Who will deliver my baby?
The physician you see in the office may not be the physician present when your baby is born. You will still receive care from a qualified obstetric team.
Most of our generalist OB/GYN or FM-OB physicians provide in-house coverage during these hours. If an FM-OB physician is in-house, there will always be an OB/GYN physician supporting them as well. Generalists care for patients in the office and also provide hospital, delivery, and surgical care. Your own physician may be caring for another patient or have other responsibilities.
Coverage changes to our laborist/hospitalist OB/GYN team. When a laborist/hospitalist OB/GYN is in the hospital during nights and weekends, there will always be a Generalist OB/GYN on-call as back-up or for other needs on L&D. The specific on-call schedule determines who is responsible for your care.
What is a laborist or hospitalist?
These are board-certified OB/GYN physicians whose work focuses on hospital care rather than office appointments. They are skilled in labor management, vaginal and cesarean births, and obstetric emergencies.
Why we use this model
Childbirth happens around the clock. Sharing hospital coverage gives generalist physicians time for rest, family, and life outside work, while a dedicated hospital physician focuses on patients on L&D. This supports physician well-being, reduces the burden of continuous call, and helps make obstetric practice sustainable. It also allows your office team to continue caring for patients during the day.
Can I request my familiar OB physician?
Yes. Tell your prenatal team and your admission nurse who you would prefer. If that physician is on call and available, your team can explore the request. A particular physician cannot be guaranteed: the call schedule, other deliveries, urgent care needs, and the timing of your birth all matter. Care should not be delayed when you or your baby needs attention.
We make an effort for you to meet the different generalist physicians who may be on call during prenatal visits. You may meet your hospitalist for the first time at the hospital. The on-call physician or the L&D hospitalist may deliver your baby.
“Who is the OB/GYN responsible for my care now? What is our plan, and when will we reassess?”
Your preferences, medical history, and labor progress should be included in the team handoff.
Additional information about delivering provider
Your prenatal OB provider is an important part of your care team, but they may not be the person who delivers your baby. Many practices and hospitals use a rotating on-call schedule. Depending on the care model, the provider attending your birth may be another OB physician from your practice or an OB hospitalist/laborist—a physician who specializes in caring for patients in the hospital during labor and birth.
This team-based approach is common across hospital systems. Choosing a particular practice or seeing one provider throughout pregnancy does not necessarily guarantee that provider will attend your delivery. We encourage you to ask your practice how its delivery coverage works.
If a particular provider is important to you
If having a particular provider at your birth is important to you, please discuss this during your prenatal visits. When induction is an appropriate option for your pregnancy, scheduling it near your preferred provider’s call day may increase the chance that they will attend. However, induction and labor can take time, and delivery may occur after their shift ends. The timing of induction should be based on your health, your baby’s health, and shared decision-making with your care team.
Attendance outside scheduled call hours
You may also ask whether your preferred provider is able to attend your delivery outside their scheduled call hours. Some providers may offer this when available, but personal commitments, other clinical responsibilities, and practice policies may limit their availability. Neither option guarantees delivery with a specific provider.
Plan your arrival at Fishers
Where to go
IU Health Fishers Hospital • 13000 E. 136th St., Fishers, IN 46037
- Follow Women’s Health signs to the south entrance, Entrance H.
- L&D and the special care nursery are on the second floor of the south tower.
- Use the maternity elevator for direct access when in labor.
- The hospital map also identifies public elevators and reserved parking for delivering mothers.
- Follow any different arrival instructions provided by your team, particularly after hours.
What is available here?
Fishers is a Level II maternity service with a special care nursery (IU Health’s website also calls the nursery a Level II NICU). The unit has private labor, delivery, recovery, and postpartum rooms, dedicated cesarean operating rooms, and an OB emergency assessment area. Private suites include space for a support person to sleep.
Labor comfort options listed by Fishers include birthing and peanut balls, hydrotherapy tubs, nitrous oxide, IV pain medicines, wireless fetal monitoring, and 24/7 anesthesia coverage. Ask which are appropriate and available for your situation. A labor tub is a comfort option; do not assume water birth is offered.
Before a scheduled induction or cesarean
- • Confirm your arrival time, entrance, and the number to call if plans change. Follow your team’s food, drink, and medication instructions, especially for surgery. Do not stop medicines on your own.
- • Confirm current visitor, support-person, and sibling policies. Arrange care for children and pets for several days. Urgent deliveries may delay a scheduled start; your team will explain any change.
- • Bring identification, insurance information, a medication/allergy list, comfortable clothing, toiletries, phone charger, your feeding preferences, and a short birth-preference sheet. Have a rear-facing car seat ready for discharge.
Call your pregnancy care team promptly
Call for leaking fluid, bleeding beyond light spotting, decreased fetal movement, or labor symptoms before 37 weeks. For term contractions, follow your individualized instructions; timing depends on your history and travel distance. If your water may have broken, note the time and fluid color, wear a pad, and call even without contractions.
Office/general inquiries: 317.328.6620
This is the published Fishers OB/GYN office number, not a verified direct L&D line. Obtain your urgent and after-hours contact instructions before delivery. Do not use a portal message for urgent symptoms. Call 911 for a life-threatening emergency.
What happens when I arrive?
Assessment comes first. Being checked for labor does not always mean you will be admitted.
A nurse reviews why you came in
Contractions, fluid leakage, bleeding, baby’s movement, or a scheduled procedure. You will be asked about medications, allergies, prior births, surgeries, and pregnancy concerns.
We check you and your baby
Blood pressure, pulse, temperature, and other observations; monitors commonly track the baby’s heartbeat and contractions. A vaginal exam, fluid test, or ultrasound may help answer a specific question.
The OB/GYN reviews the findings
You may be admitted, observed longer, or sent home with clear instructions if you and your baby are well and hospital care is not yet needed.
When you are admitted
Expect an IV, blood work as indicated, review of consent forms, and a discussion of your plan. Tell us early about difficult prior experiences, pain concerns, a need for an interpreter, religious or cultural preferences, and who you want involved. Your care plan is a shared decision. We will explain proposed exams, treatments, and medications and ask for your permission. You have the right to accept or decline them and to change your mind.
Group B strep (GBS): If you tested positive for GBS, you will generally receive antibiotics during labor or after your water breaks. This common bacterium is not a sexually transmitted infection. Antibiotics help protect your baby. Your team will review whether you need them, including if your result is unknown.
Monitoring, movement & heartbeat attention
External monitors use belts on your abdomen. Wireless monitoring may allow more movement when suitable. Continuous monitoring is commonly used with oxytocin, an epidural, or pregnancy complications. If the external signal is unclear, an internal monitor may be offered after your water breaks; the team will explain the reason and risks. Ask what positions, walking, fluids, and food are safe for you. A monitor alarm or an extra staff member entering the room does not by itself mean something is wrong.
When the heartbeat needs attention: The team may help you change positions, give IV fluids, treat low blood pressure, reduce or stop oxytocin, or use another treatment. Persistent concerning changes may lead to a recommendation for delivery. Ask what the finding means and how urgent the decision is.
A useful check-in: “What are we watching? What is the next step? When should we expect an update? What would make the plan change?”
Your Birth Plan: Sharing What Matters to You
A birth plan is a way to share your preferences, priorities, and concerns with your care team. It helps us understand what matters most to you and work together to support your birth experience. Having a written plan is optional—you will be included in decisions about your care whether or not you have one.
When should I prepare it?
Start thinking about your preferences early and discuss them during your prenatal visits. Aim to have your birth plan ready for review around 32–36 weeks, or sooner if an earlier delivery is anticipated. This gives you and your OB provider time to discuss your wishes, answer questions, and clarify which options are available at your hospital. You can update your preferences at any time, including during labor.
Share your plan with your whole care team
Discuss any specific wishes during prenatal visits rather than waiting until labor begins. Bring a copy to the hospital and review it with your nurse and OB provider. Discuss preferences or concerns related to pain relief and anesthesia with your anesthesiologist as well. If you have significant anesthesia concerns, ask during pregnancy whether a consultation before delivery would be helpful.
What should I include?
Keep your plan clear and easy to review—ideally about one page. Consider including:
- • Your most important wishes: What would help you feel safe, supported, and heard? Are there particular concerns or experiences you want us to understand?
- • Support people: Who you would like present, including a partner, family member, or doula.
- • Communication and consent: How you prefer to receive information, interpreter needs, and preferences about examinations, learners, or discussing sensitive information privately.
