Ep 194: Advice from Labor and Delivery Nurse Liesel Teen a.k.a. Mommy Labor Nurse

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Today’s guest, Liesel Teen, BSN, RN, is a labor and delivery nurse and the founder of Mommy Labor Nurse. I have been wanting to have a labor and delivery nurse on for a long time because I know how important they are to the birth experience. We obviously have quite a bit of overlap in what we do but I never want to come in front of you like I’m the only one with information to help you through your pregnancy and birth.

Now of course I offer fantastic information but it’s great to have more than one trusted source. We come from different backgrounds, different experiences, and we bring that to our work. It can also be reassuring to hear the same thing from multiple experts. Different people present information in different ways and you may just find that one educator’s style works for you better than another.

In this Episode, You’ll Learn About:

  • What exactly does a labor and delivery (L&D) nurse do during labor and birth
  • What are some misconceptions about L&D nurses
  • How L&D nurses work with doulas, doctors, and midwives
  • What should you expect from your L&D nurse
  • What you should do if you are not happy with your L&D nurse
  • What are some tricks and tips that Liesel has learned from her career

Links Mentioned in the Episode

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I want this podcast to be more than a one sided conversation. Join me on Instagram where we can connect outside of the show! Through my posts, videos, and stories, you'll get even more helpful tips to ensure you have a beautiful pregnancy and birth. You can find me on Instagram @drnicolerankins. I'll see you there!

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Dr. Nicole (00:00): In this episode of the podcast, you are going to get some advice from Labor and delivery nurse Liesel Teen, a k a, Mommy Labor Nurse. Welcome to the All About Pregnancy & Birth podcast. I'm Doctor Nicole Calloway Rankins, a board certified OB gyn, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy in birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:55): Hello there. Welcome to another episode of the podcast. This is episode number 194. Whether this is your first time with me or you're a longtime listener, welcome, welcome, welcome, and I'm so glad to have you with me today. In today's episode of the podcast, we have Liesel Teen, B S N rn. She is a labor and delivery nurse and the founder of Mommy Labor Nurse. Mommy, Labor Nurse equips pregnant women with the tools, knowledge and confidence they need to erase the unknown, feel in control, and have an even better birth no matter how they deliver. With eight years in counting as a bedside labor and delivery nurse, Liesl knows that knowledge is the key to an even better birth. To date, over 40,000 women have completed a mommy labor nurse birth class, eliminated fear, and been empowered by Liesel's comprehensive childbirth education. Liesel has been featured on ABC 11, Forbes, Healthline, Motherly, Romper and Scary Mommy, and she regularly shares pregnancy, birth, and postpartum related content on Instagram to a community of over half a million.

(02:00): And the Mommy Labor Nurse podcast, which receives over 100,000 monthly downloads. Now, as you can see, we obviously have quite a bit of overlap in what we do, but I never want to come in front of you like I am the only one with information to help you about pregnancy and birth. Now, of course, I offer fantastic information, but it's great to have more than one trusted source of information to help you. We come from different backgrounds, different experiences, and bring that to our work. It can also be reassuring to hear the same thing from multiple sources, and we also may present information in slightly different ways. So all of that is important, and that's why I'm excited to have Liesl on today. And I've also been really wanting to have a labor and delivery nurse on for a long time because I know how important labor and delivery nurses are to the birth experience.

(02:58): So in our conversation today, we are going to chat about what exactly does a labor and delivery nurse do during labor and birth. We'll chat about how labor and delivery nurses work with doulas, what people should expect from their labor and delivery nurse. Some tips about if they want an unmedicated birth in particular what should people do if they're not happy with their labor and delivery nurse? How exactly do labor and delivery nurses work with doctors or midwives? So much good stuff in this episode. Now, before we begin to the episode, one of the things you are going to hear and that we both talk about a lot on our platforms is the importance of childbirth education. So I just want to take a second and tell you about my childbirth education option. The Birth Preparation Course. The Birth Preparation Course is my signature online childbirth education class that will get you calm, confident, and empowered to have that beautiful hospital birth.

(03:54): I put my heart, soul and everything into this course to really get you ready and prepared to have that beautiful birth experience that you deserve. You learn everything from mindset, everything that's happening in your body during labor and birth, possible things that could happen, and I really approach it from the perspective of exactly what you need to know about giving birth in the hospital because there's some caveats and things that may not be covered in a typical childbirth education class. So you can check out all the details of the Birth Preparation Course at drnicolerankins.com/enroll. All right, let's get into the conversation with Liesl from Mommy Labor Nurse. Well, thank you so much, Liesl for agreeing to come onto the podcast. I am so excited to have you on. I have been really wanting to have a labor and delivery nurse and what better labor and delivery nurse to have than someone who has all the stuff you have. So thanks for coming on.

Mommy Labor Nurse Liesel (04:54): Thank you so much for having me. I'm excited to chat.

Dr. Nicole (04:57): Yeah, so why don't you start off by telling us about yourself, your work, and even your family if you'd like.

