The ABCs of Hospital Delivery
The hospital delivery process starts long before labor pains begin. Here’s what to expect.
Admissions. At around 32 weeks gestation, schedule a pre-admission appointment to complete most of your paperwork before labor, like the birth certificate and other forms.
“At that time, we do all of the pre-admit work like consents you’ll sign when you come to have the baby,” says Clara Davis, RN, pre-admission coordinator, Olathe Medical Center.
Birth plan. Do you want an epidural or prefer natural childbirth? A birth plan communicates your desires for your labor and delivery experience. If you have a plan, bring it with you to the pre-admission appointment and to delivery.
Circumcision. At hospitals, circumcisions are usually performed within 48 hours of delivery. Talk to your doctor about the procedure’s benefits and risks. Your pre-admission coordinator will have the paperwork you need to complete when you’re ready.
Delivering physician. Many doctors check in on their patients first thing in the morning and midday. “We page the delivering physician as soon as we think it’s time. If a baby is having heart rate issues, we can always page them to come evaluate,” says Jenna O’Connor, RN, Olathe Medical Center.
Epidural. An epidural is a pain-relieving local anesthetic administered by an anesthesiologist that numbs pain in the lower half of the body.
“Allow 45 minutes from the time you ask for your epidural to getting it,” O’Connor says. “We like to give IV fluids prior to that at a faster rate to help prevent blood pressure from dropping from the anesthesia.”
Fetal heart monitor. Health care practitioners will either periodically monitor your baby’s heartbeat during labor, or you will be hooked up to an electronic fetal heart monitor, especially if you are on medication to be induced.
Get ready. Pack your bag between 32 and 35 weeks of pregnancy. Bring toiletries and comfortable clothes, including warm socks and slip-on shoes. You’ll also need a take-home outfit for your baby and a car seat.
Hepatitis B. The American Academy of Pediatrics recommends all healthy newborns receive their first dose of hepatitis B vaccine within 24 hours of delivery. Hepatitis B is a potentially fatal viral infection that attacks the liver.
Induction. Prior to an induction, your provider will examine your cervix and decide whether you should go into the hospital the day of the scheduled induction or the night before. If you go in the night before, you might receive a medication or a balloon catheter that thins or softens the cervix. When your cervix is ready, you’ll be given a medication called Pitocin to induce contractions.
Jacuzzi tubs. Many hospitals offer laboring moms full-size jacuzzi tubs for pain relief early in the delivery process. Check with your doctor to see whether this an option for you.
Vitamin K. All babies are born vitamin K deficient. Upon birth, your baby will receive a vitamin K shot, which is essential to aid the body in forming clots to prevent severe and potentially life-threatening bleeding.
Lactation consultant. Breastfeeding specialists visit new moms in the hospital to address any initial questions or concerns around breastfeeding.
Marking the moment. During pre-admission, you’ll have the opportunity to decide whether you want your newborn photographed. “But, you’re not obligated to buy anything,” Davis says.
NICU. Premature infants, multiples and sick or low birth-weight babies are usually transferred to a Neonatal Intensive Care Unit, which provides specialized care.
Overnight stays. The typical hospital stay for a vaginal delivery is 24 to 48 hours, while a C-section is between three and four days.
Pediatrician. The hospital will notify your baby’s physician when you’re admitted. He or she will provide a physical examination of your infant within 24 hours postpartum.
Questions. Since questions often arise throughout pregnancy, maternity navigator and experienced labor and delivery nurse Danae Young, RN, Overland Park Regional Medical Center, tries to be as accessible as possible to expectant parents. She and her colleague Lisa Holk, RN, work one-on-one with expectant parents according to their specific birth plan.
“We give them our phone numbers, which we’ve allowed texting on,” Young says. “That’s been a game changer. If they want to text us, ‘Hey, what should I pack again?’ we can respond pretty quickly to them.”
Risks? Because hospitals are prepared for complications that can arise during labor and delivery, they remain the safest place to deliver babies, especially for those considered high-risk. High-risk pregnancies include women who are expecting multiples, are under the age of 17 or over the age of 35, or have a health condition like diabetes, high blood pressure or depression.
Surgery. A cesarean section requires an incision through the abdomen and uterus. You’ll receive an epidural and will likely be awake for the procedure. Upon arrival for a planned C-section, you’ll be hooked up to a monitor and an IV, and receive a physical assessment and bloodwork
Tours reduce Uncertainty. Scheduling a firsthand look of a hospital’s birthing center early in your pregnancy can familiarize you and your partner ahead of time with the hospital layout, parking and available classes and amenities. Some expectant parents tour as early as six to 12 weeks gestation.
“By meeting them early, we can help them feel as comfortable as possible throughout the entire process,” Young says.
Visitors. Decide who you want in the delivery room. “This can be doctor-directed a little bit. For example, if the patient is having trouble with their blood pressure, we’re not going to want them to have a lot of visitors in their room at that time,” Davis says.
When your baby arrives, your loved ones can access the locked unit during visiting hours by providing your first and last name.
Wireless monitoring. Some hospitals wirelessly monitor the baby’s heart rate and a laboring mom’s contractions. The wireless monitor allows patients the freedom to move around, use the restroom, take a shower or sit on a birth ball.
X or Y? Still unsure whether your newborn is a Xenia or a Yasmin? Try settling on a name before you check out of the hospital. Otherwise you’ll get a call from the State Department of Health for not completing your birth certificate paperwork—and it can cost you extra.
Zen. Giving birth is rarely considered a “zen-like” experience, but many hospitals prioritize comfortable accommodations for expectant parents, like private suites, in-room music options, rocker-recliners and “quiet time for moms” to allow for family bonding.
Christa Melnyk Hines is a nationally published writer. She lives in Olathe with her husband and their two sons who were C-section deliveries.
As always, please consult your health care provider with any questions or concerns.