Your Baby's Birth - Pregnancy & Childbirth Home

Congratulations! 

It is wonderful that you are expecting a child and have decided to 

share this special experience with us. Our doctors, nurses 

and staff look forward to caring for you and making your upcoming 

hospital stay very comfortable and pleasant. 

Your Baby’s Birth is designed to help you and your family prepare for the birth of your child. We 

have included tips on how you can stay healthy, what items you may need for your nursery, signs 

of labor and how families can make the most of this wonderful event. To help you through your 

pregnancy, we have divided the information into four chapters: “All the Help You Need;” “You and 

Your Baby’s Health;” “Your Hospital Stay;” and “Your Going Home Guide.” 

Your Baby’s Birth is yours to keep and can be a helpful way to organize the information most new 

parents gather when preparing for a child. Remember to bring Your Baby’s Birth with you to your 

childbirth education classes and the hospital to add information that you may receive. 

Your Baby’s Birth is not meant to replace the advice of a healthcare provider. We are always 

available to help, so please call us with your questions. Turn to the section “All the Help You Need” 

for important phone numbers. 

The birth of a baby is a special event. At PinnacleHealth we have a team of dedicated healthcare 

professionals who specialize in the care of mothers and babies. Our team includes nurses, 

obstetricians, midwives, perinatologists, pediatricians, 

neonatologists, social workers, childbirth educators, lactation 

consultants and Nursing Mothers Counselors to care for 

you and your baby. Together, we are committed to 

making your pregnancy and birth the positive 

experience we believe every birth should be. 

Again, thank you for allowing PinnacleHealth 

WomanCare at Harrisburg Campus to be a 

part of this special time in your life. 

1 

Y O U R B A B Y ’ S B I R T H

2 


You and Your Baby’s Health

You and Your Baby’s Health 

You are responsible for your baby’s health and nutrition, right from the start. Here are some topics 

you should think about now that you are pregnant. 

Your growing body and baby 

MONTH 1 

Your Baby 

• Tiny limb buds, which will grow into arms 

and legs, appear. 

• The heart and lungs begin to form. By the 

22nd day, the heart starts to beat. 

• The neural tube, which becomes the brain 

and spinal cord, begins to form. 

• At the end of the first month, your baby is 

about 1/4 inch long. 

Your Body 

• Your body is making lots of hormones needed 

to grow a baby. 

• Your breasts are slightly bigger and sore and 

may tingle. 

• You may have morning sickness. Try eating 

crackers. 

• You may crave some foods or hate foods you 

usually like. 

Prenatal Care Guide 

• Visit your healthcare provider for your first 

prenatal care checkup as soon as you think 

you are pregnant. 

• Take a multivitamin with at least 400 

micrograms of the B vitamin folic acid every 

day to help reduce the risk of birth defects 

of the brain and spinal cord. 

• Ask your healthcare provider before taking 

any prescription drugs, over-the-counter 

products or herbal products. 

• Stop smoking, drinking alcohol and taking 

street drugs. 

Body before pregnancy 

3 


MONTH 2 


• All major body organs and systems are formed 

but not completely developed. 

• Early stages of the placenta, which exchanges 

nutrients from your body for waste products 

produced by the baby, are visible and working. 

• Ears, ankles and wrists are formed. Eyelids 

form and grow but are sealed shut. 

• Fingers and toes are developed. 

• By the end of the second month, your baby 

is about 1 inch long and still weighs less than 

1/3 ounce. 


• Your breasts are still sore and are enlarging; 

your nipples and the area around them begin 

to darken. 

• You will urinate more often because your 

growing uterus is pressing on your bladder. 

• Morning sickness may continue. 

• You may feel tired and need to rest more as 

your body adjusts to being pregnant. 

• The total amount of blood in your body 

increases. 


• Visit your healthcare provider for one prenatal 

care checkup. 

• Eat a variety of healthy foods from the five 

major food groups: grains; fruit; vegetables; 

dairy products; and meats and proteins. 

• Your healthcare provider probably will 

prescribe prenatal vitamins. Your prenatal 

vitamin should contain at least 400 

micrograms of folic acid. 

• Drink at least six to eight glasses of water, 

juice or milk every day. 

• Do not smoke, drink alcohol or take street 

drugs. 

MONTH 3 


• Fingers and toes have soft nails. 

• The mouth has 20 buds that will become baby 

teeth. 

• Fine hairs begin to form on the baby’s skin. 

• You can hear your baby’s heartbeat for the first 

time (10 to 12 weeks) using a special 

instrument called a doptone. 

• For the rest of pregnancy, all body organs will 

mature and the baby will gain weight. 

• By end of this month, the baby is about 2 1/2 to 

3 inches long and weighs about 1 ounce. 


• You may still feel tired and have morning 

sickness. 

• You may have headaches and get lightheaded 

or dizzy. If these symptoms persist or are 

severe, tell your healthcare provider. 

• Your clothes may begin to feel tight around 

your waist and breasts. Try pullover tops and 

skirts or pants with elastic waists. 

6 & 7 weeks pregnant 

4 


MONTH 4 


• The baby moves, kicks and swallows. 

• The skin is pink and transparent. 

• The umbilical cord continues to carry 

nourishment from mother to baby—but it also 

can pass along hazards like alcohol, nicotine 

and other drugs. 

• By the end of the fourth month, your baby is 6 

to 7 inches long and weighs about 4 to 5 

ounces. 

12 weeks pregnant 



checkup. 

• You have a slightly increased need for almost 

all vitamins and minerals to nourish your baby. 

A healthy diet helps to meet these needs. 

• You may have gained 2 to 4 pounds by now. A 

woman who starts pregnancy at a normal 

weight should gain 25 to 35 pounds during 

pregnancy. Ask your healthcare provider how 

much weight you should gain. 

• Exercise can be beneficial. Walking is a good 

choice. Check with your healthcare provider 

before starting an exercise program. 

• If your healthcare provider recommends 

prenatal testing using chorionic villus 

sampling (CVS), you can have the test now. 


drugs. 


• Your appetite increases as morning sickness 

goes away. You should begin to feel more 

energetic. 

• Toward the end of the fourth month (16 to 20 

weeks), you might feel your baby move for the 

first time; tell your healthcare provider. 

• Your belly begins to show—you probably will 

need maternity clothes and bigger bras now. 



care checkup. 

• Pregnant women need extra iron—more than 

even a good diet can supply. Your doctor may 

recommend iron supplements. 

• You’ll probably gain about a pound a week, or 

12 to 14 pounds, during the second trimester 

(months 4 to 6). 


drugs. 

• If your healthcare provider recommends 

prenatal testing using amniocentesis or a 

blood test called a triple screen for Down 

syndrome and neural tube defects, you can 

have them at 15 to 18 weeks. 

5 


MONTH 5 


• The baby becomes more active, turning from 

side to side and sometimes head over heels. 

• Finger and toe prints can be seen. 

• The baby sleeps and wakes at regular 

intervals. 

• This is a month of rapid growth. At the end of 

the fifth month, your baby is about 10 inches 

long and weighs 1/2 to 1 pound. 


• If you haven't already, you will begin to feel 

your baby moving. Tell your healthcare 

provider. 

• Your uterus has grown to the height of your 

belly button. 

• Your heart beats faster. 

• You may need eight or more hours of sleep 

each night. During the day, take rest breaks if 

tired. Don't push yourself. 



care checkup. 

• Your baby's growth and weight gain can be 

affected if you're smoking, drinking or taking 

drugs. It's never too late to quit. 

• Eat a healthy, nutritious diet and drink lots of 

juice, water and milk every day. 


drugs. 

MONTH 6 


• The skin is red and wrinkled and covered with 

fine, soft hair. 

• Eyelids begin to part and the eyes open. 

• The baby continues to grow rapidly. At end of 

the sixth month, the baby is about 12 inches 

long and weighs 1-1/2 to 2 pounds. 


• You may feel the baby kicking strongly now. 

• The skin on your growing belly may start to 

itch. 

