Routines & Choices - Arriving in Labor at the Hospital

all fours.JPGIt's likely a day you have imagined -- and reimagined -- a hundred times over. The day you discover you are in labor and decide to head to the hospital (or birth center). It can feel exciting, nerve-wracking, or like hard work if you are far along in labor. When you arrive, there are specific routines most birth places follow, as well as choices you have during the admission process. It helps to be aware of these things in advance of the big day. 

Parking & Entrance

If you arrive in labor during the overnight hours, your hospital may require you to enter through a different entrance, separate from “Labor and Delivery.” You can learn about this during a hospital tour. Most hospitals also have a drop-off location, where you can temporarily park in front of the doors and enter directly without a long walk.

Wheelchair Ride

Sometimes, when arriving in labor, you may be encouraged or even required to be escorted to Labor & Delivery by wheelchair, due to hospital policy. For some, this may not be an issue. For others, especially those further along in labor, sitting in a chair may not feel comfortable and increase the sensation of pain in labor. You can request to walk yourself, or you can ask to stop and get out of the chair during a contraction. 

Waiting for a Room

Many hospitals have what is referred to as “triage,” a temporary room in which you are assessed to determine if you should be admitted to stay. Depending on where you are in labor, you may go directly to a room without triage, or if your hospital is particularly full when you go into labor, you may stay longer in triage. Triage usually will involve monitoring (see below) and a cervical check. You have the right to decline a cervical check, as it is not a reliable indicator of where you are in labor, can feel uncomfortable, and can increase risk of infection. 

Monitoring

Upon arriving into a hospital room (whether triage or a labor and delivery room), one of the first procedures nurses perform is electronic fetal monitoring (EFM), typically for 20 minutes. This monitoring strip will record baby's heart rate and the frequency and duration of your contractions. Being monitored does require you to be attached to a machine, but it does not mean you have to lie on your back in bed (a position that is generally very uncomfortable in labor). Ask your nurse, your partner, or your doula to help you get into a comfortable position, like sitting on a ball or on the side of the bed, standing and leaning, or on all fours in the bed, and then remain in that position for the time needed on the monitor. You can also ask if your hospital has a wireless, or “telemetry,” monitoring unit, which will allow you to move more freely while being monitored. Ask your partner or doula to keep track of time on the monitor, so that you can ask to come off (sometimes nurses are busy with other families and you can end up being on the monitor for longer than the required time) and be more free to move around.

Paperwork

Even if you registered in advance of your arrival and even if you are in the throes of labor, you will still be required to sign multiple forms upon being admitted into the hospital. Usually this takes place upon being admitted to your labor room. Nurses often are sensitive to giving you space during a contraction, but will likely ask you questions and give directions for signing in between contractions. 

Once Admitted

When you reach your final destination -- your labor room -- you may need to be monitored again (depending on how long it was since the first time), or you may be fine to go about laboring. While a hospital will provide a standard gown, you also are free to wear your own clothes (something easy to move around in and easy to provide monitor access is ideal). You also will be asked to give a blood sample upon being admitted. Most hospitals also require a IV access, which involves inserting a heplock/IV port into your hand or arm. If you have a preference of location for the IV access, please let your nurse know. Also, for most births, routine IV fluids are not necessary. 

Make Yourself at Home

Once all of the admission procedures are complete, you can get settled in. If you've never stayed in a hospital room before, it can feel unfamiliar. You or your partner can unpack the things you'll need, set up your music, and find out where extra linens, pillows, and vomit basins/bags are kept. Be sure to also find out the location of the nearest water and ice station. It helps to adjust/lower the lights and keep the door closed to maintain a more private and relaxing environment. 

 

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