Coming to give birth
The labor ward is open around the clock. You can come to give birth without calling in advance. If you wish, you can ask for advice regarding childbirth or amniotic fluid breakage. The A1 main door of the central hospital is open on weekdays from 7 a.m. to 8 p.m. At other times, you can call the labor ward from the intercom at the main door and the door will be opened for you.
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Access to the ward through the joint emergency clinic
You can also access the labor ward through the B1 door of the joint emergency clinic. The person giving birth does not have to register at the joint emergency clinic, you can come directly to the labour ward. If necessary, you can borrow a wheelchair from the emergency clinic.
There is a guided route from the joint emergency clinic to the maternity ward. Follow the blue line, walk to the end of the corridor and go up two floors. When you enter through the main entrance, you can get to the labor ward by going up the first set of stairs.
When is it time to go to the hospital?
Before the actual cervical dilation, the uterus may contract for 1-2 days and the cervix may mature, but the cervix does not open yet. This phase is called the latency stage. You should go to the hospital when contractions occur with intervals shorter than 10 minutes and are regular and painful. If you are healthy and the pregnancy has progressed normally, you can stay at home as long as you can manage the contractions and feel safe. You can try moving, massage, a warm shower, a heating pad or a sauna.
If premature (less than 34 weeks) painful and regular contractions start, you should come to the hospital immediately.
If you suspect amniotic fluid breakage, contact the maternity clinic or department. Amniotic fluid breakage can occur as a flood or as a trickle. After the amniotic fluid breakage, you can come to the hospital in your own car if the baby’s head or bottom is stuck and is pressing on your pelvis. After the amniotic fluid breakage, you will be monitored in the ward until delivery.
Sometimes labor progresses very quickly and the baby’s head starts pressing on the mother’s rectum. It causes a strong feeling of pressure in the rectum and a strong need to push. In this case, you have to come to the hospital by ambulance.
If you have been under the supervision of the maternity clinic due to having what is considered a high-risk pregnancy (e.g. you have type I diabetes as an underlying disease, hypertension or the baby’s growth is slow, you are expecting twins, etc.), then it is a reason to go to the hospital right at the beginning of labor.
A cesarean section may have already been agreed upon as the method of delivery, but the delivery may start on its own with the amniotic fluid breakage or contractions. Then you have to go to the hospital, because the surgery can be done in the emergency room if necessary.
Other reasons to come to the hospital
A small bloody discharge mixed with mucus is normal and this usually heralds the onset of labor, and you do not need to seek hospital care for this if the pregnancy is full-term. A definite bleeding is always reason to come to the hospital. Severe, sudden pain in the uterus is a definite reason to come to the hospital, preferably by ambulance.
Normally, the baby moves at least 10 times in an hour. The situation must be checked if the baby’s movements are clearly reduced or you do not feel them at all. You can count the baby’s movements by lying quietly on your side for 30 to 60 minutes.
Symptoms of preeclampsia include headache, pain in the upper abdomen, severe swelling, high blood pressure, feeling discomfort and visual disturbances in the eyes, and protein in the urine. Sometimes only one of these symptoms may be present. When these symptoms appear, you should visit the hospital.
The normal duration of a pregnancy is 37-42 weeks. Only after that do we talk about the baby being overdue. The health nurse at the maternity clinic makes an appointment for a check-up visit at the labor ward when the pregnancy has lasted 10 days beyond the calculated period. A check-up visit does not automatically mean starting labor if both mother and baby are fine. Attempts to initiate births are made only for medical reasons.
What should you bring with you to the hospital?
- maternity/child welfare clinic card
- medicines you use regularly, e.g. asthma medicines and insulin
- personal hygiene products
- nursing bras and bra protectors
- pastimes; reading, crafts
- small snacks and indoor slippers for the spouse
- camera
You get sanitary towels, patient clothes and slippers from the department. You can also use your own clothes and slippers at the department. You can bring the baby’s clothes and car seat later.
The use of mobile phones is allowed in the labor ward, but the use of mobile phones should be limited. Parents should focus on rest, breastfeeding, learning to care for the baby and getting to know the new family member.
The labor ward
At the labor ward reception, the mother’s condition during pregnancy, possible underlying diseases and medications are reviewed. We ask about the start time, frequency and regularity of the contractions. The time, amount and color of possible amniotic fluid breakage are taken into account when the parents arrive. If necessary, an unclear instance of amniotic fluid breakage can be checked with a separate test.
Heart sounds are listened to for 20-30 minutes with an echocardiogram. The midwife also performs an internal and external examination. An internal examination provides information about the opening of the cervix and how the baby has settled in the pelvis. The external examination assesses the baby’s size and position.
Based on the examinations and discussion, the midwife makes a situational assessment of whether to move to the delivery room or to the ward. If the birth is not yet properly underway and the baby is fine, it is still possible to go home and wait for the birth to start. An outpatient fee is charged for visits at the labor ward reception.
Your spouse and your support person can come along to be with you during the birth. In the delivery room, the support person can wear their own clothes and eat in the hospital’s cafeteria, canteen or bring their own food. The cafeteria is open on weekdays, but the canteen is also open on weekends.
Phases of the birth
During the dilation phase, rhythmic contractions open the cervix and help the baby descend in the birth canal. The duration of the dilation phase varies greatly depending on e.g. parity. In the dilation phase, the progress of the birth is monitored through internal examinations. The KTG device monitors the baby’s well-being and contractions. Monitoring can be external or a monitoring electrode can be placed on the baby’s head.
Birth involves pain, which is natural and positive pain. The pain is caused by the contraction of the smooth muscle of the uterus, the stretching of the muscles of the pelvic area and external genitalia, and the pressure of the baby’s head into the bony pelvis. At the beginning of the opening phase, the pain is usually mild and it intensifies towards the end of the opening phase. The body adapts to tolerate even strong pain during childbirth.
Everyone experiences pain individually and therefore it is impossible to accurately measure it. Your own description of the pain is the most important pain assessment method. If necessary, the midwife will help you find a suitable means of relaxation and pain relief.
Touch and massage have a pain-relieving effect. It can feel good when a spouse, support person or midwife rubs your sore back or holds your hand in a moment of pain.
Heat pads can relieve pain especially in the lower abdomen and lower back area. Moving and changing positions can make you feel better during the opening phase. You can use, for example, a bean bag chair, a ball or a hanging cloth.
A warm shower or being in a bath relieves the pain of the dilation phase very well. Warm water relaxes and calms. Water also makes it possible to find a comfortable position, because water supports weight well. The midwives at our maternity hospital are trained to handle water births, so we are equipped to offer a mother the opportunity to give birth in water as well, if she is healthy and meets certain criteria.
In the early stages of labor, the pain can be relieved with oral or intramuscular painkillers. Acupuncture and a TENS device (transcutaneous electrical nerve stimulation) can also be used for pain relief.
In the delivery room, labor pain can be alleviated by breathing in nitrous oxide during all stages of labor. Nitrous oxide is inhaled through a mask, from which the gas is also discharged.
Paracervical i.e. cervical anesthesia (PCB) is applied on the sides of the cervix by the obstetrician during the internal examination. The anesthesia is fast-acting, its duration is about 1-2 hours, and the anesthesia can be renewed if necessary.
Epidural and spinal anesthesia administered by an anesthesiologist usually provides effective labor pain relief. The duration of effect of spinal anesthesia is 1-2 hours and is therefore well suited for women who have already given birth before. When using epidural anesthesia, medicine can be administered through a catheter inserted in the back for as long as necessary. Before anesthetizing, a diluted saline solution is dripped into a vein. The fetal membranes can be punctured either before anesthesia is applied or after. After the membranes are punctured, an electrode is placed on the baby’s head to monitor the heart sounds. After the anesthesia is applied, the blood pressure and pulse are monitored at the beginning. After the monitoring is done, the anesthesia does not prevent movement.
Pudendal anesthesia is used for pain relief during the pushing phase. It is placed on the pelvic floor by the obstetrician during the internal examination.
Up-to-date medical equipment ensures the well-being of you and your baby during childbirth.
Between the dilation and the second stage of labor, there may be a transitional phase where the cervix is fully open, but the woman giving birth is not yet pushing. If the baby’s heart sounds are good, you can calmly wait for the need to push.
In addition to the midwife attending during the labor phase, there is also an assisting midwife, sometimes also an obstetrician and pediatrician. The spouse/support person plays an important role in supporting the woman giving birth during the second stage.
Pushing always happens during the contractions, when the cooperation between the mother and her uterine muscles helps the baby to be born. There are several positions used for pushing and they can be changed several times during the push phase. The most common push positions are half-sitting, lying on your side, and standing on your knees and hands. You can also give birth sitting on a stool. The perineum is only cut if necessary, and then it is numbed first.
The second stage ends when the baby is born. Two blood samples are taken from the umbilical cord, a thyroid and oxidation sample. The hospital uses late umbilical cord clamping. The spouse or support person may cut the umbilical cord if they wish. The baby is dried and then lifted to the mother’s breast for skin-to-skin contact.
Sometimes babies are “startled” at birth and need support for e.g. breathing. If the baby’s condition so requires, the assisting midwife or pediatrician can take the baby to resuscitation, where the baby’s condition is closely monitored.