• Your back may hurt. Wear low-heeled shoes or 

flats. Don’t stand for long periods of time. 

Exercise can help. You may feel pain down the 

sides of your belly as your uterus stretches the 

ligaments that support it. 



care checkup. 

• You may be constipated. Drink more water or 

fruit juice, eat more foods with fiber (like 

fruits and vegetables) and get some exercise 

(with your healthcare provider's approval). 

• To help with heartburn, try eating four or five 

smaller meals during the day. 

• Do not take laxatives or antacids without 

asking your healthcare provider. 


drugs. 


6 


MONTH 7 


• The baby can open and close her eyes and 

suck her thumb. 

• The baby exercises by kicking and stretching. 

• The baby responds to light and sound. 

• The baby is now about 15 to 16 inches long 

and weighs about 2-1/2 to 3 pounds. 


• If your ankles and feet swell from standing, lie 

down with your feet raised. If your hands 

and face swell suddenly, call your healthcare 

provider. 

• Stretch marks may appear on the abdomen 

and breasts as they get bigger. 

• You may have contractions. This is normal, but 

call your healthcare provider if you have more 

than five contractions in one hour. 

• As your belly gets bigger, you may lose your 

sense of balance. This makes it easier to fall. 

Be careful! 


• After the 28th week, visit your healthcare 

provider every two weeks for prenatal care. 

• Eat a variety of foods that are good for you. 

You should gain 1 pound a week this month. 

• Get plenty of rest—your body is working hard. 


drugs. 

• Start childbirth education classes if you 

haven't already done so. 

• Most healthcare providers do a blood test for 

gestational diabetes (diabetes during 

pregnancy) at 24 to 28 weeks. 


7 


MONTH 8 


• Rapid brain growth continues. 

• The baby is too big to move around much, but 

he can kick strongly and roll around. 

• You may notice the shape of an elbow or heel 

against your abdomen. 

• Bones of the head are soft and flexible to 

make it easier for the baby to fit through the 

birth canal. 

• Fingernails have grown to tips of fingers. 

• Lungs may still be immature. 

• Your baby is now about 18 to 19 inches long 

and weighs about 4 to 5 pounds. 

• Call your healthcare provider right away if 

you have: 

- Bleeding or a gush of fluid from your vagina 

- Cramps, stomach pains or a dull backache 

- Blurry vision, or spots before your eyes 

- A feeling that the baby is pushing down 

- A noticeable decrease in the baby’s 

movements 

- More than five contractions in one hour 


• You may feel stronger contractions this month. 

• You may have some leakage of colostrum 

(the fluid that will feed your baby until your 

milk comes in) from your breasts. 

• You may have trouble sleeping because it is 

hard to get comfortable. Try putting several 

pillows under your head. 

• You may have shortness of breath as the baby 

crowds your lungs. 

• The baby may crowd your stomach. Try eating 

five or six smaller meals during the day. 

• The top of your uterus lies just under your rib 

cage. 


• Visit your healthcare provider every two weeks 

for prenatal care checkups. 

• You should gain 1 pound a week this month. 


drugs. 


8 


MONTH 9 


• At 37 to 40 weeks, your baby is full term. 

• The baby’s lungs are mature and ready to 

function on their own. 

• The baby gains about 1/2 pound a week. 

• The baby usually drops into a head-down 

position and rests lower in your abdomen. 

• By the end of the ninth month, the baby is 19 

to 21 inches long and weighs 6 to 9 pounds. 


• Your belly button may stick out. 

• Your breathing should be easier once the baby 

drops, but you’ll have to urinate more often 

because the baby is pressing on your bladder. 

• Swelling of ankles and feet may increase. 

• Your cervix will open up (dilate) and thin out 

(efface) as it prepares for birth. 

• You may be uncomfortable because of the 

pressure and weight of the baby. Rest often. 


• After the 36th week, visit your healthcare 

provider once a week for prenatal care 

checkups. 

• You may not gain any weight at all this month; 

you may even lose 1 or 2 pounds. 


drugs. 

• Decide if you are going to breastfeed or 

formula-feed your baby. 

• Time your contractions. You are in labor if your 

contractions: 

- Are regular or evenly spaced apart (every 

seven minutes, for example) 

- Happen more than five times an hour 

- Last for 30 to 70 seconds 

- Get worse as you move around 

- Call your healthcare provider if you think you 

are in labor. 

*Information and photos provided by the March of Dimes 

and Childbirth Connection 


9 


10 


Early Pregnancy 

Prenatal Tests 

As part of your healthcare, your physician, nurse practitioner or midwife will order a number of tests. 

Some tests are routine for all expectant mothers; others are ordered in selected cases. Your 

physician, nurse practitioner or midwife can provide you with more information regarding these 

tests or the results of your tests. 

Common Tests for Your First Visit 

• Blood Tests: 

- Blood Type (A, B, O), and antibody screen Rh; to identify possible problems between 

mother and baby with different blood sugar types or antibody screens. 

- Iron Level: screen for low iron in blood. 

- Rubella Immunity (German Measles): prevent birth defects from rubella exposure. 

- HIV: If you are HIV positive, medication can be given to decrease the chance of the virus 

being passed to the baby. 

- Hepatitis B and Hepatitis C testing 

- Sickle Cell Trait 

• Sexually Transmitted Diseases (chlamydia, syphilis, gonorrhea, trich or bacterial vaginosis) — 

If you have a sexually transmitted disease, medication can be given to decrease the chance of the 

diseases being passed to the baby. 

• Urine Tests (tested throughout pregnancy): detects protein in the urine to screen for 

preeclampsia. 

• Culture and Sensitivity (C&S): to check for bacteria in the urinary tract. 

• Pelvic Exam: to measure the pelvic size and detect infections or certain problems. 

• Cervical Tests: 

- Pap Smear: checks for signs of cervical cancer. 

- Culture: screens for sexually transmitted disease. 

• Blood Pressure: a baseline will be obtained to watch for changes as the pregnancy progresses. 

• Body Mass Index (BMI): A standard for determining obesity using your weight and height. 

A BMI between 19 and 29 is ideal. If your BMI is less than 19, you may meet with a dietitian for 

teaching and meal planning. If your BMI is over 30, you may meet with a dietitian and have 

additional testing for diabetes and the well-being of your baby. 

11 


Tests for Later in the Pregnancy 

• Ultrasound: Some physicians routinely order ultrasound; others use it as needed. Ultrasound can 

be done to determine: 

- Due date: This test can be performed as early as the 5th week 

- Baby’s size 

- Number of babies in the uterus 

- Certain birth defects 

- Fetal well-being 

• Blood Glucose Tests: to determine the amount of sugar in the blood. A routine test is done 

between 24 and 28 weeks. Screens for gestational (pregnancy) diabetes. If positive, dietary 

changes can be started to reduce the complications of diabetes. 

• Alpha Feto Protein: screens for spina bifida or other problems with the baby’s brain or spine. 

Results are sometimes inconclusive. 

• Quad Marker Screen: measures alpha feto protein (above) and two other hormones (estriol and 

HCG) at 15-20 weeks. Screens for the possibility of genetic disorders, such as spina bifida or 

Down’s syndrome. 

• Amniocentesis*: tests for genetic disorders. This is often done between the 15th and 18th 

week but can be done earlier. Amniotic fluid around the baby is withdrawn by a needle. This can 

also be used to determine if baby’s lungs are mature in the third trimester. 

• Beta Strep Test: a culture of the vagina done to detect beta strep bacteria. Many providers test 

for beta strep in the last month of pregnancy and give antibiotics if the test is positive. All 

mothers with a positive test will receive antibiotics through an IV line during labor. 

*Other tests for fetal well-being that may be done in the last trimester are described later in this 

section (“Later Pregnancy”). 

Warning Signs 

The following warning signs may indicate that there is a problem. Contact your healthcare provider 

immediately if you experience any of these: 

• Vaginal bleeding 

• Fluid leaking from the vagina 

• Severe headache or problems with your vision 

• Decrease in baby’s movements once they have been felt 

• No fetal movement felt by 22 weeks 

• Vaginal itching or burning 

• Weight gain of more than one pound per day 

Also look under “Premature Labor” later in this chapter. 

12 


Exercise and Pregnancy 

Exercise helps the muscles, joints, heart and lungs meet the changes of pregnancy. In addition, 

keeping physically fit helps the mother feel good about herself and her pregnancy. Exercise is great 

for you and the baby. It increases your strength and energy, feels good physically, relieves stress 

and decreases joint pain. 

There are a few important guidelines to follow when beginning an exercise program while 

pregnant. 

• Talk with your healthcare provider before beginning any new exercise program. There are a few 

high-risk situations in which your healthcare provider may advise against exercise. 

• Exercise at least three times a week or every other day. 

• Warm up for at least five minutes before exercising. 

• Drink plenty of liquids before, during and after exercise. A simple rule to follow is to drink a glass 

of water for every half-hour of strenuous activity and drink more during warmer weather. 

• Eat a light snack about an hour before you exercise. 

• Dress appropriately: loose, stretchy clothes, supportive shoes and a supportive bra. 

• Your heartbeat should not exceed 140 beats/minute. 

• Never exercise until the point of exhaustion, always keep your workout at a mild to moderate pace. 

• Avoid jerky, bouncy movements and be sure to exercise on a wooden floor or tightly carpeted 

surface to reduce shock and provide better footing. 

• Listen to your body. Stop exercising if you have pain, cramps, dizziness, racing heartbeat, 

breathlessness, difficulty walking, headache or increased swelling. 

Massage During Pregnancy 

Massage during pregnancy helps to relieve symptoms of many of the uncomfortable conditions 

caused by pregnancy. The overall goals for pregnancy massage are to help minimize stress, promote 

relaxation, and prepare the muscles for childbirth. In addition, there are specific techniques and 

movements which are designed to help relieve particular conditions, including: low back pain, 

swelling of hands and feet, headaches, calf cramps, insomnia, sciatic pain and sinus congestion. 

Massage can also help to restore your muscles after delivery. 

In most instances, pregnancy massage can be received safely. At times, there are reasons not to 

receive massage or precautions that your massage therapists should take. Talk with your 

healthcare provider before getting a pregnancy massage. Do not get a massage if you have the 

following: heavy vaginal discharge, pre-eclampsia, diabetes, high blood pressure, contagious 

illness, morning sickness, fever, abdominal pain, vomiting and/or diarrhea, any malignant condition 

or unusual pain. 

13 


Working and Pregnancy 

Evaluate any hazards you may be exposed to at your job, including X-rays, lead, lifting heavy objects 

or exposure to chemicals. 

Tips for working during pregnancy: 

• Alternate sitting and standing every half-hour. Either sitting or standing for long periods of time 

will cause soreness and increased swelling in your legs. 

• When sitting, make sure your chair is the correct height for your legs, so that your feet rest 

on the floor. 

• When standing for a while, stand with one foot on a ledge or a small box so one foot is higher than 

the other and alternate your feet. 

• Stretching occasionally helps to relieve stiffness in muscles and joints. 

• Most jobs are safe to continue until the birth of your baby. Some mothers may be advised by 

their healthcare provider to discontinue work if they develop high blood pressure, risk of premature 

labor or other complications. 

Sex and Pregnancy 

Sexual intimacy is important to your relationship throughout the pregnancy. Pregnancy is a good time 

to find new ways of giving pleasure to each other. Many couples enjoy cuddling, fondling and trying 

new positions as the abdomen enlarges. Sexual intercourse is safe throughout pregnancy UNLESS you 

experience any of the following: 

• Bleeding from the vagina 

• Clear fluid from the vagina (indicates the bag of water has broken) 

• High risk for premature labor (more than four contractions in one hour before 37 weeks) 

• Placenta previa or low-lying placenta (afterbirth partially or completely covers the opening 

of the cervix) 

• Your physician or midwife advises against sexual intercourse 

14 


Nutrition and Pregnancy 

Eating for a Healthy Baby 

Good nutrition during pregnancy and breastfeeding is important for the growth and development 

of your baby as well as for your own health. By making wise choices about what you eat during 

pregnancy, you can improve your chance of having a healthy baby and healthy pregnancy. 

What Counts As One Serving 

Grains & Cereals Vegetable Fruit Dairy Protein Fluid 

6-11 servings 3-5 servings 2-4 servings 4-6 servings 2-3 servings 8-10 cups 

Make at least half Include dark green, Make most Choose low fat Choose lean meat 

your choices whole orange and starchy choices fresh, or fat free most and poultry. 

grain. vegetables. frozen or canned often. Include nuts, fish 

without sugar. 

and beans. 

1 slice bread 1 cup raw, l medium l cup milk or 2-3 ounces l cup water, 

leafy vegetables piece of fruit yogurt cooked lean mineral water, 

meat, poultry diluted juice, 

¾ cup cereal or fish lemonade 

½ cup cooked ½ cup other ½ cup canned 1 ½ ounces 1 cup cooked, 

cereal vegetables cooked fruit cheese dry beans 

or chopped raw 

½ cup cooked 1 cup chopped 1 ½ cup soup 

rice or pasta raw fruit made with milk 

6 crackers ½ baked potato ¼ cup dried fruit 2 eggs 

1 tortilla 2 Tbsp. peanut butter 

or 1/3 cup nuts = 1 oz. meat 

15 


Weight Gain 

The amount of weight you should gain during your pregnancy to have a healthy baby depends 

on your pre-pregnancy weight. If you are at a normal weight before pregnancy you should gain 

25-35 pounds; underweight before pregnancy should gain 28-40 pounds; and overweight 

before pregnancy should gain 15-25 pounds. Most of the weight should be gained in the second 

and third trimesters. Eating about 300 calories more than your usual intake in the last trimesters 

should allow gradual weight gain. 

If you are gaining too much weight, here are some ways to cut back on calories without 

decreasing your intake of vitamins and minerals: 

• Do not skip meals. 

• Use low-fat dairy products like skim or low-fat yogurt and cottage cheese. 

• Substitute water for sodas or other sweetened drinks and juices. 

• Trim fat from meat before cooking. Drain off fat after cooking. 

• Bake, broil, roast and stew meats and other foods. Limit frying. 

• Limit chips, cookies, cake, pastry and candy. 

• Decrease the amount of butter, margarine, oil, cream cheese, sour cream, salad dressing and 

cream sauce. 

• When eating out at a fast food restaurant, choose salads, small sandwiches, baked potatoes and 

low-fat milk. 

If you are not gaining enough weight, here are some strategies to increase your calories 

and nutritional intake: 

• Eat small, more frequent meals throughout the day. 

• Decrease liquids taken with meals, which make you feel full 

more rapidly. 

• Add margarine or butter to vegetables and potatoes. 

• Use whole milk, ice cream and cheese. 

• Drink high-calorie drinks during the day like milkshakes, 

Carnation Instant Breakfast, hot chocolate or chocolate milk. 

• Use margarine, butter, mayonnaise, sour cream, cream cheese, 

oil, salad dressing, gravy, cream sauce and cream soup. 

16 


Protecting Your Baby 

Prenatal Supplements 

Your diet may not meet the increased vitamin and mineral needs of pregnancy, especially if you are 

not eating a variety of foods from the food guide pyramid. A prenatal vitamin supplement including 

folic acid is usually recommended. Folic acid before and during pregnancy helps reduce the risk of 

neural tube defects (brain and spine). Iron supplements are sometimes needed to prevent anemia. 

Remember, supplements do not replace eating a healthy diet. 

Alcohol 

Just like smoking or street drugs, alcohol can cause serious birth defects in your child if you drink 

while you are pregnant. Fetal Alcohol Spectrum Disorder (FASD) is a permanent condition that 

results in brain damage and physical abnormalities. Alcohol is NOT safe during pregnancy. 

