Friday, June 12, 2009

The Baby Factory circa 1990

“Your turn,” my colleague Jennifer said, “my feet hurt.”

The delivery bell had just rung and the light above the stabilization nursery door was flashing brightly, summoning one of us to yet another delivery. It was turning out to be a typical booming night in the newborn nursery. Jennifer picked up the phone with one hand and juggled a baby and bottle with the other hand. She spoke briefly with a nurse in a distant delivery room and then hung put the phone.

“Room five,” she said with a sigh, settling back in her chair. The baby in her arms was rooting around, mouth open like a tiny baby bird, eager to get back to the feeding.

Taking the stethoscope out of my ears, I hurriedly finished my assessment of the infant on warmer number one, and then headed out of the stabilization nursery. Rushing to the elevator near the secretary’s desk, I pushed the button and the door immediately opened. This was the express elevator, used solely for nursery-to-delivery room service.

“Got a boy for you,” the delivery nurse said when I arrived into her room, simultaneously handing over a tiny newborn and his records. “Vaginal delivery with forceps, mom had Demerol, APGARS 7 and 9,”was the report she quickly rattled off.

The little guy and I immediately headed for the Newborn Nursery. He was about 7 minutes old.

Yes, I worked at the “Baby Factory”.

Did you notice that my former hospital was not very baby-friendly? I did say “7 minute old”, and there had been no bonding, no skin-to-skin contact with his mother and no breastfeeding for this new couplet. The baby was launched into a harsh, bright, cold world and then whisked away from his former source of comfort, to a four hour observation period in the Newborn Nursery.

This was my first birth center job and I as far as I was concerned, this was “state-of-the-art care”. I had no idea that this was actually no way to care for a tender new family.

“Oh my, Jennifer, you’ve got to see this little guy! Cute as a button!” I exclaimed as I returned to the stabilization nursery.

Before the little baby knew what was happening, I had him stripped naked and was inserting a rectal thermometer into his bottom. This was followed by my rapid adjustment of his warmer-bed so that he was tipped, head down, into a slightly Trendelenberg position. This position would encourage the fluid and mucous to drain from his airway. If needed, I would vigorously suction any secretions from his mouth and nose with the hard rubber bulb syringe, just the way I had been taught. And if he had many bubbles coming from his mouth and nose, I would likely grab a feeding tube, insert it down his throat and into his stomach, attach a syringe and suck all of his gastric contents out, as he gagged and sputtered.

What I know now is that being in Trendelenberg is not so great on the fragile blood vessels in the baby’s head. And of course, being baby-friendly means that you are going to be very gentle with a baby’s mouth in order to prevent him from having an oral aversion later. But, things were a bit old fashioned at the “Baby Factory”.

My naked little guy would scream from the moment that I unwrapped him, until he had his bath, about 3 hours later. The Stabilization Nursery where I worked, a division of the Newborn Nursery, was one of the loudest rooms in the hospital. At any given time you’d find at least six of our eight warmers occupied with hysterical, flailing babies.

When I started at my current job, I was shocked to find out that a healthy baby’s normal behavioral state in the first hours after birth is “quiet-alert”. Yes, quiet and alert. That is how a baby reacts to skin-to-skin contact with his mother or to just being swaddled, held and spoken softly to. Seriously, I was astounded. I had no idea!

After a couple of hours, it was time for a very stimulating bath. Grabbing a pile of warm soapy washcloths, I would scrub him down from head to toe. Working him into a full lather, I was sure to clean in all folds and creases. Once his little body was done, I would swaddle him in fresh warm blankets and hold his head under the warm flow of the nearby water faucet, always insuring that his face stayed nice and dry. The no-more-tears baby shampoo would wash all of the vernix (nature’s cold cream) and blood out of his hair. Often that little head would be tender and swollen, having suffered the trauma of a scalp wire from the fetal scalp electrode, or vacuum suction marks, or even bruises and raised forceps marks. I felt bad having to wash those sore heads. I could not help but cause discomfort as I worked the comb through the hair as gently as possible, often feeling the baby squirm and let out a squeal. But usually, the baby was peaceful and calm for that glorious hair washing.

Did I mention that I worked in a fish bowl? If I had even a hint of performance anxiety before my “Baby Factory” job, it had vanished soon after starting that assignment. Windows surrounded the nursery on three sides and I had a gawking audience each night for the first few hours of my shift, that is until visiting hours were over. People would peer through the glass, staring at me like I was a zoo animal, watching me give injections and perform other basic cares. Thankfully my little baby friends didn’t seem to be modest.

Following the bath and swaddling, it was time to feed the baby his first bottle. Yes, all babies were given a bottle for the first feeding, even if they were going to be breastfed. Following the doctor’s orders, the infants were expected to take in a certain amount of formula. If the baby dared become sleepy during the feeding, I would move that nipple up and down and all around his mouth, encouraging him to keep going. He had a job to do.

Of course, that really is not the way a breast baby should be cared for. A breast baby should not receive artificial nipples until breast feeding has been established. We can only hope that the “Baby Factory” has changed their ways.

The end of his observation period was marked by one last disruption; a set of vital signs and a final assessment. Exhausted from his four hour ordeal, he didn’t stir as I wheel him over to the main nursery room to join thirty to forty other babies. His seven day adventure at the “Baby Factory” had just begun.



“It’s your turn Jennifer,” I said with a sigh…


Carolyn said...

Wow! (and not in a good way wow!) Do US babies still go to hospital nurseries today? The stay with their mothers in the UK (unless in SCBU (NICU)) and always have.

And 7 nights! Wow again! You're lucky if you're in for 1 night here (unless Csection when you might have two). My sister was discharged 4 hours after deliver of her second, although normally they have you wait 6 hours minimum.

Morgan said...

How sad that the babies would be taken from their moms so quickly!

With the stomache being suctioned, is that necessary with a c-section? With each of my babies, they've stuck a tube down their throats and suctioned. My husband had mentioned that they were probably suctioning their stomaches, is that true? And if so, why?

With your hospital you're at now, do they do baths right away? When is it actually necessary for the baby to have one?

Mighty M said...

Hopefully they have changed their ways!! That poor baby had such a stressful entrance into the world!

Miranda said...

A seven day stay!! WOW! I'm SO glad most hospitals have changed their ways. That is one thing I checked into when having my babies, I did not want them leaving my side for ANYTHING!
So sad to hear though. working like that would be hard to do.

Anne Basso said...

Uh. Reading that just made my heart hurt! Not that everyone in "the baby factory" wasn't doing their absolute best, I'm not finding fault. It's just, I hate being separated from my babies after birth at all. It's only happened once, with my last one. He was a 35 weeker and very excited to try out every single gadget in the NICU.

But for the most part, I've carried these little people for nine months, and worked to get them out, and now I want them with me. I want to nurse them, cuddle them, count their toes, and generally not let them out of my sight. When my 5 year old was born the nurses were awesome and even brought a warmer into my post-partum room so that she could be warm enough without having to leave me.

Your story does remind me a bit of the hospital I did my OB rotation in. Most hospitals allowed women to do their labor and birthing in one room, but this old hospital was behind the times. I felt horrible making transitioning women transfer to a delivery room. Most of our moms were immigrants who had limited English and were having first babies. Here they are scared, in transition, and we're making them hop on a gurney and head to a brightly lit delivery/OR room so that we can shine lights all over them, freeze them thoroughly, and generally make their birth harder.

April said...

Hurts my heart just to think about it...sure hope things are different now! Have I told you just how much I love reading your stories, Julie? What a gift you have!

E @ Scottsville said...

Oh how SAD!!! I had Cam at a military hospital and he was with me or Jason at ALL TIMES and never had a bottle. I loved it!

But with Riley (my last), she was whisked away and we CAUGHT them giving her a bottle when I had specificially told them NO BOTTLES. I was livid! That hospital received a 2 page letter from MOM when I got back home. Never got a response, but they heard from me!

Ugggh. =0(

grandma mac said...

Believe it or not, I actually remember those days with my first ones, wow, I love the way moms and babies are "treated" today, with so much more love and compassion :) and gentleness, giggle Great post, Hope you have a terrific day!!

He And Me + 3 said...

Wow that was so enlightening. When I had Actress I feel like that was the way it was...but Model was kept at the nurses station until I called for her and was only breastfed. Stunt Man was the only baby on the floor the whole 2 days we were there. It was so nice being the favorite patient. He was held by the nurses almost the whole time unless he was with me. I felt very special.
Hope things are a little different now.
Great read my are so gifted.

BluRayn said...

Oh. My. Goodness! I feel traumatized and close to tears reading this story! How HORRIBLE!!! Soooooo glad things are different now and even more glad you work where you do cuz it's very awesome!!! Can't wait to have another little one there, that place is the best! :)

Great storytelling, as usual, you've definitely got a lot of talent in your family!!

Elaine at Matters of the Heart) said...

Oh wow, how horrible. It really made me thank God for my wonderful birthing experiencing. Hummm, Could that have anything to do with the hospital you know work at?

Elaine at Matters of the Heart) said...

Ooops I meant now work at.

Mr. Daddy said...

It just begs to be asked??? was it only boys that were treated in this fashion??? LOL

My God is it any wonder the maladjusted youth of the day. I mean yeah every body expects the doc to whack your A@@... BUTT after, to be stripped down and your Butt to be invaded by a rectal thermometer..and then the bed to be put into a range of temperatures. and then placed in a trendl-whatever position??? come on if you can't pronounce it, it can't be that good for you. Can it???? Then all the sucking of the mouth and nose. Not to mention the feeding tube ordeal....WOW..

So glad to see that things have been enlightened....

