Scott Webb (Host): Today, I'm going to have the pleasure of asking two labor and delivery nurses at Emerson some of the questions that pregnant moms or couples likely would ask, but are generally too embarrassed to ask. I'm joined today by Jen Camerano, she's a Labor and Delivery nurse with Emerson's Birthing Center. And I'm also joined by Joyce Maiore, she's a labor and delivery nurse as well at Emerson, and she's the clinical resource nurse for OB Services.

Host: This is the Health Works Here Podcast from Emerson Health. I'm Scott Webb. So, I want to thank you both for joining me today. We're going to ask some questions today that I'm sure moms-to-be, pregnant moms, maybe couples would like to ask if they had the chance and/or maybe sometimes are too embarrassed to ask. And we've got some good ones for you today.

And I'm going to start with you, Joyce. Let's talk about pain. When it comes to the pain, it feels like it must be the most painful thing ever, and I'm wondering if a pregnant mom were asking this, what would you tell them about the pain? How much pain can they expect?

Joyce Maiore: Well, it's funny. I used to the childbirth ed classes here at Emerson, and I think that was the number one question. And what I would say to people is it is uncomfortable, very uncomfortable. One of the good things is the body is kind in a way that labor typically starts very slowly. And in the beginning, you're not having the excruciating pain typically with the first baby. But it does gradually increase and get worse and worse and worse.

And the thing I recommend is for people to have coping mechanisms and prepare for labor, learn breathing techniques, take a childbirth ed class, educate yourself on all aspects of labor so that you're prepared. You know, you're not going to go into a marathon and run it. But day one, you're going to prepare for it. So, labor is similar in the way that childbirth educators compare labor to running a marathon or hiking a mountain is definitely one of think about things ahead of time. How are you going to manage your pain? Are you planning an epidural? Are you not planning an epidural? What is your plan? What is your birth plan? Talk to your provider, talk to your spouse, your partner about how you want to manage it, how involved you want them to be. That's the kind of thing that I recommend to people when they ask about pain.

Host: Yeah, I'm sure, Jen, you would probably echo that, right? Like, it will be painful at some point, but it's gradual and you have time to sort of adjust, but it is good to have a plan, right?

Jenn Camerano: Yeah, for sure. And I think like everybody has their own tolerance. And so, everyone experiences labor completely different. And everyone will get labor pains and not really understand how painful it's really going to be, or they underestimate how strong they are. We usually just say they start feeling like strong period cramps and then kind of gradually get worse. But I always tell moms, you know, have a plan like Joyce said. And then, if they have a plan, then we can always adjust to their plan.

Host: Jen, I want to ask you about this. And this is a question that I've had, and I'm sure a lot of moms-to-be have, what if they have to go to the bathroom while they're in labor?

Jenn Camerano: Oh, that's a very common question I have to say, but I always answer it kind of in the same way is that actually almost every mom does probably more do than don't. And then, we usually say if you do, it's usually a good sign that you're pushing the right way, because as a baby's head comes down, you know, sometimes it just comes through. We treat it like nothing else besides the magic of labor and delivery. It's nothing. It doesn't bother us. Most times it bothers you more than it bothers anybody else just because you're aware of it. But we clean it up, we act like nothing ever happened and we move on. You know, we're focusing on a beautiful baby being born. So, we really don't focus on that at all. But I know it's a lot of worries for a lot of people.

Host: Yeah, it sounds like just part of labor and is sort of like when children injure themselves, you try to convince them that they're fine. "You're fine. You're good. Keep going. Keep trucking." Same thing, right? You just keep on task, what you need to do. A little bit more of a serious question for you, Joyce, is about moms and babies bonding. And I'm sure that that's a concern that a lot of moms or maybe couples have. What if they don't bond with the baby right away?

