1. You might get sent home. If you show up pregnant with your first baby, and it turns out you aren’t 4 cm dilated yet, you will get sent home because you aren’t in active labor. Please don’t cuss out the charge nurse. Yes, you are in pain — we aren’t denying that. But, there are limited numbers of beds on labor suites, and we need to keep some open for people who will likely roll in right behind you and will deliver way before you. There are no appointments on L&D (labor and delivery), and you never know what will come in. Space and open beds are the issues, not laziness of admitting physician.
2. Limit it to two guests during delivery. More than that is just a distraction. If there is an emergency, the last thing we want to be worried about is having enough room to take care of you appropriately without people being in the way. In a true emergency about ten medical professionals will come barging in your room within seconds, and if your mom’s second cousin is standing in the way it prevents us from doing our job. On a random side note, please don’t text while you are actively pushing in labor and the head is starting to emerge. It happens WAY too often. Whatever is on that cell phone can wait until your baby is here.
3. Ask for the epidural early. If you plan to wait and see how it goes, likely you won’t have time to get an epidural before baby makes the big entrance. Murphy’s law will dictate that every pregnant patient on L & D will need one at the same time and there is usually only one anesthesiologist, who will invariably be back in the OR with a C-section tied up for half an hour. Don’t miss your chance!
4. You can have a birth plan, but please have it read as follows: I want to leave the hospital with a healthy baby and mom. Anything more than that, and we get superstitious. It’s just like the old wives tale about the full moon and people going into labor — there is no scientific evidence to back it up, but we all believe it’s true and witness it happen all the time. The longer and more detailed your birth plan, the higher the percentage likelihood you are to end up with a C-section. At least it always seems to work out that way.
It is true that you can expect to have more interventions and temporary discomforts while having a baby in the hospital as opposed to a home birth. Expect to not eat when in active labor, have monitors strapped to your stomach and frequent vital sign evaluations. In my opinion, these are small sacrifices to pay to ensure healthy baby and mom.
5. Contrary to popular belief, we love when you bring a doula to the hospital with you! They help you through your labor, make sure your needs are met and encourage you through pushing. They are an OB/GYN’s best friend!
6. Prepare to not eat food for a while. We are not doing this to be mean. We are doing this because having a baby is dangerous. At any moment, you could become a surgical patient. If you vomit and aspirate, this could be dangerous for your health. Nobody wants to have a newborn baby, aspiration pneumonia and recover from surgery all at the same time.
7. We are going to press on your abdomen/uterus after the placenta delivers. I have seen patients get downright angry about this. The reason behind it is that after the placenta comes out, the uterus can become very floppy and you can quickly lose a liter of blood. Massaging the uterus helps with the tonicity and also helps your doctor assess whether there is a problem or if more medications are needed to avoid a hemorrhage. The baby and the placenta are out, but there is still a need for assessment. You are almost done!
8. Don’t try to rush the OB who is suturing you after you tear with delivery. Episiotomies aren’t routine anymore and are typically only done when medically necessary. However, it can be very common to tear on your own with a first baby. Let your OB take their time and do it right, trust me. 10-20 more minutes of meticulous care will be well worth it in the long run, especially if you were “blessed” with a 10 lb baby.
9. Send your husband to get your ice chips. Let your nurse focus on your vital signs, evaluate the fetal monitoring and document your progress. Your husband/support person should be the one getting you the much-needed ice. Besides, it will help your partner feel useful at a time when they are often struggling with lack of control, and they want to help you in any way they can.
10. You are in very competent hands. A normal labor can turn into an emergency at any moment, even in a low-risk patient. On any given day, L&D will have a woman hemorrhage after delivery. In the next room, the newly delivered baby may not be breathing. Two doors down, a patient just had a seizure and dangerously high blood pressures as her preeclampsia progressed to eclampsia. Down the hall, a shoulder dystocia occurred. This happens when the baby’s head emerges but the shoulders are too wide to deliver, and asphyxia of the infant makes seconds feel like hours until skillful maneuvers can safely deliver the baby. I mention these scary but common scenarios because the best thing about having a baby in the hospital is that you are surrounded by scores of people that are trained to handle these exact situations and do so every single day.
Valerie A. Jones is a obstetrician-gynecologist who blogs at OB Doctor Mom.
Image credit: Shutterstock.com