Became an NP after 20 years and glad I am not full time bedside anymore.We are heading toward a crisis and I'm not an alarmist. Nurses are leaving the bedside almost before we can finish orienting them. They're applying to NP/CRNA school before the ink is dry on their diplomas. Most of our charge nurses at a tertiary, level one trauma center have less than 5 years experience and often 1 -2. The culture around nursing is so much worse than it was even 10 years ago...sad.

I am an ICU nurse and a Caribbean medical student.....This is not a nursing issue....This is 100% a Physician issue....the reason that Dr.'s wife died is that the OB physician forgot his/her physiology and didn't recognize that the pt already had a SBP in the 140's, a woman's plasma volume increases with pregnancy, and that once the placenta is delivered the BP will increase......let's remember that the circuit of the placenta is no longer available to receive blood so all that volume is now circulating in the mother.......the OB doctor should have had an IV anti-hypertensive on hand and administered it until the mother's body has had a chance to auto regulate her BP. Check out Dr. Francis's Pass Program.....this will bring any Physician's knowledge to the next level.

As a nurse who used to do home visits during pregnancy and postpartum, I have to say they’re extremely valuable. All my clients had my phone number and could call me with questions, I did a lot of education pre and post delivery. I caught the symptoms of PIH and preeclampsia multiple times as well as many, many cases of perinatal depression. I almost always saw clients at home long before their postpartum checks so we did catch a lot. We also did thorough assessments on each infant and caught issues with them as well. I worked specifically with women on Medicaid but there was a sister program that worked with women who had private insurance. I think every county should have these programs. Since the programs started the maternal and infant mortality rates went down in our county. I was really proud of the work I did with that program and I miss it a lot.

This hits so close to home. In my first pregnancy, I had pre-eclampsia that rapidly developed into HELLP at 32 weeks. My baby was saved by heroic nurses who called the OB and asked for repeat labs. After baby was in the NICU, I was basically left on my own. I was discharged two days later with my blood pressure still elevated, and my liver labs still in the tank (although rising). Luckily, I was fine, but now looking back holy crap it could have gone terribly.

I have been a labor and delivery nurse for over 20 years. Several years ago, pre EPIC when doctors had to physically write their orders out, I had a doctor write in the chart DO NOT CALL FOR BP LOWER THAN 160/110. He underlined this 5 times. Well, guess what?!?! She never made it to 160/110. She seized before we met his don't call criteria. She seized for 45 minutes. Her husband stood there helplessly holding their newborn baby while his wife is turning blue and foaming at the mouth. Why? Because this doctor was tired of hearing about her increasing blood pressures.

Here in Denmark we have nurses that have special training, who make home visits after mom and baby go home from the hospital. They try to visit them all within a week from discharge and then (depending on the needs of the home) make at least one visit a month in the first year or so. They check that everything is okay with the baby AND the family, because the health of everyone is important.

Yessss shout out to doulas!!! I am a doula and that definition is way off but we have proven to improve birth outcomes. Every mom should have a doula. I have supported moms and dads through csection, epidurals, and inductions. We are not just for the crunchy moms. There is actually a hospital near by that has hired a doula group full time to be available to their laboring mothers. #advocate #educate #support

There is no time to teach or do any good care for that matter .We are expected to be able to get patients in and out like an assembly line as fast as possible. We are threatened with corrective action for missing a documentation check mark . We are made to take large unsafe assignments. Older nurses are told to be quiet that they will get written up and labeled a trouble maker if they say anything and the sad truth is nobody could get it all done so they cut corners because there is no choice. It is heart breaking . I cry almost every day that I work before and after the shift . We need a champion that has enough clout that someone will listen.

Dr's might blame nurses but after having 5 babies I can tell you only one of my obgyns listened to what I was telling them. All the rest were stuck on rinse and repeat. No individual care!

How about we give these moms that handout before birth so she can be mindful of those things before she's so exhausted and brain fogged she can't even think or see straight?

That case was so sad and so rare! A number of things went wrong but it was definitely by all members of the healthcare team....not just the nurses! It’s absolutely necessary to have safe staffing levels of experienced RNs who are specialized in OB / L&D but many hospitals don’t want to pay for nurses.

I am an Obstetrician, in my 16th year of practice. I had a post partum patient who presented with a headache and high blood pressure, I begged the nurses to admit to L and D for Magnesium sulfate IV and was told that I was out of line: the patient had delivered and thus the risk of pre-eclampsia complications were over. Can you believe that?????? I made a stink and went on to do some education. But it was pretty scary at the time .

I’m in Queensland, Australia and our public hospitals have started using what’s called QADDS data which is Adult Deterioration Detection Score. It’s such a good tool to record obs and visualize when something is heading in the wrong direction. You get a score which gives you a systemic overall assessment.

I know that this is an old post but I am hearing this information for the first time in depth. I am an RN in a primary care clinic. I am going to talk to our providers and get our post partum moms seen at least virtually with in the first two weeks after delivery, then try to get them to be seen in the clinic soon after for a F2F. Then once a month either virtually or in person over the first six months after delivery to make sure that we do not miss something and have a family w/o mom. Also, I am going to talk to my nurses and medical assistants to include doing a spot check on mom when they are there for a well child check. Thank you for doing these videos. Keep up the good work sir.

Watching this in 2019. The problem with the list of "signs to watch for once you're home" is that most of those are 911-able already. I would hope that if mom has a seizure, they get EMS. By then, it may well be too late. In a perfect world, I'd love to have a postpartum home nurse go visit each mom that gives birth in our hospital to do a full assessment, vitals, edema check, etc. There aren't enough of us (nurses), and so yes, maybe telehealth would be a great step. That would get weights and vitals, and would be better than nothing. I get that most moms do beautifully. But it's shameful that our maternal health outcomes are the worst in the "first" world.

I was a labor and delivery nurse 3 years ago, and I was scared to see that 90 percent of RNs in this unit were brand new out of school. It was scary because I was the only nurse that got scared when bp was elevated with Mom. Never felt so worthless in a unit where no one cared for mom.

Preach it brother! We really need to value and respect our senior nurses! I’m a tenured nurse and had the advantage of training with some very experienced sr nurses! Now they’re all extinct!

i'm actually very happy you did this video. Im a nursing student and we are doing our maternity rotation this semester. This article is something I'm emailing to my teacher to ensure that these new statistics are brought to the forefront. As new nurses it is our responsibility to ensure we have the most up to date and correct information to help our patients. I have to say though my school strongly encourages us to consistently look these kinds of things up and to share them with the class. By being educated and sharing this knowledge everyone suceeds. Keep doing your thing ZDogg - so happy your making a difference. PS my nursing class loves the music videos too!!! lol

And thank you for bringing this information for awareness purposes.

There is a bystander effect I’ve experienced as an RN. If I express concern about symptoms I often feel pressured to defer to business as usual. To defer to what others say versus trusting myself and keep bringing attention to the team.

So many of these causes and consequences were caught when mothers were allowed to be monitored longer. But heaven forbid the cost is increased. Not enough staff anyway. WTF.

As a nurse who aspired to work in the labor and delivery field and currently expecting my first child as a high risk due to factor v, I appreciate you looking at this information for all of us to discuss.

There are some issues with the data gathered via death certificates. During the data time frame, check boxes have been added to death certificates to indicate if the patient had been pregnant in the 12 months prior to death....so the early data may not have captured the related deaths. When I first entered LD/OB nursing (way back in 1989) we were very specific about discharge education for maternal care and all the warning signs. Over the many years, I noticed a shift to only teach "individualized" for that mother. So if she didn't have GH then she might not be educated at discharge about a severe headache, visual disturbances etc. I'm all for increasing the maternal education regarding the warning signs. I also think home visits are a great idea for all families with new babies.

Loved it! very informative. I have some research and learning to do before starting a family.

An idea to get moms to listen to discharge education/instructions: lead with "hey, this is important for you to listen to because you could DIE from these things! This is about you, not your baby; you can't take care of your baby if you aren't ok!" Forget the whole "oh please listen ma'am." No! Some people need to be told in blunt terms for them to understand! Obviously don't swear or be mean. But nurses need to be firm when giving these instructions. Its important. Idk, maybe its my ER jadedness....but, when all you are thinking about is getting to take your baby home, its hard to pay attention. So maybe that bluntness would help?

Excellent discussion! Thank you!

Excellent conversation. Education all around. Yes, good format.

I loved this: you did some homework. It did not come from the 2 buddies who cheat off our homework. I loved the educational tool, I’d love to post it anonymously on our bathroom door at work. I am 60/40 on sharing with non medical friends. I partly don’t want them to know how shady we can think.

This was a great video and topic!

Love the format, not a nurse myself but my wife does L&D in Kaiser so I'm spreading the word for them to start watching you guys ......finally maybe they can watch something on KZfaq besides cat videos, dancing babies and raunchy humor , I do kinda like the "raunchy" humor videos they find, just not raunchy enough for me ..hahaha..Thanks guys.

omg my daughter turns 19 tomorrow and I am so glad I had an awesome obgyn dr. i was preeclamptic loosing vision had my gorgeous baby and was kept in hospital several days as my liver enzymes flew out of the park. Being. a nurse myself I really dont remember Hellp but wow I may have been close they never found any other cause for liver enzymes to go up I remember them checking for hepatitis n aids n doing an ultrasound of my gallbladder...ooops I rambled. Thanks for another great video.

I'm honestly surprised about the need to train nurses on the risks for problems in and after pregnancy. I am a fourth year nursing student in Canada and they drilled these postpartum assessments into us in our second year.

I feel like my HMO did a good job when I had my fist 2 kids, I was given a nurse care line number to call with concerns it was 24hours and the nurses really did a great job of not shaming me for calling even for things they might have thought of as dumb. I called one time because I got food poisoning and I was worried about nursing my son while I was sick. It was 1am and I had no one else I could ask but they were so great. I got great service, good advice and I didn't have to go into the hospital or wait a long time for a doctor to call me back. I don't even know if this was an option after my last two (different state, different insurance) and I signed them both out AMA with the suggestion that I bring them back to the hospital (20mins way and with huge wait times) if I needed anything. PITA and more expensive for everyone.

Love the idea of teleheath for this! It is such a hard time to leave the house, and telehealth would be perfect for this type of check in.

Great video and information.

I'm a practical nursing student in my maternity rotation right now. Found this enlightening. I just hit subscribe. I'll be back.

Hey doctor, great content, you have a nice voice. Man of many talents

RN nursing student love this video so informative

If you look at child birth in developed countries around the world to child birth in the USA. The USA is apx. 50 years behind. Uk, for apx 15 years has allowed women to eat in labor. USA just approved it in 2015, YET most hospitals will NOT allow it. Bed-sharing is HUGE around the world, for example... Japan custom is bedsharing is the largest sleeping arrangement, yet they have one of the LOWEST infant mortality rates. We dont allow walking epidurals, doctors are stuck in the dark ages.

When you said " lizard people " I flat out ugly laughed. Thanks for the ray of sunshine as a pre-requisite to a morbid topic.

Nurses work 15x harder change my mind. On my floor, the physicians quick scan these charts and get annoyed at the nurses for bringing up concerns they were trained to bring up to the MDs.

I appreciate this video. I had a completely uncomplicated pregnancy but a HORRIBLE delivery experience in a "Women's Hospital". No one seemed to care about MY health. It was an insanely lonely and condescending experience and actually inspired me to go into nursing because something needs to change in this process.

When a mom dies in child birth. It costs the systems more money. It's worth more to keep moms alive.

ZDoggMD, I was hoping to hear about your perspective about E.R's. I'd like to hear your opinions on 4 major topics. First the sheer volume most ED's are facing. Especially sense most of the busiest hospitals the problem is that patients don't have follow up care. Second, What do you think can be done about holds in the ED. In the ER that I work at it's not uncommon to hold patients for 2-3 days before they're able to be moved to the appropriate floor. Third, do you believe that there should be mandated nurse to patient ratios. In Texas, there are no laws regulating this. However, there are laws that protect the nurses from litigation. Fourth how do you prevent ER nurse burnout. I have found that the busiest ED's most nurses only last approx 2-3 years in those types of hospitals. How would you manage retention and prevent burnout. I look forward to any of your comments or anybody else opinions on this matter.

Great show

A nurse first duty is to the Patient not her employer or insurance company. If you have protected the patient- you have protected everyone.

This is great, I would also add that the excessive oxytocin administration adds to all of the issues as well, increasing bleeding, pulmonary edema, etc.

A great (self-proclaimed greatest) health system should be open enough to learn from all other health systems like those overseas. As a Nurse, do we not use the Evidence-Based Practice module?

Very informative show, ZDoggMD & crew. You are right...we do have a crisis in maternal care. I have over 20 years experience in labor and delivery, women's health, maternal/child care; I am a nurse-midwife student with Frontier Nursing University. As nurses and nurse-midwives, we are at the bedside with our patients for over 12 hours at a time...yet educating our patients on the most important topics relevant to peripartum care remains a challenge. Pregnancy & birth is not "dangerous"...it's how we have treated pregnancy as an illness and managed it as disease...that makes it dangerous. Interventions and procedures that are not supported by the evidence introduce risk and may not support improved outcomes. Pregnancy is a normal physiologic process all humans do and have done since the dawn of time. On the other hand, the *diseases* that occur during pregnancy must be recognized in a timely manner, intervened, and managed consistently regardless of socioeconomic status or geographic location. Educating mothers and their families on what to expect during the postpartum period is a challenging task complicated by fatigue brought on by maternal sleep deprivation, analgesic use for pain control after birth, anxiety, educational status, economic factors...the list goes on. There are innovative approaches yet to be utilized by our system such as home health care, telehealth, culturally appropriate education and information. We all have skin in this game...nurses, nurse-midwives, physicians (OBs, pedis, & FPs) and patients...when we stop providing care in silos and utilize a truly collaborative care model, maybe we can change the culture of maternal child care and improve outcomes.

How does our rate of assisted fertility in pts with preexisting conditions compare with countries whose maternity rates are decreasing?

Thank you for saying it! Nurses are so focused on clicking boxes and never utilize their education and knowledge to think critically and globally regarding patients. I believe older nurses have so much more to offer as they were allowed to treat their patients and often didn’t sit to chart until the end of the shift. I understand the thought process behind chart it as it happens but I think time will prove that patient care and satisfaction rates were higher before the computer age of drop down boxes and 40 page care plans!

I feel very lucky to be born in Switzerland and now give birth to my first child in Switzerland.

I had natural child birth. I sprained every muscle in my body. Blood vessels were broken everywhere. My green eyes looked like olives in tomato juice. The nurse would come through and say, you look terrible. (No joke) That was in the 80's and the bed was a roll up. i couldn't eat because no one would roll me up to eat. My son had been taken to a Neonatal Hospital, so my husband was with him. BTW, I went into shock and didn't talk to anyone for days. Why would someone not notice?

Now with that pie graph and teaching times, are those times reflexive to discharge? I know at discharge my teaching time is much shorter, however with each time I enter a patients room, I am doing some sort of education with the patient and family. Now I will say though ICU is much much different than L&D but just curious the correlation of teaching percentages at discharge or throughout stay.

