First, preregister at your hospital. This means giving them your insurance information and filling out all that boring paperwork in advance, so you’ll have less to do when you get there on the actual day. Then pack your bag (see our checklist here) in advance and go crazy nesting (believe us, you will) while you nervously, and excitedly, wait.
Having a c-section? Skip down to “Cesarean Birth.”
Going into labor
If you’re planning a basic birth, chances are you’ll go into labor on your own. (If you’re getting induced, you’ll check in long before contractions start.) Once you feel signs—repeated contractions that don’t slow down or stop—call your OB. She’ll tell you when it’s time to head to the hospital. “I can always tell on the phone whether a patient is in labor or not. If they’re laughing and talking in a normal tone of voice, I know they’re not,” says Alane Park, MD, ob-gyn at Good Samaritan Hospital in Los Angeles and coauthor of The Mommy Docs’ Ultimate Guide to Pregnancy and Birth. “For the ones who are truly in labor, usually it’s their partners calling because they’re too uncomfortable.”
Arriving at the hospital
When you get there, skip the ER and go straight to labor and delivery. There, a nurse will take you into a triage room, hook a fetal monitor to your belly to check baby’s heart rate, and measure your contractions. If you or the nurses think your water has broken, you might get a swab (yep, down there) that will be used to test if it really is amniotic fluid. There will be a cervical check too, to see if you’ve dilated or effaced.
At this point, you could be sent home if labor hasn’t progressed enough, Park says. (Total letdown, but don’t worry—you’ll be back.) If your contractions seem strong and your cervix is changing, you’ll be admitted. “There isn’t one thing that says you’re going to have to go home versus staying at the hospital,” says Park. “I use the patient’s clinical history and how she looks to decide.” (If you came in screaming in pain and obviously very far into labor, you would probably be admitted immediately—forget the whole triage thing.)
In the delivery room
Time to take off your clothes and put on a super-stylish hospital gown. A labor and delivery nurse will be assigned to you—she's your point person as you progress through labor.
What happens next depends on how you plan to manage pain. If you’re going medication-free or would like to wait before getting an epidural, you may want to walk around or take a shower or bath, if your hospital has tubs, to deal with the pain. Nurses will put the monitors on you periodically to check on baby’s heart rate and your contractions.
If you want to go the epidural route, there’s no specific time when you have to request it. Just know you might have to wait a bit for an anesthesiologist, most likely about 30 to 45 minutes from when you make your request before you actually are pain-free, says Park. Once it’s been administered, you’ll receive continuous monitoring, which means you’ll stay in bed with the monitors attached to your belly. You may also get an IV to provide fluids, so you don’t get dehydrated. Also be warned that having an epidural means having a catheter to empty your bladder as well—some moms-to-be are surprised to hear that. Another option is IV medication that can take the edge off your pain instead of the epidural.
At this point, your OB may have come in to check on you, but there’s no real guarantee of when you’ll first see your doctor. It could be close to the time you check in or not until it’s time to push. It depends on what time of day it is, whether they’re already at the hospital (or at home or at their office) and what’s happening with their other patients. For most of labor, you’ll be on your own with your partner, doula (if you’re hiring one) and whomever else you’ve chosen to bring along.
Over what will probably be hours and hours—every mom is different and first-time labors take the longest—contractions will become extremely intense and close together. You might find after a while that there’s intense pressure, sort of like having to go number two but worse! That’s the urge to push. Hit the call button, or send your partner to track down your nurse or doctor because it’s almost time. But don’t push yet! The OB has to check and make sure you’ve reached 10 centimeters dilated, so you don’t injure yourself while pushing.
There are a few instances—such as if there’s fetal distress or your cervix stops dilating—in which your doctor might call for an emergency c-section. If this happens, you’ll skip to “Cesarean prep” below.
Push coming to shove
It could be three pushes or 30. Just listen to your doctor’s guidance—she'll tell you when to push hard or not so hard and can help guide baby’s head out. Then, you’re a mom!
In most cases, the doctor will put baby on your chest directly after birth, as long as there aren’t any issues with his breathing, color or tone, Park says. If there’s an issue, they’ll put baby on a warmer in the room and call the NICU so they can help resolve it.
Usually, mom and baby stay in the delivery room for about two hours after birth to make sure baby’s transitioning to “life on the outside” well and that you’re doing well too—no excessive bleeding and stable vital signs. During this time, baby will be weighed and an APGAR score will be taken. You might try breastfeeding or just holding baby and talking to her. The two hours will probably seem to fly by. Then you and baby will be taken by wheelchair to your postpartum room.
Skip down to “Recovery.”
If you need to schedule a c-section for medical reasons, don’t worry—it's not like trying to get a reservation at that new, trendy restaurant. Your doctor’s office will likely set up the appointment themselves and tell you when to show up at the hospital—about two hours before your procedure is scheduled to begin. (Of course, it might not start on the dot of your reserved time. “Labor and delivery is a little bit of a minefield,” says Park. “You can’t always plan everything to a tee.”)
The procedure itself will probably take 30 minutes to an hour. If it’s an emergency c-section, you may have already had an epidural. If it was planned, you might get a spinal block. An anesthesiologist will come in and ask you about any medical problems he’d need to know about before he administers your pain meds.
Yes, your pubic hair will be shaved (no, not a Brazilian, just a little at the top), since most doctors make the incision pretty low on the abdomen. And you’ll need an IV (for fluids and medications) and catheter (to empty your bladder, since you’ll be too numb to walk to the bathroom).
You’ll lie awake with a curtain blocking the surgery itself—and you may feel some pressure, pushing and tugging as the doctor makes the incision and guides baby out. “You shouldn’t feel any pain,” Park says.
Then comes the exciting moment: baby’s birth. You’ll probably hear his first cries right away. (Don’t let anyone tell you this will be anything other than amazing!) Baby’s cord will be cut, and he will be shown to you quickly before heading off to a warmer in the room—that's because baby needs to be assessed and stabilized, and you need to be sewn up and able to sit up before you can hold him. The time will come soon for you to meet—and you’ll have tons of time together after that.
In the recovery room
After you’ve got a new person in your life, you’ll head to a recovery room, where you and baby will set up camp (for two days after vaginal birth and up to four days after cesarean). Your OB will see you every day until you go home, and a pediatrician will check in on baby daily too.
Lots of hospitals today have bunk-in policies. This means that mom and baby are never separated, unless you need to take a shower or something. Then it’s okay to take baby to the nursery for a bit.
Healing and bonding
During this time, you’re going to be super-sore. Drink lots of fluids, eat healthily and focus on feeding and bonding with baby. If you feel overwhelmed or have questions, ask your postpartum nurses for help or advice—that's what they’re there for.
With a c-section delivery, your biggest issue will be pain where you had your incision. Your doctor will likely give you pain killers to take. Make sure you don’t lift anything heavier than your baby or do anything strenuous for four to six weeks.
Plus, More from The Bump: