Pregnancy Planning Guide for Expecting Parents

Estimated Date of Delivery

The “estimated date of delivery” (EDD), or “due date” as it is commonly called, is the expected date that you will begin labor. As the name suggests, this date is just an estimate. It is likely you will start labor any time from two weeks before or two weeks after this estimated date. It is unlikely that your baby will be born exactly on the estimated date of delivery. In fact, only 5% of babies are born on the exact due date.

There are a few different ways to estimate your due date:  

• The most accurate way to determine your estimated due date is by using your date of ovulation to find the age of the fetus. However, the exact date of your ovulation is rarely known.
• The most common way to determine your due date is by using your menstrual calendar. This method is not exact because it is effected by the regularity of menstruation, which changes from month-to-month and woman-to-woman. It is also sometimes hard to remember exactly when your last period was. In this case, keeping a menstrual calendar is helpful. Despite not being 100% accurate, it is the easiest way to get a useful prediction. To calculate your estimated due date using this method, take the first day of your last menstrual period, add seven days to that, and count back three months. For example, if your last menstrual period started on May 2nd, add 7 days to get May 9th and count back three months to get March 9th. This means that you can expect your baby to arrive around March 9th.
• Your doctor can tell how far along in your pregnancy you are by listening to the baby’s heartbeat using a special ultrasound device. In most pregnancies, the fetal heartbeat cannot be heard until about 10 to 12 weeks.
• Your doctor can also use an ultrasound device to convert sound waves into a picture that you can see. He or she can use this picture to set the age of the fetus within about a week. This method is used during the first half of the pregnancy. As the pregnancy progresses past the first half, accuracy of the method declines.

Whichever method you use to determine your expected due date, it is an important and necessary step. The months ahead of you are full of planning and learning so that you are prepared for the arrival of your new baby.

Ways to Relieve Your Pain

During pregnancy your body is going through many changes. These changes are triggered by hormones that prepare your body for pregnancy. These hormones can also cause many physical discomforts. Luckily, there are easy ways to relieve your pains.

Backache

Backache is one of the most common problems women face during pregnancy. The extra weight you are carrying causes a strain on your lower back muscles causing them to become stiff and sore. If you have a backache that refuses to go away or continues to get worse, call you doctor to be sure that this pain is not caused by another health concern.

Some ways to lessen and relieve back pain:

• When picking up objects below waist level, use your legs instead of your back by bending your knees and keeping your back straight. Avoid heavy strain on your back by letting someone else pick up heavy objects. Also, keep objects within your reach so you don’t have to strain yourself to grab them.
• Wear low heeled shoes. High heeled shoes tilt your body and put more strain on your back.
• Stay off your feet! If you have to sit for a long time, sit in a comfortable chair with good support on your back or put a pillow behind the small of your back. If you have to stand for long periods of time rest one foot on a stool while you lean your weight on the other to relieve pressure on your back.
• Sleep on your side with a pillow between your legs to support your back. Also, sleeping on a firm mattress will give your back more support than sleeping on a soft mattress. To firm up a soft mattress just have someone put a piece of plywood between the box spring and the mattress.
• Exercise to keep your back muscles stretched. Strengthen your back muscles by doing exercises and using good posture.
• Use an abdominal support garment to help take the weight of your belly off your back. Some maternity bottoms have built-in, thick elastics that ride below your belly to do the same thing.
• Use a heating pad, warm water bottle, or cold compress on your back to ease pain.

Breast Tenderness

As you body prepares itself for breastfeeding your breasts become larger and heavier. They most likely feel full and tender.

To help relieve breast discomforts:

• Wear a bra that fits well and has good support. A maternity bra, a bra built with extra wide shoulder straps, more coverage in the cups, and an extra row of hooks, is a good choice.
• Wear a supportive sleep bra to give you support while you sleep.

Constipation and Gas

During pregnancy you may get “backed-up” from hormonal changes or from vitamin supplements. This can cause painful bloating and gas which may be exaggerated late in the pregnancy when the weight of your uterus begins to push on your rectum.

To reduce bloating and gas:

• Drink plenty of fluids to help flush out your digestive tract.
• Eat high fiber foods, including vegetables, whole grain bread and bran cereal.
• Exercise to help your digestive system stay on track.

Frequent Urination

Frequent urination during pregnancy is caused by many influences. Your body is working hard to remove waste from your body. As your uterus grows it begins to press against your bladder and cause you to feel like you have to use the bathroom even if your bladder is almost empty. This may lessen in mid-pregnancy, as the uterus no longer rests on the bladder, but may begin again late in the pregnancy when the uterus drops into the pelvis. You may leak urine when you sneeze or cough due to pressure on your bladder. If this happens you can protect yourself by wearing panty shields or sanitary napkins.

To relieve frequent urination:

• Eliminate colas, coffee, and tea from your diet. Caffeine makes you urinate more. Don’t reduce the amount of fluids you drink, as this will rob you and your baby of vital fluids.

Headache

Headaches during pregnancy can be caused by hormonal changes, stress, increased hunger, fatigue, or even caffeine withdrawal. It is best to speak with your doctor before taking any drugs to relieve the pain.

Here are some drug-free tips to reduce headache pain:

• Rest in a dark quiet room.
• Place a cold face cloth on your forehead.
• Gently massage your temples, or have someone gently massage them for you.
• Get plenty of rest.
• Drink plenty of fluids.
• Eat small meals throughout the day to keep your blood sugar constant.

Heartburn and Indigestion

Heartburn, a feeling of burning in the throat and chest, and indigestion, a bloated and gassy feeling that happens when a stomach is slow to digest, may happen during pregnancy. There are many drug-free ways to help relieve symptoms and prevent heartburn and indigestion. Before taking antacids you should speak with your doctor.

To reduce your heartburn:

• Eat smaller meals, more frequently, rather than three large meals a day.
• Relax and eat slowly, chewing your food thoroughly.
• Stay away from foods that bother your stomach, including fried, greasy, and fatty foods. If heartburn is a problem, avoid fizzy drinks, citrus fruit, and fruit drinks.
• Don’t lie down after eating and eat a few hours before bedtime. If heartburn is still a problem at night, try propping your head up against a pillow or elevate your head using a couple of books under the legs of your bed by your head.

Hemorrhoids

Hemorrhoids are painful, itchy varicose veins in the rectum. These can be caused by extra blood in your pelvic area and the pressure of your growing uterus on veins in the lower body. They may appear when you are constipated because straining bowel movements trap more blood in your veins. They may disappear only to return again during labor due to the strain of delivery.

Try these tips to help prevent hemorrhoids:

• Ward off constipation by drinking plenty of fluids and eating plenty of fiber.
• Keep your weight gain under control. Extra weight makes hemorrhoids more painful.
• Don’t sit for long periods of time. Sitting puts pressure on the veins in your pelvic area.

To reduce the painful swelling of hemorrhoids:

• Soak them in water.
• Apply ice packs.
• Apply witch hazel pads.

Insomnia

Your growing belly may make it hard for you to find a comfortable position while sleeping. Also, the impact emotionally and physically of having a new baby may make it hard for you to fall asleep.

To help you relax and get a good night’s sleep:

• Relax your mind and body in a warm bath or shower before bed.
• Learn relaxation exercises and breathing techniques.
• Limit your daytime sleeping.
• Sleep on your side with a pillow under your abdomen and another between your legs.

Leg Cramps

Leg cramps, especially at night, are a common discomfort during pregnancy, although the cause of them is uncertain.

To reduce cramping:

• Stretch your legs before going to bed.
• Avoid pointing your toes when stretching or exercising.

Lower Abdominal Pain

As your uterus grows, the ligaments that support it are pulled and stretched. This can cause dull or sharp pains on either side of your belly. These pains are most common between weeks 18 and 24. If these pains worsen or don’t go away, call your health care provider.

To prevent or relieve pains:

• Avoid moving quickly, especially at the waist.
• Bend toward the pain to help relieve it.
• Rest or change your position.

Nausea and Vomiting

In the beginning of your pregnancy, you may feel queasy by the smell of certain foods and have trouble keeping food down. This feeling, known as “morning sickness,” can happen at any time during the day or night and may lessen by the middle of your pregnancy. This nausea and vomiting does not harm you or your baby if mild, but if it gets severe, you can’t keep any foods or fluids down, and you begin to lose weight, you should see your health care provider.

To help relieve nausea and vomiting:

• Drink plenty of fluids to keep from dehydrating. Sweet, bubbly drinks may help you feel better.
• Eat more often to keep your stomach full.
• If you are nauseated when you wake up, keep crackers next to your bed to nibble on before getting up. Get out of bed slowly, sit and rest before standing up.
• Eat foods that are low-fat and easy to digest.
• Getting fresh air may help. Try taking a short walk outside or sleeping with a window open.

