Labor and Delivery

Your Labor and Delivery Suite

Each of the Labor and Delivery suites at ST. FRANCIS eastside are private, updated rooms that are fully equipped with the technology you need to have a safe, comfortable and smooth delivery.

While the rooms are technologically advanced, they have a home-like feel and are full of light and color, to provide you a sense of comfort and warmth during your birthing experience.

The Delivery

Once you are settled in your Labor and Delivery suite, a nurse will assess you. The nurses on the Labor and Delivery Unit are dedicated exclusively to women who are in labor, and they are experts in the labor and delivery process. Feel free to ask them any questions you may have as your labor progresses. 



When you arrive in your room, you will be asked to change into a hospital gown and your nurse will check your pulse, blood pressure, temperature, and breathing rate. She also will ask about your due date, when your contractions started and how far apart they are, whether your water's broken, and if you've had any vaginal bleeding. She'll also want to know if your baby's been moving, if you've recently had anything to eat or drink. Please remember that you cannot eat or drink anything while in labor.

Your nurse will ask you what your plans are for pain management. Some women choose to have an epidural for pain relief, while others opt not to receive pain medication and manage pain with breathing techniques. Whatever pain management method you choose, your nurses will support your decision and let you know what to expect as labor progresses. Please note that St. Francis has anesthesiologists available 24/7, every day.

If you have worked with your doctor on a Birth Preference Plan, please share it with your nurse at this time.


Your nurse also will:

  • Place a fetal monitor on your abdomen to measure your contractions and monitor your baby during labor.
  • Start an IV for hydration, to get antibiotics if you tested positive for Group B strep, if you want a spinal or an epidural, or if you need oxytocin (Pitocin).
  • Orient you, showing you where everything is in your room and on the unit and explaining what she's doing and why each step of the way.

Next, your doctor or nurse may feel your belly to assess your baby's position and estimate his size. If you’re uncertain if your membranes have ruptured, she may do a vaginal exam to see whether you're leaking amniotic fluid. You also will have a pelvic exam to check your cervix for dilation and effacement and to feel how low your baby is. If your caregiver isn't certain after the abdominal and vaginal exam that your baby's coming headfirst, your doctor may use a portable ultrasound machine to confirm his position.

Vaginal Birth

Please keep in mind that every birth is unique, and your labor and delivery may be different.

Contractions happen when your uterine muscles involuntarily tighten and relax. When true labor begins, you feel contractions at regular intervals. As labor progresses, these contractions get longer, stronger, and closer together. During active labor, you may feel intense pain or pressure in your back or abdomen during each contraction. You may also feel the urge to push or bear down, though your doctor will ask you to wait until your cervix is completely dilated.

Contractions help your cervix dilate -- or open -- so your baby can pass through the birth canal. You're fully dilated when your cervical opening measures 10 centimeters. As the cervix opens, it also thins (effaces) in preparation for delivery.

During your labor process, your nurse may suggest the use of a “peanut ball,” a large, peanut-shaped exercise ball that has been shown to help with easier and faster deliveries. While lying on your side, the peanut ball will be positioned between your legs to help relax and open the pelvis. This, in turn, gives your baby more room to rotate and descend into the birth canal.

According to research, a mother-to-be may have a shorter first and second stage labor and a lower chance of getting a C-section by using a peanut ball. This is especially true of mothers who have an epidural. Some studies show that pain-relieving epidurals can prolong labor by an average of 40 to 90 minutes and can lengthen the pushing stage as well.

One study found that women laboring with an epidural and using the peanut ball had significant positive results:

"Those who used the ball decreased the first stage of labor by nearly 90 minutes and the second stage by 23 minutes compared with a control group that did not use the ball.

The real payoff came through lower C-section rates. The C-section rate for the group of women who used the ball was 13 percentage points less than for the group that did not use the peanut ball."

When your cervix is fully dilated, your doctor gives you the OK to push. Propelled by your effort and the force of your contractions, the baby makes his way through the birth canal. The fontanels -- soft spots --on his head allow it to mold to the shape of this narrow passage. Your baby's head "crowns" when the widest part of it is at the vaginal opening.

As soon as your baby's head emerges, the doctor suctions amniotic fluid, blood, and mucus from his nose and mouth. More contractions and pushing help deliver the baby's shoulders and body
Unless your partner has requested the honor, the doctor clamps and cuts the umbilical cord and examines your newborn. It's not over yet: After your baby is born, more contractions help you deliver the placenta, or "afterbirth."

C-Section

Please keep in mind that every birth is unique, and your labor and delivery may be different.

In a normal pregnancy, the baby is positioned head down in the uterus. Sometimes the baby is breech (buttocks-first) or transverse (cross-wise), making a vaginal birth risky. Other times, certain medical conditions like placenta previa (placenta is attached too low, blocking the baby's exit) or placenta abruptio (placenta is partially or completely detached, threatening the baby's oxygen and nutrient supply), make vaginal birth nearly impossible.

A Cesarean section delivery is performed if a vaginal birth is not safe or possible for the mother or the baby. On the fourth floor at ST. FRANCIS eastside, there are two operating suites dedicated exclusively to C-section deliveries that are just footsteps away from the Labor and Delivery suites should they be needed.

Some doctors prefer using general anesthesia, which renders the patient unconscious, for emergency C-sections because it can be administered quickly and takes effect almost immediately. When the C-section is planned, the doctor may order regional anesthetics (a spinal or an epidural), which numbs only the lower portion of the body.

After the anesthesia takes effect, the surgeon makes an abdominal incision. In non-emergency C-sections, the surgeon usually makes a horizontal incision (a bikini cut) across the abdomen, just above the pubic area. In an emergency situation, the surgeon occasionally needs to make a vertical cut, from below the navel to just above the pubic area. A vertical cut sometimes allows quicker access to the baby.

Next, the surgeon opens the uterus with either a horizontal or vertical incision, regardless the direction of the skin/abdominal incision. A vertical incision on the uterus causes less bleeding and better access to the fetus, but renders the mother unable to attempt a vaginal delivery (must have another repeat C-section) in the future. If you end up with a horizontal incision, you will have the option of either going through a trial of labor (TOL) or electing a repeat c-section.

Finally, the surgeon cuts through the amniotic sac enclosing the baby. He then allows the amniotic fluid to escape. The surgeon reaches into the uterus and lifts the baby's head. An assistant pushes down on the mother's upper uterus to help guide the baby out. The surgeon will clamp and cut the umbilical cord.

A typical hospital stay after C-section delivery is two to three days. Usually, the doctor encourages the mother to get up and move around soon after surgery to aid healing and to prevent complications. For the first few weeks, the abdominal incision will be sore. The scar will lighten as it heals.

Recovery

After delivery, you will recover in your Labor and Delivery suite (recovery usually lasts about an hour). Your newborn also will have an APGAR test, performed at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score assesses how well the newborn is adapting to the new environment. In the unlikely case that your newborn needs assistance, our Neonatal Unit is just steps away.

After recovery, you and your baby will be transferred to the Mother & Infant Unit. Your new baby will stay with you in this room for the rest of your hospital stay.