Labor and Delivery Unit

About

The Labor and Delivery Unit provides normal and high-risk maternal patient care, consisting of private rooms, Operating Rooms, and a Recovery Section.

There are ten private birthing suites, two operating rooms, and two recovery beds for post-surgical cases. On average, we deliver 120-150 babies a month. We have a friendly staff of physicians and nurses who are committed to bringing you and your family current, safe and state-of-the-art medical care.

At the Brooke Army Medical Center Labor and Delivery (L&D), most of the registered nurses have attained their national certification (RNC-OB) from the National Certification Corporation. Our nurses have also received certifications in Basic Life Support (BLS), Intermediate Fetal Monitoring, and the Neonatal Resuscitation Program (NRP). In addition, many of our staff are members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN).

Planning Your Visit

After 20 weeks gestation, you may report to L&D for evaluation, treatment or monitoring for any obstetric complaints. Prior to 20 weeks gestation you will report to the emergency room where the physicians will see you in the emergency room. Your physician will discuss and review a plan of care at the time of admission or triage visit allowing you and your family to ask questions and understand why you are being admitted or being discharged.

Your stay on L&D will vary in length based on you and your baby’s specific health care needs. You will remain in L&D until you deliver your baby and recover for approximately two to three hours. Later, you and your baby will be transferred to the Mother/Baby Unit.

While on L&D, you will be assigned a nurse that will provide medical care, answer your questions and educate you on the L&D process, provide you with comfort and encouragement, and act as your advocate.

Visiting Hours: You may have three visitors in your room at one time. The primary and secondary support persons are allowed to be in the labor room 24 hours a day. The third visitor and/or any children are allowed during visiting hours from 8am to 8pm. Children individually count as one visitor. We highly encourage you to have a support person(s) during your labor and delivery. Children are allowed to be a supporter and should be educated on what to expect if there are plans for them to be present during the baby delivery. If you would like your child in the delivery room an additional adult present to care for any children under the age of 14 years is highly recommended. Hospital staff cannot be responsible for the care of unattended children in the event of an emergency. In example, if there is an emergency cesarean section and you want your primary support person to be with you in the operating room, be prepared to have backup childcare. While we do not have restrictive visiting hours, we strive to provide supportive care in a low stress environment with decreased stimulation to help facilitate and enhance the birthing process for the mother, as the labor process can be long as well as stressful.

For the safety of mothers, newborn babies and our staff, family or friends who are ill should stay home. Newborns do not have the immune system to fight off common illnesses and a simple cold could pose a serious health risk to the newborn. So please discuss with your family and friends before coming to the hospital that it is safer to postpone their visit if they are not feeling well.

Induction of Labor and Planned C-Sections

Please call L&D one hour before your scheduled induction or c-section to ensure the unit can accommodate an additional admission. Your show time may be delayed by a couple of hours or pushed to the next day if our patient census is unusually high. Medically indicated procedures have admission priority. We know this is an important day for you and your family and we try our best to keep up with the induction schedule.

What to Bring

We provide most everything you will need during your stay. Some suggested comfort items you may want to bring include:

• Smart phone (with long charging cord)
• Favorite pillow
• Lip balm
• Personal hygiene items and other personal comfort items you desire to bring

We encourage family and friends who will be providing support to dress for comfort and to pack a lunch with snacks.

Listed below are the additional items you may desire to bring after you have delivered and are transferred to the Mother-Baby Unit:

• Personal hygiene items
• Nightgowns/pajamas
• Bathrobe
• Extra panties
• Supportive bras (if desired) or Nursing bras (Nursing Pads)
• Infant car seat (required for discharge)
• Clothes/shoes for day of discharge (most likely, you will still have a tummy, so bring your pregnancy clothes)
• Outfit for baby for day of discharge (hat and blankets dependent upon the weather)

Did you know?

Every time we deliver a baby, the song, "Brahms Lullaby” is played throughout the hospital announcing the arrival of a new life.