Shortness of Breath

The increase of progesterone early in pregnancy may leave you short of breath. Later in the pregnancy, your uterus grows larger and may press against your diaphragm, making it difficult to breath. You may feel short of breath but you are still getting adequate oxygen.

To help you breathe easier:

• Give your heart and lungs a break by moving slowly and taking it easy.
• Give your lungs more room to expand by sitting or standing up straight.

Swelling

Due to the increase in water in your body you may experience some swelling, known as edema, in your hands, feet, face, and other body parts especially later in the pregnancy and during the summer. If you notice a sudden swelling of any body part you should contact your health care provider.

To relieve swelling:

• Sit with your feet up often.
• Sleep with your legs propped up on a pillow.

Varicose Veins

Varicose veins, blue bulges on your legs or in the lower body during pregnancy are caused by the weight and pressure of your growing uterus. There are no ways to prevent this, but you can reduce the swelling, soreness, and itching.

Following are suggestions to help reduce your risk of developing varicose veins:

• When sitting or standing for a long period of time, be sure to move around and change your position once in awhile.
• Sit with your legs straight not crossed.
• Relieve pressure by putting your feet up on something such a chair, desk, or stool.
• Exercise.
• Wear support hose. Avoid wearing stockings that are tight around your legs.

In any stage of your life, exercise is a part of a healthy lifestyle and pregnancy should not interfere with this. As busy as you may be, it is important for you to make the time to exercise. After all, research has shown that women who exercise while pregnant not only tend to have smoother pregnancies, but they may also experience easier labors, and feel better about themselves during pregnancy and after delivery.

Like many pregnant women, you probably wonder just how much exercise is safe, how you should do it, and at what intensities. As with all exercise programs, you should check with your own health care provider to be sure that there is no reason that you should not embark on or continue an exercise program.

Exercise Guidelines

Here are some guidelines which should be followed for a safe and healthy exercise program for pregnant women:

• During pregnancy, women can continue mild to moderate exercise routines. It is best to exercise regularly, at least three times per week.
• Non-weight-bearing exercise, such as cycling or swimming, may be the easiest to continue throughout pregnancy and may reduce the risk of injury. However, weight-bearing exercise, such as walking, may also be continued at close to your normal intensity level.
• After twenty weeks of pregnancy, avoid doing any exercise on your back, as this may decrease blood flow to the uterus.
• Avoid moderate exercise in hot, humid weather, or when you are sick with a fever.
• Wear comfortable clothing that will help you to remain cool.
• Wear a bra that fits you well and gives you plenty of support to help protect your breasts.
• Drink plenty of water to help keep you from overheating or dehydrating.
• Pregnant women need an additional 300 calories each day. Women who exercise during pregnancy should be especially careful to ensure adequate diet.

Exercise Warning Signs

While exercising during pregnancy, listen to your body and signs it may be giving you. Stop exercising and call your health care provider if you experience any of these symptoms while exercising (note: call even if you experience these symptoms when not exercising):

• Pain.
• Vaginal bleeding.
• Increased shortness of breath.
• Rapid heartbeat.
• Difficulty walking.
• Uterine contractions and/or chest pains.
• Fluid leaking from the vagina.

Right from the onset, eating a healthy, well-balanced diet is vital for a pregnant woman and her developing baby. Although many people will say that you are "eating for two," this is really not the case. In fact, most pregnant women only need an additional 300 calories each day.

Recommendations for total weight gain in pregnancy are based on your pre-pregnancy weight for height or BMI (body mass index):

• Underweight: BMI Less than 18.5 28-40 lbs.
• Usual weight: BMI 18.5-24.9        25-35 lbs.
• Overweight: BMI 25.0-30.0          15-25 lbs.
• Obese: BMI: Greater than 30.0     11-20lbs.