Thanks for doing this!!! Great show! I'm an OB nurse. Certified in Maternal-Newborn Nursing. I take care of moms and babies, from 2 hours after delivery and sometimes sooner all the way until they go home. My assignment is usually 4 mom's and 4 babies, but can go to 5 couplets. I'm well trained on complications of mom and baby. I do review/read all of those discharge instructions you showed. PLUS!! we've recently added proper disposal of opioids. Mix pills with dirt or cat litter, put them in a ziplock bag, do not flush unless it's a patch, mark out your name on the bottle. OR we list all the police stations that take meds and dispose of them. (I don't like the police station one, there's bound to be someone in the station to take advantage of the pills. It may not even be a police officer.) My hospital is great for OB. We do 6500 deliveries a year. We have a level 3+ NICU. Tom, I wouldn't deliver outside a hospital either. I know someone who delivered at home with a midwife and that child has severe cerebral palsy, due to oxygen deprivation. But I am ALL about getting patients home and facilitating discharge. It's better to be at home. In my 14 years, I've only seen 2 maternal deaths. One pt had liver rupture after delivering twins (post partum HTN- which I also, personally had with both of my kids- no BP issues in pregnancy) and another patient bled out in the OR, twice. I think she had DIC. One of the best things about my hospital is that we employee OB Hospitalists 24/7 and we can call an "OB Net" and everyone comes rushing in (docs, nurses, anesthesiologist) and it has greatly improved outcomes. Most of time, we don't even have to send the mom to the OR. We up the pitocin, and catch it early. Give cytotec and blood, manual removal of any clots and they're okay. This is way different than 10 years ago. Back then, I'd have to call the patient's doc and ask him to call the in-house doc to look at the pt. Even if they have to go back for a D&C they are stable enough to come back to us. We do yearly mock hemorrhages and we have a special hemorrhage cart. We weigh the blood on the baby scale to get how much blood is really is. It's interesting that when we started weighing the blood. When staff would estimate, we always guess about half of what the actual blood loss really is. FYI- Doulas in the hospital are just a support person for the laboring mom. It's if the mom wants someone to take care of her. They have no privileges. Tom- pregnancy is complicated because pregnant women have 50% more blood volume. Then they deliver. So their BP drops and the epidural doesn't help. That's why women usually have lower BP after delivery. And a couple days later, they'll sometimes develop re-eclampsia once they're caught up on volume. That's one of the reasons it's hard to peg sepsis on a postpartum mom. And we assess and ask all the questions- headache, epigastric pain, edema, nausea, visual changes, etc. headache is the biggest red flag for pre-eclampsia. At my hospital, We know our stuff. If there is any suspicion. Especially after lab work and anti-hypertensives, moms are often put on magnesium sulfate to prevent seizures that accompany pre-eclampsia and eclampsia, if they're showing any signs and especially if they have a h/o HTN. My hospital has a higher risk patient population, affluent, older and using fertility treatment, so we have a higher c-section rate. Some victims of sexual assault in their history elect for a c-section because it's planned out, they're in control. These moms also lean to formula feed. Which is fine. I'm pro-breastfeeding but my priority is: 1- mental health of the mom and family 2- is the baby growing and hydrated? 3- if we can make all of that happen with breastfeeding, great! But you won't be able to go into a kindergarten class and say "this one breastfed, this one didn't...." 4- trust vs mistrust is a real thing. If a baby is crazy hungry and the mom won't supplement because she wants to be exclusive breastfeeding, that trust doesn't build. We also have a goal for exclusive breastfeeding- 80%! Where do these numbers come from? THE HOSPITAL GETS PAID LESS BECAUSE WE SURPASS THE 28% c-section rate. Why is this the number? If we needed a 100% c-section rate in order to get mom's and babies out of the hospital safe and healthy, so be it! Some docs are using wound vacs for the c-section incision if they have a high BMI. We incentivize the wrong thing! I don't want the doc making the pt push through a vaginal delivery that's not going well because our c-section rate is too high that month. We should incentive if the mom and baby are stable and healthy, not an arbitrary metric. Customer satisfaction creates so many problems. Some patients are non-compliant, they don't want to walk to prevent ileus, respiratory problems, wound complications, and DVT. We are instructed by management to bring pain meds around the clock, even if they have no pain. Constipation is a real problem as you can imagine. Senekot only goes so far. People are choosing elective c-section. And to make the customer happy, hospitals are accommodating that. 10 years ago, it wasn't like this. We MANAGED pain, we didn't DRUG people. As an aside-Actually Survey monkey is just an easy way to create a survey it's easy to take. I like when my manager cares what I think. ✌️

The idea that moms can lose their lives because the OB who they usually see does not work weekends or holidays is just gross to me. There is no substitute for being there when Mom is delivering when you've been essentially her PCP for months. There has to be a better way to manage OB time vs. deliveries.

my sis in law gave birth at home. she says she did not do it on purpose but I don't know if I believe that. anyway she ended up hemorrhaging because she did not know you have to get the placenta out asap after birth. She had to stay in the hospital for 72 hours. she would have most likely only had to be there 24 hours if she would have had a qualified birth attendant with her when she gave birth.

I 💗nurses

my mfm was telling me they don't get to worried until you go above 160/100 is that pretty standard or are they behind on the issue.

My sister's protein level was off the chart, so they told her she had somehow 'contaminated the sample'. How do you contaminate protein into a urine sample? Lol...she had full-blown eclampsia, ended up intubated in the ICU after an emergency C-section. Thankfully she and her son survived, but wow!

This video seems to be predictive of today's situation even more than then!!

1:16 That's not Alex Jones....that's Willfred Brimley. :P

Love ya Dogg...Please get some sleep! I am worried of your health doing so much work, and your face is showing it! Please rest! (but thank you for what you are doing!)

Look at the CMQCC data Stanford Dr.