Mommy Labor Nurse Liesel (05:02): Yeah, sure. So my name is Liesel Teen. I am a labor and delivery nurse of eight ish some odd years now. Is it? I'm like, should I say not? I don't even know. It's been a little while, but I live in Raleigh, North Carolina with my two boys and my husband, and I'm also, if you Google mommy labor nurse, you'll probably see a whole lot of pictures and stuff of my face. I am the founder of Mommy Labor Nurse, which is a platform that I started about four years ago just to put out a lot of education that I felt was lacking from the bedside helping moms feel more prepared for birth. And I was really mainly focused on, in the beginning just writing blog articles and educating people in that way. And now it's kind of transformed into, I'm much more into Instagram and video even starting to get into TikTok but yeah, really into the visual aids and using that as a means of education.

(06:10): So yeah, it's very rewarding. I've been doing it for, like I said, for four years now, and I use lots of different props and different, I have my Barbies up here. I dunno if you can see 'em up here. My Barbies up here. Sometimes I get them in funky labor positions and I just like to do stuff with my hands and really, really have people understand. Sometimes I feel like the issue is sometimes you'll hear something from your provider and you're like, okay, I think I understand that, but you really need it from somebody who's like, Hey, okay, this is actually what happens when we do a cervical check and this, that, and the other. So it's an easy approach. It's like an approach that where I want you to feel like, okay, I really understand this and I feel comfortable asking questions and hey, this visual is interesting too.

Dr. Nicole (07:03): Yeah, yeah, yeah. Love it, love it, love it. So you still work as a labor and delivery nurse? I do. And then you do mommy labor nurse as well?

Mommy Labor Nurse Liesel (07:11): I do, yes. So my current schedule is I'm casual at my hospital, so I, I'm supposed to do 12 hours of every pay period. So right now what I try and do is once a week I'll do an eight hour shift or a four hour shift, and I was doing every other weekend, but it turned into where I was doing desk work, Mommy Labor Nurse work during the week and then weekends where I would go to the hospital. So I was able to take some of my responsibilities away and work my hospital time within the week, which was a lot better just for work-life balance and everything. And I just being there more often because what I would find is I would come every other weekend and some kind of policy would change or something would be different, so you just feel removed. So now that I'm there at least once a week it feels good to just have that day where I'm doing way different stuff than I do right on Mommy Labor Nurse and I, I'm able to put my hands on a patient and just really be at the bedside. And it kind of grounds you almost.

Dr. Nicole (08:17): Yeah, I know there's certainly some medical professionals who give up their medical practice when they start to really get things going online, but at least for me, I don't want to quite give up being at the bedside. So I agree.

Mommy Labor Nurse Liesel (08:30): I agree. Yeah, I thought about it for a while because it was getting to the point where I'm like, I'm working at the hospital and I'm working Mommy Labor Nurse stuff, but I was able to find a balance, and I think that's what a lot of people struggle with and that's why they step away from the bedside. But yeah, I've always been one that, I mean, do really love my job, so I don't anticipate leaving it not anytime soon, but one of the real main things that has made me stay was earlier this year, one of my employees who works works with me she with Mommy Labor Nurse. She left the bedside because she wanted to put all of her focus into Mommy Labor Nurses stuff. And talking with her about her leaving the bedside and her journey, one of the things that she said was, I really feel like this is the right decision.

(09:25): One thing though I will miss is just seeing birth. I don't really get to see birth anymore. I get to see it removed and people, hearing people talk about their birth stories and stuff and doing all this stuff that we do, but she was like, I'm never, it's going to be pretty rare for me to actually be in a room where somebody's giving birth. And I'm like, I've never thought about that. I was like, I don't know. I was like, wow, when you put it like that, I, I'm like, I'm good. That's one of the best parts, like it

Dr. Nicole (09:55): Oh my gosh. So yeah, it is indeed. So let's talk about then your experience with being at the bedside and give folks some tips from a labor and delivery nurse perspective, because what you all do is very different than what we do as obstetricians, and I think a lot of people don't realize that. So what exactly does a labor and delivery nurse do during labor and birth?

Mommy Labor Nurse Liesel (10:19): So we get there, we get report on whichever patient that the charge nurse gave us, and it kind of depends on the patient. Now, if I were taking care of a patient who was in labor, obviously our main job is labor support. We're giving medications that have been ordered fi by the physician, doing vital signs, doing cervical checks if needed. A lot of times the providers do those, but we'll do cervical checks. I'm assessing fetal monitoring strips and intervening in emergencies if they come up at my hospital, we circulate in the OR too for our C-sections. I know some labor and delivery nurses, and it's like a separate unit, but we circulate in with our C-section patients. We set up for epidurals and maintain the epidural lines. We really kind of act as a medium a lot of times between the provider and the patient because the provider is taking care of so many patients and we're just kind of their eyes and ears. So that's really a big part of our job is just being the eyes and ears of the provider and relaying information to them. Another big part that I don't like is we gotta chart on the patient,

(11:37): If it if it were up to me, I would have somebody else in my room charting for me and just do patient care, but Right. Yeah, it's a whole lot of different things.

Dr. Nicole (11:46): Absolutely. And kind of follow up to that, how frequently are you in a patient's room and how many patients do you have at a time?

Mommy Labor Nurse Liesel (11:54): Yeah, so I usually have only one patient if they are in active labor or let's say they're being induced or let's say they have an epidural. Now, if I had a patient who was a little bit more low risk or they were there for another, they were on there for another reason, then having a baby, I might have two patients sometimes three. It just kind of depends on the situation. Sometimes we'll staff over what we call the OB d, ob, b e d. Some people call it triage. And those nurses, when you're working over there, it's usually one to three, but we try to stay one to one as best as we can, but obviously sometimes it gets really, really crazy busy and we'll have to take two patients for the time being. But most of the time we try to do one to one if the patient's in active labor.

Dr. Nicole (12:55): And I think a lot of people, I've seen a lot of misinformation that people think labor and delivery nurses are caring for no five patients at a time. And I'm like, no, no girl. One-to-one is yes. It's just not possible one-to-one is the goal standard and it may be one to two, like you said, when it's busy, but really you to have, the nurse has to have the time to really take care of folks because it's involved. Correct. It's a lot that's involved and it's very different than other units and floors kind of thing. Correct,

Mommy Labor Nurse Liesel (13:31): Yes. Yeah. I much prefer when it's one to one, if I have two patients in active labor, I am not giving thems the care that I really want to give both of them because it is a lot. Yeah. I know you asked about how often we go in the room too, and it depends on, again, it depends on obviously what's going on with the patient. Now, if she's being induced or she has an epidural, we're supposed to chart on her every 15 minutes. Now, again, it depends. If she is like chilling and she's not doing much of anything, I'll go in there. I'll try not to. If she's resting, I'm going to try and just get in there really quick and chart and kind of come out. Now, if she's in active labor, I'm not going to, and she needs my support. I'm not going to just go in there over 15 minutes and come out. I'm going to kind of stay at her bedside the whole time and support her with what she needs. That's why we honestly love when patients have really supportive doulas because they're doing a big part of what we're trained to do, but they're just helping me also, if I need to give a medication, I have the doula there to help with labor support. So it kind of depends on the patient, but generally I like to assess the situation and see if I need to be with her or if I can step out, kind of depends.

Dr. Nicole (14:48): And I'm glad you brought that up about a doula and being able to work with doulas. Yeah, because they're going to be there the whole time. The nurse, the other members of the staff are probably going to change. So that's great that you are in a situation where you work well and are comfortable with working with doulas.

Mommy Labor Nurse Liesel (15:07): Yeah. Yeah. We're very doula. As long as doulas are, sometimes I think they get bad raps from people because they are pushy or something. And I mean, I've met obviously doulas who have more of that personality, but the majority of them are just really concerned about their moms, who they're caring for. And we work really well together because they kind of do what they are trained to do best, and I am doing what I'm trained to do best.

Dr. Nicole (15:36): Right, exactly. Exactly. So what are some characteristics or things that people should expect from their labor and delivery nurse?

Mommy Labor Nurse Liesel (15:45): Yeah, so I mean, want your labor and delivery nurse to obviously treat you with respect and be open to your questions. And that goes with every member of your healthcare team. I would never want you to be taken care of someone who, if you ask them a question, they're not either not answering or not supporting you in the way that if you're coming in and you, let's say you don't want an epidural and you're feeling like this nurse that is taking care of me is really pushing this epidural on me. It keeps asking me about how my pain is this, that, and the other. We want to really best support you. So I would say, yeah, as long as the nurse is treating you with respect and you're feeling safe enough to ask questions of her those are the basic characteristics I would say. And again, like I said, that goes for every member of Absolutely. Your healthcare team.

Dr. Nicole (16:55): Yeah, absolutely. And I think sometimes people don't realize that if you don't have those things in your nurse, like you said, maybe you have a nurse who's really pushing an epidural or you don't feel like they're listening to you or that kind of thing. What are the options for if you want a different nurse?

Mommy Labor Nurse Liesel (17:15): Yeah, that's a good question because a lot of people don't realize that, Hey, you don't have to just deal with this. So I always tell people, this is part of the prep going into into having your baby, knowing that it is okay to ask questions and say, Hey, that didn't quite sit with me. Let's talk about this because I was really, this was on my birth plan, but you're telling me this. So first of all, it is okay to ask questions. And if you're really feeling like you're not being you know she's not hearing you ask for the charge nurse and say, Hey, can I just speak with a charge nurse to get a better sense of what's going on here? Because it might be a miscommunication with the nurse. And sometimes you need that third party in there. The charge nurse usually is going to come in, you guys are going to talk, and you can either have a change in assignment.

(18:12): We do our best really to try. I mean, as long as it's not crazy, crazy busy, and there's nobody else, I mean, we don't want you to be stuck with somebody who is not taking care of you properly. That's not, that's unacceptable. So yeah, it is absolutely within you to ask for the charge nurse, have the charge nurse come in and explain your situation and say, Hey my nurse said I couldn't do this, and I just wanted to make sure. I just wanted to even ask, is this even an option? And kind of level with them? But yeah, it it's absolutely have a third party get in there, and if you need a change of assignment, hey, you need a change of assignment. Sometimes you do.

Dr. Nicole (18:56): Yeah, sometimes you do, for sure. And if you don't, guys don't know what a charge nurse is. Every shift. There's a nurse who should, well, sometimes they have some patient responsibilities, but they should not have patient responsibilities. They are just responsible for managing the floor and assignments with the nurses, and that's their job in order to help make sure you're okay and happy with your experience. And don't feel bad if sometimes it's just a personality clash or anything. Remember that this is your birth, this is your experience. All of us, the nurses, the physicians just going to keep doing what we do. We're going worry that you're hurting anybody's feelings if you ask for a different nurse. No, absolutely. Sometimes it just needs to happen. Yeah, absolutely. Yeah. So how do you work with doctors? And I don't know if you work with midwives at all, but kind of describe what that relationship is like.

Mommy Labor Nurse Liesel (19:52): Yeah, I have worked with some midwives in the past, and we still have a few that work in the ob, B E D to see patients. But the practices that I work with now are all obs. But yeah, I think I said it in the beginning best that we kind of act as their eyes and ears. And I have a phone and they have a phone, and I am kind of collectively working with them to be their eyes and ears on the patient and let them know of anything that is worrisome of me. And hey, if they're saying, here, here's this medication, or here's this plan of care, I'm implementing that plan of care. So yeah, I, it's also sometimes, especially if I'm in triage and I'm working with a couple different providers, you have to do that. You're not just, sometimes the provider is talking to a bunch of different nurses, but especially if you work in triage, you're having to go back and forth with res residents or this, that, and the other. But yeah, I think I said it best in the beginning that I'm just communication and implementing what they say to implement.

Dr. Nicole (21:02): So I think a lot of people don't realize that your nurse can be the one who's, I don't want to say coloring or framing the course of how your labor is going one way or another, but they're the one who's at the bedside often doing the cervical exams and checks and things. And you may only see your doctor a couple times during the course of your labor. So that relationship is really important to help support you in making sure you feel like the information is being communicated clearly. Would you say that's fair?

Mommy Labor Nurse Liesel (21:38): I would say that's fair. And I think that's a big difference also between not all midwives, but a lot of mid midwife practices. The midwives are just there a little bit more at the bedside, and they're doing a little bit more patient care, because that's just, I think, how they're trained in in school. But yeah, I would say that's definitely a big difference. But again, still very much the same in terms of the midwife can't be in there all hours of the day that they still need somebody to watch over things. So absolutely. Still doing similar things, but I would say the midwife just works a little bit closer with the patient. Not to say that there's anything wrong. I wouldn't say that obs need to do a better job of being at the bedside. It's, that's how it is. They usually have a bigger patient load, and sometimes they have to scrub in and do C-sections. So just a little bit different. Yeah,

Dr. Nicole (22:36): For sure. For sure. So you see different doctors, different midwives, and how they have different practice styles. What are things that you wish people knew about the different practice styles and the way that doctors approach labor and birth?

Mommy Labor Nurse Liesel (22:52): So I would say this is a big thing that we talk about in our birth courses that, hey, it's actually a really, really good idea to interview your provider and ask them questions and say, Hey, you know what I was thinking of? I really kind of want to go without an epidural. I'm really interested in a water birth per se, or I'm really interested in an unmedicated labor. I totally encourage you to talk to your provider and say, Hey, is this something that you can support? And sometimes you'll find that the more questions you ask of your provider, you might not be with a provider that kind of matches your plan of care. So that's a really important conversation to have during your prenatal care because it is okay to switch practices in the middle of being pregnant 20 some weeks pregnant, or absolutely 30 some weeks pregnant. You feel like you're not with the right provider. Because at the end of the day, we want to provide the best care possible. And if I'm the kind of person that I want to go a little bit more natural, and I'm with a practice that their C-section rate is kind of sky high and their epidural rate is sky high, wait a second, I might not be with the right practice.

Dr. Nicole (24:10): I mean, I don't want to scare people, but it's very possible that one person in one room with the particular practice and the next person in another room with the particular practice, they can be very similar, but have very different experiences even being in the same hospital. Would you say that that's fair?

Mommy Labor Nurse Liesel (24:29): I would, yeah. Especially because we have, it's not just the same providers at the hospital. We have a lot of different practices within the hospital. So it, I would say, important to look at the overall hospital statistics, but it's even more important to have that conversation within your practice and actually talking to your providers. I would say that sometimes within the practice, there are some providers that are a little bit more what's the right word, natural, or just, I don't know what the right word to say is, but they're just a little bit different. But I would say in general, most providers partner with each other. You might agree with me, but most of the time they partner with each other because they have similar values and they have similar understandings of birth. So if you're interviewing this one provider and they're like, this is way off base it, it's probably a good indication that the whole practice is, you know, might have to go to a whole separate practice.

Dr. Nicole (25:37): Yeah, that's very true. Very often people are grouped together and practices where, because like you said, they have similar practice styles. Correct. That is not uncommon at all. So you definitely need to get a feel for how everyone is. I think that was one thing that I was shocked about when I used to be in academics used to be in academic medicine for a long time, which is a little bit different than when you're in the community. When I went to a community hospital and I was like, what? Literally one person in one room was cutting the episiotomies all the time, and in a different room it would be different. So you really just have to ask those questions. This is something that I preach all the time, and waiting until you get to the hospital is entirely too late.

Mommy Labor Nurse Liesel (26:20): Entirely too late. And yeah, another thing is a birth plan is great, but it doesn't mean very much unless you're also having a conversation with your provider, you know, can fill out this whole big birth plan. But if you show up with it and the nurses are there, what this is not, yeah. It's like you might as well not even filled it out basically.

Dr. Nicole (26:45): Yes, exactly. Exactly. Exactly. So let's talk about what are your favorite pieces of advice or things you would like to say to people specifically about labor, especially for those having a first time birth?

Mommy Labor Nurse Liesel (27:00): So I would say I'm all about education. So educate yourself. Do a birth course if you're able to, for some reason, if your insurance isn't covering it or you can't afford it, there's a lot of a really great free information on the internet as long as you get it from reputable sources. We give out a ton of free information on our site and my Instagram and just really educating yourself about what's about to happen, because it really, you think about, I kind of equate this to skydiving. If you think about you're about to go skydiving, you want to kind of brush up on skydiving isn't something that the normal person knows exactly what it's about. You want to kind of just get a grasp on it before you jump out of the airplane.

Dr. Nicole (27:54): Absolutely.

Mommy Labor Nurse Liesel (27:55): Yes. So that's definitely number one is educate yourself. And I think sometimes people are, have almost a barrier to that because they're like, I don't want to hear about these horror stories. But it's usually, honestly, the more that you understand things, the more likely your anxiety is going to be lessened. Because oftentimes we have moms come in and they're just afraid of mm-hmm. What they don't know that they're afraid of. Absolutely. It's the unknown. Yeah.

Dr. Nicole (28:27): You're not going to manifest tragedy. Correct. By hearing stories. Correct. And as a matter of fact, it helps you be better prepared for whatever may come. So you're not going to manifest anything terrible just by learning more information. In fact, it's the opposite. Yeah.

Mommy Labor Nurse Liesel (28:43): Yes,

Dr. Nicole (28:44): Absolutely. What about specifically for women who during the labor process, want an unmedicated birth? What tips do you have for them?

Mommy Labor Nurse Liesel (28:51): Yeah, so one of my best ones I would say people really grasp on to is instead of tensing up at the contraction pain, you really, really want to try and relax your body as best as you can, because that pelvic floor that's holding a baby in is a muscle too. So if we're tensing up, sometimes it's just as simple as relaxing that pelvic floor, relaxing those muscles and that uterus can really contract effectively and push that baby down, get that cervix to change. And as hard as it sounds that's really, really so key to labor progression, because if you think about pain in general, what's your normal response to pain? Like you skin your knee or you stub your toe out, that hurt. So normally if we're having a contraction, you're like, oh God, this hurts so bad. But really in labor, you want to try and push against that and say, okay, I'm not going to tense up at it. This pain, I'm in pain for a reason. I didn't stub my toe. So you kind of just have to let that pain come and relax your body into it, and then let it pass. Yeah, absolutely. Another really good, another really good tip is in between those contractions, savoring those breaks, those breaks are there for a reason. And gosh, I don't think people could get through labor if it was just one continuous contraction. So really breathing and savoring those breaks is we will we'll get you through.

Dr. Nicole (30:28): Yeah. You always feel bad when you have, because sometimes the breaks are a little shorter. A little short would, and yes, when you see somebody who's having those back-to-back contractions, you're like, oh, can you please give her a little bit of a break? But yes, savor the breaks.

Mommy Labor Nurse Liesel (30:43): Yes. So I know, gosh, especially moms sometimes on Pitocin when they get a run of contractions, and you're like, oh, I just need a break. I know. I know you do. You deserve a break.

Dr. Nicole (30:55): So what about pieces of advice during pushing in the birth process? Because this is another thing that I don't think people always realize. It's actually your labor and delivery nurse who is with you for most of your pushing however long that may be, whether that's 15 minutes or four hours, your labor nurse who's going to be with you, your physician probably is just going to come in towards the end. So what is your advice specifically for the pushing phase of birth?

Mommy Labor Nurse Liesel (31:23): So I always tell people it is okay to push in different positions and to speak up for some reason. If you're in a position, you're like, this does not feel good at all. Let's say you're laying on your back and you're pushing and you're like, this is not my back hurts. I want to move. It is okay, even if you have an epidural, it is okay to get on your side and push those beds, all those labor beds, they can get into this little chair position We have, not the stirrups, but the pushing bar that you can put on the bed, and you can really squat down and push, get on your hands and knees if you have an epidural, put some pillows and kind of lean against the pillows and push that. Really, the only position you can't do when you have an epidural is stand up out of bed and do a circle around the bed.

