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Labor & Delivery: What to Expect

No matter how many doctors’ visits you’ve had, movies you’ve watched or classes you’ve taken, it’s hard to know exactly what to expect. Every pregnancy and delivery are different.

Our highly trained labor and delivery team help you prepare for your wonderful journey and address all your questions and concerns. We offer year-round classes on childbirth, breastfeeding and newborn care as well as tours of the Women & Infants Center to help you get ready for your delivery day. By creating a birth plan you and your care team can discuss your expectations and preferences prior to delivery. While you and your baby’s health is our main goal, we will always do our best to honor your plan.

If you have a high-risk pregnancy, you will receive specific instructions from your doctor about preparing for childbirth.

Here is some information to help you prepare as your delivery approaches:

How Do I Know When I’m Close to Labor?

As you count down to your due date, you’ll notice changes happening to your body. These changes may happen a few weeks or a few hours before labor starts. You may notice:

  • More frequent urination
  • More intense backaches
  • Increased discomfort in the pelvis, rectum or buttocks
  • Increased discharge from your vagina, possibly with red or brown blood streaks
  • Easier breathing because your baby has "dropped" farther down in your uterus
  • Diarrhea
  • Contractions

How Do I Know When I’m in Labor?

Certain signs signal that labor is starting or that you’re in labor. Not everyone experiences or notices all of them. They may include:

  • Your water breaks: This is when your amniotic sac (the sac filled with fluid that surrounds your baby in your womb) breaks or leaks. You’ll experience a gush of liquid (amniotic fluid) or constant trickle out of your vagina. This experience occurs for only one in ten women.
  • Your contractions get stronger and closer together: While your water may not break, you can’t ignore contractions. Labor contractions are strong, frequent and long lasting and will happen more regularly and frequently as you get closer to giving birth. When they are consistently five minutes apart, it’s time to call your doctor.

I’m in Labor: What Do I Do Now?

If you are in labor, go to the Women & Infant’s Center Women’s Assessment Center on the 5th floor of the Barnes-Jewish Hospital Parkview Tower. If possible, you should call your doctor before coming to the hospital.

After the assessment center, you’ll be taken to one of our private birthing suites or cesarean operating rooms, if you have a planned C-section or require an emergency one. You will receive compassionate, high-quality care from our nursing staff and entire labor and delivery team every step of the way.

Pain Management During Childbirth

At the Women & Infants Center, we support your birthing plan. If you would like a natural childbirth without an epidural, we will honor your request. If you choose pain relief medication, a member of our obstetric anesthesiology team will meet with you before labor to discuss your pain relief requests.

Our anesthesiology team members are all specially trained in caring for maternity patients from the most routine labors to the most complicated procedures. We work with you to provide the best pain relief method for you and your baby.

These methods include:

Regional anesthesia

This pain relief medication blocks pain in a specific region of your body. We use this type of medication for both cesarean and vaginal deliveries. The benefit of this commonly used medication is that it reduces pain and discomfort while you remain alert throughout your childbirth experience.

Forms of regional anesthesia include:

  • Epidural block: This block is the one most women receive during labor. Our anesthesiologist inserts a small, flexible catheter into the space between the spinal column and outer membrane of the spinal cord (epidural space) in the lower back. We can administer an epidural at any point during labor and provide pain relief up until you give birth.
  • Spinal or subarachnoid block: We commonly use this type of block for C-sections. We inject the anesthetic medicine directly into the cerebrospinal fluid, fluid that surrounds the spinal cord. This block takes effect faster but does not last as long, so it is not ideal for vaginal deliveries.
  • Combined spinal-epidural: This technique offers the benefits of both the epidural and spinal blocks. We use it for more advanced labor or for C-sections that may require more surgical time.

General anesthesia

During general anesthesia, medications are given so the woman is unconscious or “asleep” and unable to feel any pain during the procedure. We use this type of anesthesia only for emergency C-sections or other urgent medical conditions when regional anesthesia is not an option.

Intravenous narcotics for labor

When women are unable to receive regional anesthesia for health-related reasons, we can provide medications intravenously, or through a vein, to help manage pain.

Postpartum and Newborn Care

After you give birth, you will stay with your baby in the birthing suite or C-section operating room for a couple of hours to recover from labor and bond, skin-to-skin, with your baby. Next steps for you and your baby include:

  • You will move to a private mother-baby room to stay with your newborn until you leave the hospital. A team of postpartum nurses will care for you and your baby (couplet care).
  • A certified lactation consultant will visit you, answer your questions and help with any breastfeeding issues.
  • Your friends and family can visit 24 hours a day, 7 days a week. Find out more about our visiting hours.

If your newborn should require special or intensive care, we will transfer your baby to the Level IV Newborn Intensive Care Unit (NICU) (for critically ill babies and babies that require special care), which is connected to labor and delivery.

Learn more about our comprehensive newborn care, including newborn screening tests and daily care and monitoring.

Contact Us

To make an appointment with a Washington University obstetrician at the Women & Infants Center, call 855.925.0631.