Labor & Delivery: What to Expect

At Welia Health, it’s important to us that you are fully prepared with what to expect during labor and delivery. This information is covered in more detail during our Prenatal Education classes.

Monitoring Mother & Baby during labor and delivery

External monitoring

  • An ultrasound probe is placed over the fetus to check the baby’s fetal heart rate and watch for your baby’s overall well being
  • A monitor is placed over uterus to measure pressure changes that are present during a contraction.
    • This is not an accurate pressure reading and is used to identify timing of contractions, not their strength

Internal monitoring (if needed)

  • Scalp electrode monitoring for your baby’s heart rate
  • Intrauterine pressure catheter (IUPC) for internal contraction monitoring

Scalp Electrode

  • Used when there if difficulty monitoring your baby’s heart rate
  • Not routinely used, as it is more invasive

Intrauterine Pressure Catheter

  • Inserted into the uterus and sits next to the baby
  • Membrane must be ruptured and cervix dilated greater than 3cm
  • Measures contraction strength

Rupture of membranes (water breaking)

Spontaneous rupture of membranes

  • Bag of water breaks on its own
  • Watch for amount and color of amniotic fluid

Artificial Rupture of Membranes

  • Bag of water is ruptured using a small plastic hook and is done during labor

Any time you think that your water has broken, or if you are unsure, you need to come to the hospital.

Group beta strep (GBS)

  • Approximately 25% of pregnant women have GBS
  • This is not a sexually transmitted disease
  • Testing for the presence of GBS is done by conducting a vaginal and rectal swab and is treated with antibiotics when in active labor or with ruptured membranes
  • Can cause severe illness for infant including lung infection, blood infection, meningitis or death without antibiotic treatment


To start labor, induction can be used for a multitude of reasons, including:

  • Large for gestational age infant
  • History of shoulder dystocia and large babies
  • High blood pressure
  • If there are health concerns for mother or baby or if your baby is past his/her projected due date

Cervical Ripening

  1. Cytotec
  • Small pill inserted in the vagina to help prepare cervix for Pitocin induction
  • Can cause cramping and contractions
  • Fetal monitoring for 2 hours after administration
  • Has the potential to put you into labor, but this is not the intended use
  1. Cervidil
  • A vaginal insert that releases medication and is easily removed
  • Used to prepare an unfavorable cervix for Pitocin induction
  • Has a local cervical effect in softening, effacing and dilating the cervix
  • Can be kept in for up to 12 hours or onset of labor
  1. Mechanical cervical ripening
  • Foley bulb
  • Catheter placed in cervical opening to help thin out (efface) the cervix
  1. It applies pressure and you must be dilated to at least 1cm

Pitocin (oxytocin)

  • Used to induce or stimulate labor
  • Requires continuous fetal monitoring if administered
  • Can also be given after delivery for bleeding

Shoulder dystocia

  • Infant’s head is delivered and the shoulders are difficult to deliver
  • This is considered a medical emergency
  • Suprapubic pressure is applied
  • May cause the baby’s clavicle (collarbone) to fracture

Vacuum extraction

  • A vacuum can be applied to aide in delivering the baby’s head
  • Pressure is applied while the provider guides and while mother pushes


  • Surgical cut of perineum to allow for birth of infant
  • Not commonly performed
  • Surgically repaired after delivery by your provider

Placental abruption

  • Happens when placenta detaches from uterus, cutting off food and oxygen to the fetus
  • A medical emergency and requires a STAT cesarean section

Placenta previa

  • Placenta attaches low in the uterus or over the cervix
  • As cervix dilates, that placenta loses the blood flow and decreased oxygen to fetus
  • Diagnosed with a routine ultrasound

Cord prolapse

  • This is considered a medical emergency requiring cesarean section
  • If cord becomes compressed, it loses the ability to send oxygen and nutrients to the fetus

Cesarean section

  • Surgical procedure to deliver baby through the abdominal wall that is done in the operating room
  • Spinal/epidural or general anesthesia used during surgery

Reasons for a Cesarean Section (C-Section)

  • Fetal distress
  • Cephalopelvic disproportion
  • Failure to progress
  • Active herpes infection
  • The baby is breech or malpositioned
  • Prolapsed cord
  • Large gestational age (LGA)
  • Severe preeclampsia
  • Uterine dystocia


Learn more about Pain Management during labor & delivery >