Top Tips for What to Expect During Labor and Delivery

*This is not intended as medical advice- please speak with your healthcare provider for additional information*

I am not an obstetrician or midwife; however, training in Anesthesiology gave me the privilege of being part of many deliveries. I can tell you that it has been so wonderful to be part of such an incredible part of many people’s lives. As my own journey to becoming a mother started, I remember that despite having seen so many births, I was still very nervous for delivery. The one advantage I had was that I understood some of the routine things that happen when it is time for you to go to the hospital. I hope I can share some of that knowledge with you!

1. It is helpful for you to identify where you will deliver well before you go into labor. Hopefully you have been receiving routine prenatal care with your doctor/midwife throughout pregnancy and you have identified where you are going to deliver. Most facilities will allow you to tour the labor and delivery floor (except during restrictions for COVID-19). Alternatively, some sites have online virtual tours if they are not allowing tours with FAQs answered. Additionally, many times you can provide your health insurance information and pre-register so there are fewer things to handle when you arrive. Make sure you understand if your prenatal records will be visible to the providers when you arrive or if you need to bring copies. FYI- these records are essential to providing high quality care and there is nothing worse than contracting while trying find your latest platelet count in your prenatal records.
2. Try to think about your goals during labor and delivery before you arrive. While many things are standard between facilities, if you know that you would like a water birth or would not like and IV at all during labor, try to see if the facility you choose supports those decisions and has the resources to perform them safely.
3. Just because it is in your birth plan, doesn’t mean that it will happen that way. Every delivery is different- just like every baby is different! I have seen many people arrive with extensive birth plans (you can find some pretty lengthy ones on the internet!) but realize that their wants and need change as things progress- and that is completely fine! If you have a plan, it can be helpful to discuss it with your obstetrician/midwife beforehand. It can help everyone be prepared prior to the big day and can give you a chance to have your questions answered. My colleagues and I have also seen the internet provide some strange requests (no judgement!) that are not logistically possible in most hospital settings. Make sure you advocate for your wishes but also understand that some policies are in place for safety of you and the baby. Be flexible the day you arrive at the hospital and remember that the most important thing is to have a healthy mom and baby at the end of the day!
4. If you are at all curious- speak with the Anesthesiologist! While you may have all your questions answered with your Obstetrician prior to your delivery, you likely haven’t spoken with an Anesthesiologist about pain management options. If you are curious, the Anesthesiologist on duty is likely more than happy to meet you and answer all of your questions at the hospital- even if you don’t think you want an epidural. We like to meet everyone there, just in case you change your mind (it happens a lot!) or if there is an emergency (it’s better to meet you beforehand). To that point, there is absolutely no shame in changing your mind about pain control. To have or not have an epidural is a very personal choice, and one that often changes as things progress (or don’t progress). Healthy babies are delivered both ways and your Anesthesiologist is there to support your decision. While I am amazed at the strength by mom’s that deliver without additional pain control, it is no less noble to have an Epidural, and in some cases your OB will recommend it.
5. You may not get an Epidural right when you want one. As you can imagine, the Labor and Delivery floor is often a very busy place and there are many moms-to-be at various stages of their labor. Something many moms don’t realize is that there might be a bit of a line to get an Epidural. Many women wait until they cannot handle the pain any longer before asking to call the Anesthesiologist. Many times the doctor is doing an Epidural or in a Cesarean Section in the OR. Unfortunately, this means that you have to wait- and that can be very tough and painful. Additionally, it may take longer than you think to perform. For some women, especially those with scoliosis, the procedure can take a little longer – just do the best you can to keep breathing until you can have pain relief (speaking from experience here!).
6. There may be some downtime. If you don’t go into labor on your own you may have a scheduled induction (meaning you are given some medicine to help you along). Additionally, some first-time moms may have long labors. Just be prepared to hang out for some time – sleep if you can (easier for my husband than me). Also, you may not be able to eat, which can make time move even slower (especially if your partner continues to eat).
7. There will likely be a lot of people in the room at certain times. This part was hard for me to swallow. As a private person, I would rather have been alone during delivery because it is not a time for modesty. As things keep progress, you may have several nurses (for you and the baby), doctors (for you and the baby), and if you are at a teaching institution, several medical students/residents/fellows. While everyone is a professional in this setting, it can be overwhelming in the moment. I think this made me so uncomfortable that I was able to rally more strength to make it end sooner.
8. You will be poked and prodded a lot. This starts from the beginning and doesn’t truly end until you leave the hospital. Whether it’s drawing labs, placing an IV, placing an epidural, or having your vitals taken, you will hardly get a moment of rest. Even knowing that this is high quality care, it can still be hard when you’re exhausted and in pain.
9. Code brown is real. You may have heard about meconium in the amniotic fluid (from the baby) but that isn’t the only source of poo. In order to push effectively, women are often instructed to “bear down,” and that means poo. The delivery team is very accustomed to this and will likely handle it without you knowing but it may be helpful to prepare your partner and perhaps provide another reason to not request a mirror while you push (yes- this is an option).
10. There are 2 deliveries- the first is the baby. The second is the placenta. While the first part is all excitement and pushing. The second part can be a lot of kneading on the abdomen and pulling. I barely remember the second part because at that point I had my baby and was doing “skin-to-skin.”
11. There may be tearing (Ouch!). There is no silver lining to this part and there are several “degrees” of tearing. But after delivery, you may need some stitches to repair this part.
12. Your partner may (or may not) be helpful. Having a baby is a messy process, and likely not something your partner has seen before. Some partners step up in this moment and provide the essential support to help their partner at an important time. Other partners suddenly become squeamish, and yes, sometimes they pass out. Still more are completely overwhelmed and really don’t know what to do or how to help. If your partner falters during this moment (or you are going it alone), fear not! There are wonderful nurses and doctors who have seen it all and can provide you with lots of wonderful, helpful support.

I hope this helps! Again, this is based on personal experience and not medical advice. The best preparation is speaking with your healthcare team before, during, and after labor and delivery.