Congratulations on your pregnancy, we are so pleased that you have chosen Kent Hospital for your birth. We know the birth of a baby is a very special occasion, and we are honored to be a part of it.
Our goal is to exceed your expectations. We hope to make your birth experience as personalized as we can, while also providing you with the finest medical care available. We believe that caring for you means including your family in the process. It’s our patient and family-centered approach to health care.
If you are looking for an obstetrician, let our free physician referral service connect you with a member of the Kent medical staff who’s just right for your needs. The private practice obstetricians and pediatricians who bring their obstetric patients to Kent also bring a wealth of experience. Our maternity patients receive individualized care from Kent’s experienced OB nursing team, who will be with you throughout your birthing experience.
The Women’s Care Center includes six private labor and delivery rooms and a surgical delivery suite with anesthesia services and the latest technology in fetal monitoring. It’s an added comfort to know that the comprehensive diagnostic and treatment resources of the state’s largest community hospital are immediately available.
Congratulations on your pregnancy! We at Kent Hospital are excited to partner with you on the special occasion of your labor and birth.
We want to share with you common practices and available birth options at Kent Hospital so that you will have an idea of what to expect. We hope this information provides a means of discussion to help you and your partner identify your feelings and desires for this special day.
Please begin to think about these issues and discuss them with your health care provider. You may want to bring a copy of your preference list (Our Birth Plan, Nuestro Plan Para el Alumbramiento) with you to your next office visit as well as the hospital. Our commitment is to provide you and your family a safe and comfortable environment.
The postpartum period is not only a time to rest and recover but also a time for you and your baby to learn about each other. Our staff is here to teach you about the changes you will be going through immediately after the birth and about your baby’s behavioral cues. We encourage you to take childbirth education classes before birth to help prepare for this exciting time. We also offer Breastfeeding classes and Infant Care classes to help prepare you for taking care of your newborn and yourself after delivery.
Our desire is to honor your preferences for your birth experience. In some situations, the health of you or your baby may mean flexibility and collaboration with the health care team.
Please take the opportunity to review your preferences with your health care provider.
Our goal is to make your birth experience as personalized as possible. We offer a full spectrum of delivery options, ranging from very low-intervention births in one of our 6 private labor/delivery/recovery rooms, to both emergency and gentle cesarean births.
We are committed to ensuring the health and well-being of you and your baby. Whether you arrive in labor or are being induced for a medical indication, you will be cared for by your labor and delivery nurse in one of our six private labor/delivery/recovery rooms. Throughout each phase of your labor, we are here to answer any questions you may have, support you, and monitor your baby closely. Each room has the amenities needed to help you stay relaxed and comfortable, including ambient lighting, a rocking chair, birthing balls, and warm packs. We also have birthing bars that allow squatting during labor and childbirth and birthing beds that adjust to many different positions.
Having a cesarean birth can be an anxious time for new and experienced moms, but Kent staff make this experience a little easier by offering a gentle cesarean birth. The purpose of a gentle cesarean birth is to create a peaceful environment and to allow bonding between mom and baby to begin as soon as possible. We do this by providing a quiet room, free from noise and conversations, and filled with mom’s choice of music. We dim the lights and encourage the dad or significant other to be in the room during the delivery. And most importantly, we encourage bonding right away through skin-to-skin contact and minimizing the time that mom and baby are separated after delivery. Kent is pleased to provide the gentle cesarean section at the request of the patient and with the permission of the delivering obstetrical provider.
Pregnancy is a time of change and new experiences. You experience feelings, both physical and emotional, that you may have never experienced before. It is a big change to all areas of your life. It is also a learning experience for you, your partner, and your family. To help you adjust to these factors there are educational classes offered in many areas including, childbirth, breastfeeding, and parenting. There are also classes to help others in your family such as grandparents and siblings.
It has been decided to induce your labor. In reaching this decision your physician or midwife has considered several factors including your current health, your baby’s health and how far along you are in your pregnancy. In many cases you have been directly involved in these discussions.
Between 20 to 25 percent of patients who receive their care at Care New England hospitals have their labor induced. This information has been developed to help you and your family understand how labor induction works and what to expect. We also hope that it will answer many of the questions that you may have regarding labor induction. More specific questions that may not be answered here should be addressed with your health care provider.
Labor can be induced for many medical indications, but these indications generally fall into three categories:
In addition to prioritizing these indications, your physician or midwife has considered how far along you are in your pregnancy – your gestational age.
