Have a Lovely Labor Day

Before I had my first baby, I packed my bag for the hospital with all sorts of handy things: tennis balls for my husband to roll around on my back, the cutest nursing nightgown I could find, and a box of nursing pads. Reality: I didn't want my husband to touch me, the slits on the gown were too small for my new double D's, and my milk didn't even come in until I got home. Yep, labor hindsight is 20/20 -- and I'm here to share! This is all the info I picked up from giving birth to three babies, as well as what other moms, obstetricians, and labor nurses suggest for making the hospital visit as pleasant as it can be.

When you go on your hospital tour, find out if you can preregister and fill out any information you can right then and there. Ask for copies of forms you'll have to complete, and pack the ones you've finished in your hospital bag -- tending to paperwork during contractions is a distraction you don't need. Also, talk with your doctor about your ideal delivery.

If you've delivered vaginally, your nether region will probably be sore and swollen. "Ice it immediately," recommends Jennifer Gunter, M.D., an obstetrician in Marin, California, who is also board-certified in pain management. While you're awake, ice it for 15 minutes, then take 15 minutes off. Some hospitals offer sanitary napkins that have a twist-activated cold pack inside so they cool while absorbing postpartum bleeding. If your room has a freezer, chill a witch hazel hemorrhoid pad and tuck it inside your sanitary napkin. After the first 24 to 48 hours, warm water tends to be more soothing. Chances are, the postpartum goody bag that the nurses give you will include a plastic bottle with a nozzle. Fill it with warm water, squat over the toilet, and use it as a portable bidet. The warm water makes it easier to urinate for the first time after delivery and reduces any burning sensation.

Narcotic pain relievers such as Percocet and Darvocet offer almost guaranteed relief after delivery, but they can also constipate you, so ask for a laxative and use it right away. "You do not want to get backed up and have to push all over again with a tender bottom," says Dr. Gunter. For the same reason, drink lots of fluids, eat high-fiber foods, and walk the hospital halls as much as you can: Before birth, gravity gets a baby moving; after, it helps move other important business.

Most moms are so excited after giving birth that they feel as if they drank a gallon of espresso, which can make it difficult to rest and recuperate. It's time to cue up your iPod and try to nod off. First, though, ask your nurses if they'll take your vital signs when they bring Baby to you for a feeding, so they won't have to wake you twice.

Yes, your baby is exquisite, and it's only natural that relatives are lining up to get a peek at their perfect little new family member. Still, after you deliver, you'll probably want to limit visitors to your husband, the grandparents, and a best friend. Don't feel bad about that: You don't need an audience while you're figuring out how to feed, burp, and change the baby. "I've actually seen moms delay feeding because they don't know how to ask visitors for privacy," says Gloria Newman, manager of outpatient women's services at Mercy Hospital, in St. Louis, Missouri. Rather than presiding over a crowd, ask your husband to upload photos of your sugarplum to Facebook or a personal website to satisfy the curiosity of well-wishers. And if you change your mind and want company, just call -- your closest friends will surely come running to your side.

If you're not in a private room, when the curtain separating the beds is pulled aside, greet the mom next door warmly. Ask about her labor and her baby; she'll probably ask about yours too. Poof: You're pals! If you need something and your family isn't there, she's got your back, and vice versa. As you might recall from college dorms, a little consideration goes a long way toward happy cohabitation. Say things like: "Let me know if you need some quiet. My parents are here, and we can go to the lounge." With any luck, she'll extend you the same courtesy. (Pssst! -- you might also want to pack a pair of silicone earplugs in case she snores. Offer her a fresh pair if you do!)

Rooming in is great for bonding with your baby, but when you're sleeping, you won't be bonding -- you'll be sleeping! For safety's sake, it's best not to nod off with your baby in your arms. "With my second son, I used the baby nursery so I could sleep for a few hours. The nurses brought him to me whenever it was time for him to breastfeed," says Liz Richards, of Portland, Oregon. "But once you're back at home, you're on your own, so take advantage of the extra helping hands while you can." If you want to breastfeed only, ask the nurses to place a sign above the baby's bassinet that specifies "No Bottles." They'll then bring your little one to you when she cries.

