Labor and Delivery Nursing: Embracing the Good and the Bad

Labor and delivery nursing has highs and lows

By Jennifer Larson, contributor

Labor and delivery nurses, or L&D nurses, have a profound impact on patients and their families. L&D nursing also has an effect on those who are fortunate enough to claim it as their career.

Cyndy Krening, MS, CNS, RNC-OB, C-EFM, president of the board of directors of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), says that she feels “eternally blessed” for her work as a labor and delivery nurse. 

“As an L&D nurse, I have been the honored guest at a very intimate time for each family,” she said. 

“I have had the privilege to step into the celebration of a family’s birth, and to join in welcoming new life.”

Jamil Norman, PhD, RN, CNE, expressed similar feelings about her years as a labor and delivery nurse. 

“I got to see the miracle of life, and that will change you,” said Norman, who is now the academic coordinator for Walden University’s RN-to-BSN program. “It never gets old. Seeing a new baby coming into the world, it never gets old.”

Why nurses choose L&D nursing

If your professional goals as a nurse include making a difference and using your skills—plus experiencing something amazing—you’ve come to the right specialty. Many (if not all) of the nurses who choose to go into labor and delivery nursing do so because they get to be involved in such a life-changing experience as birth. 

They are passionate about women’s health and providing excellent care to women during such a crucial time. They are a woman’s primary caregivers throughout the whole process of childbirth. That includes all four stages of delivery:  antepartum, intrapartum, postpartum and neonatal. 

Essentially, L&D nurses are with the mother through the entire process. After her baby’s born, they also monitor the health of both the mother and her new baby. 

The job requires patience, critical thinking skills, good communication skills, and some important specialized knowledge. For example, some L&D nurses pursue certification, such as certification in Inpatient Obstetric Nursing from the National Certification Corporation to demonstrate the special knowledge and skills that they’ve attained, Krening noted. This is denoted with the RNC-OB credential after the nurse’s name. 

A career as a labor and delivery nurse also requires energy, empathy and the ability to be reassuring to a worried mother-to-be. “You have to be able to be encouraging, with ‘You can do this. You will do this,’” said Norman. 

“Working in L&D is exhilarating,” said Krening. “It is spiritual, emergent, high-risk, normal, cultural, operative, empowering, exhausting, devastating, invigorating and more! For nurses who desire an unpredictable critical care specialty, it’s everything and more.” 

The good times and the bad 

Indeed, while you get to revel in the birth of a healthy happy baby on many days, there will be days when things don’t go so well.  Sometimes the mother’s health is in jeopardy.  Sometimes, a baby is stillborn or born with serious health issues.

Although it is relatively rare, maternal death can also happen. The Centers for Disease Control and Prevention (CDC) reports that about 700 women die from pregnancy or childbirth complications in the United States each year. 

“Labor and delivery is very happy when it’s happy,” acknowledged Norman. “And when it’s sad. It’s really, really sad. Are you equipped and ready to deal with that opposite side?”

Norman is currently doing research on the mortality rates of pregnant African-American women in the hopes of moving the needle to improve the statistics. She still remembers the first time that a mother-to-be died during one of her shifts. The woman experienced complications and was rushed to the intensive care unit, but couldn’t be saved. 

“It sticks with you, and it’s hard,” she said.

Nurses have to give themselves time and space to grieve when things like that happen, Norman said. She recommends taking some time off. Then let the experience inspire you to stay vigilant about your patients in the future and to trust your instincts. 

That can also help you appreciate the good moments on the job--and there will be many. Every labor and delivery nurse can tell you about the wonderful times.

“The nurses who work in this area just want their patients to have a great experience,” said Norman. “They’re really passionate about the whole birth experience.” 

Since the circle of life is never ending, there will always be opportunities for nurses who cherish the experience of helping women during childbirth. 

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