Now, I’m not going to get into emergent situations in this post. Unfortunately, those can depend on what is medically occurring with yourself and/or the baby (babies), and hospital policies affect how the situation will be handled. In this post, you’ll find step by step guide to giving birth: what happens at the hospital when you deliver-the cut and dry version.
First, I’d highly suggest that you schedule a maternity tour with the hospital around the beginning of the third trimester. I say this early, because you never know what week you’ll go into labor, and it’s best to know which door to enter, and to have any questions answered ahead of time! Also, if your hospital allows you to ‘pre-register’, aka give your insurance, billing, and emergency contact information ahead of time, then do that, as well!
Going into labor
If you are planning to be induced, you’ll be scheduled to arrive at the hospital on a certain date, and at a certain time- please skip to arriving at the hospital.
Natural labor is unique to each woman, and each pregnancy. What you experience may not be what your friends, sisters or mother experienced. I know that can be absolutely petrifying, but there are general signs of labor.
Signs labor will occur within the next few weeks or days:
-Losing mucus plug
Signs you are in active labor:
-Painful, consistent & frequent contractions (that don’t slow or stop when sitting, lying down or with fluids)
-Water breaking (Gush or leak)
-Nausea, vomiting and/or loose stools
-Rhythmic back pain
*I can tell you from my personal experience with the twins, I had swelling (couldn’t put my shoes on), lost my mucus plug, and had some leaking earlier in the week. The day of going into active labor, I had painful, consistent and frequent contractions that took my breath away, loose stools and back pain that occurred in succession with my contractions.
Once you start having contractions, I would time them, and call your OB. They will ask you about symptoms, duration and frequency of contractions. If they deem that you may be in labor, they’ll ask you to come into the hospital (bags packed!).
Arriving at the hospital
So, you called the doctor, and they told you that you should come in. When you get to the hospital, utilize valet services, if your hospital has it! If they don’t, some hospitals allow you to park by the entrance for an allotted time, without towing. If this is an option, don’t worry about finding a parking spot, but be sure to gather parking information prior to heading to the hospital. When you arrive, don’t go to the emergency room, unless it is hospital policy. Instead, many hospitals tell you to go to labor and delivery.
When you get to labor and delivery, you’ll get ‘checked-in’. This is where they collect insurance information, collect your photo ID, give you your hospital band, and have you sign paperwork.
Depending on the hospital policy and business, you may check-in in a triage room, or you may be moved to a triage room post check-in.
At triage, a few things go on:
-A urine sample is collected and you may/may not change into hospital gown.
-You vitals are taken.
-A contraction and fetal monitor is placed (Similar to an NST)
-Abdominal and/or vaginal exam (to check dilation and effacement)
After triage has been completed, it is determined whether or not you are in active labor. If you are in active labor, you are admitted and taken to your delivery room, once available. Typical guidelines for admission is being at least 3 cm, combined with regular contractions.
In your delivery room
You’ve been admitted! In your delivery room, you’ll have a hospital bed, a fold out couch (or cot), and some hospitals even have a jacuzzi in their rooms. If you haven’t already, you’ll change into a hospital gown. At this time, you’ll be assigned a labor and delivery nurse. This nurse may or may not be your nurse for the time you are delivering. If you are still in labor around shift change, you’ll be assigned a new nurse for that shift.
Once you are settled in your room, you can start making decisions regarding your treatment during labor. If you would like to attempt a medication free delivery or you want wait to get an epidural, you may be allowed to walk around the labor and delivery floor to help with pain management. If allowed, you may also get in the tub or take a shower. Keep in mind that if you plan on waiting to get an epidural, it does take time for the anesthesiologist to get to your room, prep and administer the medication. From personal experience, mine took an hour. It could take more or less time, so if you have progressed far, are in a lot of pain or feeling a lot of pressure, keep that in mind.
If you do decide you want to get an epidural, there are a few things that happen. The anesthesiologist will have you lean over or roll on your side, and clean your back. They will then administer a local anesthesia (numbing agent- think like an injection at the dentist), in your lower to mid back. Once the area is numb, the anesthesiologist will insert a needle into the epidural space of your spine. The needle is removed and a catheter is placed. The tube is taped to your back, so you can move around. The tube gives you a continuous drip, so that you stay numb.
Since you are numb from the waist down, you’ll more than likely receive a urinary catheter to drain your bladder. You’ll also be hooked up to an IV, so that you don’t have a drop in blood pressure or get too dehydrated. You’ll be hanging out in bed at this point, with monitors attached to your belly to record contractions and baby.
