5.28.07: What's fact, what's fiction and does it matter?
I was sitting at work yesterday (the labor and delivery unit I work at) with a bunch of other nurses talking about all the hits and myths we go over time and again with patients. "The first thing my patient told me this morning was 'I did all my Kegels so I'll be able to push well.' Great—now she'll be pushing for hours," said Larena, a nurse I've worked with for years. Where do they get this stuff? Kegels are for after delivery. Your perineum has a tough time relaxing enough to get the baby's head out. It's a muscle—if it's strong and tight—well, duh."
"All the literature says to do them to prevent incontinence and help with pushing. I did them with my first and didn't leak a single drop of urine." I countered.
"Yeah, well, did you tear at delivery?" Larena asked.
"Oh yeah, a big one." I winced at the memory. I didn't do any at all with the next deliveries until well after birth (and then, truthfully, only sporadically, at stoplights, if it occurred to me). And no tears with those babies. Thank God, so far, no incontinence either.
Well is it a myth? Or not. Depends on whom you ask. You'll get a different opinion from your midwife, grandma, nurse, and best friend. Where do we get all this information? From generations and generations of women. We write about it, post it on the Internet, publish it in magazines and talk, talk, talk. When you're pregnant, there's nothing but advice, technology and mythology driving you towards delivery. Then when you finally get to us nurses, we have our own stories to tell. Ours, of course, are based on years in the birthing trenches, thousands and thousands of babies, one labor at a time. Sure, we've all got great educations and customized training but believe me, we're not above folklore. Birth is as much of an art as a science and the tricks of the trade get passed from nurse to nurse by talk, talk, talk.
Larissa chimed in: "How about the thing about, if you carry high—it's a girl and low it's a boy? Wait a minute. Maybe if it's high it's a boy and low it's a girl? Which one is it?"
Who knows? When a patient says she's carrying high/low and it's a boy/girl, she's also probably had an ultrasound that told her it was a boy/girl. I'm willing to agree that the technology simply confirmed the mythology (or vice versa).
"How about the one where everybody goes into labor on the full moon?" Lisa added.
"Well, yeah, but that one's true." I said.
"Oh yeah, that's true. OK, how about if you have heartburn, your baby will have a lot of hair." Lisa said.
"But that one's true too." Larissa confirmed.
"Bald babies' moms have just as much heartburn." I added.
Another nurse (also a Lisa) said, "Here's another one: Fast heartbeats are girls, slow heartbeats are boys. That's kind of true."
"No it's not. My patient's having a boy and his heart rate is fast." Larissa said.
"Yeah, mine too, but my other labors this week were girls and their heart rates were fast." Larena added.
"Anybody heard the Drano in the pee story? If it turns blue or something it's a boy and pink it's a girl?" I asked. I'm totally not sure what color the pee turns with what gender. Pink and blue make as much sense as anything else.
"What? That's not true." Who's peeing on Drano these days? Yikes, what if it splashes? Doesn't everybody have an ultrasound?" The conversation went round and round with all the stuff we hear based on old wives tales and stories passed down from generation to generation. People put a lot of store in stories. Call them myths, history or whatever. We nurses just go along with it for the most part. If somebody's been doing Kegels for months and has a perineum of steel—who are we to burst her bubble? If patients want confirmation based on heart rate that their ultrasound did, indeed, determine the right gender, OK, we'll go with that. The heartburn thing? Doesn't every pregnant mother have it? We'll compliment her baby's hair (or lack of) anyway.
How about the full moon myth? Well, there does seem to be some truth to that. Women come in like crazy with ruptured membranes right around that time of the month. Maybe it's tidal pull or a drop in barometric pressure. Whatever it is, that one seems to be consistent. The stories about eating pizza, salsa and arugula to start labor aren't all that accurate but what the heck. Most women prefer a good meal at the tail end of pregnancy to sex—which is also supposed to start labor. I think guys are the one's keeping that myth alive. Sure, there's some accuracy to it (prostaglandins in the semen stimulate cervical ripening) but we figure the guys know they're not getting any action for quite a while after the baby's born so they might as well talk this "old wives tale" up.
The point is that despite all the technology, people put a lot of trust in folklore. So do nurses. Technology's only taking you so far through labor and delivery then it's all about biology, anatomy, history, instinct and family. These factors have been reliable indicators for all the mysteries of reproduction for thousands and thousands of years. And nobody's more superstitious than a nurse. Any nurse fool enough to say, "Wow, the maternity unit's really slow today" will get herself shushed fast as lightening. That's no myth. Say it's a nice day. Say everything's going smoothly but never, ever say it's slow, not busy or boring. You'll bring an onslaught of patients running through the doors like there's a sale at Target. That's just plain common sense.
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