• What Happens After Labor Starts?

    Frequently asked questions about labor and delivery at Wellmont

    Here are answers to the questions we hear most often about our obstetric services at Wellmont Health System.

    What happens when I arrive at the hospital?

    Learn how to register once you get to the birthing center and what you can expect after that.

    How are babies monitored during labor?

    Internal and external electronic monitoring are the two ways we can monitor a baby’s heart rate and the mother’s contractions.

    During external monitoring, elastic bands are placed around your stomach, and a continuous printout of your baby’s heart rate and your contraction pattern are observed.

    Though internal monitoring is used only after your water breaks, it is the most accurate way to track the fetal heart rate.

    If there’s difficulty tracking your baby’s heart rate, your doctor might apply a tiny metal electrode to your baby’s scalp to get a better read on the pulse. The electrode is easily removed after the delivery.

    Why do you monitor babies during labor?

    The purpose of fetal monitoring during labor is to determine how your baby is responding during your labor and to make sure everything is going smoothly.

    If you’re given medication to start (induce) or help (augment) your contractions during labor, it’s our policy to continuously monitor your baby. If you are scheduled for a cesarean section (C-section), we will start monitoring you before the procedure.

    What medications can I get for labor pains?

    A variety of options are available to help with relaxation and comfort during labor.

    We’ll discuss your preferences for pain management when you arrive. If at any time your preference changes while you are in labor, please notify your nurse. We will support you in any method of pain control you choose.

    Epidural

    The most common pain management approach during labor is epidural anesthesia. During an epidural, an anesthesiologist, nurse anesthetist and your nurse will be at your bedside.

    You’ll be asked to sit up on the side of the bed, and a small amount of numbing medicine, and possibly narcotics, will be placed around an area called the epidural space in the lower spine.

    An epidural might also be used if you have a C-section.

    Spinal or general anesthesia

    If the epidural isn’t effective, you might need spinal or general anesthesia.

    Spinal anesthesia is very similar to epidural anesthesia, except the medicine is placed in the spinal canal. “Spinals” create a more rapid onset of numbness for the upcoming surgery.

    General anesthesia is often used during emergency C-sections when there might not time be enough time for epidural or spinal anesthesia to take effect, or if they just aren’t working.

    With general anesthesia, you are put to sleep during the procedure and wake up after it’s over.

    Narcotic pain relief

    Another option for pain control is narcotic medications given intravenously.

    These can be given every few hours per your doctor’s order. As the time of your delivery nears, this type of pain relief will no longer be available, so your baby will be born without any side effects from the medication.

    What are the differences between vaginal birth and C-section?

    Vaginal delivery

    If you progress through labor and deliver vaginally, then you will deliver your baby in the same room you labor in.

    When time for the delivery comes, your legs will be placed in stirrups or foot pedals, and your bottom might be cleaned.

    Your nurse and doctor will teach and assist you in effective pushing techniques to help your baby come through the birth canal.

    No two deliveries are the same. It might take just minutes or it can take several hours of pushing for your baby to be delivered.

    Once your baby is delivered, he or she will be placed on your chest, and the cord will be clamped and cut.

    Cesarean section

    There are many reasons you might need to be scheduled for a C-section before labor occurs or you a C-section might become necessary during your labor and delivery.

    Some of these risks include abnormal fetal heart rate, failure to progress in labor, a baby too large to fit through the birth canal and an abnormal position (which you’ll also hear called presentation) of the baby, along with other health complications.

    Also, if you’ve had a cesarean delivery before – or if there are other questions about whether your body can handle a trial of labor, which is explained below – a C-section might be necessary.

    There are operating rooms in our birthing centers, and in most cases, the C-section procedure is done on our floor. Barring emergency circumstances, a spouse or family member may usually stay with you during your C-section.

    Once the baby is delivered, he or she will be placed on an infant warmer and assessed by a nurse. If your baby is doing well, he or she will be wrapped in blankets and given to you before being taken to transition as we finish the procedure and return you to your room for monitoring.

    What is a trial of labor?

    Women who have had a C-section in the past have two options for subsequent births:

    • A scheduled cesarean procedure
    • A vaginal birth, which your provider might refer to as a vaginal birth after cesarean or VBAC

    For many women, it is possible to deliver vaginally after having a C-section.

    A trial of labor – or trial of labor after cesarean delivery (TOLAC) – is this attempt to have a vaginal birth after a previous C-section.

    If you and your doctor decide it is safe to try having your baby vaginally, you can rest assured our nurses are experienced with how to handle a trial of labor. They will monitor your progress closely and, if any concerns arise, they will communicate those to your doctor.

    As with anything, a trial of labor has benefits and risks, which you should discuss with your obstetrician in advance.

    What if I need to come to the hospital before my due date?

    If you need to come to the hospital before you are 20 weeks, you will be seen in the emergency department.

    After 20 weeks, you will be seen in the ER if you come for something not related to your pregnancy, such as a cold or flu. But if you’re leaking fluid, you will be seen in the birthing center to determine if you are in labor or have vaginal bleeding.

    Preterm labor can occur between weeks 20 and 37 of pregnancy.

    When you get to the birthing center, you’ll be taken to a room. The registration process will be the same as for delivery, so we’ll request a photo ID and your insurance card.

    Is elective labor induction safe?

    Sometimes, as woman nears the end of her pregnancy, she may have her labor started rather than waiting for labor to begin on its own. This is called labor induction.

    Indicated vs. elective induction
    When your health care provider recommends a labor induction for your health or for the health of your baby, it’s called an indicated labor induction. Labor induced for a non-medical reason, for matters of convenience or preference is called an elective labor induction.

    However, elective labor induction isn’t always best for your baby. Inducing labor before you are at least 39 weeks along in your pregnancy, which is one week away from your due date – or before your cervix is ready – has risks.

    Your doctor will follow current medical guidelines to determine if and when elective labor induction is OK for you and your baby.

    What is a neonatal intensive care unit?

    Holston Valley’s Level III neonatal intensive care unit has 15 dedicated beds with skilled physicians and staff members caring for babies delivered as young as 24 weeks – newborns requiring the very highest level of care in order to thrive.

    A specially certified NICU medical team provides essential services to ensure the safety and wellbeing of newborns prior to leaving the hospital.

    How do I get a birth certificate and SSN for my baby?

    Our medical records department will contact each patient about obtaining a birth certificate and Social Security number.

    You can choose whether to get a Social Security card and number for your child. You should be aware that, if you do want to get an SSN, we recommend you work through the hospital for that. You won't likely be able to apply at the Social Security office.

    The process for completing and filing paperwork is a little different at each hospital. But once your forms have been filled out, either you or the records department will submit everything to the state for processing.

    In many cases, you will receive a copy of the birth certificate before you leave the hospital. However, you might need to contact the state after the paperwork has been fully processed to get your child's official birth certificate.

    Processing time and fees

    Your medical records representative can explain how the process works at your hospital. They can also tell you how long you can expect it to take to get official documents back for your baby. 

    Please note: Once paperwork has been submitted, the state's process can take several weeks to complete. Your state might also require a small fee for the birth certificate.

    The state will send the birth certificate and Social Security card directly to you.

    Learn more

    The Social Security Administration has an FAQ page with information about cards for children.

    Find out more about birth certificates from:


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