Your L&D Nurse: Your Best Friend

I interviewed my sister, Katie, recently on a family vacation. Katie is a labor and delivery nurse for a large hospital in Portland, Oregon and has a lot of good advice for expecting moms to make the most of their birthing experience.

Q: What should you bring (and not bring) to the hospital in terms of helping with the delivery?
A: This depends on the hospital. Check beforehand to see if your hospital has CD players and DVD players available in their birthing rooms. Especially if you are having an induction and it might be a long labor, you might want some distractions along the lines of movies and music. Don't bring anything valuable (you shouldn't even need your wallet). Bring something to eat for after the delivery. You will probably be hungry and not all hospitals have a great selection of foods between meals.

Q: What should your expectations of your L&D nurse be? (What is realistic and what isn't?)

A: Availability of your nurse will depend a lot on how busy the day is for the nurse. Don't hesitate to call a nurse if you have questions, need to use the restroom, are hungry or have another important need. At the same time, try and be organized about your requests and fill multiple needs/ask questions in the same visit. Your guests should never make demands of your nurse (meaning they are not waitresses or gophers there to serve your family and friends. Oh... the stories Katie has told me about obnoxious guests!)

A good nurse should be on top of your pain management, and support you physically and emotionally during the last stages of labor. Nurses should never tell you what to do, but help you make an informed decision concerning the birth of your baby by presenting options and potential scenarios. Finally, they should respect your decisions.


Q: How can making a birthplan be helpful?

A: Birthplans are helpful in communicating your desired birthing experience to your doctor beforehand. However, many women get too set in their birthplan and resist alterations to it that will ultimately be better for her and the baby. It is not uncommon for women with stringent birthplans to end up having emergency c-sections when they won't adjust their plan and suddenly the baby is distressed. One common example is when women refuse petocin when they have been ruptured for a long time, which can cause infection and results in the doctor performing an emergency c-section to protect the baby. Katie suggests that if you have a birthplan and the doctor suggests straying from the birthplan, to talk out each decision and assess if it will ultimately help you achieve a better birth.

Katie's opinion on....

episiotomies... sometimes they are necessary to get the baby out quickly (such as the instance when the baby's heart rate drops) in order to avoid an emergency c-section. However, episiotomies performed to prevent tears are not very effective. The episiotomy usually takes longer to heal than the tear would have. Episiotomies are essentially SURGERIES...so your doctor should ask for consent beforehand, but in Katie's experience, that doesn't usually happen. Katie suggests discussing your preferences beforehand with your doctor, but that doesn't guarantee you won't end up with one....especially if your baby goes into distress

going to the bathroom (or passing gas) during labor...Katie says it's nothing to worry about for many reasons. First of all, there is a good chance you will and you won't have any physical awareness of it. Second, if you are consciously trying not to poop or pee, you probably won't be able to push the baby out very effectively. Finally, doctors and nurses see it every day and think NOTHING of it. So basically, you should never worry that the hospital staff will be snickering behind your back if it happens.

having a doula....Katie thinks there are a lot of advantages to having a doula during labor, especially if you want to have a natural birth. A doula will be well-trained in coping techniques and will be able to help you with effective pushing and positioning. A doula will be by your side the entire labor, whereas your nurse will likely be responsible for multiple patients. Studies have shown that doulas decrease rate of c-sections and increase the overall satisfaction of the birth experience. If you don't want to pay for a doula's services, you can always check with your hospital for a list of volunteer doulas. Often, there are doulas-in-training who need to fill clinical hours.

Final note from me: Yeah for L&D nurses!!! I was lucky to have amazing nurses for the births of my boys and it made such a difference in my overall birthing experience. Much more than my doctors, my L&D nurses were great advisors and cheerleaders along the way. I still remember after Asher's birth when my nurse showed me my delivered placenta and complimented me on how healthy it looked. "Gee, thanks!" I think I said, not exactly sure what the appropriate response should be when you are complimented on your placenta...