What nurses need to know about birth plans

Avoiding the pitfalls
You’ve prepared for years and years in nursing school to be the best nurse on the planet. The mother has come up with a birth plan to address every conceivable aspect of her pregnancy.

Enter the real world.

Here are some common pitfalls in the nurse-expectant mother relationship and tips from expert and author Kelly Whitehead on how to ride them out smoothly.

1. You forgot to ask up front about the couple’s birth plan.
D’oh! Often times a new nurse will immediately become consumed with getting what she needs, such as the initial tracings, paperwork and admission questions.

Please ask to see the birth plan or what the couple has in the plan as soon as they enter your care! Seems simple enough, but surprisingly, this easy step can be overlooked and can cause confusion and anxiety.

2. It’s another day on the job for you—not so much for the mother.
“Remember that this is the most important day/event in the lives of the parents-to-be, and not to lose sight of this,” says Whitehead. “As people working around labor, birth and new babies every day, it’s very easy for us to become desensitized to the experience.”

When the parents-to-be walk in, treat them like this is THEIR special, big day! Because it is.

3. Your nerdy nurse know-how has upset the expectant mother.
“Though as a nurse, you know and have witnessed that bad things can happen, when a normal, low-risk mom-to-be enters the hospital to give birth, she should not be unnecessarily told or reminded of this fact,” says Whitehead.

Remember, the expectant couple is already in a state of anxiety, whether it’s their first child or not. Focus on helping them stay calm and thinking positively.

4. The epidural conversation has entered the awkward zone.
“If a couple has a strong desire to have a drug-free, natural birth, please do not undercut their wishes by dangling the carrot,” says Whitehead.

Let’s face it: None of us want to see our patients in pain. However, it’s important to respect the wishes of the expectant mother. New nurses may watch their patient in labor crying, yelling and writhing in pain, and may not realize—yes, this is considered “managing well.” When the mother is entering the transition phase, the goal is to help her manage the final lap of the race, reminding her that she is almost at the finish line.

5. You’re butting heads with the doula.
Whitehead’s advice: “If the parents-to-be have chosen the support of a doula, please back them in that decision. A good doula is there to help you do your job better and more easily. Though ultimately she is there to help the parents achieve their birth plan, she does understand that things can change. On the other side, an attentive doula will also request (and challenge gently) certain areas she feels will benefit her client, such as mobility with a wireless tocodynamometer or a birth ball to help manage contractions.”

Next: It all comes back to the patient →