- • Personal needs: Cultural or religious practices, accessibility needs, or past experiences that may affect your comfort with care. You do not need to describe a traumatic experience to request support.
- • Labor environment and movement: Preferences for lighting, music, walking, position changes, a birthing ball, or shower use when available and appropriate.
- • Pain management: Comfort measures you would like to try, your thoughts about an epidural or other medications, and any questions for the anesthesia team.
- • Labor and delivery preferences: Wishes or questions about monitoring, cervical examinations, induction, Pitocin, breaking your water, pushing positions, and episiotomy.
- • If plans change: What matters to you if an assisted vaginal birth or cesarean becomes necessary.
- • After birth: Preferences for cord clamping, skin-to-skin contact, feeding, and support if you and your baby need to be separated.
Your preferences remain important if circumstances change
Birth can be unpredictable, and some options may depend on your health, your baby’s health, or available resources. If a change is recommended, we will explain the reason, discuss benefits, risks, and alternatives, and involve you in decisions. You have the right to ask questions and accept or decline care.
Induction & augmentation: the methods
Induction uses medicine or procedures to start labor before it begins on its own.
Augmentation means strengthening labor that has already started, on its own or after an induction. It may be recommended when contractions are too weak or too far apart, or when labor progress has slowed. The most common methods are oxytocin (Pitocin) and breaking the water (amniotomy), described below.
Induction may be recommended for high blood pressure, certain diabetes-related concerns, poor growth, low fluid, pregnancy continuing past the recommended time, or water breaking before labor. Sometimes a healthy patient chooses induction at or after 39 weeks after counseling. Timing depends on the reason; an elective induction should not occur before 39 weeks.
Your clinician checks the cervix, the opening of the uterus. Its softness, thinning, opening, and position, along with the baby’s position in the pelvis, help guide the starting method. A closed or firm cervix often needs preparation called cervical ripening.
| Method | What it does and what you may notice |
|---|---|
| Cervical balloon | A small tube with one or two balloons is placed through the cervix and filled with fluid to gently open it. Placement may cause pressure, cramps, and light bleeding. It stays for several hours or comes out as the cervix opens; timing depends on the device and plan. |
| Ripening medicine | Misoprostol (Cytotec) or dinoprostone (Cervidil) helps soften and thin the cervix and may start contractions. Medicine may be given by mouth or vaginally, depending on the drug and protocol. Repeat doses or a different method may be needed. |
| Oxytocin (Pitocin) | An IV medicine is adjusted gradually to produce an effective contraction pattern. Your nurse monitors contractions and the baby’s heartbeat. The dose may be lowered or stopped if contractions are too frequent or the baby needs a break. |
| Breaking the water (amniotomy) | During an exam, the clinician opens the amniotic sac with a small instrument when it is safe to do so. You may feel a gush or ongoing trickle. The baby’s head position matters because of the uncommon risk of the umbilical cord slipping down. |
Methods can be combined or used in sequence
A balloon plus medicine, followed by oxytocin and later breaking the water, is one possible pathway. There is no single sequence for everyone. Membrane sweeping at an office visit is a separate option that may encourage labor but does not guarantee it will begin.
Prior cesarean or uterine surgery?
Tell your team. It changes which methods are appropriate. Misoprostol is not used for term induction after a prior cesarean or major uterine surgery because of uterine rupture risk.
Common indications for induction of labor or medically indicated deliveries
Some pregnancy conditions make it safer to plan delivery rather than wait for labor to begin on its own. The conditions below are commonly considered.
Placental & uterine conditions
- • Placenta previa
- • Suspected placenta accreta, increta, or percreta
- • Vasa previa
- • Prior classical cesarean
- • Prior myomectomy (fibroid surgery) requiring cesarean delivery
- • Previous uterine rupture
Obstetric conditions
- • Preterm prelabor rupture of membranes (preterm PROM)
- • Prelabor rupture of membranes at 37 weeks or beyond (PROM)
- • Previous stillbirth
Fetal conditions
- • Oligohydramnios (low amniotic fluid)
- • Polyhydramnios (high amniotic fluid)
- • Fetal growth restriction (singleton pregnancy)
- – Otherwise uncomplicated, no concurrent findings
- – Abnormal umbilical artery Dopplers: elevated S/D ratio with diastolic flow
- – Abnormal umbilical artery Dopplers: absent end-diastolic flow
- – Abnormal umbilical artery Dopplers: reversed end-diastolic flow
- – With concurrent conditions (such as oligohydramnios, preeclampsia, or chronic hypertension)
- • Multiple gestations (twins, triplets, or more)—uncomplicated
- – Dichorionic-diamniotic twins
- – Monochorionic-diamniotic twins
- – Monochorionic-monoamniotic twins
- – Triplets and higher order
- • Multiple gestations—complicated
- – Dichorionic-diamniotic twins with isolated fetal growth restriction
- – Dichorionic-diamniotic twins with a concurrent condition
- – Monochorionic-diamniotic twins with isolated fetal growth restriction
- • Alloimmunization (maternal antibodies affecting the baby)
- – At-risk pregnancy not requiring intrauterine transfusion
- – Requiring intrauterine transfusion
Maternal conditions
- • Hypertensive (high blood pressure) disorders of pregnancy
- – Chronic hypertension: controlled, not requiring medications
- – Chronic hypertension: controlled on medications
- – Chronic hypertension: difficult to control (requiring frequent medication adjustments)
- – Gestational hypertension, without severe-range blood pressures
- – Gestational hypertension with severe-range blood pressures
- – Preeclampsia without severe features
- – Preeclampsia with severe features (including superimposed preeclampsia and HELLP syndrome)
- • Diabetes
- – Pregestational diabetes, well controlled
- – Pregestational diabetes with vascular complications, poor glucose control, or prior stillbirth
- – Gestational diabetes, well controlled on diet and exercise
- – Gestational diabetes, well controlled on medications
- – Gestational diabetes, poorly controlled
- • HIV
- – Intact membranes and viral load greater than 1,000 copies/mL
- – Viral load 1,000 copies/mL or less with antiretroviral therapy
- • Intrahepatic cholestasis of pregnancy
Conditions listed from ACOG Committee Opinion No. 764, Medically Indicated Late-Preterm and Early-Term Deliveries (2019), Table 1. This list is not all-inclusive.
How long will induction take?
Think in stages, not a promised delivery time. The early preparation can take longer than active labor.
| Part of the process | A realistic planning expectation |
|---|---|
| Admission and planning | Assessment, monitoring, and IV access come first. Treatment may not begin immediately at your arrival time. |
| Cervical ripening | May take 12–24 hours or longer, especially with a first birth or closed cervix. Repeat treatment may be needed. |
| Establishing active labor | Contractions may precede cervical change. Active labor generally begins around 6 cm. |
| From arrival to birth | Some births happen the same day; many take 24–48 hours or longer. These are planning ranges, not deadlines. |
Slow early progress is not automatically a failed induction
The cervix may soften and thin before opening. When you and your baby are well, allowing time can help avoid an unnecessary cesarean. In a reassuring situation, clinicians generally allow at least 12–18 hours of oxytocin after the water has broken before diagnosing an unsuccessful induction in the early phase. This is not counted simply from hospital arrival or the first ripening dose.
What if active labor stops progressing?
Once you are at least 6 cm and your water has broken, the team looks at contraction strength and how long the cervix has stayed unchanged. Guideline criteria for active-phase arrest generally include no further opening despite 4 hours of adequate contractions or 6 hours of inadequate contractions with oxytocin. These are clinical decision guides, not a requirement to wait if safety concerns arise.
Risks and reasons to change course
Induction medicines can cause contractions too close together and changes in the baby’s heartbeat. Infection risk becomes relevant after the water breaks, especially as time passes. Rarely, uterine rupture can occur, particularly with a uterine scar. An induction may end in cesarean birth.
Ask at each reassessment: “Are we still ripening the cervix or in active labor? What progress has happened? Is continuing safe? What are our options now?”
How will I know labor is starting?
Labor can begin gradually, and it is normal to be unsure whether it has started. Early labor may last hours or sometimes days. You do not need to figure it out alone—your care team is here to help.
Signs you may notice
Contractions may feel like menstrual cramps, with your belly becoming firm and then relaxing. As labor progresses, contractions usually become stronger, longer, and closer together.
You may feel aching in your back or increasing pressure low in your pelvis.
Thick, jelly-like mucus may pass all at once or in smaller amounts. A small amount of pink or brown blood mixed with mucus is called “bloody show.” Losing your mucus plug does not necessarily mean labor will begin right away.
This may feel like a sudden gush or a repeated watery trickle. Your water does not have to break for you to be in labor. If you think it has broken, call your care team right away—even if you have no contractions.
Practice contractions or early labor?
Braxton Hicks, or “practice” contractions, tend to be irregular and may ease with rest or a change in activity. Labor contractions tend to become more regular and intense and continue despite changing positions. However, early labor can also start and stop. Sometimes an examination is needed to tell the difference.
What can I do at home?
If you are at least 37 weeks pregnant, have no warning signs, and your care team has advised that you can stay home:
- • Rest when you can, drink fluids, and have a light snack if allowed.
- • Try a warm shower, gentle movement, slow breathing, or back massage.
- • Time contractions: measure how often they occur from the start of one to the start of the next, and how long each lasts from beginning to end.
- • Contact your care team when contractions become regular and painful, or sooner if you need help coping. Follow the arrival instructions you were given for your pregnancy.
Call your OB team or Labor & Delivery right away if:
- • You think your water has broken. Note the time and fluid color, and use a pad rather than a tampon.
- • Your baby is moving less than usual.
- • You have vaginal bleeding beyond a small amount of blood-streaked mucus.
- • You are less than 37 weeks and develop contractions, new pelvic pressure, persistent low backache, or leaking fluid.
- • You are unsure what is happening or feel something is wrong.
Do not wait for contractions to become regular if any of these occur. If you cannot reach your team promptly, go to Labor & Delivery for evaluation. If you feel an uncontrollable urge to push or think your baby is coming now, call 911.
Labor, pain relief & epidurals
The stages of labor
The cervix softens, thins, and opens. Contractions can be irregular or gradually become stronger. This phase may last many hours, especially with a first baby.
From about 6 cm to full dilation, contractions usually become stronger and closer together. Progress varies; everyone does not open 1 cm per hour.
At 10 cm, you work with contractions to move the baby down and out.
After birth, the placenta is delivered, bleeding is assessed, and any tears are repaired with appropriate pain relief.
Comfort options at Fishers
Breathing, support-person coaching, position changes, massage, and birthing or peanut balls can help. Ask about the labor tubs, nitrous oxide, and IV medicines. Nitrous may help you cope without removing all pain. IV opioids may cause sleepiness or nausea and can affect a newborn’s breathing when given close to birth. Suitability and availability vary.
What an epidural involves & when can I ask?
An epidural provides ongoing pain medicine through a thin tube in the lower back. You sit or lie curled on your side. After numbing the skin, the anesthesia clinician places the tube and removes the needle. The needle does not stay in your back. Relief often builds over about 15–20 minutes after medicine is given; assessment and placement add time.
You remain awake. Contraction pain usually decreases substantially, although pressure and stretching may remain. Your legs may feel heavy. Staff help with positioning, and a bladder catheter may be needed because urinating is harder. Do not stand without assistance.
There is no required cervical dilation before requesting an epidural. Tell your nurse early; the anesthesia team must assess you, and emergencies can affect timing. Low platelets, certain blood thinners, infection, or other conditions may affect whether it is safe. Tell your nurse promptly about one-sided relief, a painful spot, or pain that returns. Extra medicine, repositioning, or replacing the catheter may help. An epidural does not increase the overall likelihood of cesarean birth.
Pushing, vacuum & forceps
Your nurse and OB/GYN will guide positions and pushing with contractions. An epidural may reduce the urge to push, so coaching can help. Pushing may be brief or last several hours. The team checks your energy, the baby’s heartbeat, and whether the head is moving down and turning.
What is an assisted vaginal delivery? When the cervix is fully open and the baby’s head is low enough and in a known position, a trained OB/GYN may recommend assistance. Reasons include concerning heartbeat changes, prolonged pushing without enough progress, exhaustion, or a medical reason to limit pushing. If the head is too high or the position is unsuitable, cesarean may be safer.
Vacuum
A suction cup attaches to the baby’s scalp. The physician applies controlled traction with contractions and your pushes.
Temporary scalp swelling or bruising can occur. Bleeding under the scalp, jaundice, and rare serious bleeding inside or around the skull are possible.
Forceps
Curved instruments fit around the baby’s head. The physician uses them to guide the head during birth, sometimes helping rotation when appropriate.
