What to Expect When I Arrive at the Hospital
You’re 41 weeks pregnant. You’ve been in early labor for several hours. Suddenly, there’s a shift. The contractions get closer together and wayyyyyy more intense. You start timing your contractions again. You remember the 4-1-1 rule from your childbirth class and check your contraction timer app….and you see that your contractions are now every 3-4 minutes and lasting about a minute long each time. You grit your teeth and wait until this pattern has been going on for an hour. This is it! It’s time to go to the hospital! GAME ON!
You and your partner grab any last minute items and hop into the car. You make the drive and find yourself at the hospital in record time (thanks, partner!). Your partner parks the car and helps you out. After watching you stop and sway throught a contraction, the security comes out to where you are and asks if you need a wheelchair. Immediately yes.
You and partner make your way to the labor and delivery unit. These contractions are no joke and you are ready to get into your room. But wait! First you have to go through the OB Emergency Room (OBED), informally called Triage. A nurse takes you back into the triage area and has you sit on the bed. The “rooms” are divided by curtains. There’s a small bed for you, a computer, some small pieces of medical equipment, and a chair for your partner. The nurse takes your vital signs and asks you about your labor….how long have you been in labor? Has your water broken? How frequently are you having contractions?, etc.
Once you’ve answered the questions, the nurse will put you some monitors around your belly using a couple of thin fabric belts and small, round disks (TOCO transducers). The top belt will measure how frequently you’re having contractions. The bottom belt will measure your baby’s heartrate. You’ll have these monitors on for 30-60 minutes. This monitoring will give the medical staff a picture of what is the current norm for you and your baby before, during, and after contractions. You do not have to stay in the bed; you can stand by the bed if you’re more comfortable being upright and moving during contractions.
While you are waiting in triage, the provider that’s on call for your practice will come to the triage room where you are and, with your consent, do a cervical exam. They will put on sterile gloves, use some lube, and place their fingers into your vagina and up into your cervix. They’ll get an idea of your dilation, how soft and thin your cervix is, and where your baby is in your pelvis. They will check to see if your water has broken. Your doctor or midwife will also take a look at the information they are getting from the fetal monitoring. They will use all of this information to decide whether or not it is time to admit you to the labor and delivery unit.
Good news! You are 6cm dilated and considered to be in active labor so you get admitted to your labor and delivery room. You may have the same nurse you had in the triage area or you may have a new nurse. If you have a new nurse, they will want to do more fetal monitoring so they can get a baseline for you and your baby. Your nurse will also need to take some blood from you to send to the lab. Most hospitals want laboring folks to have a saline lock so there’s easy access to connecting you to an IV line in case you need fluids or in case of emergency. The port is closed off in either your hand or your forearm and you aren’t connected to anything unless needed. If you are GBS+, your nurse will most likely go ahead and connect you to your first dose of IV antibiotics. Once the bag of antibiotics has been administered. you can get disconnected to the IV line between doses.
Fun fact, even though you may have pre-registered for the hospital, someone from hospital registration will still come to see you while you’re in labor. They’ll ask you questions about your insurance and need to see your insurance card as well as your ID. This is a great job for your partner since you’re busy having a baby.
Finally, all the admission questions have been answered, you’ve done the 30 min of fetal monitoring, you have your saline lock placed, and now you can focus on having your baby!