Sunday, May 13, 2012

What to expect when you're DELIVERING!!

It’s safe to say I’m very excited about the new movie, “What to expect when you’re expecting”, which is in theaters May 18th

While I’ve never been pregnant and have no children, as an OB nurse (*I will admit, with only a few years of experience, I am still new in the gang), I’ve seen my fare share of deliveries. Therefore, I may not know much about what to expect when you’re expecting (although I think I know a good amount), I do know what to expect when you’re in labor and actually delivering.  

With today being Mother's Day (Happy Mother's Day to all the wonderful women out there!) and the release of this movie just a few days away, I’ve decided to compile a little list here to help those who will be soon making the trip to a hospital to deliver their little bundle of joy. If I may quote a favorite song of mine,  
“…my advice has no basis more reliable than my own meandering experience…I will dispense this advice now.
Please read with an open mind, try not to be offended, and hopefully have a laugh or two. . .

*NOTE* “To each there own”. I am in no way trying to change your thoughts or opinions about certain topics, just merely giving my side of the story. I am in no way trying to offend anyone’s choices or ideas.

1.) Let’s just get this out of the way -You’re in a hospital, therefore YES, you will need an IV, external (and perhaps internal) fetal monitoring at some point, you will you’re your cervix checked, among other things and procedures. These measures are not taken for fun or to give the nurses something to do…TRUST ME, we have plenty of things to do to keep us busy. While labor is a natural process that has been happening since the beginning of time, bad things can happen. People bleed, placentas abrupt, fetal heart rates drop, etc., and in these cases an IV is essential to save your (or your baby’s) life. And the external monitors help us address some of these issues. So just remember, if you are going to have your baby in a hospital, you need to understand that there are certain things that come along with that.

2.) “You CAN’T plan labor”, therefore Strict Birth Plans = CSECTION Disaster! It’s actually a common misconception that nurses hate birth plans, which is not true. What we do hate are unrealistic birth plans. I’m sorry, but I can’t count the amount of time couples walk in with a printed detailed birth plan spelling out every single detail of their labor. No IV. No monitoring. No Pitocin. Do not ask me my pain. Enema before pushing. Don’t look me in the eye. Don’t Cut the cord for 5 minutes. Breast feeding immediately, regardless of the situation. And on and on and on. You name it, we’ve heard it. Don’t get me wrong, I believe it’s important to do research. This will allow you to be prepared for what to expect during this exciting process and will also allow you and your partner think about what you would LIKE to happen during childbirth and thereafter. HOWEVER, coming in with a minute by minute play by play listing what you want to happen is just plan stupid. Things change. Plans change. Labor sometimes just poops out. Babies sometimes don’t tolerate labor. In the end, the most important birth plan is a healthy mom and a healthy babe(s). When thinking about your own personal birth plan PLEASE be flexible and realistic with your doctor and nurses. Be open to change, because it’s going to happen. Plan for the unexpected. COMMUNICATION is key! And remember why you’re here and why we’re doing the things we’re doing…to bring your beautiful baby into the world.  It's also important to note that we don't ofter bring our crystal balls to work therefore we cannot predict when your baby will be born, how long this will all take, how long you'll be pushing, etc

*Oh, and do us a favor, please don’t bother Googling “birth plan” and printing out the generic one you find…we’ve seen, we have copies of it, and if it has things on their that your don’t even know what it means, it’s pretty much pointless. So just don’t do it.

**Side note: To contradict myself, I did happen to come across this Birth Plan written by a labor and delivery nurse for an OB doctor on Google. It's pretty much the best birth plan I've ever read! Take a look if you're interested!!

3.) Knowledge is Power! You should do your homework and be prepared. And no, watching “A baby story”, “One born every minute”, or any other TLC show doesn’t count.  Most hospitals nowadays offer childbirth class, daddy boot camp classes, breastfeeding classes, newborn care classes and other helpful and informative classes for new (and experienced) parents. This can also give first time moms a realistic idea of what to expect during labor and delivery. 