Temporary facial marks or bruising can occur. Rare injuries include facial nerve or eye injury. Serious head injury is uncommon.
Benefits, risks and alternatives: Assistance may allow a faster vaginal birth and avoid abdominal surgery. Both methods increase the chance of vaginal or perineal injury, including a tear involving the anal sphincter, compared with an unassisted birth. Forceps generally carry a greater risk of severe maternal tearing; vacuum has particular scalp-bleeding risks. The physician will explain why assistance is advised, the relevant risks, and the alternatives: continued pushing if safe, or cesarean.
Episiotomy & perineal tears
The perineum is the tissue between the vaginal opening and anus. A laceration is a tear that happens as tissues stretch during birth. An episiotomy is an intentional cut in the vaginal wall and perineum to enlarge the opening.
| Type | Tissues involved and usual care |
|---|---|
| First degree | Skin and/or the vaginal lining only; no perineal muscle injury. A small tear may heal without stitches if it is not bleeding and the edges meet well. |
| Second degree | Skin/vaginal tissue and the muscles of the perineum, but not the anal sphincter. Usually repaired with dissolving stitches. |
| Third degree | Extends into the anal sphincter, the ring of muscle that controls gas and stool. Requires careful muscle repair and a specific follow-up plan. |
| Fourth degree | Extends through the anal sphincter into the lining of the anus or rectum. Requires repair of these deeper layers and close follow-up. |
Why might I need a C-section?
Common reasons for a scheduled cesarean
• Baby’s position: Persistent breech or sideways position.
• Placenta or blood-vessel problems: Placenta previa, vasa previa, or suspected placenta accreta.
• Previous uterine surgery: Certain incisions make labor unsafe; others permit a trial of labor after cesarean (TOLAC).
• Other individual concerns: Certain multiple pregnancies, selected maternal/fetal conditions, or a very large estimated baby after counseling.
• Repeat cesarean by informed choice: After discussing planned repeat cesarean vs. TOLAC.
Planned cesareans without a medical reason for earlier delivery are generally scheduled at or after 39 weeks.
Reasons for an unscheduled cesarean
• Persistent concerning changes in the baby’s heartbeat despite treatment.
• An induction does not establish labor after an adequate attempt, or active labor or descent stops progressing.
• Vacuum or forceps is not suitable, or an assisted attempt is unsuccessful.
• An urgent complication (cord prolapse, placental abruption, or suspected uterine rupture).
• A newly identified concern (unsafe fetal position or active genital herpes lesions/prodromal symptoms).
What happens in the operating room?
Preparation
Follow arrival, fasting, and medication instructions. In the OR, you will have monitors, skin prep, antibiotics, leg compression devices, a bladder catheter placed after you are numb, and a surgical drape.
Spinal or Labor Epidural
A single-shot spinal gives rapid numbness for scheduled surgery while you stay awake. A well-working labor epidural can often be given stronger medicine for surgery.
General Anesthesia
Used when delivery is too urgent for spinal/epidural, when severe bleeding or clotting concerns exist, or when regional anesthesia is inadequate. A support person generally cannot remain during general anesthesia.
You should not have to endure surgical pain
The anesthesia clinician tests the block before surgery. Tugging, pressure, or movement can be normal, but sharp, burning, or distressing pain should be reported immediately. Say, “I am feeling pain.” The team can reassess, add medicines, and, when safe, pause.
Recovery, feeding & your baby
First hours & hospital recovery
Your nurse checks vital signs, bleeding, and uterine firmness. Oxytocin helps the uterus contract. Call for help if you feel faint or bleeding suddenly increases.
- • After vaginal birth: Expect vaginal bleeding, cramps, and perineal soreness. Ice packs, a rinse bottle, and medicines help.
- • After cesarean birth: Expect vaginal bleeding, incision soreness, and possible gas pain. Early walking helps recovery.
- • Pain & rest: Acetaminophen and an anti-inflammatory are often used when safe. Limit visitors if helpful and share emotional concerns early.
Feeding, newborn care & Special Care Nursery
Breastfed newborns commonly feed 8–12 times in 24 hours, sometimes in clusters. Routine newborn care includes vitamin K, eye medication, immunizations, and screenings (hearing, blood-spot, oxygen screening for critical heart disease, and bilirubin check for jaundice).
