Comprehensive Childbirth Guide for New Parents

Congratulations on your pregnancy

Congratulations on your pregnancy, we are so pleased that you have chosen Women & Infants Hospital for your birth. We know the birth of a baby is a very special occasion, and we are honored to be a part of it.

Our goal is to exceed your expectations. We hope to make your birth experience as personalized as we can, while also providing you with the finest medical care available. We believe that caring for you means including your family in the process. It’s our patient and family-centered approach to health care.

If you have any concerns or questions before, during, or after your stay, please call our supervisor of patient and family-centered care at (401) 274-1122, ext. 44287 (English) or ext. 44289 (Spanish) or email SMMaldonado@Wihri.org.

*You may be randomly selected to receive a survey at home asking your opinion of Women & Infants. Please let us know what we are doing well and where we can improve.

The Warm Line

Breastfeeding, Postpartum, & Newborn Hotline
P: (800) 711-7011

Contact Information

Women & Infants Hospital Obstetrics and Gynecology Care Center
101 Dudley Street
Providence, RI 02905
P: (401) 274-1122, ext.42735

Learn About Our Obstetrics and Gynecology Center

We are proud to partner with Centering Pregnancy. Check out their website to learn more:

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Forever Grateful - The Case Family

 
 
 
 
 

 

Information and Resources for Families

Childbirth & Parenting Classes

Pregnancy is a time of change and new experiences. To help you prepare, we offer educational classes in English and Spanish to include childbirth preparation, breastfeeding, and newborn care. 

Resources and Education

The Hassenfeld Child Health Innovation Institute aims to improve the lives of children in Rhode Island. Families have access to webinars, safety information, and expert advice. 

Your Birth Preferences

Congratulations on your pregnancy! We at Women & Infants Hospital are excited to partner with you on the special occasion of your labor and birth.

We want to share with you common practices and available birth options at Women & Infants Hospital so that you will have an idea of what to expect. We hope this information provides a means of discussion to help you and your partner identify your feelings and desires for this special day. Please begin to think about these issues and discuss them with your health care provider. You may want to bring a copy of your preference list (see Our Birth Partnership below) with you to your next office visit as well as the hospital. Our commitment is to provide you and your family a safe and comfortable environment.

Labor & Birth
  • Early labor is sometimes long. During this time, it is very important for you to be able to move freely, change positions, rest, and eat light snacks. Usually, home is a much better place for early labor. Do not be discouraged if, on the first exam in the obstetric triage unit, you are asked to return home so that you may walk, rest, and be comfortable in your own surroundings. If you wish, a safe medication may be given to help you rest at home. The emergency room at Women & Infants is staffed with obstetricians, family medicine physicians, midwives, and nurse practitioners who will review suggested comfort measures with you and let you know when to return to the hospital.

  • We do not routinely start an IV upon admission, unless there is a medical reason or it is part of your pain management plan. You will be free to walk around, drink clear liquids, and try different positions for comfort and to help your labor progress.

  • Every baby’s heart rate is monitored externally in the obstetric triage unit. If the baby’s heart rate is normal, you may be monitored intermittently. Sometimes continuous monitoring is medically necessary.

  • If there is a need for your labor to be induced, your provider will discuss this with you and schedule it with the antepartum care and labor units. You may find more information on the process of induction here. Please understand that all women coming to Women & Infants are admitted according to medical need and medical priority. In some cases, and after consulting with your doctor or midwife, we may need to change the time of your induction or we may need to re-schedule your induction for another day.

  • Most of our labor and birth rooms are private; some have showers. Our in-hospital Alternative Birthing Center (ABC) has a Jacuzzi tub. We encourage you to bring your favorite music with a portable player; dim the lights to create a relaxing environment and change positions as you need for comfort. You may have support persons and/or doula with you for labor; they are a welcome part of your care team.

  • It is important to stay well hydrated during your labor, so we encourage you to drink clear liquids during this time. We provide ice chips, water, juice, broth, tea, and Jello. You may also wish to bring hard candy for yourself and snacks for your partner.

  • We support a range of non-medication options for coping with labor including walking, massage, rocking chairs, birthing balls, and heat/cold therapy. Our nurses are experts in labor support.

  • For pain medication, we offer three options that are both safe for the baby - a short-term narcotic (either IV or intramuscularly, a shot in the thigh), Nitrous Oxide is a self-administered, breathable form of analgesia that relieves pain and reduces anxiety during labor and epidural anesthesia (pain medication in the lower back).
  • Episiotomies, forceps, and vacuum births are not routinely performed at Women & Infants Hospital. However, there are some circumstances in which your care provider may recommend it.

  • Should a cesarean birth become necessary, you will likely be awake and your support person can remain with you for the birth. You and your partner will be able to hold your baby immediately after birth as long as he/she is in good health. Discuss the available option of a gentle cesarean with your provider. On rare occasions, you may need general anesthesia. In this circumstance, you will be asleep and your support person will be asked to wait outside of the operating room.
Recovery Period
  • After a vaginal birth, we usually place the baby on your belly and the umbilical cord is clamped after a period of time. If your support person desires, he/she will be able to cut the umbilical cord.

  • For security purposes, matching identification bands will be given to the baby, mother and one designated support person. Our staff will discuss our state-of-the -art infant security system with you.

  • The recovery period is a time of transition for both you and your baby. You will stay in the labor and birth room while we monitor you and the baby. During this time, you and your baby stay together as much as possible, and we encourage you to spend time with your baby skin to skin. Your baby will be receiving standard medications such as Vitamin K (to help blood clotting) and Erythromycin ointment to the eyes (to prevent infection). After the recovery period, you and your baby will be moved to a private postpartum room. If you choose to deliver in our in-hospital Alternative Birthing Center (ABC), you may stay there and opt for early discharge home with follow-up care in your home.

  • We support your decision to breast or bottle-feed your baby. While there are many studies demonstrating the health and social advantages of breastfeeding, each family has its unique needs. If you choose to breastfeed, we will help you initiate this within the first hour of life. Our staff is here to help you become successful in caring for your baby.
Postpartum

The postpartum period is not only a time to rest and recover, but also a time for you and your baby to learn about each other. Our staff is here to teach you about the changes you will be going through immediately after the birth and about your baby’s behavioral cues. We encourage you to take childbirth education classes before and after birth to help prepare for this exciting time.

