ONSET OF LABOR

Natural

• Spontaneous
• Self-Induced
• Walk
• Castor Oil
• Nipple Stimulation
• Sexual Intercourse (only if bag of waters has not ruptured).
• Use of herbs (please consult your caregiver first).

Medically Induced

• Pitocin
• Prostaglandin Gel
• Cytotec
• Cervadil
• Artificial Rupture of Membranes (Amniotomy)
• Stripping of Membranes

SUPPORT PEOPLE

• Partner and labor assistant present at all times, even for cesarean section.
• No excess hospital staff.
• Support people present at mother’s direction.
• Support people allowed pursuant to hospital protocol.

CLOTHING

• None
• Own Clothes
• Hospital Gown

MONITORING

• Fetoscope only. No ultrasound devices.
• Doptone (hand-held ultrasound device).
• External Fetal Monitoring
• Intermittent (ex: for 20 minutes upon arrival and then once every 2 hours for 10 minutes)
• Continuous
• Internal Fetal Monitor

VAGINAL EXAMS

• Only upon mother’s request.
• As few as possible.
• At caregiver’s discretion.

IV FLUIDS

• No IV fluids unless antibiotics must be given.
• If IV preparation necessary, use heparin lock (also called a saline lock).
• IV fluids as per doctor’s instructions.

HYDRATION

• Drinking fluids, eating popsicles.
• Ice Chips only.
• IV fluids (must have if you receive an epidural or spinal anesthesia).
• No liquids.

EATING

• Eat small amounts to satisfy hunger.
• Only liquids.
• Nothing by mouth.

PAIN RELIEF

• Non-Pharmacological Pain Relief
• Shower or Bathtub
• Massage
• Hot/cold packs
• Relaxation
• Deep or patterned breathing
• Vocalization
• Visualization
• Movement (walking, rocking, swaying)

Pharmacological Pain Relief

Epidural (or spinal) anesthesia

• As soon as possible
• Only if uncomfortable after 5 cm.
• Only if I ask. Do not offer.

Narcotic

• As soon as possible
• Only if I ask. Do not offer.

MOVEMENT AND POSITIONS FOR LABOR

Freedom to move around and change positions during labor.

• Walk
• Hands and Knees, pelvic rock
• Lunge
• Rock
• Squat
• Sit or lean on birth ball
• Dangle

Confined to Bed (required if you’ve had epidural or spinal anesthesia)

• Lying prone
• Side Lying
• Semi-sitting

EMPTY BLADDER

• Walk to bathroom
• Bedpan
• Catheterization (required if you’ve had an epidural or spinal)