Where did you get this list? I am pretty sure Iceland is on top or one of the top 3 at least with least death rate of childbirth complex. Both on saving baby's and mother's life. As here you have good public Healthcare when it comes to giving birth. Midwifes and doctors doing the follow-up while pregnant and afterwards. And here the Midwifes are all well trained nurses (as it's hard to get into the midwife program) so usually 10+ years nursing experience and 4 years nursing uni degree and then you have to add on top 2 years of midwife program in uni. So very educated staff who do the job related to childbirth both child, mother and pregnancy pre and post.

Thank you for reinforcing my professional decision to NEVER SET FOOT IN OB or ANTE/POSTPARTUM EVER.

I would love you to explore the origins of nurse/physician animosity. I think both sides have legitimate complaints and also that both have issues they need to grow beyond. On the physician side: I'd love to hear your thoughts on why physicians have a legitimate reason to dislike the current trend of assertions by nursing for medical autonomy and equivalency without having equivalent education & experience. On the nursing side, I would love to see how you address the innacurate view that nurses are some sort of robots that only function to execute orders. You've touched on this in various ways, but I've yet to see this issue explored fully and I would appreciate your views in one place. Thanks for the excellent content!

Really like it...

More c-sections now =more death rates and complications. What are the numbers for c-sections in these other countries? I think you will find longer periods for maternity leave and more holistic care in those countries too.

I wonder what I can do as a lab technician to help the moms after post pardum?

Did the mom who died from HELLP, have an epidural or spinal? Does spinal blocking for pain relief increase post partum complications like HELLP?

We have 8 months to educate.

No one thinks that the general state of health in the US (which is absolutely abysmal) has anything to do with it? These countries are all different in a variety of ways---activity level, diet, obesity levels (prior to pregnancy), patient compliance with prenatal care, etc. Why is it automatically "the system" or a single group of professionals? Is the general health and are the risk factors for each case tracked, or are we just looking at the instances purely as a percentage of population? Are there more cases in certain regions? Do those regions exhibit more of a certain risk factor or factors? I think this is a bit more nuanced than he's made it out to be...

Yeah !!! Deliver in a bucket!!

10 years ago nurses had more time and freedom to assess and care individually for patients. Now it is all about the money. They will not even admit women until they are 5 cm and by then first time moms are 10/10 pain , scared and unable to learn. Then after the birth moms are expected to breast feed even if they don’t want to , they have to keep baby in the room even if they need sleep desperately

It's called call the midwife!

First of all, regarding Michele Eslick's post. It is ridiculous to have so many couplets. There is no way to manage breastfeeding assistance, newborn labs, assessments, documentation, etc. and do it well with that many. The recommendation is 3 couplets. That is six patients to assess, document on, draw labs,...and do all the teaching as well as keep track of the mother's health.....way too much and with all the discharge teaching and admit teaching...it's easy for something to be missed. Way too much!!

I had preeclampsia that was not caught. I was 27 yrs old and a medical surgical nurse working straight nights right up to the day I delivered. On the night of delivery I was in trouble. I did have a history of kidney stones but otherwise healthy. I was fortunately diagnosed correctly by a nurse before the doctor got to the hospital. I received an internal monitor and given mag sulfate (this was in 1981). It was all a bit of a blur but I remember the pain. I had a great team of nurses who worked their butts off all night. The doctor came in and looked at me wide eyed and said, " What the hell is happening?! This should not be happening to you!" I was incredulous at his comment but grateful that he listened to the nurses that night. My son was delivered safely. But I agree, we pay so much attention to the baby but we need to remember that Mom is also a patient. This is not a nurse problem this is a problem of lack of education of all the health care professionals across the board involved in the care of pregnant women. I like the methods used in China and Korea where the mother is kept sequestered with the baby for 4 to 6 weeks postpartum in special apartments looked after by a special team of nutritionist, mid-wives and staff where she is allowed to rest and receive one to one instruction on how to care for her baby. Visitation is limited to the husband and immediate family only.

I always thought it was when in doubt, blame Respiratory. Hahaha.

You make me want to be a DR. But I know for a fact, I'm not smart enough to do that. But damn, do I feel like I'm not doing enough.

Hello, I'm a DONA trained Doula and a new L&D nurse. I appreciate you drawing attention to such an important topic. I would have loved for you to incorporate more discussion on the differences we see in maternal mortality by race (black mothers are dying at a higher rate than white mothers). Furthermore, I was disappointed in your presentation of Doulas. Doulas, by definition, are not medical professionals, but instead are trained to provide emotional, spiritual, and some physical support during labor. There are many studies out there right now acknowledging the benefits of having a doula at your birth. I think it would be great for you to revisit this topic in another episode after reviewing the research and reconsidering your opinion.