  • At Women & Infants, we encourage the baby and new parents to stay together as much as possible. The baby will be transferred with you to the Mother Baby Unit where we support rooming-in to promote bonding with your baby.

  • Newborn circumcision is only done by parents’ request. The circumcision is scheduled after the pediatrician has examined the baby and after you have signed the informed consent. Please discuss the procedure with your pediatrician and obstetric provider.
Information on Doulas

What is a Doula?
A doula is a skilled and non-medical companion who supports a birthing person during pregnancy, labor, birth, postpartum, during an abortion or miscarriage, or during a loss. Doulas are trained to provide continuous, on-on-one care, as well as information, physical support, and emotional support to pregnant people and their birth partners.

What do Doulas do?

  • Physiological Support: helps birthing person maintain a sense of control, comfort, and confidence.
  • Emotional Support: care for emotional health.
  • Informational Support: keep birthing person/ partner informed and provide access to evidence-based information.
  • Advocacy: facilitating communication between patient and provider.

How to hire a Doula
  • Insurance
    If you have Rhode Island-based Medicaid (For example, Neighborhood Health Plan) insurance, the RI Doula Bill ensures doula care is covered. If you have private Rhode Island-based insurance, confirm if your specific plan covers doula care.
  • Privately funded
    If you do not have RI-based insurance, you can call your insurance carrier and ask about doula coverage. You can pay out-of-pocket for doulas, use your FSA/HSA, or create a doula fund and ask family members and friends to donate.

How to find a Doula
If your RI based insurance covers doula care, find an in-network doula through RI Birthworker Co-op.
If you have out-of-state, private insurance that covers doula care or you’re paying out-of-pocket, you can find a doula through:

  • Doulas of Rhode Island
  • Calling the Doula Referral Hotline
The Doula Referral Hotline is open 24/7 to assist call 1 (833) RI-Doula

Our Birth Partnership

We know how important it is to support your birth preferences while maintaining a safe outcome and positive experience for you and your family. We want to partner with you and your family during your pregnancy to learn about what is most important to you. We encourage you to talk with your care provider about your preferences over the course of your pregnancy, and work together to create and update your birth partnership as your delivery approaches.

Childbirth Options

Our goal is to make your birth experience as personalized as possible. We offer a full spectrum of delivery options for both low- and high-risk pregnancies, ranging from the Alternative Birthing Center for very low-intervention births, to delivering in one of our 19 labor/delivery/recovery rooms, to both emergency and gentle cesarean births.

 

Alternative Birthing Center (ABC)

The Alternative Birthing Center is a cozy setting that offers minimal hospital intervention, but maximum assurance of safety. It features a comfortable bedroom where the birth takes place and you can include older children and others. After you deliver in the ABC, you can recover for four hours there and transfer to a mother-baby unit, or recover for six to 12 hours there and go home once you and your baby meet discharge criteria. This early discharge includes a home visit from a nurse who will assess you and the baby and offer support. 

Learn More About the Alternative Birthing Center (ABC)


Labor/Delivery/Recovery Unit (LDR)

We are committed to ensuring the health and well-being of you and your baby. Whether you arrive in labor or are being induced for a medical indication, you will be cared for by your labor and delivery nurse in one of our 19 labor/delivery/recovery rooms. Throughout each phase of your labor, we are here to answer any questions you may have, support you, and monitor your baby closely. Each room has the amenities needed to help you stay relaxed and comfortable, including ambient lighting, a rocking chair, birthing balls, warm packs, and an iPod docking station. We also have birthing bars that allow squatting during labor and childbirth, and birthing beds that adjust to 22 different positions.

Cesarean Birth

Having a cesarean birth can be an anxious time for new and experienced moms, but Women & Infants’ staff make this experience a little easier by offering a gentle cesarean birth. The purpose of a gentle cesarean birth is to create a peaceful environment and to allow bonding between mom and baby to begin as soon as possible. We do this by providing a quiet room, free from noise and conversations, and filled with mom’s choice of music. We dim the lights and encourage the dad or significant other to be in the room during the delivery. And most importantly, we encourage bonding right away through skin-to-skin contact and minimizing the time that mom and baby are separated after delivery. Women & Infants is pleased to provide the gentle cesarean section at the request of the patient and with the permission of the delivering obstetrical provider.

At Women & Infants Hospital, we offer enhanced recovery after cesarean delivery. With the enhanced recovery method, you will know what to expect before, during, and after surgery. After surgery, the staff in the hospital will work to help you get out of bed soon after surgery, eat and drink soon after surgery, and be able to control your pain by using mainly non-narcotic pain medications.

Induction of Labor

You and your care team are planning your induction of labor. Your care provider has considered several factors including your current health, your baby's health, and how far along you are in the pregnancy.
 
This page has been developed to help you and your family understand how labor induction works and what to expect. We hope it will answer many of the questions you may have.

Reasons for Induction

Approximately 30-35% of patients who receive their care at Women & Infants Hospital have their labor induced. The most common reasons for induction are:

  • Your baby is overdue (pregnancy between 41 and 42 weeks).
  • Your baby is small for its age.
  • Your membranes have ruptured (water has broken) but labor has not yet started.
  • Your blood pressure is high.
  • There is a medical condition affecting either you or your baby that necessitates delivery.

Patients with the most serious medical or obstetrical conditions are prioritized for hospital admission and induction.

In some cases, the impact of these medical or obstetrical conditions is serious enough that your health care provider has decided that your baby should be delivered several weeks before your due date and your induction should be scheduled right away. But in most cases, induction is performed much closer to the time that your baby is due, and scheduling is more flexible. These decisions are always made to provide the best possible outcome for you and your baby.

Because Women & Infants’ Hospital may have several requests for labor inductions every day, the decision as to which patients should be admitted on any given day is determined by the category of induction. The patients with the most serious medical or obstetrical conditions are prioritized for hospital admission and induction. For patients with a less serious indication, the need for delivery is not as urgent and more time can be taken to adequately prepare for induction.

