Delivering at Duke Birthing Center
Duke Birthing Center is located on the Duke Hospital Campus, and is one of the go-to hospitals for those seeking some of the best medical care in the area at a major research hospital. With all major specialities in one hospital, patients at Duke, or Big Duke as many refer to it, find it a great place to deliver with amazing practitioners.
Currently, Duke Women’s Health Associates at Brier Creek and Patterson Place deliver at Duke. Duke does not have a pre-registration option, so immediately upon arrival (unless your baby has different plans), you will need to fill out the necessary forms to be admitted.
Arrival
When you first arrive to Duke, you may enter through the main entrance and go directly to Labor and Delivery on the fifth floor. There is also the ER entrance if you feel like you need immediate medical assistance, located behind the hospital. Depending where you enter, there are several options for parking. First, the main hospital parking is available in the Duke Hospital Parking Garage across Erwin Road from the hospital entrance and is $2 per hour or a maximum of $8 per day. Furthermore, there are discount parking coupons are available at Duke hospital gift shops. There is also valet parking at the main entrance off of Erwin Road for $9 per day. There is a free, short term parking lot available at the Emergency Room entrance. Regardless of where you park, the hospital asks that you keep your ticket with you so when you are ready to exit, you can pay prior to reaching your vehicle.
Triage
If upon arrival, you are admitted and you are not in immediate labor, you will be sent to one of the six triage rooms. In these rooms, you will spend anywhere from thirty minutes to two hours where your medical team will check your cervix, run a few routine blood tests, and receive continuous fetal monitoring. You will also be required to receive a saline lock, but you can decline pain medication at any point. There is only one visitor allowed in these rooms, so your doula can either wait in the waiting room, or switch with your partner to allow him or her to take a break. This is a great time to mention to your medical team if you are interested in saving your placenta for encapsulation or having your cord blood banked.
It is important to note that Duke Hospital is a teaching hospital. This means students may be observing you at any point during your stay at the hospital. Furthermore, bedside reporting at shift change and hourly rounding occur. If any of these make you feel uncomfortable, you may speak with your medical team to see what can be eliminated or reduced.
Labor and Delivery Rooms
Once you are moved to one of the twenty Labor and Delivery Rooms, you will be able use any of the various comfort measures and state of the art medical technology to have the birth you desire. Once you are admitted, you will on a clear liquids diet.
In these rooms, there is a limit of three visitors, including children and support person. Children must have an adult with them other than your support person, and any visitors can be asked to leave or be limited based on the nurses discretion.
In each room, there is a shower and tub (however, you may only use the tub if your water has not broken), a birthing ball, and birthing stool. You may request a birthing bar and/or mirror, but there are only a handful available so one might not be available immediately. You may request to receive warm blankets and heat packs from the nurses, as well as IV medication that is giving in 30 minute intervals or an epidural. Epidurals are available any time of the day, as there is a member of the women’s anesthesia team on floor 24/7. At this time, only traditional fetal monitoring is available, but please ask your nurse if they have wireless fetal monitoring available if you are interested. Normal protocol is for you to wear hospital issued gowns, but you are allowed to bring your own laboring gown if you wish. If the need for a cesarean birth arrises, you will be required to wear the hospital issued gown.
There is a coach’s corner for your support person that includes snacks, a microwave, and a small refrigerator.
Once your baby is born, breastfeeding and skin to skin will be encouraged as Duke is a Four-Star Breastfeeding Friendly Hospital. Furthermore, delayed baths (usually 4-6 hours after birth, but up to 24 hours after birth) and delayed cord clamping (also usually 2-5 minutes, but can be longer depending on the situation) are standard practice. After about 2 hours, you will be moved to your postpartum room.
Please note: hospital policy states that no filming or photos during the actual birth or any procedures done in the room is allowed.
Cesarean Births
If you either have a planned or unplanned cesarean birth, you will be in one of the three ORs on the maternity floor. Only one support person is allowed to be in the OR with you, and they must be properly dressed to be in a sterile environment. If medically safe, skin to skin and immediate breastfeeding are encouraged in the OR. Please check with your medical team to see if clear drapes are available for your birth, if you are interested.
Mother Baby Room
How long you stay in your postpartum room is dependent on your medical needs, but usually it is two nights for vaginal births and three for cesarean births. While there are no limits to the amount of visitors you can have while here, your nurse can always limit the number if you wish or if it becomes a problem for your recovery.
The hospital will provide diapers, wipes, blankets, and simple shirts for your baby while in the hospital. However, they do recommend you bring your own toiletries, comfortable shoes to walk during labor, a robe, a going home outfit for yourself and for your baby, and any bedding you feel like you need (in a bright, colorful pattern to not be confused with hospital bedding). The hospital does not provide pacifiers, so if you would like your newborn to have one, you must provide your own.
At The Birth Center, there is no health baby nursery, so your baby will room in with you during your entire time at the hospital. The only time your baby will leave is for the hearing test and circumcision, if you choose to do so. There is a 57-bed Level IV Neonatal Intensive Care Unit if your new baby does require some extra attention. This is open 24 hours a day for parents, and does have a limit of only two people at a time. Breast pumps are available inside the NICU for your use.
If you decide to breastfeed your newborn, the hospital has Medella Hospital Grade pumps and parts for you to use. Donor milk is also available if you are interested. If you choose to formula feed your newborn, the hospital will provide formula and bottles upon request, but you should plan to have a back up in case the bottle or specific formula you would like is not available.
With being a large hospital, there are many meal options for both you and your support person. Other than when the full service cafeteria is closed between 10pm and 6am, you may have any meal delivered to your room. If you would like a meal during the time the cafeteria is closed, you will be given a meal voucher for Starbucks. There is a Subway and Starbucks in the hospital that are both open 24 hours per day.
Your support person is welcome to stay the entire length of your visit, and will be provided all of the sheets and pillows he or she needs. About 70% of the rooms have a couch to bed, and the other 30% have a recliner to bed for your support person. You may be able to requested a particular style of room, but there is no guarantee the staff will be able to accommodate your request.
Lactation support, newborn photography, cord blood banking, and birth certificate services are all available to during your stay as well. For your baby’s birth certificate, a birth certificate clerk will come to your room within 24 hours to conduct interview. If you have any problems, you can all the Duke Birthing Certificate office at (919) 681-5440.
Your new baby will be seen by the Duke Pediatric doctors, and you will be required to make an appointment with your own pediatrician prior to being discharged.
Discharge
Once you and your baby have been cleared for discharge by both your doctor and your baby’s pediatrician, the staff does its best to finish everything by 11:00am on the day of discharge. Before you leave, you must show proof of your first pediatrician appointment (usually the next business day), and have the carseat properly installed. The mother does not need to show any identification, but the father most show one current ID.
Special Notes for Durham County Families
Durham Connects provides free or discounted in-home nursing visits within your child’s first three weeks of life for Durham County residents. For more information about this wonderful service, please visit www.durhamconnects.org or www.Welcomebaby.org.
In our experience, families love birthing at Duke Birth Center. We hope that this information has been helpful and look forward to hearing about your experience! As always, your Doulas are available for any questions you may have about Big Duke. We always recommend that you speak with your provider regarding all protocols and procedures that may have changed or may be unique to your situation.
