Labor and Delivery

IT’S TIME!

The moment you have anxiously awaited for has finally arrived! The staff of the Women & Children’s Unit and your physician is thrilled to share in your birthing experience. We will do everything possible to make this a memorable event for you and your family.

Advance preparation will help you remain calm, so be sure to have your hospital bag packed and ready to go. Have a list of prepared support people and their phone numbers so it is easy to contact them when the time arrives. (Cell phones are prohibited in the hospital).

ADMISSION TO THE WOMEN & CHILDREN’S UNIT

Upon arrival to the hospital, enter the main hospital entrance and go directly to the desk. The receptionist will direct you to the admissions office. If you have pre-registered, all your information will already be in the computer. You will sign consent for admission at this time and one for your new baby. If it is in the middle of the night, the front door to the hospital will be locked. You will need to enter the emergency room entrance at the back of the hospital. The same admission procedure will take place irregardless of day or night. You will be escorted to the Women’s Unit in a wheelchair. You will be taken to the triage room for examination. Your nurse will take your vital signs; hook you up to the fetal monitor to check the baby’s heart rate and your uterine contractions. The nurse will also check the status of your cervical dilation. All this information will be reported to your doctor and he will detail any specific instructions to the Women’s Unit staff. Once you are admitted, you will be moved from the triage room to the LDR (labor, delivery and recovery room). Any admission forms or consents that were not completed prior to admission will be completed now. Depending on your labor progress, an IV will be started-unless your doctor specifies otherwise.

VISITING GUIDELINES DURING LABOR

You may find labor less stressful with the comfort and encouragement of friends and family. Depending on your stage of labor and your comfort level, visitors may be asked to wait in the waiting room. You are allowed 3 visitors for the actual delivery. Determine who you want present for the birth of your baby and share this with the Women’s Unit staff upon admission. This will eliminate hard feelings and confusion at the time of the delivery of the baby.
Other visitors and family may make short visits during your labor, but they must remain in your room or in the waiting room (not in hallways, please). If you need help limiting your visitors, please ask your nurse for assistance.

CAMERAS/VIDEOTAPING

Remember to bring your camera! Pictures of the new baby are essential. If you forget your camera, don’t fret, the Women’s Unit will provide you with one. It is our gift to you. Video cameras can be used but videotaping of procedures is prohibited. The best place to position the video camera is at the head of the bed to get a picture of the baby as the doctor places the baby on mom’s abdomen. Tripods are not allowed as they can be a safety hazard. Video taping in the c/section room is of the infant in the radiant warmer, only.

SCHEDULED CESAREAN SECTIONS

If your doctor plans to deliver your baby by Cesarean section, he or she will notify you of a date and time to come to the Women & Children’s Unit. Upon admission, your nurse will explain what to expect before, during and after your surgery. The operating room for Cesarean sections is located in the Women & Children’s Unit. Your nurse will remain with you during the entire procedure. The admission process requires a health assessment, a visit from the anesthesia department and the completion of admission forms and consents. After the surgery you will be recovered with your infant in the LDR. The first hour after the surgery is considered the ‘recovery hour’ and we will limit your visitors to just the father of the baby during this hour. Once the recovery period is over, you will be transferred to post partum where you will be allowed visitors. Please feel free to ask questions or express any concerns you may have regarding the surgery or the recovery period.

THE LABORING PROCESS

We’ve seen many families through the birthing experience. Our nurses are a valuable resource and may offer suggestions to make your labor more comfortable, such as relaxation exercises or various positions.

As labor progresses, your body changes in many ways. Your doctor and nurse will be carefully observing the following signals:
Fetal heart rate-Though there are temporary variations, normal fetal heart rate is 120-160 beats per minute.
Uterine contractions-When your uterus contracts regularly, it gradually opens the cervix allowing the baby to be delivered. Your nurse will want to know the duration, intensity and frequency of these uterine contractions.
The cervix-Your cervix must dilate or open to 10 centimeters before your baby can be delivered. Your doctor and nurse will also check the effacement (thinning) of the cervix. The baby’s station or position of descent in the birth canal will also be evaluated.
Rupture of membranes-The sac of fluid, which protects the baby, must be broken before delivery. Your water may break on its own, or be broken by your doctor. The status of the membranes can be checked easily with a litmus-type paper called nitrazine.
Show-This is a normal vaginal discharge containing mucus and a small amount of blood, which usually increases during labor.
Urge to push-When your cervix is fully dilated, you will feel the urge to push, which helps the baby pass through the birth canal.

PAIN MANAGEMENT

Every labor is unique, and every woman experiences pain in a different way. We are concerned about your comfort while in labor. Pain management options are discussed in detail in pre-pared childbirth classes. When appropriate, epidural anesthesia will be administered by experienced anesthesia providers. The Certified Nurse Anesthetist will be called in on “consult” to discuss your pain management options. At that time, a plan for pain relief will be discussed along with risks, benefits and alternatives. Please feel free to discuss your plans for pain management with your doctor, nurse or anesthesia provider.

