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Mother-Baby Resource Guide
LABOR AND DELIVERY
N E W B E G I N N I N G S FA M I LY B I RT H C E N T E R S
The birth of a baby is an extraordinary experience for any parent. St. Luke’s New
Beginnings Family Birth Centers are proud to be trusted by more Lehigh Valley-area
patients than any other hospital in the region. Our state-of-the-art birthing units,
in Allentown and Bethlehem, offer parents the comforts of a safe family-centered
atmosphere to welcome their new babies into the world.
The units consist of patient labor-delivery-recovery (LDR) rooms along with patient
postpartum rooms, Jacuzzi for moms in labor, a triage area, a family waiting area
and operating and recovery rooms for Caesarean deliveries. To encourage family
time and support for new parents, visiting hours are unlimited, and a multi-tiered
infant security system is in place for the safety of the newborns.
The nursing staff is highly skilled in labor, postpartum and newborn assessment
and care. They are also specially trained in Advanced Fetal Monitoring. Board-certified
anesthesiologists are available 24 hours a day, and board-certified obstetricians make
daily rounds. Once your baby is born, pediatricians also make daily rounds and
internationally board-certified lactation consultants and Mother/Baby Educators
are available to help new mothers who choose to nurse their newborns.
Where do I Come When I am in Labor?
First, call your doctor, and follow his or her directions. When you are told to come to
the hospital, you may be instructed to come through the Emergency Department. If
so, parking is available across the street in the emergency overflow area (Bethlehem
Campus). The staff of the New Beginnings Family Birth Center will come to take you
to the unit or the Emergency Department staff will bring you to us. Your partner or
support person can stay with you. Comfortable clothing for them is advised.
Where Will I Go in the Hospital During Labor?
You will be in labor in one of St. Luke’s private birthing rooms. Your support person
may stay with you. Fetal monitoring will be done for at least some portion of your
labor. The amount of monitoring you will need is determined by your doctor and
your nurse.
Where Will Delivery Occur?
Your delivery may happen in the birthing room, or in the delivery room (surgical
suite). This decision will be made by your doctor. Your support person may stay with
you. The type of delivery (vaginal or Caesarean birth) will be determined by your
doctor. The type of pain management you may use will be determined by you and
your doctor.
Caesarean births happen in the delivery room (surgical suite) on the birthing unit.
The presence of your support person during a Caesarean birth will be determined
by you, the reason for the Caesarean birth, and your doctor along with the
anesthesiologist and the neonatologist.
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What Does Bonding Mean?
Bonding means that you and your baby will be given time to get to know each other
shortly after birth.
Who May be Present During the Birth?
Your partner or other support persons, your children, grandparents or others of your
choice. Please discuss the number of people who can be present for the birth with
your doctor. Those present should be healthy (free of fever, rashes, colds and flu).
Children must have their own support person.
Having Your Baby in Your Room
After you transfer to your postpartum room, you are encouraged to keep your baby
with you as much as you want. The baby can go to the Newborn Nursery as you desire.
Your rest is important after the birth of the baby. Your nurse will check with you
frequently and will be available to assist you in the care of yourself and your baby.
Your baby’s doctor may want your baby in the nursery in the morning so he or she
can examine the baby.
Visiting Policy
Visitors are permitted at any time. People visiting should be free of any illnesses. Plan
to have another adult with your other children when they come to visit. Please let your
visitors know that you need to rest and ask them to keep their visits short. Smoking is
prohibited in all areas of the hospital for patients and visitors. Visiting children should
not be in the hallways or waiting room unattended.
Learning About Caring for Yourself and Your Baby
On-unit classes are offered daily in the Family Waiting Room on the Bethlehem Campus.
Attendance at classes is strongly encouraged by your doctor and your nurses. Classes
offered are: Mom/Baby Care, Bottle Feeding, and Breastfeeding. These classes provide you
with your discharge instructions. Your nurse and the Mother/Baby Educator (at
Bethlehem Campus) will be available to help with questions or special needs. Written
discharge instructions are given to you before you go home. The nurses at the Allentown
Campus will provide you with individualized information about your care and that of
your baby.
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PAC K I N G F O R T H E H O S P I TA L C H E C K L I S T
Fo r l a b o r :
Fo r b a by :
Prepared Childbirth book
Outfit for pictures (optional)
Socks
Outfit to go home in (including a hat)
Lotion or oil for massage
Rear-facing car seat
Tennis balls in sock (for back labor)
Blankets for the ride home
Hair bands, etc.
Basket for footprints, etc. (optional)
Camera, video camera
Baby book (optional)
Phone list (including work and home)
Baby announcements (optional)
Lip balm (non-scented)
Toy or photo for in crib (optional)
Extra pillows (no white cases please)
Cornstarch
Completed birth plan, as discussed
with your health care provider
(see form on next page)
Fo r m o m :
Nightgown/pajamas
Robe
Slippers
Toiletries (shampoo, conditioner,
brush, makeup, deodorant,
toothbrush, toothpaste)
Nursing bra/regular bra
Comfortable maternity clothes
to wear home
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birth plan guide
Dear Expectant Mom:
These are some things that will be helpful for you to think about during your pregnancy.
Please give these things some thought and fill in the information below. Your doctors,
nurses and educators who you will come in contact with during your pregnancy will give
you information that will help you make these decisions. Call your insurance company
to assist you in completing the discharge information (see page B-9). Be aware that
circumstances may arise that could change your plan.
Please review this birth plan with your doctor and bring it to the hospital for
review by our staff at your pre-birth visit to share with those who will be taking
care of you.
Your Name: __________________________________________________________
Due Date: ___________________________________________________________
Doctors: _____________________________________________________________
No. of Children: _______________________________________________________
Inquiries from others about your admission to the hospital or present condition
will be handled by:
My support person
Nursing staff
Other: ___________________________________________________________
Other requests:_____________________________________________________
During labor, if your condition allows, would you be interested in:
Having intermittent fetal monitoring
Listening to music
Being up and/or walking
Having anesthesia
Having medication
Using a birthing ball
Using the shower/Jacuzzi
Using a squatting bar for pushing
Take time to consider who you will want to support you through your labor and
birth and who you want to share your birth experience with. Discuss these needs
with your doctor.
My support person(s) in labor will be:
You will be asked to share this information with the nurse who admits you to the
birthing unit.
The support person(s) you choose to be present during your birth will be asked to
sign a consent that explains his or her role.
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birth plan guide
During the birth of my baby, I have the following requests:
To use a mirror while pushing
To have my children present (Children need their own support person separate from
the person who is supporting you.)
To have my children in the room soon after the baby is born
To have immediate skin-to-skin contact with my baby
To not be separated from my baby
To initiate breastfeeding immediately
To initiate breastfeeding within the first hour after birth
To have my support person help the nurse with giving my baby its first bath
During my hospital stay, I have the following requests:
To have my baby with me at my request
To return the baby to the nursery at my request
To breastfeed on demand and 7-12 times in 24 hours
To have footprints in my baby’s book
To have my male infant circumcised
Not to have my male infant circumcised
Other requests related to my baby:
My pediatrician is aware of my wishes
Comprehensive mom and baby care education is provided during your hospital stay.
Please list any individualized needs you may have.
Normal discharge after an uncomplicated delivery is on Postpartum Day 2,
Cesarean birth is on Postpartum Day 3.
If you have any special needs related to discharge or know what time you plan
to go home, please let us know.
Sincerely,
The Staff of St. Luke’s New Beginnings Family Birth Center
You may contact St. Luke’s Mother/Baby Educator (Bethlehem Campus)
at 1-800-260-8355 or 610-954-1355. Please feel free to call with any questions.
PAT I E N T S I G N ATURE :___________________ P H YS I C I A N S I G N ATURE :__________________
R E V I E W E D B Y: _________________________ DAT E : __________________________________
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CO N S E N T F O R B I RT H I N G RO O M A D M I S S I O N S
Allentown Campus
Quakertown Campus
Bethlehem Campus
Other
Regulations governing admission of birthing room support persons
Support persons who meet the following conditions may be present during
the birth of the baby, except as hereinafter provided.
1. He/she has the approval of the attending physician and/or anesthesiologist
for the delivery.
2. He/she will accept the directions and decisions of the attending physician.
3. If general anesthesia is indicated in the delivery room, the support person may
accompany the patient to the delivery room with approval of the birthing team.
4. If requested to leave the delivery he/she must accept that decision of the
attending physician.