Ps. there is such thing as a ‘walking epidural’, but not all hospitals offer it.
Labor progression may take a while or it may go quickly- every birth is different. Every now and then, you’ll be checked on. This may include checking your cervix to see how dilated you are. Once you get to the second stage of labor, which means you are 10 cm, you can start pushing.
Without being told by a nurse or doctor, you’ll know when you need to push. Even with an epidural, you can feel pressure, whether in your rectum, back or vagina. This pressure or sensation is similar as a bowel movement, and needing to ‘go or push’. The position you decide to push is whatever you feel most comfortable in (on your back, side, on all fours, etc.).
When it comes to pushing, here are some tips:
– Push as if you are having a bowel movement
-Trust your instincts
-Rest between contractions
-Breath, hold, and then count to 10 while pushing
Pushing can take anywhere from minutes to hours. You may or may not tear, as well.
The baby has arrived!! But, you’re not done just yet. After your baby arrives, you decide when to cut the umbilical cord. You can cut minutes after birth, or postpone cutting. With whatever you decide, you may still have to push out the placenta. Occasionally, the placenta is moved through with contractions and pushing the baby, but in other cases it may not. If you do have to deliver the placenta, it is the same concept as delivering the baby. The doctor or nurses may help the placenta come out by pushing on your stomach and uterus, as well.
After the placental delivery, if you had any tears, the doctor will stitch the area. You can hold your baby, as long as there are no issues. You may stay in your delivery room for a while to ensure that you and baby aren’t having an issues.
*please skip down to recovery, if you don’t anticipate a c-section*
Prepping at home
You are given a set of instructions regarding c-section prep. These instructions include when you need to stop eating or drinking, to shower prior to leaving for the hospital, and whether or not to take certain medications. You do not need to shave, unless it is suggested by a nurse or doctor.
Prep at the hospital
Like a vaginal birth, you are checked into the hospital, and you’ll change into a gown. Unlike a vaginal birth, you’ll be delivering in an operating room. To get you prepped, you will receive your anesthetic. You may also get pain medication, as well. Receiving the medications may happen in the operating room or in another room, depending on hospital policy.
To start your procedure, you’ll have medication on a constant drip, and you’ll have a catheter placed. Your pubic hair may be shaved, if it wasn’t already. A screen will be placed, so that you are unable to see the bottom half of your body, blocking the view of the operation. A horizontal incision is made along your bikini line, which goes down to the womb.
The baby has arrived! The baby is lifted out, along with the placenta. The umbilical cord is cut, and and your incision is stitched up. You may feel groggy, but if permitted, you can hold your baby immediately after delivery.
If you are having a vaginal birth, the typical postpartum stay is only about 2 days. After delivery, you are moved into a recovery room (postpartum room). The recovery room may be a little smaller than the birth suite you delivered in, depending on the hospital you deliver at. Many hospitals now have converted to rooming-in, which means your baby is in your room at all times. This means they sleeps in a bassinet at your bedside, rather than staying in the nursery, however if you do need to send your baby to the nursery to get some rest, you can.
You may shower anytime following birth, given that you are able to walk and stand upright (it is best to have a nurse assist you- don’t worry, they’ve seen everything). Throughout the day and night, your vitals will be checked. Periodically, you’ll receive the ‘postpartum massage’, which consists of a nurse pressing on your uterus to ensure it contracts back to its normal size.
After a c-section, you are looking at staying in a recover room for about 3-4 days. C-section patients receive the same type of recovery room as someone who had a vaginal birth. You’ll be expected to room in with your baby. You’ll get the postpartum massage, with a nurse pressing on your uterus, as well as vitals. Unlike a vaginal delivery, you’ll be expected to get up and walk around to get the bowels moving. You’ll also have your bandages changed on your incision.
Prior to being discharged from the hospital, your baby will have a screening completed. This ensures the baby is ready to leave, which includes hearing test, heel-stick blood test, and a general screening. The baby may be assessed to determine if feeding is going well (a lactation consultant will help with breastfeeding, if you chose to breastfeed). You’ll receive a screening for postpartum depression, as well as be checked to make sure your uterus is contracting back to normal and bleeding has slowed. Before you leave, you will sign the birth certificate, and other discharge paperwork. You are given a care package, which usually includes formula, diapers, wipes, a perinatal bottle (vaginal delivery), pads/disposable mesh undies (adult diapers), pain medication, and numbing spray.
Here are some items that you may need during your hospital stay or to help with postpartum recovery: