Childbirth and birth in hospital

The journey of a future mother from the moment she enters the hospital to the moment she leaves with her baby.

The acceptance

Generally, departments tend to admit the woman only if labor has started (presence of regular and painful contractions and at least three centimeters of dilation.

There is, especially if you are expecting your first child, a phase called "prodromal" which lasts a few hours and is characterized by irregular contractions and pain similar to menstrual pain.

It is an advantage for you to stay at home at this stage, trying to rest, take a relaxing bath and try not to pay much attention to these early signs, but spend these hours in the company of someone in a calm and pleasant way. Early admission to the clinic is often a cause of stress.

Upon acceptance, the woman immediately enters the labor room and then the person accompanying her completes the formalities at the counter. It is important to bring with you:

• Health card
• Clinical tests
• The pregnancy folder
• The delivery bag

The labor

During labor and delivery, the presence of the baby's father or a person chosen by the woman is normally permitted, but in the case of a two-bed labor room, they can ask the companion to remain outside.

Physiological labor is usually assisted by the midwife, who frequently checks the fetal heartbeat. During labor, frequent vaginal visits can be uncomfortable for the woman and there are other parameters to evaluate maternal and fetal well-being and the progression of labor itself.

The routine practice of amniorexis (artificial rupture of the membranes that causes the amniotic fluid to escape) is debated: on the one hand, it can shorten the duration of labor, but on the other, it intensifies the pain of contractions and reduces the woman's ability to move.

During labor, sugar consumption is very high and you may feel tired and weak: it is therefore important to drink warm drinks with sugar or honey.

Today, to relieve the pain of childbirth, more value is given to natural techniques such as breathing control, different positions, concentration and massage. Many women learn these techniques in childbirth preparation classes.

The birth

This phase begins when the woman, with the uterine mouth fully dilated, feels the "spontaneous push" the first pushes.

It is a very delicate moment, in which you will need to be able to concentrate and find reassurance. Every change of situation is tiring, you will need to find a comfortable and at the same time effective position.

At this point you will generally move to the delivery room, your partner will still be next to you. His presence can be a point of reference for your tranquility together with that of the Midwife who, with advice and encouragement, will be even closer to you.

Almost all births take place in the traditional delivery room bed and the staff does not propose alternative positions on their own initiative.

An episiotomy is a small surgical incision that artificially widens the vaginal opening; if necessary, it is performed before the baby begins to come out and generally, with local anesthesia.

At the moment of birth, the Neonatologist or Pediatrician is present, the newborn baby is given to the mother, wrapped in a sheet. The umbilical cord is cut after a few seconds and the woman can immediately attach the baby to the breast, if she wishes. Afterwards, the newborn is examined by the Pediatrician, placed in the heated cradle and transferred to the nursery.

Here the newborn is examined more carefully and subjected to routine prophylactic therapies and dressed in his own clothes that you have put in the hospital bag.

In the meantime, the woman, still on the delivery bed, expels the placenta; the episiotomy, if any, is then sutured. Transferred to the postpartum room or labor room, the woman spends the first hours after giving birth under observation.

It is well known that the first hours after birth are fundamental for the baby-mother-father meeting, for the establishment of the first bond. These are very delicate moments: a warm, welcoming, silent environment is necessary, which respects your privacy.

The puerperium

For the woman, the days following childbirth are characterized by intense emotions. On the one hand, joy for the birth of the baby, desire to see and touch him, on the other, concern for his well-being, tension for breastfeeding, physical tiredness, pain for any stitches.

After the hardship of childbirth, you may need to be encouraged, helped, supported in your new role as a mother.

The central point of this new phase is, for those who want it, breastfeeding which in turn requires energy, willingness and patience.

The colostrum of the first two days and then breast milk are the best food for the newborn from all points of view. For a successful breastfeeding a good start is essential:

• the desire to breastfeed first and foremost,
• sucking in the first hours after birth,
• breastfeeding on demand according to the baby's own rhythm,
• avoid the administration of any other substance (artificial milk or gluten solution)

How to organize this in the hospital? One answer could be "Rooming In" that is, not separating the mother and the baby during the puerperium. The close proximity of mother and newborn facilitates the realization of these conditions and promotes their knowledge and understanding.

During the hospital stay (usually three days) the new mother assists with changing the diaper and dressing the umbilical cord. Upon returning to the nursery, if the newborn has not eaten enough (check with double weighing), he is eventually given a little glucose solution.

The fact that the baby does not take breast milk in the desired quantity depends on many factors:

• the newborn may not be hungry at that moment and even sleep
• the mother may feel anxious knowing that she has little time available to feed the baby and this makes the milk emission reflex difficult,
• your milk supply may not have arrived yet,
• and so on...

Don't be alarmed because at home it will be much easier to find a rhythm that meets the needs of you and your baby.

Normally on the third day, counting zero on the day of birth, and on the fifth week if a caesarean section was performed, the baby is discharged and instructions are given for subsequent checks.

In the days following childbirth, women need material help, but above all emotional support and a suitable environment that gives them the time they need to learn how to care for and feed their newborn.

"Feeling like a mother" is a slow and complex but natural process, made up of small steps.

The return home

Every woman needs, in the first weeks, to be encouraged, supported and helped. Changing your habits, waking up at night, taking care of the baby trying to understand his needs, all this requires a lot of energy.

Emotional support is therefore essential, even with specific "technical" support, and affective support that must be given and created within the family. It could be a good opportunity for the father to have a period of vacation that coincides with the first weeks of life of the new family at home.

Our best wishes.