We ask health and wellness professionals the same six questions we always ask. This week, TWO DOULAS talks to labour and delivery nurse Jessica Morales.
Jessica Morales has worked as a labour and delivery nurse for almost 10 years. She’s currently employed at Montreal’s Jewish General Hospital in the Family Birthing Centre. She was very grateful to experience a natural, unmedicated labour and delivery when she gave birth to her daughter in January 2014 and she’s expecting her second baby in April 2016.
How would you describe your job in just one sentence?
My job can be stressful and crazy at times, but it is an absolute privilege to be helping families through one of the most important times of their lives.
What made you want to be a labour and delivery nurse?
I have always had an interest in labour/delivery and postpartum care, it is what made me go into nursing in the first place. As a nursing student, I enjoyed all the different units I got to experience, but when I was on the labour and postpartum units, I knew it would be the right fit for me. Supporting women, caring for newborns, helping with breastfeeding … all these things came very naturally to me. The labour unit is usually a joyful one, filled with excitement and I was thrilled when my very first nursing job was on the maternity unit.
How can expectant parents benefit from your services?
L&D nurses are really the primary caregiver to the labouring patients and are the medical personnel that you will see the most while at the hospital. They are there to help the labouring woman and her partner/support person find coping strategies to ease labour pain. They will answer any questions, address any fears and administer medications, fluids and treatments that are ordered by the doctor. They are there every step of the way, constantly making sure the mother and baby stay safe during the labour process and will alert the doctor if there is anything concerning. They are there to listen to your wishes and will advocate of your behalf if they feel those wishes aren’t being respected. Often labour/birth follows its own plan, and in cases where things aren’t going quite the way the patient expected, they are there to provide support and reassurance and will do their best to ensure that any aspects of the birth plan that can be done are fulfilled. Once the baby is born, they will make sure both mother and baby are stable before transferring them to the postpartum unit. Usually the first breastfeed will take place shortly after delivery and the nurse will help the mom and baby achieve a good position and latch.
What happens at your first meeting with a new or expectant parent?
When I first meet an expectant parent, it is usually because they are either in labour, not sure if they are in labour or they are experiencing something concerning in their pregnancy and need to be evaluated. If they are in active labour, we will get their file started, settle the couple into their room, fill out all the necessary documents, consent forms, and health questionnaires, go over the couple’s birth plan, answer any questions, and do the initial assessment on the mother and baby, which includes vital signs, a vaginal exam and an assessment of the fetal heart. Depending on how advanced the labour is, this might be done very quickly! To check the health status of the baby, the mother is also usually placed on an external fetal heart monitoring device that will record the baby’s heart rate and any contractions the mother is having. If all is normal and the fetal heart rate is reassuring, the monitor can be removed and the fetal heart can be listened to intermittently. Sometimes an intravenous is started and blood work is drawn as well. For most other situations the patient will be first evaluated in the triage area and depending on the findings will either go home with follow up in the clinic or will be admitted.
What’s the biggest misconception people have about your field?
I feel there is sometimes quite a lot of negativity about hospital births. I think people have the impression that the hospital’s main goal is to get patients to take the epidural and then pump them full of oxytocin to speed up the labour, but it really isn’t the case. While our main priority is always the health and safety of the mother and baby, we will always try to help the labouring mother achieve her birth goals to the best of our ability. With the right support, hospital births can be a great experience! The hospital team is always doing everything they can to make sure that you are getting the best care, while still ensuring that hospital protocol and safety standards are adhered to. Many people actually feel more relaxed and comfortable giving birth in a hospital setting, knowing that if anything urgent should arise, there is help immediately available.
What do you love most about working with new and expectant parents?
The thing I love most is being able to help my patients feel empowered, supported and secure during their labour. I love that I get to connect with new people everyday on such an intimate level. I am there holding my patient’s hand or massaging her back during those difficult contractions, wiping away sweat and tears, cheering on every push, encouraging her to keep going when she thinks she has nothing left, crying tears of joy with my patients when we hear that baby cry for the first time. It is such a hands-on, active job that is both both physically and mentally challenging. But the fact that I can be there for my patients, whatever their needs may be and establish a relationship of trust in such a amount of short time, I think that is very special and I couldn’t imagine doing any other job.