4.) C-sections are not the end of the world. While it’s not the preferred way to deliver, it happens for a number of reasons. Malpresentation of your baby. Baby cannot tolerate the stress of labor. Sick moms needing to deliver ASAP. Placenta problems. Baby is too big. Other obstetrical emergencies. Whatever the reason is, the though of having a C-section can be terrifying. In 2010 the CDC stated the national cesarean section rate was 32.8 (which is actually down slightly from 32.9 in 2009, which is the first decline in the rate of cesarean deliveries since 1996). This means roughly 1 out of 3 moms who come into the hospital to deliver will have a C-section! In most cases, moms needing a C-section are able to have spinal anesthesia (or epidural if they’ve been in labor prior to needing a C-section), meaning they will be awake during the procedure. You will be able to see the baby immediately after delivery, and sometimes are able to hold the baby in the operating room. This is major abdominal surgery though, so obviously the recovery time is longer than that with a vaginal delivery. Also, bleeding, infection and death are always a risk factor for any surgery. You’ll have a urinary catheter in your bladder, which is usually placed right after your anesthesia so you won’t feel it. It will stay in usually at least 8+ hours postop until you can get up and walk to the bathroom. You won’t be able to eat solid food until bowel sounds return, or simply until you pass gas. You’ll have a scar down verrrrry low. One thing that I find surprises new mom’s who’ve delivered via C-section is that you will still have vaginal bleeding, usually pretty heavy immediately following delivery, which lessens to a menstrual like flow. Again, we must remember that in the end the prize is the same, a new baby!

5.) Epidurals DO NOT equal failure! I cannot say this enough – Be FLEXABLE and OPEN TO CHANGE!  I've seen the movie "The business of being born", (which is an awesome movie) and I must say, it is pretty empowering and amazing to see a woman in a natural state deliver a baby without monitors, pain relief, etc. However, many women come into the hospital and have completely sworn off any pain medication, epidurals or other interventions. Then, when if the time comes where they change their minds and get an epidural they feel as though they have failed and get upset with themselves. Avoid all that by not placing such strong restrictions or limitations to your pain control during your labor. If you are planning on having an unmedicated labor and delivery, DO YOUR RESEARCH, and take childbirth classes! Understand that there is a reason what some hospitals say >90% of their patients receive an epidural. Labor hurts…really bad. But if you’re prepared and educated, it is possible to have a natural labor. Of course with all things, epidurals do come with risks and draw backs, so DO YOUR RESEARCH and decide what works best for you.

And remember - If it can hurt you or your baby I’m not gonna give it to you!

6.) Understand that if your nurse comes running in your room and asks you to turn or roll over RIGHT NOW, please DO IT! Please don’t roll your eyes, ask if you really have to, or take your sweet time. Just trust me on this one.

7.) Be prepared to see many different faces. If you are there between change of shift you will get a new nurse. The charge nurse of the unit usually attends all deliveries. There will be a nurse for your baby, and sometimes an entire team there for your baby. While your decency is important, it’s a fact that babies come out of your vagina, and that area needs to be exposed to deliver your baby. While it may not be reassuring for you to hear this, we see vaginas all day long. Understand that the people in the room are experienced and are only there to help you and your baby.

8.) Labor and delivery isn’t always a happy place. While for the most part, my job is to have birthday parties every shift, there are times when things don’t go as planned. You’ve all heard the saying, “When it’s good it’s good…but when it’s bad, it’s real bad”. It’s never easy to lose a precious little baby. Nothing I tell you will ease your pain or make it any easier. If you are ever in this situation please know that the nurses care for you and your baby. It's ok to grieve and be sad and to cry. We may cry with you. It's also ok to love that baby unconditionally, to hold the baby, and to keep the memory of that baby alive. Each and every single mother and family who endures this loss are in my thoughts and prayer forever.

9.) You may very well poop while you push. It happens. It’s ok. Moving on….

10.) Ask any nursing student where they want to work after graduation and I can guarantee you more than half will tell you Labor and Delivery or NICU (neonatal intensive care unit). I was certainly one of those students. Labor and delivery is just such a magical place. And those of us nurses who are living our dream are doing what we absolutely love. (Trust me, they don’t pay is enough to endure some of thing we do and see, and the long hours on this unit). I can speak personally that everyday I go to work I remind myself that “I’m a labor and delivery nurse, I MADE IT! This is what you dreamed of doing as a little girl and throughout nursing school! Other nurses on the medsurg floors are jealous of your job...” I tell people with pride what I do because I love it! So just keep that in mind while you’re with us. Understand that we want you to enjoy your labor experience and we’re just here to help you. Communication and flexibility with your nurses and doctors are vital! 
Above all, cherish and enjoy every moment of this magical time! 

Me as chipper, naive new nursing student, Fall 2007

Fast forward to Fall 2011, me as a real Labor and Delivery RN :)

*Aside from the last two pictures of myself, all other images are complements of Google Images searches


  1. Very informative and lots of common sense. I was very proud of you in 2007 and even prouder of you now!