Artificial Sweeteners 

During pregnancy, the best sweeteners are natural and nutritious fruits and fruit juices. Saccarine 

(Sweet’n’Low) is not recommended during pregnancy, and aspartame (Equal, Nutrasweet) and 

sucralose (Splenda) should only be consumed in limited amounts. 

Caffeine 

Beverages such as coffee, tea, chocolate and cola contain caffeine, which passes into the placenta 

and enters your baby’s circulation. A cup or two a day of caffeinated beverages shouldn’t be a 

problem, but if you can, cutting out caffeine makes for a healthier diet. 

Cats and Kitty Litter 

Cats may carry a harmful infection called toxoplasmosis that may harm your baby. Wash your 

hands after handling cats and have someone else change the kitty litter. 

Dieting 

In short, don’t diet. You should never try to lose weight once you are pregnant, no matter what your 

weight was before you became pregnant. 

Hair Color and Other Chemical Treatments 

Avoid use of chemicals on your body, especially in the first trimester of pregnancy. If you color, 

straighten, or perm your hair, discuss your concerns with your healthcare provider and hair stylist. 

Hot Tubs/Saunas/Tanning Beds 

Raising the mother’s body temperature even a small amount increases the risk of damage to the 

baby’s nervous system. Don’t use hot tubs, saunas or tanning beds until your care provider tells 

you it is safe. 

Lead 

Lead can be found in water in lead pipes and old paint in older homes. Lead poisoning can cause 

brain damage and learning problems. 

Medications 

Do not take any over-the-counter or prescription medications while you are pregnant without 

talking to your healthcare provider. Your doctor can provide you with a list of safe, over-the-counter 

medications. 

RhoGam 

When a mother’s blood is Rh negative, a medicine needs to be given to prevent blood problems 

with your baby both in this pregnancy and any future pregnancies. 

17 


Smoking 

Smoking during pregnancy is hazardous to the health of your baby. It can cause many birth 

defects, low birth weight infants, increased miscarriage, stillbirth and sudden infant death 

syndrome. Give your baby the best possible start and quit! For more information on smoking 

cessation, visit www.pinnaclehealth.org or call the PA Quitline at 1-877-724-1090. 

Street Drugs 

Street drugs can cause serious birth defects, premature birth or sick infants. Street drugs can also 

cause the baby to be stillborn (born dead), or to die after birth. 

Unprotected Sex 

Unprotected sex can lead to sexually transmitted diseases that can be passed to the baby. Latex 

condoms help prevent transmission of STDs. 

Vaccines 

A vaccine to prevent influenza (flu) can be taken during pregnancy. Vaccines to prevent measles, 

mumps, rubella, hepatitis, chickenpox and pertusses (TDAP), can be taken either before or after 

pregnancy. 

Viral Infections 

Exposure to some viral infections can harm your baby. Some infections can be prevented by 

vaccination. Please call your healthcare provider if you have symptoms or exposure to any of the 

following infections: Rubella, chickenpox, Hepatitis A, B or C, CMV, Herpes and/or HIV. 

Common Discomforts 

In addition to the joys of pregnancy, many women experience common complaints. Below are some 

common discomforts and ways that may help you feel better. 

Backache 

Lower back muscle strain is brought on by changes in how you sit and stand. Exercising, wearing 

supportive shoes with low heels and supportive panty hose, maintaining good posture, applying 

moist heat, and receiving back rubs may help you to feel better. 

Bleeding Gums 

An increase in your body’s hormones may cause tenderness and bleeding of your gums. Eat foods 

high in vitamin C, use an antiseptic mouthwash, and be sure to brush and floss your teeth every 

day to help maintain good dental health. Visit your dentist regularly. 

Breast Changes 

As your breasts get bigger, they may be tender and sensitive. To help ease overall discomfort, wear 

a supportive cotton bra or a maternity/nursing bra. As your pregnancy progresses, you may begin 

to leak colostrum or pre-milk. If this becomes a problem, tuck a handkerchief or gauze pad into 

each bra cup. 

Constipation 

To avoid or relieve constipation, increase the fiber in your diet by eating more fresh fruits, 

vegetables, beans, whole grains, high fiber cereal and drink plenty of water or juice. Also increase 

your physical activity. 

18 


Fainting or Dizziness 

Lowered blood pressure may cause you to feel faint when standing for extended periods of time or 

lying on your back. Sleeping on your side, when possible, eating frequent small meals, avoiding 

sweets, and moving around while standing should help. 

Hand Pain and Numbness 

Increased fluid and pressure on the carpal tunnel nerve in the wrist may cause numbness, tingling, 

burning and/or pain in the hand, wrist and arm. The discomfort may increase at night. Wearing a 

wrist splint, vigorously shaking your hands at the onset of pain and avoiding sleeping on your 

hands may help you feel better. 

Headaches 

Increased stress and hormone changes can cause frequent headaches. Reducing stress or relaxing 

in a dark or pleasant room may help decrease the intensity and frequency of headaches. If you 

experience severe headaches or problems with your vision, contact your healthcare provider 

immediately. 

Hemorrhoids 

To ease hemorrhoid discomfort, take a 15-20 minute bath three or four times a day or apply a cotton 

ball soaked with cold witch hazel, a Tucks pad or ice directly to the hemorrhoid. 

Indigestion or Heartburn 

Because of the hormonal and physical changes in pregnancy, food sometimes moves more slowly 

through your system, which causes bloating and indigestion. To help lessen your discomfort and 

heartburn, follow the tips for nausea (below) and also: 

• Remain upright for 30 minutes after eating and don’t exercise for 45 minutes after a meal. 

• Stop eating 2-3 hours before going to bed to give your stomach time to settle. 

• Cut back on coffee, tea, soda and other high acidic foods and beverages. 

Leaking Urine 

As your abdomen enlarges, pressure is continually placed on your bladder and can lead to urine 

leakage. Practice kegel exercise several times per day to prevent leakage. 

Leg Cramps 

You may get leg cramps that come and go for no apparent reason. Increasing calcium intake and 

exercising may help prevent leg cramps. To ease the pain, push away from your body with your heel 

while pointing your toes toward your head, gently massage the cramped area, and take a warm bath. 

Nausea and Vomiting 

These unpleasant problems occur most often during the early months of pregnancy. There are many 

causes of nausea, including hormonal changes. If vomiting and nausea continue for a longer period 

of time, you may have weight loss and loss of appetite. To help you cope with this common problem, 

you might try to: 

• Eat crackers before you get out of bed, and get out of bed slowly. 

• Eat several small meals instead of a few large meals. 

• Only eat when you are truly hungry, and take your time with each bite. 

• Avoid spicy or greasy foods. 

• Try to drink fluids in between meals instead of during meals. 

• Take your prenatal vitamins with meals. 

• Get fresh air. 

• Stop smoking. 

19 


Shortness of Breath 

Your growing uterus takes up part of your breathing space causing shortness of breath. To temporarily 

relieve symptoms, raise your arms over your head and stretch. 

Swollen Legs, Hands and Feet 

Many women retain fluid while pregnant, which causes swelling. You can help decrease swelling by 

eating plenty of protein, drinking eight glasses of water a day and eating low sodium foods. 

Vaginal Discharge 

Pregnancy hormones cause the vagina to increase its normal secretions. Yeast infections are also 

more common among pregnant women. To help ease discomfort, wear skirts and dresses rather than 

pants, avoid wearing panty hose when possible, and wear cotton undergarments and/or a minipad. 

Call your doctor if you think you have a yeast infection or other infection. Do not take over-the-counter 

medications before talking with your doctor. 

Varicose Veins 

Varicose veins may ache or hurt in your thigh, calf, pelvic area or groin. Help improve your 

circulation by putting on support stockings before getting out of bed in the morning, avoiding 

crossing your legs, and keeping your legs elevated when seated. 

Conditions of special concern 

Anemia 

Anemia results from having low iron and folic acid levels in your body. Most pregnant women have 

a difficult time getting the iron and folic acid they need. Prenatal vitamins help, but make sure 

your diet is high in iron and rich in folic acid and vitamin C. Orange juice is an excellent source of 

both folic acid and vitamin C. Vitamin C, taken with vitamins, increases iron absorption. 

