Labor & Delivery

A safe and comfortable welcome for your little one

Providing the Latest Options in Childbirth

When it comes time to welcome your newest family member, Beth Israel Deaconess Hospital–Plymouth is here to offer you the latest labor and delivery options. We provide care throughout your pregnancy to help ensure a healthy arrival, and classes to help you feel confident once your baby arrives. You have many options for giving birth, and you can expect a comfortable, empowering experience at BID Plymouth.

Signs of Labor

You may be in labor if your contractions are five minutes apart and last at least 60 seconds each. If this activity occurs for an hour, it is time to contact your physician or midwife.

Be prepared to tell your doctor or midwife:

  • How far the contractions are apart, their length and intensity.
  • Whether or not you’re using breathing techniques.
  • Whether or not your bag of water has broken. You should also note the time it broke and the color of the fluid.
  • If  a bloody show (a blood and mucus discharge) is present.
  • If you have felt your baby move in the past hour.

When To Go to the Hospital

Your provider will instruct you when to leave for the hospital. If you’re a first-time expectant parent and can manage the contractions at home, new research suggests that you should continue to stay at home until it is difficult to breathe through the contractions. However, if you live a great distance from the hospital, are concerned about not getting there on time or have other special concerns, plan to leave sooner.

What To Expect When You Arrive at the Hospital

Once you arrive at the BirthPlace reception desk, you will need to present a picture ID (driver's license or other photo identification).

After you check in, a nurse will escort you to a room where we will check your blood pressure and temperature and get blood and urine samples (with your consent). The nurse also will place devices on your stomach to monitor the baby's heart rate and your contractions.

The nurse, on-call physician or midwife may suggest a vaginal exam to evaluate the dilation (how much your cervix has opened) and effacement (how much it has thinned). It’s best to be admitted when active labor begins, especially if this is your first delivery.

You may be considered in active labor if your cervix is dilated three centimeters or more and your contractions are less than five minutes apart and last 45-60 seconds.

Depending on your stage of labor, contraction pattern, how far dilated you are and fetal heart tracing, your physician or midwife may admit you to the hospital, or suggest you return home until the contractions are closer together. If you’re in early labor and sent home, it’s common to feel disappointed, maybe even embarrassed. Activities such as walking, showering, resting, drinking fluids, watching a movie or listening to music can be helpful during early labor.

If you’re admitted and have had a positive culture for Group B, or Beta, Strep during your pregnancy, or if you have any risk factors, your provider may recommend starting antibiotics during your labor.

Pain Management

The BirthPlace offers a variety of methods for managing labor pain, including:

  • 24/7 Epidurals
  • Intravenous pain medicine
  • Nitrous oxide
  • Showers
  • Water labor
  • One to one nursing support

We also supply numerous items for labor including birthing stools, birth balls, peanut balls, rocking chairs and a shower in each room.

We do allow doulas, but do not provide them.

Vaginal Birth After Cesarean

Our team is committed to providing you with the best, safest option for your labor and delivery. If you had one cesarean delivery in the past, you can choose between a second cesarean or a vaginal birth, also known as a TOLAC (Trial of Labor after Cesarean). There are risks and benefits to each, and we help you make the decision that is right for you and your family.

If you're interested, please schedule a consultation with an obstetrician on BID Plymouth's OB/GYN & Midwifery team at 508-830-6116.

What To Expect During Childbirth

Breastfeeding Tips

Use these tips to get started on your breastfeeding journey:

  • Put the baby to breast within the first hour after birth.
  • Within the first hour, your baby is most alert and interested in nursing. Your baby is eager to meet you and needs the colostrum (initial fluid from your breast) for energy and protection against infection.
  • After the first hour or two, your baby will become sleepy and more difficult to nurse.

Get more breastfeeding support; from BID Plymouth experts.

Comfort Measures

There are several effective approaches to pain relief that you can try throughout labor, such as:

  • Apply warm or cold compresses.
  • Carefully select your support people for a calm environment.
  • Effleurage (light massage of your abdomen).
  • Guided meditation using calming imagery.
  • Have your partner or a support person rub a tennis ball over your lower back.
  • Keep a restful environment in your labor room, such as quiet, low lighting and soothing music.
  • Massage/back rubs by a support person.
  • Pray or enjoy other religious ceremonies.
  • Sit or lean on a birthing ball or rocking chair.
  • Try various positions (such as all fours, sitting on the toilet, kneeling, squatting or pelvic rock) and support with pillows if necessary.
  • Use relaxation/breathing techniques.
  • Use water therapy (shower or tub).
  • Walk.

