You can't be pregnant or take care of pregnant people without hearing the phrase "Go the Full Forty." People everywhere are talking about letting your baby chose their due date, waiting for spontaneous labor and staying healthy during pregnancy. It's difficult for people who don't work in obstetrics to understand what all the fuss is about. The beauty of birth and the beauty of babies creates an illusion of labor and delivery that is blinding. As a labor nurse, every day, we witness this beauty and this is what keeps us coming back day after day. Watching the birth of a baby is sweet and magical and so incredibly special... even after my third delivery of the day, the process still has the ability to take my breath away. When we see a baby born, we observe a flood of emotions from every single person in the room. At that moment, no matter what the situation is, that family's life changes forever. This is why we all want the very best outcome for our moms and babies, and this is what we all fight for.
When there's a medical reason for a woman to be induced, her provider is weighing the risks of induction with the risks of staying pregnant. If a woman's cervix is not "favorable" or "ripe," it means that we will have to do more things to get her cervix to dilate. Every day, a ton of women give birth, and a couple of days later, mom and baby leave the hospital, happy and healthy. But every day, many women give birth and someone isn't healthy, someone isn't happy and someone leaves the hospital missing and empty. It's hard for a family to leave the hospital without their baby because their baby is in the NICU. It shatters everyone and is completely devastating when a family leaves the hospital without a mother or a baby, knowing that they will never come home. That's just not supposed to happen.
As a new graduate nurse, I was required to take Advance Cardiac Life Support. I remember doing chest compressions on a mannequin, thinking to myself, hard and fast, pushing myself to compress the chest quicker and with more force, as if someone's life really depended on it. I remember waking up the next day, my arms sore from something I'd never done before. Years later, when it wasn't just a doll beneath my hands, I would wake up and my arms would not be the only thing hurting and heavy. Why do things like this have to happen? Why would a baby have to leave the hospital without its mom? Everyone talks about the babies, but no one ever mentions the loss of mothers... it's too unimaginable to think of. But it happens, and it happens more than anyone would like to believe. And we can't talk about it, because that's not what we do. We cry to each other, we cry to ourselves, we cry with our providers and then we just go on. But really, I want to scream it until I have no more voice and every single woman out there knows that this could happen. This does happen. And your provider, and your nurse -- and me -- none of us want this to be your story. We don't want it to be anyone's.
And maternal death is not the only thing that can be life-altering. Early in my career, I remember a young mother who was pregnant with her first baby. It was a hundred degrees outside, and I remember her telling me how uncomfortable she was, heavily pregnant in the middle of summer. Multiple medications could not encourage her cervix to dilate. She was finally sectioned for failure to progress and it wasn't until we were in the OR that we realized we had a major problem. Her blood puddled onto the ground, brilliant and bright red against the white flooring. The nursery nurses called for neo, there was something unexpectedly wrong with her baby. They hurriedly rushed the baby to the NICU, and I was left in the OR with her physician, the anesthesiologist, back-up nurses to help me handle the hemorrhage, and the scrub tech. All of our footprints had been tracked around the OR in the patient's blood. Looking at the floor, you could see every quick step we had taken to help save that mother's life. As the anesthesiologist began intubating the patient, I heard the doctor call for instruments for a hysterectomy. My heart broke for a woman, still in her teens, who would never have another baby. And at that moment, I just prayed that her baby was OK, and would grow up to be healthy, since she never knew when she came in to deliver that this would be the last baby to come out of her body. This would be just one of the many, many "close-calls" witnessed in labor and delivery. And this could be any of our stories. We've all seen this, we've all lived this. We've all sent a mother to ICU, intubated, empty without a uterus, or in DIC. And we all tell ourselves at least she lived. Thank God her baby survived. But it shouldn't be like this.
The beauty of OB is the birth of a baby, the addition or completion of a family and the witness of a miracle. It's inspiring and magical and full of wonder. If you are a nurse, talk to women about the importance of staying healthy throughout pregnancy, and talk about the importance of active labor. Every day you go to work, remember that lives change all around us every single day. Fight for that to be a good change. Strive to better your practice, to better those around you, to better your unit or your hospital. We all want better for our patients.
If you are pregnant, or know someone who is, encourage them to be as healthy as possible and to wait for active labor if there's not a medical indication to be induced. There are so many things you can do to ensure you have a healthy pregnancy and delivery. Get prenatal care. Don't smoke. Take your prenatal vitamins. Talk to your provider about the major causes of maternal death. And unless there's a medical reason to be induced, wait for active labor! Healthcare providers have lived through countless experiences where a family did not get to experience all the beauty that OB has to offer. Set yourself up for the healthiest scenario possible. Women who go into active labor are less likely to need medications to help their cervix dilate. Women who go into active labor are also less likely to have a cesarean delivery, which can trigger a whole slew of additional complications. None of us want you to be the one who leaves the hospital stripped of the ability to ever have another child. We don't want you to leave empty-armed without your baby, and we don't want your family to leave empty-hearted without you. We want you to be that mom that leaves a couple of days after delivery healthy and happy with her baby.
If you were ever the nurse that took care of a family who did not get to fully experience the beauty of OB, remember that we all have to fight for healthier moms and babies together. And if you were the mother or family who left the hospital shattered, empty, and missing -- know that every day all of us fight for the miracle that averted you.
Until my next delivery ♥