Keep in the mind the following tips in order to keep your weight gain within the recommended ranges:

• The goal of eating a balanced diet is to make healthy food choices for meals and snacks most of the time. Depending on your caloric need for appropriate weight gain, it is okay to include sweet and savory treats sometimes and in limited amounts for those special times. It may help curb those cravings.
• Eating in short intervals of time (6-8 times) and in small amounts throughout the day, helps to keep your hunger in check and may prevent over-eating. It may even help the common gastrointestinal disorders like nausea, vomiting and heartburn of pregnancy.
• It is very important to stay hydrated every day. Drink at least eight 8-ounce glasses of fluid per day. This can include: 
  
  • Water.
  • Milk.
  • Fruit juice.
  • Vegetable juice.
  • Naturally decaffeinated coffee and tea.
  • Soup.
  • Plain soda water or seltzer.
  Limit your intake of highly sweetened beverages.
• For a healthy, balanced diet, simply eat from all of the basic food groups, including:
  • Low-fat dairy.
  • Meat and meat alternatives for protein.
  • Fresh fruits and vegetables.
  • Starches and other whole grain products such as bread and cereals.
• Good fats such a vegetable oils, nuts and avocado can add flavor, but do contain more calories
• Your health care provider may prescribe a prenatal vitamin-mineral pill that may contain extra iron, folic acid and omega fatty acids.
• You may already eat a balanced diet; therefore you may only have to eat a few extra calories (approximately 300 calories/day more than your maintenance intake).

Making Healthy Food Choices the MyPlate Way

MyPlate is a simple and practical guide to help you choose a healthy diet. You can access more reputable nutrition education in many categories including pregnancy at the ChooseMyPlate.gov website. There is an interactive activity called "Super Tracker" that can help you design an individualized food plan depending on your trimester of pregnancy. MyPlate was designed by the United Sates Department of Agriculture (USDA) and based on the 2010 Dietary Guidelines for Americans and simplified to Five Food Groups.

1. Grains (6-11 servings)
This group provides your body with complex carbohydrates that give you energy. They are a good source of vitamins, minerals, and fiber. When choosing a food from this group try to include at least half of your intake as whole grains such as whole-grain bread, cereals, oatmeal, whole wheat pastas, and rice. Try to avoid foods that are loaded with fat and sugar.

One serving equals:

• 1 slice of whole-grain bread.
• ½ English muffin or bread roll.
• ½ of a large pita or flatbread or 1 small tortilla.
• 1 ounce (3/4 cup) of cold cereal.
• ½ cup cooked cereal, rice, or pasta.

2. Vegetables (3-5 servings)
Vegetables are a good source of many vitamins, such as vitamins A and C, and minerals such as iron and magnesium. They are also great for you because they are low in fat and high in fiber. To ensure that you get a wide variety of these vitamins and minerals choose an array of colorful fresh vegetables such as:

• Dark-green leafy vegetables (spinach, broccoli).
• Starchy vegetables (potatoes, corn, peas).
• Deep yellow or orange vegetables (carrots, sweet potatoes, squash).
• Legumes (chick peas and all types of beans).

One serving equals:

• 1 cup of salad greens.
• ½ cup of other cooked or raw vegetables.
• 3/4 cup vegetable juice.

3. Fruits (2-4 servings)
Like vegetables, this group also provides many vitamins and minerals such as potassium and vitamin A. Choose from fresh, frozen, canned, and dried fruits such as melons, berries, and citrus fruits. Another good choice is natural, unsweetened, fruit juices. Fruit drinks, which contain excess sugar and artificial flavors, should be limited.

One serving equals:

• 1 medium apple, banana, or orange.
• ½ cup chopped, cooked, or canned fruit.
• ½ cup fruit juice.
• 1/4 cup dried fruit such as raisins.

4. Dairy (3-4 servings)
Dairy products are a significant source of calcium and other nutrients such as protein and phosphorus. Calcium is very important during pregnancy and breastfeeding. When meeting your daily dairy requirements, try to choose low-fat, skim, or part-skim varieties of your cheeses, milk, and yogurt.

One serving equals:

• 1 cup milk or yogurt.
• 1 ½-2 oz. of cheese.
• 1 cup of cottage cheese.

5. Protein (2-3 servings)
This group includes meat and meat alternatives and provides protein, vitamin B, iron, and zinc that the fetus needs to develop. To reduce unnecessary fats, choose lean meats and cut off fat and skin before cooking.

One serving equals:

• 2-3 oz. cooked lean meat, poultry, or fish.
• 2 eggs.
• 2-3 oz. of meat substitute such as a veggie burger.
• 1 cup tofu.
• 4 tablespoons peanut butter or ¼ cup nuts.

