Each childbirth experience is different and unique in its own right, and as your due date draws near, you want to be prepared for what is to come. Get the inside scoop and helpful advice from those who have seen it all—labor and delivery nurses.
Most nurses don't hate birth plans. Well, maybe just a little bit. "They are good in theory," says Krystal B.*, a Dallas-area RN who has worked in labor and delivery and is now an antepartum nurse. She explains that it's great for any woman to have an idea of how she wants to experience labor and delivery, but if you use a birth plan, it's important to stay flexible and realistic. When preparing a birth plan, begin by talking with your healthcare provider, says April Boney, nurse manager for labor and delivery at St. Francis Medical Center in Monroe, Louisiana. "One of the biggest problems we see is that parents arrive in labor with a birth plan that nobody else has ever laid eyes on," says Boney. "There might be something in there that the obstetrician doesn't agree with, or the pediatriciandoesn't agree with, or even something that we can't carry out due to state laws." Your healthcare provider will also be able to help you become informed about the policies of the hospital or center where you'll be birthing—policies which affect how much of your birth plan is actually possible. Remember that birth itself is not predictable. "Your birth plan needs to take into account that things happen during birth that you can't plan for," says Boney. Sometimes, plans must be set aside to protect your health and the health of your new baby.
*Asked to be identified by first name and last initial only.
The nurses surveyed all agree: in childbirth,
knowledge is power. "Almost any class is worth the effort," says Sara Pickett, a Chicago-area nurse. Pickett worked in labor and delivery while stationed at the Naval Hospital in Okinawa, Japan. She also taught childbirth education classes for two years. Childbirth classes can help new parents get a realistic idea of what to expect from their labor and delivery. "No matter how many episodes of ER or A Baby Story you've watched, taking a class at your chosen facility strengthens your knowledge, both about the birthing process and about policies at that facility," says Krystal B. Boney recommends what she calls a "true prepared childbirth class." Often lasting four to six weeks, the best classes are small and very interactive, and are helpful to both parents. In addition, says Boney, "Make sure the childbirth class that you attend talks about variations in childbirth — things that could go differently from what you expected, such as having to have a C-section." Expecting couples may want to consider taking classes in more than just giving birth. For first-time parents, a newborn care class is often helpful. And if you're planning to nurse your baby, a breastfeeding class is a great idea.
Want an unmedicated birth? No matter what you may have heard, "going natural" is indeed a realistic option, according to Norma McClary, and a labor and delivery nurse at Florida Hospital in Orlando. "It is harder for first-time moms, though, because of all the 'unknowns.' They aren't always as relaxed as women who have been through labor before." If you desire an unmedicated birth, prepared childbirth classes are a must. In addition, McClary advises her patients to keep an open mind. "Sometimes patients come in saying, 'I do not, DO NOT want an epidural,' and then if they decide they do want it later, they are setting themselves up for what they may perceive as a failure." "Don't put those kinds of boundaries on yourself," says Pickett. "That's when you get let down." Being flexible is a good idea even if you haven't the slightest interest in natural childbirth. Unfortunately, epidurals aren't given in the hospital parking lot! You may have to cope with a little—or a lot—of pain before you are able to receive an epidural or other pain medication. And pain meds aren't always foolproof. It's best to prepare yourself by taking a childbirth class, where you can learn non-medical methods of coping with pain. "Know what you think you want," says Pickett, "and then be ready for anything."
"[Nurses] are essentially an intermediary between the doctor and the patient," says Krystal B. "It's our job to carry out the doctor's orders while acting as an advocate for the patient, which can be a challenge." This job is easier when patients are prepared, realistic, and—believe it or not—ready to ask questions. Boney recommends patients ask about anything that makes them feel hesitant. "Start by asking, 'Is this an emergency, or do we have time to talk about what's going to happen?' Of course, if you are then told, 'No, it's an emergency and we need to do this now,' then you know the staff is doing what's best for your baby." says Boney. "But if your nurse says, 'No, it's not an emergency, I can explain it to you,' then you can ask, 'How is this benefitting my baby or my labor? Why are we doing this?' Ask about the pros and the cons, and ask what would happen if the procedure in question was delayed a little bit." Also, listen to what your nurse has to say. "Your nurse went to nursing school, and if he or she asks you to do something, such as change positions, it won't be for his or her selfish reasons," says Krystal B. "There may be times when your nurse comes off as abrupt, but please remember they are there to help you and assure the best possible outcome for you and your baby."
If you've never given birth before, you may be feeling a little inhibited about labor. But don't worry; your nurse has seen it all. Pooping on the table? Yes, it could happen to you! "If that happens—and it happens a lot—it just means you are pushing the right way," says Pickett. "It's no big deal, and most women don't even realize they've done it," adds Krystal B. In fact, once you're in advanced labor, you're probably not going to care who is in the room, what you say, or what you do. Most labor and delivery nurses are pretty tough. "They are used to being screamed at, yelled at; that is just a part of childbirth," says Boney. And if you do or say something that you really have regrets about later? "Don't be afraid to apologize," says Pickett. "Nurses are human too." Finally, keep in mind that no matter what happens during your labor, in the end, it's the outcome that's really important. "To your nurse, your health—and the health of your baby—are the first and foremost concerns," says Pickett.