[maryk99]

Hi all! Doing my homework to prep for observation tomorrow on L&D. I feel like I'm kind of missing the mark this semester and would appreciate any input. Need to see a vaginal birth, and no kids myself this is all a new world...

General-type stuff:
Pre-delivery: assess/monitor mom/fetus/contractions, vitals, ABCs, pain; provide comfort via positioning/emotional support; clean perineum (?); assess/monitor meds i.e. oxytocics/epidural/IV fluids; I assume mom is NPO - book really didn't say; uterine hyper/hypotonia assessing here or more during delivery?

During delivery: having some trouble here.... this hospital has NICU RN attend every birth - responsible for neonate; during delivery the L&D RN would keep monitoring mom? assist MD? Hands on w/mom for support? Be prepared for complications i.e. shoulder dystocia

Immediate postpartum (0-4h): assess/monitor mom - PPhemorrhage/meds; "8 point PP assessment" handout given to us; level of anesthesia, pain, episiotomy, bleeding, urine; clean mom up as indicated; assist 1st breastfeed; discharge teaching assessment;

Thanks in advance for any feedback; just really looking for other things I need to be thinking about. Kay

[Aimee03]

WOW sounds like you pretty much got everything covered. Relax and have fun! I understand it is school and there is a certain degree of nervousness expected. Seeing a birth is an awesome experience. Don't forget the beauty of birth by being wrapped up in the "work" part of it. Main thing to remember is ASSESS MOM. Vitals, bleeding, fundus (postpartum). GOOD LUCK!

PS I love L&D! hope you enjoy it.

[CEG]

Originally Posted by maryk99

Hi all! Doing my homework to prep for observation tomorrow on L&D. I feel like I'm kind of missing the mark this semester and would appreciate any input. Need to see a vaginal birth, and no kids myself this is all a new world...

General-type stuff:
Pre-delivery: assess/monitor mom/fetus/contractions, vitals, ABCs, pain; provide comfort via positioning/emotional support; clean perineum (?); assess/monitor meds i.e. oxytocics/epidural/IV fluids; I assume mom is NPO - book really didn't say; uterine hyper/hypotonia assessing here or more during delivery?

During delivery: having some trouble here.... this hospital has NICU RN attend every birth - responsible for neonate; during delivery the L&D RN would keep monitoring mom? assist MD? Hands on w/mom for support? Be prepared for complications i.e. shoulder dystocia

Immediate postpartum (0-4h): assess/monitor mom - PPhemorrhage/meds; "8 point PP assessment" handout given to us; level of anesthesia, pain, episiotomy, bleeding, urine; clean mom up as indicated; assist 1st breastfeed; discharge teaching assessment;

Thanks in advance for any feedback; just really looking for other things I need to be thinking about. Kay

I guess it's already tomorrow so maybe I am too late. A lot of the way a birth goes varies hugely by hospital and care provider. So what may be NPO, IV, stay in bed, episiotomy, lithotomy, epidural, babe to nursery in one hospital might be ambulate, labor in a tub, eat to comfort, no iv, babe stays with mom in another hospital.

Enjoy the process and don't get too wrapped up in things. I would be aware of warning signs for abruption, postpartum hemorrhage, etc. Enjoy!

[OzMW]

Thats a comprehensive list Kay! Hope it went well. Can I suggest some articles for you to read. Important things that we need to keep in mind when caring for birthing women:
http://www.sarahjbuckley.com/articles/articles.htm
Try "Pain in Labour: Your hormones are you helpers" and "Ecstatic Birth: Natures Hormonal Blueprint for Labour".
They are fab for describing the intricate hormonal things that happen during labour. They are obviously alternative in thought but I think it is so important to remember this stuff even in labour wards where lots of procedures occur. We disturb this process so much in hospital and then wonder why women need augmenting and pain relief. If you can get a woman off the monitor and the bed and get her in the dark in the shower you are doing her a BIG favour!