Supporting patients during labor and delivery

The Someday Starts Now Birth Plan offers a convenient way to ensure your patients’ wishes regarding labor, birth and recovery are clearly understood.

The guide provides a helpful starting point for patient-provider discussions and can be appended to a patient’s chart for convenient reference during her hospital stay. It is available as a fillable PDF that can be emailed to providers and added to patients’ electronic medical records.

Managing a patient’s pain

From the use of water and massage to progressive relaxation and meditation, many options exist for non-medical pain management during labor and delivery. Medical pain management techniques should be explained during prenatal care and patients should be encouraged to attend birth classes to prepare for their delivery.

Educating your patients about pain

A patient must be educated about pain management options and have their expectations realistically set prior to delivery. Doing so results in a greater likelihood of responding effectively during labor. An excellent way to mediate pain is through the use of a doula, or trained birth attendant.

Doulas are trained in relaxation techniques, massage, labor support for both parents and are aware of the biophysical progression of labor and delivery. They can serve as an advocate for the family and also liaison between the medical team and family when there are incongruent expectations or understandings.

the importance of postpartum follow-ups

Immediately following delivery, it’s necessary to remind patients of the importance of a post-partum follow-up and early entry into prenatal care with their next pregnancy. If the family experiences a premature delivery, clinicians can refer them to support programs such as those offered by the March of Dimes, First Candle and Hand to Hold. In addition, if the infant was born premature, educate parents on the importance of alerting their clinician when they seek prenatal care for their next pregnancy, as well as initiating 17P as appropriate.

Initiating breastfeeding

If there is no immediate danger to mother or infant, breastfeeding should be initiated at delivery. The hour after delivery is known as the “golden hour” when bonding through skin-to-skin contact and initiation of breastfeeding should be supported. Skin-to-skin contact has been shown to regulate the infant’s body temperature and reduce hypoglycemia.

It’s also believed to boost the baby’s immune system as the baby is exposed to the mother’s pheromones and circulating oxytocin. In order to give the new family this time together, vitamin K, erythromycin administration and other routine tasks following delivery should be deferred.

Cord blood is an option

Umbilical cord blood transplants can be a life-saving option for patients who are treated for leukemia and other cancers or for those with serious blood disorders. In Texas, cord blood can be collected for storage through private companies or donated to the public cord blood supply through one of several participating hospitals. Patients can also request cord blood collection kits from the South Texas Blood and Tissue Center or other blood banks and take them to the hospital to use with a trained collector.

Clinicians play an important role in educating patients about their options for donating umbilical cord blood. Since immune types are specific to ethnic groups, encourage your African-American, Asian and Hispanic patients to consider donation. Lack of genetic diversity among donated samples represents unmet need for donors in these populations. Texas law requires physicians to provide information to patients on cord blood banking and DSHS provides a patient brochure that physicians can obtain for free. The Texas Medical Association has developed a resource page to further support providers in cord blood banking promotion.


The Healthy Texas Babies Patient Worksheet gives your patients a useful “checklist” of topics to discuss during their office visits, from their medical histories to the importance of breastfeeding and taking their baby to full term.

These Healthy Texas Babies exam room posters help keep your patients informed and spur discussion of important health topics.