Crossroads, Another Rant About Ob's

To get your RN... in most places... is 5 years of those 8 years.

2 years of prereqs.
1 lag year (usually filled with phelbotomy, or emt, or labwork, or volunteering, or internships -paid or unpaid-, or unit secretary, or, or, or... insert med field work while you wait to pick up into nursing school)
2 years of nursing school.

Yes. It's a long time. Because you have people's lives in your hands. Where mistakes COST lives. And in prenatal/perinatal/etc... TWO lives (mom and baby's).

___

I can't speak for your area, or your experiences... What I can say is that here:

In our area:
- CNMs often partner up with OBs. The office I went through had 4 or 5 CNMs and 4 or 5 OBs. (Heck. I was super high risk and still had the CNM team as my primary.)
- Midwives, doulas, and coaches (good ones) are ALWAYS linked with emergency medical support and have privileges through local hospitals (for when home births go wrong... births go wrong... period. No matter where they're at. Most are fine. For the ones that aren't, rapid medical response saves lives)
- In school, people are taught about and trained in different options (from everything from surgical intervention to perineal massage)... and in offices patients are presented with those options. ((In all cases? Of course not. In good places? Absolutely. I don't know a single mother, locally, who was not educated by the OB's office as to different options available to them.))
- VBACs are super common
- Natural births, CNM or OB are super common

Maybe it's because I live right next to a med school... but the vast majority of things you 'want' are TAUGHT in the medschool and nursing schools. ALONG with all the stuff you don't like.

Willful ignorance is a very dangerous thing.

Just because you don't like or want something doesn't mean that you just ignore it. Or worse, rail against it.

Csections can be optional, or they can save lives.
Prenatal care can be frosting (easy pregnancy, normal fetus, normal gestation, healthy mom)... or can be life saving.

You've already had some up close and personal experience with willful ignorance. Yes. It is a LONG educational path before a person is ready to be responsible for the lives of other people. For good reason. Yes. You'll be 40. With 25+ years in which to practice afterwards. And you won't be a danger to every new mom around you, because you won't be ignorantly putting their and their baby's lives at risk, because you don't know what you're talking about... because you don't want to learn about it.

I don't like a lot of stuff. Abreidment of burns on children has to be about one of the lowest on my list. And yet... without scraping off their burned flesh... they die. We OFTEN have to both learn and do things we don't like... for good outcomes. If you think you're capable of learning and doing things you don't like... then take a deep breath... and get started.

C.,

It's great that you've found your passion. However, you can't let your passion and opinions override reason, reality, science, and experience.

It's wonderful that you want to help new moms to be educated about options---but that means ALL of the options--- because in some emergency situations, the option you hate is the one that may save the life of the baby and mother.

I didn't plan on having a c-section. Wasn't happy when the doctor said that's what we needed to do, but when my baby was in distress, it was no longer A. "option." It was the answer.

I am truly sorry that the birth of your second child did not go the way you had planned. Yet, you can't take your experience and determine that no one should be going to OBs for prenatal care or that no one should have a c-section.

Maybe you could start taking some pre-req classes and get any college entrance exams out of the way, if you haven't taken them previously. If you already have a BA or BS, there are some accelerated nursing programs that allow you to complete your RN in under two years. We have one here in town, but it is exceptionally competitive and demanding, and you'd have to be prepared to be away from your kids for long hours. You can check to see if such a program exists in your area if this kind of program interests you. You might also want to check into a lactation consultant program. That is not quite as intense or as long as A. RN. You could complete the LC program and practice for a while, and then, when your children are in school full-time, it might be easier to work on your RN. Just some possible suggestions.

I know you have a vision of how you'd like to help, but being in this kind of helping and medical profession requires you to have a broad understanding of the childbirth process that goes beyond just your personal preferences. Without a willingness to do that, you become a detriment and a danger to those you hope to help.

J. F.

I'm a little offended that you think people don't consider the paths that you're talking about. Just because they don't make the same choices you do does not mean they have not considered them. Many, many people consider those paths and reject them because they feel just as passionately that they are wrong as you feel their choices are. I would never use a doula, have a midwife, deliver at home, or any of the other options you mention -- I was extremely well educated about my choices. Had I made those choices, my son would very likely not have survived delivery, and his complications were completely unforeseeable. It was only because I was educated that I was prepared for the complications that occurred. I admire that you want to make a difference, but I am put off by how judgmentally you are speaking of those who choose otherwise.

Wow - you need to take a deep breath and chill. First of all - insurance companies don't pay OB's if the c-section wasn't neccessary. Be thankful that we live in a country where those options exist. My nephew was a forced vaginal birth and broke his collarbone on his way out becuase the OB was determined to reduce his c-section rate. My second child was a c-section after a quick and easy deilvery of my first. My doc tried a version and I saw stars when he tried to repostion my son. Thankfully he didn't have spinal cord injury and I didn't have a torn rectum becuase we live in America and I was in a hospital. I had considered using a nurse midwife and am thankful I wasn't at a birthing center since A. ambulance drive to the hospital on a hot summer Saturday afternoon would have taken a looooong time.

No I'm not a loobyist for OB's - I just try to see both sides of A. issue.

All that being said - becoming a nurse-midwife is A. awesome goal. Yes, it's 7 years of school but that's the time it takes to become a Physician's Assistant or a Nurse Practitioner. Your idea of beginning as a nurse is A. excellent idea - a 2 yr degree is to become a licenced practical nurse (LPN) a registered nurse (RN) is 4 years. Either way it's a great start and there's a shortage of nurses so you might even be able to find funding for school. Many hospitals will pay for you to become A. RN once you're a LPN and are working for them.

(My mom and both of my sisters are nurses, as are my SIL and BIL. I have a cousin who's A. orthopedic surgeon and a few friends who are physical therapists and I work in the health insurance industry so I know way too much about the health care business.)

Finally, consider waht Dear ABby & Ann Landers used to say when posed with your dilemma of A. education taking a long time. They would say "7 years will pass one way or another, you can either have that degree at the end of the 7 years or not" so how would you rather arrive at that point? By having attained some or all of your goal, working towards it or not?

you go girl.

Hi C., I hope you are able to find your passion and follow it, and I'm sorry it's so frustrating for you right now. From reading your post, I feel like you are sort of riding a pendulum swing. Your c-section and watching the Business of Being Born have really struck a chord with you, and you are high on spreading the word about what you learned, and the down side of c-sections. I do hope you let the pendulum come back to the middle before making any sweeping decisions.

Yes, there are bad docs. But I truly believe they are a small minority. Without going into the whole story, I will tell you that if it were not for A. OB and the medical community and having my baby in a hospital, me and my baby would have died. No question, no doubt, and I didn't have a c-section. Thank God for them, and thank God I live here with the medical advances and knowledge that saved our lives.

So yes, women should be given the whole picture as far as choices. And the ones who feel better because they gave birth at home? Happy that they embrace the experience and it was the right decision for them. And for those of us who gave birth in a hospital hooked up to who knows what and had healthy babies and lived to tell about it? I know I embrace that experience as well. All I need to do is look into my beautiful daughter's face to know that I made the right decision, too.

Okay a couple of things. One, SAHM is not for everyone. I have done it and its the hardest job I have ever had. But it was necessary at the time for our family to have me at home with the kids.

I also went back to college when my youngest started kindergarten. I went for 4 years to get my BA. It wasn't easy but nothing worth doing is. I was struck by your surprise about the length that the education would take. Its not like you can just take a couple of seminars and poof be a midwife. I think you really need to talk to a counselor at school and find out what is required and what is not. You may be doing research but until you find out for sure you don't know. I didn't think you could get A. RN in only 2 years. I thought that was LPN.

Next, I had 2 c-sections and I am so thankful for that procedure because you see it save my life and that of my daughter's. While you have passion about your birth plan, I had passion about mine. Survival.

I did research before and I decided there was no way I was having a home birth or midwife. I wanted the hosptial because I wanted to be sure I was in a place that if something unforseen happened (and it did) that I and my baby would be cared for and we were.

If this is something that you truly want to do then the length of time for your education should not limit you. The only thing limiting you is you.

Hi C.,

What A. interesting post. It certainly caught my attention.
I really wish that more people would have the opportunity to know more about *both* kinds of birth.
I did go with a midwife and homebirth-- first and foremost-- to escape the highly medical care I received during the pregnancy I had before I became pregnant with my son (that pregnancy ended in miscarriage--I had been sent in for ultrasound after ultrasound until I finally put my foot down). I had read loads on the 'evils' of hospital birth and knew I did not want to go that route. The midwives I sought, however, were A. expert team across a variety of disciplines: each of them were RNs, CNAs and Naturopathic Doctors. Because of this, I trusted them to transfer me if necessary.

I learned a lot in their birthing course. I learned to look my fear of hospitals and cesarean birth in the face and knew that, if necessary, I would be strong and participate in that process. I learned, too, that for many women, birth does not go typically. My cohort of pregnant moms was atypical, but out of 10 of us, only three of us did not have to be transferred (tearing, uterine prolapse, overdue baby, etc.) and one of the babies died shortly after birth. Even during the most well-supported natural birth, stuff happens.

I am not a gloom-and-doom drama mama, but this was A. eye-opener. Our son's birth was great-- medically uneventful (acupuncture induction because I was ten days late, Kiddo said his first squally hello about 12 hours later.).

What concerns me so much, though, about the polarized presentation of birth (via "Business of Being Born") is that we put moms in a place of feeling that if they couldn't have a natural birth for any reason, that their baby missed out on all those good chemicals and bonding with the mother. As if there is only ONE time to bond with mama. I have been with women who have had cesarean births and who felt hurt by this movie. We need to create a dialogue of support and support systems for mothers who have harder births, because this IS traumatic and can certainly affect that mother's subsequent birthing experiences.

Sometimes, a cesarean birth is a medical necessity and the safest option. I have two friends who labored,unmedicated, for over 36 hours before deciding to go forward with the 'section'. Yet, cesareans are often discussed derisively as a 'convenience'. We need to find some factual middle ground and balance. In underdeveloped countries, it is common for women (who are told that birth should be natural) to labor to the point that the baby dies and then the mother must pass the stillborn child, while also developing devastating fistulas and other incredible trauma to their bodies.

I agree that your mission of providing good information is important. I would encourage you to find materials which provide balanced information. As a hobby, I studied midwifery books for about ten years (considered becoming a midwife when I was younger), so I knew a bit of what I was getting into. That said, I've also known many women who really chose not to pick up a book and go the extra mile to educate themselves. They just left it to the 'experts' who were teaching their birthing class. There has to be some sort of personal responsibility for seeking out information. Even if you present it and make it available, if someone doesn't want to think about it (and I have heard this) the information stays 'mute' for them.

Your kids are young, and 2 and 3 are some of the MOST trying ages to be dealing with.
There's many a Mom who will be driven stir crazy by that age group.
I think it will get better when they are a little older (school age) and there's more for you to be involved in.
There's nothing wrong with wanting a career but as YOU are gearing up for school, so will your kids and you are going to feel pressure like you never have before.
It certainly can be done, but you are going to feel torn because your classes and studies will demand time and right when you need to study is when the kids will need you for something dire - it's Murphy's Law of mothering.
In my 20's I could burn my candle at both ends easily.
In my 30's and 40's - no WAY could I manage it.
But that's just me.
I think (career) decisions are best made when you feel you are moving toward something and not desperately running away from something.
And I do get a feeling from your post that you ARE running away from something.
Motion just to be moving in any direction is often a waste of money, time and resources.

The first thing I thought when I read your post, before getting to the end, was that you should become A. L&D nurse first. Then you'd understand things first hand - the good and the bad. You'd see who the excellent doctors are and the ones you are berating.