In some cases, the impact of these medical or obstetrical conditions is serious enough that your health care provider has decided that your baby should be delivered several weeks before your due date and your induction should be scheduled right away. But in most cases, induction is performed much closer to the time that your baby is due and scheduling is more flexible. These decisions are always made in an effort to provide the best possible outcome for you and your baby.
Because Care New England hospitals may have several requests for labor inductions every day, the decision as to which patients should be admitted on any given day is determined by the category of induction described above. The patients with the most serious medical or obstetrical conditions are prioritized for hospital admission and induction. For other patients with a less serious indication, the need for delivery is not as urgent and more time can be taken to adequately prepare for induction.
As labor induction is often unexpected and may be performed at an earlier point in your pregnancy than anticipated, your body may not be quite ready for labor.
In these cases it is usually best to take additional time to prepare your body for labor by a process called cervical ripening. The goal of cervical ripening is to soften, dilate and efface (shorten) your cervix (the area of the uterus that the baby will pass through). By taking additional time to ripen the cervix, your labor is usually shorter and safer for you and your baby. Because everyone’s starting point and the response of their body is different, the time required for adequate cervical ripening is difficult to predict and can extend for more than one day.
Cervical ripening can be performed using medications called prostaglandins or by placing a balloon-like device inside the vagina (birth canal) to dilate your cervix. For some patients both options are used. Prostaglandins can either be taken by mouth or placed in the vagina.
Many patients may start to experience mild contractions during the cervical ripening phase. This is normal and helps to better prepare the cervix for the actual induction. Occasionally patients will start labor with cervical ripening.
When cervical ripening is needed, it can take place in the hospital after admission or in the emergency department as an outpatient. When outpatient cervical ripening is performed, it is usually with the intention to induce labor within the next few days.
Once the cervix has reached the point where adequate ripening (dilation, effacement and shortening) of your cervix has taken place, you will be admitted or transferred to the labor room for induction. As with admission and cervical ripening, individual patients will be brought to the labor room based on the seriousness of their indication.
Your induction will be started by using oxytocin (an intravenous medication) or performing a pelvic examination to break your water. When oxytocin is used, it is started at a very low dose and gradually increased until you are having regular labor contractions.
As with cervical ripening, the starting point for induction and the response of each patient is different and, as a result, the time required for your induction is difficult to predict.
Occasionally during an induction, the decision is made to allow the patient to rest and the induction will be stopped. When that occurs, the patient will often be transferred from the labor room to the Antenatal Care Unit. In those cases the patient usually returns to the labor room the following day to continue the induction.
The decision to induce labor is also influenced by the potential outcomes. Women who undergo labor induction typically have longer labors and are also more likely to be delivered by cesarean section. The most common reasons for cesarean section are poor progress in labor and difficulty tolerating labor for the baby. Patients who are delivered by cesarean section usually have longer hospital stays after delivery and a slower recovery. There is also a greater chance of complications such as infection and heavier blood loss with cesarean section.
Many women who have had a previous cesarean delivery (c-section) would like to consider a vaginal birth for other babies. If you have delivered one or two babies by c-section in the past, you may have two options for delivery with this pregnancy:
Women & Infants, Kent, and Care New England are providing you with information about both types of delivery to help you make your decision, along with your health care provider. This information will also be helpful before you are asked to sign an obstetrical consent form at the Care New England hospital (Kent or Women & Infants) at which you will be delivering your baby.
Between 60 and 80 percent of women who attempt a trial of labor after a cesarean delivery will be able to deliver vaginally. There are tools that will allow your doctor or midwife to look at your individual history and try to predict your chance for a successful vaginal delivery.
The type of incision in the uterus (womb, not the skin) is an important factor in deciding who is a candidate for TOLAC.
A sideways, or transverse, incision in the lower part of the uterus forms a strong scar with a low risk of rupture in future pregnancies. This is the most common type of cesarean delivery.
Women with an up and down, or vertical incision in the lower part of the uterus can be considered for TOLAC but may have a higher risk of scar rupture.
Women with a "classical" incision, or a vertical incision in the upper part of the uterus, are not candidates for TOLAC, as the risk of uterine rupture is considered to be too high.
