{new #OutsideTheMomBox post} Touring The Birth Place at #Duke Regional Hospital - Part II

In this post, we continue where we left off and will tackle what happens from delivery to discharge. Part I of this post was published here.

After you have delivered your baby, you will spend only about 2 hours in your labor & delivery room. Then onto the mom & baby rooms. Before that your nurse will help you get up at some point and use the bathroom. At Duke Regional, the labor and delivery rooms are separated from the mother and baby rooms by the nursery. It's a nice quick jaunt to get from one to the other. However you'll likely be in a wheelchair. If you delivered vaginally, you may find yourself to be ravenous (I was!) and you are encouraged to eat. Your IV will be removed. If you delivered via csection, it will be a slower progression to get to foods but the goal is to get you back on a regular diet. 

This is a L&D room from the 1960's. Thanks News Tribune Attic for this photo.

This is a L&D room from the 1960's. Thanks News Tribune Attic for this photo.

Once you are in your new room, you can expect to stay there for 2 nights if you delivered vaginally or 3-4 if you delivered via csection. It is your right to leave after 24 hours but this is discouraged for many reasons, not least of which is due to helping you figure out breastfeeding. An IBCLC at Duke Regional will come after the first 24 hours because after the first 24 hours is when a feeding challenge might show up and because newborns are super sleepy in the first 24 hours so may not be as interested in feeding. These rooms are private and simple, not fancy. They don't offer much in terms of comfort for your partner i.e. there are "reclining chairs" not a sofa for them to rest on. There were be pretty regular interruptions as staff come in to check on your and baby's vitals but they will try to be mindful of your rest. The nurses will teach you how to swaddle, diaper, bath baby and also help with breastfeeding. They will likely show you the movie "The Period Of Purple Crying" and perhaps offer a copy for you to take home or...share with your nanny or other caregiver. Circumcision, if you have decided to go that route, can happen anytime but like the hearing test, baby will be removed from the room for this. The newborn screen includes a bilirubin test as well as the hearing test. Finally, the carseat will need to be brought into the hospital on the last day of your stay. You cannot leave the hospital without a carseat so my guess is this extra schlepping is simply to prove you have one.

A couple of other miscellaneous bits of information:

  • If you do't have a breast pump, you can buy one at the gift shop at Duke Regional with a 35% coupon that comes in your tour packet. I advise checking which brands they stock and the price. THEN comparison shop a bit at places like Buy Buy Baby or somewhere similar to make sure you are getting the best deal.
  • There are options for photography in your room, at the hospital, if you are interested in that. It's free, easy and confidential. I've blogged about wishing I had more photos of myself and Elisabeth during the first few days so I think this is just a terrific service.
  • There are no set visiting hours at The Birth Place but there is a very strict security system. Your baby gets a little bracelet that, if it falls off or is removed, will alert staff to come and check on baby as well as lock down doors (although perhaps not immediately). 

As always, one of the most important bits of advice I can offer is to make sure that you have good support before, during and after childbirth. That means a birth doula, childbirth educator, postpartum doula and IBCLC. But good support i.e. a birth doula, during labor, increases your satisfaction with your birth. Greater satisfaction with the birth process (feeling heard, listened to, appreciated, understood, comforted) helps decrease the chances of a postpartum mood disorder. 

What have I missed? If there is something you wish I had included here, please leave me a comment below and let me know. Thanks for reading.

 

Touring The Birth Place at Duke Regional Hospital - Part I

A few weeks ago I had the opportunity to tour The Birth Place at Duke Regional Hospital.  Part of the requirement for my Lamaze Childbirth Educator program that I took through Duke AHEC was the completion of an education session and tour of a local hospital and since I delivered at Duke Hospital, I wasn't familiar with Duke Regional.  Imagine it: me and...25 other very pregnant couples. Between me not being pregnant and the fact that I asked a million questions, I stood out like a sore thumb!  But all in the name of offering good information to you, dear friend! So much that I'm going to divide this up into two posts.  This first one will deal with what happens up until you deliver your baby.  The next one will discuss what happens immediately after baby is born.

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  • If you think you're in labor, call your doctor/midwife/birth doula. They can help you figure out if you should go to the hospital or labor at home a bit longer.  If it is decided that you should head to the hospital, tell your doctor if you want a room with a bath.  There are 4 rooms with baths (the others have showers) at Duke Regional and they can fill quickly.  
  • When you're on your way: head to the Emergency Room entrance.  Don't worry about parking.  You can leave your car there if need be and move it later.
  • Once you're at the hospital, you likely will have a few things happen pretty quickly:
    • Cervical check.  Unfortunately, this seems pretty standard although it is not necessarily best practice.
    • An IV will be started and blood will be drawn.  We were told both steps were precautionary , in case you decide to do an epidural later was one reason given).  
    • You would also be hooked up to two monitors for a minimum of 20 minutes, to monitor contractions and also the baby's heartbeat.
  • After this point, things can go in different directions-  
    • You might have continuous monitoring if there are risk factors present (vague I know but that's between you and your doc) or if there are medications involved.
    • Or you might have intermittent monitoring which would be every 30 minutes if you aren't pushing or every 10-15 minutes while pushing.
    • You might also be offered an IV pain narcotic such as Fentanyl or Stadol.
    • You might also see the anesthesiologist who will talk to you about an epidural.  Once that decision is made and after your blood tests come back, you can count on about 60 min from start to finish for this medical procedure.
  • If you are having a C-section-
    • You will be given a spinal which will numb you from the neck down but you will be awake. If you have an emergency C-section (unplanned), you may need to be out completely but that isn't the norm.
    • It takes about 20 minutes to deliver your baby.  
    • Baby will go to the nursery for about 20 minutes then be returned to you.
  • Duke Regional Hospital basics:
    • Labor and delivery rooms are private, small and some, as noted above, have tubs.  The others have showers.  Beds are adjustable. Lighting can be adjusted.  You can bring your own bedding, if you'd like. They have birth balls on hand.  Movement is encouraged.
    • Food tends to be limited in labor and while in the ed session we were told food would be available from the hospital cafeteria after delivery, I have also been told the opposite.  I would advise bringing your own food and snacks if possible.  Or having someone, other than partner, go out for some.
    • Clear liquids (broth, water, popsicles) are always available.
    • The nursery is between labor and delivery rooms and  "mom and baby" rooms.
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  • Other nuggets to know:
    • Cameras are allowed at any point but you cannot take video of the delivery, C-section surgery or any other medical procedure.
    • There are breast pumps at the gift shop at Duke Regional and with the coupon that you are given in the packet (handed out pre-tour).
    • You can wear whatever you want to at any point. I know I felt most comfortable, most like me, after the delivery in a gorgeous delivery / nursing gown that I had bought on Etsy.  You don't have to be wearing a hospital gown, if you don't want to. 

Tours of The Birth Place are free but must be registered for in advance.  Sometimes well in advance!  

What would you like to know, that wasn't discussed here?  Leave a comment below. 

In Part II, I will discuss what happens after delivery until discharge time.  Stay tuned!