The Other Side of Labor and Delivery: Reflections on Burnout, Loss, and Compassion

As I sit in my taxi home watching the sunrise, I reflect on my shift from last night. This feels like my 100th “24hr day” since I started NP school, and I can feel the burnout creeping up on me.

I had a patient last night who would have made my new grad self sob, with tears streaming down her face. But instead, I stood there with no thoughts, no expression, and no remorse, watching a mother deliver her 34-week unalive daughter. I spoke to her as if I was speaking to any other fetal demise patient. I chose phrases that the modules taught me: “This isn’t your fault.” “I’m going to keep you and your baby in my prayers.” “You have support around you; use it. Do not be afraid to ask for help.” I wonder if she knew I was speaking from a script, if she really felt I meant those words.

I took her baby to the butterfly room, which is a nice way of saying the baby morgue. This baby had been dead for many days. I could tell by the skin sloughing off.

The mom told me she had decreased fetal movement for days, but she didn’t know that was a ‘bad thing.’ How is that she didn’t have that education? I wonder now if it was because of her immigration status or language barrier, as she was a patient of a physician who was funded by the government for uninsured patients. When patients lack education, it always upsets me. Every patient should know the ‘red flags’ for when to seek care. Maybe she could have come in sooner, and maybe we could have prevented this tiny baby’s life from being lost.

In the butterfly room, I tried my best to get perfect footprints of her tiny, limp feet. I wanted the baby’s mother to never know of any of its imperfections. I made her look presentable for her mother to hold her. I didn’t want her mom to think her baby suffered.

Bringing the baby back from the butterfly room to let the mom and dad hold and grieve over their lost child is the worst part. A whole world that they had hoped for is now gone, wrapped up in a tiny crochet swaddle that another person knit. It is even worse to think that this was the mom’s first baby, first pregnancy, first introduction to motherhood. Such a fragile role for her has begun with such a trauma.

I wonder what her next few days, weeks, and months will be like. She now has to heal not only mentally but physically from this pregnancy. She was 34 weeks, so almost full-term. I saw the stretch marks on her belly, and she has a second-degree tear from the delivery. Those are things that heal, but they are still physical reminders of their baby’s life. I wonder if she will try to get pregnant again. I wonder what will happen to her and her husband’s relationship.

As I write this in my taxi, I am starting to tear up. I am starting to feel sadness again, and I am grieving the loss of their baby. I feel this may be a good sign, an indication that at least I’m not as burnt-out as I’d thought. I hope that this baby gets to meet the others that I’ve delivered, in heaven or wherever they go.

I told the mom that I will be thinking of her, her baby, and her family. When I said that, I really meant it; the modules didn’t tell me to say that. Now I am going to get some rest and remember why this job is so important to me and the patients I care for.

Marykate O’Malley, BSN, RN, is a labor and delivery nurse in New York City. She is completing her doctor of nursing practice (DNP) degree in the Family Nurse Practitioner program, with a subspecialty in women’s health, at Columbia University School of Nursing, with an expected graduation in December 2026.