If your baby needs the special care nursery: Some babies need extra help with breathing, feeding, blood sugar, temperature or jaundice. The Level II team will explain what Fishers can provide. Babies needing more intensive or specialized care may be stabilized and transferred to a higher-level nursery. Occasionally the safest delivery location is changed before birth. Maternal and newborn transfer decisions are separate; ask how the teams will keep you informed and support contact and feeding.
Intimacy, birth control & emotional health
Intimacy, ovulation & contraception
Wait about 4–6 weeks before vaginal intercourse and until bleeding stops and wounds heal (6 weeks is not a deadline). Use water- or silicone-based lubricant for dryness.
No period does not mean no pregnancy risk. Ovulation releases an egg before the next period. It can return within a few weeks after birth, especially if you are not breastfeeding.
Pregnancy is possible as early as about 3 weeks postpartum. Choose contraception before you resume intercourse rather than waiting for your first period.
Breastfeeding may delay ovulation, but timing is unpredictable. Breastfeeding alone is dependable contraception only under the strict lactational amenorrhea method (LAM): baby is younger than 6 months, your periods have not returned, and feeding is fully or nearly fully at the breast day and night, with no gaps longer than about 4 hours by day or 6 hours at night. Pumping, supplementing or longer sleep stretches can make protection less reliable. Discuss another method before any condition changes.
Options: IUD or arm implant, progestin-only pill or injection, condoms, permanent contraception, or delayed estrogen pill/patch/ring. Avoid pregnancy within 6 months; discuss intervals under 18 months.
Blues, depression & anxiety
Postpartum blues: “Baby blues” often start in the first few days: tearfulness, mood swings, irritability, feeling overwhelmed or mild worry. Symptoms tend to come and go and improve within 2 weeks. Rest, meals, reassurance and practical help can make a difference. Symptoms that are severe, worsening or affecting daily functioning need attention immediately – do not wait two weeks to ask for help.
Postpartum depression & anxiety: Depression may begin during pregnancy or anytime in the first year after birth. Signs include persistent sadness, emptiness or hopelessness; loss of interest or pleasure; guilt or feeling worthless; irritability or anger; difficulty concentrating; appetite changes; and trouble sleeping even when there is an opportunity to rest. Some people feel disconnected from their baby or struggle to manage everyday tasks.
Contact your OB/GYN promptly if symptoms last longer than 2 weeks, get worse, or interfere with eating, sleeping, bonding or caring for yourself or your baby. Do not wait for a scheduled postpartum visit.
Postpartum anxiety: Anxiety can occur with or without depression. Symptoms may include constant worry that is hard to control, feeling on edge, racing thoughts, panic attacks, repeated checking or reassurance-seeking, and being unable to sleep even when the baby sleeps. You may avoid normal activities because something feels unsafe. Ask for help when worry takes over your day or prevents rest.
Some parents have frightening, unwanted thoughts or images that feel unlike them and that they do not want to act on. These can occur with postpartum anxiety or OCD. Tell your clinician promptly so you can be assessed and supported. An unwanted thought is different from wanting to act, but any uncertainty about safety needs urgent help.
Mental health emergency: Thoughts of suicide or harming your baby require immediate assessment. Call 911 or go to the nearest emergency department if you might act, cannot keep yourself or the baby safe, or develop hallucinations, unusual fixed beliefs, severe confusion, or extreme agitation/energy with little need for sleep. These can be signs of postpartum psychosis, a rare emergency. Have a trusted adult stay with you and care for the baby while help is arranged.
Interactive checklists & trusted resources
Typical stay: 1–2 days after vaginal birth and 2–4 days after cesarean birth.
Your voice, your choices, your care.
You should always be included in your plan of care. Shared decision-making means we bring our medical recommendations and you bring your preferences, values, questions and goals. We will explain the expected benefits, risks and alternatives, including what may happen if you choose to wait or decline. You have the right to accept or refuse treatments, procedures and medications.
We will respect your informed choices and continue working with you on your care. We will do our best to keep you informed as your care progresses and whenever the plan changes. If you feel unheard, unsure about the next step, or concerned about a lapse in communication with a physician, provider or nurse, please speak up and let us know. You can ask to speak directly with the clinician responsible for your care or the charge nurse. Your questions and concerns are welcome.