(32:10): But I mean, pretty much all of the pushing positions that someone who doesn't have an epidural you can still do if you have an epidural. So I would say change positions if the position that you're in is not feeling so good. And also change positions in general if you've been pushing for 30 minutes. Yeah, maybe it's trying time to change your position, push on your side a little bit. Unless you're making substantial after 30 minutes and everything's feeling great, I usually try to maybe not set my phone timer, but look at the clock and say, okay, it's been about 30 minutes, let's make a change. Change is good. We like change.

Dr. Nicole (32:52): Yeah, absolutely. Absolutely. And I think I love your points about doing different positions because although it's true that not a lot of doctors are always comfortable with someone giving birth in different positions, and most often they're going to be like, when they come in, feel most comfortable with the patient being on their back. Up until that point, you can be,

Mommy Labor Nurse Liesel (33:16): You do whatever the heck you want to do.

Dr. Nicole (33:17): Yes, exactly. You can be moving around, you can be doing different things. And although it's not, no one should be forced to give birth on their back. Obviously, we should always be able to accommodate. Unfortunately, we're not always trained to do so. But please know that with a good labor and delivery nurse, you'll have the opportunity to move around and do all kinds of different things. It's not like you're doing that the whole entire time that you're pushing on that have to be in one position.

Mommy Labor Nurse Liesel (33:42): I think that's sometimes something that gets missed because people think, oh, I don't want to give birth on my back. And you're right. It doesn't mean that you're pushing for two hours on your back. You might be doing all these different crazy positions, but maybe once the provider comes in, you know, kind of turn over onto your back and just give birth on your back. But that's a way different situation than be doing five positions before that.

Dr. Nicole (34:07): Yes, exactly. Exactly. So as we get towards the end, do you have one or two favorite lab and delivery nurse tricks that you would like to share for people to know?

Mommy Labor Nurse Liesel (34:19): So I'll say I just shared this on my feed the other day, the alcohol swab trick for nausea. So sometimes people will, whether it's you have an epidural or not, but you get this real big wave of nausea during labor and just taking a little quick alcohol swab and opening that up and taking a stiff nine times out of 10 can get that nausea to go away. It's not fun to throw up during labor sometimes. It makes you have a whole lot of progress all of the time. It does. It's not fun.

(34:56): Does. So we're

Dr. Nicole (34:57): Kind of laughing because I think we both are thinking in our head, you see somebody throw up and you're like, here we go. Here comes some progress.

Mommy Labor Nurse Liesel (35:05): Here. Go, yeah, let's go. Yeah, yeah. I know. I'll see on the, I'll be out of the room and see on the monitor. I'm like, she's not pushing. I know she's not pushing cause I'm not in there, but big spikes go, yes. I'm like, oh, I bet she's vomiting. And then ding, I I'm throwing up. Yes. It's like, oh, okay. I bet that baby's way down there.

Dr. Nicole (35:23): Yep. Yep.

Mommy Labor Nurse Liesel (35:27): And then other tricks, gosh, I'm trying to think of one off the top of my head. Oh, you know what? I have a really good one. So one of my favorite positions when you're me laboring without an epidural, maybe you're at home, is to get on your toilet and spin around and sit, just sit on your toilet like that with your legs splayed apart. And then you have that tank right there, and you can put a pillow right there and kind of lean your head down. That's one of my favorite positions because you're just squatting and you're relaxed. And if you have to go pee or poop, you're right. There you go. Poop. You don't have to move. So that's one of my favorite positions. But a lot of times in hospitals, either you can't do that because you have an epidural, or the big thing is that sometimes there's not backs on the toilet. They're just our hospitals. It's just

Dr. Nicole (36:24): The, it's just the

Mommy Labor Nurse Liesel (36:25): Bottom. Yeah. A pipe. So one of my favorite things to do is to get mom in that position, sit around the toilet, and then bring the bedside table in there and lock it. And then she has a little stand right there, and you can just put a pillow right there.

Dr. Nicole (36:39): Can I like that?

Mommy Labor Nurse Liesel (36:40): I know. I saw someone do that. I saw a picture of it and I was like, that is so smart.

Dr. Nicole (36:45): It's a good one. That is a good one. I'm going to have to take that back to back to our hospital. I don't know if I've seen anybody do that. All right. So as we wrap up, what is the most frustrating part of your work?

Mommy Labor Nurse Liesel (36:59): Let's see. I would say sometimes I get frustrated when there is a communication barrier between providers and us as the nurses. And unfortunately, sometimes I am trying to tell them, Hey, this patient, I know you really want to break the water because you want labor to keep going, but this patient, she's really telling me that she really just wants to have a little bit of time to wait, and sometimes they can push back a little bit. So I would say that's a pretty frustrating part. And then I also would just say, I mean, I don't know if this is frustrating or not, but sometimes things happen and you just don't, all of a sudden the patient has to go back to the OR for a C-section and you're like, what the heck even just happened? I didn't able to even predict that was happening. So that's really frustrating sometimes that things kind of get thrown at you and you just have to go with it.

