During the last four weeks of your pregnancy you should watch for signs of labor: You do not need to call the office or the hospital first, but instead should go directly to Labor and Delivery,

IF: You are having regular, painful and timeable contractions, 5 minutes apart for over one hour.

IF: Your bag of water has broken or is leaking. Do not wait for contractions to begin if you may be leaking fluid.

IF: You have a gush or flow of blood. However, a slight bloody discharge (bloody show) is not of concern and does not need to be evaluated.

Throughout your labor you may walk, sit, shower or bathe in the whirlpool – as long as there are no problems. You may still be up after your membranes rupture once the position of the baby’s head is checked and the head is firmly against the cervix.

Each labor is unique and different situations call for different approaches. In general we feel it is best to allow labor to progress at its own pace as long as steady progress is being made. When progress is delayed, medications may be necessary to augment labor. Your bag of water is often ruptured prior to delivery to help identify problems with the fluid before birth occurs.

Ice chips, popsicles and small amounts of clear liquids are fine in early labor as desired.

IV’s are nearly always started upon admission, but are often times capped and not connected to fluids unless needed. This allows the nurse to draw blood initially for lab tests and then to administer pain medications, antibiotics or pitocin if needed without having to repeatedly stick you. IV’s are mandatory.

External fetal monitoring is usually used at least intermittently throughout your labor. Sometimes internal monitors are needed if there is a need to follow your baby’s heartbeat or contraction pattern more closely, but they are not routinely used.

Patients generally start with simple measures such as Lamaze breathing, warm baths, walking, etc. and may not require any additional medication. If additional pain relief is needed, then IV pain medications can be administered. These medications are safe and take the edge off the contractions.

If still additional relief is needed, an epidural is available 24/7. You will be in close contact with your nurse and physician while in labor and the amount and type of pain management you desire is largely up to you.

Episiotomies are not routinely performed. They are used when the likelihood of a tear, that is potentially worse than the episiotomy itself, could occur. An episiotomy may also be needed to speed your delivery in the case of fetal problems.

When you arrive in Labor & Delivery you will be examined and admitted by your nurse. Your physician will be notified and will stay in contact with your nurse throughout your labor. Your nurse and/or physician will typically examine you following your admission and at various times throughout your labor.

Before you deliver, you should discuss disability benefits with your employer. The standard medical leave for both a vaginal delivery and a C-section is 6 weeks off. You may be eligible to take up to 12 weeks of non-paid time off through the Family Medical Leave Act.