Labor & Delivery

We are so excited that you have chosen Natividad for the birthplace of your baby! We are here for you, every step of the way. Remember to honor this time. Make it count for you and your family.  Take the time to enjoy your baby/babies and yourself.

We are proud to be a Baby-Friendly Certified Hospital, which means that we support breastfeeding. All of our staff have been trained to help moms with breastfeeding. If at any time you have a question regarding what it means to be “Baby-Friendly,” please feel free to ask.

Here are some suggestions of things to pack for your hospital stay:

For You

  • Your birth plan, if you have one
  • Robe
  • Pajamas or comfortable clothes
  • Underwear
  • Deodorant
  • Toothbrush/toothpaste
  • Soap and shampoo
  • Hairbrush
  • Slippers or flip flops
  • Body lotion
  • Camera

For Your Baby

  • Diaper bag
  • At least one outfit for baby to wear home
  • Baby blankets
  • Baby book (optional)
  • Car seat: bring it to the hospital but leave it in your car until you have been discharged

Honoring Your Labor Options

Our team of highly skilled professionals at Natividad Women & Children’s Services believe the miracle of pregnancy and childbirth are to be embraced with deep respect, in the safest environment possible. Read about the many labor options we support below.

Midwifery Options

Natividad is proud to be the first hospital in Monterey County to offer midwifery services before, during, and after birth. We have a team of midwives to care for you while you’re pregnant, during your labor, and after the baby is born. Midwives offer personalized, family-centered care to help you achieve your birth goals safely. We will support you and your decisions in all phases of pregnancy.

According to the American College of Nurse Midwives, benefits of receiving midwifery care include:

  • Decreased risk of needing a cesarean section delivery
  • Reduced rates of labor induction and augmentation
  • Reduced use of regional anesthesia
  • Decreased infant mortality rates
  • Decreased risk of preterm birth
  • Decreased third and fourth degree perineal tears
  • Increased chances of having a positive start to breastfeeding
  • Increased satisfaction with quality of care

Midwives are experts in supporting women in normal, healthy childbirth. They are an essential part of the team and rely on the expertise from obstetricians, family practice doctors and nurses if complications arise.

Doula Options

A doula is a labor support professional 
whose expertise is providing emotional and physical support to the mother and her partner throughout the pregnancy, during labor and the postpartum period.

While a doula does not provide any medical care, they work closely with the nurse and physician to optimize the birth process and experience. Doula care has been shown to decrease the chance a mother will need a cesarean section and they also improve the birth experience.

At Natividad, we support and encourage women and their families to bring a doula of their choice to participate in their care.

“I chose Natividad for my third birth because I wanted labor options and my desire for a natural birth to be respected. Natividad’s low cesarean rate and support of midwifery care made the decision easy. With support from my husband, midwife, physician, and doula we welcomed our 11lb 5oz son after laboring using movement, hydrotherapy, and upright pushing positions. Being an informed consumer helped us achieve the positive birth we desired.”
— Cori Gentry, mom of 4, Natural Childbirth Educator, President of the Birth Network of Monterey County

The Natural Process of Birth

The Natividad birth process offers patients in labor multiple pain management options.

Water Therapy Shower/Tub
All labor rooms have a shower stall and a tub can be set up for those that request it. Warm water immersion in a tub during the first stage of labor is one method that promotes relaxation and labor pain management. Water immersion during the first stage of labor has the potential to decrease labor pain and anesthesia use, as well as shorten the duration of labor.

Alternative Labor Support
Each patient is assigned a labor nurse who is present during labor and birth. Your labor nurse may encourage activities and positions that will be helpful to the progress of labor.

Labor Tools Available

  • Labor balls
  • Labor peanuts
  • Rocking chairs
  • Squatting bars
  • Mirrors and other tools
  • Birthing stool

Labor nurses provide support with their presence, and train your designated partner/coach on how to assist you in labor. Other techniques used by labor nurses include proper positioning, touch, application of heat and cold therapies, and encouraging fluid intake. Labor nurses are also advocates for laboring patients. They will communicate your wishes to other health care providers and offer information about progress of labor, coping methods and relaxation techniques.

Patient-Controlled Pain Management
Nitrous oxide inhalation is a method of patient controlled analgesia pain management which empowers patients and provides the potential benefits including:

Reduction of pain perception without interfering with the labor or delivery process

  • Rapid onset and release from system
  • Decreased anxiety
  • Maintains mobility and changes in position
  • Option for patients unable to get epidural anesthesia
  • Avoids the side effects of narcotic administration or epidural anesthesia

Intermittent Monitoring
Staff will provide intermittent auscultation (IA) for low-risk patients in labor. This means you do not have to be continuously attached to a fetal monitor , and the nurse checks the baby’s heart rate at various intervals with a doppler tool, based on your stage of labor. This allows freedom of movement during labor. Other fetal monitoring options for patients in labor who are not low-risk may include interrupted fetal monitoring. This means you would be attached to the fetal monitors for approximately 10-20 minutes every hour and have freedom of movement for the rest of the hour.

Vaginal Delivery

A vaginal delivery is a childbirth option that happens when the baby is pushed down the birth canal and delivered through the vagina. Every labor and delivery is different. How long labor and delivery lasts and how it progresses varies depending on previous births, the position of the baby’s head, and the size of the baby and the birth canal.

There are, however, general stages of labor and delivery that a health care provider uses to decide whether it is progressing normally for a vaginal delivery:

  • First stage: The cervix opens and thins to full dilation. The average woman in her first labor may dilate about 1 cm per hour during the active phase of labor. If you have had a baby before, the cervix usually opens faster.
  • Second stage: The baby moves through the birth canal and is born. This stage of labor usually lasts 15 to 75 minutes but may last as long as 2 or 3 hours. This is the stage of labor when a mother pushes to help the baby come through the birth canal.
  • Third stage: The placenta (afterbirth) passes through the birth canal and is delivered. This usually happens within 30 minutes after the birth of the baby.

Most vaginal deliveries stay 24-48 hours in the hospital before going home.

Cesarean Delivery

If you are pregnant, chances that you will be able to deliver your baby through the birth canal, also called a vaginal delivery, are good. But there are cases when a cesarean section (C-section) is needed for the safety of the mother or baby. Even if you plan on a vaginal birth, it’s a good idea to learn about C-section, in case the unexpected happens.

What is a Cesarean Birth (C-section)?
A cesarean birth (C-section) is an abdominal operation performed to deliver a baby when a vaginal delivery is not possible or safe. Your doctor performs a cesarean birth by making an incision in the abdomen and uterus to remove the baby.

For Scheduled and Emergency Cesarean Sections (C-sections)
If you are scheduled for a C-section, or if you should unexpectedly need one due to a pregnancy complication, Natividad’s Labor & Delivery staff are committed to providing you with a safe and healthy delivery.

Please note: We do our best to honor the times assigned; however, many events in obstetrics cannot be planned. Your baby will be delivered as soon as possible and your nurse will keep you informed.

Our Facility
Natividad’s Labor & Delivery Department has two fully-equipped operating rooms and a neonatal team is present at all C-sections. Your labor coach or significant other is allowed to be with you during your C-section.

In the unlikely event that your child requires specialized care after birth, they will be taken immediately to the NICU and attended by the neonatal care team.

When Do I Go to the Hospital for a C-section?
For a scheduled C-section, you should arrive three hours prior to your scheduled surgery time.

Sometimes the baby does not wait for the scheduled date, so please come to the hospital immediately if you experience any of the following:

  • If your water breaks (a gush or a trickle of fluid)
  • If you are having contractions regularly
  • If your baby is not moving or is moving less than usual
  • If you are having bright red bleeding from your vagina

At the hospital, you will be checked to see if you are in labor. If you are not in labor, you will be sent home to return on your scheduled date. If you are in labor, you may have your C-section prior to the scheduled date.

Our nurses and physicians are happy to answer any questions at any time during your care.

If you have any questions or concerns regarding your hospital stay, please talk to your health care provider or call the Labor & Delivery Department at (831) 755-6226.

Preparing for a Cesarean Section

  • Do not have anything to eat or drink (including water) for 8 hours prior to your surgery
  • Take only acetaminophen (Tylenol) if needed for pain
  • Do not wear jewelry or bring money or valuables to the hospital
  • Do not wear any makeup, lotions or powders the day of your surgery
  • The day you arrive at the hospital, you may bring one adult visitor with you
  • Report to Labor & Delivery with your paperwork at the scheduled time and date
  • If you should experience vaginal bleeding, leakage of fluid from your vagina, regular contractions, or your baby is not moving, come to Labor & Delivery immediately, regardless of your scheduled date and time

What Happens During a Cesarean Delivery?

  • An IV will be started and blood will be taken
  • Nurses will monitor your baby to make sure everything is okay
  • You will be given medication in your IV and will drink some medication before going to surgery
  • The staff will talk to you about what type of medicine you will get during your surgery
  • You will have a catheter (a plastic tube placed into your bladder to keep it empty of urine). This will be removed 12-24 hours after your surgery
  • You can decide on one family member to be with you in the operating room
  • There will be doctors and nurses in the operating room to take care of you and your baby
  • You will be in the operating room for about one hour and then moved to a room to recover for about one hour. You will be able to breastfeed in the recovery room. You will move to your new room in the Mother-Infant Unit once your health care team says it’s okay
  • You will stay in the hospital 2-4 days, depending on your recovery.

Vaginal Birth After Cesarean (VBAC) Delivery

Many women who have had a cesarean delivery can later give birth vaginally. A Vaginal Birth After Cesarean (VBAC) delivery may be an option for you. Your physician can discuss with you whether you are able to have a VBAC delivery.

