Labor Room: What to Expect for Woman, Baby, and Delivery

THINGS TO EXPECT IN THE LABOR ROOM

In the labor room, expect a series of procedures and assessments to ensure the safety and well-being of both the mother and baby. Here’s what to anticipate:

1. 1. Nurse Welcome: Upon arrival, expect to be greeted by nursing staff who will guide you through the initial process.
   2. Preliminary Questions: A midwife or nurse may ask you some preliminary questions regarding your symptoms, due date, allergies, and medications.
   3. Triage Assessment: You will be brought to the triage area for assessment of your labor progress and overall condition.
   4. COVID-19 Testing: Depending on hospital policy, a rapid COVID-19 antigen test may be conducted.
   5. Comprehensive Interview: Expect to undergo a detailed interview to gather information about your medical history, obstetric history, and antenatal care.
   6. Physical Examination: A physical examination will be conducted, including abdominal palpation (to estimate baby’s weight, lie and presentation) and speculum or vaginal examination (if applicable).
   7. Vital Signs Monitoring: Your vital signs, including temperature, pulse, respiration, oxygen level, and blood sugar, will be assessed.
   8. Fetal Monitoring: You will be attached to a fetal monitor for 20 to 30 minutes to monitor your baby’s heart rate and contraction pattern.
   9. Urine Sample Collection: A urine sample will be collected to check for various parameters such as blood, leucocytes, protein, glucose, and ketones.
   10. Blood Tests: Blood may be collected for a complete blood count, liver function tests, and kidney function tests.
   11. Intravenous (IV) Fluids: IV fluids may be administered if necessary, such as in cases of dehydration, preterm abdominal contractions or fetal distress.
   12. Consultation with Doctor: You will be interviewed and examined by a doctor to determine further management.
   13. Discharge Planning: If there is no immediate need for hospital admission, you will be discharged with appropriate instructions (signs of labor, signs of complications, follow up care and when to return to the hospital) and documents (prescription, request form for ultrasound, referral note to a clinic, summary of cares received whilst at the hospital).
   14. Admission or Transfer: If admitted, you will be moved to a labor and delivery room for active labor management or the antenatal ward for closer observation.
   15. Discussion of Birth Plan: If in active labor, expect discussions with healthcare providers about your birth plan and care preferences.
   16. Continued Monitoring: Throughout your labor, expect continuous monitoring of your progress, vital signs, and fetal well-being.

Remember, every labor experience is unique, and healthcare providers will tailor their approach to your individual needs and preferences. Stay informed, ask questions, and communicate openly with your healthcare team throughout the process.

WHEN THE WOMAN IS IN ACTIVE PHASE OF LABOR

During the active phase of labor, which is characterized by regular and strong contractions leading to cervical dilation and effacement, several key actions and procedures take place in the labor room:

1. Transfer to Labor and Delivery Room: If not already in the labor and delivery room, the woman will be transferred there for continued care.
2. Settling In: The midwife or nurse will assist the woman in settling into the labor and delivery room, familiarizing her with the environment and available equipment such as patient call bell.
3. Contractions Monitoring: Contractions will be monitored closely, with their frequency, duration, and intensity recorded regularly, usually every 15 to 30 minutes.
4. Medication Administration: Medications for pain relief or to augment labor may be administered as needed, with close monitoring for any side effects.
5. Communication with Healthcare Providers: The midwife or nurse will maintain communication with the attending doctor or obstetrician to provide updates on the progress of labor and any emerging issues.
6. Assessment of Vital Signs: Vital signs, including fetal heart rate, temperature, blood pressure, pulse, and respiration, will be assessed at regular intervals to monitor the baby and woman’s condition.
7. Position Changes: The woman may be encouraged to change positions periodically to optimize labor progress and relieve discomfort.
8. Vaginal Examinations: Vaginal examinations may be performed intermittently to assess cervical dilation and effacement and monitor the progression of labor.
9. Pain Management: Pain relief measures, such as relaxation techniques, breathing exercises, or pharmacological interventions, will be offered and adjusted according to the woman’s preferences and needs.
10. Support and Encouragement: Emotional support and encouragement will be provided by the midwife, nurse, and birthing partner to help the woman cope with the intensity of labor.
11. Preparation for Delivery: As the woman approaches full cervical dilation, preparations will be made for the delivery, including setting up the delivery trolley and ensuring the presence of necessary equipment and personnel.
12. Sterile Preparation: The doctor or midwife wearing a sterile gown and gloves minimizes the risk of infection during childbirth, maintaining a sterile environment for both the mother and baby.
13. Perineal Cleansing: Cleansing the perineal area with antiseptic reduces the risk of infection and prepares the area for childbirth, ensuring optimal hygiene during delivery.
14. Pushing Instructions: Providing clear instructions and support to the woman during the pushing phase helps facilitate the birthing process and minimize complications, ensuring a safe and efficient delivery.
15. Management of Delivery of Baby’s Head and Body: Careful management of the delivery process, including suctioning the baby’s nose and mouth, clamping and cutting the umbilical cord, and promoting skin-to-skin contact immediately after birth, supports the baby’s transition to the outside world and enhances bonding between mother and baby.
16. Collection of Umbilical Cord Blood Sample: Collecting a sample of blood from the umbilical cord allows for important tests, such as blood typing and screening for conditions like sickle cell disease, to be performed, aiding in the assessment of the baby’s health status.
17. Delivery of Placenta: Ensuring the complete delivery of the placenta and measuring the blood loss afterward helps prevent postpartum complications such as retained placenta or excessive bleeding, promoting the woman’s recovery after childbirth.

