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Role Transition: Labor & Delivery (L&D): Home

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Oak Point Library
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Perinatal Regionalization Levels

From the Illinois Department of Public Health: "Perinatal Regionalization"

Infants that deliver at appropriate level facilities are more likely to have better neonatal outcomes.  Neonatal mortality is associated with gestational age, low birth weight, congenital malformations, and health problems originating in the perinatal period.  The purpose of Risk Appropriate Perinatal Care is to increase the delivery of high risk infants and mothers at appropriate level facilities.  Illinois has partnered with The Collaborative Improvement & Innovation Network (CoIIN) to reduce infant mortality, however, Illinois is dedicated to continue with these efforts after CoIIN funding has completed. 

Illinois hospitals receive the following ranking, based on the level of service and knowledge applied to obstetric patients:

Level 0 - Hospitals with no obstetric services available.

Level I - Hospitals that provide care to low-risk pregnant women and newborns, operate general care nurseries and do not operate an NICU or Special Care Nursery.

Level II - Hospitals that provide care to women and newborns at moderate risk, operate intermediate care nurseries and do not operate NICU or Special Care Nursery.

Level IIE -  Hospitals with Extended Neonatal Capabilities which can provide care to women and newborns at moderate risk and do operate a Special Care Nursery but do not operate a NICU.

Level III - Hospitals that provide care for patients requiring increasingly complex care and do operate a NICU.

Labor & Delivery Nurse

What is Labor and Delivery?

"'Labor' and 'delivery' describe the process of childbirth. Contractions of the uterus and changes in the cervix (the opening of the uterus) prepare a [pregnant person]'s body to give birth. Then the baby is born, and the placenta follows." (NICHD, 2017)

 

Did you know...?

  • Around 140 million babies are born every year worldwide (The World Counts, 2021). Nearly 4 million babies are born in the United States every year. (NICHD)
  • There are many different ways one's delivery can go - The Cleveland Clinic has a very informative webpage about vaginal births and cesarean births (or c-sections).
  • A cesarean procedure can take anywhere from 1-2 hours; vaginal birth can take as short as a half-hour to several hours ("Stages of Delivery," Mayo Clinic).

Image courtesy of Getty Images (KidStock / Photodisc / Getty Images)

 

The Role of the Labor & Delivery Nurse

According to NurseJournal, "Labor and delivery (L&D) nurses assist women / pregnant people with childbirth. L&D nurse jobs can be very emotionally rewarding and, like most nurse salaries, L&D nurse salaries are above the U.S. average."

"Labor and delivery is emotionally and physically intense for any mother / birthing parent, no matter how many times they’ve been through it, the birth plan they’re following, or the unforeseen choices they may have to make. As a L&D Nurse, you’ll help care for patients and newborns before, during, and after the birth. Your patients will look to you for information, reassurance and guidance in handling a delicate new life, new family member, and entirely new experience. It’s on you to meet their emotions with compassion, address their questions with a calm and honest attitude, monitor their pain with proper treatment and support, and prioritize the health and safety of their newborn." (JNJ Nursing)

"From admission to discharge, L&D Nurses are there for every step of the birthing process and postpartum care. This means that L&D Nurses monitor vitals of both birth parent and baby; track and measure contractions; proactively assess and address patients’ needs (e.g., pain medications or other support); assist with delivery and provide care." (JNJ Nursing)


Some (but not all) of the tasks that the L&D Nurse is responsible for:

  • "Assess patients in triage for preterm labor, active labor, rupture of waters, pregnancy complications, or co-existing issues
  • Assist in maintaining pregnancy in antepartum mothers
  • Fetal assessment and monitoring
  • Maternal physical assessment(s)
  • Manage patients in labor, including induction assistance, epidural assistance, pain management, education, and delivery support
  • Assist and circulate in operating room for cesarean sections, tubal, and emergency obstetric and gynecological procedures
  • Medication administration and immunizations
  • Patient education related to medications, labor, pushing, delivering, and postpartum care of mother and baby
  • Newborn care and assessment for healthy infant
  • Breastfeeding and postpartum support/management
  • Charting via electronic medical records
  • Assist with fetal demise
  • Collaboration with care management team, including anesthesiologist, physician or midwife, lactation nurse, and charge nurse"

(Incredible Health)


"Though L&D nurses have a lot of autonomy, they still work intimately with a variety of different providers and individuals. The L&D nurse is responsible for updating and communicating with the patient’s OBGYN/midwife, the charge nurse, the anesthesiologist (or certified registered nurse anesthetist (CRNA), the lactation nurse, the delivery nurse (if there is one), the neonatal nurse practitioner (NNP) and the family." (Incredible Health)

"Since it’s hard to predict labor duration and potential postpartum challenges, L&D Nurses often form unique bonds with patients and their families, as they’re one of the most consistent points of support while in the hospital. Because of this, the best L&D Nurses are compassionate and clear communicators. At a moment when everything is moving and changing at a rapid pace, it’s important for L&D Nurses to be a point of stability for both patients and doctors in the room." (JNJ Nursing)

Work Environments for L&D Nurses

Image: One of the birth centers from the West Suburban Alternative Birthing Center in Oak Park, IL

Birthing Centers

"Birthing Centers are healthcare facilities dedicated to a wellness-centric approach to birthing. Here, L&D Nurses function as midwives or doulas, who differ from registered nurses in that they don’t require the same level of medical certifications. However, a Labor & Delivery Nurse’s skill set is applicable and valuable."

 

Image: A hospital delivery room at Swedish Hospital in Chicago, IL

Hospitals

"A large majority of L&D Nurses work in hospitals. Here, you’ll have the opportunity to work in the maternity ward in delivery rooms, hospital nurseries, and neonatal care units."

 

Image: A Chicago resident inside their home, with a midwife, weighing their newborn (Chicago Tribune)

Patients' Homes

"Similar to their roles in birthing centers, L&D Nurses can assist in home births as a midwife or doula, bringing their expertise to a home setting, and guiding parent and child through the process." (JNJ Nursing)