Labor and Delivery

The idea of going into labor and delivering a baby can be overwhelming for some — especially first-time moms. There’s no need to be concerned, as the team of nurses and providers will help you through the process. Be sure to read the pregnancy book you receive in your prenatal care.

Learn more about the labor and delivery process:

• Am I in labor?
• Active labor
• Pain management options
• Cesarean delivery
• Immediately after delivery

Am I in labor?

How do you know when it's time to come to the hospital? Sometimes every little ache and pain seems like the "real thing."

Expect false alarms. Remember, no one knows for sure what triggers labor, and every woman's experience is different. Sometimes it's hard to tell when labor begins.

Don't hesitate to call your healthcare provider if you're unsure about if you're in labor. Preterm labor can be especially tricky. If you arrive at the hospital in false labor, don't feel embarrassed or frustrated. Think of it as a practice run. The real thing is likely on its way.

If you have any signs of labor, including any form of bleeding, before 37 weeks, consult your healthcare provider. If your water breaks or contractions begin, contact your healthcare provider during normal business hours or contact the birth center outside of the normal business day.

Call 507-334-3921 to talk to a nurse.

Back to top

Active labor

Upon your arrival, you will be assessed by a nurse who will share information with your provider.

This assessment may include:

• Taking your vital signs, including temperature, pulse, respiration rate and blood pressure
• Feeling your abdomen for strength of contractions
• Performing a vaginal exam to check for cervical dilation
• Placing you on an external fetal heart monitor to assess fetal heart rate and frequency of contractions
• Drawing blood for laboratory tests
• Asking questions about your current and past health

Nurses will monitor your labor progress and communicate with your provider, as needed. You may remain on the fetal heart monitor throughout your labor or you may only use it intermittently, depending on the health and welfare of you and your baby. Some providers order an IV access to be started for their patients. Ice chips or clear liquids will be provided during labor, depending on your provider's orders.

Active labor can take many hours, and the nursing staff will support you during this time. As you near the time of delivery, staff will call your provider.

The birth center staff wants your entire experience to be positive for you and your family. Help the team by letting them know if you have special requests or concerns.

Back to top

Pain management options

Preferences for comfort management during labor and delivery are different for each woman. You are invited to consider and explore pain management options, and select the option that best meets your needs. Your care team wants to partner with you to provide the support and assistance you desire. You can help by informing the team of the plans you made with your provider to manage your comfort during labor.

Comfort measures and labor support are encouraged and promoted, as they can be the most effective comfort resources you have during childbirth. Your labor partner or coach, and the nurses, will help you initiate the comfort measures you prefer. Comfort measures also can enhance the positive effects of any anesthetic or medications you choose.

You can enjoy a number of non-medication options, such as relaxing, walking, listening to music, breathing in a pattern, showering or using a tub to manage labor pain and fear you may feel during labor. You will be encouraged to change position to help with cervical dilation and help you deal with the intensity of labor. Often, walking, sitting or rocking in a rocking chair or on a labor ball can be good choices for position changes as long as it is safe for you and your baby.

Medication options are available as well.

Back to top

Cesarean delivery

Cesarean section, also known as C-section, delivery is a surgical procedure used to deliver a baby through incisions in the mother's abdomen and uterus. A C-section might be planned ahead of time if you develop pregnancy complications or you've had a previous C-section and aren't considering vaginal birth after cesarean. Often, however, the need for a first-time C-section doesn't become obvious until labor is underway.

If you're pregnant, knowing what to expect during a C-section and afterward can help you prepare. Learn more about C-section delivery in this video.

Why it is done

Sometimes a C-section is safer for you or your baby than is a vaginal delivery.