There are lots of reasons that women go to OB docs, C.. I never considered a home birth. No matter how much you would have educated me, I wouldn't have done it. It's lovely that some women are willing to, but I would not have been one of them. What I WOULD have loved to have was a doula. That's another possibility for you, to be a doula.

For both of these jobs, A. L&D nurse and a doula, you have to be willing to work crazy schedules. You can't always get a day job in a hospital, and as a doula, you show up when baby starts to come. And that means you have to have someone watch your kids. Nursing school is a lot of work and you have to be AT school for most of it. And when you start your clinicals, you can't miss at all. You must have a safety net for your kids for sickness or any other reason.

The best thing you can do is get your education, put your toe in the water with the work, learn as much as you can and try to see both sides of the argument in regards to L&D and docs vs midwives (you must do this or you will upset those you are helping in the hospital) and then move from there. The more experience you have, the better.

For what it's worth, I started classes to get my nursing degree after my second was born. I loved my L&D nurses so much that I wanted to do for other women what these ladies did for me. I took night classes while I worked fulltime with 2 kids (with some help from my mom in addition to daycare). One night I had to take a chemistry test, and my husband was late and I sat at the testing center with my two kids waiting for him so that I could go in and take my test. I missed 40 minutes of test time - he showed up, I ran in, sat down and barely finished before they turned out the lights. Super stressful...

I would be a nurse today if we hadn't started moving for my husband's job. Everytime I'd just get caught up to our new surroundings (and working with my younger son's speech problems), we'd move again. I gave up my dream, but I understand where you are coming from. However, Rome wasn't built in a day, and though you want women to choose midwifery over ob docs, start small by helping women have a successful delivery in whatever way it ends up happening. You cannot fight the doctors and you can't argue with what they recommend to the patient. You can learn while "doing" and then take THAT knowledge and build on it with more education, and possibly work with a midwife in another capacity. (In other words, working within the system to learn from it, so that you can eventually move OUT of the system and serve the smaller percentage of women who will accept the alternative to the ob doctors.)

Good luck!
Dawn

I am a certified nurse midwife. I had a bachelors degree in another field so I did a combined RN-MSN program (there are several out there). The advantage of that is the shorter education time (2 years for RN and 3 years for the masters). If you don't have a bachelor's degree in another field (this is always a requirement for the accelerated programs) I would recommend A. associates degree in nursing followed by bridge program to the master's degree (this combines fulfilling the requirements for a bachelors degree).

Look carefully at your options. I hate to be a downer but if I had it to do over again I would not be a CNM. I agree with you on all of your points but in reality due to the restrictive laws in my state I work with doctors. I cannot "educate" patients against what the other providers are recommending or I will get fired. So when I am in labor and delivery and the first time mom is coming in for induction at 40 weeks for no reason and it ends in a c-section for "fetal distress," I just have to bite my tongue. Because as far as the patient is concerned the doctor has saved her life and her baby's life, as far as the doctor is concerned it just didn't work out (because s/he doesn't know any other way to do it) and if I were to start making waves I would be gone. If I were working in a patient friendly midwifery practice I would probably be happier. But those are very hard to come by. There are none in my town. Also, working as A. L & D nurse was awful- following orders for unnecessary inductions, pitocin, etc was not a good experience for me.

So, that being said, I have four children and I was able to complete my education. Look at your nearby options, start the application process, and look at doing your pre-reqs now. Apply early because often times the application process itself is very long and then you may have to waitlist for a year or more. Lactation consultant is a great career but also pretty extensive education wise. Most hospitals actually hire "lactation counselors" rather than IBCLC's (international board certified lactation consultants) and there is much less educatio involved in being a lactation counselor but they tend to be part time nurses/part time lactation consultants so you would still need the nursing.

Every journey begins with the first step. When you run a marathon you don't think about the 20 + miles ahead of you, you take it step by step, mile by mile.
I am going back to school today, I have a 5 year old and I am in my late thirties. I have been taking classes for the last 8 years, meeting pre-req's and back to school full time for the last year and a half. I will have a B.S. by next summer, after that I am hoping for grad school... but who knows what's going to happen.

Take it one step, one class at a time to begin with - who knows along the way you may even take a turn you can't anticipate yet and end up doing something different than what you set out to do.

Good luck!

Your post is definitely all over the place, but it seems the heart of the matter is how you can best support birthing women.
How do first-time moms know that doctors often do not practice research based medicine? Often they don't. I was a Bradley educator for 13 years. Most women don't start doing their own research or take responsibility for their own pregnancies/births. They hand that responsibility over to a doctor. They assume their GYN will be their OB, and never think to question that. They think OB"s deliver babies and isn't that happy? But OB is a surgical specialty. That's the OB/GYN's training - the diseases of womens' reproductive organs and how to surgically treat them. Most women who get pregnant don't think to ask their doctor's birth philosophy, or question their own birth philosophy or even really know what a birth philosophy is. If they have to choose A. OB, they often pick one because his/her office is close to the mom's home or work, because they're on the insurance plan, because their SIL say he's nice, because they prefer a woman doctor, etc. Women aren't taking responsibility for themselves. When they look for childbirth education classes, they typically contact their local hospital - A. establishment who stays in business by charging insurance companies for epidurals, c-sections and nursery stays.

As for continuing your education ... be sure to look into your options before investing time and money. Sure, getting your RN in two years sounds great, but remember that if you're working in a L&D unit in the hospital, you're not going to take the birthing world by a storm. Your job there will be to follow the orders of the doctors, not educate women against hospital procedures. You'll be fired for that. Lactation consultant is a great profession, but remember that you have to be working with breastfeeding women for - I think the number was 1,000 hours - before you can sit for the IBCLC exam, and most hospitals want to hire IBCLC's, it may be hard to get the 1,000 hours you need. Being a nurse in the hospital means you'll be on shift rotation, so when your kids are 5 and 6, you may be working A. 11pm-7am, come home after no sleep, put kids on the bus, and have to wake up in time for your half day kindergartner to come home. Being a doula means you'll be supporting the laboring parents and being a medical caregiver, but it also means that you may be called to come to a birth 2 hours after you've fallen asleep (and then get home just as your kids are getting off the school bus), having to leave your own child's school concert or birthday party. Be sure that you want to make this commitment!

Good luck and I hope that you find your right fit into the birthing community! I loved working with so many women/couples who were preparing well for a natural birth. If you're looking to educate expectant parents, maybe you want to consider training to become a Bradley teacher. Typically that'll mean teaching classes at night and/or on the weekends though, and it's not full time work.

I only got half way through. A couple thoughts and I don't mean to be unkind here but....did you really think being a sahm was going to be easy? We ALL struggle with it when the kids are yours ages. What I think you are really saying is that you need things to be more about you-which is fine. Many people are and remain like that forever. Many outgrow it too (I did) when they have children. Secondly- I was THRILLED to have c-sections so DONT assume that since you were unhappy to have one we all were cause its not true. Thirdly-there is a whole interweb out there to research your career questions. I would start there and then do a simple google search for midwives or whatever it is you want to be when you grow up in your hometown and then make appointments to meet. I am sure that women in this field would be more than happy to tall you about it.

I became a mother at the stupid young age of 19, but I rose to the challenge. I chose to be informed about birth and breastfeeding and delivered my bouncing baby boy completely naturally with the guidance of a midwife. Maybe you don't give us mommas enough credit. Even now, I have birthed all 3 of my children with the assistance of a midwife, and breastfed on demand.... because it's what I felt was right.

I agree, there is a serious gap in knowledge {for some} mothers to be. There is this medical way that women have been having babies for a few generations, and now no one knows any different. {Except that a lot of us do know different.}

Truthfully, I don't know how to help expecting mothers take charge of their birthing experience. It might help if teenagers and too-young adults weren't having babies. But that's another post, isn't it? And I can say that, because I know I was too young. Yet here I am. ;) A conservative Christian, farming, sewing, cooking, breastfeeding, birthin mama. Oh the path that the Lord has me on ;)

I would love love to be a lactation consultant, but know that for now my place is at home. I'm sorry that you don't feel the same way, but can honestly say that I relate, so I'm not judging!

