Navigate your hospital stay by knowing what to expect after your baby's delivery and before you take her home.
The day after I gave birth to my daughter, Olivia, I decided to take her for a walk down the hall. Within seconds, nurses came flying at me from every direction and herded me frantically back to my room. I had unwittingly set out for my walk carrying Olivia in my arms—a huge no-no, they told me, because I could become dizzy and fall due to blood loss. Most hospitals insist that you stroll with your baby in her wheeled bassinet. Who knew?
As your due date draws near, you're probably an expert on all things pregnancy, including how to negotiate with hospital staff when it comes to your birth preferences. Chances are, though, you're not as clear on what your hospital stay will be like after your baby makes her entrance. Knowing what's up can make that time a lot more enjoyable. Here's how it usually plays out.
The First Hour
In some hospitals, unless you specify otherwise, the baby is cleaned and evaluated immediately after delivery. Many women, however, prefer to hold their babies straight from the womb. "The first hour after birth is when the baby is most awake and alert," says Joyce McKeever, M.S., R.N., I.B.C.L.C., L.C.C.E., clinical program manager for the Baby-Friendly Hospital Initiative and director of clinical services at the Center for Breastfeeding at Jersey Shore University Medical Center in Neptune, N.J. "It's a great time to get acquainted by holding your baby skin-to-skin on your chest and to start breastfeeding, which helps the mom's uterus contract and reduces bleeding immediately after delivery."
When writing your birth plan or discussing the delivery with your doctor or midwife, specify how you want that first hour to go, says Meagan Francis, a mother of four and co-author of One Year to an Organized Life with Baby (Da Capo Press).
"If the baby is healthy, most everything can be put off a little while to give you one-on-one time," she says. For example, you may want to delay having antibiotic drops placed in your baby's eyes—a standard post-birth procedure that can blur her vision temporarily. As with all medical care, you have the right to question or refuse any treatment that doesn't sit right with you.
After you've delivered the placenta and have been stitched up if you had an episiotomy or tear (or your Cesarean section is complete), you might be transferred to a postpartum room. Others offer LDRP (labor, delivery, recovery and postpartum) rooms.
More and more hospitals are embracing "family-centered care," offering private postpartum rooms that include a fold-out bed for your partner. Rooming-in, or having your baby with you at all times, is also increasingly popular, and in some hospitals, it's obligatory. While this practice provides a nice opportunity to bond with your baby, it's also OK to let her spend a few hours in the nursery while you sleep. If you do so, tell the nurses whether they can give your baby formula or you want her returned to you for feedings.
If you'd like to breastfeed but it's not coming easily, ask to see a lactation consultant. (Large hospitals usually have one on staff.) It may also help to adopt a "no visitors" policy while breastfeeding, says Portland, Ore.- based maternal health nurse Jeanne Faulkner, R.N. "Some babies—and moms—need peace and privacy to learn the big job of nursing," she says.
Faulkner, who writes the Ask The Labor Nurse blog, also suggests using your room call button wisely. "Don't hesitate to ask for help from your nurses and hospital staff, but consider asking for several things at once, such as ibuprofen, juice and breastfeeding help. Clustering requests lets nurses provide more focused, efficient care," she says.
And if you decide to shower after you deliver, don't do it alone. Postdelivery fainting is common and it happens most often in the shower because the hot water causes blood pressure to drop, says Faulkner. Use the shower bench and ask your partner, a friend or a nurse to watch over you.
The hospital staff will also be keeping a close eye on your newborn. Don't be surprised if a wireless tracking device is attached to your baby's ankle. "If your baby is taken too close to an exit, the doors will go into lockdown mode," McKeever explains.
Many insurance plans cover a two-day hospital stay for a vaginal delivery and four days for a C-section. However long you stay, a few things are required before you leave:
Baby Exam A pediatrician will examine your baby and administer a heel-stick blood test, which screens for several metabolic disorders, such as phenylketonuria. Some states perform a hearing screening as well.
Mommy Exam The staff will make sure that you're healing properly—i.e., that your uterus is contracting and your bleeding is slowing. You're likely to have heavy bleeding that lessens with each subsequent day, finally letting up in about six weeks.
Skills Check They'll determine that your baby is able to breastfeed or bottle-feed successfully and that you understand how to perform basic tasks such as bathing, caring for the cord stump and diapering.
Forms Signed You'll need to fill out a birth certificate even if you haven't named your baby yet.
If possible, have someone take home gifts and flowers the day before you leave so that your last day is less hectic, McKeever suggests. Also, make sure your vehicle is equipped with a properly installed car seat that you know how to use—you don't want vexing straps and buckles to delay your happy homecoming.
—Christina Frank is a freelance writer in Brooklyn, N.Y.