For Our OB Patients

Planning for the Big Day

As your due date approaches, how will you know when it's time to call the doctor, grab your bag and head to the hospital? Not so fast! There's still so much to discuss!

The Countdown to Delivery

As you get closer to delivering, there will be a few changes you will notice. First, your office visits will become more frequent. The visits will be scheduled every two weeks during the last two months of your pregnancy, until your labor begins and you deliver. Although we have calculated your due date, your delivery may be different than that date.

We also will be performing one or more additional diagnostic tests during this time. Typically, between the 34th and 36th week of pregnancy, a Group B Strep test is performed to check for the presence of this common bacteria. If your test result is positive, we will treat you with antibiotics to make sure you don't pass Group B to your baby during delivery. Your doctor also may request additional tests.

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Birthing Classes

Although not necessary, many women and families find it helpful to enroll in Birthing Classes. Not only do these classes help prepare you for the actual birth by teaching proven techniques for delivery, they also famiarize you and your family with the hospital and its procedures.

If you are interested in enrolling in the Birthing Classes at Christiana Care Hospital, visit this website for more information:
http://www.christianacare.org/womens_health/womens_health_parent_education.cfm

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What to Pack

It's always a good idea to have a suitcase packed and ready to take to the hospital … just in case. Here's a handy checklist to help you.
http://my.webmd.com/content/article/49/39976.htm

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All About Labor and Pre-labor

Premature Labor

Premature labor, also called preterm labor, is labor that starts before 36 weeks of pregnancy, or more than 3 weeks before your due date. Premature labor can often be stopped if you identify it early. Premature labor is related to 70% of infant deaths due to low birthweight. A low birthweight is 5 lbs, 8oz or less.

Warning Signs

• Uterine Contractions — If you feel like your uterus tightening or the baby balling up for four times or more in one hour.
• Menstrual-like Cramps — Cramps like those you may have during your period may come and go, or be constant.
• Abdominal Cramps — These feel like stomach cramps with or without diarrhea.
• Low Backache — This is a backache near your tailbone that comes and goes or is there constantly.
• Pelvic Pressure — This feels like the baby is pushing down in your vagina.
• Change in Vaginal Discharge — There may be a sudden change in your discharge. It may increase, or become more mucousy, watery or slightly bloody.

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What to Do

• If you have one or more of these warning signs, you could be in premature labor. You should:
• Lie down
• Drink 2-3 glasses of water
• If the symptoms are not gone in 1 hour, call your doctor immediately. Also call your doctor if you have any vaginal bleeding that is more than a light day of menstrual period or if you experience a sudden gush of fluid from your vagina.

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Causes of Premature Labor

Experts do not really know the actual causes of premature labor, but some things that may put women at risk include:

• previous premature labor or delivery of a premature baby
• twin or triplet pregnancy
• medical problems, such as high blood pressure, diabetes, kidney or lung disease
• abnormality of the uterus or cervix
• abnormality of the placenta
• women under 17 years
• DES exposure

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The Labor Process

Things to Watch for in the Next Several Weeks

• Some swelling of the legs and feet is normal. Excessive swelling in the hands and face are not, and you should call me immediately if you experience this. In addition, if you experience unusual headaches, you should call the office.
• Sharp abdominal pain with bleeding or bright red bleeding is not normal and you must call the office immediately.
• You may sense that your baby's movements have subdued somewhat, however, what is happening is that as the baby grows, there is less room for him or her to move. Be aware of the overall patterns of movements as you progress. Please call the office if you have concerns about these patterns.
• A gush of fluid from the vagina or continuous leaking should be evaluated. If you experience either, please call the office.
• The onset of labor – If you experience contractions that are regular and are no more than 5 minutes apart, please call the office.

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Preparing for Labor
When you finally do go into labor, you may feel generalized pain from time to time. This is normal. If you are uncomfortable at times, you may do any of the following:

• Sit in a warm bath
• Have someone give you a lower back massage. Using common household items such as a tennis ball or a rolling pin can be effective.
• Use ice, a heating pad, or a combination of both on your lower back.
• Consume water, juice or even a popsicle as a way of maintaining fluids.
• Generally speaking, anything you find relaxing is acceptable.

By the time you go into labor, you will likely feel frequent contractions (sometimes referred to as Braxton-Hicks contractions). These are normal and are an indication that your body is preparing for actual labor. While the onset of labor is different for each woman, one of more of the following may occur as you begin to go into labor:

1. You may begin to suffer persistent back pain. Many times the pain will be accompanied by a feeling similar to premenstrual cramps.
2. The appearance of a mucous discharge. It might be slightly blood-tinged. This plug blocks the cervix and its passing indicates that labor could be imminent. Even if it's several days away, this indicates that things are moving in the right direction.
3. You also may begin to suffer from diarrhea.

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Is it Really Time?
At All About Women, we recommend that patients call us when any or all of the following occur:

1. Your water breaks
2. You are having contractions 5 minutes apart, or less, for more than 1 hour.
3. You can't carry on normal conversation during the contraction
4. You are experiencing heavy vaginal bleeding
5. You notice a significant change in fetal movement patterns

These are all signs of active labor and you should call our office and plan to proceed to the hospital immediately.

But … always call us if you have concerns not listed above.

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Hospital Procedures

When you arrive at Christiana Care Hospital, go to the Maternity Receptionist Desk in the Women's Health Building. The admission staff at the hospital will ensure that you are properly processed and admitted in a timely manner. If you are not pre-registered, please contact our office to identify the documents you will need upon admission to the hospital.

At the Hospital
Once you are admitted, and probably before your doctor sees you at the hospital, several things already will have occurred:

• You will be placed on a fetal monitor so that your contractions and your baby's heart rate can be monitored.
• A member of the hospital's labor and delivery team will do a vaginal exam to determine your dilation and effacement.
• There are various forms of anesthesia or analgesics that may be offered to treat your labor pain. If you have elected to have an epidural, the labor and delivery nurse will coordinate with your physician (or the delivering OB) and the anesthesiologist to administer the epidural at the appropriate time. This may occur before you are seen by your physician, but not without the consent of your physician.
  

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Christiana Care Hospital OB Information

Parent Education

Christiana Care Hospital offers you resources and education to help increase your knowledge and confidence during pregnancy and prepare you physically, mentally and psychologically for childbirth, postpartum, breastfeeding and early parenting.

The professional team of certified childbirth educators are all registered nurses experienced in labor and delivery, pediatric and postpartum care. There also are lactation consultants available to meet your special needs.

Childbirth Education helps prepare mothers and fathers for active participation in the birth of their baby and to make informed choices in the birthing process.

If you have any questions about any testing you may need at Christiana or any of its offerings for the OB patient, please call 302.733."MOMS". You can learn more about the Women's Health Services by visiting their website: Christiana Care Hospital.

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Christiana Chare Child Safety Seat Inspections

Nationally certified technicians are available to answer questions and check children's car seats on Mondays between 10a.m. and 2p.m. and Thursdays from 10a.m. to 2p.m. at the Women's Health Building entrance at Christiana Hospital. Call Referral Services at 302.428.4100 to make an appointment.

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Christiana Care Classes

Register early, call 302.733.2472

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Visiting Hours

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All All About Women of Christiana Care, Inc.
4735 Ogletown-Stanton Road, Suite 2300
Newark, DE 19713
FAX (302) 633-6508

PHONE (302) 224-8400