The Labor and Delivery Experience from the Nurse’s Perspective

Let’s face it: the actual physical process of birthing babies is not a very beautiful or breathtaking scene! This incredibly hard act of “labor” could definitely make Mike Rowe’s top 10 list of “World’s Dirtiest Jobs!” Yet, as a parent, it also represents one of the most memorable, exciting, happiest, move-you-to-tears moments that you may ever experience in your life. For all of those out there whom are about to be a first time mommy (or even those seasoned vets), keep on reading for some light-hearted, random thoughts on childbirth from an experienced labor and delivery nurse and first time preggo!

What to Expect OR Not to Expect

Packing

photo-14So, your “hospital bag” has been packed since your 2nd trimester! You have loaded it with all of the essential items, and are ready to bring home your beautiful, bouncing, bundle of joy. WARNING: While you are packing, PLEASE keep in mind that you are going to have a baby! I am often deeply stupefied by the thought process that went into selecting certain items that you think you will require to deliver your baby. Now, I understand bringing an ipod, and even possibly a magazine or two in order to help pass the time of early labor. But, please leave the lamps, incense, candles, coloring books, end tables, pool noodles, board games, lingerie, crockpots, Christmas lights, your mucus plug, & Cornish hens at home. YES, I said Cornish hens! As a very experienced labor and delivery nurse that had extensive schooling and clinical training, I can pretty much guarantee you that you will not require any of the above items! Pack yourself some toiletries, a pair of shower shoes, some socks, and something comfortable to wear home, and you’ll be set. The hospitals will supply you with some sexy mesh underwear (you laugh, but you will learn to love), king-size feminine pads (delivery vets know the “king” size is necessary), and a rather revealing hospital gown (there is no modesty on L&D). Please remember that there is a high probability that you will be a swollen, crampy, bloody, oozing mess postpartum, and that just doesn’t go with the pretty lacey underwear and the matching nighty that you were expecting to put on post-delivery!

The Admit

You arrive on the labor and delivery unit all smiles! You may not realize this, but that smile will soon be replaced with a face of anguish & tears as be your contraction frequency and intensity begin to increase! NO, your doctor will not be immediately meeting you here right now. YES, I will call him/her to let them know your status, but don’t expect him/her to show up at 3:30 in the morning to sit with you for the next 10 hours as you labor. YES, I said 10 hours.

First time moms will more often experience longer labors and just because your water bag broke, does not mean the baby is about to fall out. NO, I have no idea how many centimeters you are until I actually place my hand inside and check your cervix! And, NO I cannot tell you what time you will have this baby. If I could peer into my crystal ball and predict these things, I would be rich and would not be working the night shift on Christmas Eve! YES, you will most likely need an IV! YES, you will most likely need to keep the fetal heart tone and contraction monitors on! And, NO, you cannot eat that cheeseburger that you just rolled up with! I am not trying to take you hostage, torture you, or starve you; I am trying to take the very best care of you so that you can have a safe delivery for both you and your baby!

The Expectations

Are you planning on IV pain medications? An Epidural? Or, are you planning on going au natural? Prefer intermittent monitoring so that you can walk during labor? Do you have a birth plan? Are you planning on a water birth? Perhaps hypnotherapy is more your speed? Will your doula be making an appearance? Are you cordblood banking?  Taking the placenta home? Do you require a birthing ball, birthing chair, or birthing bar? These are all important things to discuss with your labor and delivery nurse upon admittance so that we are able to understand what you are wanting out of your labor and delivery experience. We are there to make sure we can provide you with the very experience you are hoping for, and most nurses I have worked with really do want to make this a special time.

With that said, we want all future moms-to-be to know that anything can change and anything can happen at any second! Go into this with an OPEN MIND! We promise to stick to your realistic requests, but sometimes the minute-to-minute circumstances may prevent you from welcoming your new baby into a quiet, sunlight room,  you on all fours, with your doula playing the violin in the background. Often times, the baby will experience some fetal distress as it progresses through labor and the nurse may need to change your position, put an oxygen mask on, or even perhaps rub the baby’s head in order to “fix” the heart tones. Other times, a C-Section may be warranted if the doctor feels it is the safest way to deliver your baby. I have worked at many hospitals in the New Orleans area with most of the OB/GYNS. Most are not the scalpel happy, episiotomy cutting, c-section Nazis that are sometimes stereotyped in people’s minds.

