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Questions About Labor and Delivery You Need to Know Now

Pregnant brunette in yellow shirt

If you’re having a baby — especially if this is your first baby — you’ll have many questions about labor and delivery. Even the most seasoned healthcare professionals cannot possibly tell you everything there is to know about the birthing process or facility policy. I’ve talked about questions to ask BEFORE going to the hospital. But here are some questions to ask about labor and delivery as you leave for the hospital and once you arrive.

Am I in real labor? Should I go to the hospital?

First, remember that when you’re at home, you have a lot more control over what you do or don’t do. And, you can have your partner or other birth companion with you at home. Learn how to time your contractions. If you are healthy and at term, there’s probably no benefit to going to the hospital at the first sign of contractions. So, think about staying at home if you’re in very early labor, or if you’re in false labor.

Here’s some good information on telling the difference between real and false labor. However, don’t feel silly if you have trouble distinguishing false labor from real labor. Many mothers are unsure. And, even as a highly experienced labor and delivery nurse, occasionally, I can’t immediately tell, either. 

However, labor isn’t the only reason to go to the hospital. If you develop worrisome signs, with or without contractions, take action. Call your provider, go to the hospital, or maybe even call an ambulance.

How long can I stay home?

Certainly, some women deliberately plan to stay at home for their entire labor and birthing experience. But before you opt for or against that possibility, take a look at some of the pros and cons of a home birth.

I’ve had plenty of babies delivered into my own hands. Not by choice, but by circumstance. (I vividly remember the premature baby who was born in the back seat of a car in a dark parking lot.) But here’s my point: Women can give birth without any of the trappings of the hospital.     

Who is allowed to assist during labor and delivery?

Is a midwife legally authorized to care for a laboring woman at home? It is my understanding that this differs from state to state, so you’ll want to check that out.

What about labor doulas? I’m a huge proponent of doula care. Recently, however, in some cities, doulas have not been allowed to escort a client to the hospital. Why? Because the doula was not considered a “healthcare professional.” In other cities, doulas have been allowed in the hospital if they could show they have a business license.

What should I know about pain relief in labor?

Ah, yes. Perhaps the most glaring questions about labor and delivery pertain to pain relief. Understandable.

These days, epidural analgesia is popular in the United States; some sources say as many as 70% of women have epidural or spinal anesthesia. (That figure seems conservative to me.) However, it is not the only option for alleviating pain. But even if you love the idea of epidural analgesia, there might be a reason why you might not be able to actually have it. Here’s one: Some people are allergic to a medication used in the epidural infusion.

Full disclosure here, I’m not keen on epidural analgesia. But I think every woman should be aware that while it’s popular, it’s not the only way to go. We talk a lot these days about empowerment. Yet, epidural anesthesia can be un-empowering  I’ve already discussed pain management in labor as related to empowerment.

I’m big on Lamaze™ preparation, or the Bradley® Method. Sure, with the COVID crisis, those aren’t being offered in person right now, either. Online Lamaze classes are available, and hybrid Bradley Method classes are an option.

Want to be much less conventional? I love these possibilities.

  • Dancing for Birth is a very new concept. I have explained why dancing in labor works, and I’ve interviewed Stephanie Larson on why dancing in labor works. 
  • Hypnosis and HypnoBirthing®. is, in my opinion, this is the best-kept secret in modern obstetrics. There’s scientific evidence for its safety and efficacy. And, I can attest to its effectiveness in clinical practice. I talked to Robin Frees about how HypnoBirthing can be a positive experience.
  • Water births can be done in a fancy tub, or at home. I was totally fascinated with all that Lois Wattis has to say when I interviewed her.

What happens if I need cesarean surgery?

If you have questions about labor and delivery, you’ll need to also have questions about cesarean surgery. Why so? Because there’s a big chance you’ll end up with a “c-section.”

According to the latest statistics, about 32% of births occur through cesarean surgery. Currently, Alaska has the lowest rate (22.4%) whereas Mississippi has the highest (38.3%).

I often remind mothers and their immediate and extended families that cesarean surgery is major abdominal surgery! We wouldn’t expect anyone, other than a new mother, to go home after major abdominal surgery and care for a baby!

Consider lining up a family member or hiring a postpartum doula. (Note, a postpartum doula may or may not be certified as a labor doula.)

Maybe you’re disappointed about your birth experience. Consider listening to my podcast with Colby Cohen-Archer. She talks about how mothers who haven’t had the birth they might have dreamed of often feel very let-down and disappointed.   

What about assessments and interventions?

When I was a young nurse, I raised enough questions about labor and delivery practices for my co-workers and bosses to label me as a trouble-maker.  “Why do we…?”, “What would happen if…”, and “Is there any science for…” and much more.

You know I could talk about this all week long, right?

I’m in the low-intervention camp. Why do healthy laboring women carrying healthy term infants need all of the “routine” assessment and interventions we subject them to?

In the same breath, I’d say that I’ve seen situations where assessments and interventions are truly needed. The key words here are “routine” and “informed consent.” You should question “routine” assessments. And, be aware that you are entitled to and deserve informed consent before having an assessment or intervention.

All women deserve informed consent for “routine” episiotomy, epidural anesthesia, amniotomy, Pitocin® induction or augmentation, the use of assisted (forceps or vacuum) or surgical (cesarean) delivery, and any other assessment or intervention.

Electronic fetal monitoring (EFM) is more “routine” than any other labor and delivery practice I can think of. Yet, in my experience, the laboring woman is never given a choice about it.  Some argue that routine EFM without informed consent is “an egregious ethical failure”. Meanwhile, the efficacy of routine EMF has yet to be established.

As always, my posts are for information only, not advice. I cannot possibly know your individual situation. But you have a right to be informed of your individual situation. You should also know that you have the right to refuse an assessment or treatment. (Just make sure you understand what you’re agreeing to, or what you’re refusing.)

What’s most important about getting breastfeeding started?

Yes, most women have many questions about labor and delivery. Far fewer have questions about getting breastfeeding started after that. But they should! I’m hoping you’re already wondering how to optimize that first breastfeeding experience.

Simply stated, make sure you have sustained skin-to-skin contact within the first hour of life.

Most adults think that latching and suckling is instinctive for the newborn. Some equate such an instinct to what “little puppies” do. However, there’s a big difference between little newborns and little puppies. In most cases, the puppies have been born in a quiet, peaceful environment with few or no interventions.

In a hospital-based birth, that’s usually not the case. To “activate” an instinctive reaction, the newborn needs to be skin-to-skin with its mother, and preferably, have no separation from the mother.

Be sure to tell the nurse NOT to weigh and measure the baby until after that first hour. Vital signs can (and should) be assessed while the baby is on your naked chest.

Babies come when they are ready. That includes times when moms can’t have visitors in the birthing facility, or even on the side of the road in the backseat of a car. You can handle labor and delivery alone if need be! It may not be your first choice or part of your birth plan, but you are equipped!

Have you asked these types of questions about labor and delivery? Are you prepared to labor and deliver alone? Tell me in the comments below. Please share with expecting mothers you may know!

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