Get Ready: Baby and Your Body in Labor
Labor is hard work (don't let anyone tell you otherwise), but it's also the most rewarding work you'll ever do.
Contractions
The first signal of labor is contractions — the tightening and release of your uterus that helps propel your baby down the birth canal. These contractions are different from the Braxton-Hicks ones you've possibly had in that they occur at regular intervals, are painful, and are slowly but surely opening the door (that is, cervix) for baby's exit.
You don't need to rush to the hospital or birthing center after your first contraction. But you should call your doctor or midwife to let her know labor has started and how far apart contractions are. Remember, contractions are timed from the beginning of one to the start of the next. Your provider will let you know at what point you should head for the hospital or birthing center. Until then, you can labor in the comfort and privacy of your own home. However, if the pain from contractions starts to be more than you can handle without professional help, have your coach call your provider back and let her know you're heading for the hospital early. Read on for early pain relief options you can try at home.
Prep
When you do arrive at your birthing center or hospital, the nursing staff will prep (or prepare) you for labor and delivery. What prepping involves depends on facility policy and doctor preference, but here are some procedures you might encounter.
Suit Up
You'll change into your hospital gown or nightgown from home. Try not to wear a lot of jewelry or other extraneous items that can get lost in the shuffle from room to room.
A Close Shave
You could be getting a partial shave of your perineal area or, less commonly, a full shave of both your abdominal and pubic area.
The Enema Within
It's possible that your hospital requires an enema to clear out your bowel so baby will have a smoother passage down the neighboring birth canal. It's not very common in today's hospitals and birth facilities, but it is a possibility. Find out in advance if this is required; you might be able to administer it at home if it makes you more comfortable. If contractions have had you on the toilet all day and you've got nothing left to give, let your nurse know and staff could bypass this step.
Drop a Line
Your nurse may insert a needle with a heparin lock and secure it with surgical tape. If intravenous (IV) medication is suddenly needed during labor, it can be easily hooked up. Other hospitals will hook you up to an IV line as a matter of course and administer a glucose solution to keep you hydrated. Other medications can be added to the line as necessary.
Baby Monitor
Chances are good you've experienced the fetal and uterine monitors during a visit to your provider, so this part of the procedure should be familiar to you. The monitor will give you a visible and audible look at your contractions and the fetal heart rate; it will allow you and your coach to see when a contraction is coming and, more important, when it seems to be almost over. It will also pick up fetal heart sounds and alert you to any stress the baby may be experiencing from oxygen deprivation or problems with the umbilical cord. An internal monitor might be used if you are considered to be at high risk. (For more on fetal monitoring, turn back to Chapter 5.)
