??!!
Winnie Mading RNC, IBCLC

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