Your healthcare provider might recommend a C-section if:

• Your labor isn't progressing.
  Stalled labor is one of the most common reasons for a C-section. Perhaps your cervix isn't opening enough despite strong contractions over several hours or the baby's head is too big to pass through your birth canal.
• Your baby isn't getting enough oxygen.
  If your healthcare provider is concerned about your baby's oxygen supply or changes in your baby's heartbeat, a C-section might be the best option.
• Your baby or babies are in an abnormal position.
  A C-section might be the safest way to deliver the baby if his or her feet or buttocks enter the birth canal first (breech) or the baby is positioned side or shoulder first (transverse). When you're carrying multiple babies, it's common for one or more of the babies to be in an abnormal position.
• You're carrying multiples.
  A C-section might be needed if the babies are being born early or if there are other medical concerns.
• There's a problem with your placenta. 
  If the placenta covers the opening of your cervix (placenta previa), C-section might be the safest way to deliver the baby.
• There's a problem with the umbilical cord.
  A C-section might be recommended if a loop of umbilical cord slips through your cervix ahead of your baby or if the cord is compressed by the uterus during contractions.
• You have a health concern. 
  A C-section might be recommended if you have health conditions, such as complex heart problems, high blood pressure requiring urgent delivery or an infection that could be passed to your baby during vaginal delivery, such as genital herpes or HIV.
• Mechanical obstruction is involved. 
  You might need a C-section if you have a large fibroid obstructing the birth canal; a severely displaced pelvic fracture; or your baby has severe hydrocephalus, a condition that can cause the head to be unusually large.
• You've had a previous C-section.
  Depending on the type of uterine incision and other factors, it's often possible to attempt a vaginal birth after a previous C-section. In some cases, however, your healthcare provider might recommend a repeat C-section.

Some women request C-sections with their first babies to avoid labor or the possible complications of vaginal birth, or take advantage of the convenience of a planned delivery. However, this is discouraged if you plan on having several children. Women who have multiple C-sections are at increased risk of placenta problems and heavy bleeding, which might require a hysterectomy. If you're considering a planned C-section for your first delivery, work with your healthcare provider to make the best decision for you and your baby.

Risks

Recovery from a C-section takes longer than a vaginal birth. And like other types of major surgery, C-sections also carry risks.

Risks to your baby include:

• Breathing problems.
  Babies born by scheduled C-section are more likely to develop transient tachypnea, a breathing problem marked by abnormally fast breathing during the first few days after birth. C-sections performed before 39 weeks of pregnancy or without proof of the baby's lung maturity might increase the risk of other breathing problems, including respiratory distress syndrome, a condition that makes it difficult for the baby to breathe.
• Surgical injury.
  Although rare, accidental nicks to the baby's skin can occur during surgery.

Risks to you include:

• Inflammation and infection of the membrane lining the uterus.
  This condition, known as endometritis, can cause fever, foul-smelling vaginal discharge and uterine pain.
• Increased bleeding.
  You're likely to lose more blood with a C-section than with a vaginal birth. However, transfusions are rarely needed.
• Reactions to anesthesia.
  Adverse reactions to any type of anesthesia are possible. After a spinal block or combined epidural-spinal anesthesia — common types of anesthesia for C-sections — it's rare but possible to experience a severe headache when you're upright in the days after delivery.
• Blood clots.
  The risk of developing a blood clot inside a vein, especially in the legs or pelvic organs, is greater after a C-section than after a vaginal delivery. If a blood clot travels to your lungs ― this is called a pulmonary embolism ― the damage can be life-threatening. Your healthcare team will take steps to prevent blood clots. You can help by walking frequently soon after surgery.
• Wound infection.
  Infections are more common with C-sections, compared to vaginal deliveries. C-section infections are generally found around the incision site or within the uterus.
• Surgical injury.
  Although rare, surgical injuries to nearby organs, such as the bladder, can occur during a C-section. Surgical injuries are more common if you have multiple C-sections. If there is a surgical injury during your C-section, additional surgery might be needed.
• Increased risks during future pregnancies.
  After a C-section, you face a higher risk of potentially serious complications in a subsequent pregnancy, including problems with the placenta, than you would after a vaginal delivery. The risk of uterine rupture, when the uterus tears open along the scar line from a prior C-section, is also higher if you attempt vaginal birth after C-section.

How you prepare

Consider the following prior to your C-section:

• If your C-section is scheduled in advance, your healthcare provider might suggest talking with an anesthesiologist about any possible medical conditions that would increase your risk of anesthesia complications.
• Your healthcare provider also might recommend certain blood tests before your C-section. These tests will provide information about your blood type and your level of hemoglobin — the main component of red blood cells. These details will help your healthcare team in the unlikely event that you need a blood transfusion during the C-section.
• If your C-section is planned before 39 weeks for a non-emergency reason, your baby's lung maturity might be tested before the C-section. This is done with amniocentesis, a procedure in which a sample of the fluid that surrounds and protects the baby in the uterus (amniotic fluid) is removed from the uterus for testing. Maturity amniocentesis can offer assurance that the baby is ready for birth.
• Even if you're planning a vaginal birth, it's important to prepare for the unexpected. Discuss the possibility of a C-section with your healthcare provider well before your due date. Ask questions, share your concerns and review the circumstances that might make a C-section the best option. In an emergency, your healthcare provider might not have time to explain the procedure or answer your questions in detail.
• After a C-section, you'll need time to rest and recover. Consider recruiting help ahead of time for the weeks following the birth of your baby.

What to expect during the procedure

While the process can vary depending on why the procedure is being done, most C-sections involve these steps:

• At home.
  While research suggests the benefit is unclear, you might be asked to bathe with an antiseptic soap before your C-section to reduce the risk of infection. Don't shave your pubic hair. This can increase the risk of surgical site infection. If your pubic hair needs to be removed, it will be trimmed just before surgery.
• At the hospital.
  Before your C-section, your abdomen will be cleansed. A tube (catheter) will likely be placed into your bladder to collect urine. IV lines will be placed in a vein in your hand or arm to provide fluid and medication. You might be given an antacid to reduce the risk of an upset stomach during the procedure.
• Anesthesia.
  Most C-sections are performed under regional anesthesia, which numbs only the lower part of your body, allowing you to remain awake during the procedure. A common choice is a spinal block, where pain medication is injected directly into the sac surrounding your spinal cord. In an emergency, general anesthesia is sometimes needed. With general anesthesia, you won't be able to see, feel or hear anything during the birth.
• Abdominal incision.
  With an abdominal incision, the doctor will make an incision through your abdominal wall. It's usually done horizontally near the pubic hairline. This is called a bikini incision. If a large incision is needed or your baby must be delivered quickly, the doctor might make a vertical incision from just below the navel to just above the pubic bone. Your doctor will then make incisions layer by layer through your fatty tissue and connective tissue, and separate the abdominal muscle to access your abdominal cavity.
• Uterine incision.
  The uterine incision is then made — usually horizontally across the lower part of the uterus. This is called a low transverse incision. Other types of uterine incisions might be used, depending on the baby's position within your uterus and whether you have complications, such as placenta previa. This is when the placenta partially or completely blocks the uterus.
• Delivery.
  The baby will be delivered through the incisions. The doctor will clear your baby's mouth and nose of fluids, and then clamp and cut the umbilical cord. The placenta will be removed from your uterus, and the incisions will be closed with sutures.

If you have regional anesthesia, you'll be able to hear and see the baby right after delivery.

What to expect after the procedure

After a C-section, most mothers and babies stay in the hospital for two to three days. Soon after your C-section, you'll be encouraged to get up and walk. Moving around can speed your recovery and help prevent constipation and potentially dangerous blood clots.

While you're in the hospital, your healthcare team will monitor your incision for signs of infection. They'll also monitor your movement, how much fluid you're drinking, and bladder and bowel function.

You will be able to start breastfeeding as soon as you feel up to it. Ask your nurse or a lactation consultant to teach you how to position yourself and support your baby so that you're comfortable. Your healthcare team will select medications for your postsurgical pain with breastfeeding in mind. Continuing to take the medication shouldn't interfere with breastfeeding. Pain control is important since pain interferes with the release of oxytocin, a hormone that helps your milk flow.

