All In Due Time.......

Just off the elevator on the 2^nd floor, triage is the first place our patients and their families stop.  Our unit clerk is the first to welcome you to our unit.

Triage is a challenging place to work, and you never know what you may hear or see.   Most of the time it is a place to meet our patients, provide education, encourage healthy choices during pregnancy, and support labor dreams and goals.  Occasionally it does turn into a place of prioritization when patients present having critical needs.

 

I have seen patients who are not sure if they should even be seen: but every time you move you uncontrollably gush large amounts of fluid and have to keep a towel between your legs?  Or patients who would like to answer my questions but every 2-3 minutes you can’t talk and breathe at the same time - you are contracting.  You definitely should be seen.

What would a good pregnancy story be without the occasional false alarm? 

If every patient that came to triage was obviously in labor there would not be a need for triage.  But sometimes you just are not sure what is going on – did your baby just shift positions and hit your bladder?  Or are these consistent and uncomfortable cramps really labor or just miserably annoying?  We don’t know until we see you either.  That’s what we do – that’s what we are here for.

In order to assess your situation we welcome you and a guest into one of our triage rooms.  These are not large, spacious rooms because we don’t anticipate extended stays here in triage. 

But we do want to figure out what is going on and know that both mom and baby are doing well.  

We will place a fetal heart monitor on to give us information to help us understand if baby is tolerating the situation as well or better than you are.

We will also place a monitor to visualize contractions.  This monitor only tells us how far apart the contractions are and how long they are lasting – it does not tell us how strong they are – we need you to help us with that information.

Not all contractions will change your cervix – and thus just because you are having some contractions does not automatically mean you need to be admitted.  Just like you would not run a marathon without training first, your uterus muscle also needs to “warm up” or practice a little before the big event. 

What can you do at home?  Here are some insider hints I would suggest:

Drink WATER.  Hydration may slow your contractions, but if it does they were probably not going to change your cervix any time soon.  A hydrated uterus contracts more effectively and efficiently.   Since it is football season I like to use the example that these athletic men occasionally drop to the field and cannot stand or walk on their own when their muscles are dehydrated and cramp.  YOUR UTERUS IS A MUSCLE TOO, and needs to be hydrated or those “cramps” can be extremely painful…..and you will feel like you need help off the field!

Take a Warm Bath.  If you relax in a warm tub and your contractions continue (while drinking a lot of ice water)…..then come and see us for additional assessment!  We have Jacuzzi tubs available in every room because laboring women tend to relax in water.  Learning to relax during labor helps your uterus to work better and that baby to descend easier. 

If you are early in your pregnancy or concerned for any reason, please don’t delay your trip into our triage.

Change position.  If you are uncomfortable, and your muscles are hurting, then move.  Hands and knees is a great way to get that baby off the nerves in your back that can really be quite painful.  It is also a great way to get the baby to find the best position for delivery.   Go for a walk but don’t wear yourself out.  Heat and ice are great at relaxing sore and stretched muscles.

Leaking Fluid?  If your water is broken the risk of infection goes up for you and for baby and admission to the hospital is recommended.  We like to see labor start within a few hours of your water breaking.  If it does not start on its own, then we can discuss with you the risks, benefits, and side effects of all options to decrease the risks associated with prolonged rupture.

Still concerned or uncertain?  Come in or call your doctor.  We all work as a team throughout your pregnancy to keep you and your baby safe.  Pregnancy is not predictable.  Trust me, we know and understand that things change quickly and what can be normal one minute can be very different and even scary the next.  If you are concerned, so are we.  It does not matter if you have been just a little worried for a day or two or you just left the office or the hospital and something just does not seem right, come in, come back!  We only get a snap shot of what is going on in your pregnancy during the moment while you see us – we will always take another look!