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The Grand Tour

A Quick Trip Through the Labor and Delivery Room

By Jacqueline Rupp

Now is the moment we've all been waiting for! Labor is over and it is time to push. "When a vaginal delivery begins we bring over to the bedside a delivery cart that is on wheels and has everything we need inside, including sterile towels, instruments, scissors, draping, a syringe to suck out the baby's nose and mouth and sterile water bowls," says Stark. The bottom of the bed comes off for delivery and the patient can then use the stirrups, which are attached. Although most hospitals will probably not allow you to get out of bed for delivery, you can request delivering on your side, with legs comfortably supported by staff, to get you off of your back and aid in delivery.

"For the birth, we now know some things that are good to do, such as pushing in an upright position or sideways with legs comfortably apart," says Goer. "Pushing while lying on the back can contribute to pelvic floor injury so it is best, even if you have had an epidural, to try to birth while lying sideways."

"A vacuum assist is in every room [but] forceps are not really used anymore," says Stark. "The vacuum is used if the patient had been pushing too long and the baby's heart rate drops dramatically. Quite a few women come in with birth plans stating which interventions they consent to and we never try to use these techniques unless absolutely necessary."

The delivery can take longer than some women may think, but it is important not to feel pressured to use an intervention if you and Baby are safe and there are no signs of distress. "Make sure there are no arbitrary time limits placed on you during delivery," says Goer. "This is especially important if you have had an epidural. A slow, gentle birth is always best and usually ca happen, given the time. Push when you feel you should and stop when you need to. Directing your own delivery can help prevent needless tearing and vaginal injury. An intervention should only be used as a last resort when there is a serious danger to Mother or Baby."

Want to see more?

• Birth Positions: How the Right Position Can Prevent an Episiotomy
• Drafting a Birth Team: Finding the Support You Need for Delivery
• What Not to Do in the Delivery Room
• Talk about it!
• BirthPlan.com