If becoming a CNM is too long a process you should consider becoming a doula. It seems similar to a program for adults going back to school, almost.
It has you read a gazillion books, but it is at your own pace. I guess you sort of teach yourself. I think that it is about a 2 year program.

I can't remember. There was a while when I was really thinking about it, so I started accumulating all of the books.

Start here: http://www.dona.org

Best of luck,
KATIE

First, take a deep breath.

Next, give women more credit for learning the facts before childbirth. What is right for one may not be right for another. There is no way in H E double hockey sticks I would have deiivered at home, but I did know my options.

Third, I don't think the "Lord intended" for all births to be at home or he wouldn't have created highly intelligent women and men that have the desire to study for years and years to become OB's. These individuals save lives every day.

Next, passion is a wonderful thing, but as a self-titled drama queen, you will need to reign in the drama because a delivery room (or living room with a pool) is the LAST place one wants drama.

Lastly, 39 is not too old to start a new career. Besides, you will not be starting at 39, you will be working in your field as you study. Go for it!

I have a friend who is a doula and she loves it. I'm not sure how long exactly it took her to become certified or whatever they do for doulas, but she loves helping moms have babies the way they want to. Maybe something you could look into.

Hi, C.:

What does your name mean? "Helping those in need."

I would suggest you volunteer in A. organization that "helps those in need."

Volunteer at Social Services to help new mothers.

Good luck.
D.

well, i don't know how to answer the only question i could dig up from this post! i hope young mothers-to-be use the internet and look around before deciding how to deliver their babies. i didn't so much, but it was a different world then.
what i DO love is that you are climbing out of the pit and recognizing your strength and working on ways of following your passion. even if you don't go to school, you could work FOR a CNM in a support capacity.
i don't think you're a drama queen. i think you're just tired of having your wings bound tightly to your sides, and are fighting to spread them.
i'm cheering for ya, babe!
khairete
S.

What sort of qualifications (if any) do you have to have to become a doula? You could offer your services as a birth coach on through to mom's maternity leave. Just a thought.

I can't see any of the other responses so I don't know if you have already been given this suggestion or not. I suggest that you look into becoming a doula and/or a birthing class training. I would guess that a lot of first time moms would take a birthing class and you would be able to reach out to them. Hope this helps. If you want more information about doulas, check out the website www.alldoulas.com

My first was A. unexpected c-section and I wasn't traumatized by it like some women I've read about, however I was determined to have my second baby naturally. I was lucky enough to find "one" doctor who would support me in my effort (and I live in a city of 8 million people, in China). So I was lucky enough to have my second in four hours start to finish with no drugs and this was even in a hospital setting. After being able to compare the two experiences I was in a similar place as you, and since I just turned forty I can understand not wanting to take the long route. Good luck in your endeavor. I grew up in PA close to Frederick so congrats to your friend for starting ICAN!!

J.

I took a Bradley Birth class before my delivery, and it was the greatest experience. They talk about a lot of the same issues you do -- and how to handle to pain of childbirth without drugs. Anyway, you might want to look into being a birth instructor? Run a twelve-week class for expectant parents? You'll probably need to take a course or two to be certified, but then you could have a job working with new moms-to-be, without taking 8 years of school.

how old will you be in eight years if you dont take these classes ? and how many women will be bullied into A. c section and other un-necessary complications if you dont complete theses classes ? childbirth has turned into A. easy way for obgyns to make A. incredible amount of money by scaring women into believing that childbirth is alot more painful, mysterious, dangerous and complicated then it really is, and the obgyns are laughing all the way to the bank because of the misinformation that they are providing women. more later, my home birthed baby and i are going to the grocery store
K. h.