Last Minute Tips for the Laboring Mom

  • If you are planning on an epidural, remember that it may take 20-45 minutes from the time you ask until the time you receive.  Don’t wait until you are barreled over in pain, unable to sit still (if you can help it).
  • Yes, you will need a urinary catheter if you are getting an epidural BUT the nurse won’t place it until after you are numb, so you won’t even feel it! It will be pulled right before delivery!
  • You are usually not allowed to eat or drink anything while in labor. This is for your own safety in case an emergency c-section is necessary. And, once you become completely dilated, you will often feel nauseous and you need to vomit. So, if this is a “planned” delivery, eat a big meal ahead of time!
  • Try to get your rest (as much as you can) during the laboring process. Sometimes it’s difficult when everyone you have ever met has shown up for your 2 day induction. Don’t be afraid to ask family members to hang out in the waiting room for a little while so you can rest-labor is hard and pushing is even harder! Don’t want to offend? Ask the nurse to have them step out so you can rest!
  • The most important: be NICE to your nurse! The two of you will become very close and she is the one that is always rooting for you and will be your very best advocate for what YOU want out of the birth process!

Alyssa Gele’ RN, MSN

photo-13Alyssa Gele’ RN, MSN received her Associate’s Degree in Nursing from Charity School of Nursing, and later received her Master’s in Nursing from Loyola University. She has practiced labor and delivery at Touro Infirmary, East Jefferson General Hospital, Ochsner Kenner Campus, & Spohn South in Corpus Christie. She has also worked for a home health company that specializes in high risk prenatal patients. Alyssa recently took a small break from patient care to practice legal nurse consulting for a major law firm in Downtown New Orleans.  She also owns Essie’s Sparkling Confections, a custom cookie business that has been featured on the New Orleans Mom’s Blog! Alyssa and her husband, Keith, are expecting their first child at the end of September.

 

35 COMMENTS

    • Thanks! thanks! We work our butts off and it means the world to hear things like this!! a smile and a thank you goes a really long way!!

  1. This is great advice and I even laughed out loud to myself a few times. Being on the other side of birth number one and birth number two coming up in October I can say that I have a much more realistic idea of what L&D is really like. I felt quite rigid with my son’s birth – had to go all natural, no episiotomy, no epidural, etc. By the end of my labor – I did not show up in all smiles on the L&D floor – I didn’t care what we had to do as long as the BABY GOT OUT. I think your advice to take things as they come is great. So hard to do that with your first baby! This time I’m around I know what my body is capable of, know how hard the end is and know that birth is unpredictable.

    • Yes! First time around is sooooo difficult. You learn a million different things during pregnancy, but people often don’t know what to expect on their big day! Catheters. iVs, monitors, etc. no one prepares you for the insane amount of hospital personnel coming in and out asking you all the same questions!!! It can be frustrating. As the nurse, I always try to go over the patient’s wishes upon admit. I try to explain that I will try to stick with their wishes as much as possible. But, unfortunately, things happen beyond our control. We always have mom and baby’s best interest at heart. But, being open minded will only make these minor changes of plans less dramatic! In the end, as long as mom and baby are both safe,that’s the most important!

    • I agree! I worked with some of the best doctors and nurses over there! I will actually be delivering my baby there in September

  2. I’m sorry but I had to stop reading after you listed all the things not to bring to the hospital. I don’t think you are really taking into account those of us that have had or plan to have natural deliveries. Incense and candles can be really soothing for laboring mothers because it can be a familiar and calming presence. Crock pots are great at keeping things warm that can also ease the pain of natural delivery such as tube socks filled with rice. Now if the L&D room had a microwave, there may not be a need for this. And if games keep a woman distracted even a little, then bring it! I’m just not a fan of this perspective at all. Whatever makes a laboring mother more comfortable, bring whatever you want!