After the baby is born, the placental stage follows, when the placenta and fetal membranes are born from the uterus. This usually happens about 10-30 minutes after the baby is born. After the post-stage, any tears or incisions in the perineum are sewn up with thread that dissolves on its own after some time.
After stitching and early breastfeeding, the baby is weighed and, if necessary, bathed, and vitamin K is given. It is recommended to continue skin contact also during the rooming-in treatment.
After the birth, the parents are served birthday coffee.
The birth of a baby can sometimes be assisted with the help of a vacuum extractor. The decision to use a vacuum extractor is always made by the obstetrician. Reasons for using a vacuum extraction cup can be that the baby’s heartbeat is weakening, the mother’s tiredness or weak contractions.
The baby can be delivered vaginally, even during a breech birth. Then the midwife handles the dilation phase in the normal way. During the pushing phase, an obstetrician is present and handles the breech birth.
During a twin birth, the dilation phase is handled by a midwife. During the pushing phase, in addition to the midwife attending the birth, the obstetrician(s), pediatrician and midwives assisting for both babies are present.
A caesarean section can be performed as a planned, urgent or emergency caesarean section. Mothers who give birth by planned caesarean section are interviewed at the maternity clinic before the operation. The mother will go through an overview of what will happen on the day of the surgery together with the midwife. The mother comes to the hospital on the morning of the surgery day as agreed. The operation is most often performed under spinal anesthesia, while the mother is awake. A spouse or support person may be present during the operation. The mother can see the baby immediately after birth. If the health of the baby and the mother allows, the baby can be placed in skin-to-skin contact with the mother immediately after birth in the operating room. After the operation, the mother’s condition is monitored for a few hours in the recovery room, and the spouse is allowed to care for and hold the baby in skin-to-skin contact in the ward. Usually, the baby visits the mother for the first feeding in the recovery room.
You may have to have an emergency caesarean section in the middle of childbirth. The reason may be that the birth is not progressing or the baby experiences a threatening lack of oxygen. Even an urgent caesarean section is performed under spinal anesthesia, and the spouse or support person can also be present. During the emergency clinic’s opening hours, the mother comes directly from the operating room to the delivery ward and her condition is monitored in the delivery room.
An emergency that threatens the health of the mother or the baby requires an emergency caesarean section. In that case, the birth must be performed immediately. The mother is sedated, and the spouse or support person cannot accompany her to the operating room. A pediatrician is always asked to accompany during an emergency caesarean section to check the health of the baby.
After birth, the baby may need more intensive monitoring, in which case the baby will be treated at the neonatal intensive care unit. The ward is located in the same wing A, on floor 0, and you can get there directly from the maternity ward by elevator. Parents are allowed to take care of the baby there, and if the mother’s condition allows, the family can move to the family room at the children’s hospital.
A situation that suddenly threatens the health of the mother or the baby requires an emergency caesarean section. In that case, the birth must be performed immediately. The mother is sedated, and neither the spouse nor the support person can accompany her to the operating room. A pediatrician is always asked to accompany during an emergency caesarean section to check the health of the unborn baby.
After birth, the baby may need more intensive monitoring, in which case the baby will be treated in the neonatal intensive care unit. The ward is located in the same wing A, on the 0th floor, and you can get there directly from the labor ward by elevator. Parents are allowed to visit there to take care of the baby, and if the mother’s condition allows, the family can move to the family room in the children’s department.
Rooming-in
At the department, midwives and childcare workers work in multiprofessional cooperation with obstetricians and pediatricians.
At the ward, the baby is next to its mother/parents around the clock. In order to support the family-child relationship, the baby is not separated from its parents. Rooming-in supports early interaction and helps parents identify and respond to the baby’s needs. Families are supported and guided in baby care and breastfeeding. At the department, we encourage full breastfeeding. Baby-paced breastfeeding is possible when the baby is by the mother’s side at all times. You can read more about breastfeeding at www.imetys.fi. The goal is for every family to return home safe and confident.
A pediatrician checks all babies before discharge. Before the family returns home, we discuss the birth, talk about the period of adjustment after childbirth, and give written instructions for home care.
The Central Ostrobothnia Central Hospital also offers the possibility of LYSY delivery, i.e. short-term postpartum care. In this case, the mother and baby can be discharged from the hospital earlier if the discharge criteria are met. The mother and baby come to the midwifery clinic for a check-up at the central hospital 2-4 days after discharge.
Visiting
The department has limited visiting hours.
An asymptomatic spouse/support person can visit the department between 10 am and 7 pm.
Siblings of the newborn can visit the ward during visiting hours from 2 pm to 3 pm and 6 pm to 7 pm.
In double rooms, please consider the roommate’s privacy and opportunity to rest. Visitors may not come to the department if they have a runny nose or are otherwise ill.