I don't know about you, but when I went into labor, I was a hair distracted by pain to think about what was happening in my body. Fortunately, you have providers you trust to take care of it. The checklist your OB-GYN goes through when you go into labor is pretty extensive, and it's actually nothing you need to worry about. Instead, it gives you a glimpse of what your provider is doing as you're huffing and puffing and praying for relief.
Labor and childbirth is a really complex process wherein a lot of things can go sideways quickly. That's why it's so important for the provider to be really zeroed in on every little thing happening in your body as it prepares to bring your baby into the world. Your safety, and the safety of your baby depend on it.
I spoke with recently retired OB-GYN, Dr. David Williams of Ontario, author of the upcoming book Stories from The Delivery Room, to find out the procedures surrounding labor and childbirth, and how it happens. He shared the checklist your OB-GYN goes through when you go into labor — the condensed version — because, holy cow is there ever a ton of stuff they're looking at during any given minute of childbirth. It's overwhelming, and I'm glad I'm not an OB-GYN.
Williams tells Romper, "I'm assuming the mother is full-term, and has had an uncomplicated pregnancy and not group B strep positive or Rh-, and free of any other concerns like HIV or active herpes infection, because the protocol is slightly different in those cases. But always, the first thing we do is what's called a rapid assessment and history. We look at how the patient appears and sounds upon arrival, whether or not she appears ill, or just generally in pain."
According to Williams, your doctor will also determine if you're on any meds or allergic to anything. Then your airway is checked along with your breathing and circulation to make sure you're healthy, as you're the first priority of the obstetrician. "We then assess the mother with significantly more scrutiny. If you're not breathing properly, or if your color is poor or your heartbeat is thready, those are concerns we need to take seriously." He adds that your OB-GYN and nurses will check your blood pressure frequently during childbirth and immediately upon arrival at the hospital, as it is one of the most important monitors of maternal safety. They will also check your urine for protein and glucose which can signal preeclampsia.
Williams tells Romper that the nurse is also going to get you hooked up to a fetal monitor to assess your baby's heart rate and contractions while they evaluate your cervix for bleeding, dilation, effacement, position, and general health of the fetus and mother. They will also evaluate if your water has broken, and if that's the case, evaluate the fluid for meconium (baby's waste) to determine if immediate intervention is required. "This whole time, we've got an eye on the mother and her vitals as well. Is she holding up OK? Responsive? If we have a relationship with the patient, we'll already have a good idea of her labor and childbirth history. If not, I need to know things like if she's had a forceps delivery before, or a delivery with significant tearing so that I can be prepared for the possibility this time around."
After the vaginal exam, they'll continue to monitor you closely, says Williams. They'll assess the strength and duration of your contractions, how your baby responds to the stress of childbirth, and how the mother is coping with the pain. They'll check your vitals around every 30 minutes (though he notes that may be slightly different from patient to patient, but it's always pretty frequently), and periodically check your progress with a vaginal exam as they notice your contractions moving you closer to delivery.
I remember learning to hate the blood pressure cuff, but being very grateful for it during my second birth when my blood pressure suddenly dropped, requiring medical intervention. The checklist that your OB-GYN goes through, and all they have to think about during your initial assessment, is astounding. When I was speaking with Williams, it felt like he was going through the pre-flight check for an Apollo mission, and it made me truly grateful for their expertise in this area, as I'm sure it does for you. Trust them — they leave no stone unturned in your health and want the same outcome as you — a healthy mom and baby.
Check out Romper's new video series, Romper's Doula Diaries: