Hospital birth

Most womenhave their babies in hospital, and the American College of Obstetricians and Gynecologists (ACOG) rates it as the safest option for delivering your baby.

You’ll be strongly advised to choose this type of birth if you’ve had any complications during pregnancy or if you’re expecting twins or multiples, or a breech baby.

Most OB-GYNs and nurse-midwives are affiliated with a particular hospital in your area (it’s possible they may have admitting privileges at more than one). Bear that in mind when you’re choosing your caregiver, and do some research to see if you’re happy with that hospital.

What you need to know about your hospital

• Does it offer tours of the maternity and delivery wards?
  
• When you go into labor, can you go straight to maternity or do you need to be admitted via the emergency room?
  
• Is there round-the-clock anesthesiologist cover?
  
• What is the hospital’s policy when it comes to fetal monitoring (some hospitals specify continuous monitoring), VBACvaginal birth after a cesarean), natural breech deliveries and delivering twins or multiples?
  
• Is there a neonatal intensive care unit (NICU)?
  
• What is the ratio of nurses to laboring women?
  
• How many people can you have with you for the birth and can your children attend?
  
• Can you opt for a private room after the birth and if so how much extra will it cost?
  
• Can your baby stay with you in your room after the birth?
  
• Can your partner stay overnight after the birth?
  
• Does the hospital have a lactation consultant on staff to help you with breastfeeding?
  
• Is there a strict visitor policy?

What happens when labor starts
When you arrive you’ll need to deal with paperwork unless you pre-registered in the weeks leading up to your due date. A nurse will then take you to an examination room to check if you’re in established labor. If you aren’t, you’ll probably be advised to go home and wait to see if things progress. If you are, you’ll be admitted and taken to a delivery room – now is the time to mention your birth plan and make sure your caregivers are informed of how you’d like your labor to proceed.

You’ll be asked for a urine sample and your pulse, blood pressure and temperature will be taken. The nurse will ask how long you’ve been contracting, if you’ve felt your baby moving and whether you’ve eaten in the previous few hours.

Your contractions will be monitored (remember that hospital policy may require continuous monitoring) and you’ll be given a pelvic exam to check how far your cervix has dilated. If there is any doubt as to how your baby is lying, his position will be checked with ultrasound.

Some blood will be drawn, in case you need a transfusion at any point, and you’ll have an IV set up if you’ve chosen an epidural for pain relief. In some hospitals it’s policy to set up a routine IV.

How long am I likely to stay in hospital?
How long you stay in hospital all depends on what kind of birth you have and the health of you and your baby after delivery. If you have a straightforward vaginal birth with no complications you might be able to go home the day after you give birth if your caregivers are happy that your baby is feeding well. This means that if you’re breastfeeding, the lactation consultant will want to see your baby latched on and feeding well before you’re discharged.

Although you are probably desperate to go home, it's a good thing to stay a day or two after you give birth because the nurses will help you to establish breast or bottlefeeding and will show you how to give your baby a bath (see our video, bathing your newborn) and how to wind her properly.

If you’ve had a cesarean section you won't be as mobile after the birth and you should expect to stay in hospital for around five days. Your blood pressure will be checked, and also your scar, to make sure you’re healing properly. Again, the stay in hospital may be frustrating but it’s no bad thing if you get used to having your baby for a while before you have to go it alone at home.

What about birthing centers?
Your hospital may have a birthing center in addition to the standard delivery ward. These centers offer a more low-tech birth experience under the care of certified nurse-midwives and have a more comfortable and homely atmosphere. You may feel more in control in this type of setting, and are more likely to have access to a birthing pool if you want to try a water birth. While you’re less likely to have medical interventions in a birthing center, you can labor in the assurance that you can be swiftly transferred to the delivery ward if complications arise or if you feel you need stronger pain relief such as an epidural.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.