Fats, oils, and sweets (eat sparingly)
Excessive intake of these items may have too many calories and cause high weight gain. Choose a limited amount of good fat such as olive oil or low saturated vegetable oils to provide some flavor. Other foods such as low-fat salad dressings, avocados, olives, nuts butter, margarine, and gravies can be eaten in small quantities depending on your caloric need. Limit your intake of sugary foods and high calorie desserts. Sugar substitutes or sugar free products even natural sweeteners such as stevia are likely safe in very small amounts, but need to be researched more to determine the effects on your developing baby.

Other Information:

Food Safety:  To minimize the risk of exposure to harmful bacteria or toxic chemicals, wash with cold water all fresh unpeeled and peeled fruits and vegetables before eating them. Avoid raw or undercooked meats, fish, and poultry. You can heat sandwich meats to destroy any surface bacteria. Also, only eat "MADE WITH PASTEURIZED MILK" dairy products and no RAW milk. Some fish is good to eat in limited amounts as they provide good omega-fatty acids. Do not eat large, older fish such as:

• Fresh or frozen tuna.
• Striped bass.
• Swordfish.
• Shark.
• Marlin.
• Spanish or king mackerel.
• Tilefish.
• Chilean sea bass.
• Orange roughy and large fresh water fish like walleye.

Commonly eaten fish like chunk light canned tuna (not white albacore), shellfish, shrimp and smaller whitefish such as cod, haddock, flounder, and salmon are lower in risk of contamination from pollutants. Limit to 4-12 oz./week.

Label Reading: Learning to read a food label can be very helpful. The food label (usually titled Nutrition Facts) lists important information such as the serving size, the amount of calories and major nutrients per serving. The percentage listed on the labels refers to a basic intake of 2,000 calories per day. This may or may not be your caloric intake so the percentage listed may not be appropriate for you.

Vitamin Supplementation: Often your health care provider will prescribe a prenatal vitamin-mineral supplement. This is primarily for the iron and folic acid (a B vitamin) contained in the multi-vitamin as those two important nutrients during pregnancy are difficult to meet your daily requirement even if you eat a well-balanced diet. It is wise not to take any individual vitamin or mineral supplement unless your health care provider recommends or prescribes them for specific medical conditions or nutrient deficiency.

If you need further assistance with nutrition education or counseling for specific nutrition-related medical conditions during pregnancy, please have your health care provider refer you to a registered dietitian or call Women & Infants' Outpatient Nutrition Services at (401) 274-1122 ext. 42749.

Pregnancy is a time of change and new experiences. You experience feelings, both physical and emotional, that you may have never experienced before. It is a big change to all areas of your life. It is also a learning experience for you, your partner, and your family. To help you prepare, we offer educational classes in English and Spanish to include childbirth preparation, breastfeeding, and newborn care. We also offer a virtual hospital tour of Women & Infants Hospital in English and Spanish.

Some feel no symptoms until they are right in the beginning of labor. Others have many symptoms such as cramping for weeks before labor actually begins. During labor four major changes occur:

• Ripening- the softening of the cervix.
• Effacement- the thinning out of the cervix.
• Dilatation- the opening of the cervix.
• Station- the movement of the baby’s head onto the ischial spines.

Labor Facts

• Only five percent of women actually deliver on their due dates. The typical range for delivery is two weeks before to two weeks after the actual due date.
• The average length of a first labor is 14 to 17 hours. Subsequent labors generally last 6 to 8 hours.
• The position of the baby can effect the length of labor.

Prelude to Labor

Before labor actually begins, many women experience some of the following:

• Braxton Hicks contractions - These “practice” contractions (sometimes felt throughout the second half of pregnancy) tend to be irregular and are focused in the abdomen, as opposed to beginning in the back. They generally cause no changes in the cervix. Many women find that walking may give some relief.
• Lightening - Lightening, or “dropping,” occurs when the presenting part of the baby moves down into the pelvis. This often relieves shortness of breath, but can increase pelvic pressure and frequency of urination. In first time pregnancies, lightening may occur several weeks or just a few hours before the onset of labor. In subsequent pregnancies, lightening does not generally occur until just before labor begins.
• Weight loss - After all of those weeks and months of gaining weight, many women lose two or three pounds before labor even begins.
• Bursts of energy - Many women experience a burst of energy before the onset of labor. Often referred to as “nesting,” many women find themselves cleaning and preparing their homes for the arrival of the new baby.
• Activity of baby - The baby may become slightly less active as labor approaches. You should still feel the baby move several times an hour - if you don’t, call your health care provider immediately.
• Changes in the cervix - Particularly for women who have already had a baby, the cervix may begin to change weeks before labor begins.
• Increased vaginal discharge - Discharge may become thicker and may even be blood tinged.

Signs of Labor

• Contractions - In true labor, contractions will become very regular and will often start in the back and work their way toward the front. They will become progressively stronger and closer together. While walking often stops Braxton Hicks contractions, it will often make real contractions stronger. Time your contractions from the beginning of one to the beginning of the next.
• Rupture of membranes - Also known as “water breaking,” this may be experienced as either a gush of fluid or a slow trickle. Call your health care provider immediately, and be prepared to tell him/her the color of the fluid, the time of rupture, and the movement of the baby.
• Bloody show - As the cervix readies itself for labor, the mucous in the cervix will often emerge from the vagina.
• Effacement and Dilation - The cervix must thin out (effacement) and dilate (enlarge) in order to deliver the baby. The cervix must be 10 centimeters dilated in order for the woman to push.

Braxton Hicks Contractions

Before you go into true labor, you may experience what is known as Braxton Hicks contractions, or false labor. These are labor-like contractions, often felt for many weeks, that help to prepare your cervix for true labor by thinning, softening, and sometimes even opening your cervix slightly. The contractions often occur more frequently as you get closer to your due date and in the afternoon, evening, after you have exercised, or at other times when you are tired. These contractions can range from mild, when you can’t even feel them, to severe, where they can be quite painful.

Some ways to tell if you are feeling Braxton Hicks contractions are to:

• Time your contractions- False labor contractions are often irregular and don’t get close together as time goes on. True labor contractions come at regular intervals and get closer together. They last from 30 to 60 seconds.
• Try to move around. False labor contractions often stop when you walk, rest, or change position. Real labor contractions do not stop as you move around.
• Notice the strength of the contractions- False labor contractions do not increase in intensity. True labor contractions steadily get stronger.
• Note the place of the pain- Pain from false labor contractions are usually only felt in the front while true labor contractions often start in the back and move to the front.

If you begin to feel contractions, time them for one full hour and write down how they feel. Don’t hesitate to go to the hospital if you really can’t tell if you are in labor. It is better to be safe than sorry.

If you have any of these symptoms, call your doctor’s office or the hospital:

• You have symptoms of labor before you are 37 weeks.
• You feel your water break even though you have no contractions.
• You have vaginal bleeding.
• You have constant severe pain.
• You have a fever or chills.
• You feel your baby moving less.

What Should I Bring to the Hospital?

Some time around 33 to 36 weeks might be a good time to pack that overnight bag and leave it near the door, as you really could deliver at any time over the next month. Many women like to have some “comfort” items in the labor room, including:

• Watch or clock with second hand for timing contractions.
• Your favorite music and portable player, if music soothes and relaxes you.

• Camera and/or video equipment if you want to capture the moment. Women & Infants does not allow the use of video and audio equipment while the birth or a medical procedure is in progress. However, this equipment is permitted during labor and after the birth of the baby or the completion of medical procedures. Still photography is permitted during the birth experience or at any time during your hospital stay. 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.

• Lotions or oils you might like for massage.

• Tennis ball or plastic rolling pin for firm counter-massage if you are experiencing lower back pain.
• If there are other items that are important to your cultural, religious, or spiritual beliefs, please speak with your nurse to be sure these items are appropriate to have in the hospital.

For your peace of mind, never bring large sums of cash, credit cards or other valuables such as jewelry with you to the hospital. The hospital cannot store your valuables, and is not responsible if they are lost. Cell phones and personal electronics are the responsibility of the patient for the duration of their stay.

At Women & Infants, the clothing that you wear on arrival is usually sent home and we will provide you with a “johnnie” (hospital gown) to wear during your stay. The following are some additional items that you may want to bring:

• Toothbrush and toothpaste.
• Deodorant.
• Shampoo and soap.
• Nightgowns and robe (if you plan to breastfeed, be sure that your nightgown has the appropriate openings).
• Shower shoes.
• Breast pads.
• Comfortable undergarments (bras and underpants).
• Additional toiletry items.

Clothing will be provided for your newborn infant as long as he or she stays in the nursery. It is recommended that you have clothing for yourself and your baby brought to the hospital the day before you are scheduled to return home.

The Department of Anesthesiology welcomes you to Women & Infants Hospital. We care about you and your family and want to make sure that you are well cared for during your labor, delivery and recovery. That’s why we’re here 24 hours a day, seven days a week for you.

The Department of Anesthesiology

The Anesthesiology Department consists of physician anesthesiologists, certified nurse anesthetists and registered nurses. Women & Infants Hospital was one of the first hospitals in the country to provide around-the-clock coverage for obstetrical patients, and we maintain a record of excellence with respect to patient care and safety.

Goals

Sensitive to the needs of each individual patient, we recognize that some women may not need any pain relief medicines; whereas, other women may want some medicines to help relieve their pain. There are a number of choices available for you. The choice of anesthesia for your labor and delivery is important for your comfort and safety, as well as for the well-being of your baby. The members of the Anesthesiology team are here to make this time especially memorable for you and your loved ones. Whether or not you choose to have anesthesia, a member of the Anesthesiology team will be present during your delivery to be sure that you and your baby do well.

Types of Anesthesia for Labor and Delivery

• Intravenous or intramuscular medication.
• Local anesthesia.
• Epidural anesthesia.
• Combined spinal epidural anesthesia.
  
  

Intravenous or intramuscular medicine

Your obstetrician or midwife may order a medicine to be given by injection into your intravenous line or your muscle. The medicine will help ease the discomfort of labor, but may make you sleepy.

Local anesthesia

Your obstetrician or midwife may give you an injection of local anesthesia into the birth canal during delivery. This will cause numbness of the birth canal and surrounding areas, making you more comfortable.

Epidural anesthesia

This is the most common form of anesthesia to make patients comfortable during labor and delivery at Women & Infants Hospital. The anesthesiologist will place a small, soft tube into the epidural space in your back and then inject some local anesthesia into the tubing. This will cause a tingling, warm, numb sensation of your belly and legs. Your legs may become heavier over time, and you will not be able to get out of bed. The procedure usually takes a few minutes to complete, and the anesthesiologist will make you as comfortable as possible during the procedure. Many women will continue to feel a tightening or pressure sensation that is not painful after having the epidural.

Combined spinal epidural anesthesia

This procedure is similar to having an epidural but involves injecting a small amount of medicine into the spinal space before placing the tube into the epidural space. The effect of the medicine will be similar to that of the epidural; however, the medicine acts much faster. You will feel a tingling, warm, numb sensation of your belly and legs. Your legs may become heavier over time, and you will not be able to get out of bed. The procedure usually takes a few minutes to complete, and the anesthesiologist will make you as comfortable as possible during the procedure. Many women will continue to feel a tightening or pressure sensation that is not painful after having the combined spinal epidural.

Types of Anesthesia for Cesarean Section

• Epidural anesthesia.
• Spinal anesthesia.
• General anesthesia.

Epidural anesthesia

If you have an epidural placed for pain relief during your labor it can be used for a cesarean section. The anesthesiologist will give you a stronger medicine through the epidural. Your belly will become very numb and your legs very heavy. You will feel some pressure during the cesarean section, but you will be comfortable.

Spinal anesthesia

If you do not have an epidural in place, the anesthesiologist will perform a spinal anesthesia for your cesarean section. The anesthesiologist will inject medicine into the spinal space which will cause your belly to become very numb and your legs very heavy. The medicine acts very quickly. You will feel some pressure during the cesarean section, but you will be comfortable.

General anesthesia

In emergency situations or if you are not able to have an epidural or spinal, the anesthesiologist will give you medicines into your intravenous to make you sleep during the cesarean section. You will not be awake for the surgery and will not feel anything during the surgery.

Other Strategies for Pain Relief

Other options to help control your pain during labor and delivery include:

• Jacuzzi.
• Showers.
• Birthing balls.
• Rocking chairs.
• Breathing techniques.
• Back rubs.
• Music.

The Department of Anesthesiology holds two to three classes per week for anyone who is interested in learning more about the choices of anesthesia for labor and delivery. You can have all of your questions answered by an anesthesiologist and an anesthesiology nurse during this time. There is no charge. Please call the Department of Anesthesiology at (401) 274-1100, extension 41565 or 41566 to learn about the program and to enroll.