Nurses in labor and delivery have the autonomy to care for women in labor by increasing the patients’ activity level, repositioning the patient, providing natural pain relief methods, and trying to decrease medical interventions.10 Labor support must become part of the unit culture for it to become the norm of that unit. Promoting physiologic birth (which means normal labor and birth) requires a combination of practices including continual support, position changes and movement, water therapy, birthing balls, peanut balls, and emotional support. Intermittent fetal monitoring can also help promote vaginal birth.11
During labor, a nurse has many options available to support the woman. There are numerous interventions that can be used to help a woman cope with labor and pain, such as movement, heat, a shower or jacuzzi, and aromatherapy. It is important that hospitals have guidelines that allow low-risk women to have intermittent fetal monitoring, so the woman is free to move. If the woman is high-risk, or on Pitocin, it is helpful if hospitals have wireless fetal monitoring, but if unavailable, a birthing ball or rocker at the bedside can still allow for movement while using fetal monitoring. Massage may also help. Nurses can learn how to provide therapeutic massage for their patients. If the RN cannot perform massage, he or she can teach a support person how to perform the massage that will help the woman. One of the most important aspects of labor support to help the woman is being present at the bedside. Nurses should be at the bedside, providing care and support, listening to their patients, and even documenting.
BirthTools.org is a website managed by the American College of Nurse-Midwives that can help all L&D nurses. This website has toolkits, articles, links to other resources, and patient and nurse education for support during labor.12 There is still a need for a more concise education plan for nurses to provide labor support. The resources that are available are scarce, and some are expensive. Educating nurses on labor support skills needs to become part of all nursing education.