Dr. Nicole (38:05): Yeah. Your first point is kind of angry in some ways. I mean, no one should be doing anything to anybody without of

Mommy Labor Nurse Liesel (38:15): Course

Dr. Nicole (38:16): Them agreeing. And to your second point, I always say the only predictable thing about birth is that it's unpredictable. And

Mommy Labor Nurse Liesel (38:22): That's right.

Dr. Nicole (38:24): Because God knows one things can be one way, one both, I don't want to say good and bad, but it can be like we're running to a stat, or it can be like you were four centimeters and an hour ago, and now the baby's on the perineum about to come out. You have to go with the flow of the process, and none of us can accurately predict exactly what's going to happen. Right,

Mommy Labor Nurse Liesel (38:49): Exactly.

Dr. Nicole (38:50): Yeah. So what is the most rewarding part of your work?

Mommy Labor Nurse Liesel (38:54): So I love when I have patients who maybe they came, come in, maybe they're a first time mom, and they are just scared, nervous. Obviously, I want you to come in and not be scared and nervous and be really educated. But I love when I have moms come in and they feel anxious and nervous about their birth, and then I'm able to, in 12 hours or eight or four hours, to really ease their anxiety and go on that little journey with them and support them best. I love those first time moms that really, it kind of being eight years now at the bedside, I realize more the more years I get under my belt that our jobs, they're really so important in someone's life because if they're having a negative experience when they're having their first baby or their second baby or any baby that can make such an impact on so many parts of their lives.

(39:57): Absolutely. So yeah, I love that feeling when I leave a shift and I'm like, okay, that mom, at least for me, she felt like she was well taken care of. And then I do, I always say this too, I also feel really honored when I'm able to take care of a mom who is experiencing stillbirth or a fetal demise, because a lot of people would think that's the worst part of a labor and delivery nurse's job. And I would say it's the sad, definitely the saddest part, obviously, but it's really rewarding in a sense because it's not anything that anybody ever wants to go to. Sure. And just me being able to be there at the right moment for someone and care for them in that situation is it leaves when I leave this shift after caring for one of those patients, I feel really like, okay, I mean, this is not anything that anybody wants to go through. Sure. But I was able to be with her in this time. So yeah, it is very rewarding for me to take care of those patients, unfortunately in those situations.

Dr. Nicole (41:11): Yeah, that's really special. Always said that the moment stillbirth doesn't affect me and my work anymore, I need to retire, because yes, if it doesn't, then Oh, yes. Because it's never always difficult. So I love that you find it rewarding to help people during that difficult time because it is extremely difficult for sure. Yeah. Yes. Do people ever, random question, do people ever make the connection between your online presence and when they see you in person?

Mommy Labor Nurse Liesel (41:43): Sometimes. Yeah. Okay. It depends obviously on the patient. But yeah, I've had that happen a few times where people, I'll come in the room and they'll be like are I think I've seen you before? Or sometimes I'll have people who clearly, they're like, I follow you on Instagram. Right. Very often though, what happens is I'll come in and I'll be talking to my coworkers and they're like, oh, I had a patient the other day and she was asking about you, or she took your course or something. But yeah, I know one of the practices that I work with, one of the private practices, they are like Mommy Labor Nurse fangirl, all of 'em. So they just play up all of my stuff. So all of their patients usually come in and they know who I am. Right. It's fun.

Dr. Nicole (42:28): Yeah, for sure. For sure. So last thing, and you may have already said it before, but what's your favorite piece of advice to give to expectant families?

Mommy Labor Nurse Liesel (42:36): Yeah. Obviously educate yourself, but I will say partners are also important too, so yeah. Yeah, definitely include your partner in all of this. It's not just you. And that's something that I definitely made a mistake of the first time is I thought on, I'll do my education, but my husband was just, it's okay, honey. I'm a labor and delivery nurse. Just it's fine, just be in the room. But he was like, he didn't know what was going on at all. So include your partner. This is a journey that you guys are going on together. Obviously if you have a partner, include them. Sure. This is a journey that you guys are going on together. And yeah, your partner can do so many things to best support you during labor, and it can be really such a bonding experience for the both of you. You guys are both going to be taking care of this little baby that's about to be born.

(43:27): So including them in just all of the education and filling out the birth plan, especially with my first birth. My husband was just completely blown away at how, because I went not completely unmedicated, but I didn't get epidurals with both mines. So he was just blown away at how difficult it was to see someone that he loved so much in so much pain. So that's what I always tell people in my birth courses in that specific sec, in our partner section, that make sure you tell your husband or whoever your boyfriend or who your partner, that even if you plan on getting an epidural, hey, it might be really, really hard for them to see you in so much pain before you get that epidural.

