Doula Options

Information About Doulas

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

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

Epidural

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.

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 to 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;

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

Induction Options

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:

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.

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:

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

What Happens During a Cesarean Delivery?

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:

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

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 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

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 to 20 minutes every hour and have freedom of movement for the rest of the hour.

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:

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.

Breastfeeding Support

Breastfeeding can be challenging for some women, and having the right resources can make all the difference. At Natividad, we want to give you the tools for success, whatever your breastfeeding goals may be. Whether you simply have a question or concern, or need more in-depth support, we are here for you.

Natividad Women & Children’s Services has the only Lactation Clinic in Monterey County that offers breastfeeding support to expecting and new mothers, regardless of where the baby was born. We take appointments seven days a week, and are here to support and educate any mother needing breastfeeding assistance.

We have a team of six internationally board-certified lactation consultants  who offer private, one-on-one consultations for breastfeeding support, including pumping and storing milk.

For appointments, call (831) 796-1652. If there is no answer, please leave a message and we will return your call within 24 hours.

Natividad is a Baby-Friendly® Hospital

Natividad has been designated as a Baby-Friendly birth facility by Baby-Friendly USA®. Natividad offers the best possible level of care for breastfeeding mothers, giving them the education, confidence and skills to successfully breastfeed their babies.

Neonatal Intensive Care Unit (NICU)

Affiliated with the University of California San Francisco (UCSF) Benioff Children’s Hospital and certified by the California Children’s Services, the Neonatal Intensive Care Unit (NICU) at Natividad is devoted to the newborn infant requiring specialized care. It provides stabilization of the initially ill newborn and intermediate intensive care and continuing care for growing newborns.

Two UCSF neonatologists/pediatricians – highly trained physicians in the care of ill newborns – oversee the NICU, offering families the security of knowing their infant receives the highest level of newborn care.

At Natividad’s NICU, we provide aggressive care when needed but eliminate ventilators, central lines and laboratory work as soon as it is safe to do so. We remove invasive support earlier than most NICUs, and as a result, discharge our smallest infants home earlier than the “average” NICU in California (per CPQCC data)*.

Our highly skilled neonatal nurse practitioners are in the hospital 24/7 in order to provide emergency care until our board-certified neonatologist arrives. Their presence adds an extra level of safety not found in any other NICU in Monterey County.

There is no need to transport any infant to a higher level of care due to birth weight or gestational age. We transport infants away from our NICU only for services/expertise not available in Monterey County. Our experienced neonatal transport team is capable of routine and emergency transports. We transport infants to our NICU from other Monterey County hospitals who need a higher level-of-care or for recovery care from our Tertiary Center, UCSF.

Our strong commitment to family, as part of the healing process, keeps parents and their children united throughout the treatment and recovery process.

We have a parent room so parents can stay and care for their infant as discharge draws near.

*Accounts for babies weighing less than 1500 grams (3 pounds, 5 ounces) or less than 30 weeks gestation- 45.6 days (2007), 38.2 days (2008), and 39.4 days (2009).

Retinopathy Screening

Premature and very low birth weight newborns receive the added attention of our four highly-skilled and trained staff members who administer retinopathy screening thirty days following birth. Results are sent to Stanford Medical Center for reporting and diagnosis, and consultations are done weekly.

NINOS

The Natividad Interdisciplinary NICU Outpatient Services (NINOS) ensures the follow-up of high risk infants. The NINOS program tracks an infant for 3 years following discharge to assess developmental and physical needs, assuring that the children are meeting cognitive and physical milestones. Assessments include: developmental, family psychosocial, hearing, ophthalmologic, nutritional, and home assessments.

For 11 years, the Neonatal Intensive Care Unit at Natividad has held a Level III designation
from the California Department of Health, the highest designation in Monterey County. Our facility meets the strictest criteria and is staffed and equipped to care for critically ill infants. We have become known by other NICUs across the region as the place to which they refer their most seriously ill newborn patients.

Multi-Disciplinary Care

The newborn care team provides care to babies in the unit 24 hours a day, 7 days a week. Our team includes:

Specialized Services

Experienced Transport

Our neonatal transport capabilities allow us to bring infants to our NICU from other Monterey County hospitals.
Our experienced neonatal transport team is capable of routine and emergency transports. We transport infants away from our NICU only for babies that need advanced cardiac care, surgical intervention, or sub specialty services not available in Monterey County.

Quality and Safety

Through our Program for Patient Safety and Quality, we continually monitor and improve the care we provide to our patients.

At Natividad, we believe that patients and families deserve to know whether the hospital where they have chosen to receive their care meets the highest standards and is committed to excellence.

Family Services

Our strong commitment to family, as part of the healing process, keeps parents and their children united throughout the treatment and recovery process; parents are welcome 24/7.

We recognize the stress having a sick baby places on families, and our team of physicians, nurses, social workers, respiratory therapists, lactation consultants, and others work to provide a family-centered experience for patients and their families. As a commitment to family, parents and their children are kept together throughout the treatment and recovery process.

We understand a baby’s illness is a challenging and sometimes frightening experience, and we do everything we can to support the family: