What I want you to know about how I do my job

I’m pretty new at my job. I only worked for 6 months before I had a baby of my own (the ultimate work-related research) and went off on a year of maternity leave. I’ve been back at work for a couple of months now, and I confess, I have anxiety before every single shift. I learn something new every day, and try my best to build on my knowledge and glean wisdom from those with much more experience. I love seeing babies be born, and I love helping their mamas give birth to them. I find myself drawn to conversations, movies, news articles – really anything to do with birth stories. And in the past few years, as I have become more interested and passionate about this, I have noticed an underlying tension between the “medical” world of birth and the “natural” world of birth.

Over the weekend, I had a conversation with some fellow nurses on this topic. We lamented over the stories we had heard regarding non-hospital births in which scopes of practice were overstepped, and moments where unfortunate advice was given. In the course of this discussion we also admitted that the “other” group probably have some not great stories about us. We too are not perfect. As a coworker and I rode the elevator together at the end of our extra long night shift (thanks Daylight savings), she told me it made her sad that there wasn’t better understanding and cooperation between “us” and “them” because wouldn’t it be great if we all understood our roles, respected each other, and could work together? We wondered, what needs to happen in order to make that happen?

I’ve been thinking about that question the last few days, and I can’t help but wonder if part of the problem is just a fundamental misunderstanding of how each “group” feels and thinks about labour and birth. When I watch documentaries about the medicalization of birth, or read articles by the “other” group on hospital births, I sometimes think to myself, This isn’t how I feel about birth. This doesn’t represent my work at all.

Look, I’ll be the first to admit that I am not an expert on this topic, so I don’t want to put words into other people’s mouths. I don’t want to make assumptions or stereotype or make generalizations about groups of people.  I’m just saying that sometimes the “medical” world of birth and the “natural” world of birth can clash. And I think that if we actually sat down and talked about it, we might find that we agree on a lot more than we don’t.

Why does this even matter? It matters because of all you pregnant women out there (and there seems to be a lot of you right now), who are caught in the middle of this battle, trying to make a decision about what kind of birth you want to have. So, here are a few things I want you to know about how I do my job:

  • I want you to know that I care about you and your baby. Sometimes I come into your life hours before your baby’s birth, and have time to get to know you. Sometimes I come in right before you deliver and have a full view of your most intimate private places before you have even heard my name. Sometimes I have to leave before I get to meet your baby (which kills me every time, cause I hate missing out on it!). No matter what the scenario I care about what happens to you, and I’m going to work hard to make this as great an experience as it can be.
  • I don’t expect you to have a baby the way I would want to have my own. If you come in with a ten page birth plan, I will read every word. If you come in and your birth plan is to get the baby out by any means necessary, I’ll do my best to guide you through that.
  • If you don’t want to have an epidural, then I don’t want you to have one. I will gladly rub your back, hold the shower head on your tummy, help you keep your balance on your birthing ball, or let you squeeze the life out of my fingers while I remind you to breathe. I will do this for hours if that what it takes to help you get through a birth with no pain medications. Please understand that if I suggest an epidural at any point, it’s not because it will be less work for me, it’s because I think there may be a real benefit for you specifically in getting one. Maybe your baby’s heart rate is indicating it’s not coping well with labour, and I am worried about you needing to have a c-section. Maybe I’m concerned about you getting so exhausted that you won’t have any energy left to push when the time comes, and that could be dangerous for you and your baby. If you don’t want an epidural, I won’t suggest one unless I think it’s necessary.
  • If you want to have an epidural the second you feel the slightest tinge of a contraction, I want to get you one. I will gladly start your IV, wake up a surly anesthesiologist at 4 am, monitor your blood pressure a billion times, and keep my eyes glued to your baby’s heart rate for any signs of distress. Please understand that if you are in early labour, it’s not healthy for you to have an epidural yet. On the other hand, if you are on the verge of pushing out your baby in the next three minutes, there just may not be time for an epidural to actually take effect before your baby is born. In either case, I will do whatever I can to help you get through the pain.
  • I don’t want you to have to have a c-section. In fact, no one does. I feel like there is this idea out there that C-sections are easier for us. They aren’t. They require a higher nurse to patient ratio, which leaves fewer nurses to cover the labouring patients. The recovery time for a c-section patient is more work intensive for nurses. And we are all too aware that the recovery for you after a C-section is harder. We honestly think about the fact that it will be a while before you can lift anything, or sit up in bed like a normal person. No one wants for you to have to have a C-section. But the nurses I work with will unearth from inside them a superhuman speed at the first sign of trouble for you or your baby, because they know that every second counts when it comes to your baby’s life. I’ve seen a woman with a baby in trouble go from the assessment room to the OR and the baby delivered in less than 8 minutes. I don’t want you to have a c-section, but I will hand you over to the OR team in a heartbeat if it means saving your baby’s life.
  • Every single shift, as I drive from my house to the hospital, I pray for you. I don’t know you yet. I haven’t yet heard how complicated or uncomplicated your pregnancy has been. I have no idea if this is going to be a breeze or if I am going to spend the next three hours before your baby is born with my heart in my throat and my mind racing. But I pray for you. I pray for health and safety for you and your baby, and I pray that God would give me and the doctors I work with wisdom to be able to make the right decision at the right time.
Because the truth of the matter is, whether it’s at home, in a birthing centre, in a hospital room, or in the OR, the goal is always, always, to have a healthy mom and healthy baby. And that’s something I think we can all agree on.
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12 thoughts on “What I want you to know about how I do my job

