by Patty Hardy
Knowing what to expect when it comes time for your labor and delivery can help ease any anxiety you may have about the birth process, especially if this is your first baby.
Reviewing these facts will help, as will talking to your healthcare providers and taking advantage of childbirth classes. Your experience depends on your own arrangements, where you've chosen to give birth, and which providers you've chosen to assist you.
Before you are formally admitted to your hospital's labor and delivery area (or birthing center), you'll probably be given a vaginal exam to determine the progress of your labor. This exam will determine your cervical effacement and dilation, and how far your baby has descended into your pelvic cavity.
You'll be asked for general information that includes the following:
• Review of your medical benefits coverage
• Determination of pre-registration
• Your partner's or support person's name
• The name of the doctor or midwife you've chosen for your baby
• Your participation in any type of childbirth classes
• Your plans for breastfeeding
• Your plans for circumcision if the baby is a boy
• Any plans for postpartum sterilization
You will be asked for specific information that includes the following:
• The date and time your contractions began and the average length (duration) of your contractions
• How frequently your contractions are occurring
• The date, time, color, and amount of vaginal discharge
• The date, time, and color of fluid if your "water broke" (amniotic membranes rupture)
• When you last ate, had a bowel movement, and any occurrence of diarrhea.
• Your complete medical and prenatal history will be reviewed
• A hospital/birthing center patient I.D. bracelet will be attached to your wrist
• Measurements will be taken of your temperature, pulse, breathing rate, and blood pressure
• Blood and urine samples and vaginal cultures may be taken
• A test may be performed to determine whether your amniotic membranes has broken or is still intact
• An estimation of fetal age and weight and presentation of your baby will be made
• You may receive an intravenous (IV) line that can be used to give fluids that prevent dehydration and/or administer medication quickly
• You probably will not be allowed to eat during labor -- ice chips are usually allowed
Your doctors and nurses may use one particular method, or possibly a combination of methods, to help them determine how your baby is reacting to labor. Here are some of the different methods:
Auscultation Monitoring: This method involves listening to the fetal heartbeat with a Doppler device or stethoscope and recording it at specific intervals between contractions. Our doctors and nurses will also place their hands on your stomach to feel for uterine contractions.
Electronic Monitoring: This method measures the response of your baby`s heart rate to the contractions of your uterus, and provides a continuous printout of information that can be read by our doctors and nurses.
Monitoring is done through one of two different methods:
• The external monitor is secured to your abdomen with two elastic belts, one holds a sensor that measures your contractions, and the other secures an ultrasound device that uses sound waves to pick up your baby's heartbeat.
• Internal monitoring is done by attaching an electrode (a thin spiral wire) to your baby's scalp to provide a recording of his heart rate. At the same time, a catheter (thin tube) or transducer (pressure gauge) is placed in your uterus to measure the strength and frequency of your contractions. Internal monitoring can't be used until your amniotic sac has ruptured and your cervix has begun to dilate.