5. He/she must sign the following agreement and the patient must consent here to.
6. He/she agrees that Hospital personnel are not responsible for breakage or damage
of camera/video equipment during use. He/she understands that no pictures or
videos of the birth are allowed.
7. He/she has been offered the opportunity to wear protective attire for the delivery.
I, as the mother, approve of the support person’s attendance.
Signature
Witness to Signature
Patient
I agree to the above regulations and absolve the hospital, its employees and staff and
the attending physician of any liability caused by my presence in the Delivery Room.
Signature
Witness to Signature
Father of the Child
Signature
Witness to Signature
Support Person (when applicable)
Signature
Witness to Signature
Support Person (when applicable)
Signature
Witness to Signature
Support Person (when applicable)
Signature
Witness to Signature
Support Person (when applicable)
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IS T H I S L A B O R ?
How will you know when labor has begun? A woman’s body usually gives clues that
labor is beginning. You must learn to recognize these clues.
As your baby matures, your body prepares for labor and birth. You may notice
several signs. These may be different for each woman or even for each pregnancy.
They can happen in any order and take place in a few hours or over several days.
Some of the more common signs are:
★ A sudden burst of energy, perhaps after feeling very tired. No one knows why
this happens. It could be that you want to prepare a place for your baby, or it
could be the energy to get you through labor.
★ Lightening (dropping), or the baby moving down into the pelvis. Your baby
seems lower; you may breath more easily; you may need to urinate more often.
If this is not your first pregnancy, your baby may not “drop” until you are
actually in labor.
★ An upset stomach or diarrhea. These may be signs that your body is getting
ready for labor.
★ Blood-stained show. A plug of mucous fills your cervix (the opening to the
uterus) during pregnancy. This plug, called “show,” may look cloudy. It could be
streaked with either bright red or darker, dried-looking blood. You might notice
“show” before labor begins. Sometimes, after a vaginal (internal) exam by your
caregiver, some mucous may be discharged. This can also happen during labor.
Preterm Labor (labor before 37 weeks)
Babies need about 40 weeks to grow, mature and be ready for birth. Before this time,
the lungs and other important organs may not work properly. If you have signs of
labor before 37 weeks, it could mean your baby may be born too soon. Contact your
caregiver right away. You and your baby may need special care. Do not wait to see
what will happen in a day or two. If you have contractions that come closer than
ten minutes apart for over an hour, call your caregiver – you may need to go to
the hospital.
Early Labor
Late in your pregnancy, your caregiver may check for some signs of approaching or
beginning labor. You might also be checked for these in early labor:
★ Ripening (softening) of the cervix. During pregnancy, your cervix remains firm
and closed. The cervix must soften, or ripen, before it can thin and open for
your baby to pass through. Ripening usually takes place several days or weeks
before labor begins. Sometimes this can happen in a few short days.
★ Effacement (thinning) of the cervix. This is the shortening or “taking up” of the
cervix. The muscles around the opening to the uterus are pulled up into the
lower part of the uterus. It is something like the shortening of the neck of a
balloon as it is inflated or the shortening of a turtleneck sweater. Effacement is
measured in percentages from 0 percent (thick) to 100 percent (very thin).
Sometimes as the cervix becomes thinner, or effaced, it begins to dilate or open.
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★ Dilatation (or opening) of the cervix. When your cervix has softened and thinned
out, it then opens for your baby to pass through. Dilatation is measured in
centimeters. One centimeter means that the cervix has just begun to open. At 10
centimeters, the cervix has opened completely so your baby can move down into
the vagina (birth canal). Early effacement and dilatation (up to two to three
centimeters) may take place before labor begins, or it may not happen until
you are actually in labor. Often women having their second or later baby will
efface and dilate at the same time.
Most caregivers will do pelvic exams to determine effacement or dilatation. Some do
them beginning around the 36th week of your pregnancy and others wait until later.
Check with your caregiver if you have questions about when or if pelvic exams are done.
Labor Contractions
During your pregnancy, you might have noticed your uterus (womb) becoming tight
and hard. For some women, this feels like the baby is “balling up.” These tightenings are
called Braxton-Hicks contractions. Like with any muscle contraction, the uterus shortens
and becomes hard. The Braxton-Hicks, or practice, contractions prepare your uterus for
labor. As your pregnancy progresses, these contractions can become stronger, longer,
more frequent and more uncomfortable until you recognize them as “labor.”
