Welcome To Labor and Delivery!
Arriving to Labor & Delivery can be very exciting (and a bit nerve-wracking).
Here are some guidelines to help you know what to expect when you first arrive.
Upon arrival to Labor and Delivery, you will be admitted for an evaluation so that the nurse can check you in, collect basic information, and begin monitoring your baby. It’s at this point that the Midwife or Doctor will be notified of your arrival.
After your baby has been well monitored the midwife/doctor will then check your cervix.
If the exam shows that you are in very early labor (meaning that the cervix is dilated less than 4 centimeters and contractions are not coming every few minutes apart with regularity and increasing strength) there are a few different options that may be offered. One option is to administer a medicine called pitocin which can help to increase the length and strength of your contractions. This is not for everyone and depends on how far along you are in your pregnancy and what you and your caretaker feel is the safest option for you and your baby.
Another possibility is to simply walk around, take a shower, and increase body movement to see if your body can go into a more active labor on its own.
And yet a third option (if there are no concerns with your pregnancy) is to simply go back home and wait for labor begin naturally.
Sometimes waiting is the hardest part of labor! So don’t worry, it will happen
(and usually does when you are most relaxed and have your mind on something else).
Once admitted to Labor and Delivery (either because active labor has begun or your doctor feels it is important to start the labor process with medications), you will be moved to a more comfortable room.
The nurse may place an IV and start fluids during this time and the doctor or midwife will review the plan with you. He or she will go over possible medications that may be administered, options for pain control, and obtain consent for any emergency procedures that may be performed, even if the possibility is remote. Most patients don’t like talking about a possible cesarean section if that is not the plan. However, for the safety of both mom and baby, it is important to have a plan in place in the event of an emergency. For this reason, many doctors will ask for your consent early in the labor process, even if cesarean delivery is not planned or anticipated.
Certain medications to start labor require your baby to be monitored continuously, while others allow for periods of time off of the baby monitor. If it is safe for you to be removed from the monitor, you may want to walk around and stretch during this time to relieve muscle aches and to help the baby come down the birth canal.
The doctor or midwife will periodically check your cervix. During this time, medication may be administered or procedures performed to help your cervix dilate more. If needed. Additionally, your caregiver may break your bag of water.
Active labor is defined as 6cm or greater. The transition to active labor can be an overwhelming process, and may be marked by increasing pressure or pain along with shivering or shaking. Don’t worry. This is normal!
Once your cervix is fully dilated or 10cm, it is time to start pushing!
If it is your first baby, it may take up to 4 hours to push the baby out. Your nurse, doctor, or midwife will help you find the optimal position for pushing. For many women, this process can be physically exhausting. You may experience increasing pressure during this time, which may not be helped by medications that were previously providing relief.
Once your baby is crowning (meaning the doctor can see the head begin to emerge), you will receive specific instructions about when to push so as to minimize tears.
Make sure to look down as your baby is crowning so you don’t miss the birth! The doctor will place your baby on your chest for stimulation, drying, and bonding time. The cord will be allowed to continue pulsing for at least 30 seconds before being clamped, as long as there are no concerns for the safety of your baby. After this, you or someone you select can cut the umbilical cord.
To prevent postpartum hemorrhage, medication may be administered and the placenta delivered. If there are any tears of the vagina, your doctor will repair them using local anesthesia. These sutures will dissolve on their own and do not require removal later. Ice packs will then be placed on your perineum to reduce swelling.
Most importantly, it’s time to welcome your baby, bond and begin breastfeeding!
THE JOURNEY IS JUST BEGINNING!!!!!