Each diagnosis has a recommended time frame for delivery, most with a range of time.

Scheduling

  • Unfortunately, due to the uncertainty in obstetrics, we do not know what the bed availability in the Antenatal Care Unit and the Labor Room will be in advance.
  • Therefore, we are unable to schedule a specific time until the day of induction.
  • Your place on the schedule is determined by your reason for induction.
  • All ELECTIVE inductions are subject to rescheduling to a different day depending upon availability. During our busiest times, when we have a higher volume of medically- indicated inductions, we may not be able to accommodate ELECTIVE inductions. Please continue your normal routines and keep your OB appointments.

Prior to Arrival

  • You may eat/drink as usual and engage in everyday activity before coming to the hospital.
  • The secretary will call you with a time (usually about 2 hours in advance). If we are able, we will call sooner.
  • Arrive at the hospital 15 minutes before that appointment time to allow time for registration in Admitting.
  • Remaining active will help the labor process. Try to walk regularly
  • PACKING:  Bring what you feel you need for the labor process. Shoes/slippers easy to slip on/off are suggested for walking during the ripening process. We will provide johnnies, slipper socks, and disposable underwear

When You Arrive at the Hospital


  • Your partner can drop you off at the FRONT MAIN ENTRANCE to the hospital
  • Public Parking is around corner to the right “PLAIN STREET PARKING”.  Your support person must walk around to front of hospital to come in through the same front entrance as you.
  • The Emergency Room entrance is only for those going to the emergency room.
  • When you come through the main entrance tell the front desk you are here for induction, they will direct you to Admitting for registration. 
  • When your partner comes in he/she will need a photo ID to show at the desk for a sticker to be in the hospital. You will both then be directed to either the Antenatal Care Unit (ACU) or to Labor and Delivery depending on your doctor’s plan for starting labor.
  • Bring only what you feel you need for the labor process.   Leave the infant car seat, baby bag, and anything else you need for after delivery in the car. Your partner will be able to go out to car when you need them.
  • The process time varies per individual. We never know in advance how long it will take. It is possible the ripening process will take 1-3 days. 

COVID - 19

  • If you or your partner have any symptoms of COVID or have been told to quarantine for any reason, please let the unit know in advance so we may accommodate you safely.
  • Masks need to be worn by both you and your partner throughout the process. 

In the Hospital Room

  • We will begin fetal monitoring and start an IV/get blood work.
    • Please let your nurse know if you have tested positive for Covid in the last 3 months. This will change our testing procedures. Please know that your health and safety, as well as all people in the hospital, are our utmost concern.

The Induction Process

Cervical Ripening

Labor induction may be performed at an earlier point in your pregnancy than anticipated, so your body may not be quite ready for labor. In these cases, it is best to take additional time to prepare your body for labor by a process called cervical ripening.

The goal of cervical ripening is to soften, dilate, and efface (shorten) your cervix (the area of the uterus that the baby will pass through). This process can take more than one day.

If your provider determines you would benefit from cervical ripening, and you have not had a cesarean delivery before, you will come to the Antenatal Care Unit (ACU). Cervical ripening agents have been shown to help get the body ready for labor. There are several different options that can be used alone or in combination with each other.

  • Misoprostol - A tablet that can either be taken by mouth or be placed in the vagina. It can be repeated every four hours until your cervix is ready for more active labor.
  • Cervidil - A hormone-infused string (like a thin tampon) that a care provider can place in the vagina. It remains in the vagina for approximately 12 hours and is then removed.
  • Cervical ripening balloon - A small rubber tube is placed through the cervix and a balloon inside the tube is inflated just inside the inner edge of the cervix. The balloon given time gently opens the cervix. 
You can expect to be on a fetal monitor intermittently during the cervical ripening process. You will start to experience contractions during this phase. This is normal and helps to better prepare the cervix for the actual induction.

To help keep you comfortable during this ripening process we offer labor balls, warm packs, showering, walking, nitrous oxide, and pain medications. Your nurse will review these options with you.

Once it has been determined that your cervix has been adequately ripened, you will progress to the LDR to begin the induction of labor phase. We encourage you to eat a light meal and take a shower prior to transfer to the LDR. As with admission for cervical ripening, patients will be brought to the LDR based on their labor status and priority of their medical condition.

Induction of Labor

If you do not need cervical ripening, a Labor & Delivery staff member will call you the day of your induction when a room is available.

Your induction will be started by using oxytocin (an intravenous medication) or by performing a pelvic examination to break your water. When oxytocin is used, it is started at a very low dose and is gradually increased until you are having regular labor contractions.

Before, during and after labor, we pay special attention to your comfort. Labor can be uncomfortable and painful, and we have many amenities in our labor/delivery/recovery rooms to help you labor comfortably:

  • Bed that adjusts to accommodate multiple birth positions
  • Birthing balls
  • Hydrotherapy (Jacuzzi and showers, when available)
  • Rocking chairs
  • Television with cable
  • Walking path and corridor with activity map to promote comfort in coping with labor
  • Warm packs

Speak to your Labor Room nurse about your options and preferences for pain management for labor, including an epidural.

We do not know in advance how long the induction process will take as everyone is different. Some women deliver in several hours. For others, the process is much slower.

After your delivery and recovery, you will be transferred to one of our Mother Baby Units (MBU).

Contact Information

If you have further questions, contact our Induction Coordinator at (401) 430-3408. If the coordinator is not available and you cannot wait for a reply, you may call the ACU Nurse’s Desk at (401) 430-3400.

Vaginal Birth After Cesarean Delivery

Many women who have had a previous cesarean delivery (c-section) would like to consider a vaginal birth for other babies. If you have delivered one or two babies by c-section in the past, you may have two options for delivery with this pregnancy:

  • Trial of Labor After Cesarean (TOLAC), with the goal of a vaginal delivery.
  • Elective repeat cesarean delivery.

Women & Infants and Care New England are providing you with information about both types of delivery to help you make your decision, along with your health care provider. This information will also be helpful before you are asked to sign an obstetrical consent form at the Care New England hospital (Kent or Women & Infants) at which you will be delivering your baby.