CIRCUMCISION

Circumcision is the surgical removal of foreskin that covers the head of the penis. The American Academy of Pediatrics reports newborn circumcision has risks and benefits. Your physician/and or hospital have no desire to influence your decision regarding circumcision. If you have questions, consult your pediatrician or physician. The medical facts may not be as important to you as family, religious or cultural beliefs. For instance, circumcision may be done as a family tradition to avoid the emotional distress of being different, or as part of a religious rite in some faiths.

CARING FOR YOUR BABY

Neonatal Screening Test The PKU (phenylketonuria) test is administered to all newborns to test for a rare form of metabolic disorder which can be corrected by diet alone. It also tests for other rare metabolic disorders. By state law, your baby will receive a neonatal screening test prior to discharge. This test is free and the results of the test will be sent to your baby’s doctor. There are times when the test has to be repeated. The hospital lab or your baby’s doctor will notify you if this occurs.

Eye Prophylaxis Ointment During delivery, infants may be exposed to a number of organisms that could cause eye infection in the eye or more serious problems. To reduce this possibility, The American Academy of Pediatrics recommends one application of antibiotic ointment to the eyes within one hour of birth. This is routinely given to all infants.

Hepatitis B Vaccine The nurse will ask you during the admission process if you want your baby to receive the first hepatitis B vaccination. She will also provide you with written information regarding the vaccine. Discuss any questions regarding hepatitis B vaccine with your nurse. The vaccine is routinely administered shortly after delivery. Unless you specify that you do not want the vaccine, the infant will be vaccinated.

Vitamin K Deficiency Infants are born with inadequate stores of vitamin K. This deficiency can put your baby at risk for bleeding excessively. To prevent the possibility of hemorrhage, infants are routinely given one injection of vitamin K immediately after birth.

Cord Care Your baby’s umbilical cord will be clamped with a yellow cord clamp. The cord is damp and soft the first day of birth. With every diaper change wipe the cord with alcohol. This will hasten the hardening and drying process so that the cord will fall off in a timely manner. The yellow cord clamp will be removed once the cord starts hardening and drying. The cord will turn black in color as it dries. With diligent care, the cord should fall off within one to two weeks after delivery. The baby should be sponge bathed until the cord falls off. Do not immerse the infant in a tub bath until the cord falls off. Tub bathing keeps the cord wet, delaying the drying process. The cord could also become infected if left too wet. Notify your baby’s doctor if you notice drainage or a foul smell from the umbilical cord. Fold the infant’s clothes and diapers away from the cord to facilitate drying.

Bulb Syringe Remember that babies normally breathe through their noses for the first few weeks of life. You will want to keep a bulb syringe with your baby, even at home. The bulb is used to clear mucus or milk away from your baby’s mouth or nose. To use it to clear the mouth, turn the baby to the side and deflate the bulb away from the baby’s face. Then place the syringe into the back corner of the baby’s mouth and release as you sweep forward into the mouth. Clear the bulb into a cloth and repeat the procedure if necessary. To clean the bulb syringe, wash in hot soapy water, and then boil 10 minutes in water. Ask your nurse to demonstrate the proper use of the bulb syringe. If the bulb falls on the floor, ask your nurse for a new bulb or wash the bulb as above.

Fingernails Your baby’s fingernails and skin are not completely separated after birth. For your baby’s safety, do not try to cut your baby’s nails for 2 weeks. Use mittens or socks on your baby’s hands to prevent scratching of his or her face.

First Check-Up Appointments:
Do not forget to make arrangements with a baby doctor prior to delivering. Ask friends and family who they use. Call the doctor’s office and complete the necessary paperwork or meet just to get acquainted with the doctor. After delivery, the staff of the Women’s Unit will schedule your first appointment. If problems occur sooner, call your physician, the Women’s unit, or go to the nearest emergency room.

Prevention of Infection Always wash your hands thoroughly before feeding or handling your baby. Ask friends and family to do the same.

Rooming In We strongly encourage rooming-in with your baby to promote the bonding process. Bonding is the early attachment which takes place between parents and infant within the first few hours and days after birth. It can be enhanced and reinforced by physical contact from both parents. The nurse taking care of mom will also be taking care of baby. Everything can be done for your baby at your bedside. This way, not only will you learn how to care for your baby, but also how to listen to him or her and learn how unique babies are. The only time your baby will need to go to the nursery is for the pediatrician to examine him or her, or for any test the pediatrician may order. Rooming-in is not mandatory however, and if you need time to rest, let your nurse take the infant to the nursery.

Our goal is to provide you and your family quality care in a supportive, nurturing environment that promotes the health, safety and welfare of your family.

Thank you for choosing the Women & Children’s Unit at Angel Medical Center.