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Preparing for Birth

Birth Plan

It is important to plan for the birth of your baby. A birth plan is a docment that tells your healthcare provider and the hospital staff what kind of childbirth you would like and how you would like your baby cared for after birth. Learn more about birth plans.

Download a Birth Plan template.

Finding a Doctor for Your Baby

Before you give birth, ensure that you find a doctor that will care for your newborn. You can ask your family doctor or find a pediatrician. Your newborn should see his/her new doctor within three to five days of discharge from the hospital.

If you are searching for a new doctor, visit Health Care Connect.

Packing List

It is best to be prepared and to pack a few things in advance to bring to the hospital. Print our packing list.

Time to Go to the Hospital

Please note:
WDMH is a Level 1 hospital and we do not provide care for very high risk pregnancy. If you have a high risk pregnancy, your health care provider may refer you to a tertiary care hospital. WDMH does not have a neonatal intensive care unit. If your baby is in significant distress after delivery, we may have to transfer your baby to CHEO. Please note that this only happens in 1% of all pregnancies. If you arrive at the hospital in preterm labour (before 36 weeks of gestation), you may be transferred to a tertiary hospital if time allows. Again, this happens on rare occasions.

Your doctor will review the signs and symptoms of labour with you. The early part of labour, called latent labour can take a while. Most women spend this part of their labour at home. Be sure to stay hydrated and get some rest if you can. Learn more about true labour and pre labour.

When you think it’s time to come to the hospital, please give us a call and let us know you’re coming - 613-774-2422 ext. 6860. If you have a midwife and you believe you are in labour, please page her. She will let us know when you’re coming.
If you are in active labour or if your water has broken, you will probably be admitted, so bring your hospital bag.

Other reasons to call us are if you are worried about preterm labor, ruptured membranes (water), bleeding, pain or if the baby is not moving frequently as you are used to.

Being Admitted

When you arrive at WDMH, go to the Emergency Department where you will be registered as an outpatient to start. Please bring your insurance an OHIP card with you. Once you are in active labour, your support person will register you as an in-patient.

  • If you live in Ontario, please bring your OHIP card and insurance information.
  • If you live in another province in Canada, please bring your provincial health card and insurance information.
  • If you live outside of Canada, please bring your driver’s license, passport, and insurance information, and payment preference (cash, debit, or credit).

If you have questions about payment, please contact the Business Office at 613-774-2422 ext. 6809.

Comfort during Labour

Each woman’s experience of labour will vary. Most women find labour a challenging process, but one that is very rewarding. At WDMH, there are a variety of options available to help you cope with labour, some include medication and some do not. Please be assured that no medication will be given to you without your consent.

The following information is not intended to be comprehensive. Some options may not be applicable or beneficial to your specific situation. For more information, please speak to your doctor, nurse, and/or midwife.

Different positions & movements

Changing positions often while you’re in labour is a great way to help labour progress and to enhance your comfort. One of the worst places to labour is in bed. Lying on your back can decrease your blood supply, slow labour, and increase your pain. Where possible, take advantage of gravity to help your baby come down. Also, leaning forward (for instance, on your hands and knees) encourages your baby to face your back, which may relieve your back pain and help the baby to move through your pelvis more easily.

Here are a few positions/activities you may find comfortable. Your nurse or midwife can help you find the positions that are most helpful at the time.

  • walking
  • slow-dancing
  • hands-and-knees
  • rocking in a rocking chair
  • sitting/swaying on a birthing ball
  • on your knees with your upper body supported by a birthing ball
  • squatting
  • sitting backwards on a chair and leaning over the chair back

Massage

Consider asking your support person to gently massage your hands, arms, back, and/or feet. Be specific about what feels good and what doesn’t. You may find a firm, intense massage helpful, but more often a gentle effleurage (light massage) is most relaxing.

Massage can be over clothing or directly on your skin. We provide lotion, but feel free to bring your favourite massage lotion from home, if desired.

Counter-pressure

If you experience significant back pain during labour, it is often related to the direction your baby’s head is facing as it enters your pelvis. To encourage your baby to rotate, find positions in which you can lean forward. Counter-pressure can also help to ease the back pain. Ask your support person places the heel of his or her hand on your lower back and press firmly, especially during contractions. Be sure to clarify where and how firmly to press.

Transcutaneous Electrical Nerve Stimulation (TENS)

TENS is another excellent tool for easing back pain. It involves placing 2-4 adhesive pads on your lower back. They are attached to a small, battery-operated device by which you can adjust the intensity of the electrical stimulation. There are a couple of theories as to why TENS works. One suggests that TENS blocks your body’s pain signals (the Gate Control Theory). Another suggests that it prompts your body to produce endorphins (your “feel good” hormones). Don’t forget to take off the TENS machine if you decide to go into water!

Heat and/or Cold

Depending on your preferences, both heat and cold and can help you to relax, ease muscle tension, and provide comfort. It is a good idea to place 1 or 2 layers of cloth between your skin and the warm or cool compress to avoid accidently injuring yourself.