  1. From what I am understanding…you are quite a new grad! I am a 32 plus year veteran and really appreciate you views written hear. I am an NICU nurse…..and I too want the best for the mom and baby. I too pray on my way to work every shift that God allow me to give the best care I can to every family/baby that I come into contact with. I too hate the generalizations of both sides! Thanks for writing this!

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    • Thank you for the support! I am so blessed to work with people like you who have such a wealth of experience. And I so much appreciate your line of work in caring for the moms and babies who need your specialized care!

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  2. HI Raquel! I can hear your frustration and desire to work more collaboratively with ‘others’ which I am assuming is midwives and doulas. I have made quite the journey myself, starting as an obstetric nurse in few different settings, then moving to New Zealand where I have worked in NICU for 3 years and now am just qualifying as a midwife. 80% of women chose midwives here, yet that doesn’t always mean they have a ‘natural experience’. For me and what I’ve come to learn is like you said, recognize that we as professionals come from different philosophies and perspectives. For midwives we believe that birth is fundamentally normal, and we protect that as much as possible for women. Here, midwives work in the hospitals, so no nurses and this philopsophy is carried (by most midwives) into hospital even when women have complex pregnancies and many risk factors. We also aim to provide woman centered care and it was lovely to hear that really that’s what you are trying to do as well. It is also about informed choices for women, and recognizing that there is a power imbalance in the medical world…where women don’t always have all the options available to them. When I look back on my years as an obstetric nurse, I approached my job in a very similar way that you did, however the reality was that I worked in a medical system that had a view that birth is only normal in retrospect. It is also the risk averse culture we live in that has lead us to believe that birth is risky…Trust me I could go on! haha. Thanks for the post…it’s something I’m passionate about 🙂

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    • Thanks for the comment Julie. I agree with so much that you said and I really admire all that I have heard about how labour and birth are approached in New Zealand. I really hope we can move toward that type of collaboration and perspective here too. My intention in writing this is to do my small part in making that happen 🙂

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  3. It sounds like you are doing a fantastic job…it’s an amazing privilege to be able to work with women at this time of their lives x Great post!

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  4. Hi I saw this blog posted on the Lucina Midwives and Birth Centre facebook page. Lots of women have commented how they had a good experience transferring from midwife to Dr. care or midwife care during birth in the hospital. I think the more educated women and birth professionals are on the roles and jobs of midwives, doctors, nurses and doulas the better the birth experience will be for women and the better the professionals will be able to work together. Your blog helps explain labour and delivery nurses jobs wonderfully. In my experience (post partum nurse) there is a little medical/midwife care tension but it is easing least 3 nurses on unit have used midwife care. I like the blog.

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    • I absolutely agree! I really think we have skewed perspectives about each other. I wish I could see the comments you mention, as it would be great to hear those experiences. Thanks so much for your comment!

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      • If you are on Facebook go to the Lucina page and send a request to join just explain you wrote a blog that was posted to the page and are interested in seeing the replies. If you have any questions about midwifery care, scope, or philosophy they are really good about answering.

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  5. Wow! Raquel!!! This is such an amazing post. Im sitting here with tears in my eyes because you just spoke my own heart. I so strongly believe in the marriage between “natural” and “medical” because there needs to be both for a healthy outcome. I love your heart for moms and babies. You are a beautiful nurse and i could not have put this better myself. The conspiracy theories and frustrations from both sides are not based on reality and come from hurt and frustration. If we could find harmony between the two I believe we can have much more positive outcomes. Moms and families deserve to have their wishes heard and respected and to have their caregivers do their best to make them a reality, while also looking out for their safety. And you do that! You are a wonderful example. ITs great to hear your perspective

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    • You are so right Rachel! I couldn’t agree more that harmony between our two worlds would result in more positive outcomes. I hope we can make that a reality as we educate ourselves better and find common ground!

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  6. Love your words, so perfectly stated. I had a very complicated birth in an OR because everyone in the medical world around me was so prepared and concerned my baby has a momma. I think home births are an amazing experience for the right people, hospital births are amazing for the right people and we all need to love and appreciate the choices of others!

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  7. Wonderfully written!! I am a paediatric nurse and believe that the medical world is needed and effective. I also had a midwife attend the birth of my daughter…in the hospital. Birth is normal…but lots can go wrong, which is why I chose to have both ‘sides’ available. From reading this, I would love to have you as my nurse if I needed one during labor. Its great to see that you care so much, and will advocate so much for the desires of mothers. More people should be open to both ‘sides’ like you are. Thanks for the post 😀

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