I had a laboring woman recently, wanting natural childbirth. Things weren't going smoothly (the baby was OP) and we had been trying multiple positions, etc in an effort to get the baby to turn. At one point, the woman is crying and begging me for something for pain. The father is arguing with her about it. He doesn't want her to have anything. We manage to keep her going and don't give her anything (although I was ready to). Time passes. No progress. Baby is still OP. Mom is getting out of control. I talk to dad about the various options including continue with position changes in the hopes that baby will turn, try the peanut, Get IV pain medication, get an epidural and put her sidelying with the peanut. Possibly pitocin if necessary. He gets upset and tells me that epidurals and pitcoin are a joke...blah blah blah. I felt like I was being very reasonable but also honest about the options. He told me he had to make a phone call...he was gonna call his childbirth educator who they had spent 10 weeks with so "I think she knows about this stuff". The 'better than you' was left off the sentence but was definitely implied. I told him to that was fine and to let me know what they needed from me. I went out to the nurses station and declared that I was done. I told the nurse to let me know what they need and I will order it but that I wasn't going back in there otherwise.
It's one thing to decline an option I offer - no problem. But no need to be an a$$ about it. And I promise that I know just as much as your childbirth educator/massage therapist/mechanic whatever.
Well anyway, I went to the patient because she was wanting to her what her options were. I asked her to give me a little more time in the tub on her hands and knees in the hopes the baby would turn. She did that very reluctantly. Then we re-checked and she was an anterior lip and the baby was changing his position. I had her wait fifteen minutes on her hands and knees then was able to reduce the anterior lip and push. She pushed for about an hour to deliver her baby into our waiting hands (dad was helping catch) over an intact perineum.
So I have mixed emotions over this experience. It's a very fine line to walk between encouraging and supporting a women's desire to go natural and her requests for pain relief. Especially when things are not going 'normally'. I think we pushed her harder than we should have. But yet I am happy (and hope she was too) that she did it naturally. But I feel like I forced it on her but not allowing pain meds/epidural. I would have had she not made any change but by that time she was so close to being ready to push I couldn't see drugging her at that point or making her numb. I'm uncomfortable also because I did what I did out of some desire to keep the peace between her and her significant other. And that's maybe not the right motivation. I don't know....gotta ponder this one a bit more.
Oh, and I got an email from the nurse that was working with us last night. She's sweet as can be, a future midwife, and a doll to work with. Apparently she was planning to give a bath to the baby (which she would have not done had the parents told her they didn't want that done) and the father got upset and threw water all over her papers. Then when another nurse later came in to check on momma, he told her she was stupid three times to her face (not sure what the context was).