How successful is a Trial of Labor After Cesarean (TOLAC)?
Between 60 and 80 percent of women who attempt a trial of labor after a cesarean delivery will be able to deliver vaginally. There are tools that will allow your doctor or midwife to look at your individual history and try to predict your chance for a successful vaginal delivery.
Some factors that may increase your chances of a successful TOLAC:
  • Women with a prior vaginal delivery.
  • Women who begin labor on their own.
  • Women who had their first cesarean section for reasons that are not likely to happen again (i.e. the baby was in the breech position or the baby was not tolerating labor)
Some factors that may decrease your chances of a successful TOLAC:
  • Increased age of the mother.
  • High birth weight of previous baby(ies).
  • Women who are overweight.
  • A pregnancy that continues beyond the due date.
  • Short time interval between pregnancies (less than 18 months).
Who is a candidate for a TOLAC?

The type of incision in the uterus (womb, not the skin) is an important factor in deciding who is a candidate for TOLAC.

A sideways, or transverse, incision in the lower part of the uterus forms a strong scar with a low risk of rupture in future pregnancies. This is the most common type of cesarean delivery.

Women with an up and down, or vertical incision in the lower part of the uterus can be considered for TOLAC, but may have a higher risk of scar rupture.

Women with a "classical" incision, or a vertical incision in the upper part of the uterus, are not candidates for TOLAC, as the risk of uterine rupture is considered to be too high.

Most women who have had one previous cesarean delivery with a transverse incision are candidates for a TOLAC. The American College of Obstetrics and Gynecology (ACOG) recently affirmed that women with two prior cesarean deliveries and women with a twin pregnancy and one prior cesarean delivery can consider TOLAC, but may have a higher risk of uterine rupture. You should discuss your options with your own obstetrical provider

Your doctor or midwife will review your records to determine what type of incision you had with your previous c-section(s). If your records are not available, your clinician will not be able to tell your type of incision, and you will both decide on your best option for delivery.

Which delivery option has the least risk?
  • The fewest complications occur with a successful trial of labor after cesarean and vaginal delivery, also called a vaginal birth after cesarean (VBAC).
  • The risk of complications with a scheduled or elective repeat cesarean delivery is greater than with a successful TOLAC and VBAC.

The highest risk for complications is with patients who have an unsuccessful TOLAC and emergency cesarean delivery.

What are the benefits of a TOLAC?

If a TOLAC results in a vaginal birth, the patient typically has the best outcome.

These improved outcomes include:

  • Faster recovery time.
  • Shorter hospital stay.
  • Less chance of a blood transfusion.
  • Lower risk of infection.
  • Avoiding major surgery.
What are the risks of a TOLAC?

Uterine rupture is a risk with a trial of labor. The risk of uterine rupture with a previous low transverse (sideways) cesarean delivery is less than 1percent.

If a uterine rupture does occur, an emergency cesarean delivery will be needed.

The baby may be seriously injured or could die if a uterine rupture occurs.

Occasionally, the uterus cannot be repaired after a rupture and hysterectomy (removal of the uterus) is required. The risk of uterine rupture is increased when labor is induced, rather than when a woman goes into labor naturally.

Other risks to the patient with uterine rupture include:

  • Blood transfusion.
  • Infection.
  • Injury to internal organs and structures (bowel, bladder and urinary tract).
  • Blood clotting problems.
  • Very rarely, patient death due to complications.

If a trial of labor is not successful, you will need to undergo a repeat cesarean delivery and will have more risk of complications than with a planned or elective repeat cesarean delivery. These risks include a greater chance of blood transfusion and infection.

Who should NOT attempt a TOLAC?

For some women, the risks of TOLAC exceed the benefits. These women include those with:

  • Previous classical cesarean delivery, due to the type of incision.
  • Some types of previous uterine surgery including the removal of fibroids.
  • More than two consecutive cesarean deliveries with no prior vaginal deliveries.
  • Prior uterine rupture or dehiscence (separation of scar).
  • Too small a pelvis.
  • Medical or obstetrical problems that prevent vaginal delivery.
What are the benefits and risks of a scheduled or elective repeat cesarean delivery?

Patients who undergo a scheduled or elective repeat cesarean delivery avoid the risks of an unsuccessful trial of labor. They can also select a date for their delivery.

The outcomes of scheduled or elective repeat cesarean delivery are more complicated than with successful TOLAC and may include:

  • Higher rate of infection than with vaginal birth.
  • Greater blood loss and higher risk of transfusion.
  • Rare injury to bowel or urinary tract.
  • Increased risk of problems with the placenta with future pregnancies.
  • Rare need for hysterectomy (removal of the uterus).

All of these risks are higher the more cesarean deliveries you have.

In addition, there is an increased risk of problems with the placenta with each cesarean delivery.

If you have further questions, please speak with your health care provider.

For most patients with a prior cesarean delivery, a Trial of Labor after Cesarean (TOLAC) is a reasonable option to consider. Once your obstetrical provider has decided that you are an appropriate candidate for TOLAC, the choice is up to you. You also have the option of an elective repeat cesarean delivery, and your provider will help you make this decision.

If you decide on TOLAC, you can change your mind and have a cesarean delivery. Your doctor or midwife may also decide that it is unsafe for you to continue your trial of labor and perform a repeat cesarean delivery.

Preparing for Your Stay

 
 

Interpreter Services

Women & Infants serves patients from many different cultures. We want to communicate with you in the language with which you are most comfortable. The hospital will provide an interpreter at no cost.

Childbirth Education Classes

Childbirth & Parenting Education Classes Women & Infants offers customized eClasses in English and Spanish. For more information about our class offerings or to register for classes, please visit our Childbirth & Parenting Education page or call the Health Education Department at (401) 276-7800.  

 

The Newborn Channel

To help you prepare for the birth of your baby and those first few years of life, we’re making it easy for you to access The Newborn Channel programs offered at Women & Infants Hospital. Log on to thenewbornchannelnow.com and enter the password 06222 to watch videos on topics including preparing for your baby, breastfeeding, child safety, and keeping you and your baby healthy. 

