Labor and Delivery

 Our practice wishes to make your labor and delivery experience a safe and memorable one. When the time comes, you should contact your physician on-call (by calling the office) and head to Saint Barnabas Medical Center (3rd floor P.E.T. unit) for evaluation. Your doctors are always here to answer your questions.  Following are some signs/symptoms of labor.
See also... How to Tell When Labor Begins

Am I in Labor? The onset of labor is the most anticipated event during pregnancy. Fortunately, there are several clues that the body will give that may indicate that the labor process has begun. Every woman’s labor onset is different, so if unsure, please call your provider for further guidance. However, here are some of the most common clues...

• Contractions occurring every three to five minutes for greater than one hour and increasing in intensity and duration; contractions of true labor usually last more than 30 seconds each and are not relieved with rest, position change, Tylenol, etc.
• Rupture of membranes – Slow or periodic leaking of fluid from the vagina or large gush of fluid may indicate that your water has broken; note the color of the fluid and tell your provider
• Bloody Show – Blood-tinged mucous appearing discharge that may indicate the onset of cervical thinning and dilation

Pregnancy Warning Signs: Whether or not your pregnancy has been problem-free up to now, and whether or not you think you might be in labor, be sure to call your caregiver right away in the following situations...

• Your water breaks or you suspect that you’re leaking amniotic fluid
• You have vaginal bleeding (unless it’s just a small spot of blood, which is common after a recent cervical check or vaginal exam in the office)
• You are having contractions every 3-5 minutes for one hour
• You have severe or persistent headaches unrelieved with Tylenol, vision changes, intense pain in your upper abdomen, or abnormal swelling
• Your baby is less active. If decreased movement of your baby is noted after 28 weeks, drink 2 glasses of cold water and lie down on your left side. Remain lying down for one hour, and count the times you feel your baby moves. If no movement is felt, call the doctor.
• You are experiencing sharp pains or severe cramps in your stomach

Induction of Labor: Due to certain medical and pregnancy-induced conditions, it may be necessary to give birth prior to your due date. Your doctor will discuss the induction plan with you and instruct you on the next step.

Vaginal Delivery: Whenever possible, our goal is always a safe, natural vaginal delivery for you and your baby. When you believe that you are in labor, you will call the service and then proceed (please have someone drive you) to the Perinatal Evaluation and Treatment (PET) Unit at Saint Barnabas Medical Center. You will be assessed by the hospital staff (Resident Physician, Nurse Midwife) and if in labor, you will be admitted to our Labor and Delivery Unit. We wills see you there! Of note, some women choose to proceed with labor and delivery without medications; others require intramuscular/intravenous/epidural medications for pain control. Anesthesia is available 24-7.
See also... Medications for Pain Relief During Labor and Delivery

Operative Vaginal Delivery: Sometimes due to a variety of reasons i.e. maternal fatigue, issues with the fetal heart rate, an operative vaginal delivery may be required via vacuum or forceps. Your provider will counsel you appropriately. Occasionally, an episiotomy is required to allow for your baby to deliver naturally (vaginally). Under anesthesia (local or epidural), an incision is made to allow for adequate room so that your baby's head can deliver safely. This is not a common procedure, though our doctors are skilled in the practice
See also... Assisted Vaginal Delivery

Cesarean Section: Some women cannot have their babies vaginally for their safety or for the safety of their child. Our doctors are skilled to recognize when a cesarean section should be scheduled and/or performed. Both are trained to perform routine and emergent low-transverse and classical cesarean sections.
See also... Cesarean Birth (C-Section)

Vaginal Birth after Cesarean Section: After thorough discussion and counseling sessions with your doctor, some women are deemed eligible for attempting a vaginal birth after ONE low-transverse cesarean section. If your wish is to have a trial of labor, our doctors will happily speak to you regarding the goals of treatment, risks and plan of action.