I'm off to see my therapist...I have a few NEW idea's as to why I am the way that I am...

Loved the story...

Can't wait to see what Firehubby has to say about it....LOL

Kelley said...

wow! so crazy! It's so interesting to see how much nursing care changes over a short amount of time!

Helene said...

Wow, things definitely are so different nowadays! I was just talking to a friend of mine who said, with both of her kids, she held them the minute they were born and breastfed them immediately. She said they stayed with her for hours before they were taken away to be weighed, cleaned up, etc. I was impressed, as all my kids had been rushed to the NICU since they were all premature.

Oh and I especially loved when each of the nurses explained how my babies didn't feel any pain when they had to insert the gavage tubes down their noses into their tummies. My heart broke every single time it happened.

I love reading your nursing stories!!

Rachel said...

Wow. Unbelievable to read it firsthand like that...

I'm sure I was laughed at as a control freak, but I walked in with my birth plan and absolutely determined to spend every possible moment with my kiddo and on my terms (as non-invasive as possible).

So very glad things are different now!
You are a terrific storyteller :)

-stephanie- said...

Thanks goodness times have changed. My mother was knocked out to have her kids, dad couldn't be in the room, and we babies got swatted on the butt to start crying. Nice!

Beth E. said...

I agree with Stephanie...I'm so glad that times have changed! I have to admit, though, that I would have LOVED a seven-day stay in the hospital. C-sections with both of my babies, yet booted out after 48 hours. Not fun...not fun at ALL!

Rebekah said...

Julie, Thanks for the trip down memory lane. Funny how things change. Ive been swaddling babies for 24yrs with their arms tight to their sides until last year I went to a newborn Neuro class and the latest thing is to be sure to swaddle a baby with its hands to the center. Go figure? I love to hear your stories and Im especially glad you are feeling better.

Eyeglasses & Endzones said...

It is a serious travesty (spelling) if you don't write a book and I am NOT kidding...Please find a publisher and remember who to send those checks!

I can't believe the job you have..the one and only who puts it into words like you and your stories just make me ache for another chapter....HURRY!!!


Notes from the Nursery
Patient Patience

Just rambling now...WOW~

grandma mac said...

Hey Julie, thanks for the comment on by blog..We lived in the Mtns for 25 years, then three years ago, moved here to the High Desert. We still have our house of there, one of the things that I would love to do is "update" it a bit, renovation project...giggle I still, in my own way consider myself a mountain girl, but, without all the Have a great day!!

mrosev14 said...

Woah for the baby factory. I could imagine how scary those first hours/days are for a newborn to be thrown into our world. I am glad you work at a new place where they value the importance of nurturing more. :)

As for the children's hospital in my neck of the woods...still hasn't been built. :( Maybe someday.

Jen said...

this is such a shocking story to me. How long ago was this. I can't believe that mother's let this happen, babies just taken to the nursery.

chickadee@afamiliarpath said...

oh that's sad.

Orah said...

Thank G-d we have learned and come a long way. People make fun of me for having my baby room in the entire time. I figure - I am taking em home in two days and there is no newborn nursery in my house, so what's the difference.

AtYourCervix said...

Sad to say, it's still like this at some places. I am so tired of the BS "mandatory" several hours in the newborn nursery after birth. Gimme a break.

momstheword said...

Erica kindly gave me your blog URL. I tried to respond to your post on our Five Mom's And A Blog, but it wouldn't go through. So I thought you had deleted your blog or something!

This is so amazing. I had no idea they went away that long.

I remember them giving my my sons and me nursing. Then they took them away for whatever it is you all do.

With my first son, they took him for quite awhile, but he was o.k., but they wanted him to cry more and get all the gunk out (and he'd swallowed some miconium or something, I don't really remember). I was barely able to see him before they took him. They said something about a weak cry, I don't remember.

I'd had complicatons anyway, so I couldn't have held him until that was all taken care of anyway.

But I got my second son right away!

Pam D said...

Oh, see.. I now understand why God made me wait so long to have my Bug Hunter! If I'd had him in the "normal" timeframe, what you described would've been my experience. But at 40, I was able to write out a plan.. to detail what I wanted (and Plan B and C), and to make sure it happened the way I wanted. There were a few deviations, because plans? They just don't always fall into place perfectly. Still, it all worked out for the good, and I'm thankful that all things fell into place. You write so beautifully, even when the things about which you're writing aren't. I s'pose that's why I love your blog so much! (well, that, and the fact that I just think I'd like YOU if I knew you in person...)

Joy said...

SHOCKING! This makes me relieved and glad for how much things have changed (well not sure if your previous place of employment has changed, but at least many places have!).

Becca~TimeWellSpent said...

Things had come along a little further when I started working OB in '96 but not by much. The stay was shorter and we kept the babies in the room a little longer but they were always taken away for the bath etc. Last place I worked (after working at several other more progressive hospitals) was a hosptial working toward Baby Friendly status. Such a better way!