Comfort Measures

Women have several options when coping with the discomfort of labor and childbirth. Delivering naturally is when no anesthesia is used. Many women, through the support of their significant other or labor partner, their nurse, midwife or physician, choose this option and feel empowered by this experience. Some women choose to have pain medication given either through an intravenous line or injection. This option will ease the pain of the contractions and can be helpful in early labor. Nitrous Oxide is a self-administered, breathable form of analgesia that relieves pain and reduces anxiety during labor.

Another type of medication is epidural anesthesia which allows mom to feel only mild to moderate contraction intensity and pressure during labor and childbirth. Whatever your choose, our exceptional labor and delivery nurses, midwives, and physicians will guide, support, and encourage you through each phase of your labor and ultimately the birth of your baby. You can learn more about anesthesia through childbirth education classes.

Antenatal Care Unit

Some women must be hospitalized before delivery to monitor their health and the health of their unborn baby. These women are cared for in our Antenatal Care Unit. Rooms here are larger with private bathrooms. The unit also features an amenities suite with exercise equipment, a washer and dryer, and a hairdressing sink and massage table for appointments.

Carter Family Neonatal Intensive Care Unit

We operate one of the nation’s largest single-family room neonatal intensive care units (NICU), offering outstanding care for more than 1,200 premature and sick babies each year. Each room offers the latest technology and most advanced care in a quieter, more private setting. The care team includes: parents, care managers, neonatal nurse practitioners and nurses, neonatal-perinatal fellows, neonatologists, nutritionists, occupational therapists, pharmacists, respiratory therapists, and social workers. The unit offers lounges, a kitchen and shower facilities for parents.

Choosing a Pediatric Care Provider

You must choose a pediatric care provider - a family practitioner, pediatrician or nurse practitioner—before you are 35 weeks pregnant. To help, we provide information on choosing a pediatrician or you can call our Care New England Access Center at (401) 227-3669. Tell the hospital when you choose a provider so we can call him/her when the baby is born. If the provider does not come to Women & Infants, our team of doctors will care for your baby.

Parenting Newsletter

Sign up for our parenting communications and get the right information at the right time. You will receive weekly emails with tips and advice, information on your child’s development, links to local services and online resources, and more! This newsletter is available in multiple languages.

It’s easy to sign up!

Text your hospital code: WIRI to 617-580-3050. You will receive a text message back with a link to an online sign-up form or

Click here to sign up.

Arriving at the Hospital

When to Arrive

If you think you may be in labor, call your doctor or midwife, who may tell you to come to Women & Infants Hospital to be checked.

If you are scheduled for an induction of labor or a cesarean section, please arrive 15 minutes prior to the time you were instructed to arrive.

Checking In

If you are presenting to be seen in the emergency room, when you arrive at the hospital, come into the Women's Emergency entrance and check-in at the Triage desk. When entering the hospital, we ask that your labor support person check-in at the Security window to receive a visitor badge. You will be taken to a private area where you will be evaluated by a physician or a midwife. Patients are seen according to their medical needs. Depending upon how your labor is progressing, you may spend some time in the Triage area or you may be transferred to the Labor/Delivery/Recovery Unit. Your labor partner may stay with you.

If you are coming in for a scheduled induction of labor or cesarean section, please enter the hospital through the main/front entrance (not through the emergency room). There, you and your labor support person will be screened for viral symptoms and directed to check-in at Registration.

What to Bring

During your stay, Women & Infants will provide hospital gowns for you and clothing for your baby. You may also want to bring:

  • Toothbrush and toothpaste
  • Deodorant
  • Shampoo
  • Soap
  • Nightgown
  • Robe
  • Slippers
  • Shower shoes
  • Breast pads
  • Comfortable bras and underpants
  • Clothing for you and the baby to wear home and for baby’s first photo

For your peace of mind, never bring large sums of cash, credit cards or other valuables such as jewelry and personal electronic devices, such as cell phones and iPods. The hospital cannot store your valuables, and is not responsible if they are lost.

Parking Valet Services 

Our complimentary valet service is available for anyone coming for outpatient surgery and for people picking up patients being discharged. Valet parking is available from 7:30 a.m. to 4:45 p.m., Monday through Friday. Use the main drive in front of Women & Infants’ main entrance on Dudley Street. Staff will park your car and get it for you when you are done. If your surgery lasts beyond 4:45 p.m., please return to the valet area. One of our security officers will be available and drive you to your vehicle.

Please note: for the safety of children that require a car seat, we are unable to transport them in our security vehicles. Please have them stay with another adult while we take you to your vehicle.

If you are unsure where to park or have any questions, call Security at (401) 274-1122, ext. 41635.

Public Parking

Parking is available in the public lot which is located opposite the Emergency Triage entrance of the hospital. There is a fee for parking in this lot. Patients with either a United Health card with an anchor in the upper right hand corner, a white Rhode Island medical card with an anchor in the center, or a Neighborhood Health Plan card, or a state welfare card are eligible for free parking. In order to receive free parking, the patient must go to the exit gate in the parking lot, push the HELP button, and display their card and proof of appointment or surgery. Patients who display a Handicapped placard may also park for free.

Visitors are not eligible for free parking and may pay using the kiosk in the South Pavilion lobby near the Nursing Mom’s store.

Admission Forms

Admitting staff will ask you to verify the personal and financial information submitted by your health care provider. You must also sign admission forms and provide:

  • Positive identification, such as a license
  • Your insurance card(s)
  • Name of the pediatric care provider
  • Consent for first portrait of your baby

You may also provide copies, if you have them, of a Living Will (written document stating your wishes for withholding or withdrawing medical care or treatment if your condition becomes terminal) or Durable Power of Attorney (written document that appoints someone to make health care decisions for you). You can get these forms through the Admitting Office, (401) 274-1122, ext. 41422. Contact your attorney with any legal questions.

Cord Blood Banking

Patients may choose to donate their cord blood to a private cord blood banking program. Please have the appropriate materials when you deliver, and we will make every attempt to collect the sample from the cord for you. You would then be responsible for sending this to the bank.

