Labor & Delivery

Planning for your hospital stay is something that you should plan well before your due date. Don't wait until the last minute and try to pack while you are in labor!
You should plan to pack at least two separate bags: a bag for labor and a bag for your postpartum stay. You might always want to pack a bag for your birth assistant, and a bag containing your labor comfort aids.
Leave your bags by the door, or if you have the space, in the trunk of your car so that you are prepared when labor begins.
The labor bag should contain some or all of the following items:
Items to help you pass the time if you are in early labor, such as a book, cards or a board game.
Lollipops or something to suck on to keep your mouth moist.
Lip balm to keep your lips moist.
Your birth plan (use our BabyPartner birth plan if you don't already have one).
Address book or PDA so that you can call family and friends.
Socks to keep your feet warm.
A camera (with spare batteries and extra film so you can record the moment of birth).
The postpartum bag should contain the kinds of items you would need if spending a weekend in a hotel. You should consider bringing:
Toothbrush and toothpaste
Cosmetics (optional)
Hairdryer (optional)
Bathrobe
Slippers
Nursing bras
Nightgowns (nursing type)
Birth Announcement cards, envelopes, stamps and a pen!
Loose-fitting clothes for your trip home.

A birthing bed is similar to a standard hospital bed (with all of the usual features such as electric controls to raise the head and foot of the bed). The foot of the bed is modified so that the matress can be removed and stirrups added to convert it into a delivery bed. This means that you won't need to be moved during your labor for the baby to be delivered.

The birthing chair is designed with stirrups and handles to be used in the delivery room. The bottom of the chair is open like a toilet seat, and can be electrically elevated by your doctor to aid in the delivery of the baby.

A prep may or may not be routine in your hospital. You should ask your doctor before on your hospital tour. If your hospital does prep, it involves shaving the pubic hair in the perineum (the area between the bottom of the vagina and the anus) where an episiotomy may be performed.

False labor, also known as Braxton-Hicks' contractions are mild irregular contractions of the uterus that may occur at any point during your pregnancy, although they are most common near term. Some women never experience false labor at all. While many women find that false labor pains are not really painful, they are annoying. Some women describe them like experiencing mild menstrual cramping, while others are aware of their uterus getting hard and their abdomen feeling tight. The contractions last for no longer than 30 seconds. The contractions are irregular and may occur once every hour or once every few minutes, lasting for several hours. Unlike true labor they are short and are not accompanied by an increased flow of mucus from the vagina. They will usually disappear if you get up and walk around or lie down on your side. If you are unsure whether you are experiencing false labor or true labor, call your doctor. Your doctor will help you discover what you are experiencing by monitoring your contractions and checking your cervix. You may find yourself calling your doctor several times before experiencing true labor, but don't feel embarrased because this is not uncommon.

Contractions during labor are regular and last from 45 to 90 seconds. They are accompanied by a mucus discharge from the vagina often mixed with blood (show) and sometimes by the leaking of amniotic fluid. While there is no set rule, true labor contractions usually appear at 15 - 20 minute intervals, are mild and last only 30 seconds. At some point the interval between contractions will shorten to about 5 minutes. This may happen after several hours (most like during a first pregnancy) or take place within 1 hour (common during subsequent pregnancies). Sometimes contractions will initiate with 5 minute intervals, and this is most likely if you experienced a short labor during a previous pregnancy.

Yes! Labor will not decrease the movements of the fetus, and you will still be able to feel your baby kicking and rolling inside the uterus. If for any reason you notice a decrease in the movement of your baby during labor, contact your doctor immediately.

Yes! There are a number of hormonal changes that occur during the onset of labor which may provoke diarrhea in some women. You may want to discuss the use of an enema with your doctor.

This is something you will need to work out with your doctor. You will certainly be asked to contact your doctor if you membranes have ruptured, even if labor has not yet started. If you are in labor, then you should consider calling your doctor when, after timing for 1 hour, your contractions last about 1 minute and are 5 minutes apart. Time from the beginning of one contraction to the beginning of the following one. Of course if you experienced labor that lasted less than four hours during a previous pregnancy, then you should contact your doctor when the contractions are 8 - 10 minutes apart. Don't eat once labor has started, and don't rush to the hospital. The safety of you and your baby is important and there's no point in rushing to the delivery room if you're going to end up in the emergency room instead.

