Labor and Delivery Instructions

The Labor and Delivery Center at UT Medical Center has experienced doctors and nurses to help you with pregnancy problems after normal office hours or those that cannot be handled by your regular doctor in the office. You should always be able to contact someone from the office to seek advice before using these services. The following information will help if you need to go to triage.

• Triage and Registration
• Admission
• Labor Instructions
• Family and Friends

Triage and Registration

Your first visit to Labor and Delivery might be a visit to OB triage, located in the Labor and Delivery center on the 3rd floor of the hospital. Triage is an obstetric emergency room for evaluation of pregnancy problems if you are more than 18 weeks pregnant. If you need to be seen in triage, there is a receptionist from 7 am to 11 pm at the desk in the Labor and Delivery waiting room that will be able to help you get registered.

You may have already pre-registered or have been to triage before, but you need to register each time. If the receptionist is unavailable, follow these instructions.

• Pick up the phone on the wall near the door, or press the button on the white box next to the desk and someone will help you.
• When someone answers just talk, you do not have to press the button again.
• When you come through the door, turn to your right and follow the signs all the way down the hall to triage.
• There are four private triage rooms, and only one support person may come with you to this area.
• Please do not go to the Emergency Department on the 1st floor unless you need transportation to triage.

Sometimes you will be evaluated in triage and sent home for follow-up care with your regular doctor the next day or at your regularly scheduled visit. At other times, depending on the problem, you will be admitted to Labor and Delivery or the Mother/Baby unit (3 East) for continued care. These can be very anxious times, but be assured that your doctors are experienced and making decisions about your care to protect you and your baby.

Call the doctor and report to triage if any of the following occurs.

• Your water breaks
• You have vaginal bleeding
• You think you're in preterm labor before 37 weeks
• You think term labor has started because contractions are every five minutes or less for at least one hour or you are following your doctor's instructions
• You notice a significant decrease in your baby's movement or you are not getting your kick counts
• You feel pressure in your vagina or pain in the lower abdomen that you have not felt before. (It feels like your baby is pushing down and it is getting worse.)
• You have been vomiting for more than 24 hours, especially if you cannot keep liquids down and you have not urinated in six to eight hours
• You have sudden or severe swelling of legs, face and hands
• You have a severe headache and have vision changes such as blurring or spots in front of your eyes
• Fever of 100.4 degrees Fahrenheit or higher and/or chills
• Pain that is severe and not going away
• Painful, burning bumps in your private area
• Burning with urination or pain in the area of the kidneys
• You fall or are in an accident, especially if you hit your abdomen
• Any problem that your doctor advises you to go to the triage for.

Admission

Your room in labor and delivery is called a labor, delivery and recovery room or LDR. For vaginal births, you will labor and deliver your baby in the same room. After the birth, you will stay in this room until you are stable enough to move to the Mother/Baby unit on 3 East. Patient rooms are private and include a shower, phone, TV with a VCR, labor bed, chairs for visitors and a baby warmer. Upon admission, you will be asked to undress completely and put on a patient gown. You can leave your socks on, if you prefer. We encourage you to use the bathroom at this point. After that, most of the time you will be in bed and connected to an electronic fetal monitor. The monitor tells us how your baby is handling labor and the duration and frequency of your contractions. There may be times when monitoring, called telemetry, is allowed. This way you can walk around or continue to be monitored while sitting in a chair or on a birthing ball. IVs or needles in your vein usually are started in order to give you necessary medications and fluids to keep you from becoming dehydrated. Unless you are having surgery, you can have ice chips or popsicles.

You will have several doctors throughout labor and they will all have many questions to ask you. Make sure you bring your birth plan if you have one and let your nurse know that you have it when you arrive. The care team wants you to be a part of everything that is going on and to have an active role in your care. Remember, no questions are stupid and everyone is there to make sure you and your family have a great birth experience.

Labor Instructions

Every birth is a miracle, and every woman and every labor is unique. Most women are very excited when they think they actually are in labor. They have been waiting for this day and many are tired of being pregnant. Along with excitement is some fear of what's ahead. Remember, you can not talk, walk or laugh when you are having true labor contractions, and you may need to stop and use your relaxation breathing.

If you think you are in labor, do the following.

• Stay calm and let your body do the work. As long as your water has not broken and you have no other problems, you may stay at home.
• Start timing your contractions. They may start by lasting 20 to 30 seconds and come every 20 minutes. These contractions usually are mild. The cervix dilates from 0-3 cm during this time. This early part of labor can be as long as eight hours or longer.
• You can continue to eat. Do not eat anything fried or greasy, and avoid milk products.
• Eat lightly; it will give you energy for later labor. Juices, Gatoradeﾨ, toast with jelly, crackers, soup, gelatin and scrambled eggs are good choices.
• It is fine during this time to stay active, go for a walk, do chores around the house, pack your bag if you have not done so, watch a movie or just enjoy each other.
• Use different labor positions. Remember, gravity helps your baby come down into the pelvis.
• Alternate periods of activity and rest. Keep from wearing yourselves out. Do not paint the house, mow the grass or do anything else that will tire you.
• Do not begin breathing patterns until you notice that you are tensing up with the contractions.
• Monitor fetal movement.

During early labor it would be helpful if the labor coach could stay with mom and focus on her. Help her time contractions, and stay calm. Distracting activities are great.

Massaging her back or feet may help to keep her calm and relaxed. A warm shower is very relaxing during early labor. Remind her to empty her bladder every hour. You may be getting worried, but try and keep your focus on your baby at the end of this journey.

Encourage mom with words such as "I'm here for you," "I'm proud of you" or "You are doing a great job!" This is a great time to use touch such as gentle stroking, a kiss or massage. Make note of any changes that indicate labor is progressing, and call your doctor or go into Labor and Delivery if you are concerned.

If this is your first baby, many doctors will tell you to call them when your contractions are five minutes apart and lasting 60 seconds for an hour. If you already have had a baby, your doctor may want you to call sooner. Follow his rules when making your decision to stay home or go to the hospital.

Remember, if your water breaks, it's time to go to the hospital. Do not wait! Note time, color and amount of fluid. Be aware of fetal movement.

Call your doctor's office and notify them that you are on the way once you have decided to head for the hospital.

Family and Friends

Many women want one or two people in the room during labor, whereas others want to be surrounded by many who offer love and support. Our Labor and Delivery center welcomes four visitors at a time. If there are more, they can take turns. Think about who can provide the kind of support you want during labor.

Your privacy is of utmost importance to us and there will be times when visitors are asked to wait outside the room such as when the doctor or nurse checks your cervix and for epidural placement. The nurse may also use her discretion in sending visitors out if she can not fulfill her goal of caring for you and your baby properly with everyone in your room.

Family members often want to be helpful and call or talk to us about problems on your behalf. Remember, it is against HIPAA regulations for hospital staff and caregivers to discuss your health issues with anyone other than you unless we have written permission. We do, however, want your family members to feel as though they are welcome and helpful. Timing contractions, helping you to get comfortable, fetching items and helping you remember to breathe and stay relaxed helps everyone.