Postpartum Nursing, Pascale Middleton, Cedars-Sinai

How has your own experience as a mom impacted your work in postpartum and prenatal education?

Being a mom, I take the support and education of moms and partners very seriously.

The first of my children was a premature baby who was in the NICU for almost a month. Even though I was a professionally trained postpartum nurse, I still had my own emotional reaction and felt inadequate as a mother.

The staff on that postpartum unit made a lot of assumptions about me because I was a postpartum nurse, but I was honestly terrified of taking the child home. In the end, I had postpartum depression.

Having experienced that makes me even more sensitive to moms’ circumstances. I’m a much better listener now — basically, I talk less and listen more. I like them to feel empowered to talk about how they feel. When I’m able to be that present for my patients, it feels so good.

I ended up having three kids (they’re now 33, 29, and 22), and with each one, I felt more and more comfortable. I also felt more natural about giving birth and breastfeeding.

What do you find most challenging about your work?

From the outside, labor and delivery and postpartum can appear easy and laid back, but it can be very emotionally intense and taxing. You have to have a high level of empathy, but also protect your own heart.

How do you navigate communication and personal boundaries in the intimate setting of postpartum nursing?

I’m a very social person, so as soon as I walk into a patient’s room, I’m ready to connect. I use humor as a tool, and I feel them out to see how they’re doing: Do they want space, are they needing to talk, or would laughter be healing in this moment?

In terms of personal boundaries, I don’t tell patients my deepest secrets, but if we have something in common, I use that as a bridge for connection. For instance, if they’re listening to music I love, or if they mention something that I can authentically identify with, those are moments I use to break the ice, which is so important in this work.

I try to keep in mind the concept of therapeutic use of self. Oversharing is inappropriate — if I share anything about myself or my life, I’m mindful that it’s about the patient and not me.

For instance, with moms with postpartum depression or who have babies over in NICU, I may choose to tell them a little bit of my story, saying, “Your experience is different than mine, but here’s where I can possibly understand what you’re going through.”

I also remind them that they’re working for their baby even as they rest. Their baby is going to need them, and they have to take care of themselves.

Overall, how do you feel about your career and the choices you’ve made?

I love what I do and I love my career so much. Being fully present for patients both as a nurse and a mom is gratifying. I’m very grateful for my nursing career — it allowed me to choose to work nights and be home with my kids during the days when they were younger.

Now that we’re empty nesters, I can work more if I want to. I like that sense of freedom to join committees and get involved. As a working mom, I was always too busy to do that, but now I can commit to anything that piques my interest.

I’m a member of our antidiscrimination perinatal health council, which seeks to understand more about biases and racial inequities. Being part of committees and projects that are important to me and my personal values holds a lot of meaning.

How do you define success, personally or professionally?

It means something different to each individual. For me, it doesn’t mean I have a lot of letters behind my name — I don’t need all that. Success is when I come home and say, “Wow, I made a difference in someone’s life today.”

KEITH CARLSON, RN, BSN, NC-BC, has worked as a nurse since 1996 and offers expert professional coaching at www.nursekeith.com.

In this Article: Labor & Delivery