During Your Stay

Patient Information

While you are in the hospital, your family and friends can call (401) 274-1122, ext. 43100 to learn if you are a patient here. Due to the Patient Privacy Act, we do not give out specific information regarding your care or condition. If do not want any information released, tell your doctor or primary nurse.

Length of Your Hospital Stay

Hospital stays are relatively short. This is not dictated by you or the hospital, but by your medical condition and health insurance plan. Discharge time is by 11 a.m. Arrange transportation in advance so you will be ready to go home.

Visiting Hours

Visiting hours are from 9 a.m. to 9 p.m. Children of the patient (siblings of the newborn) are welcome when visiting with a banded support person. A maximum of six people may visit at one time, including the banded support people and children of the patient. However, all visitors need to check in and receive an identification badge before visiting a friend or loved one. In the labor room, only your designated support persons, up to three people maximum, are allowed.

Who's at the door?

In the short time you're a patient at Women & Infants, you can expect a variety of people who visit your room to support you during your stay. Family and friends will want to see you, but staff at the hospital must also check-in to make sure you have all the information and support you need.

The following people may stop in your room while you're here:

  • Nurses or nursing assistants check on you hourly to make sure you are safe, comfortable and have everything you need. Nursing instructors may also ask permission for a nursing student to aid in your care.
  • Nurse managers or hospital administrators may stop by to make sure you are happy with your stay and the care you are receiving.
  • Physicians and midwives will monitor your recovery and discuss ongoing care and your transition home.
  • Lactation consultants will help you if you are breastfeeding.
  • Housekeepers will keep your room and bathroom clean.
  • Food and Nutrition staff will deliver your meals, assist with ordering meals, and obtain feedback on your dining experience.
  • Visiting nurses representative will check in to talk about setting up a possible visit in your home after discharge, if eligible.
  • Social services representative will see you on a referral basis to explain community services.
  • Chaplains may visit to offer spiritual support.
  • Research study assistants will discuss studies that are recruiting patients.
  • Photographers from Mom365 will take your baby's first portrait.
  • Business Office representative may explain payment for your hospital stay, if needed.

Please be aware that we do have visitation signs that can be placed on your door if you want to limit visitors to support your rest and recovery.

Hospital Safety

The hospital follows measures to protect your safety, including:

  • Having staff identify patients by asking their name and checking the identification bracelet.
  • Having staff mark the procedure/surgery site.
  • Having staff ask what procedure you are having.

Hand washing is the best way to prevent passing colds or infection. Everyone, including children, should wash their hands using soap and water if visibly dirty, or use the hand-gel dispensers located throughout the hospital.

Electronic devices—such as heating or cooking devices, electric fans, portable air conditioners, and coffee pots—are prohibited in the hospital so we can maintain a safe environment for everyone.

Women & Infants is not responsible for lost or damaged electronic devices.

Patient Representative

To help promote patient- and family-centered care throughout your hospital experience, Women & Infants provides a manager of patient and family centered care who acts as a liaison between you, your family, hospital staff and administration. The patient representative addresses your rights, concerns and complaints, answers questions, and lets you and your family know about the services that are available to you. Contact the Patient Feedback line at (401) 274-1122, ext. 44287 (English) or 44289 (Spanish). At night and on weekends, patient experience will return your call on the next business day.

Women & Infants Auxiliary

This group offers several services, including baby’s first photo by Mom365, Lori’s Zen & Now Gift Shop, Au Bon Pain café and the Nursing Moms, Etc. store for nursing mothers and newborns. All proceeds from these businesses are donated to the hospital. For more information, go to womenandinfants.org or call (401) 274-1122, ext. 43151.

Use of Video and Photography Equipment

At the request of our medical staff, we cannot allow the use of video and audio equipment during delivery or a medical procedure. You can use such equipment during labor and after the birth or procedure. Still photography is allowed at any time. Please respect patient and staff privacy by limiting the use of cell phones and refraining from using cell phones to record, FaceTime, or engage in other social media activities.

Smoke- and Tobacco-Free Campus

Women & Infants is a smoke- and tobacco-free campus. Smoking and the use of tobacco are not allowed within 50 feet from the entrances to our buildings or in our parking lots.

Participation in Research Programs

As a Brown University teaching hospital, Women & Infants is involved in important medical education and research programs, and you may be asked to participate. The hospital’s Institutional Review Board reviews all studies. You will be asked for permission before you are involved in any research activity, and you have the right to say no.

Amenities

Before, during and after labor, we pay special attention to your comfort. Labor can be uncomfortable and painful, and we have many amenities in our labor/delivery/recovery rooms to help you labor comfortably

  • Bed that adjusts to accommodate multiple birth positions
  • Birthing balls
  • Birthing bar so you can squat during childbirth if you choose
  • Bouncy chairs
  • Comfortable Upright Birth (CUB) chairs
  • Hydrotherapy (Jacuzzi and showers, when available)
  • Rocking chairs
  • Television with cable
  • Walking path and corridor with activity map to promote comfort in coping with labor
  • Warm packs

Alternative Birthing Center (ABC)

Women & Infants' Alternative Birthing Center offers an option for women having a low-risk pregnancy who want to give birth with minimal intervention in a cozy home-like setting.

The Alternative Birthing Center is located next to Women & Infants’ Labor/Delivery/Recovery Unit, allowing for a quick and seamless transfer to that unit should the need arise. The Alternative Birthing Center features a comfortable bedroom with lots of space to move around, a private bathroom with a Jacuzzi tub, and all the needed amenities to help you stay relaxed and comfortable during labor, birth, and recovery. It also has a small private waiting area where your family can stay during your labor and birth. You are welcome to include a doula, children, and others in your birth experience.

Learn More about our Alternative Birthing Center (ABC)

Skin to Skin

How do I do skin-to-skin?

  • Hold your baby, wearing just a diaper, on your bare chest with his or her head under your chin and face turned to the side.
  • Your baby's chest should be flat against your chest between your breasts.
  • Cover the baby with a warm blanket, making sure the baby's face is uncovered.

Why should I do skin-to-skin?

  • The best place for your newborn to be is skin-to-skin with you. It allows the baby to stay at an ideal temperature and regulate his or her breathing and heart rate using the least amount of energy, keeping calm, and comfortable.
  • It is a way of bonding with and soothing your baby.
  • Having your baby close to you will help you recognize the early signs of hunger. Skin-to-skin holding, also called kangaroo care, is ideal for early breastfeeding sessions and for babies who are not breastfed.
  • Babies held skin-to-skin are better at calming themselves as they get older.

How can I soothe my baby?

  • Offer your breast.
  • Use other comforting techniques such as swaddling and skin-to-skin.
  • Ask for help. Our nursing staff can teach you other comforting techniques and are happy to help.

Will a pacifier help?

The American Academy of Pediatrics recommends not using pacifiers for the first four weeks, especially if breastfeeding. This is important as babies need to feed on cue in order for mother’s milk to come in and pacifiers can interrupt this process. There are also a few infants who have a difficult time latching on a mother’s breast after they have been sucking on a pacifier. So for the early weeks, or until breastfeeding is going really well with ample milk supply, we do not recommend pacifier use. After that time there is some evidence to suggest they may reduce the risk of SIDS, but breastfeeding decreases the risks even more than pacifiers. We at Women & Infants utilize pacifiers only during painful procedures and do not distribute pacifiers to babies or their families.

Rooming In

After you deliver your baby at Women & Infants, we recommend "rooming-in." This means you will keep your baby with you in your private hospital room the whole time you are in the hospital.

This is a healthy choice for families because it lets you care for your new baby. Rooming-in will help you learn to care for all your baby's needs while staff is around to help if you need it. This will also help you feel more comfortable taking care of your baby once you go home.

When you Room-in

  • You can more easily hold, cuddle, look at, learn to respond to and get to know your baby.
  • Your baby can get to know you more easily.
  • Your baby should cry less than babies in the nursery who are away from their mothers.
  • Your baby can learn to breastfeed faster and gain weight sooner.
  • You should feel more able to take care of your baby when you go home.

What to Expect

  • You and the staff will work together on bonding with your baby, keeping your baby warm, and, if you choose, breastfeeding.
  • This is an exciting time for you and your family. We suggest you limit your visitors for the first few hours after you get to your private room so you and your partner can give all your attention to your new baby.
  • Your baby may need to go to the nursery for a short period of time to:
    • Have a circumcision (if you choose for your son).
    • Be examined by his or her doctor with special equipment in the nursery.
    • Let you be cared for if you are not feeling well or allow staff to watch you or the baby more closely.
  • You might think you will get less sleep if your baby is with you. However, studies actually show that mothers get more sleep with their baby in the room.
  • For the first few hours, we suggest that you keep your diapered baby directly against your skin (called skin-to-skin contact). When you are sleeping, we ask that you put the baby in the pram next to your bed to be safe. Please talk to your baby's doctor about sleeping with the baby in your bed if you plan to do this at home.
  • If you have visitors, please ask them to wash their hands thoroughly. Hand-washing is the best way to prevent passing colds or infections. Everyone, including children, should use an alcohol-based hand gel like Purell. Dispensers are located throughout the hospital.
  • If hands are visibly dirty, use soap and water to clean them. In addition, to keep you and your baby healthy, please ask your visitors to stay home if they have any symptoms of a cold or diarrhea, or have recently been exposed to chicken pox, measles, mumps, rubella, or the flu.

We want this to be the best possible experience for you. If you have any questions, please ask the nurse who is caring for you. Rooming-in is just one way to get to know your baby. It will help you learn all the exciting noises your baby makes and see the many things your baby can do.

Pain Relief

Coping with the Discomfort of Labor and Birth Labor and birth are different for each person. The type and amount of discomfort during labor and birth varies from woman to woman and changes throughout the various stages of labor. Whether you wish to try strategies such as movement, massage, water immersion, or relaxation techniques, or epidural, nitrous oxide, or other medications, your birth team can help. 

Preparation for labor:

  • Stay active during pregnancy. 
  • Find a doula.
  • Find a support person. 
  • Talk to your support person, doula and care givers about what you want. 
  • Take a childbirth class.
  • The more you know, the less you fear. 
  • Learn about the medication and non-medication options for labor. 

Know Your Options for coping in labor  

Most women find they need a variety of ways to help them cope with labor. Take the time to familiarize yourself with the many options and gather your support team. Ask your support team in advance to remind you to move around, to breathe, and to ask you how they can help. If one technique doesn’t work, try something else.  

Early labor. Stay up and out of bed. Walking and being on your feet can help your contractions work better and feel less painful.  

Environment. Make your environment comforting. Choose soothing music and become used to relaxing to it, then play the music during labor and birth. Have your birth attendants dim the lights and adjust the temperature to suit you. Wear comfortable clothing. Ask your support team or the birth center or hospital staff to be quiet, especially during contractions.  

Water immersion. A warm bath or shower can be comforting during labor and birth. Soaking your feet may be relaxing, even if you only sit at the bedside and immerse them in a basin. If you and your baby are doing fine, you may use the tub any time that you want and for as long as you want. Water will provide the most comfort and benefit if it completely covers your body and stomach up to your breasts.  

Relaxation. Practicing relaxation before labor will help you stay calm during difficult contractions. To practice, lie down in a comfortable position with pillows under all joints. Have a partner “talk you” through relaxing each muscle. Tense, and then relax, all body parts. Your support person can test your relaxation by lifting each limb, one at a time. If you are truly relaxed, the limb will drop as soon as your helper lets go. Breathing is also integral to relaxation. Deep breathing provides the best oxygenation for your baby and calms your body. Some women attend yoga classes, or practice yoga with the aid of books, tapes or videos. Vocalizing is a good release, too. Chant, hum, or moan. Hypnosis. The goal of labor hypnosis is to reduce anxiety, facilitate labor, and relieve pain. No form of hypnosis works for everybody. Certain individuals are more susceptible to hypnosis than others. The technique should be tried and practiced before labor. Books and other resources are available to help you with self-hypnosis.  

Positioning. Unless you need continuous electronic fetal monitoring, you should be able to move around. If possible, avoid lying flat on your back—it interferes with blood flow to the fetus. Use pillows to support your joints. Find out in advance if you can bring extra pillows for labor. Use the bed or your partner as a leaning post. Try the hands-and-knees position (as if you were going to crawl), but on the bed. Experiment with walking, rocking back and forth, or swaying during contractions. Change positions frequently.  

Birthing balls. Birthing balls are large, inflatable rubber balls that are used in exercise classes or children’s play groups. In labor, you can sit and relax your back against the ball (with the ball supported by the wall or your partner) or lean your belly over the curve of the ball from a hands-and-knees position. Find out if you can bring a birthing ball to labor, or if one is available.  

Visualization and affirmations. Visualization involves creating mental images of the body letting go, the cervix (opening of the uterus) thinning and opening, and the baby moving down in the pelvis. There are visualization tools available, many are free, or you can make your own or have your partner or somebody with a soothing voice make one for you. Create your own affirmations, using phrases with personal meaning.  

Heat and cold. Some women prefer applications of heat, others prefer cold. Sometimes alternating between the 2 works best. You might try placing an ice pack on your lower back or a heating pad on your lower abdomen. However, don’t apply heat to skin that is covered with lotion or ointment—it might burn.  

Massage. Effleurage is a gentle massage used during or between contractions. You or your partner can glide the tips of the fingers in an up-and-down or circular motion on the uterus. Late in labor, however, even effleurage may be too much pressure for the uterus. Back massage is good for back labor and general relaxation. Your partner or doula can give the massage.  

Aromatherapy. Aromatherapy uses the soothing scents of essential oils, extracted from flowers, plants, trees, roots, and fruit. Many health-food stores and pharmacies sell these oils. Lavender, sandalwood, chamomile, melissa, geranium, rose, and orange oil may be relaxing or refreshing. You may not be able to bring candles to a hospital, but you can use the oils in a tub for massage or as a compress. Dilute the oils; 6 drops in a bathtub is sufficient, and half that makes a good compress. Try the oils before labor to make sure you don’t have a negative or allergic reaction to them.  

Acupressure. Acupressure is a massage technique in which the body is stimulated by touch.  

Medication coping techniques  

Nitrous Oxide. Also known as “laughing gas,” nitrous oxide is often used in dental care to help patients manage pain. For labor pain, half nitrous oxide gas is mixed with half oxygen and breathed through a mask or a mouthpiece. In some countries, such as Canada and Australia and many parts of Europe, as many as 8 in 10 women use nitrous oxide to manage the discomfort of labor

Narcotics. Narcotics are another common type of pain medication used in US hospitals to help women manage the discomfort of labor. Sometimes these medications are available in birth centers as well. Narcotics are usually given directly into your blood stream through an IV.

Epidural. An epidural (epidural analgesia) is a local anesthetic placed in a part of your back where it numbs the nerves that go from your pelvis and legs to your brain. This is by far the most common form of labor pain management in US hospitals. With an epidural, you get an injection into the space around the nerves in your spine that makes your body numb below the site of the injection.  

Resources:  

The American College of Nurse Midwives Childbirth Connection: Comfort in Labor   

Childbirth Connection: Labor Pain. 

Going Home

Before you Leave

  • Choose a health care provider for your baby.
  • Fill out and hand in your birth worksheet.
  • Arrange for a ride home and a car seat for your baby. 
  • Check your car seat to be sure it is installed correctly.  Only patients being discharged from Women & Infants will be provided the car seat installation check and service.
  • If you haven't brought an outfit and blanket for your baby to go home in, have them brought to you.
  • If you haven't brought an outfit and your comfortable shoes to wear home from the hospital, have them brought to you.
  • If it is hard for you to get a ride home after a morning discharge, please talk with your health care provider about the possibility of going home the evening before.

At Women & Infants, discharge is at 11 a.m. Please arrange transportation in advance so you will be ready to go home at that time. The person driving you home should arrive by 10:30 a.m. Our free valet service at the main entrance will park the car.

Someone from Central Patient Registration will call or come to your room before your expected discharge. At that time, a financial counselor will verify that the financial arrangements are in order for your hospital stay. If you have not been cleared by a financial counselor, please stop at the Business Office on the first floor when you are discharged.

If you have a vaginal delivery, you can expect to go home on the first or second day after you have delivered your baby. If you have a cesarean section, you can expect to go home on the third or fourth day after your baby has been born.

Additional Information

  • You can talk to your health care provider about having your baby boy circumcised the day or night before you plan to go home. This will help prevent a delay in your discharge.
  • The Warm Line is a popular service for new parents, staffed by professional nurses, that offers helpful information regarding your new baby and postpartum issues. The Warm Line also offers breastfeeding tips.

    The Warm Line may be reached by calling 1 (800) 711-7011.
  • You can also visit Nursing Moms, Etc., a specialty store located on the hospital's first floor. The store offers breastfeeding supplies, clothing, and special items for mom and baby.

Early Maternal Discharge Home Visits

Many new mothers choose to recover from childbirth in the hospital. But, if you and your baby are both healthy, you may bond more quickly at home. Women & Infants offers home visits for mothers who decide to be discharged early.

Early Maternal Discharge Home Visits replace some of the recovery time in the hospital with a personal visit in your home by a registered nurse specially trained in maternal child health.

Benefits

  • Being at home brings your family and the new baby closer together.
  • The nurse provides health exams and educational support to you and your baby.
  • Your health care provider and your baby's health care provider are kept informed of your progress.

You are eligible for an Early Maternal Discharge Home Visit covered by your insurance if you:

  • Meet discharge criteria in your insurance plan.
  • Are discharged by your primary care provider and/or pediatrician and leave the hospital one day before your expected day of discharge.

If your insurer does not cover home visits, you can pay for the service on your own.

If you would like to schedule an Early Maternal Discharge Home Visit, let your nurse on the postpartum unit know within 24 hours of your baby's birth. While you are still in the hospital, your medical record will be reviewed to confirm your eligibility for early discharge, and you will be contacted to schedule your home visit.

Once you are home, you will receive a follow-up call from a nurse. A home health nurse experienced in maternal and child health will then visit approximately 48 hours after your discharge from the hospital. During this visit, the nurse will conduct a thorough and complete assessment of you and your baby and help with your physical and educational needs as a new mother.