To decide if labor has started, keep track of how long your contractions are and how
often they come. Put your hand on your abdomen to feel for hardness. Write down the
time when a contraction begins and when it ends. Note when the next contraction
begins to see how many minutes pass between the beginning of one contraction and the
next. Your caregiver will want to know how long it is from the start of one contraction
until the start of the next and how long your contractions are lasting.
Contractions farther than 10 minutes apart or those that are irregular (with no pattern
of how far apart they are) may just be more Braxton-Hicks contractions or very early
labor contractions. Go about your regular routine until they either stop, become closer
together or more regular.
If this is your first baby, your caregiver may want you to call when the contractions have
been about five minutes apart, lasting about 60 seconds, for over an hour. If you have
had a baby before, you will probably be asked to call sooner. Ask your caregiver when
you should call if you think you are in labor.
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One of the hardest things about deciding if you are in labor is the mixed messages
your body may send. You may have heard of “false labor.” Your body acts as if it is
in labor, only to stop later. Some ways you can tell the difference between “true”
and “false” labor are:
True Labor
★ Contractions get stronger, longer and closer together.
★ Contractions are in a regular pattern or regularly get stronger, longer and closer.
★ Walking or changing position makes them stronger.
★ Usually felt beginning in the back, moving around to the front and low down
in the abdomen.
★ Cervix thins and opens (as determined by pelvic exam done by caregiver).
★ Water may break.
★ Bloody show can occur and increase throughout labor.
False Labor (Braxton-Hicks)
★ Contractions remain same strength, length, distance apart.
★ Contractions may be irregular.
★ Walking or changing positions does not make them stronger and can make
them go away.
★ Usually felt mainly in the front and up high.
Many women wonder whether or not labor is beginning. They worry about when to
call their caregiver. Contact your caregiver if you have concerns or questions.
Rupture of Membranes
Sometimes labor begins when the membranes or “bag of waters” breaks. This does
not usually happen until a woman is having regular, strong contractions. But it can
also happen before labor begins. If your water breaks, your may notice a trickle of
fluid. It can come and go as you walk or change position. Or you may notice a sudden
gush of fluid from the vagina. It can be hard to decide if your membranes are leaking
or if it is urine. Remember that the odor of urine is different from the odor of
amniotic fluid. Even if you don’t know what amniotic fluid smells like, you will
recognize the smell of urine. Let your caregiver know right away if you think your
water has broken or is leaking. He or she will want to know what time it broke, the
amount of fluid, the color and if a specific odor was noted.
All women will have some of the same sensations during labor, yet each woman will
be different. Labor, while it is similar for all, it a unique experience for each woman.
Some women will have many signs that labor is getting closer. Others will suddenly
find themselves in labor. Whatever your situation, you can be aware of what is
happening to your body. Childbirth preparation classes will help answer the
questions you have about labor and birth.
All the preparation your body does for labor may seem to take forever. It may seem
as if nothing is happening and labor will never begin. Remember that the final days
your baby grows and matures are important. These last few days are a time to enjoy
this pregnancy and the special time with this baby.
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T H E FAC TS ABOUT INDUCTION AND AU G M E N TATION OF L A B O R
Like many women, you are probably hoping for a fast, easy labor. But as you know, every
labor is different and presents its own challenges. Sometimes labor needs assistance
either getting started or becoming more effective. Beginning a labor that has slowed
or stopped is called “augmentation.” Starting a labor is called “induction.”
Why is Labor Induced?
The most common medical reason for inducing labor is going past your due date, or
“post-dates.” It is important that the due date is reliable. Induction too early can mean a
premature birth, which carries risks of its own. Current medical guidelines recommend
that induction not be done before the 39th week of pregnancy, except for very specific
medical reasons. Many caregivers recommend induction one or two weeks past a reliable
due date. Others do tests to make sure the baby is doing well, and if so, take a more
“wait-and-see” approach.
If your bag of waters breaks (membranes rupture) and you don’t have contractions, there
is a small risk of infection. If you are near term, some caregivers recommend inducing
labor right away. Some wait from 12 to 24 hours to see what will happen naturally.
