The Secret of Labor and Delivery

Sometimes, even in the midst of a bad delivery, we can look around and the work that we do is validated right there, before our eyes.   If only people knew what really happens in labor and delivery…

Labor and delivery is hard. A combination cocktail of things makes every day exhausting. Sometimes we have bad patients. Sometimes we have bad deliveries. Our coworkers are an extension of our family, and we all know how that can sometimes be. Management seems to want more and more from us at the start of every shift. And providers can be good, and sometimes they can be bad, and sometimes it just depends on what day it is.

But one good patient, one good delivery, has the ability to minimize any bad factors. When labor and delivery goes well, it’s addicting. And this keeps us coming back for more when we question if labor and delivery is worth it.

Years ago, I labored a woman all day who gave me no warning at all that her delivery would blindside every single person at work that day. Excited about the birth of her first baby, we laughed all day long and made bets on when her baby would be born. As family came in and out of her room throughout the day, I felt like my patient, her husband and I were members of a secret little club. We were the only three people (besides her provider) who were going to be at her delivery. We were the only people who were going to be part of every process – from the start of her labor to the end of it. And we were the only three people who knew what they were planning on naming their baby. I felt so lucky to be a part of it all, excited to bear witness to their own little delivery of a miracle.

When her baby’s head delivered, I leaned into her ear and whispered for her to look down at her baby. Her husband looked on in amazement, taken aback by the beauty of it all. And less than a second later, I realized that things were about to go terribly wrong. Her provider stood there, positioned between her opened legs, asking her to stop pushing. I quickly propped myself up on the bed, and jammed my fist low into her abdomen to give suprapubic pressure. Expecting to hear a pop with the release of her baby’s stuck shoulder, instead I heard nothing.

My own heartrate pulsated in my ears, and with each passing moment, we all watched the pink drain from her baby’s face. Anxiety fed the adrenaline bubbling up inside of me. From the corner of my eye, I could see the nursery nurse calling for additional help. From the corner of my eye, I could see her husband reassuring his wife that everything was going to be okay. From the corner of my eye, I could see the frightened look on my patient’s face. And as the room flooded with nurses and a neo team, all of my efforts were finally rewarded with a pop! and the quick delivery of very big baby girl.

The doctor handed the baby to the nursery nurse, its arms and legs dangling limp and lifeless beneath it. I then watched as nurses and a neo team brought color back to that baby’s face, and life back to that baby’s body. And as I turned to smile at my patient, ready to reassure her that everything was going to be okay, I instead saw energy draining from her eyes. Blood was spilling out of her, and all at once I could hear so many things: her provider requesting more instruments from the surgical tech, someone saying they were going to open up the OR, someone else saying they were calling anesthesia, her baby crying angrily in the warmer, her husband snapping pictures and gushing over his new baby, and above all, I could hear blood pouring out of my patient. I began snapping cords out of the wall to release her bed from the room. And before I knew it, we were in the OR, my patient intubated and her provider repairing the source of the bleed.

That day, I left work not knowing so many things. I wanted to ask my patient if her last memory of her delivery was of her baby’s face turning every shade of blue while still stuck inside of her. I wanted to ask her if she got a chance to see all of the work that everyone did to bring her baby back to happy and healthy. I wanted to know if she really understood just how close she came to an unhappy ending. I wanted to know so many things, but that day I only left work knowing that her baby’s name was Emma.

When I got home, I put my kids to bed and left my husband downstairs. I got into my bath, still shaking inside from the events of my one delivery of the day. I cried into the bathwater, not really sure what I was crying about. My mom was going to be okay. My baby was okay. But as images of my baby’s blue and purple face flashed through my mind, as I remembered the blood pouring from my mom like my bathwater from the faucet, I knew we got so close to everything just being wrong. And I think I cried for that.

I slept hard that night, exhausted from replaying every scenario in my head and giving that family every ounce of energy from my body. When I woke up, I felt better. I put on my scrubs, excited to see how my patient and her family were doing, and so grateful for the people, providers, nurses and neo team I work with.

There is so much beauty in OB, but the people that we work with keep us coming back for more.  Sometimes, even in the midst of a bad delivery, we can look around and the work that we do is validated right there before our

Until my next delivery ❤

8 thoughts on “The Secret of Labor and Delivery

  • April 8, 2016 at 11:37 pm

    Being part of this senario as and L&D nurse for 30 plus years, I understand completely your words. Being married to the Obstetrician also makes me sympathize with his situation.. There are so many heartfelt narratives of the nurses experiences, and nearly zero of the Obstetrician’s. Please know there is pain, heartache, frustration, anger and joy for them also. So many stories from the nurses about the “nurse who saved the mother and the baby,” but in reality it is a team effort, and the MDs are the captains of the ship no matter how amazing you believe you are. When things go bad, as you all know they can, when there is an unexpected complication, or and unexpected bad outcome, where are the nurses taking responsibility for it? Or actually critically thinking about what is really happening, what is the diagnosis and what is the best, most current evidenced based treatment for it.. Just taking credit for beautiful births, and criticizing the less than optimal is incorrect . That being said, L&D nurses, who understand the whole situation, who are knowledgable in the physiology and pathophysiology of disease and the labor process are amazing an invaluable asset to the team. The Team…… its about all of us together, working for the best outcome for mom and baby.

  • July 9, 2016 at 3:18 am

    45 Years of obstetrical nursing. This. PTSD. Obstetrical nurses and their employers absolutely need to be proactive. Brushing it off at “addicting” and mostly-thrilling ignores the stress.

  • April 15, 2017 at 2:37 am

    Wow! You capture it perfectly! My question though is: How do you handle it when it doesn’t right itself at the very last possible moment?

  • January 29, 2018 at 4:38 am

    I’ve absolutely felt what you were feeling. I’ve been a L&D RN for a long time, and one of my worst deliveries was also a shoulder dystocia… and I’ve done chest compressions in the OR, praying that my pt would live. Adrenaline, home, tears… unfortunately I get it… along with every other L&D RN.

  • February 2, 2019 at 7:16 pm

    This response is directed to the nurse married to the OB. I’ve worked in LD for 38 years and I can honestly say that the reason the nurse gets more praise than the OB is because it’s the nurse that is at that bedside her whole 12 hour shift. And the OB pops in once in a while. And we all know this is true. I’m not saying that the OB isn’t the Captain of the ship because I believe he is but only because it is outside of the nurses scope of practice to be the official Captain.


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