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Each hospital has its own set of routine procedures for labor. If you’ve visited beforehand, you’ll probably have a good idea what the regulations are. Hospitals can be intimidating, but are much less so when you get to know them, so it’s a good idea to take a look at the labor and delivery rooms, meet the staff who’ll be caring for you, and get some idea about ward routines before your due date.

Admission to the hospital Once you’ve arrived at the hospital, you may be offered a wheelchair to transport you from the hospital entrance to the labor ward. If your labor is well advanced, you’ll welcome the chair; if not, you’ll be able to walk comfortably, so make sure you are allowed to do so.

You’ll have outlined in your birth plan how you’d like your labor to proceed, and once you’ve met your midwife or doctor, this is the time to make sure they have a copy of your plan so that you can look over it with them. They’ll also make some checks and ask you a few questions about your labor.

If there’s anything you’re not happy with-if equipment, lights, and needles frighten you, for example, or if you’re upset by a staff member-do something about it right away. Don’t wait, letting your fears and anxieties fester and grow. Your partner or birth coach can voice your feelings if you aren’t feeling strong enough to be assertive.

Examinations Your baby’s heart will be monitored regularly by Doppler or an electronic fetal monitor. Your midwife will probably give you an internal check every two to four hours during the first stage to see how far your cervix has dilated, but there’s no hard and fast rule.

Each time you have an internal check, ask how things are going. It’s very comforting to know how far your cervix has dilated between examinations. If you’re asked a question while you’re having a contraction, concentrate on your relaxation techniques and answer the question when the contraction is over.

Pain relief Once you’ve been admitted, an anesthetist will visit you if you’ve asked for an epidural, and the procedure will be set up. This usually takes 10-20 minutes. If a top-off is needed, this can usually be given by your midwife. If you’ve decided not to have any medical pain relief, you will be left with your birth coach and a midwife who’ll stay with you throughout your labor.

ELECTRONIC FETAL MONITORING

This high-tech replacement for the stethoscope is used to track your baby’s heartbeat. In all high-risk pregnancies, electronic fetal monitoring (EFM) will be used throughout labor for your own and especially your baby’s safety. You’ll have EFM if you are being induced or your labor is being accelerated for any, reason, or if you’re having epidural anesthesia. The main to function of the monitoring is to give early warning if your baby is in any distress.

What it is There are two kinds of electronic monitors, external and internal. An external monitor is used for routine short periods of monitoring, and it’s sometimes used in pregnancy if it’s necessary to monitor the baby’s heartbeat over a period of time. Belts are strapped around your abdomen with sensors that record your baby’s heartbeat and your uterine contractions, which are then printed out on a graph.

The internal monitor is slightly more accurate. You’ll have belts strapped around your body and a tiny electrode will be clipped to your baby’s scalp once your cervix is 2-3 cm dilated. The baby’s heartbeat is printed out on a paper trace.

The latest type of EFM, known as telemetry, uses radio waves. The baby’s monitor is attached to a transmitter that’s strapped to your thigh, so in theory, at least, you’re able to move around while being monitored. The older equipment confines you to a bed or chair.

How it works During a contraction, the blood flow to your placenta is reduced for a few seconds, and your baby’s heart rate may drop from its baseline. The heart rate should return to what it was before when the contraction passes. If it doesn’t or the return is delayed, your baby may be distressed and your medical team may need to take action to protect his well-being.

How monitoring helps doctors EFM provides medical staff with a second-by-second report on your baby’s condition. It warns the doctors if your baby is in distress so they can intervene before anything untoward has happened. If your doctors decide that you
and your baby would be better off with monitoring, try not to resent it and to see it as something that gives reassurance that your baby is doing fine.

Disadvantages The use of monitoring means that there’ll be more electronic equipment in the delivery room, making the atmosphere very clinical. You may also feel that the nursing staff might concentrate more on the machine than on you. As staff are aware of any tiny changes that may take place, they’re more likely to intervene rather than letting labor take its natural course. However, many mothers do find it comforting to know that the doctors and midwives will know right away if there is a problem with the baby.