The hospital will be prepared for your arrival because your doctor will already have notified them. Once you have arrived you will be taken to the labor and delivery room in a wheelchair. If you want to avoid filling out all those forms while you are in labor, it is a good idea to preregister. It is advisable to do so, because it can save a lot of frustration while in labor, especially if you have arrived in the middle of the night!

After being taken to your room in the labor and delivery area the nurse will give you a hospital gown to change in to, and ask you for a urine sample. This will be used to test for sugar (glucoseuria), protein (proteinuria) and ketones. The nurse will also put in place various external monitors so that your baby's heartbeat (and stress levels) as well as your contractions can be monitored. Your blood pressure, temperature and pulse will be recorded and you will also undergo a vaginal exam. Your doctor will then be informed about your condition and your presence.

You may have already discussed your labor and delivery with your doctor, or perhaps created a birth plan. Depending on your requirements and your needs your doctor may order various blood tests, intravenous fluids (glucose), medications, pain relief, an enema. The doctor may also restrict your movement. If you have any special requirements to create an environment or limit certain procedures discuss it with your doctor ahead of time and create a birth plan Consensus with your doctor will make your delivery experience the way you want it.

Hospitals try to make the labor and delivery rooms as comfortable as possible and work to remove any institutional setting. The end result is a room that ends up looking like a bedroom in a budget hotel. Although your labor room may contain two beds, you will almost certainly be the only occupant. There will be nightstands by the beds, along with telephones, intercoms and a television. There will be pictures on the wall, and in the corner you will probably find portable oxygen and a fetal monitor. There will be additional chairs for your guests. If you have arranged for additional features you may find a birthing pool, labor stool and other equipment you ordered. Visit the labor room when you take your hospital tour so that you can prepare to customize it for when you enter labor.

Your doctor's timing will depend on a number of factors. If you are a first time mother then your doctor most like will arrive just before you start pushing. If you have delivered before your doctor will visit after you have reached the active phase (the second part of the first stage) of labor. If your labor is progressing normally your doctor will arrive for the delivery of the baby and the placenta. If you arrive at the hospital during the night the the doctor most like will see you early the next morning, or after office hours if you arrived during the day.

When you are ready to deliver the baby you will be taken to the delivery room. The nurse will clean your vagina and perineum and your legs will be plaed in stirrups. The doctor will prepare for the delivery by dressing in gowns and gloves and placing sterile sheets over your abdomen and legs. If necessary and episiotomy may be performed at this stage. You may also request a mirror to be placed in such a way that you can watch the delivery of your baby.

Once the head of the baby is delivered your doctor will check to make sure that the umbilical cord is not looped or wrapped around your baby's neck. Your doctor will then place a bulb syringe (a device that looks like a turkey baster) into your baby's mouth and nostrils to clear any excess amniotic fluid and mucus.
With the next push comes the shoulders, rotating round as they pass through the birth canal one at a time, the rest of the baby passing through easily with another final push. Your doctor will probably check your baby's mouth and nostrils again for fluid and then will place your baby on your abdomen. This is a key bonding moment, so cuddle your baby. Hugs immediately after delivery also help stimulate oxytocin that will help your uterus contract after the delivery of the placenta.

A baby will usually start crying within a minute of being born. This helps the baby expand its lungs so that it can begin the process of breathing and adjusts the baby's circulation from that of a fetus to one of a newborn.

The Apgar score is a general test given 1 minute and 5 minutes after the birth of a child to determine its wellbeing. it uses the rating of five factors to judge the baby's ability to adjust to life outside of the uterus. It was developed by Dr. Virginia Apgar, an obstetric anesthesiologist, in 1958. The test consists of measuring the baby's heart rate, respiratory effor, muscle tone, reflex action and color and is scored from a low value of 0 to a high value of 2 which are then added. A perfect score is 10, although this is rarely achieved, with most newborns rating a score between 7 and 9. A score of below 5 at five minutes may indicate and increased risk of neurological problems later in life. The score is given as two numbers: a score of 9/10 would indicate a score of 9 at 1 minute and 10 at 5 minutes.
If you have had a vaginal delivery the score is assigned by the nurse present. If you have had a cesarean section the score will be assigned by your pediatrician.

