Hospital Policy re: admission

shortstuff15 · January 2014

I have a question. With all these ladies going into L&D and having babies, I'm seeing a lot of hospitals admitting them at 1 or 2 cm's dilated. Do your hospitals not have a minimum dilation requirement to be admitted? I understand induction might be different, although here even with induction they don't admit you until you are in labour or needing the drip but they will try multiple days before moving to the drip or going to a c-section. Here even if you go into the hospital they won't admit you until you are at least 4 cm's (in most situations) and even then they will look at your history and go from there. I've had friends get sent home at 6 cm's because of their delivery history but unless it was a scheduled c-section, there have only been one or two friends get admitted prior to 4.

So what has been your hospital experience?

ababymaybe · January 2014

I think I was around 3cm max with DS when I was admitted. But it was on my due date and my contractions were VERY strong on the monitor (and freaking painful! Back labour with a sunny side up baby is a btch. I got the epi at 4cm).

I do recall being disappointed at the lack of dilation and unsure if they would admit me but somehow they knew it was still the real deal. I tried walking for a bit to help things progress but the pain really was too bad.

peanutmuse · January 2014

My guess would be that even if there is a policy, there are also case-by-case considerations.

Deblondie1 · January 2014

I think it goes case by case. I know because of my history and current status, I'll get admitted as soon as I have a pattern to my contractions. It just depends I think.

grml14 · January 2014

From what I understood last night they would have admitted me if I had dilated from the 2cms I was when I came in to 3cms after 3 hours. I think it's just a matter of what your progression is.

Emily6778 · January 2014

I was in labor for 19 hours at home, inconsistently contracting. 3 min apart, 8 min, 2 min, 6 min, etc. Every time we called they said to wait until they were consistency under 5. After 19 hours I had enough and couldn't take the pain anymore so we went in. I was at 4cm in triage and they said they were considering sending me home. I went from 4cm to 5cm within an hour in triage so they admitted me. My contractions never once got consistently at 5 min or less.

salsamommy · January 2014

I believe there is a policy, however they do treat everybody case by case.

With DS, I was GBS negative and did not want pain medication. So they sent me home to labour. I wouldn't be admitted until I was between 3 and 4 cm. I didn't go back to the hospital until I was 6 cm.

This pregnancy though, they will admit me right away as I am GBS positive, so I will need antibiotics during labour.

jwp325 · January 2014

ANDYLEAH said:

I believe there is a policy, however they do treat everybody case by case.

With DS, I was GBS negative and did not want pain medication. So they sent me home to labour. I wouldn't be admitted until I was between 3 and 4 cm. I didn't go back to the hospital until I was 6 cm.

This pregnancy though, they will admit me right away as I am GBS positive, so I will need antibiotics during labour.

This exactly in my case too. I knew I needed antibiotics and doctor on call for my practice told me to just go in and let the nurse know my GBS status. If I'd been negative I'd have labored at home until contractions were close enough to go to hospital.

MrsGraham06 · January 2014

With my 1st, I was 9 days past my due date and my water broke. With my 2nd and 3rd, I was induced. This one, I went to L&D with contractions, but wasn't dilated and then contractions stopped. I haven't been back. On Friday, if my contractions continued, they would have kept me, even though I wasn't dilated at all. Mostly because of position of baby (any way but head down).

nbbride06 · January 2014

With DD I was consistently contracting even though I was only 2cm so I was admitted.

Emily6778 · January 2014

ANDYLEAH said:

I believe there is a policy, however they do treat everybody case by case.

With DS, I was GBS negative and did not want pain medication. So they sent me home to labour. I wouldn't be admitted until I was between 3 and 4 cm. I didn't go back to the hospital until I was 6 cm.

This pregnancy though, they will admit me right away as I am GBS positive, so I will need antibiotics during labour.

I too was GBS positive with DD and no one ever mentioned anything about going in right away. As long as I was on the antibiotic 45min prior to delivery there was no concern. This time, they didn't even bother to test, just said they will do antibiotics again based off my last delivery. Again, different doctor even, and no mention of rushing in. I really just hope my water breaks this time so I don't have to deal with any of the questioning on when to go in!

ababymaybe · January 2014

Now I feel dumb - I never even considered GBS status as a factor. Yeah, that's probably why I was admitted with DS last time. I was GBS positive.

shortstuff15 · January 2014

jwp325 said:

ANDYLEAH said:

I believe there is a policy, however they do treat everybody case by case.

With DS, I was GBS negative and did not want pain medication. So they sent me home to labour. I wouldn't be admitted until I was between 3 and 4 cm. I didn't go back to the hospital until I was 6 cm.

This pregnancy though, they will admit me right away as I am GBS positive, so I will need antibiotics during labour.

This exactly in my case too. I knew I needed antibiotics and doctor on call for my practice told me to just go in and let the nurse know my GBS status. If I'd been negative I'd have labored at home until contractions were close enough to go to hospital.

See even here if you are GBS+ they will give you your dose as an outpatient. It just seems like my hospital just doesn't like patients labouring there. It's not a bad thing, but it seems so out of the ordinary.

With my first I had been labouring for almost 12 hours, all back labour, and contractions started at 5 minutes apart and were definitely showing up on the monitor. When I got there I was a 2, maybe a 2 1/2. They had me walk the halls for an hour and then go back to triage to get checked. By that point I was a 2 1/2ish and they sent me home. I laboured at home for another 8 hours before going back. At that point I was a full 4 so they admitted me.

With my second I showed up at 3 1/2 and they had me walk the halls for an hour again. I did 1 1/2 hours of walking around the empty waiting room at midnight before going back to find out I was a 4. At that point they admitted me. Baby was born 2 1/2 hours after that. Even my cousin, whose water broke at about 8:30 am, wasn't admitted until her contractions started at around 8 pm. And she was GBS+ - they just gave her a dose as an outpatient.

MrsGraham06 · January 2014

Wow, I was told that for being GBS+, I need 2 doses of antibiotic, and 4 hours between doses. Since my last labor was 8 hours, I'll be going in hopefully with plenty of time. Unless my water breaks, then it's a c/s.

brideandbreve · January 2014

peanutmuse said:

My guess would be that even if there is a policy, there are also case-by-case considerations.

This.

My hospital doesn't have an overall, set-in-stone policy. They have to review everything that's going on with you before they'll make that call. I've had friends get admitted at 2 cm, and I've had friends sent home at 4 cm. It just really depends on their individual circumstances.

BuckeyeANG · January 2014

I got sent home at 4cm last night because I hadn't progressed since my OB appointment Monday and my contractions weren't consistent (I was contracting but they were all over the place time wise). So it's my understanding they admit if you're progressing and/or have a good labor pattern of contractions going.

jessicat2283 · January 2014

I've never heard of that. I don't think either hospital has that policy here. Id be sol I don't dilate even while in active labor until I get an epidural.

sugarland726 · January 2014

I was admitted at 2-3 cms because I was actively contracting and I was a RCS and my hospital doesn't allowed VBACs. With DD, I was expected to deliver vaginally. I came in walked for an hour, and was only about 1cm, so they sent me home until my contractions were longer and closer together. When I returned several hours later, I had progressed to 3-4 cms, so I was admitted.

4lilmunchkins · January 2014

My first DD I was 3cm my water broke but I wasn't having contractions so they kept me. With DD2 and DS I walked in at 5cm and was admitted. With this one I went in around 34W with a sharp side pain and contractions. I was 2.5cm when they checked me. I was told if I progressed more they would keep me but an hour later I was still at 2.5cm so they sent me home. I think it depends on the situation.

LimeDrops · January 2014

My hospital takes things case by case based on history, pain level, birth plan, GBS, and progression... But generally speaking they seem to like you to be around 4cm OR in pain and progressing quickly. This time I'm a scheduled c/s but they told me to follow the same 5-1-1 pattern as far as when to call. They have stricter guidelines about c/s before 39w and I think they're not allowed to take me before then.

jwp325 · January 2014

MrsGraham06 said:

Wow, I was told that for being GBS+, I need 2 doses of antibiotic, and 4 hours between doses. Since my last labor was 8 hours, I'll be going in hopefully with plenty of time. Unless my water breaks, then it's a c/s.

I know i already posted but i was told two doses four hours apart was ideal as well. I think it all depends on hospital and doctor.

tesskerr · January 2014

We are turned away in New Zealand if we will not be ready to push soon. We labour at home, push at the hospital, stay there for 2 hours, then transfer to a recovery hospital. I think it's 5-1-1 rule, call midwife, she either makes a house call, or visits at home. But I'm sure it is different case by case as well.

If we are not progressing, we are generally sent home. Pit is not really an option unless you really really need it.

bananas1112 · January 2014

two people I know and same hospital told me they would have been sent back home to labor some more if their BP wasn't so high and were then admitted and given pitocin to push them along.

also-just found out i'm GBS+ which sounds super fun since I'm allergic to pennicillin group antibiotics. did not even realize that would be an admitting factor but I guess they check everything before sending you home and can't take too many chances.

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