10 Pieces of Advice from a Labor and Delivery Nurse
10 Pieces of Advice from a Labor and Delivery Nurse
Hi Mamas! My name is Liesel Teen, and I have been a labor and delivery nurse for over 4 years now. I absolutely adore what I do, and I’m so happy I get to share the most precious/intimate times with my patients as they become parents!
It’s truly a gift to be able to provide support for a woman as she’s in the process of becoming a mom for the first/second/third/tenth time!
With that said, I do notice (especially for first-time moms) that there is a TON of anxiety surrounding the delivery room!
“What’s this thing?”
“Does that hurt?”
“What the heck are you going to do with THAT?”
Lots of questions…
It’s tough to not have ANY fear going into a situation where you have nothing to compare it to. Having a baby is truly like NOTHING you or your partner has ever experienced. While I can’t go over every smidge of every detail surrounding the birth of your child, I thought I’d give out a few pieces of advice to hopefully help ease your nerves on the big day!
We Don’t Care about your Pubic Hair Situation
First and foremost, unless you have a dire need to groom yourself for delivery day… please don’t put too much thought or energy into the process. I’ve seen my share of pubic hair, and the only one I remember thinking “wowsers” was a kind woman who had thick course pubic hair down to her mid-thighs.
She rocked it out in labor though, and didn’t seem to give a darn about the amount of hair she had “down-there”. Her husband was very supportive during her labor, and you could tell they were just so in love, and excited to become parents!
Literally everyone else (waxed, shaved, hairy, groomed etc.) just kind of runs together! The amount of hair, or lack thereof, doesn’t make it any easier for your baby to appear between your legs.
My advice is, whatever you’ve got going on down there right now… keep it going. Don’t do anything extra special for delivery day!
Also, PLEASE don’t get waxed for the first time when you are 9 months pregnant. If you’ve been waxing throughout your pregnancy, that’s fine… but you’ve got a TON of nerve endings down there and they become extra sensitive the bigger you get. If you wait to wax yourself at 40+ weeks pregnant, it’s not going to feel so nice!
There’s Really Not a Whole Lot you can do to Prevent Tearing Down There
Tearing happens. There are a bunch of articles out there about “how to prevent tearing during childbirth”. While some of these methods do make sense and can be effective, there’s a little more that goes into tearing than just perineal massage and open-glottis pushing.
I am a big advocate of perineal massage. This is basically applying downward pressure to your vagina in the weeks leading up to birth. You’re told to do it for a few minutes each day.
It’s done so that the perineal tissue is more elastic leading up to birth, and less likely to tear. It makes sense.
The reality is, many times tearing is tough to avoid. Sometimes babies like to come out with a hand near their face, or facing up (occiput posterior position), or they come out way too fast on their own terms.
All the perineal massage in the world is not going to prevent a first-time mom from tearing if your baby has a compound presentation (a hand near their face). Almost all mamas tear in this circumstance.
But it’s all good! Tearing is not that bad.
What’s much worse is receiving an unnecessary episiotomy. Which you can advocate against. It’s much healthier for you to tear yourself, than for your doctor to artificially cut your perineum. Many doctors nowadays have gotten rid of episiotomies (unless in an obstetrical emergency), but there are some that still perform them routinely.
We grade vaginal tears on a 4-grade scale:
1st degree – least severe, only involving the skin of the perineum
2nd degree – involve the skin and muscles of the perineum
3rd degree – deeper tear into the muscle that surrounds the anus (but not completely through)
4th degree – most severe, the deepest tear that tears completely through the muscles of your anus (you have a vaganus ☹)
Okay before I scare you with the Vaganus, know that 4th degree tears are extremely rare. MOST COMMONLY, you will either have a 1st degree tear or a 2nd degree tear (3rd degrees don’t really happen that often either!).
In fact, most first-time moms will have a 2nd degree tear that requires some stitching! Your provider will do this immediately after delivery, and the stitches are dissolvable, so you don’t have to worry about getting them taken out.
Trust me, we don’t want you to have a C-Section if you don’t wanna have a C-Section!
Guess what? I REALLY don’t want you to have a C-Section. Really… I don’t. If I can avoid a C-Section for one of my patients, you’d better believe I am doing everything in my power to make sure I’m not in the OR.
Sometimes C-Sections are unavoidable. There are certain situations where there’s absolutely no getting around one (malpresentation of your baby, your placenta is covering your cervix, your baby’s heart rate drops dangerously low, etc.).
But, there are also situations (such as failure to progress), when a C-Section is more avoidable (and controllable) by your nurse.
I hate going to the OR if I don’t have to. A C-Section means a longer recovery time for you, along with many other reasons, and it’s a lot more work on my part as your nurse!
You’re Probably going to Poop… it’s Cool
Pooping during delivery happens. In fact, probably about 50-75% of women do it at some point during delivery. It’s really not that big of a deal! Most of the time what I do if a woman starts to poop while she is pushing, is wipe it away quickly with a chux pad, or washcloth. We usually have lots of pads underneath you while you are pushing, so it’s easy to get rid of the evidence!
Pooping is also going to be the least of your worries while you are having a baby. It also usually means you are pushing effectively!
Essentially, a baby passing through your vagina is going to push out any little bit of poop that is hanging out in your rectum. Baby’s head is so big that it compresses your rectum, and if you’ve got poop chillin’ in there, the only way it’s coming is out.
The women who DON’T poop while they are pushing just have empty rectums. Many women also have diarrhea/loose stools BEFORE they go into labor (or during early labor). This is sort of your body’s way of “clearing the pathway”.
Take some sort of Prenatal Class or Educational Course before you go into Labor
Any time you’re more educated about a subject, it’s going to be WAY less scary. I would highly recommend you take a prenatal class in your area, or online! Talk to lots of women who have had babies, interview your providers about what’s to come. The more questions, the better!
Staying informed about what’s going to happen during your birth will ABSOLUTELY help alleviate some of the anxiety that comes along with the birth process.
Don’t forget about your partner, either! He/she is not going to be in any physical pain during the labor process, but it’s very emotionally taxing to watch someone you love go through hours of pain.
Involve your partner in your labor research, and have them come to classes with you!
It’s Going to Hurt
I’m sorry to say so, but labor is painful. Even if you receive an epidural when you are 1cm, there’s still a good chance you will feel labor contractions, and feel an ample amount of pressure and discomfort as you are pushing your baby out.
Labor is single-handedly the most painful experience you will have in your life. It’s not a fun day,
I thought early labor was a lot like really bad menstrual cramps. As labor progressed and I dilated further, it felt more like knives in my back and stomach. And eventually, it was so horrible I’ve blocked out how bad it actually was.
But don’t get too nervous, labor is HORRIBLE, but it’s doable. We’ve been giving birth for thousands of years, and it’s definitely not IMPOSSIBLE. You’ll get through it, but it will be hard. Having lots of support, and positive energy in your room will make it easier!
For me, it was more of a mental game. Labor is truly one of the biggest mental games you will go through in your life. If you have the ability to completely clear your mind, USE THIS TO YOUR ADVANTAGE, because your mind is your worst enemy in labor (at least it was for me, and for many of my patients).
If you are interested in learning more about how to manage labor pain, head on over to my article on giving birth naturally! Even if you plan on getting an epidural, I promise these techniques will help you pre-needle!
Related: Meditations for Labor and Delivery
We Will be with you for Every Step of the Way
Your labor nurse is going to be your advocate and your support person for every part of your labor. Unless you want some privacy (or you’ve just gotten an epidural and you want to take a nap!), your nurse will be in your room (or coming in-and-out of your room) for your whole labor process.
Your provider generally has a LOT of patients he/she is caring for, so that’s mainly why you don’t see him/her as frequently as you do your nurse. You are my only patient (in most circumstances), so you and I are 1:1 care.
I got your back!
Labor is like Running a Marathon
Have you ever run a marathon (or a half-marathon)? Labor is very similar to running a marathon! I tell my patients this all the time. Running a marathon is very mental, you’ve got to really commit yourself to it and KNOW you can finish. The end is also usually the hardest, but once you are finished you feel like a rockstar.
You’re also super tired when you are finished… and hungry!
Sometimes Emergencies Happen Regardless of how Healthy you are
Sometimes unexpected circumstances happen during birth. There are USUALLY signs that an emergency is about to happen, but unfortunately, sometimes there are not.
I’ve seen babies that look beautiful on the fetal monitor come out blue and limp, and need resuscitation and quick interventions. I’ve seen women start bleeding for unknown reasons, and need emergency C-Sections very quickly. I’ve seen women bleed and bleed after delivery, and require multiple blood transfusions.
I don’t want to scare you, I just want to let you know that sometimes emergencies happen and we, as healthcare providers, need to act fast to save your life or the life of your baby.
I always try and do the best I can to explain what is going on, or why things are moving so fast, but sometimes this doesn’t happen until we are out of the clear. I want you to know that we all have you and your baby’s safety in mind at all times!
We are your Biggest Cheerleaders!
Finally, we are ABSOLUTELY your biggest cheerleaders! We wanna see you have the birth that you want. And, we want you to feel positive and empowered after you give birth, not confused and scared. For this reason, I always try and do my patients the service of explaining all procedures as they are happening, being with you every step of the way, and cheering you on as you give birth.
Most of the labor and delivery nurses that I’ve met LOVE their jobs as much as I do, and we LOVE to support you during your journey as a mom!
If you loved this article, check out Liesel’s online labor and delivery course, Birth it Up! She teaches you everything you need to know about what to expect on the big day!