Question for experienced L&D nurses

babyktchr, BSN, RN · Apr 3, 2012

thankfully I have had no mom deaths. there were a few that died post baby from complications. i deal with stilbirth and neonatal birth much more, which is heartbreaking. it isn't always roses in L&D, and its not all rocking babies. its hard work.

klone, MSN, RN · Apr 4, 2012

Whether you ever see a maternal death also might depend on the type of facility at which you work, as well. The first five years of my OB career, I never once saw a maternal death. The last two years, there have been two maternal deaths at the facility where I currently work, but where I work now is a high risk facility, and we get the highest of the highest acuity.

Maternal deaths don't happen too often because OB is generally well patients, but eventually you will probably see one in your career. Maybe not *your* patient, but maybe someone in the unit. Fetal demise is part of OB, though, and it's just something you accept as part of the job of an L&D nurse. A normal labor that goes bad and a healthy baby that dies is far less common, and that has never happened to me, personally.

jujubug · Apr 5, 2012

So what were the maternal deaths related to?

eden · Apr 5, 2012

Well in 10 years I have yet to see a maternal death though I know there was one in our facility when H1N1 swept the region. We do see several stillbirths a month but 99% of those are known stillbirths/known fetal anomalies so we can try to prepare ourselves to help the families cope.

klone, MSN, RN · Apr 5, 2012

So what were the maternal deaths related to?

PE, DIC (2/2 sepsis)

These were women who had comorbidities. Not healthy women. Women who were brought to us because they were high acuity.

Elvish, BSN, DNP, RN, NP · Apr 5, 2012

H1N1, amniotic fluid embolus that led to DIC, sepsis that led to DIC. A couple were healthy pregnant women that came to the hospital to have their babies and never left.

Calabria, BSN, RN · Apr 6, 2012

I've never worked L&D and it's always been an area I've wanted to do. When I worked dialysis a fellow nurse who had worked L&D for 30 yrs. previously mentioned that it wasn't all peachy and that she witnessed some awfully sad cases where mom & baby died in the OR. I already knew of course it's not a happy unit all the time and things can go bad quickly. I'm just curious and want some info from those who are experienced L&D nurses. How many maternal and/or fetal deaths have you experienced in your career? Of those, what were the deaths related to....c-sections? uterine ruptures? Thanks!

A few from H1N1, one recently from acute fatty liver of pregnancy (she died a little over 24 hours postpartum).

jujubug · Apr 6, 2012

I am also curious about the debate between elective RCS and VBAC. In your experiences which route did you see more problems with? Also how often do you see complications with general anesthesia for CS?

Elvish, BSN, DNP, RN, NP · Apr 6, 2012

I am also curious about the debate between elective RCS and VBAC. In your experiences which route did you see more problems with? Also how often do you see complications with general anesthesia for CS?

Probably it's a good idea to start a new thread for that topic, it's a bit heady. :)