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Understanding the Hospital Birth Process

By Harry S. Cohen & Associates on

Childbirth is a very exciting time, but it can also be an anxious time. Whether you are a first time parent or a seasoned veteran, there are a lot of complexities to keep in mind.

Of course, parenting and preparation for parenting begin before childbirth. Pregnancy is about 40 weeks worth of preparation itself. Even after the baby arrives, you will have a recovery and adjustment period.

We will touch on all of these stages to provide you with the information you need to know from childbirth to your baby's first checkup.

This information is focused on a hospital birth setting. There are families who choose to deliver babies at home or in another setting, and many of these considerations apply still. However, some of it is unique to a more medical setting such as a hospital. One of the most important things to know is that your medical practitioners are there to follow the appropriate standard of care to ensure the safety of you and your baby.

And finally, we will discuss how to look out for medical mismanagement and the potential for birth injuries, so you can know what to expect.

Getting The Details in Order

Taking a childbirth course can be a helpful way to prepare for labor and delivery. You can also visit the hospital before you are in labor, which can be very useful in familiarizing yourself with the space and their procedures.

Some people choose to hire non-medical support professionals, such as doulas, or photographers. If you are using these services, make sure you know the hospital’s policies around who can be in the room at what point, and let your support team know.

Some hospitals allow you to preregister, which is helpful when you are actively in labor and not wanting to deal with paperwork. If you can pre-register, you will give your insurance information and other details to the hospital in advance, minimizing the wait time day of.

Other details to consider in advance include selecting a pediatrician, packing a hospital bag, and installing a car seat. Some people like to have a list of contacts ready to go, to text or call family members and friends after the baby has arrived.

Going into Labor

For many, going into labor can be as relieving as it is exciting, and yes, a little bit scary. If you are pre-term and experiencing any labor pains or contractions, be sure to get in touch with your doctor right away.

If contractions are not slowing or stopping, it can be a good sign that it is time to call. Heed your doctor’s advice about when you should go in, but remember that you can always err on the side of caution if you feel worried for any reason.

Heading to the Hospital

Your doctor should have informed you about the check-in process. Some hospitals want patients to go straight to labor and delivery, while others have a different process depending on arrival. If you are being induced, you will have an appointment set already.

For patients going into labor on their own, the first step after checking in will be an assessment. Nurses will determine the baby’s heart rate and measure your contractions to determine your progress. You may get a cervical check at this point to see how dilated you are.

Based on this assessment, you may be sent home if you are not far enough into labor to be admitted. If this is the case you will be coming back again for another assessment when your situation has changed, so don’t despair.

If you are showing strong signs of progress, your doctor may choose to admit you.

Being Admitted to the Hospital

When it’s time to be admitted, you can expect a few more routine procedures. You may have a blood sample taken and may be asked to provide a urine sample. Depending on your hospital’s policy you may have an IV line put into place.

If you are being induced, you will have all of these things done before you are induced. Labor can be augmented and started in many ways, depending on your doctor’s preferences and your medical situation. Typically, labor will be started with an IV drip of medication or internal prostaglandin applications. This mimics what your body would do on its own were you to go into labor without induction.

Nurses will first monitor your contractions. Cervical checks will continue as needed, to track your progress, and medical staff should be keeping an eye on your vital signs and the baby’s heart rate. This is important to note, as any failure to adequately monitor the pregnant individual and baby can lead to problems as you near delivery.

If your labor is not progressing as quickly as doctors deem it should, you may require intervention or augmentation. Again, this is usually in the form of an IV medication such as oxytocin, to encourage your uterus to contract more regularly and with more intensity.

Whether your body is experiencing contractions on its own, or you are getting help from augmentation or induction medications, you will find that the contractions get more painful and more intense, lasting longer and happening with more frequency. Some women choose to use pain medication or other management and relief techniques.

Pain management is up to each patient to decide, with help from medical staff. There are many options for pain management such as breathing techniques, movement, water, or medical interventions such as an epidural.

If your pain management plan involves anesthesia such as an epidural, you will have to consent to having it placed if you have not done so already. The anesthesiologist will go over the process with you and tell you the risks and what to expect from this pain relief. Generally, if you are having an epidural placed, your spouse will be asked to leave the room if he or she is present.

Epidurals, in most cases, will prevent you from being able to move about the room or the hospital, as you will need to be catheterized. Epidurals are adjusted in strength, and some women choose to have the numbing effect turned down for when it comes time to push.

There is no right or wrong method for managing one’s pain and discomfort during labor and delivery.

Delivering the Baby

For a vaginal delivery, it will be time to push when your cervix is dilated to 10 centimeters. If you feel an intense urge to push, make sure to let a nurse or support person know. This is a good indicator that your body is ready, but make sure to wait until your medical practitioners have cleared you to get started. If your body is not fully ready, or baby is not in a good position, pushing could result in injury to you or your baby.

With your doctor’s go-ahead, it is time to deliver that baby! You will push with each contraction as directed by nurses and support staff. The amount of time you will be pushing depends on your situation. As you push, listen to what your support team is telling you to do. Monitoring will continue through the pushing process, which is important. If the baby becomes distressed, your medical practitioners should manage the situation immediately.

Unless you are vaginally delivering a breech baby, your baby’s head will arrive first. Once the baby is fully delivered and deemed healthy, he or she will be given to a parent for skin-to-skin contact, or dried and wrapped in blankets. Tell your medical team what your preferences are for handling baby after delivery. If you are interested in breastfeeding, try to feed your baby as soon as possible to help establish a good nursing relationship with the baby.

You will stay with your child in the delivery room for a few hours to recover and ensure that you are both doing well.

If there are problems with the baby’s health, you may be separated from them as they are moved to the neonatal intensive care unit (NICU).

Cesarean Sections

There are different reasons to have cesarean sections. This is a surgical birth, which can be planned and scheduled, unplanned, or emergent.

A scheduled cesarean section involves arriving at the hospital at a set time as determined by your doctor. Upon arrival, you will sign consent forms and discuss the procedure.

An unplanned cesarean section usually happens when vaginal delivery is not successful for any number of reasons. An emergent cesarean happens when the baby or pregnant individual is in distress and in need of an immediate delivery. In the case of an emergent cesarean, medical staff may have to use general anesthesia instead of local.

Typically, patients will be prepped for surgery, including a catheter and whatever anesthesia is being used. For patients who are awake during surgery, a curtain is hung to block your view of the surgery.

The physician will make an incision through the abdominal skin and muscles, into the uterus, after which the baby will be delivered. You will feel pressure, tugging, and/or pushing during this moment, as it takes a bit of effort to get baby out! Some hospitals allow for skin to skin contact with the mother or support partner while the incision is being closed. If not, you will be able to hold the baby or have your partner hold the baby, once your incision is closed.

Cesarean patients will spend some time in a recovery area to ensure that all is well physically before being moved to a patient room.

Recovering from Delivery

In the first few hours after delivery, whether vaginal or surgical, a nurse will monitor your condition. He or she will perform massage on your abdomen to help your uterus contract down to its former size. This can be uncomfortable (especially following a cesarean), but is important for recovery and health.

If you have had a vaginal delivery, recovery may involve stitches and pain management such as ice packs. For cesarean patients, a nurse will check your incision dressing, monitor for bleeding, and offer pain relief.

Your IV will stay in for a few hours after a vaginal delivery, and for a cesarean, until a course of antibiotics is complete, usually within 24 hours.

Nurses and other support staff will assist you in getting up and moving. Many women find that moving as soon as possible helps with recovery, but it’s important to know what your condition allows.

Following this immediate recovery, you will stay in hospital until both you and baby are ready to be released. This is an opportunity to learn more about taking care of your baby, breastfeeding or bottle feeding, bathing, diapering, and taking care of yourself, too.

Many hospitals have done away with traditional nursery rooms, opting to leave the baby to room in with his or her parent(s). Some hospitals still have nurseries if parents need to rest or shower.

