We have reviewed the 3 Stages of Labor and what to expect during each stage. We have also learned about breathing, relaxation, and distraction. Do you remember when is generally the best time to go to the hospital? 511, that's right! Look back in the manual or at your Contraction Timing Chart for reminders on when you should call your provider or go to the hospital prior to 511.
In this unit, we will learn about the "What's" of the hospital. That is, What to bring, What your hospital has to offer, and What to expect when you get there.
Turn to page 30 in the manual. Read the right hand column and take a look at the yellow box. (READ).
You should preregister at the hospital now, before you are in labor. They will collect your insurance info, copy your ID, and get you in the system. This will make going to the hospital easier for you if you don't have to stop at registration. Both American Fork and Timpanogos Hospital would like you to pre-register. At pre-registration, Timpanogos staff will show you the Labor Rooms and the Mother/Baby rooms if they have open rooms, if their rooms are full they also have a video you can watch. American Fork doesn't allow for tours for security reasons at Intermoutain facilities, but they do have a virtual tour.
Timpanogos has birthing balls available. Room 7 has a large jetted tube. The beds have squat bars that can be added to the bed if you desire. They have private labor and mother baby rooms. All rooms have rocking chairs. There is a TV in every room with cable. They also have a portable monitor available, where you can walk the halls with your monitors in place, cord free. American Fork also has private rooms, birthing balls, TVs in each room, and a squat bar that you can add to the bed. AF has tubs in every room. AF also has portable monitoring and TV in every room. Hospitals in the area have "birth balls" and peanut balls available for use in labor. There is also free wireless internet access available.
As far as what to expect, most hospital are similar in their admission process. If you are going in at 511/ if you are going because you are in labor and are 37 weeks or more, this is what you can expect.
The nurse will have you change into a gown and you will have painless and non invasive monitors placed on your belly. These monitors record your baby's heart beat and your uterine activity/contractions. The nurse will also check the dilation and effacement of your cervix shortly after you arrive. As the monitors are recording data, the nurse will ask you questions and document them in her computer. She will ask you questions about your current pregnancy, your past medical history, also your birth preferences, and other questions as well.
The monitors' recorded data is very telling of how your baby is feeling. If your baby's heart beat tracing is reassuring, you will be allowed to come off the monitors and walk the halls or continue with the movement or rituals you may have been using prior to coming in to the hospital. Once an hour has passed, the nurse will check your cervix again. If your cervix has made change in an hour's time, you will likely be admitted. I like to say you are a "keeper".
Once you are a keeper, you will have blood work done, sign consents and other paperwork, and an IV started. If you are Group B strep positive (this will be tested at 36 weeks in the office), they will start your IV antibiotic. You may decide that you would like to just have a saline lock in place instead of continuous IV fluids.
Let's go to the manual. Turn to page 43. Read the entire page and yellow box. (READ) Also, watch the video from chapter 5, entitled, Fetal Monitoring.(WATCH). (When you and your baby are being monitored, a nurse may be in and out adjusting the monitors so that the heart rate tracing and your contractions are showing on the computer screen. This is not uncommon to need readjustments. The baby moves and so do you, as a result the monitor sometimes doesn't get a good reading.)
Let's go to the manual. Turn to page 43. Read the entire page and yellow box. (READ) Also, watch the video from chapter 5, entitled, Fetal Monitoring.(WATCH). (When you and your baby are being monitored, a nurse may be in and out adjusting the monitors so that the heart rate tracing and your contractions are showing on the computer screen. This is not uncommon to need readjustments. The baby moves and so do you, as a result the monitor sometimes doesn't get a good reading.)
After all the paperwork and admission actives are complete, you are there until your baby is born. About 1-2 hours after your baby is born, you will be moved to your mother/baby room for the rest of your hospital stay. For a vaginal birth you will likely stay 24-48 hours after birth, for a c-section, you usually stay about 72 hours after birth.
If you are admitted and your labor progress stalls after a time, you have some options to help your labor progress. You may have guessed...use gravity and move your pelvis! Getting your baby in a more optimal position may help your labor to progress. You might consider trying nipple stimulation, this may cause a hormone to release that may promote contractions. If your efforts don't seem to help and a designated time has passed, the Health Care provider may want to help move things along by suggesting to break your bag of waters, called an amniotomy (see the last row in the table on page 42). This commonly will help labor to progress. If time has passed, and your cervix is still not making significant change, then the doctor may suggest you receive Pitocin through your IV to strengthen contractions (also on page 42). Let's watch the Augmentation video. (WATCH)
If your admission is planned, you are likely there for an induction (or a c-section). The admission process is about the same, except you will be a "keeper" right away. There is not the 1 hour wait-and-see period. If you are there for an induction, they will begin your medication to induce labor. Please turn to the left hand column on page 41 and read. Also see the yellow box on page 42. Note that the most common form of induction is cervical ripening for an unfavorable cervix and Pitocin administration through an IV.(READ) Please watch the Induction video from chapter 5.(WATCH)
In regards to the stripping membranes, this is something usually offered in the clinic once you are full term, and while it can start contractions, it is the least reliable method of inducing labor.
Your assignment for Unit 5
1. Practice moving your pelvis and using gravity. See Unit 3 on Labor positions for a refresher.
2. What are 5 comfort items that you plan to take to the hospital (you may have more!)?
3. If you need a medical induction, do you need continuous monitoring of your baby and your contractions?
4. Questions are always welcome. Email me when you have completed Unit 5!