Before you leave the hospital, talk with your healthcare provider about any preventive care you might need, including vaccinations. Making sure your vaccinations are current can help protect your health and your baby's health.

When you go home

While you're recovering:

• Take it easy.
  Rest when possible. Try to keep everything that you and your baby might need within reach. For the first few weeks, avoid lifting from a squatting position or lifting anything heavier than your baby.
• Support your abdomen.
  Use pillows for extra support while breastfeeding. A pregnancy belt might provide additional support.
• Drink plenty of fluids.
  Drinking water and other fluids can replace the fluid lost during delivery and breastfeeding, as well as prevent constipation.

• Take medication as needed.
  Your healthcare provider might recommend acetaminophen or other medications to relieve pain. Most pain relief medications are safe for women who are breastfeeding.

• Avoid sexual intercourse.
  Don't have sex until your healthcare provider gives you the green light — often four to six weeks after surgery. You don't have to give up on intimacy in the meantime, though. Spend time with your partner, even if it's just a few minutes in the morning or after the baby goes to sleep at night.

Contact your healthcare provider if you experience:

• Any signs of infection, such as a fever higher than 100.4 F (38 C); severe pain in your abdomen; or redness, swelling and discharge at your incision site.
• Breast pain accompanied by redness or fever.
• Foul-smelling vaginal discharge.
• Painful urination.
• Heavy bleeding that soaks a sanitary napkin within an hour or bleeding that continues longer than eight weeks after delivery.
• Postpartum depression is sometimes a concern. This can cause severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life. Contact your healthcare provider if you suspect that you're depressed. It's especially important to seek help if your signs and symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.

Back to top

Immediately after delivery

After the birth of your baby, the baby is placed on your abdomen or under a warmer. The nurse or provider will assess the baby and assign Apgar scores at one and five minutes of age. The Apgar score assesses the baby's condition.

This is your baby. Let the care team know when you are ready to hold him or her. Some mothers want to hold their baby as soon as possible, and some prefer to wait until the provider has finished with delivery of the placenta and any stitching that may be needed. Feel free to continue to take pictures of your new baby.

Following the delivery of your baby, identification bands will be placed on the baby and mom. These bands have a matching number that will be used to make sure you have the correct baby. A band also will be available for dad or another family member to wear. The identification bands will be checked each time you and your baby are brought together after separation. You're asked to partner with your care team in providing the safest care possible for you and your family. If a care team member forgets to check the identification bands, you should remind him or her to do so.

Mayo Clinic Health System also has the Hugs and Kisses security system. The hugs device is placed on the newborns ankle and a kiss device is placed on mom's wrist. The bands will jingle to confirm that the correct mom and baby are united. If the bands are tampered with or become loose, an alarm will sound.

Baby vital signs, including temperature, pulse and respiratory rate, will be checked shortly after birth and every one to four hours for the first 24 hours. Babies are then weighed, and their length, head and chest are measured. Two medications are encouraged for all babies: a vitamin K injection is given into the thigh muscle to aid in blood clotting and an antibiotic eye ointment is placed in the baby's eyes to prevent eye infections. When the baby has a stable temperature, you can give baby a bath. This may be delayed until your postpartum time. A blood sugar screen may need to be performed after birth to screen baby for certain health conditions. This involves a small poke to obtain a blood droplet from the baby's heel.

Your baby's provider will generally see your baby the morning after your delivery, unless your delivering provider is also your baby's provider or your baby has needs that require immediate medical attention.

Mothers who choose to breastfeed are encouraged to nurse as soon as possible after birth. Mothers who choose to bottle-feed their babies will be assisted with the first feeding.

The official birth certificate paperwork will be initiated after you have delivered.

Nurses will continue to check your baby's vital signs, well-being and feeding patterns throughout your stay. You should share any concerns or questions with your nurse or members of your healthcare team. Your baby will have recommended screenings before discharge. If you choose to have your baby boy circumcised, this is usually performed on the first or second day. Circumcision care instructions will be provided.

Back to top