Nurses are educated,not trained. Dogs are trained. Having worked in all areas of OB,inpt and op for over 30 yrs can see too many coworkers are pigeonholed in thinking. Unwilling to see the continuum of process,unable to speak up, let alone call the dept head on Saturday when resident fails to respond. Reading multiple journals cover to cover is rare,discussions of research will make sure you are labeled weird. do it anyway. Prenatal care needs to expand beyond the uterus and be more collaborative with PCP, best teaching is done while putting them on NST and later while doing PP checks.Teaching also needs to be written handouts. Mom /baby care is most effective!! CS rates in TX are nearly 50%,most for convenience and complications are mostly pt noncompliance issues since Press -Ganey rules and pain is 5th VS,nurses there are hobbled. In those rare places where telephone triage nurses are not available, hospitals need to staff to allow proper response and documentation of pt calls, NOT say call MD in am. Nursing triage has been falling off last 10yrs and it shows in all the metrics. All MD's need to follow up on nursing triage instead of disparaging...

Omg

Hospitals switching over to a mother baby format can be to blame for mortality rates as well

I think that the mothers need care by expert providers not functionaries. Those mothers are so busy- you can't cram any more teaching in. THEY need CARE...an observer and support professional to be there that know what they are looking at and can give the right information on time. The reason for bad outcomes...is staff sometimes have to stop the health care machine so that it doesn't run the patient over. That means the nurse is not just there in a role checking off boxes ...but are the person that stands between the patient and the grim reaper.

Alex Jones Shoutout!! Woohoo❣️💞

Sang it...

"...could there be holes in our global way of treating these things" - that would imply there IS a global way of treatment in the U.S., but there isn't. We don't think of healthcare as a system because we don't have a healthcare system. All we have is an industry, and a lot of people do their absolute best to operate systematically, but until there's support from the top - which in turn would mean removing a lot of greedy people from power - we don't have an actual system.

This is why I'm never having kids. Fuck pregnancy and having to deal with crying kids while the husband goes to work, (sometimes cheat), and expect and hot meal. And now possibly dying? Fuck that

Do socialized medical places have HCAPs? just wondering. Ireland by the way is incredible. But they have mandatory Prenatal Care. We have moms on drugs in greater numbers, poor prenatal care, and HCAPs. moms are suing because they the birth plan was ignored. Does any of that happen in those countries? Aussi land or Brits or Irish? Denmark? doubt it.

How dare you blame nursing!! Help us advocate for safe staffing ratios, a unit secretary and more nursing assistants. Definitely an MD issue and not a nurse issue here!

aw i thought zmom was there

Could the rise in the u.s. have to do with more women here waiting til they are older to give birth?

What about midwifed?

JosT kAvE Ihe Boby A1 HOME keCauSe tis SafER

MAYBE YOU SHOULD RESEARCH WHERE THOSE MOM'S COME FROM. NO PRENATAL CARE?

1. Md/nurses should pre teach patients 2 medical clearance for childbirth 3. telehealth 4. Train nurses not using health stream 5. Mds should teach nurses 6 see number 5, 7 bedside nurses should be involved in meetings regarding quality improvement 8 improve nursing communication, use hospital blog format

This makes me never want to have a baby in the USA 🙃

Brother you need some rest. Those bags under those eyes of yours... Take a break. That being said, I LOVE YOUR CHANNEL! But for real, get some rest. 💚

Seriously?! Why can't you show a little empathy and respect for moms that have terrible horrific hospital births and then find hope and a positive experience in birth centers or home births. No one answer ever is best for every person, no matter the subject... So why assume it with this? I have had 3 home births, 1 hospital birth and usually also see a doc throughout... I always have less complications outside the hospital, even if I have to go in after the birth for some reason. I had a completely euphoric and pain free birth by using hypno birthing techniques at home and avoiding all the distracting drama of the hospital. I am cool with anyone choosing a hospital birth... But don't tell me or anyone else what to do. It is a super personal decision and shouldn't be judged so harshly. Don't be blinded to the benefits of someone choosing differently than you because of your ingrained bias.