Labor and Delivery Experience

When you first enter the unit you and your family will be placed in a Labor and Delivery room for a medical screening exam.  This exam will help us establish the well being of you and your baby.  You will be placed on monitors that will help us with this exam and a nurse will be asking you lots of questions.  After the nurse is finished, you will be seen by a Labor and Delivery clinician.  This could be an Obstetrician, Certified Nurse Midwife or an Obstetrical Resident MD.  We will then determine whether or not you are in labor.  If you are not in labor you will be discharged home with instructions on when to call or return to the hospital.  Any of the clinicians will be able to answer any question that you may have during this time.

Once you are in labor and have been admitted to the hospital, the nurse will have additional questions, start an IV start in your arm, draw lab samples, and you will be visited by one of our admitting staff. The clinician will also complete a history and physical examination at this time.

During your admission, you and your baby will be monitored for well being by our very competent Labor and Delivery staff. We will assist you with coping techniques for labor. These techniques may include the use of breathing, relaxation, walking, shower, massage, TENS unit, IV medication or an epidural. If you have other coping techniques you would prefer, please let us know if we can help.

Managing your expectations around labor pain is very important to us.  The options available to you are natural childbirth, IV medications or an epidural.  The clinicians will discuss your options with you when you are admitted, but also as you are progressing in labor.  We do not use a traditional pain scale in Labor and Delivery; instead we use the Labor Coping Scale.  This scale is used to tell us if you are coping well with labor with no interventions, if you are coping well with labor with interventions or if you are not coping well with labor.  Your nurse will explain the coping scale to you when you arrive.  Remember this scale does not tell us how to manage your pain, only you can help us with that.  Do not be afraid to ask questions regarding the different types of coping that are available to you.

Epidurals:  we have anesthesiologists in the hospital 24 hours a day 7 days a week.  They are the clinician that will explain Epidural pain management and will do the insertion of the catheter.  Please view the brief video on epidurals provided here for more information.

IV Pain management:  there are different options of medications that can be given through your IV with the most common one being Fentanyl.  If you feel you need medical intervention for your pain, we are able to discuss the different options and help you decide what is best for you.  Remember that only you can help us to manage your expectations regarding labor and pain management.

There are two different ways to have a baby, either Vaginally or by Cesarean Section.  The method in which you deliver will be determined by many factors with the most important being the safety of you and your baby.

Vaginal Delivery:  Once you are completely dilated to 10 centimeters you will begin the process of pushing.  This process could take 10 minutes or over 2 hours.  Do not worry.  You will have a Labor and Delivery team member with you to support you as you are pushing.  In the beginning you will typically push with the nurse who has been providing your care during labor.  Once you reach a point where the nurse is able to see your baby’s head, they will call one of the Certified Nurse Midwife , Obstetricians or Resident MD’s into the room to assist with the delivery.  As you prepare for the delivery, your legs will be placed in stirrups to help support them as you continue to push.  For the safety of your family and our staff we ask that you use the stirrups or yourself to hold your legs if necessary.  This will help you with your pushing efforts.  Your newest addition will be delivered and if stable placed immediately on your stomach.  The clinician who assisted with the delivery will clamp the umbilical cord and your partner can cut the cord with the guidance of the clinician.  The nurse will be at your side with warm blankets drying the baby and providing stimulation if needed.  They will then move the baby to your chest for skin to skin bonding.  When you and your new baby are both stable, the nurse will help you breastfeed, give the first bath, weigh and measure the baby and give the infant medications.  Your nurse will explain these medications to you before they are given to your baby.  The medications are Erythromycin eye ointment, Vitamin K shot and a Hepatitis B vaccine.  Typically in about two hours you will be moved to our Postpartum Family Care Unit.

If the baby is not stable, he or she will be immediately taken to the infant warmer that is located right beside your bed.  The baby will be cared for by a team of Pediatricians and Intermediate Care nurses until stable.  If the baby cannot be stabilized, they will take the baby to our Intermediate Care Nursery for further care and intervention.  You can have your significant other go with the baby to the nursery or stay with you.

Cesarean Section:  this can be either a scheduled or unscheduled event.  If you are arriving for your scheduled Cesarean Section you will be admitted the same as above but will not labor.  You will be visited during this time by the Anesthesiologist who will be providing you with your anesthesia during your surgery, the Obstetrician who will be doing the surgery and sometimes the pediatrician who will be in the room for your delivery.  Once you are prepped for surgery you will be taken to the Operating room either by bed or if able you can walk.  Once in the room Anesthesia will begin to prepare you for your surgery.  Once complete the team will lay you down on the table and the Nurse will insert a catheter into your bladder and wash your abdomen.  After this is all complete your significant other will be brought into the room to be with you during surgery and see the baby right after delivery.  The team will then proceed with the surgery to deliver your baby, once delivered the baby will be given to the team of providers who are in the operating room just to care for your baby.  This will be a Pediatrician and an Intermediate Care Nursery nurse.  Do not be alarmed they attend all the deliveries in the operating room.  Once your baby is stable he/she will be brought to you for skin to skin and bonding time.  As your surgery progresses the baby will be taken to the recovery room and you will be reunited as soon as you are finished with your surgery.  Your significant other will accompany the baby to the recovery room to wait for your arrival.  While in the recovery room your baby be given the first bath, weighed and measured and given the infant medications.  Your nurse will explain these medications to your before she gives them to your baby.  They will be Erythromycin eye ointment, Vitamin K shot and a Hep B vaccine. Your newest addition will be ready for your when you enter the recovery room.

Once in the recovery room the Nurse and Anesthesiologist will ensure your safety.  They will monitor your heart rate, blood pressure and oxygen levels.  The nurse will do frequent assessments on you while you are in the recovery room, and once stable you will be reunited with your baby.  We encourage skin to skin bonding and initial breastfeeding at this time.  You and your baby will remain in the recovery room for approximately 2 hours depending on how stable you both are. Once stable you will be transferred to our Postpartum Family Care Unit for the remainder of your stay.

Unscheduled Cesarean Section:  this can be a very scary time for you and your entire family.  The Labor and Delivery team will be with you every step of the way to ensure the well being of both you and your baby.  Your significant other may or may not be able to accompany you to the operating room during this time.  If they give you general anesthesia (you go to sleep) instead of a spinal they cannot join you until you are out of the recovery room.  They will however be able to be with your baby as soon as he/she is out of the operating room.  They will both be waiting for you to return to either the Labor and Delivery recovery room or your Postpartum Family Care Unit bed.  We will reunite you as soon as it is safe for both you and your baby. If you are having your surgery because the team was worried about your baby, he/she may be admitted to our Intermediate Care Nursery for care.