My husband had always wanted to have a baby, but as a transgender man, he'd felt like that might never be a possibility for him. A lot of his fears that kept him from starting the journey of trying for a baby centered around medical care and how he'd be treated as a trans man in labor and delivery. He knew that a lot of the medical treatment might trigger intense dysphoria, and he also knew that a lot of the standard language around labor and delivery was super gendered. "How's Mom doing? Does Mom need anything? You're doing great, Mom!" He did not feel like he would be seen or receive compassionate, appropriate care.
I share all this because these worries were deep, and we came into Duke Regional Hospital with a lot of anxiety, but also a lot of hope. And that hope was met by the incredibly kind, competent, and down-to-earth nurse who greeted us when we arrived at Labor and Delivery.
She was affirming and encouraging from start to end, and immediately eased all our worries about whether he'd receive competent, affirming care. She was our nurse for 5 hours of our first day shift and was kind and helpful. She assisted me in finding places to put the little "How's DAD doing?" posters around the room. She made a point to check with other staff before they came into the room (like housekeeping or nutrition) to double-check with them about his gender before they entered. We encountered a weird glitch with Obix software where it would not display his monitoring in the system since his gender in the intake was male, and we couldn't change that without putting his insurance billing at risk (since it had to match his insurance, which was male). She worked hard and was able to find a workaround that connected his monitors to the display as long as we didn't turn it off. When she went off shift, we were disappointed -- how could another nurse be that cool, kind, and funny?
As things would work out, we were still there the next morning when she came back on shift, and we were DELIGHTED to see her. By that point, M's exhaustion meant that he'd accepted the epidural he'd hoped to avoid, but when it came time to push later that afternoon, Sierra went out of her way to help M get into positions he wanted to try out to see what was effective. He'd feared that the epidural would mean he was stuck in one position, but he was able to try hands and knees, kneeling over a birth ball, supported squat, using the handles, and using the birth bar. Anything he suggested, she found a way to help him into that position despite the epidural.

As my husband neared the birth of our baby, Sierra's shift was about to end. She knew he was close and asked his permission to stay after her shift to see the baby born. He was grateful to have her stay over. The next nurse came in to chart and be present, and Sierra was there for no reason other than sharing in the joy of our baby's birth with us. As he pushed, I could tell the head was starting to be visible before being told because I could see the genuine excitement on Sierra's face! She was nodding enthusiastically while alternating between grinning and looking genuinely awed, and I was really touched to see that someone who does this every day can still find such wonder in the process of birth. It was clear that this was work, but more than work. Her presence at the birth of our baby made the entire process less scary, more comfortable in all the ways, and very, incredibly special.
The next day, as my husband recovered in the postpartum unit, Sierra stopped by for a visit. She sat with us for a few minutes, fussed over how cute and sweet the baby was, and chatted some about the birth. She reminded him of some of the parts he hadn't remembered and reassured him about how well he'd done, how strong all his choices had been, and how hard he'd worked to bring this baby into the world.
For years (in other hospitals in other towns), I'd worked as a childbirth educator and doula, during which I've attended a lot of births. I've had three hospital births of my own. I've seen the ways that nurses and other medical providers can make a birth experience beautiful, but more often I've seen ways they can make it more frustrating, more fearful, or entirely disempowering. To get to be present and see someone do all the things right has not only made me more grateful that this was my sweet husband's experience -- it's shifted some of my existing biases about hospital births. Sierra played a big role in that, and I'm grateful.
I would love to see her honored for her incredible work, compassionate approach, and down-to-earth presence at Duke Regional. It's an honor to nominate her for the DAISY Award.
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I am a transgender man and was very apprehensive about giving birth in a hospital in North Carolina, a state that had recently passed anti-trans legislation.
When I arrived, my first nurse, Sierra, was the charge nurse for the day and had just come on duty. Sierra carefully went over my birth plan with my partner and me, asked questions that made it clear that she took it seriously, and helped me feel like my needs and preferences mattered.
My partner had made signs to help people remember to use the right pronouns and language for me ("Dad" rather than "Mom") - Sierra immediately saw the value of these and helped my partner find tape and put them up in visible places.
I was happily astonished at how well everyone who came into the room did with my name, pronouns, not being surprised by my gender, and generally being respectful and trans competent. I found out later that this was at least in part because Sierra could see my door from her spot at the nurse's station, and would intercept anyone she saw about to go in and make sure they actually needed to go in, and had basic knowledge of how to treat a trans birthing patient with respect.

In addition to all these things, Sierra advocated and helped push to find a workaround when a piece of vendor software made it so that nurses could not see my fetal heart rate and contraction monitoring information, because my chart has me as male, and for some reason, the software simply would not send the information if the chart had the patient as male. With the help of her advocacy, the staff were able to do a temporary workaround, meaning I didn't have to deal with my chart having the wrong sex on it and possible insurance issues stemming from that, or having the monitoring information only on paper, with the risk to the baby and more interruptions that would come from that.
I ended up having a very long labor, and I was pleased when Sierra ended up being my nurse the next day as well! She met us where we were that day - more tired and subdued - and gently supported my partner and me all day. When it came time to push, Sierra stayed with us as much as possible. Even when she had to leave to respond to alarms in other rooms, I always felt that she was around to support me when I needed it. She helped me move into different positions for pushing even though I had had an epidural, was patient, gently repositioned the monitors when they would shift, and was generally wonderful.
As I came closer to giving birth, it was also closer to shift change, when Sierra would be going off. Sierra respectfully asked if she could stay, and I gratefully welcomed her to do so. As my baby was being born, Sierra supported my leg and welcomed her into the world. She seemed genuinely happy for my family and rejoiced with us, which felt very sweet.
After we were moved to the postpartum part of the hospital, the following day (or was it the one after? Time was a blur), Sierra came to visit us and just to check in and see the baby. It was a sweet way of bringing the experience full circle, and really bringing home that we weren't just another set of bodies to push through the system.
I am so grateful for Sierra's fierce advocacy and gentle compassion. I truly believe it made a huge difference in my experience of something so tender and vulnerable, and I will always be grateful to her.