In the last several weeks before delivery, your body starts to prepare for your baby’s debut. Your cervix starts to soften and thin out (effacing) and also begins to dilate. The thick plug of mucous that blocked the cervix during pregnancy may fall out. It’s common to see streaks of blood, especially after cervical exams in the office. Losing your mucous plug isn’t a sign that active labor is beginning, so you don’t need to worry when this happens. Labor could happen days or weeks later.
Your body will let you know when baby is on the way. If you experience any of these signs of labor, go to labor and delivery, as planned with your physician:
- If you have regular, painful contractions that have increased in intensity and frequency over time. Generally, contractions should be every 3–5 minutes (lasting 60 seconds) for 1–2 hours before you head to the hospital (if your baby is full-term). Adjust that time frame if you are traveling a long distance to get to the hospital, if you have a history of rapid labor or if your cervical dilation is advanced (typically greater than 3cm).
- If you think you are leaking amniotic fluid, also known as your water breaking.
- If you have any concerns regarding your baby’s movements.
- If you have bleeding in excess of bloody mucous.
Labor and Delivery
Labor and Delivery at Baptist Health is located on the second floor of the Women First office building at 3900 Kresge Way, Louisville.
When you arrive, proceed to the same the entrance you use when visiting our office and go to the second floor; do NOT go through the emergency room. At the hospital, you will be evaluated by the labor nurse, and your Women First Care Team will be contacted.
- Items for comfort, such as your own pillow, toiletries, etc.
- Camera with fully charged battery and adapter
- Cell phone and charger
- Comfortable robe and house shoes
- Loose fitting clothing for the ride home
- An outfit for the baby
- Car seat already in the car and inspected
- Insurance card
- Any medications that you take
- Name and contact information of your baby’s doctor/pediatrician
- Personal undergarments—i.e., nursing bra
Most births are natural experiences, and the physicians at Women First want you to have as natural a birth experience as possible. We also view pregnancy and delivery as a cooperative endeavor between physician and patient to provide a healthy outcome for both mother and baby. The following guidelines for a typical birth help you bring your baby into the world safely and naturally.
- Presence of husband or significant other at all times through labor and delivery
- Presence of baby’s siblings if appropriately prepared
- No shave prep
- No enema
- Saline lock rather than continuous IV fluid
- Labor positioning as you desire
- No episiotomy unless necessary for delivery of your baby
- Option to use nitrous oxide for pain relief during labor
- Intermittent fetal monitoring after 30 minutes when a normal fetal heart rate is documented
- Wireless telemetry
- Spontaneous delivery of the placenta
- Ambulation in early stages of labor provided fetal heart rate is checked
- Ice chips, popsicles and sips of clear liquids
- Kangaroo Care (skin-to-skin holding of newborn baby)
- Delayed cord clamping
At Women First, we believe in helping you champion your own birthing experience so that it is all you’ve ever imagined it to be. Our birthing plan guide is designed to help you consider your personal preferences for the childbirth process. If you are interested in customizing your birthing options, please download the Women First Birthing Plan PDF here, select your preferences, and bring them to your 36-week appointment to review with your physician. You will also need to bring a copy with you to the hospital to give to your labor and delivery nurse on the “big day”!
As much as we want to help you experience a natural childbirth, some births require a little extra help. That may mean that your first preference for your birthing plan is not possible—to ensure your safety and that of your baby. If that should happen, we’ll keep you informed of your new choices and work closely with you to achieve your birthing goals in a safe and nurturing delivery environment.
The following interventions may be used if needed for your baby’s or your wellbeing.
- Pitocin IV to assist contractions and to prevent hemorrhage
- Rupture of membranes
- Oxygen administration
- Continuous fetal monitoring by internal monitors
- Cesarean section
- Manual delivery of placenta should hemorrhage occur
Each birth is unique to that mother and child, and the guidelines and procedures shown here certainly don’t make up an exhaustive list of what can happen during labor and delivery. We encourage you to talk with your doctor about your wishes for labor and delivery, share your Birthing Plan guide selections at your 36-week visit, and bring us any questions you have at any time. Your Care Team wants to have a positive relationship with you, based on mutual respect and a true partnership for the benefit of you and your baby.
Women First wants to support you in the birth experience YOU want. If you have had a cesarean section in a prior delivery, it’s very possible you can have a vaginal delivery in your next pregnancy.