Dr. Nicole (44:14): Yeah. Yeah. For sure. I say the same thing. So where can people find you? Where are all the ways and places and things you have available? Yeah,

Mommy Labor Nurse Liesel (44:23): So I also have a podcast. It's the Mommy Labor Nurse podcast on whatever, Spotify, apple, any podcast and wherever you listen to your podcast. And then I'm most active on Instagram and I'm just at mommy dot labor nurse. Same handle on TikTok. I'm starting to get a little bit more into TikTok these days. And then our website is just mommy labor nurse.com. That's why where we have all of our birth courses. We have three different, three different kinds. The epidural series, the natural series, and the C-section series. We really feel like birth education should be tailored to what you envision your birth to be like. So that's why we're really, we decided to split them up.

Dr. Nicole (45:05): Gotcha. Gotcha. Yeah, so thank you so much for agreeing to come on. Obviously we have some overlap in the things that we do and that we offer, but nobody is perfect for. Yes. Nobody's going to be perfect for everyone, so you want to have options available, and this is a great option for ways to get a different view of information. I'm always about working together with, there's so many people having babies in the space.

Mommy Labor Nurse Liesel (45:30): Oh yes. There's always people having

Dr. Nicole (45:32): Been always

Mommy Labor Nurse Liesel (45:33): Easy at, and I tell people that too. I'm like, I don't care if you take my birth course, I just want you to take a birth course. I just, that's, that should be, this is the goal here. Okay. Yes,

Dr. Nicole (45:43): Absolutely. Absolutely. All right. Well, thank you so much, Liesl, for agreeing to come on. It was a pleasure to chat with you.

Mommy Labor Nurse Liesel (45:49): Yeah, it was a pleasure. Thank you so much for having me.

Dr. Nicole (45:59): All right. Wasn't that a great conversation? I really enjoyed chatting with her. It's just really nice to talk to other people in the field who have similar passion and commitment to really helping pregnant people have the best birth experience that they can. Now people listen to the podcast that after every episode when I have a guest on, I do something called Dr. Nicole's Notes where I talk about my takeaways from the conversation, and here are my thoughts or takeaways from the conversation with Liesel. Number one, I want to be clear, and I want to help you understand that it is your labor and delivery nurse who is going to be with you during most of your birth experience. I can't say this enough. It is their job to be at the bedside with you, which is why they only have one at the most, two patients at a time.

(46:51): So you really should feel supported by your nurse. You really should feel like there's a connection even to your labor and delivery nurse. If you don't feel that way, if things don't feel great, if you're not feeling supported, then please don't feel bad about asking for another nurse who more suits your needs because I cannot say or overstate how often this person is going to be there with you. Some people are quite surprised actually at how little their doctor is there during their labor experience. They may be in the office seeing patients. They're just not at the bedside. So if you're not feeling supported by your nurse, don't be, be afraid to ask for another one. Okay. Number two is that this is just my opinion and you take it with a grain of salt, but I believe it's really important that you find people who have actual experience in what they're talking about.

(47:54): Liesl comes to you from the perspective of being an actual practicing labor and delivery nurse. So her social media content, her childbirth education class brings that important experience to that. I come to you with the experience of being a board certified practicing ob gyn, who still practices. I've been in practice for over 20 years. I've helped well over a thousand babies into this world, and it's really important that you find people who have experience than what they're talking about on social media. There seem to be more and more people who are talking about things and is particularly in pregnancy and birth, but don't necessarily have any experience. And I don't want to say that I'm discounting their own personal experience because that certainly matters. And I'm not saying that people can't talk about pregnancy and birth because they don't have experience at the bedside, but I do think it makes a difference.

(48:52): And at the very least, you should know what experience people have when they are talking about a particular topic so that you can decide, okay, hey, maybe that didn't sound great, or maybe that did sound great, even though they don't have experience or they do have experience. I just think it's just really important that you know what the background and expertise is of the person who is giving you the information. And ideally, you want to learn from people who have experience and what they're talking about. I just think that's important. Okay. And then the last thing I'm going to say as a reminder is just do childbirth education. Please just do childbirth education. There are options out there. Find something that works for you. But childbirth education is so, so important. It's not something that you can skip. And when you're giving birth in a hospital-based system, that too often can take a patriarchal approach to birth.

(49:51): It can try and take away women's power about what happens to them in their own bodies. It can be racist. You really need to empower yourself with information and education. So childbirth education is important. Yes, I have a option. It's the Birth Preparation Course. Check it out at drnicolerankins.com/enroll. However, it's just, I want you to do something, so if you don't do mine, do something. Please. It is that important. All right. So there you have it. Share this podcast with a friend. Sharing is caring and helps me to reach and serve more people, and I so appreciate you sharing it, and I so appreciate hearing you all when you say that you share the podcast. And speaking of hearing from you, I love it when you send me dms on Instagram, come follow me on Instagram at Dr. Nicole Rankins. I love it when you see send me dms, let me know that you share the podcast or that you found the podcast helpful or anything that you find in particular, love getting messages from folks. So come follow me on Instagram, get more information. We can continue the conversation there. Again, I'm at Dr. Nicole Rankins. Also be sure to subscribe to the podcast, an Apple podcast or wherever you're listening to podcast right now. All right, so that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.