Others monitor for infection, and induce if signs appear. It would be helpful to discuss
ahead to time what your caregiver would recommend if this situation should happen to
you. Then you know your options.
Diabetes, pre-eclampsia, heart disease or kidney problems are conditions that may
influence your caregiver to suggest inducing labor. Sometimes fetal testing shows that
the baby is stressed or not getting enough nutrients through the placenta to grow well.
If you have genital herpes and there are no active lesions, some caregivers recommend
induction at term. If you have had difficult deliveries, fetal loss or your baby might have
special needs after birth, induction may be considered. If it appears you or your baby
would benefit from an induction of labor, you should discuss the risks and benefits with
your caregiver.
Over the last decade the induction rate has nearly doubled. Part of the reason for the
increase has to do with the way in which doctors are handling “post-date” pregnancies.
Inductions are generally not done for convenience. It is better to let your baby decide
when it is time to come. Induction is not a routine procedure, and should be done only
for sound medical reasons. Current medical guidelines recommend that induction only
be done when the benefits of delivery outweigh the risks of continuing pregnancy.
Methods of inducing or augmenting your labor will be individualized to your needs
and will be explained by your doctor.
Why is Labor Augmented?
Your labor may be augmented if your contractions are not close enough or strong
enough to cause timely dilating or effacing of your cervix. This may be done by breaking
your water or with medication.
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CA E S A R E A N B I RT H
A Caesarean birth is delivery of the baby through an incision in the lower part of
your abdomen. In most cases this will be done on the birthing unit. St. Luke’s makes
every effort to make your birth special, no matter how your baby is delivered.
The decision for a Caesarean birth can be made by your doctor prior to labor or
when you are in labor. The reasons that a Caesarean birth may be performed include:
★ The baby is in the wrong position, including not head down (breech), face
presentation or transverse presentation (lying side-to-side).
★ Changes in the baby’s heartbeat, which can mean that the baby is not
tolerating labor.
★ The bag of water is broken for an extended amount of time and the baby
has not been born.
★ Medical conditions of the mother, including diabetes and hypertension.
★ Baby is too large to fit through the pelvis, or the pelvis is too small.
★ The opening to the uterus will not dilate (open).
★ The placenta covers the opening to the uterus (placenta previa) or comes away
from the wall of the uterus before delivery (placenta abruption).
★ The umbilical cord comes through the birth canal in front of the baby
(prolapsed cord).
If you have a planned Caesarean, you will arrive on the birthing unit about two
hours prior to the time your surgery is scheduled. (See the PAT — Admission
Instruction sheet that follows.) One of our staff will prepare you for your birth.
Preparations may include:
★ Completing of admission information.
★ Taking your vital signs.
★ Listening to your baby’s heartbeat.
★ Shaving or clipping the hair on your lower abdomen and upper pubic area.
★ Inserting an intravenous line.
★ Placing the elastic stocking (worn prior to and after surgery).
★ Placing a catheter (tube) in your bladder.
★ Taking a blood sample.
★ A visit from your anesthesiologist.
★ Performing an ultrasound to check your baby’s position.
Your support person may stay with you during your preparation and will join you
again in the operating room after you have your anesthesia, as long as you are able to
have anesthesia such as an epidural or spinal, which allows you to be awake for the
birth. Your doctor will give you general anesthesia (where you are asleep for the
surgery) if the need arises. If you have general anesthesia, your support person will
not be in the operating room for the birth, but will still be able to go to the nursery
with your baby, as long as the baby goes to the newborn nursery.
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In the operating room, you will be covered with surgical drapes and will have a heart and
blood pressure monitor connected to you. There will be several doctors and nurses in the
room to care for you and your baby. The room is usually cool, and you may hear sounds
such as heart monitors and suction. There will be a warm bed prepared for your baby.
Your support person will be brought into the room once the drapes are in place and your
doctor is ready to start your surgery.
You will spend one to two hours in the birth room recovery area (Bethlehem Campus).
Your family may visit you there. At the Allentown Campus, you will recover in your
postpartum room. The nurse caring for you will check your vital signs and the dressing
on your abdomen often. The nurse will communicate with your anesthesiologist about
your need for pain medication.
After your time in the recovery room (Bethlehem Campus), you will be taken to your
postpartum room where you will spend the rest of your hospital stay.
