12 Things Labor And Delivery Nurses Would Never Do During Birth (2024)

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12 Things Labor And Delivery Nurses Would Never Do During Birth (1)

It’s normal for parents-to-be to have some jitters over how their birth is going to play out. Childbirth is painful, unpredictable and transformative. After all the care you’ve taken in choosing a doctor or midwife to deliver your baby, many families are surprised at how little time their provider spends with them in the hospital.

But there is someone who will be by your side the whole time — or at least as long as the shift lasts. Your labor and delivery nurse will be there to read your birth plan, talk you through any interventions, keep you hydrated, suggest labor positions, and monitor your contractions as well as your baby’s heart rate and your own vital signs. When a problem arises, your nurse is often the one to flag it.

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Given this experience and wisdom, HuffPost asked a number of labor and delivery nurses for the things they themselves would avoid in labor. Because every individual’s labor is different, it’s important that you discuss your preferences with your provider, and that you ask any questions you have about the risks and benefits of any interventions during your labor.

1. Being induced for non-medical reasons

It can be tempting to do anything possible to get labor to start if you’re past your due date, but there are some downsides to induction. “Inductions are typically more painful and might cause you to have more interventions and a longer, harder labor. Natural labor eases you into the pain most of the time, and it’s easier to cope,” Hanna Murray, a labor, birth and postpartum RN who runs the Instagram account @babytalk.birthnurse, told HuffPost.

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“Induction is great if it’s medically necessary, but if it’s only ‘because you’re sick of being pregnant’ then it’s better to avoid it,” Murray said.

2. Working “too hard” as soon as labor begins

It’s impossible not to feel excitement at the first signs of labor, but early labors can be a long endeavor. Contractions may come on and off for days, and it’s best to rest as much as possible in the beginning.

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Lo Mansfield, a labor and delivery nurse who offers childbirth education courses at The Labor Mama (and also happens to be 31 weeks pregnant with her fourth child) told HuffPost that she thinks it’s ideal to try to ignore labor for as long as possible.

“To notice a few contractions that are regular, and then to immediately start doing different exercises, going on a walk, trying to kind of encourage labor along can actually be pretty detrimental to the process, because it could be a long process,” Mansfield explained.

“It does a lot of good to just stay home, to try to ignore, try to do other things,” she said. “Resting before that full marathon, even when you’re in the beginning of it, can be so so valuable.”

3. Leaving too soon for the hospital or birth center

This one is super tricky for first time parents. If you’ve never been in labor before, how will you know what go-time feels like? A doula can be helpful in making the call on when to head in, as can guidelines like 5-1-1 (or 4-1-1): contractions are no more than five (or four) minutes apart, at least one minute long, and have been going on that way for at least an hour.

Most childbirth educators advise staying at home for as long as you can. “Being more comfortable in your labor setting will do so much in terms of your labor progression. Truly the longer you can labor at home, the better,” said Liesel Teen, an RN who provides childbirth education at Mommy Labor Nurse.

Ideally, you want your labor to progress uninterrupted for as long as possible. “When we go to the hospital, we are interrupted,” explained Mansfield.

“We’re interrupted by nurses and doctors and midwives at the hospital, even when they do an incredible job. Because there’s people speaking to us, asking us questions, there’s some required initial monitoring at the hospital.”

Unless you have a history of fast labors, or need to head in for a medical intervention such as IV antibiotics if you have tested GBS-positive, Mansfield believes it’s best “to let labor progress physiologically as normally as possible ... and delay interrupting until we’re at a place where we really recognize we need some help.”

“The ideal time to go to the hospital is once you’re in active labor (six or more centimeters),” Sarah Lavonne, an RN who offers education to both families and nurses through Bundle Birth, told HuffPost.

“The earlier you are admitted, the higher your chance of other medical interventions that could potentially have otherwise been avoided or even a c-section.”

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4. Having too many cervical checks

While they’re a standard part of the care you’ll receive in labor, not every cervical check is necessary. It can be discouraging to learn that you aren’t as far along as you would like, and cervical checks also come with a risk of infection, especially if your water has broken. In addition, they can be quite uncomfortable, particularly in the early stages of labor.

“Some providers want to check every two hours ‘just to see what is going on,’ but I always say, if it isn’t gonna change the plan of care, there’s no point,” Murray said. She added that patients always have the option of refusing these routine cervical checks.

“Some of them might be important, like when they are worried about your baby’s heart rate and need to make a decision about how the baby is going to be born,” she added. You can ask your provider why they want to perform a cervical check at that moment.

5. Getting an epidural too early

As a general rule, you want to exhaust your other pain relief options (nitrous oxide, IV medications, being in the tub or shower) before getting an epidural. There are some risks to an epidural, and Murray advises trying to wait until you’re officially in active labor (at least six centimeters dilated).

