Midwifery Week: Spontaneous Labor at Women & Infants Hospital

At the start of the pandemic and throughout, many prenatal education services were cut out or transitioned to zoom or other online platforms. Here at Women and Infants Hospital it was no different. Our prenatal education courses quickly transitioned to online as we sought to protect our educators/clinicians and most importantly, our patients, from the COVID-19 virus. However, not everything can be substituted for online practices—especially a tour of the hospital. As a pregnant person it can feel calming and give you a sense of preparedness when you tour the hospital where you will be giving birth and see the spaces you’ll navigate throughout your stay. As we become accustomed to our new normal and navigate re-opening spaces in COVID-19 era, the midwives of the Midwifery Council at Women and Infants, wanted to walk you through your labor experience and the people and spaces you’ll encounter.

Spontaneous labor: So, you started having contractions!

For many pregnant individuals, labor starts when your practice contractions become rhythmic intense contractions that are four to five minutes apart and last for an hour or more. You call your midwife (or your doctor) and after some initial questions and telephone triage they may say, “Come on into triage!” If you have a doula, this may be a good time to get them involved as well.

Obstetrical triage, or our version of the emergency department (ED), is where we assess if you truly broke your water or if your contractions are laboring contractions and changing your cervix. You will come through the ED entrance, walk by security, and check in at the front desk. Our nurses are skilled in triaging patients, and we have a keen eye for folks who are in early labor versus active labor! Once checked in you’ll be asked to register with your insurance or if you’re contracting away, you will be brought into the triage box and asked a set of questions and have your vital signs measured (think blood pressure, temperature, etc). If you’re in early labor, you may be asked to wait in the waiting room. If you’re in active labor, you’ll be asked to move into the ED rooms.

There you will meet your ED nurse and your ED doctor or midwife. Women and Infants is a teaching hospital so your care team may involve medical students, nursing students, midwifery students, and resident doctors. Your evaluation can consist of a non-stress test (electronic fetal monitoring) and a cervical exam. If your cervix has made considerable change with your contractions, you will make your way up to the labor and delivery floor on the 2nd floor to either a labor and delivery room or the alternative birth center (ABC) room. Sometimes, you may wait downstairs with the ED team for an available operative room or labor room. If you opt for medications for pain relief in the ED, pain medications are available in the form of nitrous oxide or intravenous medications.

If you were scheduled for a cesarean and went into labor before your c-section date the operating room (OR) will be notified and you will go to the OR, also on the second floor, where you will meet your OR team of nurses, doctors, and technicianIn your labor and delivery room (LDR) or ABC room you will meet your labor nurse and your clinic’s on-call team, which may include a midwife depending on your obstetrical practice. If your birth plan includes a want for an epidural, you may request one on LDR along with intravenous pain medications or nitrous oxide. If you are in the ABC your pain relief measures include nitrous oxide and hydrotherapy in the form of a tub. Our labor nurses are integral team members, and they are well versed in understanding labor and helping you with positional changes, pain relief, and labor coaching.

After having your baby, whether via cesarean or vaginally, you will recover in the labor room or operating recovery room for at least 2 hours. During this time, we can help you initiate chest/breastfeeding during this time, if you so choose. After 2 hours and all is stable, you will then make your way up to floors 5 or 6, which are called the mother and baby unit or the postpartum floors. You will meet your postpartum nurse and team and have the chance to bond with your baby and significant other and continue breast/chest feeding or learn paced formula feeding. Our team is composed of lactation consultants who can help you with chest/breastfeeding. Most birthing people will stay in the hospital for one to two days for vaginal births—or 6-12 hours for ABC births— and up to four days for operative deliveries.

We are elated for your birth journey and happy you’ve chosen Women and Infants for your experience.