Depending upon the circumstances you will be taken to a triage area (to assess your labor) or right to a birthing room, where you will spend the rest of your labor, delivery and postpartum period.
After you get to the room you will be asked to put on a hospital gown and leave a urine sample. Your nurse will then get you in bed and place you on the fetal monitor. This will assess how baby is tolerating labor as well as tell us how often uterine contractions are occurring (more to come on this on the next page). Your nurse will then perform a head to toe assessment that includes vital signs – your temperature and blood pressure. The nurse will review your current symptoms, (contractions started when, how far apart, did your water break?) as well as go through admission questions with you. An internal exam will be done at this time to check dilation and the progress of your labor. This will be done several times while you are in labor. You will be able to “get off” the monitor while in labor once it is known that baby is tolerating labor. You can then rest, walk the halls, shower, rock in the rocking chair, take a tub bath, or whatever else you would like to do to cope with your labor pains. Typically the only rule is that you do not leave the labor and delivery unit. You will need to go back on the monitor hourly, to assess baby and check on status of contractions, and be monitored for approximately 15-20 minutes.
If the bag of water that surrounds the baby has not broken and the fluid has not leaked out, your physician may painlessly break the bag and allow the fluid to leak out so your labor can progress.
When your cervix has dilated all the way (10 cm) it is often time
to push. If an episiotomy is needed (a surgical cut to make the vaginal opening larger), it may be done at this time. Now you will help push the baby out. Your nurse will review with you and your partner the technique of pushing. When the baby is out, the cord is cut and baby is placed on your belly, where they are wiped off and wrapped in a blanket. Eventually the nurse will take the baby to the warmer at your bedside and perform an assessment that includes height, weight, vital signs, security sensor placement and footprints.
Finally the placenta comes out. Often, when directed by a physician, a little pushing by you will help get it out. If an episiotomy was made or you suffered a tear, it will be sewn at this time.
If you had a cesarean section, you will be taken to a recovery room to rest and be watched for several hours. Often times your baby will come to the recovery room with you and a nurse will provide cares for them while you are resting.
Many factors influence the length of labors. Most of the time is spent waiting for the gradual opening and enlargement of the cervix. Your first baby usually takes the longest, and the total time often gets shorter with each later pregnancy.