Oh Baby! A Look Into Obstetric Nursing

Crystal Lynn Norris RN - 07/31/19

Obstetric nurses, according to some- are the spoiled princesses of the hospital.  They have a reputation of having the sweet, sought-after job of rocking babies, changing diapers, and dealing with whining women with a case of TOBP (tired of being pregnant).  Ask any ER nurse, however, and they will tell you that there's nothing scarier than a pregnant woman in a crisis. 

OB nursing is so much more than the stereotypes portray.  In this article, we will discuss the typical working environment of registered nurses in LDRP (Labor & Delivery, Recovery, and Postpartum).  Also, we will review job duties expected from RNs, skills to acquire,  and personality traits needed to excel in OB nursing.  If labor and delivery nursing is a field that piques your interest, use this article as a guide to the nursing job of your dreams!

Welcome to Labor and Delivery! There are two typical birthing center settings found in most hospitals in the United States.  Traditionally, a woman in labor would go to Labor and Delivery first, delivery her baby there. Then it is off to the postpartum unit where babies spend time in the nursery while moms rest and recover.  Baby friendly LDRP units, however, are gaining popularity in modern times. This newer unit layout keeps mom and baby together to foster bonding and continuity of care. 

Expectant mothers typically start their journey to LDRP a few weeks before they are due with a pre-admission visit to the hospital. A registered nurse will meet with the patient to obtain information about the patent's expectations, birth plans, etc. A tour of the unit follows as well as tips and advice to assist the patient in preparing for delivery.   The registered nurse conducting pre-admission visits needs to provide information to mothers in a that will calm her budding nerves about the upcoming birth. 

When the mother feels that she may be in labor, is concerned about decreased fetal movement, or has any emergency -  she is admitted to triage.  OB triage nurses are the detectives of LDRP.  Women who are worried about their baby will sometimes leave out important information that may help resolve their problems.  Triage nurses assess the mother's vital signs, contraction pattern, fetal heart rate, and cervical dilatation.  Tests for rupture of membranes and the likelihood of the mother going into preterm labor will determine the next steps for the patient. 

Yay! She's in labor!  Once the OB/GYN on call gives the order to admit the patient, the triage nurse hands the patient off to a labor nurse.  Labor nurses have extensive training on inducing and managing labor.  They also implement interventions for fetal distress, recognize emergencies, and act appropriately.  Prepping patients for emergency cesarean sections, or even delivering newborns when the doctor doesn't make it to the delivery is also part of the high-paced world of labor and delivery nursing!

Whoo-hoo! The baby is here!  Baby and mama are healthy and doing fine.   On LDRP units, patient's are not transferred to a postpartum unit.  Instead, they stay in the same room where they delivered, and their infant remains with mom versus going to the nursery.  Infant's in distress go to the NICU, a special care nursery, or may even be transferred to a different facility.  As long as everyone is healthy though, baby stays with mom.  Registered nurses care for mom and baby after delivery.  They teach new moms to care for their infant,  how to recover from having their baby,  and breastfeeding.  Some registered nurses have their lactation consultant certification. These nurses are significant assets to their patient population.

Nurses working on LDRP also have extensive training in surgery.  Most hospitals have scrub techs that assist OB/GYNs with cesarean sections, but in emergencies, the LDRP unit may have to scrub their own c-sections.    Registered nurses also are trained to resuscitate neonates in distress at the time of delivery, and recognize newborns having trouble in the days after birth.  They work closely with pediatricians to correct issues to ensure babies get the best start. 

Registered nurses interested in working in obstetrics need to have critical thinking skills and be able to react calmly in emergencies.  They also need to be able to push any prejudices and biases aside to support families, regardless of their social situations.  LDRP nurses work closely with Social Work to ensure that infants leave the hospital for safe home environments.  Bereavement is also a part of labor and delivery, as all situations do not have happy endings.  Supporting a family through the loss of a child is the most heartbreaking, yet rewarding work a nurse can do. 

Labor and delivery is an exciting, fast-paced option for nurses looking for a new adventure.  Every birth and every patient is different.  The job evolves with growing technology in the field.  Nurses in LDRP and OB/GYNs develop a trusting relationship by working so closely together.   Like any job, LDRP has its challenges, but this position offers so many rewards.  So if ever offered a position as a labor nurse, take it!  Oh, and sometimes we even get to rock babies!