    • Hey-I totally agree with bringing whatever makes you comfortable,but to a certain limit! Items such as incense kits, crockpots or other items that may pose a fire risk are usually not allowed. We usually encourage calming oils or fragrance oil diffusers. All nurse stations usually provide a microwave somewhere on the unit for patient’s use. As far games, I’ve seen people bring in multiple board games that never get opened because there are so many other things going on! But, more power to you if it helps pass the time! My blog was,by no means to offend, but to see the lighter side of labor through the eyes of a labor and delivery nurse. Just a little witty write up! But I do appreciate you thoughts!

  3. I thought this was a little condescending, especially ” just because your water bag broke, does not mean the baby is about to fall out. NO, I have no idea how many centimeters you are until I actually place my hand inside and check your cervix! ” I know L&D nurses see a good deal of mothers who are unprepared or over prepared with unrealistic expectations. However, the majority of the mothers I know are well educated and have prepared for their babies. While it’s a wonderful asset to have a great L&D nurse who has seen birth a thousand times, I wish nurses and doctors would give well-prepared women who know their bodies well more respect during labor.

    • I am sorry if I came off as condescending-that was not intended. I tried writing this from the nurses’ perception. We often see a plethora of patients rushing to the unit or taking an ambulance because their water bag broke. As this is a major sign of labor and you do need to get to a hospital ASAP, many people are unaware that even though this occurs-it could still be hours upon hours for the baby to deliver. We are also constantly bombarded with questions about cervical change. Unfortunately, we are unable to assess that without checking the cervix. It’s amazing how many times I walk into my patient’s room and that is the first thin I’m asked yet I have not laid a finger on the patient! Most doctors and nurses I have worked with at various hospitals do give great respect to their patients and do go above and beyond for them. But, no matter how prepared one is, it’s nearly impossible for anyone to know exact cervical change with out a cervical assessment! Hope this makes sense?

  4. Or if you have a low risk pregnancy, have a planned homebirth with a midwife and then you don’t need to pack a bag at all. And you’ll have the same caregiver from your very first pre-natal checkup to your very last post baby visit. And for at least some of those visits, they come to you.

    • I agree that continuity of care in OB is huge! And props to you for having the stamina to go through with a home birth! Takes a lot of strength and preparation!

  5. My L&D nurse was Julie and she was my angel! My doctor was out of town and Julie carried me through everything. I always tell mommas-to-be, don’t worry about your doctor, make sure you get a great nurse!

  6. I love this post!!!! As a NICU nurse myself, I naturally gravitate towards a post that tells it like it is about any kind of healthcare! Your post is honest, fun, and FUNNY! As women I think we should all enjoy the truths that your post brings forth and be able to laugh at ourselves a little too. Cornish game hens?!?! hehehe.

    Thank you for sharing and I wish you all the luck with your own upcoming delivery! I would LOVE to read a post about the labor and delivery room nurse giving birth when (and if) you are ever ready to write that story for us!

    • Karen- thanks so much! My post was supposed to be light and witty! I feel terrible that I have offended anyone here. As a fellow nurse, you understand where I am coming from! I would love to write another post, so you never know!!! Thanks again!!

  7. Alyssa- as one of those first time moms who wound up in L&D at 1:00 in the morning, I can tell you I was READY to get the show on the road, especially since I knew that I was having a C-section from the get go. I think, that in our state of hormones, etc. we are just so ready to meet our babies that we forget that there is protocol!

    This was a funny look at how crazy I know I must have seemed when I waddled into EJGH’s L&D unit having contractions and saying “can we just have this baby already?” hahaha

    This is a great post!!! THanks for sharing!

    • Thanks!! You can’t imagine how many people come and are just “ready” to get the baby out no matter how! I’m 35 weeks and I’m getting to that point! Hormones run rampant at the end and combine that with pain and being uncomfortable- us pregnant women are in a totally different state of mind! I’ve had patients come in laboring and in terrible pain-they spit, kick, curse, vomit, and look at you like you are Satan himself!! But, the nurses just smile through it knowing and understanding what they are going through. By the time they either get the epidural or deliver-they do a 360,and see us as their angel for getting them through it!! It’s all good though! My good L&D friend is going to be my nurse at Touro and I told her to just muzzle me if I start acting up! Lol

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