Is a VBAC Right for You?
Of the women who try a VBAC, about 70% are successful. If you are thinking about having a VBAC at Natividad, you may be a good candidate if:

  • Your previous cesarean delivery was twelve months from your due date
  • You have had no more than two cesarean deliveries
    If you choose a VBAC:
  • You will start your birth process naturally
  • You may be given oxytocin to augment your labor
  • You will have the monitor on at all times to listen to your baby’s heartbeat, even when you are up walking
  • You may have an epidural for pain management when you request it
    Some women who choose a VBAC may have a repeat cesarean delivery during their labor because of a possible complication, such as:
  • Uterine Rupture — a mother who has had a previous cesarean has a small increased risk (less than 1%) to open the cesarean scar
  • The baby cannot tolerate the labor

How Do I Find Out if I Am a Candidate for VBAC?
If you are considering a VBAC, you can consult one of our providers, who will help you determine if VBAC is right for you. For an appointment, or if you have questions, please call us at (831) 755-4156.

Induction

Labor induction means starting (inducing) labor instead of waiting for labor to begin on its own. Your doctor will decide if an induction of labor is right for you.

Your doctor or clinic staff will call Natividad and arrange a time for you to arrive at the hospital for an evaluation and possible induction of labor.

Please note that sometimes a scheduled induction of labor may be delayed or postponed. This is because the Labor & Delivery Department must give priority to women with urgent medical needs.

The hospital staff will do their best to keep you informed if your induction is postponed or delayed. As soon as we are able to see you, we will call you to come to the hospital. Still, you should be prepared to be flexible.

If your induction should be postponed for 24 hours or more, we will schedule an appointment in our Prenatal Testing Unit to monitor you and your baby to be sure you are both doing well.

Induction Instructions
1. Call 2 hours prior to your scheduled appointment to ensure room and nurse availability
2. You may take a shower or bath prior to coming in for your appointment
3. You may eat a light meal prior to coming in for your appointment
4. Do not wear jewelry, or bring money or valuables with you to the hospital
5. You may bring visitors with you, but remember delivery will take 1-3 days

Once you are at the hospital, the team caring for you will review your pregnancy and medical records. Try to be patient if they are asking questions you have already answered. Sometimes double-checking is part of the safety process.

Checking Your Baby
Before beginning your induction, the team will examine you to check;

  • Your baby’s heartbeat using a fetal monitor
  • Your heart rate, blood pressure and temperature
  • The position of baby inside your uterus
  • The cervix to see how soft or if it is open

Starting and Progressing Labor
Using the information above, the team will decide which method will be used to start your labor.

Induction Options

  • Pitocin by IV drip: This medicine is given to you through a tube put in your veins. This is a synthetic version of the natural hormone that causes contractions. It would be increased at slow intervals until you have strong contractions.
  • Cytotec by mouth or vagina: This is a very tiny pill that can be taken by mouth or placed in your vagina and may cause contractions of your uterus.
  • Foley bulb induction: This is a tube that is inserted into your vagina, then into your cervix (opening of the uterus), by the doctor and a balloon at the tip is inflated to open your cervix.
  • Amniotomy (breaking the bag of water): This is done during a vaginal exam and involves making an opening in the amniotic sac with a thin plastic hook. (You may feel a gush of warm fluid once it opens but no pain). This may intensify your labor contractions and would allow internal monitoring of your baby’s heartbeat and the strength of the uterine contractions if necessary.

Pain Management Options

Labor is known for being a painful process. There are many options for managing and decreasing your pain. It’s a good idea to talk to your doctor about these options before you go into labor, so you fully understand your choices.

IV Pain Medication

  • Purpose: To reduce and relieve pain and help you relax between contractions. You will still feel contractions.
  • How it is given: Pain medication is given by a shot or through your IV line. It usually takes effect very quickly and may last 1-2 hours.
  • Effects on you and your baby: You may feel dizzy or like you are floating. The medication could make your labor slow down for a short time.

Epidural

  • Purpose: The epidural relieves pain from below the breasts to mid-thigh for labor and birth. You may still feel touch, movement, and pressure. You may also be able to move your legs. You will be alert but can also rest or sleep during labor.
  • How it is given: A nurse anesthetist numbs the injection site, and places a very small tube in your back. Medication flows through the tube into the space just outside the spinal cord. It usually works in about 5-10 minutes and lasts as long as needed.
  • Effects on you and your baby: You must have an IV in during your whole labor and birth. Most patients have very good pain relief from an epidural.
  • Possible side effects: Your blood pressure may become low after the epidural is placed. Medication can be given to correct this. You may feel numbness or tingling in your legs.

Once the epidural is placed, you will have to stay in bed. If you have to urinate, the nurse will help you with a bedpan. If you are unable to urinate, a tube may be placed in your bladder to keep it empty.

Natural Techniques
Some women choose to manage their pain with natural techniques, and we have several options and tools available. A shower may be taken to relieve pain if your condition allows. Rocking chairs, labor balls and alternative positions in bed are also available.

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Women & Children’s Services
Natividad

1441 Constitution Blvd.
Salinas, CA 93906
(831) 755-6226