Most babies do well during labor and are born healthy. Others might not tolerate the stress of contractions as well. In order to check your baby’s condition during labor, we will monitor your baby’s heart rate. Most often, it will be done by placing an electronic monitor on your abdomen.

The monitor detects your baby’s heart rate and will send the signal to a machine at the bedside. This monitor usually will stay on throughout labor, along with a second monitor that detects contractions. Certain rooms have portable monitors that will allow you to get up and walk during labor. When you are admitted, please let your nurse know if you would like to walk around on the Labor and Delivery Unit.

Prentice Women’s Hospital has monitoring equipment that allows our care teams to check on you and your baby from all parts of the Labor and Delivery Unit. If any concerns arise about you or your baby’s well-being, your nurse may call other team members into the room, including obstetric residents, anesthesia staff and other nursing staff. This system helps keep all our team members informed and helps to increase patient safety.

At times during labor, your caregiver may want to perform a cervical examination to check how much your cervix has dilated. This will help your provider know your labor progress and plan for your care. This exam will also tell your care team how the baby’s head is positioned, how far down the birth canal the head has come, and when it is time to push. Exams will be performed every few hours, as needed. The obstetric residents and nurses are also trained to perform vaginal exams.

Rupture of membranes means that the bag containing the amniotic fluid around the baby has broken. This may also be referred to as when your “water breaks.” For some women, this happens before or early in labor, while for others it can happen in the middle or end of their labor.

Your provider may recommend breaking the “bag of water” at some point during labor, which often shortens the length of labor. This may be done by inserting a plastic hook toward the bag during a vaginal examination. You will not feel the hook breaking the bag, but you may feel the water (amniotic fluid) running out after it is broken. Your contractions are likely to become more frequent and intense after this happens.

Oxytocin is a hormone in your body that causes labor to start and contractions to begin. Your provider may recommend Pitocin®, a version of oxytocin that is administered through your IV, for the following reasons:

• Your labor is going to be induced.
• Your water has broken and you are not having contractions.
• Your labor is not progressing at the expected rate.

If you will be receiving IV Pitocin, your nurse will begin the infusion at a low level. The rate will gradually increase, as needed, to cause contractions that are strong and frequent enough to dilate your cervix and progress labor.

Many women feel increased rectal pressure or an urge to bear down when it’s time to push. Your provider and your nurse will help guide you to push with your body’s natural urges. While your physician or midwife may have to step away from your bedside to care for other patients, your nurse will remain with you during the pushing phase to provide coaching and support.

For women having their first baby, pushing lasts an average of two hours, but can be longer. Women who have had other babies tend to delivery more quickly.

When you are ready to deliver your baby, your physician or midwife and other members of the care team will be with you. Sometimes, our team of neonatal specialists from the Neonatal Intensive Care Unit (NICU) may also be present for delivery. This team is called as needed if there are special issues during the delivery, such as infection during labor, presence of meconium (baby’s first bowel movement) or multiple babies (twins or triplets).

The nursing staff and NICU team will check the health of your baby right away at the moment of birth. After you deliver, your physician or midwife will check your health status and ensure you are stable.

Please note: Northwestern Medicine policy does not allow anyone to take photographs or videos during any procedure, including vaginal delivery and C-section delivery. All guests must adhere to this policy. Photography is permitted before and after the procedure.

The last stage of labor will be the delivery of your placenta. This happens after the baby is delivered.

Your placenta may be sent to the pathology laboratory for testing. This happens when there are certain medical conditions or an infection during labor.

If you wish to take your placenta home with you, please tell the nursing staff when you are admitted to the Labor and Delivery Unit. You will need to have a cooler with you and someone to take the placenta out of the hospital before you leave the Labor and Delivery Unit. You cannot take the placenta to the Mother-Baby Unit after delivery.

If your placenta is not sent to pathology, and you do not wish to take it home, we will dispose of it for you.

Sometimes, a mother may have difficulty pushing the baby out, or the delivery needs to progress more quickly for the best outcome. If this happens, your provider may recommend assisting you with vaginal delivery by using forceps or a vacuum device. This is referred to as operative vaginal delivery, and can help you to have a vaginal delivery and avoid a C-section delivery.

Your provider will explain the procedure to you, including the risks and benefits, so you can make an informed decision. If forceps or a vacuum is used, you can expect to have an obstetric resident, our anesthesia team and another nurse present for delivery.

Situations may arise during labor that cause your care provider to recommend a C-section delivery. This may happen because your labor is not progressing or there is a change in your baby’s condition.

If a C-section is needed, your provider will explain the procedure, including risks and benefits, and will allow time for you to ask questions. Once you have consented to the procedure, you will be transferred to the operating room. 

If you already have an epidural, it will be dosed adequately for the procedure.

Postpartum bleeding is expected for all mothers after delivery. However, some mothers bleed more than usual. This can happen soon after delivery or later in your recovery.

If you have excessive bleeding, the obstetrics resident team, anesthesia staff and the nursing team will be with you to manage the issue. There may be more measures needed to help keep you safe, including an internal examination of your uterus, additional IV placement, lab draws and medications to help control bleeding.

In cases where bleeding continues, a blood transfusion may be recommended. Your care team will update you at every step to keep you informed.

If you have religious objections to blood transfusions, please tell your provider during your prenatal care. This will allow us to alert the anesthesia team before your hospital admission.