You have options if you have had a prior cesarean section. You can plan a scheduled repeat C-section that will be done even if you are laboring. You can also explore Trial of Labor After Cesarean (TOLAC), with the goal of having a Vaginal Birth After Cesarean, or VBAC.
With VBAC, you may be able to experience a planned vaginal birth with your baby. There are many benefits of a VBAC, but there are also risks. The benefits include no abdominal surgery, usually shorter recovery from delivery, less risk of infection, and less blood loss. The biggest risk of VBAC is that the prior uterine scar may rupture. While this is uncommon, when this happens, it is an obstetrical emergency that can be life-threatening for baby and/or mom.
While 60-80% is the accepted standard success rate for VBAC, Women First is proud of having a significantly higher VBAC success rate. We work with our patients who are pregnant to determine the best candidates to try to labor. So, for our patients who attempt a trial of labor, we have close to 90% who achieve successful vaginal deliveries.
Who Can Have a VBAC?
Favorable factors for VBAC include prior vaginal delivery and the reason for the prior C-section. When the prior cesarean was done for a non-recurring reason, such as breech position, the baby not tolerating labor, or previa, chances of successful VBAC are best. Recurring reasons would include things such as the baby being too big to fit or labor not progressing. We also do not recommend trying to labor if a mom has had more than one prior cesarean section.
One of the biggest contributors to a successful VBAC is spontaneous labor. Women First doesn’t aggressively induce labor in moms with prior C-sections, so spontaneous labor is a major factor in a successful vaginal birth after C-section.
Use the calculator below to input your personal information and get your individual calculated success rate.
There is always the chance that issues may arise, so Women First spends time with you to review your concerns and expectations, discuss your risks and benefits, and help plan your best delivery experience. Baptist Health Louisville is a VBAC-friendly hospital supportive of your choices. They also have the ability to deal with a VBAC emergency should it happen. Either way, you’ll receive exceptional care throughout your entire labor and delivery.
If you are pregnant or planning to get pregnant and want to explore the options of a vaginal birth after cesarean section, talk with Women First. We’re here to help you make an informed decision that’s best for you and your baby.
Baby’s Here!
Once your new baby has arrived, so does a whole set of new questions! Here’s some basic information to get you started on your journey as parents to this beautiful little bundle. Feel free to contact our office with other questions or concerns: 502.891.8700.
If you have a vehicle made after September 2002, it should be equipped with the new LATCH car seat attachment system. This new anchor system makes safety seats easier to install because you no longer need to use seat belts to secure them. Be sure to purchase your baby’s car seat, install it, and bring it with you to the hospital.
Babies who sleep on their stomachs are much more likely to die of sudden infant death syndrome (SIDS) than babies who sleep on their backs. To reduce your risk of SIDS, always place your baby on his or her back to sleep, for naps and at night. Do not co-sleep or put your baby in bed with you. Place your baby on a firm sleep surface. Never place your baby on pillows, and keep baby’s crib free of bumper pads, loose blankets and stuffed toys. Don’t overheat the baby during sleep. Do not smoke around your baby.
“Tummy time” when your baby is awake and you are nearby is good for your baby and helps reduce molding of baby’s head, but not when baby is sleeping. For more information, go to www.sids.org.
For most women, having a baby is an exciting time. Yet, after childbirth, many mothers feel sad, angry, afraid, or anxious. Most new mothers (about 70–80%) have these feelings in a mild form called postpartum blues. This is a passing state of heightened emotions.
About 10% of new mothers have a more serious condition called postpartum depression (PPD). Postpartum depression is more intense and lasts longer. Women with PPD have strong feelings of sadness, anxiety, trouble sleeping, tearfulness, fatigue, suicidal thoughts or impaired concentration. PPD often requires counseling and treatment. Postpartum depression can occur after any birth. Please call us if you feel you have any of these signs. Help is readily available.
Women First refers to a wonderful therapist Donna Huber. Donna is a licensed clinical social worker who has worked in the mental health field for more than 15 years. She specializes in the treatment of perinatal mood disorders, as well as other concerns such as depression, anxiety, stress, relationship difficulties, grief and loss, and post-traumatic stress disorder (PTSD). Donna treats women between the ages of 18–55, is in-network with Anthem® and Humana® insurance, and accepts many other plans as out-of-network coverage. You may schedule an appointment with Donna by calling 502.550.7718.
