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Wednesday
Mar022011

L&D Nurses... (& midwives, doctors, doulas, etc.)

... when a woman says, "It hurts!" Don't come back with, "It shouldn't hurt." That minimizes the laboring woman's feelings as well as creates a belief that the woman's body is wrong/bad for feeling something it "shouldn't" be.

Her body is not wrong.

If a woman says, "It hurts!"

Answer her with, "I'm sorry. I'll slow down and you tell me when I can proceed." Maybe even, "I'll stop moving. Let me know when I can go again; I'll go slowly. It might be uncomfortable... it might hurt, but I'll talk you through it."

Now, doesn't that sound more humane? 

Why, yes... it does.

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  • Response
    Response: www.pmar.in
    Well worth the read. Thanks for sharing this information.

Reader Comments (6)

Great post! I have been to at least one cesarean where the mom later told me that she complained to anest about being able to feel things and the anest. denied it and told her she was imagining it and not feeling what she thought she was. :(

I think it goes the other way, too. If a mom isn't saying that something hurts, a careprovider shouldn't program her to expect or believe it will hurt her. Let her have her own experience! She is perfectly capable of describing her feelings. It drives me bonkers in triage, while a mom is totally relaxed and focused in La-la land and the nurse putting in the heplock decides to start a narration of how it will burn, sting and pinch. I always want to say, "Mom knows how it will feel! She is doing her best to relax through it and not let it affect her. She will let you know if it hurts!"

Or when a mom is in transition and focused inside and a nurse comes in a clicks her tongue and makes comments like, "Poor mom, this contractions must be so hard." Maybe not for this mom, especially if she isn't asking for pain relief.

March 2, 2011 | Unregistered CommenterVanessa

"I have been to at least one cesarean where the mom later told me that she complained to anest about being able to feel things and the anest. denied it and told her she was imagining it and not feeling what she thought she was. :("

This happened to one of my clients, too. She was very traumatized, and I wasn't allowed in the room with her so I didn't find out until after. I was LIVID that she could actually feel them cutting her, and they acted like she was crazy and couldn't possibly be feeling it and didn't do anything more to control the pain.

March 2, 2011 | Unregistered CommenterRaeanne

Well worded post. Short, but sweet - and very true.

March 2, 2011 | Unregistered Commenteratyourcervix

THIS. They did this to me numerous times with my first. When the catheter was in, and I kept saying "It hurts! It hurts! Get this effing thing out of me!" (the only time I yelled that during labor, and it was about a catheter not a baby lol) and they blew me off. When the thing fell out 30 minutes later (a hole in the bulb, leaked all the saline out and then slowly fell out) they apologized and wisely did not insert another one. (Until they were prepping for the CS, hours later)

And again, when the epidural was working on only one side. I had to argue with them to get them to call the anesthesiologist ("You will still be able to feel pressure..." "This is not PRESSURE, it HURTS" repeat ad nauseum) and then had to argue with him as well.

March 3, 2011 | Unregistered CommenterStassja

Argh, the pressure vs pain "argument"! "IT HURTS." "Are you feeling pressure or pain? Because you're going to feel pressure." "I FEEL PAIN." "Sharp or dull... dull like pressure? Because we can't do anything about that." @#$%^& Not wanting her to feel pain does not, unfortunately, mean it is not happening.

Although, @ Vanessa: When I am doing something like placing an IV, or doing a cervical check, or whatnot, I do narrate what I'm doing as I do it, and give warnings about things that might be painful. Like, You're going to feel a stick and a burn, but it should be very quick, if it doesn't go away quickly let me know. I don't like to spring things on people. I see it as part of building trust. "Uncomfortable" procedures vary in pain intensity, but getting, say, an injection is never a tickle.

March 4, 2011 | Unregistered CommenterKatie

I did have a mama the other day that was in excruciating-seeming pain, late preterm, and although the pain did seem to be cyclic, did not correspond with the very mild to palp ctx (it was coming in waves more frequently than her ctx). While I could tell she was in extreme pain, I did let her know that it shouldn't be hurting like it was... and the reason I let her know was because I wanted to be sure we weren't missing something else (kidney stones, appendicitis, etc.) by assuming that it was "just" labor. She was also spiking a temp and dilating, albeit slowly. That was difficult.

Also, when something does hurt when it usually doesn't, I do like to r/o anything else going on. Why is this hurting? I will stop, acknowledge it, but I do want to figure out the root of it. A VE definitely hurts sometimes, some women more than others, even so-called 'gentle' VEs.

It's the same thing with the pressure/pain post epid. Pressure is normal. Pain is not. We need to differentiate to guide our next action. If you feel something and it is tolerable, and it is pressure, then that is ok, and we talk to you about it. If it is pain, and not acceptable to the mama, then we need to figure out what kind and where and how it hurts so we can figure out what we need to do (nothing? change position? SVE/immenent delivery? call the anesthesiologist?). Always assess first!

September 17, 2011 | Unregistered CommenterL&D RN

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