Getting Ready for the Hospital

Everything to have in place before labor

A timeline from 32 weeks, what goes in the bag, what to ask your hospital and the two plans I write, one for my care team and one for my family.

Key points

Pack your bag by 36 weeks, and pre-register with your hospital around 32 weeks. Put both dates on your calendar now.
Certified technicians check car seats for free at more than 8,000 events run by Safe Kids Worldwide, a child safety nonprofit. Install the seat and book a check before 36 weeks.
A common cue to call in a low-risk pregnancy after 37 weeks is the 5-1-1 rule: contractions every 5 minutes, lasting 1 minute, for 1 hour. Your own provider’s instructions come first; ask what yours are.

The timeline

By 32 weeks: Pre-register with the hospital. Ask about the hospital’s support-person, room and visitor policies.
By 34 weeks: Write both birth plans. Review the care team plan with your provider.
By 36 weeks: Bag packed and in the car. Car seat installed and checked. Pediatrician chosen.
36 to 37 weeks: Group B strep (GBS) test, a swab for a common type of bacteria, unless GBS has already shown up in your urine.
Any time: Know the route, the parking and the exact entrance for labor and delivery triage.

If you’re being induced, or might be, move everything earlier. In my first pregnancy, I was admitted for an induction early term, after going in because I felt my baby moving less.

What to ask your hospital

Most of this is hospital policy, and the labor and delivery unit or a hospital tour can answer it. At the hospital where I had my first child, the answers were:

Two support people at most, and they had to be the same two the whole time. Only one could come into the operating room for a cesarean. A doula counted as one of the two.
Inductions started at night, by residents (doctors in training) and the doctors covering the hospital.
A stay of one to two nights after a vaginal birth, two to three after a cesarean.
Private rooms cost extra and had to be requested at the labor desk after delivery. Otherwise rooms were shared.
No water birth.

Ask yours the same things, plus where to park, which entrance to use at night and whether you can bring food, a speaker or your own pillow.

What goes in the bag

Paperwork

ID and insurance card
Your care team birth plan
Your medication and allergy list
Key records: recent labs, your blood pressure log, and the operative report from any past cesarean

For labor

Comfortable clothes, socks or slippers, a hair tie and lip balm
A pillow and blanket from home
A phone charger with a long cord, and a speaker
Snacks and drinks for your support person

For after the birth

Nursing bras, postpartum underwear and toiletries
A going-home outfit for you and the baby
If you had a cesarean before, or might have one, a high-waisted outfit that won’t press on the incision

Usually provided by the hospital: diapers and wipes for your baby, and basic hygiene supplies for you (Hoag). Ask yours.

What was in mine the first time: I didn’t have a bag packed. It came together in about six hours, with help from a lot of family: comfortable clothes, pillows, a blanket, a speaker, essential oils, a peanut ball (a peanut-shaped birthing ball), slippers, a hair tie, lip balm, electrolytes, adult diapers, a cooler and the kit for collecting my baby’s cord blood.

The car seat

Install it before 36 weeks, not on the way home. The National Highway Traffic Safety Administration (NHTSA) explains free inspections at stations near you, and Safe Kids runs free checkup events.

Two birth plans

The plan for my care team. My preferences, my history in a few lines and the questions I want answered before any decision: what’s being recommended, why now, the risks and the alternatives. I review it with my provider and ask for the final version to be scanned into my chart. (“Getting a Real Explanation Before You Agree”) The plan for my family. In my first pregnancy, when I realized an induction could happen with little warning, I wrote a second plan, titled “Unexpected Induction: Priority Plan.” It was the most useful document I made that year:

One job for my partner. Get to the hospital. Text only. Nobody calls with questions.
Two people to triage everything else, so my partner didn’t have to.
A packed bag with a deadline. Everything in the car by 9 p.m.
The house, handled. The cleaners called, the bassinet set up, the car seat delivered and the ride home arranged.
Night help confirmed, starting the day after we came home.
A line for anyone who panicked: “Is this premature labor? NO.” (37 weeks is early term, not premature.)

Last time, my family’s plan assumed a 24-hour induction, and it took three days. Now that I’m pregnant again, both plans assume the long version: who has my toddler for several days, who covers home and who brings what on day two. (“My Birth Story”)

When to go in

Follow your own provider’s instructions first. Commonly:

Labor: contractions every 5 minutes, lasting 1 minute, for 1 hour, in a low-risk pregnancy after 37 weeks.
Right away, whatever the clock says: your baby moving less or not at all, leaking fluid, bleeding, a severe headache, vision changes, chest pain or trouble breathing, or a blood pressure reading with a top number of 160 or higher or a bottom number of 110 or higher.

If you were told to come in for a symptom, you belong there. (“The Day I Offered to Leave Triage”)

A few lines from the script I wrote for my husband: “What are you recommending, and why now?” “How urgent is it? Do we have time to talk it through before we decide?” “Before she’s discharged, we’d like the operative report, or the date we’ll get it, and someone to explain it.” Add your own questions and put the list in the bag.

Before you leave the hospital

Ask for these in the day or two before discharge, while the people who cared for you are still there. Your support person can hold the list.

Your discharge medications, checked line by line against what you’re actually taking.
Your follow-up appointments, booked, including a blood pressure check within 7 to 10 days if you had high blood pressure, or within 72 hours if it was severe.
If you had a cesarean: your operative report, or the date you’ll get it, and who will explain it. Ask what type of incision was made on your uterus and how it was closed.
What you were given, and why: antibiotics, steroids, magnesium, blood pressure medicine, blood products.
Anything unexpected that happened during the birth or surgery, in plain words.
Your wound care plan, and who sees you if the incision opens or drains.
Who to call, and for what, once you’re home, and whether the after-hours line uses the same blood pressure thresholds as your discharge papers. (“What Postpartum Care Should Include”)

Take this back

To discuss with your care team:

When should I pre-register, and when should I come in for labor?
Which symptoms mean come in right away, rather than call?
If I’m induced, how long could it take, and what should my family plan for?
Can my final birth plan be scanned into my chart?

To discuss with the people in your life: What’s your one job if I go in early? Who answers everyone’s questions so my partner doesn’t have to? Who has the bag, the car seat and the keys?

Next in the series: “Getting a Real Explanation Before You Agree”