Throughout your stay, your assigned medical staff will continue to monitor your vital signs, and the baby’s. Some testing on your baby may include a hearing screen, blood tests, blood sugar testing, and certain medical treatments or vaccinations.

Heading Home with Baby

Your baby will be checked again before being officially discharged.. You will be assessed too, with a check of your uterus, examination of any stitches you may have, and another round of vital sign monitoring.

When your medical team has determined that it is safe for you and baby to go home, you will get ready to be discharged. This stage of the adventure usually involves paperwork. You may be given notes to help with continued recovery at home, prescriptions for medication, or information for follow-up doctor appointments after you have been home for a while. Paperwork may also include the forms and information you need to register your baby’s birth and sign him or her up for identification documents.

If your child is in the NICU or is not healthy enough to go home for any reason, you may be discharged without them. Make sure you are aware of visiting hours and policies for parents of children who are hospitalized.

If you are both leaving together, you will place your baby in the car seat and head home! Don’t worry — as new as this all may feel, you will get the hang of it.

Settling in at Home

It is just as important to have a support network in place after baby comes home as it was to have during pregnancy and childbirth. Have a list of people you can contact if you need help, including your doctor, your baby’s pediatrician, and even friends and family members who are willing to come over and help.

Your medical team will give you a list of warning signs to watch for, such as, dehydration, a lack of weight gain, trouble feeding, infection, and postpartum mental health issues. If you have any fears or concerns, don’t be afraid to reach out for help.

Baby’s First Doctor’s Appointment

Your baby should visit his or her doctor for an appointment within 48 to 72 hours of hospital discharge. At this time, the practitioner will weigh and measure your baby, taking note of his or her weight changes. It’s important to know that babies drop a certain amount of weight after birth, and that is normal. Your doctor will advise if your baby is gaining back his or her weight at an appropriate rate.

At this appointment, your baby can be checked for jaundice and other physical health concerns. It’s also a good time to complete any screenings that were not done at the hospital.

How to Spot Medical Negligence

Medical negligence and birth injury isn’t something expectant parents want to think about, but it’s a reality of life and something to be aware. They usually happen because of improper prenatal care, or problems during delivery.

Birth injuries occur when oxygen to the baby’s brain is disrupted. This typically happens through interruption of oxygen supply through the bloodstream. Birth injuries can also result in physical injuries caused by medical practitioners during labor or delivery.

Specifically, birth injuries present as, or as the result of conditions such as cerebral palsy, shoulder dystocia, stillbirth, preeclampsia, toxemia and gestational diabetes, separated placenta, delayed cesarean section, forceps injury, failure to diagnose preterm labor, maternal infection, or surgical error.

Medical negligence, legally, means there must be carelessness or a preventable error involved. If a medical professional fails to meet the standard of care required under the specific medical circumstances, there can potentially be a negligence case. However, not all medical errors and birth injuries are medical negligence cases, as some are not preventable despite practitioners providing the standard of care.

Medical negligence must also involve an injury that is life altering, for either the baby being born or for his or her family.

Many birth injuries and medical negligence cases are preventable with proper communication between medical staff. Unfortunately, many parents are never informed that birth injuries have been caused by medical negligence during pregnancy, labor, or childbirth. Some may not know that their children have been injured until later in life, when developmental milestones make it clear. This is why it is so important to be aware of the risk of birth injury and medical negligence. Asking your medical professionals outright may not be enough, as many have shown that they will be reluctant to disclose errors.

If you suspect medical malpractice, it is vital to connect with an experienced law firm. Birth injury and medical negligence cases are complex and involve a lot of research and legwork to prove. Harry S. Cohen and Associates is a law firm with the experience to investigate your case, ensuring that you have the best possible chances of reparations.

Financial relief for families impacted by birth injury is important. For children living with a serious birth injury, care and assistance can be quite expensive. A settlement or verdict with financial compensation goes a long way toward meeting families’ needs.

Please contact us with any questions or concerns. You can call us at (412) 281-3000 or 1-888-MEDMAL1, or send us a message online. We are here to help.