Examples of Heat: rice bag; warm blankets; warm tub or shower; warm compresses on the perineum, especially while pushing

Examples of Cold: ice pack; ice chips eaten with a spoon; fan; cold can of pop rolled up and down the back

Hydrotherapy

Each of our labour rooms at WDMH has a whirlpool tub. Resting in warm water may soothe tension and reduce pain and often speeds labour progress. Alternatively, try standing under the showerhead or sitting on a chair and using the showerhead to spray your abdomen.

Breathing Techniques

Many breathing techniques can help you relax and stay calm during labour. The best time to learn these types of breathing is prior to labour, for example, when you’re at prenatal classes.

Distraction

Distraction can be a powerful tool. In early labour, watching TV or movies, reading a book or magazine, or simply engaging in conversation with those around you may help take your mind off your contractions. As labour progresses and the contractions become more intense, you may need to focus on your breathing or on a rhythmic movement (like gently swaying on a birthing ball). Listening to music may aid you by promoting relaxation and blocking out sounds such as voices in the hallway.

Continuous labour support

Continuous support from an experienced labour support provider has been shown to decrease the length of labour and the need for pain-relief medications. Doulas are specially trained to offer women physical and emotional support before, during, and after the labour process. They are not health care professionals and can not replace nurses, midwives, or doctors. Nevertheless, they provide valuable support. Doulas are not covered by the Ontario Health Insurance Program (OHIP).

Some of the most valuable support you can receive throughout pregnancy, birth, and parenting comes from those you love: your partner and your family. We strongly recommend that you and your partner take prenatal classes together to prepare for the journey ahead.

Narcotics

At WDMH, we offer three different narcotics during labour. Nalbuphine (Nubain) and morphine are long-acting narcotics and are usually reserved for the early part of labour. Fentanyl is a fast-acting narcotic and can be given throughout labour. Narcotics blunt your pain and help you to rest, especially between contractions. As with all medications, there are side effects to narcotics. Your doctor, nurse, and/or midwife can explain the benefits and risks of these medications.

Epidural

Epidurals are a safe and popular form of anesthesia (i.e., freezing) used during labour. At WDMH, we offer epidurals 24 hours a day, 7 days a week. They are administered by an anaesthesiologist and monitored by your nurse. The anaesthesiologist will numb the insertion site with a local anaesthetic (this may sting) and then use a hollow needle to find the epidural site. Once he or she has found the right spot, the needle will be removed leaving a thin plastic catheter (i.e., tube) in its place. This catheter will be connected to a pump and will give you a continuous infusion of medication to keep you comfortable through the rest of your labour. In addition, you can give yourself small amounts of extra epidural medication (if needed) by pressing a button. Hence, this called patient-controlled epidural analgesia (PCEA).

Most epidurals work well and provide significant pain relief. At WDMH, we don’t provide “walking epidurals.” If you choose to have an epidural, you will have to remain in bed once it has been inserted. Further details regarding the benefits and risks of epidurals can be obtained from your doctor or midwife or from the hospital at the time of admission.

Pudendal Block

The pudendal block anesthetises (i.e., numbs) just the vagina and perineum. It can be administered by your doctor, usually just before you start to push. It can provide relief to women who choose not to have an epidural but find the pushing stage exceptionally painful. If you think you may be interested in this option, speak to your doctor. Many, but not all, delivering doctors offer this form of pain relief.

Your Baby’s Well-Being

When you are in labour, your nurse or midwife will monitor your baby’s heart rate. There are two ways to do this:
Intermittent auscultation (IA) is done with a small hand-held monitor and involves listening to your baby’s heart rate for about a minute every 15-30 minutes during active labour, and every five minutes while you’re pushing. IA is the preferred method of fetal monitoring when there are no complications.

Benefits: You will have more freedom to move around and to enjoy the whirlpool and/or shower.
Risks: In cases where there are risk factors, IA may not provide enough information about your baby’s wellbeing.

Electronic fetal monitoring (EFM) involves two small, round instruments that are held on your abdomen by pink and blue straps. One monitors your contraction pattern, the other, your baby’s heart rate. This type of monitoring is usually continuous.

EFM may be used when your labour is induced rather than spontaneous, your labour is slower than expected and needs to be augmented, you have had a caesarean section previously, or there are concerns about the wellbeing of your baby.

Benefits: EFM is a good way to monitor the wellbeing of your baby when there are concerns or risks or when your labour is long or difficult.

Risks: There is a higher likelihood of having an operative delivery (either caesarean section or a vaginal delivery assisted by vacuum or forceps) with EFM compared to IA. Your ability to move around freely may be impeded by the monitor.

Types of Deliveries

Induction of Labour

Ideally, your baby will choose his or her own birthday and come when ready. Sometimes, labour needs to be induced (i.e. started by medical means). Induction is not without risk and therefore should only be done when there is a good reason (e.g. you are a week or more past your due date and haven’t gone into labour). Your healthcare provider will explain the reason(s) for and method(s) of induction of labour if the need arises.

Caesarean Section

If you are having a scheduled caesarean birth, your surgery date will be booked by your doctor. You will be admitted to the Surgical Daycare Unit on the day of your baby’s birth. Your doctor will talk to you about the details of your admission. Learn more about caesarean birth.