Supporting a woman in labor...

  1. I've been working in L&D for about 5 months now... and I feel like I'm too quiet during labor when my pts. are pushing. Sometimes they will be discouraged and feel like they can't push anymore. I try my best to cheer them on, and sometimes I really don't know what to say to them... but however I still feel like I'm not being supportive enough... maybe I'm just too mellow?

    JW.... if you can share the different ways to support a laboring mom or give suggestions ... that would be great.
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    About winter_green

    Joined: Sep '10; Posts: 117; Likes: 17


  3. by   lilkuz06
    I'm not a nurse (yet), I start the program in the fall. However, I have 3 young children. My youngest is 16 months and I gave birth to her med-free (not by choice). The nurse actually delivered her. So, I remember all too well, what it's like to be the "laboring mom"

    That said, cheering was the last thing *I* wanted to hear while pushing through some intense pain. What I really would've preferred were some positive comments, "You're doing great", or reassuring comments, "Everything is going great, baby is almost here". I say that because with my baby, I was SO nervous and scared. Yes, she was my 3rd, but I went from 5-10 in a matter of minutes and the nurses were all running around the room hitting buttons, paging "OB Stat" to my room, setting up the table, etc, etc.. I really just wanted someone to turn to me and tell me everything was fine! I also think that after a mother has her first, it's assumed she knows what she's doing or what to expect. NOT THE CASE! Every labor/delivery is different... completely different. As I'm sure you know, but as the mother, it's an anxious time.
  4. by   mauiiRN
    First of all, good for you for looking to improve your skills to better help your patients!
    Second, a lot of things will come in time. Five months is not that long to be in L&D. Pay attention to other nurses and how they work with patients, things they say, and their behaviors. You will learn a lot this way. Keep in mind, everyone works with their patients differently. I know nurses that quietly encourage patients, saying things like, "that's great, keep going, keep pushing, keep it up, you've got it, that's the spot, right there," etc. Others count to ten, then offer some encouragement after the contraction. Others are like cheerleaders, really loud and cheery. I tend to ask my patients what is working for them. I will say, "how does the counting to ten work for you?".
    Some courses may help- I took a doula course which was amazing for boosting my confidence.
    One thing I learned over time is that "you cannot save everybody from everything". Basically a woman has to find her own energy and motivation to push, and not everybody will push well no matter what you do! Some might benefit from a rest, a small nap, or some juice, then to continue. Try changing positions, or encouraging her to visualize her baby descending, or holding her baby in her arms.
    Keep trying! It will get better
  5. by   rkitty198
    I just had my baby and wow it was tough! I didn't want any talking or anyone saying "push harder." I only wanted to hear "good job!"
    I was on a mag drip and was so uncoordinated and exhausted that I didn't want to hear a lot of background noise unless it was a "good job"
    I really appreciated one nurse who asked me how she could encourage me and during that experience I had no problem telling her. I also pushed for 3 hours, on pit, no epidural, and was in labor for 32 hours... Sorry I am still having PTSD lol.
    Thanks for asking how you can help, I bet you are amazing!
  6. by   nurturing_angel
    I have been a labor/delivery nurse for such a long time. I was quiet and shy when I first started and was afraid to say anything at first. I didn't even want to touch my pts for fear of hurting them or getting yelled at. I have to agree with the posters above.
    1) Observe other nurses for ways to encourage and support moms.
    2) Doulas are awesome at this job. If any are around your unit try to get a few minutes to talk to or observe them at work. Also, taking a doula class is a great way to learn. Even sitting in for a childbirth class might help give you helpful info.
    3) Most importantly (IMHO) is to take your clues from your mom. Some love to have lots of feedback and help. Others just want you to be there. Thats all the support they need. Ask her how you can best help her.
    4) The confidence will come as you gain more experience so don't give up. This is a great job. I wouldn't want to do anything else.

    Welcome to the labor room!

  7. by   winter_green
    Thank you for all the suggestions! It will really help me. I am shy too, so I think that also plays a role. I hope in time, this will become 2nd nature to me.
  8. by   NurseNora
    AWHONN has a booklet on managing the second stage of labor. You can get it from their website, even if you're not a member (you'll just not get the member discount). There is a lot of good information in the book. And I think you can get CEUs with it too.

    If your patient has an epidural, let her labor down: up to 2 hours for a primip or 1hr for a multip. Even if she doesn't have an epidural, remember that not everyone is ready to push just because she's 10 cms. Some people have to wait a little while to get the urge. You'll both do best to let her rest until the baby moves down enough to give her an urge to push.

    Change her position. If she's OP, have her push on her hands and knees for a while. Have her push on one side and then the other, then help her squat.

    Watch other nurses to get ideas from them. If your patient isn't making much progress, ask another nurse to come in and see if she has any suggestions.

    I have had patients deliver beautifully when all I did was just say, "Listen to your body and just do what it tells you to do." Most docs don't have the patience to do it that way, but some do, or I may choose not to tell the doc right away.