Joyce Maiore: Birth is a beautiful thing. It really is. But I think that some women, you know, whether, they're feeling overwhelmed by the experience or their experience was much more difficult than they were expecting or they had expected to have a vaginal birth, but they had a C-section. And those things can really complicate your bonding with your baby right away. And sometimes that bonding comes later. Sometimes life events that happen in pregnancy, for example, I lost my mom when I was pregnant with my first, and so I really had difficulty bonding with my baby right after she was born. I mean, it came a little bit later, but that was a concern of mine that I talked to my nurse about when I was, having her.

But everyone's different. Like Jen really focused on that and I think answering her first question is everyone's different when it comes to your pain and how you bond. And not everyone bonds right away. Those hormones that are released after delivery have a lot to do with how you're feeling, the overall experience, how you're feeling as well. So I think it's important to recognize that if you don't bond with your baby right away, there's nothing wrong with you. Nothing wrong with you. That happens, and it'll come later. And if you're finding it hard to bond with your baby, and you need to talk to somebody, talk to your nurse, talk to your provider. We have a social worker on staff that can meet with you and talk to you as well if you're feeling depressed. So, it's natural to feel that way, to feel overwhelmed by everything that's happened. It can be an overwhelming experience. I mean, it can be beautiful, and some people bond right away, and that's fabulous, that's great for them. But just understand that labor and delivery is a very individual experience.

Host: Yeah, that makes sense. Jen, I'm sure this comes up and this happens, that pregnant moms, I'm sure they get annoyed with their partners while they're in labor, or maybe a partner passes out during labor. What happens when partners do, or they're just being annoying?

Jenn Camerano: Most times, we'll kind of get the cue from mom that like they're getting overwhelmed. And so, sometimes you're overstimulated with noises, touch, whatever. Most times if we could tell that getting annoyed by your partner, we kind of like say, "Maybe she'll like this instead," or "Let's try a different thing. Maybe get her a cool cloth" and kind of let them step away for a minute. And we've had plenty of dads pass out and we always say, you know, they're taking the attention away from baby and mom. We always kind of like try to keep the focus on mom. But also, if it's a medical thing and they've passed out, we obviously make sure that they get the attention that they need. And usually, they come right around and then, they sit in there embarrassed and then they get to hold their new baby. So, a lot of times it's kind of forgotten pretty quickly. But we try to get our cues from our patients and kind of like try to stir that away, you know.

Host: Yeah. And Joyce, I know they say that what happens in Vegas stays in Vegas. Does that apply to the laborer in her room? Does, you know, what happens there stay in the room?

Joyce Maiore: it does. It does. I mean, there's a lot that happens. You know, kind of adding to what we were just talking about with partners, I think women are embarrassed at the things they say to their partner in labor, or the partner is embarrassed that he's passed out. And I always try to have a chair, by the way, right next to the partners, because it can be very overwhelming for them as well. But, yes, what happens in labor stays in labor. We have a, an amazing group of nurses here that are very supportive. That would never make anyone feel bad or say anything. You know, we just are like, "That's an amazing experience. It's an intense time in your life." And so, there's no judgment. It's a judgment-free zone for sure.

Host: Jen, back to just a little bit more of a serious one. What if a mom to be, pregnant mom has signs of depression before or after they deliver the baby? Is it, again, really a matter of speaking with family and friends, sure, but also speaking with you, perhaps?

Jenn Camerano: Yes. That's a big topic and something that we've been trying to educate more moms on and families. You know, there's been a lot in the news and a lot of moms worry about postpartum depression. And once we come in, we kind of try to screen them, ask the important questions. If it's during the pregnancy, we encourage them to have an open conversation, like with their midwife or their doctor so that, you know, what they're starting to feel beforehand is normal, or if it's not, sometimes they may need medication. Sometimes it's just kind of to talk through it, sometimes it's just therapy. Once baby's born, a lot of times moms do get the baby blues and, usually, that's more short-lived. Sometimes they do end up with a postpartum depression and we have a great social worker at the hospital who give support as well. And a lot of our nurses are great with kind of saying, "Hey, this is normal" or "This is not. I'm worried about you, so maybe we should talk to your doctor, have a plan set up now for postpartum." There's always hopefully open communication very close after the delivery, just to kind of make sure things are doing okay, and that the families are aware too of what the signs and symptoms are.

Joyce Maiore: There's a lot of resources that people are, I think, not aware of that our social worker or even the nurses provide. There's the MCPAP for moms. It's a great resource for new moms on getting support, especially the baby blues. And if lasts for a long time and leads into postpartum depression, there's a lot of support, different types of groups that you can join and individual therapy that you can get. It's really important we educate the partners on the signs of postpartum depression. We do a lot of discharge planning around this as well, just recognize signs and symptoms, where to go for help, and try to encourage them to speak up when they are feeling that way.

Host: Yeah, there's lots of help, lots of resources. And I want to give you a chance here, Joyce, address this one, actually the next two, to both of you. What's your best tip for moms in labor?

Joyce Maiore: My best tip for moms in labor is, as I said earlier, just maybe have a plan. And be really open with your partner on what you want, what you don't want. You know, bring things into the room that help you cope, such as music or a soft blanket or maybe a picture of family member or whatever it takes to make yourself comfortable and how you're going to manage labor. But also be flexible, because things change all the time. You know, it doesn't always meet your expectations. So, I think that was the biggest tip I have.

Jenn Camerano: I would parallel with her basically. And a lot of things I usually say to my patients is kind of when you come into the door, into your labor room, throw any expectations that you kind of had out the window and just let the labor be. A lot of times they come with this strict plan and they think like it's going to go that way. And like Joyce said, everybody's individual. It doesn't always go the way that you think it's going to go. And again, having a plan with your partner that kind of is helping guide you through it as well is usually ideal. But for them to have just an open mind, like she said, and kind of just go along with it, and a lot of times we will coach you along when things change, you know.

Host: Definitely. Give you a chance here at the end, fun one for both of you. Jen, I'll start with you. What do you love most, let's say, about being a labor and delivery nurse at Emerson?

Jenn Camerano: I love that it's a small community hospital and that, you know, we get stories all the time that, "Oh, I was born here," or people tell their stories. And I will most times follow with, "I had my three kids there and I was taken care of so well that that's where I wanted to be a nurse for the rest of my career." I just love how personable everybody is. Everybody's friendly and compassionate. Usually, you see faces and everyone smiles at you. And it's just for me a warm comforting place to be. And I work there, but even as a patient, I've gone to other departments and I still feel the same compassion and care no matter what department it's in. But I love everything about it, honestly.

Host: That's funny. That's sort of common thread, right, Joyce? You were telling me before we got rolling here today that you had your child there and thought, "Well, I'll just be a nurse here. This is awesome. This is the place for me," right?

Joyce Maiore: Yeah. The experience was just so overwhelming and wonderful. And the two nurses who helped me deliver my baby ended up being my colleagues. And in fact, the next day, I didn't have a name for my baby, I just couldn't think of something. So, I met a tech here and her name is Lucy and she came in. She's like, "Hi, my name is Lucy." And I said, "Oh, I love that name." And we talked about it. And then, I named her Lucy and now I work with Lucy and it's just so wonderful. We do have such an amazing team here. And, you know, the one thing I really want to say is having a baby is one of the biggest milestones in your life, and I take that very seriously, and I'm really, really proud to be a part of it.

Host: That's so awesome. Well, it's been great to get to know you guys today and we've had some fun along the way, a couple of serious questions, but generally a whole lot of fun and smiles on everyone's faces today. So, thank you so much and you both stay well.

Joyce Maiore: All right. Thank you.

Jenn Camerano: Thank you.

Host: And visit emersonhealth.org/baby to learn more about giving birth at Emerson, schedule a tour of the birthing center, and learn more about support groups.

And thanks for listening to Emerson's Health Works Here podcast. I'm Scott Webb. And make sure to catch the next episode by subscribing to the Health Works Here Podcast on Apple, Google, Spotify or wherever podcasts can be heard.