“If you get an epidural too early, there’s a risk that your baby won’t get into a good position for birth. You’ll get stuck in bed not able to move around as much,” Murray said. With this limited mobility, it can be harder to coax the baby into an optimal position.

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She also mentioned that epidurals can prolong labor, and sometimes they stop working toward the end of labor.

6. Looking at the clock

It seems counterintuitive to ignore the time of day when you’re supposed to be timing contractions, but, as with early symptoms of labor, not focusing on how much time is passing can help you endure what may be a long road ahead.

“In reality, and especially if you are a first time mom, there’s a very good chance it will take longer than you had envisioned,” Teen said.

“I hear, ‘How much longer?’ in the labor room all the time. I cannot stress how important it is to let go of how long labor is taking,” she continued.

“Covering the clock with something during labor is an easy way to help you focus more on getting through labor and less on the length of labor.”

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Once you’re in the hospital, “There are times where interventions are suggested after a couple of hours of no progress,” Mansfield explained. If you’re hoping to avoid interventions, “It’s always appropriate to say, ‘Hey, can I have a little bit more time?’ Or ‘Hey, can I try some position changes before we consider XYZ?’”

“We need to hold that clock loosely. And we need to be careful with how we attribute labor progress specifically to how much time has gone by,” she said. Not all labors adhere to the textbook timeline, but as long as the patient and baby are doing well, there’s no urgent need to try to speed labor along with interventions.

7. Bright lights

While there are times that your provider needs bright lights to see what’s going on, and no one is advocating for a dimly lit c-section, keeping the lights low while you’re laboring is one way to encourage your labor to progress.

“Bright lights inhibit melatonin which in turn can inhibit oxytocin. Oxytocin is the hormone that’s responsible for contractions. Sometimes the bright lights can stall your labor. Ask your nurse to turn them down,” Murray advised.

8. Tensing your body

Easier said than done, but tension is another factor that could slow your labor.

“During labor that’s actually the exact opposite of what you want to do,” Teen said. “It’s going to be harder for your cervix to dilate.”

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Commanding your whole body to relax may seem overwhelming. Teen suggested you focus on just one place: your jaw. “Relaxing your jaw can actually help your pelvic floor relax, too.”

Making low, guttural moaning sounds during contractions will help keep your jaw loose.

9. Not moving around during active labor

“The movement of your body is incredibly important for the descent of the baby through your pelvis,” said Mansfield.

“Those who are unmedicated typically have pretty significant impulses or intuitions about how to move,” she continued, suggesting that laboring people follow those urges.

“Changing positions or getting up to move around is one of the most effective ways to keep your labor progressing and to cope with pain,” Lavonne said.

If you’ve had an epidural, you can still move from one side to the other, adjust the bed, and use a peanut ball to vary your positions.

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10. ‘Purple pushing’ or coached pushing

“Purple pushing is when you hold your breath and ‘push like you are pooping,’” Murray explained. The name comes from the color your face can turn while doing so. This is how we typically imagine pushing, but “it’s not necessarily the best way to push,” Murray said.

A variation on this is coached pushing, in which someone tells you when to breathe and when to push. (If you’ve had an epidural, you will probably need someone to tell you when a contraction is happening so that you know when to start pushing.)

Instead, Murray recommended, “Breathe out while you are bearing down.” This kind of pushing is sometimes called “open glottis” because air can pass through the space between the vocal cords. You may hear the person exhaling or making a humming sound — it doesn’t have to be a peaceful one.

11. Getting pressured into doing something you don’t want to do

“I have heard from so many women that they felt pressured into something they didn’t want or were uncomfortable with during labor,” Teen said. “You should never feel bullied or forced into doing something you don’t want to do.”

“Caring for patients with normal, uncomplicated labors is one of the only areas in the hospital that doesn’t have as many rigid rules,” Lavonne said.

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“Ask for the risks, benefits, and what your other options are, and you may find that you have more options than you thought.”

Unless there is an emergency, there should be time for you to ask all your questions. Because it can be difficult to communicate while you’re in labor, it’s always a good idea to discuss your preferences with your provider beforehand, and to have someone there with you, such as a supportive partner or doula, who can advocate on your behalf.

Many patients aren’t aware that they can also ask for a new nurse if they are struggling with the one assigned to them. Lavonne believes that most nurses, doctors and midwives truly care about their patients and want to treat you with respect, but if you’re not getting that from your nurse, ask for a different one who can give you the care you deserve.

12. Feeling bad about changes to your birth plan

“Make a birth plan but be flexible with it, and give yourself some grace if things don’t go according to plan, because there’s a really good chance they won’t. A rigid birth plan can set you up for disappointment and possible birth trauma,” said Teen.

For these reasons, Lavonne suggests that people refer to them as birth preferences instead of a birth plan.

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“Know your preferences, advocate for them, but also be willing to be flexible based on how your labor and birth unravel,” she said.

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12 Things Labor And Delivery Nurses Would Never Do During Birth (2024)

FAQs

What is the hardest part of being a labor and delivery nurse? ›

Being a labor and delivery nurse comes with some incredibly challenging moments on the job, such as experiencing the loss of a birthing patient or baby.

What can I refuse during birth? ›

You have the right to bodily autonomy and self-determination. For example, you can decide whether or not to get an epidural or whether to accept a recommended c-section, regardless of hospital policies. Your consent is also required before any procedures like vagin*l exams or breaking the bag of water.

What are some interesting facts about labor and delivery nurses? ›

During labor, these nurse specialists will be monitoring both the baby's heartbeat and the mother's vitals. They will be the first responder to any complications. And when the physician is called in, they are second in command and act as the primary advocate for the mother.

What is the 1 1 1 rule for labor? ›

This means that you should call your doctor and head to the hospital when: Your contractions are coming every five minutes, or more frequently. Each contraction lasts one minute or longer. This pattern has been consistent for at least one hour.

Why do I touch myself during labor? ›

The reality is that while giving birth, some women have an org*sm (sometimes called birthgasm). For part of those women, that happens without conscious stimulation, whereas some other women deliberately stimulate themselves to org*sm to relieve labour pain.

What is the hardest unit as a nurse? ›

Intensive care unit (ICU) nurses

The ICU is an extremely high-pressure environment. Intensive care nurses are frequently asked to make split-second decisions, and the actions they choose can make the difference between life and death.

Are L&D nurses happy? ›

Pay, salary, and job security aside, many labor and delivery nurses speak fondly about the incredible fulfillment they get at work. Assisting parents as they bring new life into the world brings these nurses a lot of happiness.

What is the shortest and most difficult stage of labor? ›

Although it is the shortest phase, the transition phase is the most challenging. Transition typically lasts 30 minutes to 2 hours as your cervix fully dilates from 8 cm to 10 cm. Contractions will last roughly 60-90 seconds with only 30 seconds to 2 minutes between.

Why you shouldn't push when giving birth? ›

Labor is the process that prepares a woman to deliver her baby into the world. Doctors tell a woman not to push during labor because she is not ready, there may be a problem with the baby or she may have had an epidural.

What age should you not give birth? ›

A woman's peak reproductive years are between the late teens and late 20s. By age 30, fertility (the ability to get pregnant) starts to decline. This decline happens faster once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely.

Can I refuse an IV during labor? ›

Can I refuse an IV during labor? If you plan to labor without pain medication and you don't need to induce labor, you may be able to refuse an IV. While IVs for labor are routine in many hospitals, they're not always needed for childbirth.

What are 5 facts you should know about childbirth and delivery? ›

8 Incredible Facts About Pregnancy, Delivery, And Newborns
  • Only 5% of babies are born on their due date. ...
  • Newborns also have more bones than adults. ...
  • Babies Can Hear in the Womb. ...
  • Your Blood Volume Goes Up When You're Pregnant. ...
  • The Uterus Expands Quite A Bit. ...
  • Your Baby Only Makes Up Part Of Your Weight Gain.

How many babies do labor and delivery nurses have? ›

The patient load would depend on the acuity of the patient. For instance, if the patient was to have a vagin*l delivery, the nurse might have 1-3 patients. If the patient were in active labor, the nurse might have 1-2 patients, depending on staffing.

How many nurses will you have during labor? ›

Nurse-to-patient ratios vary based on the unit and hospital. Labor and delivery units often have ratios around 1:1 or 1:2 during the active labor phase, but may increase to 1:4 during less intense recovery periods after birth.

What is the 5 1 rule for labor? ›

Takeaway. If your contractions are 5 minutes apart, lasting for 1 minute, for 1 hour or longer, it's time to head to the hospital. (Another way to remember a general rule: If they're getting “longer, stronger, closer together,” baby's on their way!)

What position should be avoided during labor? ›

Several evidence-based guidelines encourage and help women to move and adopt any position they find most comfortable throughout labor and childbirth, except supine or semi-supine position [3,34,35].

What not to do while your wife is in labor? ›

Try Not to Totally Fall Asleep

Yes, labor is an incredibly intense experience for both partners, and yes, it's exhausting. But no, you cannot go into deep-snooze mode. If your partner isn't sleeping, neither are you. That's just the way it goes.

What's the worst thing that could happen during labor? ›

Uterine rupture is at the top of our list because it is arguably the most dangerous of all obstetric complications for both baby and mother. Uterine rupture is a rare event in which the wall or lining of the mother's uterus tears open.

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