Using several comfort techniques is an excellent way to involve first-time partners in supporting and working with you in the childbirth process.

Early Labor

If you’ve never experienced labor before, you may find it difficult to know whether you are in labor. Before heading to the hospital, call your physician or midwife to discuss your symptoms.

For first-time pregnancies, early labor is best managed at home in order to help your labor progress with minimal intervention. Once in active labor, your contractions will be fewer than five minutes apart — lasting 45 to 60 seconds — and the cervix is dilated three centimeters or more.


Over the last 10 years, the national trend has been to avoid routine episiotomies (a surgical cut to avoid tearing of tissues), only performing the procedure when necessary. What used to be a national episiotomy rate of 60–80% for first-time mothers has decreased to less than 20%.

The main concern is that the episiotomy could extend into the rectum during delivery. This may lead to greater problems with bowel control (loss of gas or stool) both short and long term. Close to 70% of women will have a natural tear with the birth of their first baby, usually involving less tissue and trauma than an episiotomy. During an emergency, or if your anatomy suggests you may encounter a larger laceration without an episiotomy, we will discuss this option at length with you prior to moving forward.

Labor Induction

Although inducing labor may be needed for certain medical problems or prolonged pregnancies, induction during first-time pregnancies carries added risk. Inducing labor for during a first time pregnancy — especially with a cervix that is nearly closed — doubles or triples the length of labor and possibility of a cesarean birth. However, in later pregnancies, the chances for a cesarean delivery after induction are lower.


As your labor progresses and contractions become stronger, you may request medication to manage your pain. Your physician or midwife can explain the benefits of each type and help you select the best and safest medication for you and your baby. Our options include nitrous oxide, oral pulls, intravenous pain medicine and epidurals. It’s best to discuss medications with your doctor or midwife at an earlier appointment before you’re in labor.

Pain Relief for Cesarean Delivery

If you already have an epidural in place for labor and you require a cesarean, you may be given a stronger dose of local anesthetic through your epidural catheter. Alternately, your anesthesiologist may give you spinal anesthesia to keep you comfortable during the surgery. If you need an emergency cesarean section, you may have to undergo general anesthesia.

Most often, your doctor adds a small amount of narcotics to your spinal block before your cesarean. This medication allows for prolonged pain relief after the procedure (about 24 hours).


Also known as the second stage of labor, pushing starts sometime after the cervix is completely dilated (10 centimeters). It’s important to wait for the natural urge to bear down before starting active pushing. There may be circumstances, such as having a strong regional anesthetic or labor stops, when you may not feel the urge to push. If that happens, our staff will help you with pushing.

Allowing the baby's head to gradually stretch the tissue at the outlet of the vagina (perineum) will reduce the risk of a significant tear. Delivering on your side is associated with fewer significant tears. Perineal massage (gradual stretching of the vaginal and perineal tissues) from 36 weeks on has been associated with fewer perineal tears. Ask your physician or midwife for details on perineal massage.

If your obstetrician or midwife is concerned about you or your baby's health, we may offer to help you shorten the second stage of labor by using a vacuum extractor or forceps on the baby's head (performed by the physician). These procedures rarely carry a health risk to you or your baby.

Regional Anesthesia (Epidural, Spinal and Intrathecal Medications)

If you reach a point in active labor where your medication is no longer relieving your pain, you may decide to ask for a regional anesthesia to provide stronger pain relief. The goal of regional anesthesia — especially after your cervix is fully dilated — is to reach a balance between easing your feeling of pain and still feeling the urge to bear down to actively participate in delivering your baby.

Water Birth

You have safe options for pain management during labor, including a water birth. Many women benefit from the relaxation and freedom of movement offered by our birthing tub.

We offer water labor and water birth to low-risk women who meet certain criteria. Speak with your provider during your pregnancy to see if you may be a candidate.

Make an Appointment

Services We Offer

Our team is committed to giving you, your baby and your family a positive birth experience. You'll have access to a full range of labor and delivery services, including:

  • Breastfeeding Support
  • Cesarean Section Delivery
  • Unmedicated Childbirth
  • IV Pain Medications
  • 24/7 Epidurals
  • Hydrotherapy
  • Nitrous Oxide
  • One on One Nursing Care
  • Continuing Care Nursery Transfer
  • Newborn Care
  • Postpartum Support
  • Pregnancy Care

Meet Our OB/GYN & Midwifery Experts

Our specialists provide a comprehensive range of gynecologic and obstetric care options. 

Services & Specialties

Our goal is to provide exceptional maternity services to you and your new baby before, during and after labor and delivery. Depending on your needs, as well as your baby’s needs, you may see one or more of these specialty providers.