You've probably imagined the moment you go into labor a million times throughout your pregnancy, but do you know what to expect once you arrive at the hospital or birth center? Knowing the specifics of arrival procedures when before you go into labor can help bring a sense of comfort and confidence to you, your partner, and birth support team. Your birth place follows a specific set of routines and procedures upon arrival/admittance in labor. Knowing your choices and decision making points in advance can help the process go smoother.
Parking & Entrance
If you arrive in labor during overnight hours, your hospital or birth center may require you to enter through a different entrance, separate from 'Labor and Delivery.' You can learn about this during a hospital or birth center tour. Most hospitals also have a drop-off location, where you can temporarily park in front of the doors and enter directly without a long walk. At some point, your support person will need to go back out and officially park the vehicle.
Sometimes, when arriving in labor, you may be encouraged or even "required" to be escorted to Labor & Delivery by wheelchair, according to hospital policy. For some, this may not be an issue. For others, especially those further along in labor, sitting in a chair may increase your sensation of pain in labor. You can request to walk on your own or you can request to stop and get out of the wheelchair during contractions.
Waiting for a Room
Many hospitals have what is called "triage," a temporary room in which you are assessed to determine if you should be admitted to stay. Depending on how far along (visually) you are in labor, you may go directly to a room without triage. If your hospital is particularly full when you go into labor, you may stay longer in triage. Triage usually involves monitoring (see below), an assessment of symptoms, and a cervical check. You have the right to decline a cervical check as it is not a reliable indicator of labor, it is often uncomfortable, and it increases the risk of infection.
Upon arriving into a hospital room (whether triage or a labor and delivery room), one of the first procedures nurses perform is electronic fetal monitoring (EFM), typically for 20 minutes. This monitoring strip will record baby's heart rate and the frequency and duration of your contractions. Being monitored does require you to be attached to a machine, but it does not mean you have to lie on your back in bed -- a position that is generally very uncomfortable in labor. Ask your nurse, your partner, or your doula to help you get into a comfortable position, like sitting on a ball or on the side of the bed, standing and leaning, or on all fours in the bed, and then remain in that position for the time needed on the monitor. You can also ask if your hospital has a wireless, or 'telemetry,' monitoring unit, which will allow you to move more freely while being monitored. Ask your partner or doula to keep track of time on the monitor, so that you can ask to come off (sometimes nurses are busy with other families and you can end up being on the monitor for longer than the required time) and be more free to move around.
Even if you registered in advance of your arrival and even if you are in the throes of labor, you will still be required to sign multiple forms upon being admitted into the hospital. Usually this takes place upon being admitted to your labor room. Nurses often are sensitive to giving you space during a contraction, but will likely ask you questions and give directions for signing in between contractions.
When you reach your final destination -- your labor room -- you may need to be monitored again (depending on how long it was since the first time), or you may be fine to go about laboring. While a hospital will provide a standard gown, you also are free to wear your own clothes (something easy to move around in and easy to provide monitor access is ideal). You also will be asked to give a blood sample upon being admitted. Most hospitals also require IV access, which involves inserting a heplock/IV port into your hand or arm. Unless you require medication or fluids, you do not have to have the IV hooked up. If you have a preference of location for the IV access, please let your nurse know. It can be more comfortable on the wrist instead of the hand, for example. For most births, routine IV fluids are not necessary.
Make Yourself at Home
Once all of the admission procedures are complete, you can get settled in. If you've never stayed in a hospital room before, it can feel unfamiliar. Your birth support team can unpack the things you'll need, set up your music, and find out where extra linens, pillows, and vomit basins/bags are kept while you focus on labor. Be sure they also find out the location of the nearest water and ice station. Adjusting or lowering the lights and keeping the door closed helps maintain a more private and relaxing environment.