Congratulations! You’re in labor! Your beautiful baby will be in your arms very soon, gazing into your eyes for the first time. Hopefully, you were able to do most of your laboring at home and have waited to head to the hospital until your contractions were 4 or 5 minutes apart, lasting a minute, for at least 1 hour (4-1-1 or 5-1-1), or your water broke. Your contractions should be strong enough to stop you in your tracks and make it difficult for you to focus on much else. This means you are probably in active labor! Don’t be afraid of the discomfort you’re experiencing. This is a good thing! It means your baby is almost here! Waiting until you’re in active labor means there’s less of a chance of medical interventions, or that the hospital will send you home upon arrival. Some hospitals have a policy to send birthers home if they aren’t dilated to at least 6 cm. Talk to your care provider for instructions on when to call to let them know you’re in labor.
After calling, grab everything you need or wanted to bring to the hospital. Hopefully, you were packed ahead of time and all of your things are in the car and ready to go. If not, that’s ok. While you’re in early labor, pack your things to help distract from the irregular or not-super-uncomfortable contractions. It will be an exciting ride to the hospital and probably not very comfortable. That’s normal and you’ll be at the hospital soon. Never drive yourself to the hospital! Contractions make it difficult to focus on anything else, including driving.
When you pull up, have the person driving drop you off at the front because walking a long distance may be difficult without support. After they park the car, they will escort you inside. If you’re struggling with walking, ask for a wheelchair and head to the maternity ward.
Once in the Maternity Ward, you may have paperwork to fill out unless you filled it out ahead of time (pre-registered). A nurse will take you into Triage. In Triage, the nurse will ask you questions relating to your progress:
Has your water broken?
Have you passed your Bloody show?
How far apart are your contractions?
These and other questions will help the nurse to know how to help you best.
The triage nurse will most likely want to hook you up to a Continuous Electronic Fetal Monitor, and a monitor that measures your contractions. The nurse will also want to physically check your cervix for dilation. Dilation checks are done by inserting fingers into the vagina and measuring the opening of the cervix. It can be uncomfortable, but it doesn’t take long. If your water has broken, or is suspected of being broken, the fewer the amount of dilation checks, the better. Especially if you have any vaginal infections or Group B Strep as it can cause pathogens to enter the uterus causing more harm than good. Ensure a sterile speculum check instead as they’ll want to test your amniotic fluid.
If you are dilated enough to be considered in Active Labor (6cm and consistent contractions at most hospitals), you will be admitted to continue on with the remainder of your labor and birth. If you are not quite there yet, they may advise you to head home. Even though you may be excited to get the delivery moving forward and feel discouraged by returning home, early admittance to the hospital is correlated with increased medical intervention, C-Sections, and discouragement among birthers. If you don’t mind medical interventions, or you’re ready and willing for pain relief to be administered, you may be allowed to stay depending on your hospital’s policies. Keep in mind epidurals, especially when administered early in labor, have been shown to slow labor down in many cases. There is no stopwatch or alarm clock during labor. Your baby will come in due time, even if it’s not as fast as you had hoped.
Once you’re admitted, you’re wheeled to your birthing room which may or may not be private. The hospital will make every effort to provide you with your own room, but depending on the amount of people giving birth in the hospital, it may be necessary to double up some patients. This can be uncomfortable, but there are typically curtains to offer privacy between patients within the same room. You will change into a hospital gown, or you may ask to wear your own gown (be aware birth is messy so choose your own clothing carefully). The nurse will most likely draw blood, ask for a urine sample, and hook you up to monitors and an IV. Additional fluids through an IV during labor have been associated with higher levels of Jaundice and potential lung issues in newborns. You may not be able to avoid having an IV inserted due to hospital policy, but ask to have it capped off unless needed. The nurse will check baby’s position, make sure you’re comfortable, and leave to tend to other patients.
You will then be left to labor with your support team. The nurse will check on you periodically. If your doctor is already at the hospital, they will come check in on you, as well. If your doctor is on-call while you’re in labor, they will come after your labor has progressed and you are closer to pushing. If your doctor is unavailable during your labor, then an on-call doctor at the hospital will attend your birth. You will most likely see a doctor very rarely and that is a good thing. It means everything is going well, and no interventions are needed or expected. You will see the nurse much more frequently. Shift change occurs every 12 hours, so you may see a different nurse if labor continues after shift change. You may prefer one nurse over the other, that’s ok. Your Doula will fill in the gaps of what you’re missing.
Upon first getting to the hospital, it may feel overwhelming and/or scary. Don’t be intimidated by all of the hustle and bustle of the maternity ward. You may hear screams and moans, but those are sounds of beautiful babies entering the world! Once you are comfortably in your room, things will usually calm down so you can focus on your labor and delivery. If you need anything to make you feel more calm or less stressed, vocalize your concerns to your support team so they can jump into action to best support your needs. They are there for you and you are going to do great!