If you are planning to give birth in a hospital, you may be surprised to find there are a startling number of people who will come in and introduce themselves while you are laboring, birthing, or recovering. Below is a list to help you prepare for that reality!
Front Desk Attendant: This is the person you will be sharing the exciting news that you are in labor/induction/scheduled cesarean. It is helpful to share with this person if you have called ahead, and if you have pre-registered at the hospital. But no worries, if you don’t haven’t done any of those things, they will get you where you need to be.
Triage Nurse: The Triage nurse will take your vitals and place external monitors on for heart rate monitoring and contraction frequency. This person will also start the charting process and get your information into the system for your stay at the hospital.
Phlebotomist: In some hospitals, you may be visited by a phlebotomist who will take a blood sample. It may also be possible that the phlebotomist comes if placing an IV is complicated because of your vein size, if you opt to not have an IV placed, or if other attempts to place an IV does not work.
Labor and Delivery Nurses: These nurses will be the folks you interact with the most while in labor. They typically have multiple patients they monitor from a central desk, but you should expect to see them once an hour once your waters have broke, or every other hour if you are laboring well.
2nd L&D Nurse covering breaks, or covering while other patients are delivering: Your nurses typically work 12 hours shifts, so depending on when you arrive, your nurse will have back up for her breaks, and also when any other of her patients start pushing. Once the 2nd stage, or the pushing phase, begins, nurses typically stay in the room with the patient until after delivery.
Certified Nurse Midwife: Midwives are a nursing specialization that deals specifically with pregnancy, labor, and postpartum concerns. They also can be seen regularly for well-women care. If you are undergoing the supervision of a Midwife, you will usually have the on-call midwife when you are in labor. Midwives practice medicine following the midwifery model of care, meaning they tend to have fewer interventions and believe that for most delivery people, the process of labor and birth is something that does not need to be managed but needs time to progress. BID-Plymouth and South Shore Hospital both have excellent midwifery programs.
Recovery Nurse post-surgery: If you are giving birth by cesarean, you will have a dedicated nurse in the recovery area, which is where you will spend about two hours being monitored closely for fever, hemorrhaging, vomiting, dizziness, or other adverse reactions to the surgery. This nurse charts vitals regularly about every 15 minutes.
Postpartum Recovery Nurses: These nurses will be the faces you have while you recover from birth in the postpartum ward, sometimes called the Mother & Baby unit (although BID-Plymouth has you labor, deliver and spend your postpartum in the same room typically). These nurses can help you learn how to do primary care of your baby if you have never done things like change a diaper or swaddle. They also help to get you to and from the bathroom, get you the supplies you ask for to make your stay comfortable, and again, monitor your recovery and chart your stay.
Shift Change: The transition between one care team and the next care team. When shift change occurs, they will “round” on their patients to let you know to expect a different person, or if time allows, they will introduce you to the next nurse that you can expect to see for the next 12 hours.
Residents: If you are giving birth in a teaching hospital, you will have interactions with medical residents. Residency differs in length depending on the field of medicine the provider is entering. For obstetric gynecology residents, it is typical to have 3-year residency programs. So on a labor and delivery floor, you may be introduced to 1st, 2nd, or 3rd-year residents, and sometimes a 4th year. Residents have obtained their MDs or their medical degrees, but they have yet to gain the knowledge of a practicing doctor. Their residency is the part of their education where they apply their book knowledge and learn the nuance of medical care. As a person delivering, you have the option to allow or refuse care (meaning vaginal exams, etc.) from residents.
OBGYN on duty: This is the medical doctor who is overseeing the labor and delivery ward. OBGYN stands for Obstetrics and Gynecology. Medical groups all perform differently, and sometimes your specific doctor may only be in the hospital on certain days, meaning they have clinic days, which were when you would have your prenatal appointments, and hospital days, where they will be present to deliver your baby. This person is NOT a resident.
2nd OBGYN on duty: Same as above. There are usually many doctors present, depending on how many practices have delivery privileges at the hospital you choose.
Obstetric Anesthesiologist: This is the person responsible for anesthesia for surgery, and epidurals in the labor and delivery ward. Anesthesiologists do not specialize in just labor and delivery – they are trained to administer anesthesia for all patients in all capacities. Depending on the size of your hospital, there may be an anesthesiologist on the L&D floor at all times, or, they may operate with an on-call schedule. Asking for this detail will help you understand your options if you are interested in having an epidural as a part of your pain management tool kit.
Obstetric Anesthesia Resident: A licensed doctor who works closely with the attending doctors to continue their medical training in anesthesia.
Physician Assistant: These people are medical providers who are licensed to diagnose and treat illness and disease and to prescribe medication for patients. Their education is focused on a disease-centered approach, while a nurse practitioner, for instance, follows a patient-centered model.
Physician Assistant Resident: A medical professional licensed in medicine which is working with attending doctors to continue their training.
Pediatrician: These are the doctors who work in the care of your child. A pediatrician will see your child before they get discharged from the hospital. You can choose your pediatrician before you deliver, and have someone from their practice round on you and your baby while in the hospital. If you are unsure of a practice before delivery, there is always an on-call pediatrician who will help you while you find care for your child.
Hospitalist: This physician is a person specialized in caring for patients while they are in the hospital setting. These doctors are typically trained in internal medicine and are extremely helpful in the changing world of our health care, as they stay in the hospital setting, and do not have clinic hours.
Charge Nurse: The charge nurse is just what it sounds like. This person is the nurse in charge. Charge nurses provide many of the same tasks as RNs, but they also tend to have managerial and supervisory duties.
Pediatric Nurse: This professional may be present at your birth to ensure your child is healthy at delivery. If there is meconium present when your bags of water break or there is fetal distress during labor, pediatric nurses will be available to focus on the transition your child undergoes from birth to life separate from your womb and placenta, and while learning to breathe air.
Pediatric team: This is the collection usually referred to as “Peds” who may be present at delivery to help with your baby’s transition.
NICU Nurse: This is a pediatric nurse specialized in the Neonatal Intensive Care Unit. NICU nurses work specifically with families who have their babies in the NICU, and are usually sensitive to the emotional nature of the situations that bring the littlest patients into their care. South Shore Hospital has a level 3 NICU, whereas BID-Plymouth has a level 1b Continuing Care Nursery.
Lactation Consultant or IBCLC: Once you deliver your baby and are on your first full day in the mother & baby ward of your hospital, you may have a visit from a lactation consultant or an IBCLC (International Board Certified Lactation Consultant). It is possible you may need to ask for a visit from these professionals. Ask your nurse how you can be visited, or when to expect them. They usually only have time to visit once a day. If you are planning on breastfeeding, having help to write down your questions as you learn to feed your baby can be helpful, as it is tough to remember all the things for the meeting that you never know the exact time of! South Shore Hospital and BID-Plymouth have lactation consultants on staff. If you are in need of additional support from an IBCLC, we have a wonderful lactation consultant at New World Doula Services who will come to your home for a more in depth visit.
Hospital staff member with paperwork for birth certificate and social security card: You will be visited by a hospital staff member with a large pile of paperwork once you are in the postpartum recovery ward. The paperwork includes necessary information about what is “normal” behavior for babies, and a packet of information for your care after birth when you are home. They will also ask for the full name of the baby so that they can file paperwork for birth certificates and social security card. You are not required to provide this information while in the hospital; however, completing these documents while there is significantly easier than filing on your own after you leave.
Audiologist: Before your baby gets discharged, she or he will be visited by an audiologist for a hearing test. The test measures brain waves and is painless, and lets families know if their baby has “normal hearing” or is thought to have possible hearing problems. The hearing test can happen with your baby awake or asleep and uses sensors on the outside of your baby’s head in various places. There are no loud noises, and it does not take long.
What do you do with all these people?
We understand that this is an extensive list of possible interactions while you are undergoing a very moving and potentially stressful time. We hope that you can have a better understanding of the various roles that exist in a hospital setting, and know that it is ok if you need to ask several times for a providers name, or specialty.
If you are trying to limit the number of people who enter your room while in labor, talk candidly with your nurse. They are usually able to let residents know you are not interested in being rounded on so that you can focus on your labor and your process.
Once you deliver, it is common to have a lot of people knock on your door throughout daytime hours. But as a new parent who needs rest too, you are allowed to ask for people to visit at a different time if you are unable to reasonably pay attention. Your partner can also collect information and answer questions.