The Brooke Army Medical Center Labor and Delivery policies and procedures practice under the following clinical guidelines:

• American Academy of Pediatrics (AAP)
• Neonatal Resuscitation Program (NRP)
• Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN)
• American Congress of Obstetricians and Gynecologists (ACOG)
• American College of Nurse-Midwives (ACMNM)

FAQs

Q: Should I have a birth plan?
A: It is not required; however, it is a great way to educate yourself on common labor and delivery medical interventions. Your prenatal history or medical status during labor may cause changes in your birth plan to keep you and your baby safe and healthy. The more prepared and knowledgeable you are regarding labor, delivery, and postpartum the better chance you will have in achieving your birthing goals. It is important to talk to your provider and go over your birth plan prior to coming to labor and delivery so you are aware what can or cannot be accommodated because of maternal or fetal conditions. A plan is a guideline; you can change your mind about any of the provisions. You and your delivery team will work together to make this the best possible event for you and your family. Some common request that are standard practice at BAMC include... use of a peanut ball during labor with frequent position changes, delayed cord clamping, skin-to-skin during the golden hour, delayed bathing for baby, and mother baby rooming in.

Q: When should I come to labor and delivery?
A: If you are under 20 weeks gestational age and are having any bleeding, cramping, or concerns you think need to be assessed by a health care professional, you need to either be seen in the OB/GYN Clinic or the Emergency Department.

If you are at least 20 weeks gestation, you should come in to L&D on the 5th floor for assessment if you have any vaginal bleeding or gush of fluid (note the time and color and put on a peripad), decrease in fetal movements (you want the baby to move at least four times in an hour), or if you are having four or more contractions in one hour.

If you have a medical emergency, call 911.

Q: I am scheduled for an induction, what should I do?
A: If you are scheduled for an induction, plan to call L&D an hour before your induction at 210-916-0223 the morning of your induction. This phone call is to ensure the plan is still to induce you and that there is room for you. Also, you will want to take a shower/bath before coming and eat a light nutritious meal.

Q: I am scheduled for a cesarean section (C-section), what should I do?
A: If you are scheduled for a C-section, DO NOT eat or drink anything after midnight. Plan to call labor and delivery an hour before you are supposed to arrive at 210-916-0223. This phone call is to ensure the plan for you to have a C-section has not changed, and to make sure we have an operating room open. You will need to take a shower/bath as well as use the special antiseptic scrubbers the night before and the morning of prior to coming.

Q: How many visitors can I have in my labor and delivery? What are the visiting hours?
A: Each patient is encouraged to have supporters to stay with throughout the labor, delivery and immediate postpartum period while on L&D. Our current visiting hours are as followed: There are 3 visitors allowed in the room at one time, the primary and secondary support persons are allowed to be in the labor room 24 hours a day. The third visitor and/or any children will have visiting hours from 8am to 8pm. Children individually count as 1 visitor.

Q: What should I plan ahead of my pending labor and delivery time?
A: Remember to make childcare arrangements for when your labor begins (back-up plans can be helpful if you go into early labor). Also, remember to plan transportation for trips to and from the hospital.

Q: What are my options for pain management?
A: You will be provided a wide range of options for pain management. These include breathing techniques and positions changes, IV pain medication, and epidural analgesia. What route you take for pain management will depend on your preparation for the labor, the baby, how far along you are in your labor, the mother's health, and the decision you and your health care team agree on.

Q: Do I have to have and intravenous infusion (IV)?
A: Yes, an IV is used during the labor process as a way to give you hydration, medications, and provides access in an emergency.

Q: Can I walk around while I am in labor?
A: Yes, as long as your baby is doing well and you haven't received any medications that could interfere with walking, your physician may order for you to walk around if you desire. Many times, walking around can be very comfortable to women during the early part of labor.

Q: What is Pitocin?
A: Pitocin is a medication which is a synthetic form of the hormone your body already produces to stimulate uterine contractions. Pitocin is sometimes ordered by your physician to induce or augment labor. Your physician and your nurse will inform and educate you along the way if they plan to start Pitocin.

Q: Do you have a nursery?
A: No, we are fortunate here to have mothers and babies’ room together. For infants who require more medical care, BAMC has a Neonatal Intensive Care Unit (NICU).

If you have any concerns during your stay or are not fully satisfied with your experience, please contact the Clinical Nurse Officer in Charge at 210-916-0244.