After your baby is born, your support person can accompany your baby and your baby’s
nurse to the newborn nursery. He/she can make phone calls, relax or admire your baby
until you are brought out of the operating room. You can reunite in the PACU (post
anesthesia care unit).
After the birth, as long as your baby is healthy, you and your support person can see and
touch the baby. You may also see and hold the baby in the recovery room. You also may
breastfeed if you desire. We encourage you to breastfeed the baby at this time, as your
baby is usually awake and interested in feeding at this time. Your nurse will help you
get started.
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Admission Instructions
PAT — Caesarean Births
Day of Surgery
Bethlehem Campus
Report directly to the Priscilla Payne Hurd Pavilion (PPHP) 3rd floor by utilizing
the PPHP elevators. PPHP-3 is a locked unit. Ring the button outside the unit and
someone will let you in and direct you from there.
Allentown Campus
Report to Admissions. You will be directed to the birthing unit from there.
Date: ________________________________________________________________
Time: ________________________________________________________________
Dietary Restrictions: (It is vitally important that you follow these
instructions exactly).
Scheduled for morning surgery: DO NOT eat or drink anything after midnight
(NO WATER!). You may have light dinner early in the evening up to 9 pm and
then liquids until midnight.
Scheduled for afternoon surgery: Clear liquids between 12:00 midnight and 8 am.
DO NOT EAT ANYTHING AFTER MIDNIGHT. (Clear liquids consist of 7-Up,
ginger ale, tea, black coffee, Jello, broth or Tang. You may use sugar. NO milk or
milk products or orange juice. NO chewing gum or candy.
Failure to follow these instructions could result in the cancellation of your surgery.
Do not smoke or drink alcohol for 24 hours before surgery.
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Personal Belongings:
★ Do NOT wear makeup, lipstick or nail polish (on fingers or toes).
★ Leave valuables, such as jewelry and money, at home.
★ Bring a bathrobe, slippers and personal care items.
Medications:
★ Check with your doctor about taking any medicines.
★ Your doctor may want you to continue your routine medications (e.g., blood
pressure, heart pills, etc.) the day of the surgery. Pills may be taken with a few
sips of water (if so ordered).
★ Inform the nursing staff upon your arrival about any medications taken the
day of surgery.
★ If you have diabetes and are taking medicines, including insulin, please be sure
to contact your doctor for insulin dosage and other orders prior to admission
to the hospital.
Other:
★ If your spouse, partner or significant other plans to attend your Caesarean
birth and has any questions, you may call our Just-In-Time Information Line
at 610-954-1355.
★ Inform your doctor if you develop a cold, sore throat, cough, fever or other illnesses
before your surgery.
If you have any questions regarding these instructions, please call:
Pre-Admission Testing Center at 610-954-4495 (Bethlehem Campus) or 610-770-8352
(Allentown Campus) or the Priscilla Payne Hurd Pavilion (PPHP) 3rd floor (Bethlehem
Campus) at 610-954-1300.
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CO N S E N T F O R A D M I S S I O N O F S U P P O RT P E R S O N TO O P E R AT I N G
R OOM IN CESAREAN SECTION DELIVERIES
I,
hereby apply
for permission of
to be present for the Cesarean Birth.
In support of such application, we agree to the following:
I agree to follow all instructions from the attending Obstetrician and
Anesthesiologist, Neonatologist and nursing personnel of the delivery/operating
room, and will do nothing which in the sole judgement of that person would
interfere with the proper patient care.
I understand that if my presence in the delivery/operating room at any time appears
to the attending Obstetrician, Anesthesiologist, and Neonatologist to be detrimental
to the care of the patient or the functioning of the Hospital, I will leave at once
on request.
I understand and release St. Luke’s Hospital and the physicians and nursing personnel
in the delivery/operating room of all claims with respect to injury or damage sustained
by me in the delivery/operating room, including, but not limited to any injury or
damage resulting from fainting, cardiac difficulty, or nervous reaction.
I as the mother approve of the support person’s attendance.
I understand that Hospital personnel are not responsible for breakage or damage
of camera/video equipment during use. I understand that no pictures or videos are
allowed during the birth.
I have been offered the opportunity to wear protective attire during the surgery.
Signature
Date
Witness to Signature
(Signed) Support Person
Signature
Date
Witness to Signature
(Signed) Mother of Child
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