If you’re planning to have a vaginal birth, you’ll head to the hospital when you feel regular contractions. These are different from “practice” or Braxton-Hicks contractions, which are usually sporadic.
Some providers tell patients to go to the hospital when they’ve had contractions for over an hour, and they’re five minutes apart. You should also head to the hospital if your water breaks or you’re concerned about any unusual symptoms, like bleeding, pain, or a decrease in your baby’s movement.
When You Arrive
When you arrive for a hospital baby delivery, a midwife or obstetrician will meet you.
Once in your hospital room, you’ll meet your labor team. This includes at least two providers, such as your obstetrician and nurse, midwife and nurse, or two midwives.
Someone on your team will check your cervix to see how much you’ve dilated and time your contractions. The nurse will check your blood pressure, heart rate, and baby’s heart rate.
If you are not actually in labor or your labor hasn’t progressed far enough, your provider may send you home. You’ll get instructions about when to return.
If you’re past your due date, or have medical issues affecting you or your baby, they might induce labor with a medication.
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Early labor
The first part of your labor is when your uterus contracts and the cervix opens slowly. This may take minutes, hours, or even days. You can often move around, sit in a chair, or lie on the hospital bed during early labor.
During this time, your health provider will monitor your baby’s heart rate. They may do this continuously with a monitor that sits on your belly or intermittently with a handheld doppler, both of which use safe ultrasound technology.
Your provider can also do other tests to give more accurate heart rate and contraction readings if needed. For example, they can send a thin wire with an electrode on it through your cervix and attach it to your baby’s scalp.
Your provider may also place a device on your abdomen that senses pressure changes to measure contractions. This shows your team how frequent your contractions are so they can see how labor is progressing.
One of the benefits of a hospital birth is that you can get an epidural, which isn’t available during home births or at birth centers. An epidural is continuous pain medication delivered through a small tube placed in your back.
Many women like to wait to get an epidural until they feel they need one. Keep in mind, though, that it can take 30 minutes or more for an anesthesiologist to arrive.
Active Labor
During the active stage of labor, your cervix will start to open more quickly. The contractions become stronger, longer, and closer together.
Birth
Once you are fully dilated (10 centimeters), your care team will tell you when to start pushing. The time range for the active stage is different for every person. Some people push for five minutes, others for more than three hours.
If your baby isn’t progressing down the birth canal as expected, or is not tolerating the contractions well, your provider may assist use special equipment. Options include a suction cup or forceps to help gently pull your baby out.
Your team will coach you on when and how to push, and they’ll let you know when they see your baby’s head. That’s called crowning.
When your baby comes out, your birth provider might put your little one on your chest right away. Or they might clean up, weigh, and measure your baby. Some babies need a little extra help transitioning to breathing air, and the nurses and providers may take the baby to a warming bed to help the baby adjust to the outside world. (You can let your team know which order you prefer.)
After Delivery
One and five minutes after your baby’s birth, your health care team will score your baby’s breathing, reflexes, skin color, heart rate, and muscle tone. This AGPAR score helps your team determine if your baby needs extra oxygen or other treatments as they adapt to the outside world.
You can breastfeed right away if you’re ready, and your nurses will be able to help guide you. You and the baby may be alert with the adrenaline of birth.
Within 30 minutes after birth, you’ll deliver the placenta. You may feel contractions at this time as well.
Many women spend at least one night at the hospital after a birth with their baby. (Depending on where you deliver your baby, your baby may have a secure bassinet beside your bed, or may go to a nursery if you desire.)
The next day, you’ll be able to get help with breastfeeding and bathing your baby. Your health providers will also draw a small amount of blood from your child’s heel. This goes to a lab, where it’s screened for genetic disorders that require early treatment.
When you’re ready to go, a provider will check to make sure you have safely strapped your baby into their car seat.
If You Need a C-Section
If you’re having a planned cesarean birth, you’ll show up at your scheduled appointment time. Depending on your hospital guidelines, you may have to stop eating up to eight hours before your C-section (a sports drink, such as Gatorade®, is recommended and clear liquids are fine until a few hours before your surgery). The surgery team will call you the night before with instructions of when to stop eating and drinking.
Although many C-sections are planned ahead of time (for example, due to the baby or placenta position), you might need an unexpected C-section during labor. This happens if your labor stops progressing or if your baby is in distress.
When your surgical team is ready, your team will take you to the operating room. A doctor will inject numbing medications into your back so you will be awake but do not feel any pain.
With a C-section, your baby will usually emerge after 10 to 15 minutes. Your health care providers will care for your baby or pass him or her to a support person while the doctor finishes your C-section. (This takes another 30 minutes.)
After that, your hospital experience will be similar to a vaginal birth, though you’ll stay a bit longer, typically 2 to 3 days. This gives your wounds more time to heal as you rest. It also allows your doctor to monitor you for any surgical complications.
Sources
American College of Obstetrics and Gynecology. Labor and Delivery Resources. Link
Christina Frank and Elizabeth Stein. Here's What to Expect After Giving Birth in a Hospital. Parents Magazine. Link
MedlinePlus. Cesarean section. National Library of Medicine. Link
Marygrace Taylor. Delivering in a Hospital: What All Moms Need to Know. What To Expect. Link
About UPMC Magee-Womens Hospital
For more than a century, UPMC Magee-Womens Hospital has provided high-quality medical care to women at all stages of life. UPMC Magee is long-renowned for its services to women and babies but also offers a wide range of care to men as well. Our patient-first approach ensures you and your loved ones get the care you need. Nearly 10,000 babies are born each year at Magee, and our NICU is one of the largest in the country. Our network of care – from imaging centers to hospital services – provides care throughout Pennsylvania and Maryland, giving you a chance to get the expert care you need close to home. The U.S. Department of Health and Human Services recognizes UPMC Magee as a National Center of Excellence in Women’s Health, and the Magee-Womens Research Institute is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology.