Delivery Advice: From the Nurses that Help Bring Babies into the World

Who better to get labor and delivery advice from then the nurses? If you've given birth in a hospital before, you know that these are your go to resources and the person that will be supporting you through the process. 

I'm lucky to call a few of these gems my personal friends! I thought it would be PERFECT to get them to answer commonly asked questions about labor and delivery. They all we're excited to contribute and hopefully HELP a few women as they prepare! 

I deeply believe in MENTALLY preparing for birth. I’ve noticed a lot of women get really nervous at the end of pregnancy. It seems they would rather AVOID the thought of the delivery process. No matter which way you are going to give birth, I recommend doing yourself a huge favor by spending some time preparing. My sister Krystle wrote a tremendous blog post about C-sections including the emotions and recovery that go into it.I just wanted to add that because I would definitely prepare myself mentally and physically for a C-section too!

First, I wanted to take a second to introduce these amazing women, who were excited to come on and share their knowledge:

Rachael Fehrenbach: I’m friends with Rachael’s brother Mike and then got to know her better when my friend Chris from college fell madly in love with her. To know Rachael is to love her because she is so sweet, fun, and just as beautiful on the inside as she is on the out. She has been working in the labor and delivery unit for 4 years.

Rachael.JPG

Alecia Raschke: I met Alecia in nursing school and we messaged all the day long. We went to an online accelerated program, so we hit it off as virtual friends.  She is one of those women that exudes confidence and warmness. Alecia has been SO supportive of this blog over the years. She has consistently read, intentionally shared, and cheered me on! I know she is such a huge blessing to her patients. Alecia has been a labor and delivery nurse for 4.5 years.

Amanda Schmidt: I met Amanda in nursing school too! She is one of the most kindhearted people I know. We share many of the same interests and can pick up right where we left off each time we get to see each other. She just had her first baby in September, so it was fun to ask her about being on both sides of the experience. Amanda has been a labor and delivery nurse for 3.5 years.

Amanda, Me, Taylor, and Alecia! Nursing school friends 

Without further adieu, let’s dig in and learn more!

Amy: As a labor and delivery nurse, what is the BEST piece of advice you could give women that are about to experience their first delivery?

Rachael: My advice is to take everything one step at a time and know that the labor process is not black and white.  Every labor is different. Labor and delivery is such a unique and beautiful process that you cannot always be 100% prepared for.

Alecia: Take the time and research what to expect during your delivery. Please use scholarly sources or take a birthing class provided at your hospital. Please DO NOT rely on Youtube or whacky Facebook groups for your information. BE FLEXIBLE and trust the nurses and physicians taking care of you. OB takes a special breed of nurses who are passionate and dedicated to helping you and your family welcome the biggest miracle into your life. Ask questions! There are NO dumb questions and sometimes we accidentally forget you don’t understand our nursing lingo. #pit #LR #foley  Ames: Can you tell Alecia is in school?! 

Amanda: 

-It’s not always going to go as planned so be flexible.

-It takes time (usually), so be patient.

-Ask questions during the process so you know what to expect and know what’s going on.

Best advice: Take your full recovery time (usually 2 hours post delivery) with just you, baby and your significant other!! It’s such a magical time! I don’t suggest visitors until you are fully recovered (up and walking around and considered postpartum). Take the time to bond with your baby!!! If you have eager family members that want to visit immediately but you don’t want them to, don’t tell them you are in labor or let them know 2 hours after baby is born if you’re afraid they will visit too soon  Amy: I LOVE that this was Amanda’s best tip. Drew and I waited until the morning to even tell our parents that Maxwell had arrived (he made his grand entrance at 11:04pm). Even after we called them we had hours before anyone could get there and the world was just the 3 of us for an entire 12 hours. Women have been reaching out about this and their parents or in-laws not being happy about their decision. Believe me, we were asked, “Can’t you give us warning since we have to drive there?” I said, “No. This is how we want to do it.” It is OUR baby and OUR experience to have, so I had no problem being honest and standing my ground. The second time around we had to let my parents know because we needed help with Maxwell. Everyone was still very respectful and we got about the same amount of time before visitors with Trey. 

Amy: How many of your patients come in with detailed birth plans? Do you find that mama-to-be with the birth plan is pretty adamant about sticking to the plan?

Rachael: I would say birth plans are somewhat rare (at Froedtert) due to our population being high risk.  But, there are some women who come in with detailed birth plans.  I do find that mama-to-be’s are pretty adamant about their plans and as the nurse I always try my best to accommodate.  We are definitely advocates for our patients as nurses and I feel strongly about helping women reach their labor and delivery goals.  The problem we come across as nurses is when patient’s become so dead set on their plan that it interferes with the safety of the baby and patient themselves.  My suggestion with birth plans is to keep your goals in mind (and their are some plans with goals that are 100% reachable), but also be okay with everything not going exactly according to plan.  Every labor and delivery process is beautiful no matter how it is accomplished.

Alecia: Honestly, maybe 10% of my patients come in with a detailed, written out plan. I would say the majority of families have a few special verbal requests such as skin-to-skin, delayed cord clamping, etc. which our hospital promotes anyways. As above, if you do come in with a birth plan, please take the time to research (from scholarly sources) the things you are requesting. Do not simply rely on what your sister’s friend’s cousin did. It is your body and child and your choice and it should be an informed one.And always remember, it is in God’s hands and no one can predict how every birth will go (not even the OB physician). Not every labor and delivery experience will turn out exactly the way it was originally planned.  Your nurses and doctors have you and your baby’s safety at their utmost interest and will do everything in their effort to accommodate your wishes as long as it is what is best for you and your baby.

Amanda: We do see them from time to time.  Most mamas that come in with birth plans are pretty adamant to stick with it, but there are some who say they are flexible and it’s not set in stone.

If you want a birth plan I would include what you want to do for your labor (birthing ball, walking, tub, etc), do you want us to offer pain meds or not, do you want visitors in the room (I don’t mind being the bad person and having people leave the room if that’s what the patient wants), are you going to do skin to skin (most mamas do and I highly suggest it), are you breastfeeding?  Do you want a mirror to watch your child being born?  That’s pretty much all we need to know :). Otherwise just be verbal during your labor and let us know what you want and if you have any questions; we are there to help!  Just remember the most important thing is that you and baby are healthy so if things change or happen that isn’t exactly what you want, we are doing it for mama and baby’s benefit.   We don’t do things just to do things.

Amy: If a mama-to-be DOES want to make a birth plan, what would you suggest including?

Rachael: Honestly, I had a patient the other day that brought in a birth plan and all it said was, “I want a healthy baby and my husband to be with me throughout the labor and delivery process.” This birth plan made me smile due to the simplicity and it’s focus on that main goal “a healthy baby.”  Some other basics I suggest for a birth plan would be skin to skin contact with baby immediately after delivery(if possible) and delayed cord clamping.  A lot of times birth plans are simple and easy enough to just be told to the nurse.  Typed out birth plans are nice to have if they are a little more complex.

Alecia: I attached a link from the bump that has a decent plan to use as a guide.. just know that not everything can be written in stone. Also, I recommend discussing this list with your OB several weeks in advance to know what options are available at your hospital and familiarize the OB with your wishes. Give the doctor a copy and bring one in when you deliver just in case. Nurses will always do their best to accommodate but sometimes people’s requests can be unrealistic. This is also where birthing classes or orientation classes can be extremely helpful in knowing what to expect. https://www.thebump.com/a/tool-birth-plan

Also just FYI, our doctors all do delayed cord clamping as a standard practice unless baby needs to be brought to warmer right away!  I see this on birth plans frequently that moms want delayed cord clamping until cord stops pulsing; our doctors do not clamp the cord until 3 minutes of life unless cord stops pulsing before or unless baby needs immediate attention at the warmer.

Amy: I’ve received a lot of messages lately about women that are really interested in attempting a natural birth. The concern is that the healthcare team will try to dissuade her from doing this. As a nurse, do you have any thoughts about this?

Rachael: I don’t feel that the healthcare team dissuades patient’s from attempting natural births.  I love having a good natural patient that knows this is what they want and ultimately will accomplish.  Its amazing to see women do natural birth and it amazes me every time I get to be a part of it.  Especially when I’m the nurse and get to help them through such an amazing process.  With that being said I do understand why some people believe the healthcare team dissuades patients from natural birth. One reason might be because the epidural rate now a days are very high.  So many nurses and doctors are used to their patients getting epidurals.  Although this may be the norm, natural births still happen every day and our nurses and doctors have the experience to help women through it.

Alecia: I have met doctors and nurses alike who say they just hate to see their patients in pain, especially when we have medicine to help them. I think pain is so often perceived as a bad thing and that it needs to be treated with medication right away. As long as you let your nurse and physician know that you do not want to be offered pain medication or an epidural during labor, the healthcare team will absolutely respect your wishes. Also, know that everyone’s pain experience and tolerance is different. Just because your sister may have not needed medication does NOT mean you have to do the same. As far as inducing labor, ACOG (the American Congress of Obstetrics and Gynecology) recommends NOT inducing until after 39 weeks gestation unless medically indicated. Therefore, many doctors are now going back to the old practice of letting your body naturally go into labor. (Research is always changing and practice always comes full-circle). However, there are certain situations when it may be best for you to be induced or even receive pain medication, so trust your doctors and your nurses. They see hundreds (if not thousands) of deliveries year, they will only recommend what is safe.

Amanda: I work with a wonderful team and I don’t think we persuade women to get epidurals.  We always offer them if patients would like them, but we do not push them into it by any means!  I also think it’s important to talk to her doctor prior to delivering so her doctor knows her wants as well; and then mention it to the nurse that way everyone is on the same page!  We have labor balls, whirlpool tubs, mirrors, push bars, etc so we are fully prepared to help mamas labor and deliver naturally.

Amy: As a women that has now delivery a baby, did your perspective change after having your own experience?

Amanda: Yes, totally! I think now that I’ve been in this position and had a baby of my own, I’ll be able to relate better since I know what it feels like. I know I can make suggestions for coping with labor both mentally and physically based on what worked for me.

Amanda and Babe.JPG

Ames: BEST tip for a mama that does want to do a natural birth?!

Rachael: You have to really know that is what you want and that is what you are going to do.  Like I said earlier, you can’t always be 100% prepared for the labor process, but most women who are set on natural birth have usually prepared for it.  I can’t tell you how many women come in and say they are going to have a natural birth, but don’t seem prepared or seem to be wavering if they can do it or not.  I think it’s great when women come in a say they would like to try natural birth and of course I am willing to help them try.  But, ultimately, I feel women who seem to be wavering don’t usually have a natural birth.  I feel as thought natural birth is a mindset.  It can’t be a last minute decision. Ames: I love Rachael’s answer here. With my first birth, I KNEW I could do it and I became more confident as labor progressed. I didn’t even think of pain medication, rather what else we (the nurse and I) could do if I need to adjust. 

Alecia: MENTALLY PREPARE YOURSELF!! This will likely be the most pain your body has ever endured. Take classes such as hypnobirthing or meditation, utilize aromatherapy, music, water therapy, positioning, etc. Have a good support person. If you do not have a partner or family member who can fulfill this role consider hiring an experienced doula to help you.

Amanda: Research and practice!!!! It’s so important to practice breathing and practice focusing on your labor rather than just winging it.  I read a book called ‘Hypnobirthing: The Mongan Method’ Whole I was pregnant and it was so informative about giving birth naturally!  There were different breathing techniques to practice and different mantras to practice as well, that way you can use them during your labor and birth.  It’s not easy to go through labor but if you research and figure out how you want it to go and what you want to do, it makes it doable.  You never know how the pain is going to be until you go through it but it’s not something you can wing.  Just like running a marathon, you need to practice, condition and train yourself both mentally and physically!

I highly suggest working out while pregnant (Ames: YES! cc: Expecting and Empowered) and also stretch daily especially doing hip openers!  Also during labor, get in the tub and turn on the jets (if jets are available)!

My husband asked me what he needed to do while I labor and I told him he needed to remind me to breathe :). Make sure whoever is in the delivery room with you knows your plan and what you need!

Also while I was pregnant I practiced positive visualization.  I visualized myself in labor practicing my breathing techniques and saying positive mantras breathing and giving birth naturally.  I did this frequently and I think that really helped because then I knew I could do it!

Amy: Anything else you can think of that would help women that are about to tackle labor and delivery? 

Rachael: Know that your nurses are there for you. We are there to answer your questions, be the hand to hold if your husband or support person cannot, and safely help you deliver your baby.  We will help your through your beautiful birth process, whatever way that may be!

Alecia: No matter how you deliver (vaginal vs. c-section) (no pain meds vs. epidural) (breast vs. bottle) (etc.) IT WILL ALL BE WORTH IT, YOU GET A MIRACLE IN THE END, AND YOU ARE GOING TO BE THE BEST MOM EVER!

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I hope you loved this post as much as I did! All 3 women were so happy to help and it was easy to see their passion for their jobs.

Amy