It’s not all sunshine and rainbows when you’re a labor and delivery nurse.

[Lampritl]

Imagine your coworker and his wife arriving to the labor unit. She’s 39 weeks pregnant and contracting. It’s Mother’s Day. Everyone is so excited that the day is finally here for this couple, the nurses, doctors, the patient and her husband. We had all become so close over the last 9 months talking about the baby girl that was on her way. How amazing to be having a baby on Mother’s Day! You put the patient in a labor room and starts to place the baby on the monitor in usual fashion. You’re having a difficult time finding the heartrate but, that’s not unheard of. You look for the heartrate for a few minutes longer. The dad, your coworker, starts to look at you nervously. You stay calm and say, “maybe today just isn’t my day, I’ll go grab someone else to try.” You go to the nurse’s station and ask the charge nurse to come look for you, staying calm on the outside, panicking on the inside... it shouldn’t be this hard. You and the charge nurse go to the labor room and she tries this time to find the heart tones. 1 minute, 2 minutes, 3 minutes pass…. No heart tones. The charge nurse says, “I’m going to call the doctor, they can do an ultrasound and see where the heart is so we can know where to put the monitor.” She goes out to the nurse’s station and calls the doctor and tells the doctor to come quickly because we can’t find heart tones. She knows something is wrong. She anticipates the worst. The doctor rushes to the beside with the ultrasound machine and scans the baby, looking for a heartbeat… which isn’t there. The doctor tells the patient and her husband that the baby has died. The sounds coming from that room are unimaginable. Screaming, wailing, sobbing, disbelief, more sobbing… a lot of “I’m so sorry” from the doctor. This day will forever be engraved in your memory, as well as all the nurse’s working that day and would have a ripple effect on the whole labor unit.

As labor nurses, we work in the happiest part of the hospital. Everyday, we experience the miracle of birth, and that’s exactly what every healthy birth is… a miracle. It is a miracle that from just a few cells, a baby is formed. It’s miraculous when, during each part of the developmental process, nothing goes wrong… when so much COULD go wrong. It is a miracle that during labor, when so many stressors are put on that mom and that baby, that the baby comes out perfectly healthy and the mother’s body recovers quickly. Birth is miraculous and it’s beautiful. Every… single… time. Seeing the delivery of a healthy baby boy or girl never gets old. The joy on the parent’s faces, when the mom cries, when the dad cries (this is my favorite part) and when the family in the room all cheer when the baby comes out crying… that never gets old. The patients start to seem more and more like family. We celebrate with them, cry tears of joy with them, feel proud of that momma for accomplishing her goal of a successful birth… it is an amazing place to work when your work is fun and rewarding all at the same time.

Although we work in the happiest part of the hospital, on bad days… it’s REALLY bad and the happiest part of the hospital turns into the saddest part of the hospital. Mothers and fathers that have waited so long for their baby girl or baby boy to arrive, do not get to bring that baby home in a car seat… they leave empty handed. The next time they see their baby is in a casket. You never get used to this. The pain and sadness are never numbed. The screams, the cries, the wailing, the yelling, the “whys” and the last-minute prayers to God to “save my baby, please” … you never forget them.

Amid the all the crying and sadness and mourning… we still have a job to do. We must monitor that mother during labor, seeing her in pain, seeing her push a baby out and work so hard to do so, knowing that her baby will not every take it’s first breath, ever have a beating heart, or ever cry. We must help that mother find the strength to do that when all she feels like is dying herself, when all her hopes and dreams about becoming a mother have been shattered. We must control the mother’s bleeding after she delivers, causing her more pain when we press on her belly to ensure she doesn’t hemorrhage. We must monitor her vital signs, manage her pain, educate her on the changes that her body will be going through in the coming days, weeks, months, even though she doesn’t get to bring her baby home with her. We must bathe a lifeless baby, dress him or her, take photos, handprints, and footprints, wrap the baby up, and hand a cold, dead, baby to a devastated and sobbing mother and father. We must chart an extensive amount of information during the labor, during the delivery, and after the recovery. We have to make phone calls to Lifenet and report the death of a baby that never lived, speak with the organ donation center to see if the baby is a candidate for donation, call the chaplain, and even help the parents figure out what kind of memorial, burial, service they want for their child. We must do all these things, remain calm, remain strong, while silently grieve all at the same time.

To be a labor and delivery nurse you have to have compassion, patience, understanding… you have to be kind, nurturing, caring, educated, flexible… you have to have the ability to multitask, critically think, and respond to emergencies quickly… you must be brave, empathetic, and be able to grieve in silence so that you can take care of your patient without your emotions getting in the way. The job is HARD. The job is challenging. The job is sad. The job is happy. The job is rewarding. The job is amazing!

If you talk to any labor and delivery nurse they will tell you that the good days heavily outweigh the bad ones, they will tell you that every birth is special, they will tell you that when a health baby comes out screaming… it never gets old. They will tell you that feeling like a part of the patient’s family and celebrating with them is one of the greatest honors of their lives. Sure, we have bad days… and they suck. But we keep showing back up to work despite these bad days. We show up again because the next day is a new day, new moms and new babies need us to take care of them, and the only way we know how to heal from one of those bad days is to show up the next day for our patients and for ourselves… and hope for and see that miracle again.

1000% true. My good friend is a NICU nurse and was called to a delivery for a 26 weeker born to a 15 year old undocumented immigrant who was gang raped and ended up pregnant. Baby did not survive, mom almost hemorrhaged to death in the OR. Hearing her describe that scene is still with me months later.

[Lampritl]

Thank you so much for your reply, MDHNURSE. I started this topic because far too often people talk about how wonderful and easy labor and delivery nursing is... not always!

[Just-floored]

Well said. It isn't always the best job in the world but many days it is.

[midwife228]

Beautifully said, Lampritl! And so very true.

[lexxa25, ASN, BSN, RN]

So true, thank you for sharing, it's not the easiest job but even on the worst days, I love this specialty. We're privileged to be a participant in the miracle of life every day and even to support mothers and families in the tragedies that accompany life.