A recent Dutch study (see Birth Complications More Common at Night) of over 700,000 births revealed that newborn deaths and complications occurred more often at night which came as no surprise. In a make-believe- world, everyone would have a baby before the end of the day-shift in a fully-staffed hospital manned by people who are alert. But reality is a different story. Obstetrics is a specialty of the unexpected and women can spontaneously develop labor at the most inconvenient times within a 24-hour day. Yet, all is not lost. With proper recognition of potential red flags, a pregnant woman may have a wonderful delivery even if it’s at the most wretched hour of the night or early morning. Based on my years of clinical experience and medical malpractice case reviews, here are some tips worth remembering:
- Try to be admitted to a hospital where they have 24-hour anesthesia service to having to waiting for them to arrive from home. If there’s an emergency, an “in-house” anesthesia department will save precious time.
- Try to deliver in a level 3 hospital has neonatology specialists in the event that you baby requires immediate specialized care after birth.
- Make sure your information is updated properly during the change of shifts. If your fetal tracing has been lousy during the past hour or your blood pressure has been elevated, the incoming staff should be made aware.
- Do not hesitate to ask about the whereabouts of the doctor or midwife if they are not in the hospital. By law, the admitting physician or midwife should be documenting your care by writing notes on a chart. Your physician or midwife has the ultimate responsibility for your care; not the nurse. If you’re in a teaching hospital and being managed by resident physicians, always ask to meet their supervisor, the attending physician.
- Ask whether you’re making progress in labor. If you’ve been the same number of centimeters for greater than two hours, there might be a problem with your labor.
Being in labor at night should no longer be a grave concern. When you are empowered with the proper information, the chances of encountering birth complications will be greatly reduced.