Sometimes labor starts off very smoothly and it’s just a little bit of discomfort. The patient comes in and they are already well into labor. Other times they’ve been here several times because they’ve had various false starts in the labor process and they may be a little frustrated. I think fear is a big, huge factor because these are young women who probably for the first time are in the health care system. Having the nursing staff that we have and the physicians I work with make it a very much more reasonable and understandable experience. There’s an initial evaluation that they can count on and that initial evaluation involves a physical exam and an evaluation of their baby so we’re placing them on monitor equipment so we can get a good set of vital signs. Then there’s a long questionnaire the nurses conduct that’s very helpful in terms of the consequences for the rest of the hospitalization. We need to know about their health history and review with them the course of the pregnancy and whether they’ve had any particular concerns during the pregnancy which has not shown up on their prenatal record. Once that evaluation is finished and if they are becoming increasingly uncomfortable with the labor, we get them medicated or we offer epidurals for conduct during labor as long as mom and baby are stable enough to proceed with that.
