Wednesday, December 9, 2009

Using Technology to Train Doctors about Labor & Delivery

Dou-la-la posted this video recently which shows a model woman being used to train doctors and nurses how to handle a woman when she's pushing her baby out. 



It makes me think of what we learned in our doula training workshop about "purple pushing" or directed pushing which the doctors and nurses always try to use - this is where the woman is sitting, curled forward and she is told to push for 10 seconds (during which she holds her breath, hence the term purple pushing) and becomes light-headed and strained. However, this is not a realistic pushing technique, because the mother can't make it a full 10 seconds without wearing herself out (my trainer says she follows the nurse's directions but counts much faster than this... 12345678910!). Though directed pushing is useful when the mother has had an epidural and can't feel her urges to push, it is just frustrating for a woman who CAN feel those urges. This is because they come several times over the course of one long contraction, and she has to just go with it when it comes, not count it out for 10 seconds whenever the doctors says to!


Here is another video about a pregnant robot who trains obgyn residents at Johns Hopkins:



A commenter on this post from Dou-la-la's blog said exactly how I feel: "Great. A whole new generation of doctors and nurses being trained to lay a woman flat on her back, open her legs, and push her knees up to her ears. Why not use a simulator to learn how to "catch" when a woman is in ALTERNATE birthing positions?"

I think training doctors and nurses for different scenarios is great, they should learn how to do births with an IV, a fetal monitor, an oxygen mask, woman on her back, however they should ALSO learn how to deal with different birthing situations. This is why we encounter nurses who are so flustered when a woman wants to have a natural birth or give birth in a squatting position out of the bed - because they are only trained for this one scenario!

Sigh. But, as Michael said after he watched these with me, "Change takes time."

3 comments:

  1. I think this should be heralded as a great achievement. Now, instead of working on patients as guinea pigs, we're using robots that simulate even something as complex as childbirth, with all its possible complications, without the risk of harming a real patient with an inexperienced medical student. The robot already can pee, bleed, deliver a blue baby or breach baby, and has a pulse, etc, like many of the other sims we'll use in medical school. To be unhappy that it also doesn't change positions is like saying, "Yeah? You can drive a car? Well, why won't you drive a plane?" Change takes time indeed. I'm just annoyed at the negativity toward medical doctors and nurses. Midwives, doulas, and doctors should be working together!

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  2. Of course it is a great achievement! I have no negativity towards training with technology. As I mentioned, training doctors and nurses to deal with situations that require emergency medical attention is certainly important. Working with a robot is certainly better than learning on a real human and making terrible mistakes. They do have to know how to handle births that go wrong, and even births with women who choose to be anesthetized and deliver on their backs.

    However, obstetricians and labor and delivery nurses are not being trained for any situations in which there is a regular, normal, healthy natural birth going on. I have heard and read too many stories where they just keep pushing meds on a birthing woman because they only know how to deal with a woman who is confined to her bed. true stuff! So I am simply advocating for training that ALSO includes what a non-medicalized birth can be.

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  3. Well I'm not sure about that-- I will let you know when I come to OB/GYN in my studies!!!

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