Most women who have had one previous cesarean delivery with a transverse incision are candidates for a TOLAC. The American College of Obstetrics and Gynecology (ACOG) recently affirmed that women with two prior cesarean deliveries and women with a twin pregnancy and one prior cesarean delivery can consider TOLAC, but may have a higher risk of uterine rupture. You should discuss your options with your own obstetrical provider
Your doctor or midwife will review your records to determine what type of incision you had with your previous c-section(s). If your records are not available, your clinician will not be able to tell your type of incision, and you will both decide on your best option for delivery.
The highest risk for complications is with patients who have an unsuccessful TOLAC and emergency cesarean delivery.
If a TOLAC results in a vaginal birth, the patient typically has the best outcome.
These improved outcomes include:
Uterine rupture is a risk with a trial of labor. The risk of uterine rupture with a previous low transverse (sideways) cesarean delivery is less than 1 percent.
If a uterine rupture does occur, an emergency cesarean delivery will be needed.
The baby may be seriously injured or could die if a uterine rupture occurs.
Occasionally, the uterus cannot be repaired after a rupture, and hysterectomy (removal of the uterus) is required. The risk of uterine rupture is increased when labor is induced, rather than when a woman goes into labor naturally.
Other risks to the patient with uterine rupture include:
If a trial of labor is not successful, you will need to undergo a repeat cesarean delivery and will have more risk of complications than with a planned or elective repeat cesarean delivery. These risks include a greater chance of blood transfusion and infection.
For some women, the risks of TOLAC exceed the benefits. These women include those with:
Patients who undergo a scheduled or elective repeat cesarean delivery avoid the risks of an unsuccessful trial of labor. They can also select a date for their delivery.
The outcomes of scheduled or elective repeat cesarean delivery are more complicated than with successful TOLAC and may include:
All of these risks are higher therfore cesarean deliveries you have.
In addition, there is an increased risk of problems with the placenta with each cesarean delivery.
If you have further questions, please speak with your health care provider.
For most patients with a prior cesarean delivery, a Trial of Labor after Cesarean (TOLAC) is a reasonable option to consider. Once your obstetrical provider has decided that you are an appropriate candidate for TOLAC, the choice is up to you. You also have the option of an elective repeat cesarean delivery, and your provider will help you make this decision.
If you decide on TOLAC, you can change your mind and have a cesarean delivery. Your doctor or midwife may also decide that it is unsafe for you to continue your trial of labor and perform a repeat cesarean delivery.
We want to communicate with you in the language in which you are most
comfortable. If you prefer to use an interpreter, we will provide one at no cost. Sign language interpreters and auxiliary aids are also available.
Women & Infants offers classes taught by experienced, certified educators at various times and locations. If you have not received a brochure and registration form, call (401) 276-7800.
Women have several options when coping with the discomfort of labor and childbirth. Delivering naturally is when no anesthesia is used. Many women, through the support of their significant other or labor partner, their nurse, midwife, or physician, choose this option and feel empowered by this experience. Some women choose to have pain medication given either through an intravenous line or injection. This option will ease the pain of the contractions and can be helpful in early labor. Another type of medication is epidural anesthesia which allows mom to feel only mild to moderate contraction intensity and pressure during labor and childbirth. Whatever your choose, our exceptional labor and delivery nurses and physicians will guide, support, and encourage you through each phase of your labor and ultimately the birth of your baby.
We operate a special care nursery (SCN in conjunction with Women and Infants’ Hospital, another Care New England hospital. Our SCN can manage neonatal emergencies as well as certain newborn complications. If necessary, we can work with Women and Infants to transfer your baby (and you) when unforeseen complications arise. The care team includes:
You should choose a pediatric care provider - a family practitioner, pediatrician, or nurse practitioner—before you are 35 weeks pregnant. To help, we provide information on choosing a pediatrician or you can call our Physician Referral Health Line at 1 (401) 737-9950. Tell the hospital when you choose a provider so we can call him/her when the baby is born. If the provider does not come to Kent, our team of doctors will care for your baby.
When arriving please use the main entrance and go directly to the Women’s Care Center (WCC) on the third floor. Use the emergency department entrance if you need special assistance or between the hours of 11 p.m. and 4:30 a.m.
A support person is strongly encouraged but only two coaches per patient. The support person’s role is to actively participate in making the work easier for the laboring mom. This includes getting drinks, helping you change positions, helping you to the bathroom, and providing comfort measures that your nurse will teach you. Taking the Prepared Childbirth Class is very helpful for you and your support person and is recommended at seven months of pregnancy. We also have other classes available by calling (401) 736-1988.
We use a four-band system for infant identification. All four bands have the mother’s first and last name and the same ID number on them. You and your significant other will each wear one band. Once the baby is delivered a band will be placed on his/her wrist and one on their ankle. Do not remove these bands until discharge. The band will be checked throughout your stay each time your baby is separated from you. To gain access to the Nursery, you must show this numbered band. In addition, an electronic security device will be placed on your baby’s ankle.
For added security, we use an electronic access card system to gain entrance to the WCC. You will be given one card upon your admission and it is activated for two-four days. This card will not work for the nursery door.
For privacy and patient comfort, we cannot allow visitors in the LDR area until after delivery. Family and friends are welcomed between 1 and 8 p.m. on the postpartum floor. Siblings of the newborn are the ONLY children under 14 that may visit the WCC unit.
We ask that you decide on feeding methods prior to birth. If you plan on breastfeeding, we strongly recommend that you take the breastfeeding class. Your baby will be cared for in your room during your stay. Whether you chose to breastfeed or formula feed, our staff members are available to assist you. Board-certified lactation consultants are available almost every day.
The Women’s Care Center does not supply pacifiers.
Personal electrical equipment cannot be used for safety reasons. Hairdryers are available for your use. Cell Phones are allowed in patient rooms. Still, cameras are allowed but we cannot allow videotaping until after the birth.
Please do not bring valuables, or large sums of money with you to the hospital.
Our nutrition and food service staff will provide a menu for your selection. Your significant other will receive a 15 percent discount in the hospital’s dining room by showing their ID band. The dining room is open from 6 a.m. to 7 p.m. We have a pantry with a microwave, refrigerator, and hot and cold beverages which are available to you and your significant other throughout your stay.
All postpartum suites are private with private bathrooms. Most include sleep accommodations for your significant other. Your baby will be cared for in your room during your stay. Your significant other is here to support you and help with the care of the newborn, even during the night. Only one guest is permitted to stay overnight. They are asked to be awake, dressed and ready to assist you as necessary when your breakfast is served.
The same nurse is responsible for both you and your baby. Your nurse will provide you with personal and individualized care with a family-centered approach. Infant Security: For your baby’s protection, the Women’s Care Center is secured with access only through monitored doors and an electronic pass card. Visitors must ring a door buzzer to enter and leave the unit.
Siblings may visit at any time but must have another adult present and may not stay overnight. Non sibling children under 14 years old are not allowed to visit on the unit. There is a comfortable waiting area located in the lobby of the WCC which is available to visitors. Grandparents are welcomed to visit before 1 p.m. for a brief time.
Traditionally vaginal births stay approximately 48 hours; C-Section births approximately 96 hours. Early discharge is possible at your request, but not before 24 hours. You and your baby must be stable and your health care provider has to give a written order.
On this exciting day, you will be seen by your OB provider and your baby by the pediatrician/nurse practitioner. Discharge instructions need to be reviewed and signed for by you and for your newborn. Security bands will be checked by two nurses. Birth certificates are completed prior to discharge. Affidavits of paternity are also available as needed.
The American Academy of Pediatrics recommends not using pacifiers for the first four weeks, especially if breastfeeding. This is important as babies need to feed on cue in order for mother’s milk to come in and pacifiers can interrupt this process. There are also a few infants who have a difficult time latching on a mother’s breast after they have been sucking on a pacifier. So for the early weeks, or until breastfeeding is going really well with ample milk supply, we do not recommend pacifier use. After that time there is some evidence to suggest they may reduce the risk of SIDS, but breastfeeding decreases the risks even more than pacifiers. We at Women & Infants utilize pacifiers only during painful procedures and do not distribute pacifiers to babies or their families.
The following is a list of screenings and treatments performed on all newborns as recommended and required by the Rhode Island Department of Health and the American Academy of Pediatrics. These tests and treatments take place in the hospital prior to discharge. We encourage you to ask any questions to be sure you are comfortable with the procedures.
Applied in your baby's eyes after birth to protect the eyes from infection.
Given shortly after birth to improve the baby's blood clotting ability. Without vitamin K, some babies have a tendency to bleed during the first few days of life.
The Rhode Island Hearing Assessment Program (RIHAP) provides hearing screening for each infant born at Kent Hospital. This is quick, harmless, and non-invasive. Results are reviewed and interpreted by an audiologist. In the event that a test is not normal, you may also receive a phone call recommending a reevaluation of your infant's hearing.
Recommended by the American Academy of Pediatrics, the baby's first hepatitis B vaccination is usually given in the hospital. This vaccination consists of three separate injections given over a period of months. It is important to finish the entire series for complete protection.
All newborns are screened before they leave the hospital for a group of endocrine, metabolic, genetic, and hematologic diseases. Using a tiny sample of blood drawn from your baby's heel, these tests are performed at a Rhode Island Department of Health regulated laboratory. Early identification of these disorders allows for early treatment and prevention of more serious illnesses. The test results are mailed directly to your baby's doctor.
Your baby's primary care physician can provide further information to you. Please do not hesitate to ask our staff or your doctor to explain the reasons for the tests to your satisfaction.
After you deliver your baby to Women & Infants, we recommend "rooming-in." This means you will keep your baby with you in your private hospital room the whole time you are in the hospital.
This is a healthy choice for families because it lets you care for your new baby. Rooming-in will help you learn to care for all your baby's needs while the staff is around to help if you need it. This will also help you feel more comfortable taking care of your baby once you go home.
We want this to be the best possible experience for you. If you have any questions, please ask the nurse who is caring for you. Rooming-in is just one way to get to know your baby. It will help you learn all the exciting noises your baby makes and see the many things your baby can do.
Pain relief is an important part of your care. Your health care team wants to make you as comfortable as possible, but you are the key to getting the pain relief you need. Pain is personal and individual. Each person feels pain—and its relief—in different ways.
Our staff is here to support you and to help you manage your pain during and after labor. There are several non-medicine options you can try, if appropriate. These can be used alone or with medication to help you get the most pain relief possible.
These options include:
Your nurse will work with you to make a plan of care regarding your pain control. Pain medication is given, as needed. If you would like pain medication during labor, ask for it as soon as you start to feel pain. It is easier to control pain in the early stage before it becomes bad. If you have pain that does not go away, tell your health care provider.
You can help by letting your health care team know what has helped control pain for you before, and about any allergies or reactions, you have had to medication in the past. Tell them all the medications you are taking, including herbal products, to avoid problems caused by mixing medications. Ask about the side effects you can expect from any medications you get. Many people are afraid they will become addicted to pain medication, but that usually does not happen. If you are worried about this, talk to your health care provider.
Pain medication is given in different forms, including:
You will be asked how the pain medication is working. You will need to measure your pain on a scale of zero to 10. It is important to know what your goal is for pain relief, on a scale of zero to 10. Reporting your pain helps the health care providers know how well your pain medication is working.
At Kent, discharge is usually between 11 a.m. and 1 p.m. Please arrange transportation in advance so you will be ready to go home at that time. The person driving you home should be available during that time. Your ride may park their car at the main entrance just prior to your discharge.
Someone from Patient Financial Services will verify that the financial arrangements are in order for your hospital stay. If you have a vaginal delivery, you can expect to go home on the first or second day after you have delivered your baby. If you have a cesarean section, you can expect to go home on the third or fourth day after your baby has been born.
If you have a vaginal delivery, you can expect to go home on the first or second day after you have delivered your baby. If you have a cesarean section, you can expect to go home on the third or fourth day after your baby has been born.
Many new mothers choose to recover from childbirth in the hospital. But, if you and your baby are both healthy, you may bond more quickly at home. Kent can arrange for home visits for mothers who decide to be discharged early. Early Maternal Discharge Home Visits replace some of the recovery time in the hospital with a personal visit in your home by a registered nurse specially trained in maternal-child health.
You are eligible for an Early Maternal Discharge Home Visit covered by your insurance if you:
If your insurer does not cover home visits, you can pay for the service on your own.
If you would like to schedule an Early Maternal Discharge Home Visit, let your nurse on the postpartum unit know within 24 hours of your baby's birth. While you are still in the hospital, your medical record will be reviewed to confirm your eligibility for early discharge, and you will be contacted to schedule your home visit.
Once you are home, you will receive a follow-up call from a nurse. A home health nurse experienced in maternal and child health will then visit approximately 48 hours after your discharge from the hospital. During this visit, the nurse will conduct a thorough and complete assessment of you and your baby and help with your physical and educational needs as a new mother.