	0	1	2
Heart Rate	Absent	Slow (< 100)	Above 100
Respiratory Effort	Absent	Slow, irregular	Good, crying
Muscle Tone	Limp extremities	Some flexion or motion	Active
Reflex response (tube in nostril)	None	Grimace	Cough or sneeze
Color	Blue or pale	Body pink	All pink

One minute after delivery of the baby, the nurse will assign the first of two Apgar score tests (the second takes place five minutes after delivery). The nurse will also take footprints of the baby which are placed on the birth certificate along with your fingerprints.
A hospital identification bracelet will be placed around the baby's ankle and wrist (which matches the one on placed around your wrist). The baby will then be administered an injection of Vitamin K and antibiotic ointment will be placed in the baby's eyes.

Babies are born with an insufficient supply of vitamin K which is necessary for blood clotting.

It is required by law in most states within the United States to administer antibiotic ointment to the eyes of newborn babies. It is used to prevent an eye infection from gonorrhea or chlamydia transmitted from the mother. The antibiotic is either erythromycin or tetracycline ointment which are designed not to be irritating to the baby's eyes.

You can breastfeed your baby immediately after delivery, although most babies are usually not hungry until 20 minutes later, prefering instead to get warm and start breathing!

Dr. Frederick Leboyer, a French obstetrician, developed a method of delivery which he felt minimized the trauma of birth. It includes a quiet environment with dim lighting and placing the baby on its belly after delivery. Once the pulsations in the umbilical cord have stopped, the cord is clamped and cut and the baby is bathed in a warm bath to help it acclimatize in its new environment. Many parents like the Leboyer Method, not only for its gentle birthing procedures but also because it allows the partner to bathe the baby after the delivery helping to create a father-child bond.

After the birth of the baby you may be moved to the recovery room where you will stay for about 1 hour. Nurses will check your blood pressure and pulse and massage the fundus to ensure proper contraction of the uterus as well as monitoring the flow of blood. It is common for hospitals to allow your partner and baby to accompany you to the recovery room, and if you are hungry you will be able to eat.

Back labor are labor pains that are mostly felt through the lower back. Where the pain is felt, and the intensity with which it is experienced is mostly dependent on the individual mother and her nervous system.

No evidence exists to prove that labor is more likely to occur during a full moon.

Studies show that the percentage of babies born during each hour of the day remains about the same.

Meconium is the waste matter passed by the fetus in utero or newborn. Varying in color from yellow to dark green, its shade depends on the level of amniotic fluid present and can either be watery or like pea soup in consistency.
The fetus passes meconium as a response to the compression of the umbilical cord while in the uterus or a reduction in the supply of oxygen. As the fetus matures it simply represents the normal bodily function of the growing fetus.
Meconium is present in the amniotic fluid of about 20% of all babies at term, and up to 40% by Week 42.

The presence of meconium in the amniotic fluid is not necessarily indicative of fetal distress. If meconium is present in the amniotic fluid your doctor will test to make sure that the fetus is not in distress. Your doctor will also check to confirm whether the baby is in a breech presentation, a condition which is often indicated by the presence of meconium in the amniotic fluid. If there are signs of distress the baby may score lower on the Apgar scale and be depressed at birth.

If there is meconium present in the amniotic fluid your doctor will use internal fetal monitors to monitor the stress of the baby during labor. The monitors are used to measure the heart beat of the fetus during and between contractions.
If necessary a procedure called amnioinfusion can be used to flush out excess meconium. After the head has been delivered the doctor will use a bulb syringe to remove meconium from the nose and mouth of the baby. Thick meconium may require the baby to be placed in a warmer while the doctor examines the vocal cords with a larygoscope and removes any remaining fluid from the trachea with a bulb syringe in order to prevent meconium aspiration syndrome.

Meconium aspiration syndrome is caused by meconium entering the lungs resulting in inflamation and breathig problems. If there are signs of excess quantities of meconium present as the baby is being delivered the doctor will place the newborn in a warmer while examining the vocal cords and trachea with a larygoscope and removing the excess with a bulb syringe. Most cases of meconium aspiration syndrom occur before the baby is born.