You're going to be plenty hungry once you've had the baby, and the hospital tray isn't always brimming with the most appetizing options (understatement alert). So have vitamin- and antioxidant-fortified snacks on hand, such as granola bars, fruit, and juices. "Dairy can be constipating, which is why you'll want to wait until your normal bowel function returns before adding it to the menu," says Roberta Kline, M.D., an ob-gyn in Glastonbury, Connecticut. Healing requires adequate levels of zinc, selenium, and vitamin D, along with many other nutrients, and a good multivitamin helps, she says. If you're nursing, be sure to drink plenty of water. "To help you get into the habit of drinking when you breastfeed, keep glasses of water within easy reach of the hospital bed," says San Francisco nurse practitioner Barb Dehn. A refillable water bottle can come in handy too.

Nursing staff can be so overloaded these days that at times, it may be difficult to get their attention. Become a favorite patient by being polite from the get-go. Cluster your requests for acetaminophen, juice, and baby advice. And a little buttering up never hurts: Have a candy dish in your room, or deliver a nice box of chocolates to the nursing station. You could also preorder a basket of fruit and enclose a card from you and the baby. That's what Sara Abbott, a mother of two who lives outside of Boston, did before the birth of her second child: "My husband and I actually chose to spend Thanksgiving at the hospital when I could have been released early," she remembers. "It was like being in a hotel with a bunch of sweet grandmothers."

Your postpartum hospital stay is pretty much the only time you'll be surrounded by so many baby-care experts at once, so don't be shy. "Many problems can be prevented or easily solved by simply asking a few things," Dr. Kline says. "There are really never any stupid questions!"

Take a deep breath...and read on for ways to have a delivery that will let you be calm and comfortable.

They don't call it labor for nothing, but there are more ways than ever to manage that pain. "The trick is to have as many tools in your bag as possible," says Kim Hildebrand Cardoso, a certified nurse-midwife in Berkeley, California. "You don't know what's going to work until you're in it, and what helps a woman at one point can change five minutes later." Know your options -- and keep an open mind.

Relaxation "The most important thing you can relax during labor is your mind," says Stacey Rees, a certified nurse-midwife in Brooklyn, New York. When you fear pain, you tense up, which makes the pain worse, and causes you to tense up more. Cardoso, who had back labor for 21 hours with her first baby, says, "I tried to not spend pain-free minutes stressing about what was to come."

Moving Around Walking, swaying, changing positions, and rolling on a birthing ball can ease the pain and help labor progress by putting the force of gravity to work on your behalf and encouraging Baby to move down the pelvic canal. "It really helped to be on my hands and knees, leaning onto my husband's chest," says Andrea Vander Pluym, of Oakland, California.

Breathing Whether you're hee-ing or haa-ing, panting or inhaling deeply, as long as you focus, you'll find relief.

Massage Even if gentle counterpressure on your back doesn't reduce your pain, having your partner rub your swollen feet or give your temples a gentle massage can help distract you.

Epidural It's given via a slow continuous drip, and takes 10 to 25 minutes to work. Most hospitals use patient-controlled epidural anesthesia, which allows you to press a button for more. You should still feel enough pressure to be able to push. Contrary to what you might have heard, getting an epi doesn't put you at a higher risk for C-section, but it does add about an hour to labor. You also don't need to worry about missing the window of opportunity to get one, says Benito Alvarez, M.D., codirector of obstetrics and gynecology at the Cleveland Clinic: "It's really only too late if the head is coming out." It's not given to women with certain blood-clotting disorders, scoliosis, or past back surgery. But for the vast majority, an epi is A-OK.

Spinal and Combined Spinal-Epidural A spinal is an injection into the lower back that works in seconds and lasts about 45 minutes. It's standard protocol for most elective cesarean births. Sometimes docs do a spinal-epidural combo for women far along in labor.

Opioids When epidurals aren't possible, some women opt for painkillers such as Demerol, delivered via IV. Unlike spinals and epidurals, these medications can make you drowsy and nauseated. "IV meds can make the baby groggy," Dr. Alvarez notes. "So if we think the delivery will happen within an hour, we try not to use them."

Originally published in the October 2011 issue of American Baby magazine.

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