IF THE WOMAN IS SCHEDULED FOR A C-SECTION

If a woman is scheduled for a cesarean section (C-section), several specific preparations and procedures are involved to ensure a safe and successful surgical delivery:

1. Informed Consent: The woman will be required to provide informed consent for the cesarean section procedure. This involves understanding the risks, benefits, and alternatives to surgery, as well as any potential complications.
2. Preoperative Preparation: Prior to the surgery, the woman’s abdomen will be washed and shaved, and she may receive intravenous fluids for hydration.
3. Administration of Medications: Antibiotics and antiemetics (medications to prevent nausea and vomiting) may be administered intravenously to reduce the risk of infection and discomfort during and after the procedure.
4. Urinary Catheterization: A urinary catheter may be inserted into the woman’s bladder to keep it empty during the surgery, minimizing the risk of accidental injury and improving surgical access.
5. Preoperative Checklist: A preoperative checklist will be completed by the nursing staff to ensure that all necessary preparations have been made, including verifying the woman’s identity, confirming the surgical site, and ensuring that appropriate equipment and supplies are available.
6. Preparation for Surgery: The woman’s clothing, jewelry, prosthetics, and other personal items will be removed and safeguarded, and she will be provided with a hospital gown and any necessary coverings for her head and feet.
7. Transfer to Operating Room: The woman will be transported to the operating room on a stretcher, accompanied by the nursing staff.
8. Handover to Surgical Team: Upon arrival in the operating room, the nursing staff will hand over the woman to the surgical team, which typically includes the obstetrician, anesthesiologist, and operating room nurses.
9. Anesthesia Administration: Anesthesia will be administered to ensure the woman’s comfort and pain relief during the surgery. This may involve either regional anesthesia (such as epidural or spinal anesthesia) or general anesthesia, depending on the circumstances and preferences of the woman and her healthcare providers.
10. Surgical Procedure: The cesarean section surgery will be performed by the obstetrician, who will make an incision in the abdomen and uterus to deliver the baby safely. The surgical team will closely monitor the woman’s vital signs and respond to any changes or complications that arise during the procedure.

11. Postoperative Care: After the surgery, the woman will be transferred to a recovery area where she will be monitored closely for any signs of complications, such as bleeding, infection, or adverse reactions to anesthesia. Pain management and breastfeeding support may also be provided as needed.

WHEN THE BABY IS BORN

When the baby is born, several important steps are taken to ensure their health and well-being, as well as to provide support to the mother. Here’s what typically happens after the baby is born:

1. Initial Assessment: The doctor or midwife will immediately assess the baby’s condition, including their breathing, heart rate, muscle tone, reflexes, and color. This initial assessment helps determine if the baby is transitioning well to life outside the womb.
2. Suctioning and Drying: If necessary, the baby’s nose and mouth will be suctioned to clear any fluids and facilitate breathing. The baby will also be gently dried with a towel to prevent heat loss and promote comfort.
3. Skin-to-Skin Contact: Whenever possible, the baby will be placed on the mother’s chest for skin-to-skin contact. This intimate contact helps regulate the baby’s body temperature, stabilize their heart rate and breathing, and promote bonding between mother and baby.
4. Apgar Scoring: Apgar scoring is performed at one and five minutes after birth to assess the baby’s overall health and well-being. This quick assessment evaluates the baby’s appearance, pulse, grimace, activity, and respiration, with scores ranging from 0 to 10.
5. Physical Examination: A thorough physical examination of the baby will be conducted by the healthcare provider to check for any abnormalities, congenital conditions, or signs of distress. This examination may include assessing the baby’s weight, length, head circumference, and vital signs.
6. Umbilical Cord Management: The umbilical cord will be clamped and cut shortly after birth. In some cases, delayed cord clamping may be practiced to allow more blood to transfer from the placenta to the baby, which can benefit their health and development.
7. Blood Sampling: A small sample of blood may be collected from the umbilical cord for various tests, including blood typing, screening for genetic conditions, and assessing overall health.
8. When the baby is born, they will be given a special identification label. This label contains crucial information such as the mother’s name, the baby’s sex, the date and time of birth, and the baby’s birth weight. This helps ensure accurate identification and proper record-keeping throughout the hospital stay.
9. Breastfeeding Initiation: Breastfeeding is typically initiated within the first hour after birth, if possible. Healthcare providers will assist the mother with latching the baby onto the breast and ensuring proper positioning and technique for successful breastfeeding.
10. Newborn Care: Basic newborn care, such as bathing, dressing, and diapering, may be provided by the healthcare team. The baby’s vital signs, including temperature, heart rate, and breathing, will be monitored regularly to ensure their well-being.
11. Parent Education: Parents will receive guidance and education on newborn care, breastfeeding, safe sleep practices, and other important topics to help them care for their baby at home.

Pertinent information to note:

After the birth, the woman will stay in the labor room until her vital signs are stable, and any bleeding is under control. The labor and delivery staff will provide care for both the woman and baby, including monitoring vital signs, managing pain, and administering medications.

If the baby is healthy, they will remain in the same room with the mother, promoting bonding and facilitating breastfeeding.

Once the woman has recovered and is ready, she and her baby will be transferred to the postnatal or postpartum ward, also known as the mother-baby unit. Here, they will continue to receive care and support as they transition to the next phase of postpartum recovery.