Recovery for vaginal delivery

Specialties Ob/Gyn

Published

I am looking to see when the recovery from a lady partsl delivery starts at other hospitals.

Where I work we start it when the MD/midwife has completed all repairs, placenta is delivered and basically they are ready to walk out of the room.

My mother has only work in facilities with this same policy.

My aunt and my mom's friend have had the same experience until recently when they changed jobs (work at the same hospital). The policy there is to start recovery when the placenta is delivered. My aunt feels this isn't safe and refuses to do this and she's getting a lot of grief.

I'm trying to see what other facilities do. Also, if you know of any standards of care regarding this I would appreciate seeing them.

Thanks.

Specializes in Community, OB, Nursery.

Man....there is so much variation.

Our M/B couplet nurses have on average 4 couplets. Sometimes we start with 3 and get an admit or two, others we keep 4 the whole night, others we start with 4 and get an admit.

After an hour or so, depending of course on how mom and baby are doing, L/D takes baby to the nursery for his bath/assessment etc. Until that time, L/D is responsible for at least getting a set of vitals q30min.

We get mom to mother/baby shortly after L/D takes baby to the nursery. Most of our L/D nurses, since they are getting Mom up to get in the wheelchair, will see if she needs to void, and get her cleaned up. If not, she still comes to us.

M/B is responsible for everything past that. If mom needs to void, we do that. If Mom's legs are still dead from the epidural, so be it.

Once baby is bathed and warmed up afterward, he goes out to Mom and the M/B nurse takes over his care from there on out.

I wouldn't know what to do with myself if I got a postpartum Mom already having gotten up for the first time, voided AND showered!!!

Specializes in L&D,Lactation.

We do 2 1/2 hour recoveries. We are a level 3 facility doing 500+ deliveries. We have 18 labor rooms and 6 antepartum rooms. Our Csections recover until they can lift their hips. But we do baby vs, assesment, meds, skin to skin breastfeeding and bath. We don't shower the mom though, most of them cannot walk well enough. MB has 4 couplets, and about 52 beds on 2 floors.

At our hospital we don't time recoveries. Sometimes the labor nurse does recovery and takes them as a couple for the rest of the shift. When she's done with the busy part of recovering mom and admitting the baby, then she'll offer to help another nurse or take some triage pts. We're flexible, and we help each other.

I'm a baby nurse. I take couples and then come at delivery time. If I have time, I will do most or all of the baby admit. If I don't have time, the labor nurse will finish what I don't do. During births and for about a half hour afterwards, there is a labor nurse recovering mom and a baby nurse stabilizing and admitting baby. (And of course, the doctor or midwife is there until they are done with the placenta, stitching, etc.)

If the labor nurse is needed for another labor, then someone like me will take over mother and baby at any point in the recovery. She tells me what she's done and what is not done. I finish recovering mom and admitting baby.

We only move them out of rooms when it's needed. Sometimes they stay in labor rooms their whole stay, other times we move them out to the postpartum rooms. If they are in the popular tub room, we move them a couple hours after birth, whenever it's convenient. The nurse follows them to the new room.

We have eight labor rooms, and we average two births a day. Everyone does couples and surgeries. Some do labor, others do babies and NICU, a few can do everything. (We only get NICU babies occasionally. We ship out the bad ones.)

Specializes in OB.

Our MB unit would love if the pts were just tucked into bed. Really though after the 1 hr recovery in L&D they only have to do fundal checks q 1 hour for 4 hours then q 4 for 24 hours. They help mom up the first time then the pts are walkie talkies. A few times I have worked MB I have seen the MB nurses running around like they are so busy and I am sitting at the desk waiting for my next check or for a pt to need something. May have something to do with the fact that in L&D things can change so rapidly that we have to have everything just right from the moment we receive report. I love our MB nurses. They are awesome, but we also have unit to unit concerns. Our PCM is over the whole birth center. We have also had nights where out triage is full, (Ours is only 5 beds. We have a seperate 4 bed ATU) and we have pts laboring in the OR and waiting rooms. Those times are when we need to send pt out to MB and at times can't due to couplet care even if there are empty beds. It gets so bad at times that we double 2 delivered pts in 1 room. I love my job and could not imagine working in any other hospital though. I work nights and our nurses are like a huge family. Couldn't be happier even with the frustration.

We are a small unit so it just depends on how my night is going on how fast Pts get moved to PP. If we are slammed I try to get the moms moved as soon as they can walk and hopefully pee. If all the other L&D rooms are empty I am not in such a rush. On average its about 2 hrs.

Specializes in L&D,Wound Care, SNC.

Our recovery time varies. We typically don't transfer mom and baby until mom has showered and voided. It can take anywhere from 1.5-4+ hours. We also try to have baby bathed during mom's recovery time. If we need the room then we do end up transferring mom and baby without a shower. Part of the reason for this is there are community bathrooms on the MBU! (ick). As in the whole ward has two toilets and two showers, with the exception of the private rooms. We like to have our moms have one nice, shower in a private room. Sometimes the moms luck out and get a private room, but they are reserved for c-section patients.

Our MBU does couplet care, but they tend to get overwhelmed when they have more than 2 moms and 2 babies. In their defense the bulk of the MBU are "butter bars" 2nd Lts. (I work in a military hospital), essentially new grads.

where i work recovery starts 15 min after baby is born. i do not think this is appropriate. at the place i worked in denver the recovery started after the placenta delivered and the repairs were complete.

Specializes in OBGYN, Neonatal.

Where I work our LD nurses keep moms for one hour after delivery time i.e. if baby is born at 1800, mom usually comes over to MB at 1900, sometimes later but usually not, and they come numb or not, most of the time. That is for vag deliveries. C/S are 2 hours post delivery time but its been earlier on occasion. The baby comes to us fairly quickly, ideally they are to keep them an hour but that doesn't happen all of the time, just depends on the baby/mommy/etc.

We do couplet care, we usually start with 4, but more often 5 couplets and on occasion go higher, I've had up to 7 couplets. Also during dayshift you may be getting couplets while discharging others, so by the end of your your shift you may have had a looot of couplets LOL. There have been times when I've started with 5, sent 3 home and got 2-3 more, so by the end of the day I had 7-8, not fun when it comes to charting LOL!

Specializes in OBGYN, Neonatal.

Elvish I'm with you, I would be totally shocked if all my patients came over tucked into bed and already showered LOL! No way, most of the time they are still partially numb, or at least a little shellshocked and we are expected to do all of their care, orientation, plus recovery (once we get them we recover them with vs and fudal checks q30 mins x 4 ad q 1hour x 2, then q 4 hrs x 24 hrs and the q shift unless there are problems), plus our other couplets (average for us is 5 most days) and do other work (vital signs, i's ad o's, pass meal trays, change linens, empty foleys on surgery patients, assist with circumcisions, etc.).

Specializes in Med Surg; OB.

At my hospital we do 1 hr recovery for vag and 2 hr for c/s before transferring to M/B depending on complications. baby stays with mom for vag and for c/s baby goes to nursery for assessments, meds ect until mom is stable. MB does couplet care usually 3-4 depending. Before mom goes to M/B she has to be stable, and at least voided once. No requiremnent on showering though. We do teach skin-to-skin/breastfeeding within the 1st hr.

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