Behind almost every mother, there is a nurse – the one who helped her through the birth of her child.

Labor and delivery (L&D) is one of the most recognizable nursing specialties, and one that many aspiring nurses wish to pursue. Like any other specialty, however, it has its challenges and rewards.

“We don’t just rock babies all day,” said Crystal Paunan, MSN, RNC, an instructor at Chamberlain’s Addison campus and nurse with 10 years of experience in labor and delivery. “There’s a lot more to it than that.”

Here are seven things to know about L&D nursing:

1. You build strong connections with your patients.

Nurses in other specialties often juggle multiple patients, but L&D nurses are typically assigned to one actively laboring mother at a time. This set-up helps foster a strong bond between the patient and the nurse.

“The doctor or midwife is not there all the time,” said Paunan. “The person that’s their go-to is that labor and delivery nurse.”

L&D nurses generally work 12-hour shifts, but because of the strong connection that forms, it’s not unusual for them to stay past their shift change just to be there when the baby is born.

2. Assertiveness is a must – and so is a sense of collaboration.

Things change quickly during labor, and the unexpected can arise. L&D nurses need to be on their toes and serve as a strong patient advocate. That’s made somewhat easier by the fact that they get to know their patients so well.

“Nursing students are very impressed when the see the relationship between the L&D nurse and the doctor or midwife,” she said. “It’s a team approach, not hierarchical. It’s not ‘Doctor, what should I do?’ It’s ‘This is my patient, this is what I need.’”

3. You need an open mind.

L&D nurses will care for many different kinds of patients – teen moms, older moms, women who’ve undergone fertility treatments, even women who are incarcerated.

“In our specialty, it’s important to remember that not every family is made the same way, and not every family has the same things,” said Paunan. A nurse must be able to extend the same caring and empathy to all patients, no matter what the circumstances are.

4. It’s not always happy.

“I always tell people that it’s 99% good stuff,” said Paunan. “But when it’s bad, it’s really bad because you’re dealing with the loss of a baby or the loss of a mother.”

L&D nurses may be tasked with helping usher in a new life, but they must also be versed in end-of-life issues. Even during those moments, however, the nurse has a crucial role to play.

“The connections with your patients can still be deep, because you’re there for someone during probably one of the most difficult times in their life.”

5. You’ve got options.

Like caring for mothers and babies, but not sure if L&D suits your personality? There are several related positions that might be more up your alley.

Maybe you prefer a slower-paced environment with opportunities for patient education. Post-partum (or mother-baby) nursing might be right for you. Are you all about the babies? Try neonatal intensive care unit (NICU) nursing. You can even continue your education and become a Certified Nurse-Midwife. (See below.)

6. You can take the next step.

With additional education and certification, you can take on a higher level of responsibility during labor and delivery. Certified Nurse Midwives (CNMs) do much of the work that an obstetrician would do during labor (albeit with a more holistic, woman-focused philosophy of care).

According to the American Midwifery Certification Board, there are some 13,000 CNMs in the United States. Forget the stereotypes about midwives only attending home births – in 2012, almost 95 percent of CNM/certified midwife–attended births took place in hospitals.

That’s not all they do. CNMs can also serve as primary care providers for women throughout the lifespan, from the teenage years to menopause and beyond. They give annual exams, write prescriptions and can even treat intimate partners for sexually transmitted diseases. For more information, visit the American College of Nurse-Midwives.

7. It’s amazing.

“You’re there not only when a baby comes into the world – you’re there at the creation of a family,” said Paunan.

“You get a picture taken with you giving the baby’s first bath. You know that’s going into a baby book and that kid’s going to see your face when he’s older. Those are those cool moments when you realize ‘this is why I do this.’”

  1. A great list with some very good reminders of why we should have started a career in Nursing in the first place: a connection with the people we care for! Thanks for sharing…it’s a list I’ll be sure to pass along!

  2. I’m currently a BSN student at Chamberlain, and I love this list. I plan to pursue my Master’s degree and become a CNM once I’m finished with my Bachelor’s. I just wish that Chamberlain offered Master’s level CNM training. Only UIC in Illinois offers Midwifery currently. This is similar in other states as well, where there is only one school per state that offers Midwifery training. How great would it be if a more widespread school like Chamberlain offered Midwifery??!?!

  3. We do have a connection with our patients. We are there for one of the most important days of their life. However this article is not unlike all of the others I read that paints a pretty picture but not totally accurate. I never stay over to look after a patient until their baby is born. It is not worth the safety risk to the patient and I have a family too! L/D nursing is critical care, PACU, OR, ER, and plain ol’ delivery all rolled into one. It is not for the faint of heart, or those who do not like adrenalin rushes. You have to act fast on your feet and know about a lot of things. Moms are sicker than they were just even 10 years ago it is not uncommon to be monitoring a mom in a SICU environment on pressers for sepsis. We give mag bolus that could stop respiratory drive in seconds, not even ICU nurses run Mag like we do. It is not fun and games. It is serious business. I get really tired of so many people ( even my fellow nurses) viewing L/D as a fun area to work, with annual competency instructors making comments like “oh you work up in L/D, you don’t’ really need to see this trauma blood protocol but…” Ignorance at it’s finest. Obviously they have zero understanding of how fast a woman can bleed out post delivery. Ever been in an OR pouring any and all volume expanders in a woman as fast as you can alongside anesthesia? I have. Labor and delivery requires crit care level thinking and experience mixed with some ER trauma level speed.

  4. I’ve been a Labor nurse for almost 40 years and the changes I’ve seen are not all good. With the advent of computers nurses no longer stay at the bedside of the laboring woman throughout labor and delivery. They spend more time at the nurse’s station during labor than coaching, assessing, providing support, comfort, and actual nursing care to the laboring woman as well as using the time during the latent phase of labor to educate the mother and family members who may be present. Call me an old dinosaur but as a Clinical Nurse Specialist in Maternal-Infant Nursing as well as ANCC Certified as a High Risk Perinatal Nurse, (yes, one of the few left), and working on my PhD, I can see why more women are choosing to deliver at home or in a birthing center rather than in a hospital setting. More and more of our younger nurses have very little knowledge of the theory behind the policies and procedures they follow. They don’t identify the risks involved in working with laboring women so they find it acceptable to “monitor” the woman’s labor from the monitor at the nurses station. The woman is left to labor alone or with a family member as a coach. If the mother is financially able she’ll come “equipped” with a doula who will provide comfort measures for her while the nurse is sitting at the nurses station socializing. Does this sound harsh? Yes, but true. Mothers no longer get the nursing care necessary during labor and delivery as they once did. As a “dinosaur” we were not permitted to leave the labor room while Pitocin was running unless another “license”, meaning RN or physician, took over at the bedside to assure the safety of the mother and fetus. Today the risks of running Pitocin are minimized in the minds of nurses as they sit at the nurses station and miss recurring episodes of impending problems with the fetal heart rate pattern. Then when the outcome of their neglect becomes evident the situation becomes an emergency. Is there no wonder that more and more women desire a home birth with a midwife? I’ve questioned many women regarding the amount of time they saw and/or interacted with their labor nurse and the most frequent reply was that they saw the labor nurse on admission, if or when they put on their “call light”, and at the time of delivery. Let’s take a closer look at the current pattern of nursing care on labor and delivery units to see if improvements can be made in actual “hands on” nursing care as we had in the past. I’m betting that there would be a decrease in medical interventions and c-sections if the current labor nurses spent more time at the bedside and less time “monitoring” the labor from the monitors at the nurses station.

Leave a Reply

Your email address will not be published. Required fields are marked *