Whether you plan to have a vaginal delivery or if you have a scheduled c-section, here’s a breakdown of what to expect during labor in the hospital, from a postpartum nurse and mom of two.
If You Go In Already Laboring
Most labor nurses and OBs will tell you to follow the 4-1-1 or 5-1-1 rule. This means you are having contractions every 4-5 minutes (from the start of one to the start of the next), each lasting about a minute, and this happening for about an hour. At this point, it’s typically a good time to go ahead and go to the hospital.
For some women, especially if this is their first baby, their cervix may still be what we call “closed, thick, and high”. For others, especially the more babies they’ve had, they may have progressed pretty far at this point in their labor.
Other reasons to go ahead and make your way to the labor and delivery unit is if your water has broke (meaning the amniotic sac has ruptured), or if you are having vaginal bleeding. Once the membranes have ruptured, it’s typically preferred that the baby is born within 24 hours due to the risk of infection.
If You Go In For A Scheduled Induction
There are many reasons for someone being scheduled for a labor induction. Any number of pregnancy complications such as preeclampsia or intrauterine growth restriction can result in an induction of labor being scheduled if the provider thinks the benefits outweigh the risks. But even in perfectly normal, healthy pregnancies, it’s very common now for elective inductions to be scheduled once the patient reaches 39 weeks gestation.
Typically scheduled inductions begin at either midnight or at the beginning of of day shift, so around 6-7am.
There are pros and cons to being induced at both of these times. Overall, I’m more of a fan of morning inductions to allow the patient to try to get some quality rest at home the night before.
Once you get registered and settled into your room on the labor and delivery unit, you can expect an IV to be started, blood labs to be drawn, and bags of fluid to be started.
In some cases, an OB may choose to start the induction with a suppository of cytotec. This drug stimulates strong contractions to begin.
Otherwise, IV pitocin is typically the standard method of induction.
Your labor nurse will also begin by going ahead and doing an initial assessment of your cervix.
This will give them a baseline of how dilated and effacted (thinned out) your cervix is.
Cervical exams also give insight into baby’s positioning and station in the birth canal.
Depending on your OB, you may be able to get an epidural almost immediately if you choose.
Some OBs prefer for their patients to be progressed to a certain point prior to receiving the epidural though. So that’s definitely something to talk to your doctor about during your prenatal visits.
Whether you plan to receive an epidural or not though, I highly recommend still taking the time to learn some breathing techniques to help you be better able to manage your contractions if they do start to become strong before you are able to get the epidural, or for it to take effect.
You will also have a Foley catheter put in place once the epidural starts to work.
Depending on the baby’s positioning and your level of comfort, your nurse may suggest and help you be in numerous different positions to help things progress smoothly.
Some examples are hands and knees, laying on your side with a peanut ball between your legs, sitting up in a “high throne”, etc.
Make sure to also stay in communication with your nurse and if there’s a certain position you want to try or think would help you feel more comfortable, let that be known.
Once your cervix has dilated to 10cm and is 100% effaced, it’s time to start pushing. The duration of pushing varies depending on many factors such as the mother’s ability to adequately push (it can take a bit of some technique and epidurals can cause the mother to be too numb to adequately push), whether this is her first baby or not, the size of the baby, etc.
Typically, once someone reaches the point of full dilation and effacement, the urge to push becomes very strong.
The amount of time spent pushing varies. But typically if you’ve been pushing for close to 3 hours, a C-Section starts to become a discussion.
Although there may be some exceptions, the majority of the time your labor nurse and OB want you to have the best birthing experience possible.
But with that being said, and as you can probably gather, there’s so many ways that labor and birth can go. So ultimately, your healthcare providers’ greatest priority is the safety of both you and your baby.
Also, there’s no one “right” way to birth.
Each person’s birthing experience is unique to them and it’s important to note that everyone may process their birth experience differently.
Whether you have the perfect labor and birth that goes exactly according to all your plans and dreams, or if you end up having a more traumatic birth, it’s important and necessary to acknowledge the need for time to process your birth story.
If You Go In For A Scheduled C-Section
The process when you go in for a scheduled C-section is pretty cut and dry.
- You’ll be registered, admitted, and head to your room to begin being prepped for surgery.
- Once you’ve changed into your hospital gown, been given an IV, and given necessary medications, you’ll be taken back to the OR.
- An anesthesiologist will place the required spinal or epidural and it will be confirmed that you won’t feel pain from the procedure.
- The surgical site will be cleaned and the surgical team will do what’s called a “time out”, which is a safety measure to ensure the correct number of surgical items being used and to verify that they of course have the correct patient!
- You will likely still feel pressure and some tugging throughout the procedure, but you should never feel actual pain.
- For those of you who may be a bit queasy at the medical details involved in surgery, I’ll skip the specifics and just tell you that before you know it, your sweet baby will be pulled from your womb and enter this world to take their first breath.
- Depending on how baby is doing, you can likely still enjoy the beautiful experience of having your sweet newborn baby placed on your chest to get that first look and to hear that precious voice cry. You’ll want to discuss the logistics of this with your OB during a prenatal visit.
- Your incision will be closed and bandaged and your newborn will be assessed by nurses trained in newborn transition. Once it’s confirmed that you both are doing well, you’ll be taken back to your room to begin your postpartum recovery. Depending on the facility, your recovery can take place either in a room on the labor and delivery unit or on a postpartum mother/baby unit.
Now while these above examples are how the MAJORITY of hospital births go, there are obviously numerous exceptions as well. It is many women’s experience to not have their birth go as planned.
Many mothers who have their babies via cesarean section had originally planned, and maybe even dreamed, about having a vaginal or “natural” birth.
Whether you had the birth of your dreams, or if your birth story went nothing like you’d hoped, it’s important to give yourself time to process your individual birth story with each baby.
In a future blog post, I’ll go into detail of what you can expect for postpartum recovery after birth, no matter how your birth story may have gone.
I hope this can be helpful information for someone. And as always, please join the Baby Momma Nurse family email list! This is how you can receive info about all upcoming resources! Thank you for reading and stopping by the blog!