Group B Streptococcus (GBS) and Pregnancy 

During pregnancy, your healthcare provider will take a vaginal culture to test for group B 

streptococcus. GBS is a bacteria that usually does not cause problems for women, but may cause 

problems for your baby. Babies can be infected with GBS during labor or delivery. 

While your baby is in the hospital, the nurses and doctors will monitor your baby for signs of GBS 

infection. Early signs occur within six hours of birth and may include problems breathing, problems 

with temperature, low heart rate, seizures, vomiting, diarrhea, or abdominal swelling. However, a 

baby may be infected with GBS and not show any signs for days or even weeks after birth. This is 

called late-onset GBS infection and has many of the same signs as infections that occur earlier. 

Both early and late-onset GBS infections are very serious and need to be treated as soon as possible. 

Not all babies born to mothers with GBS become infected with the bacteria. A mother with GBS 

can be treated with antibiotics during labor to decrease the risk of infection to the baby. After 

being admitted to Newborn Nursery, the baby will be observed for signs of infection. The baby’s 

blood may also be tested. Babies whose mothers did not receive the recommended antibiotics 

prior to delivery may need to stay in the hospital for at least 48 hours after birth so that they can be 

observed for signs of infection and other problems and for treatment if necessary. 

GBS is common in pregnant women. Not all babies of women with GBS will have problems 

related to the infection. It is important to call your baby’s healthcare provider with any concerns 

after leaving the hospital. 

20 


Preeclampsia 

Preeclampsia is a group of changes that can occur after the 20th week of your pregnancy. The most 

common change is high blood pressure. Not all women have the same symptoms, and many 

symptoms are mild. That is why seeing your healthcare provider for blood pressure and urine checks, 

is so important. Warning signs of preeclampsia include: 

• Sudden weight gain of more than one pound a day 

• Changes in your vision (blurred vision or spots before your eyes) 

• Headaches that won’t go away 

• Pain under the upper right part of your rib cage 

Call your healthcare provider immediately if you have any of these discomforts. 

Gestational Diabetes 

Gestational diabetes mellitus (GDM) is a temporary condition that results in high blood sugar levels. 

Screening for GDM occurs between 24 and 28 weeks of pregnancy. If you are at high risk for GDM, you 

may be screened early in your pregnancy and rescreened if early testing was normal. Risk factors for 

GDM are: 

• Previous history of GDM 

• Glucose in urine 

• Strong family history of diabetes 

• Obesity 

• Previous history of large babies 

• Previous pregnancy loss 

• Ethnic background (Hispanic, African, Native American, South or East Asian or 

Pacific Island ancestry) 

If you are diagnosed with GDM, your healthcare provider will recommend a special diet, blood testing 

and exercise and lifestyle changes to keep your blood sugar levels in normal ranges. Insulin may 

also be required. A diabetes educator and dietician are available to help you learn how to manage your 

gestational diabetes and have a healthy pregnancy. 

Ultrasounds and non-stress tests may be done to check the health of your baby. Women with GDM may 

have large babies and/or babies with low blood sugar after birth. If you have GDM, your baby will have 

blood sugar testing after she/he is born. 

Women with gestational diabetes have a higher risk of developing diabetes later in life and should 

receive follow-up care by their primary care provider within the first year after delivery. 

21 


Premature Labor 

Preterm or premature labor is labor that begins after 20 weeks and before 37 weeks. About 

10 percent of infants are born more than three weeks before the due date. The uterine contractions 

may feel like menstrual-type cramps, dull backache or pelvic pressure. Drinking fluids and lying 

on your side may make the contractions go away. If there are more than four contractions in one 

hour, immediately call your physician or midwife. It is important to know the difference between 

preterm labor and the normal growing pains of pregnancy. 

Normal Discomforts of Pregnancy 

• Contractions occurring three or fewer per hour. 

• Backache as the baby grows. 

• Pressure as the baby presses on your pubic bone and legs. 

• Pulling and stretching of muscles causing localized pain. 

Signs of Preterm/Premature Labor and Warning Signs 

Signs of preterm labor may be easily apparent or very subtle. Call your caregiver if you have 

any of the following symptoms: 

• Regular contractions or uterine tightening, more than four per hour. These contractions may 

be painless or feel like the baby is “balling up.” 

• Rhythmic, lower abdominal cramps - with or without diarrhea, nausea or indigestion. 

• Lower back pain or pressure. 

• Achiness or pressure in the pelvis, thighs, groin or lower abdomen. 

• Increase or change in vaginal discharge (watery, pinkish or brownish) sometimes preceded 

by the passage of a mucus plug. 

• Bleeding (more than one inch of spotting on your undergarments). 

If you think you are having preterm labor, call your healthcare provider right away. Treatment can 

often stop or postpone premature labor and increase the baby’s chance of survival. Limiting physical 

and sexual activity, bed rest, and sometimes hospitalization may be needed to stop preterm labor. 

Emergency signs for contacting your healthcare provider 

Other problems can also occur later in pregnancy. Call your healthcare provider if any of the 

following occur. 

• Trickle or flow of amniotic fluid from the vagina. 

• Bleeding—more than one inch of spotting on your undergarments. 

• Green or tarry color (meconium) when your water breaks. 

• Decreased fetal movements. 

22 


Later Pregnancy 

Now that you are in your second trimester, you should continue to see your care provider, exercise 

and eat right for a healthy pregnancy and begin planning your baby’s birth. 

Things to Arrange 

• Tour 

Consider touring Harrisburg Campus Maternity Center before delivering your baby. Tours are 

included in childbirth classes if your class meets at the Brady Building next to Harrisburg 

Hospital or the Fredricksen Outpatient Center in Mechanicsburg. Call the Learning Institute 

at 221-6255 for other community tour information. 

• Baby’s Healthcare Provider 

You must choose a healthcare provider for your baby before you deliver. Make sure the caregiver 

you choose accepts your insurance. To find a pediatrician in your area go to 

www.pinnaclehealth.org and click on Find a Doctor. 

Circumcision 

Circumcision is a choice. Only you can decide whether it is right for your baby boy. Circumcision 

is a surgical procedure that cuts away the foreskin, which is the skin covering the glans (head of the 

penis). Remember, as with any surgical procedure, you will need to sign a consent form and there 

are possible complications. Talk with your obstetrician for more information about circumcision. 

Check with your insurance provider to be sure the cost of circumcision is covered by your policy. 

Breastfeeding or Bottlefeeding 

Deciding whether to feed your baby by breast or bottle is one of the most important decisions you 

will make concerning the care of your baby. The best decision is one that you feel most comfortable 

with. Read books that offer objective information. Friends and family may offer advice that 

reflects good or bad experiences with newborn feeding. Keep this in mind when making your own 

personal decision. 

Attend a breastfeeding class that offers accurate, up-to-date information. PinnacleHealth Learning 

Institute has a lactation center staffed by registered nurses who are board-certified lactation 

consultants. The lactation consultants teach breastfeeding classes, offer guidance to moms 

experiencing difficulty with breastfeeding, and provide assistance to moms returning to work who 

wish to continue breastfeeding. See the section “All the Help You Need” for more information about 

the Learning Institute. 

Benefits of breastfeeding include: 

For baby: 

• Breast milk is easier for baby to digest 

• Protection against gastrointestinal infections 

• Protection against ear infections 

• Reduced incidence of childhood lymphoma 

• Reduced incidence of childhood onset diabetes 

• Reduced incidence of Crohn’s Disease 

• Reduced incidence of allergies 

For mother: 

• Reduces blood loss after birth and helps the uterus return to its normal size 

• Produces hormones that help keep mother calm 

• Decreases risk of osteoporosis 

• Protects against ovarian and breast cancer 

Y O U R B A B Y ’ S B I R T H 

23

Planning Your Baby’s Healthcare 

Your prenatal care has helped to provide the best possible start for your baby. Now is the time to 

make preparations to continue that care after your baby is born. One of the first steps is to choose a 

healthcare provider for your newborn. (Note: the physician who delivers your baby does not provide 

newborn care.) This decision must be made prior to your baby’s birth. 

Types of providers: 

• Pediatrician - a doctor specializing in the care of children 

• Family Practice Physician- a doctor who can care for the entire family. If the baby develops a 

serious illness, he would probably refer you to a pediatrician or other specialist 

• Pediatric Nurse Practitioner 

Find a provider: 

Check with your insurance company to get a list of participating providers. Some people like to talk 

to friends, family and their own healthcare provider to get recommendations. Once you have 

identified a potential provider, call their office to ask: 

• Is the practice accepting new patients 

• Does the practice accept your insurance coverage 

• Does the healthcare provider see patients at PinnacleHealth If not, does the provider refer to a 

practice that takes care of newborns at the hospital 

• Request an appointment before your baby is born, if possible, to allow you to meet the provider 

and the office staff. 

Make a list of questions that you would like to have answered at your visit, or by phone. Here are 

some suggestions: 

• What are your office hours 

• What type of on-call and after-hours coverage do you have 

• Do you offer phone support for questions that may not require an appointment When is that 

available 

• Who takes the calls and answers the questions Does the provider return phone calls if requested 

• What is your recommended well-baby visit schedule and immunization schedule 

• Do you support breastfeeding 

If you plan to breastfeed your baby, here are some questions you may wish to ask the provider. 

Hearing their responses will help you determine whether or not they support your thoughts and 

feelings about breastfeeding. Be aware of enthusiastic responses versus a sense of indifference. 

This can tell you a lot. 

• When do you have breastfed babies come to the office for their first weight check 

(The American Academy of Pediatrics recommends two days.) 

• Do you recommend routine formula supplementation for breastfed babies 

• If someone is having difficulty breastfeeding, what support is available within the practice 

or by referral 

• To what age do most of your patients breastfeed their babies 

24 


If the provider you have selected does not see patients at PinnacleHealth, you should ask that the 

baby’s physical exam report be sent to your provider’s office or that a copy be given to you before 

you are discharged. 

Be sure to have the name, address and phone number of the provider you have chosen for your 

baby available at the time of your hospital admission. Use the checklist at the front of this book to 

record this information. 

Childbirth and parenting classes 

If you are interested in registering for a class, or want more information, call 221-6255. 

Adoptive Parent 

A single evening class designed for couples or individuals who plan to adopt a child within the 

next year. Class discussion is individualized to the type of adoption that is being planned. Content 

focusing on adopting an infant includes baby care, necessary supplies, travel with baby, as 

well as the emotional and social aspects of adoption. Content focusing on adopting an older child 

includes facilitating attachment, finding local support services, as well as addressing unique 

concerns, such as maintaining sibling contact. 

Baby Care Basics 

In this two-week series, expectant parents learn how to care for a newborn. Discussion, 

demonstration and class participation are used to teach basic information about baby’s bath, cord 

care, diapering, safety and feeding. Other topics include normal newborn behaviors, symptoms of 

illness, how to stimulate learning, parenting and issues around returning to work. 

Birth Center Tour 

This tour provides an opportunity to visit the Labor and Delivery, Neonatal Intensive Care and 

Maternity Units. You may tour the facility at any phase of your pregnancy. Due to the areas being 

toured, we are not able to accommodate children on this tour. There is no fee for this tour. 

Becoming a Grandparent 

This single evening class focuses on the experience of the grandparent. Discussion includes 

supporting the new family, and recent changes in medical practices and infant care. 

Breastfeeding Basics 

This class for expectant parents focuses on the joys and common concerns of breastfeeding. 

Information includes the benefits for mothers and babies, initiating feedings, maintaining a milk 

supply and other practical considerations. Discussion includes combining breastfeeding and 

working, expression and storage of breast milk and use of breast pumps. Expectant fathers are 

encouraged to attend. 

Cesarean Birth 

A single class designed for expectant parents who are anticipating a cesarean birth. Focus is on 

the physical and emotional aspects of a cesarean birth experience. Class includes information 

about the reasons for cesarean birth, medications and anesthesia, and discussion regarding the 

role of the support person before, during and after the birth. 

Childbirth Refresher 

This class is a three-week series for expectant parents who have previously attended a childbirth 

education program. Class includes review of relaxation, breathing patterns and comfort measures 

for labor. This class does not include a Birth Center tour. 

25 


First Aid for Parents 

This one-day non-certification class for parents and other caregivers of infants and children 

includes basic first aid, emergencies common to babies and children, and Infant/Child CPR. 

Instructors are certified by the American Heart Association. “Family and Friends First Aid for 

Children” and “Family and Friends CPR” participation cards will be received in this class. 

Individualized Childbirth Classes 

This class is available to expectant parents who request individualized instruction. Course content 

includes phases of labor, comfort techniques medical interventions, and more. This class will 

enhance your understanding of labor and birth. A certified childbirth educator will address your 

specific needs and concerns. Two class sessions, two hours each. 

Infant/Child Cardiopulmonary Resuscitation (CPR) 

This one evening non-certification class focuses on Infant/Child CPR and obstructed airway 

techniques taught in a “watch and practice” format. Instructors are certified by the American Heart 

Association. A “Family and Friends CPR” participation card will be received in this class. 

Lamaze ® Childbirth Classes 

This six-week series provides information on the phases of labor, common medical options and 

comfort techniques, including support, positioning, breathing and relaxation. Brief overviews of 

postpartum and newborn are presented. These classes promote the Lamaze ® Philosophy of Birth 

and the Six Care Practices of the Lamaze ® Institute for Normal Birth. Additional time is spent 

practicing comfort measures, as these classes are a half-hour longer than Prepared Childbirth 

classes. They are taught by childbirth educators certified by Lamaze ® International. A tour of the 

Harrisburg Hospital Birth Center is included. 

Prepared Childbirth 

This six-week series focuses on preparation for childbirth, emphasizing the experience of labor and 

birth and the supportive role of the partner. A variety of comfort measures are taught and practiced 

in class, including relaxation and breathing techniques. Medical options are discussed, as well as 

a brief overview of postpartum and newborn. Taught by certified childbirth educators, these 

classes will enhance your understanding of labor and birth and provide valuable information to help 

you prepare for your birth experience. A tour of the Harrisburg Hospital Birth Center is included. 

Siblings: A New Baby at Our House — Babies and Big Kids 

This class, designed for children four to nine years of age, includes discussion and a children’s 

video about birth and becoming a big brother or sister. Children also have the opportunity to 

practice holding dolls and learn how newborn babies look and behave. Class includes a child’s tour 

of the Maternity Center and Newborn Nursery. 

Siblings: A New Baby at Our House — Babies and Toddlers 

This group is designed for two and three-year-olds who are about to become big brothers or sisters. 

Each child should bring a favorite doll or teddy bear for the play activities. There will also be a short 

tour, but no video will be shown. 

The Happiest Baby 

Join the growing number of parents using Dr. Harvey Karp’s method to calm their crying babies. In 

a single class you will learn Dr. Karp’s secrets for making babies happy. Practice the 5 S’s used to 

engage your baby’s “calming reflex.” These techniques are most beneficial for babies from birth to 

two months of age. Instructors teaching this class have completed The Happiest Baby Certification 

Program. Class fee includes “The Happiest Baby on the Block” DVD and “Soothing Sounds” CD. 

26 


Tiny-Touch Infant Massage 

Loving, nurturing touch between parent 

and infant has a positive effect on the 

child’s development. Bring your baby 

(six weeks to six months old) and learn 

the techniques and benefits of massaging 

your infant. This four-week series also 

offers time to meet with other new parents. 

Massage oil is provided in the class. 

Twins, Triplets or More 

This class, for parents expecting multiples, 

is recommended for the second trimester. 

The class is intended to supplement the 

regular childbirth class with information 

specific to your family’s unique needs. 

A tour of the Neonatal Intensive Care Unit 

(NICU) is included. 

Vaginal Birth After Cesarean (VBAC) 

Individualized or small class instruction 

for parents who previously had a cesarean 

and want a vaginal birth for this pregnancy. 

Guidelines for a vaginal birth and the 

additional needs of a VBAC mother are 

discussed. Parents are also encouraged to attend a refresher class to learn confort techniques 

and medical options. 

Weekend Childbirth Seminar 

This seminar condenses the material taught in the six-week Prepared Childbirth course. 

There is a one-hour lunch break on Saturday. This class does not include a Birth Center tour. 

Weekend Lamaze ® Seminar 

This seminar condenses the material taught in the six-week Lamaze ® Childbirth course. 

There is a one-hour lunch break on Saturday. This class does not include a Birth Center tour. 

27 


Tests for Your Baby’s Well-Being 

There are different tests your physician may order during the later part of pregnancy to determine the 

condition of the baby. Some of these will not be covered by insurance unless the physician indicates 

there is a condition requiring the test. 

Fetal Kick Count 

The fetal kick count is a no cost, no risk test that every mother can use. Starting in the 28th week, the 

mother chooses a time each day to begin the fetal kick count. It should be the same time every day. 

She counts the baby’s movements and determines how long it takes for the baby to move 10 times. If 

the baby is not moving, or is moving much less than usual, the mother should rest and direct her 

attention to the infant’s movements. If she notes less than five movements in 30 minutes, the 

physician or midwife should be called. Other tests can then be used to evaluate the baby’s condition. 

Non-Stress Test 

A non-stress test is a safe, painless way to check your baby’s well-being before it is born. An external 

monitor will be placed onto the mother’s abdomen using elastic straps. One part will record fetal heart 

rate. One part will record contractions, if you are having any. Your healthcare provider will look at the 

baby’s heart rate. Normally when a baby moves, his heart rate speeds up. That is a sign of good health. 

The test can take up to 60 minutes to complete. 

Biophysical Profile 

A biophysical profile is another safe test to check your baby’s health before it is born. It is an 

ultrasound study that looks at your baby’s movement, body tone, breathing and the amount of fluid 

around the baby. It is often done in addition to the non-stress test. 

Oxytocin Challenge Test 

This test measures how your baby’s heart rate responds to contractions. An external monitor will be 

placed onto the mother’s abdomen using elastic straps. One part will record fetal heart rate. One part 

will record contractions. A catheter will be placed into a vein (IV) and a medicine called Oxytocin 

(Pitocin) will be given through that catheter. The medicine will be run on a pump and will be increased 

slowly to create contractions. Your healthcare provider will look at your baby’s heart rate during and 

after contractions. A baby that can handle the stress of labor will not have any slowing of the heart rate 

associated with contractions. 

28 



29

30 


Choosing and Using a Car Seat 

Pennsylvania’s Child Passenger Safety Law requires that all children under age 4 must be 

properly restrained and transported in a federally approved car seat that is appropriate 

for the child’s age, height and weight. Children ages 4-8 must use a booster seat if they are 

no longer in a car seat. Children ages 8-18 must use a vehicle seatbelt. 

In addition to compliance with the law, the use of a car seat also has the following benefits: 

• Prevents your infant’s body from acting as a missile in the event of an accident. 

• Reduces the incidence of death or injury by spreading the impact along the strongest part of the 

infant’s body. 

• Reduces discipline problems of toddlers in the car, since they are used to sitting securely 

fastened in their seat. 

When installed and used properly, a safety seat can reduce a child’s chances of being killed or 

injured in a crash by 71%. 

In March/April 2011, The American Academy of Pediatrics (AAP) and the National Highway 

Traffic Safety Administration (NHTSA) revised their child restraint guidelines in order to 

keep pace with the latest scientific and medical research and the development of new child 

restraint technologies. They are now advising parents and caregivers to keep children in 

each restraint type, including rear-facing, forward-facing and booster seats, for as long as 

possible before moving them up to the next type of seat. 

Types of car seats 

Rear Facing Seats 

• Keeping your child rear-facing as long as possible is the best way to keep him or her safe. 

• In a policy published in the April 2011 issue of Pediatrics, the American Academy of Pediatrics 

(AAP) advises parents to keep their children in rear-facing car seats from birth until the age 

of 2, or until they reach the maximum height and weight allowed by their car seat’s manufacturer. 

• In the event of a collision, the impact is spread along the back. A rear-facing child safety seat 

does a better job of supporting the head, neck and spine of infants and toddlers in a crash, 

because it distributes the force of the collision over the entire body. 

• Newborns must be reclined at a 45 degree angle to prevent their head from dropping forward and 

blocking their airway. As the neck becomes stronger, the car seat may be more upright. 

• Many rear facing car seats can also be used as infant carriers. 

• Harness straps should come out at or below the shoulder level. 

Convertible Seat 

• Designed by the manufacturer to be both a rear-facing seat and a forward-facing seat. 

• Not used as an infant carrier, due to larger size. 

• There are usually two different belt paths for the car seat belts, depending on whether the seat is 

facing forward or backward. 

• When the seat is facing forward, it is essential to move the harness straps to the upper shoulder 

slots, so they come out at or above your child’s shoulder level. 

31 


Forward Facing Seats 

• Children face forward when they reach the maximum height and weight for their rear-facing car 

seat. A forward-facing seat with a harness and tether is the next step. It is safer than a booster 

seat. It limits your child’s forward movement during a crash. 

• In the event of a collision, the impact is spread across the shoulder, breast and hip bones. 

• Adjust the harness snugly so you cannot pinch the webbing together between your fingers at the 

baby’s shoulders. Only one finger should fit snugly beneath the harness and your baby. 

• The harness clip should be at the armpit level, so it lies across the breastbone. 

• Harness straps should come out at or above the shoulder level. 

Combination Seat 

• Designed by the manufacturer to be both a forward facing seat with a harness and belt 

positioning booster. 

• When the child is ready for the booster, the harness straps are removed, and the car lap and 

shoulder belt are used to secure the child in the car. 

Belt Positioning Boosters 

• The belt-positioning booster seat positions an older child so that the vehicle shoulder belt fits 

snug across the middle of the shoulder bone and middle of the breastbone, and the lap portion 

rides low across the thigh area. 

• Used with both the lap and shoulder belts. 

• A belt-positioning booster seat provides better protection than a seat belt alone, until the seat 

belt fits correctly. 

• The AAP advises that children must ride in belt-positioning booster seats until they have reached 

4’ 9” tall and are between 8 and 12 years of age. Ideally they should also weigh 80 pounds. 

• Keep your child in a booster seat until he or she is big enough to fit in a seat belt properly. 

- Your child’s legs should be long enough so the knees bend at the front edge of the seat. 

- Your child should be able to sit with their back straight against the vehicle seat back cushion. 

- The vehicle lap belt fits low and snug across the upper thighs (hips), not the stomach. 

- The shoulder belt should cross the collar bone and center of the child’s chest. It should lie snug 

across the shoulder and chest and not cross the neck or face. 

Children should ride in the back seat of a vehicle until they are 13 years old. 

32 


Selecting your car seat 

• Consider if you would prefer a rear facing only seat (which can be used as an infant carrier), 

or a convertible seat (which can also be used forward facing when the infant is older). Shop and 

compare prices, as well as the pros and cons of each option. 

• Keep in mind that, because of its size, convertible seats often do not fit newborns properly; 

especially smaller newborns. The convertible seat for newborns is also less convenient, because 

baby must be wrapped and unwrapped when getting in and out of the car, especially in cold 

weather. 

• Keep in mind that rear-facing only seats must be replaced with a forward-facing seat when your 

baby outgrows the manufacturer’s height and weight restrictions. 

Installing your car seat 

Be willing to invest the time to learn to use your car seat properly. Many people spend hours, days 

or even weeks picking out a vehicle, but don’t think of taking the time to get acquainted with a car 

safety seat. 

• Read the instruction booklet that comes with the car seat. 

Correct 

• Check your car owner’s manual for special instructions on the 

use of car safety seats. 

• Infants should never travel behind an airbag. 

• Put your weight into the car seat as you fasten it. It should 

move no more than one inch side to side at the seat belt. 

• To be sure your baby is safe, it is best to have your car seat 

checked by a Certified Child Passenger Safety Technician 

before you are admitted to the hospital. 

Call Dauphin County SAFE KIDS at (717) 531-SAFE (7233) 

Incorrect 

or South Central PA Highway Safety at (717) 766-1616 

or 1-800-822-2358 for an appointment. 

Additional car seat check points, recall information, and other 

child safety seat information can be accessed by contacting: 

- The National Highway Traffic Safety Administration 

www.nhtsa.gov or call 1-888-327-4236. 

- Traffic Injury Prevention Project (TIPP) 

www.paaap.org or call 1-800 CAR BELT (227-2358) 

- www.carseatdata.org 

- www.seatcheck.org or call 1-866-SEAT CHECK 

33 


Car seat safety 

Head Support Cushions 

• Do not put a head support cushion in your baby’s car seat, unless it came with the seat from the 

manufacturer. Head support cushions put padding behind your baby’s head and may cause his 

head to tip too far forward, possibly blocking his airway or changing the fit of the harness, 

making it unsafe in an accident. Manufacturers who have head supports in their car seats have 

done safety tests with them in place. 

• Bring three to four extra blankets to the hospital. The blankets may be used to support your baby’s 

head properly in the car seat if the car seat head support is too big for your baby’s head. 

Outerwear and Carrier Bunting 

Do not use outerwear or carrier bunting (the type 

that lay in the car seat and your baby lays on top 

of). Fabric on or under your baby pushes down 

during an accident and may change the harness 

fit. Put your baby in the car seat with one layer 

of clothing; secure him in the seat with the 

harness snug, and then place blankets over the 

harness system for warmth. Use a hat, mittens 

and booties if needed. Remember to bring three to 

four extra blankets or a carrier cover to keep your 

baby warm when going home from the hospital. 

Correct 

Incorrect 

Carrier Toys, Baby Mirrors and Baby Window Shades 

Toys, baby mirrors and window shades may be thrown loose during an accident and injure your 

baby. Anything loose in your car, including groceries, pets, sports equipment, etc., can become a 

projectile during an accident and cause serious injury to passengers, including your baby. Use a 

cargo cover or your trunk to store loose items. Note: a projectile’s weight is multiplied by the 

speed of your vehicle at the time it becomes airborne. For example, if a one pound window shade 

loosens from the window when your car is traveling 50 miles per hour, its weight on impact will 

be 50 pounds! 

Fitting your baby in a child safety seat 

• Place your baby flush against the car seat in one layer of clothing. 

• Adjust the harness snugly so you cannot pinch the webbing together between your fingers at the 

baby’s shoulders. Only one finger should fit snugly beneath the harness and your baby. 

• Position the retainer clip on your baby’s upper chest (armpit level), about one inch from his neck 

so it does not press on his airway. 

• Check that the harness straps are not rubbing on the sides of your baby’s neck. Pull your baby’s 

collar out over the shoulder straps, or pull up the fabric on his clothes alongside his neck. 

• If your car seat did not come with a head support, or did, but it is too big for your baby’s head, 

fold a blanket in half and roll it into a tube. Mold the rolled blanket around your baby’s head or 

inside the existing head support, and then tuck the remaining length along side of the baby’s ears. 

• Layer blankets as appropriate for warmth. 

34 


Car Seat Challenge Testing 

Some babies who are born prematurely (early) or small may have breathing problems when sitting 

in a semi-reclined car safety seat. The breathing problems usually go away as the baby grows 

during the next month. If your baby was born at less than 37 weeks gestation, he will be tested in 

the newborn nursery to be sure that he can breathe well while sitting in an upright car seat. It is 

important to bring your car seat to your hospital room immediately following transfer to the 

maternity unit so that your baby can be tested. 

If your baby was born prematurely or small and has not passed the car seat challenge testing, this 

information will help you transport your baby safely: 

• Your baby will need to use a car bed if any of the following occur while in a car safety seat: 

- a decrease in oxygen levels 

- slow heart rate 

- apnea (breathing stops for a moment or two) 

• Car beds can be rented from PinnacleHealth. 

• Car beds that meet Federal Motor Vehicle Safety Standards allow babies to travel while lying 

down. Some reasons why a baby may need to travel in a car bed include: 

- problems breathing when sitting up or semi-reclined 

- decreased muscle control 

- bones that break very easily 

- recent surgery on the spine 

- wearing a cast 

• It is important to use the car bed every time your baby travels in the car, and monitor baby 

at all times. 

• Position your baby on his or her back in the car bed. 

• Use the car bed ONLY in the vehicle to prevent injury to your baby. DO NOT use in your home or 

on a shopping cart. 

• When you return home, make an appointment to bring your baby to be retested in the car safety 

seat. The test can be done in 3-4 weeks at PinnacleHealth Pulmonary Function Lab. You must 

bring your car seat and paperwork with you. For more information, please call (717) 782-3684. 

• If your baby has outgrown the car bed before he is scheduled for the retest, please call the 

Pulmonary Function Lab for an earlier appointment. 

• When your baby passes the retest, the Pulmonary Function Lab will return the car bed. Your 

deposit, less $10, will be mailed to you. 

Until your baby passes the retest, DO NOT place him in the infant chair, swing or other upright 

position. Upright positions may cause breathing problems. 

For more information on child safety seats or to schedule an appointment for car seat installation 

visit www.carseatdata.org, www.nhtsa.dot.gov, www.seatcheck.org, or call 1-800-CARBELT or 

Dauphin County SAFE KIDS at (717) 531-SAFE, or South Central PA Highway Safety at (717) 766-1616. 

35 


36 


All the Help You Need

All the Help You Need 

In this section we have listed resources and programs that may be useful during and after 

your pregnancy. 

PinnacleHealth Resources 

Adoption Information 

Birth parents and adoptive parents can obtain 

individual information and support from the 

Maternity clinical nurse specialist (782-5906) 

and social workers (231-8896). 

Behavioral Health | 231-8360 

Counseling and support services are provided 

for individuals and families needing 

psychological or emotional support, especially 

with postpartum depression. 

Childbirth Education | 221-6255 

A variety of classes including childbirth, 

breastfeeding, baby care, infant/child CPR, first 

aid and sibling preparation are available 

through our Parent/Child Education department. 

Childhood Lead Poisoning 

Prevention Center | 782-6442 

Children under six years of age and pregnant 

women are screened for lead exposure. 

Diabetes Education | 221-6250 

Provides education on all aspects of diabetes 

management. 

Doula Services | 221-6268 

A doula is a specially trained labor companion 

who provides physical and emotional support 

for women and their partners during labor 

and birth. A list of certified doulas who attend 

births at Harrisburg Hospital is available for 

interested families. Call for additional 

information if you are looking for a doula or are 

interested in becoming a certified doula. 

Children’s and Teen Center | 782-4650 

Provides well and sick healthcare for children 

0-21 years. Specialty clinics include lead, 

neurology, asthma and pulmonology, family 

planning and neonatal follow-up. 

Lactation Consultants | 782-5372 

Professional support, education and counseling 

for breastfeeding mothers are provided in the 

hospital by certified lactation consultants. 

One-on-one counseling and assistance is also 

available by appointment or by phone after 

discharge. A variety of breastfeeding aids, 

including rental of breast pumps, are available. 

Learning Institute | 221-6250 

PinnacleHealth Learning Institute offers a 

variety of programs for groups and individuals 

with a focus on wellness and prevention. Our 

team includes health educators, dietitians, 

nurses, childbirth educators, diabetes educators 

and lactation consultants. 

Mothers and Children (MAC) | 231-8900 

This group provides an opportunity for moms 

and tots to interact socially. 

New Mom Network | 231-8900 

An informal time of sharing for new mothers. 

This group is facilitated by an experienced 

nurse in maternal/child health, infant massage 

and lactation. Join other new moms and their 

infants, 0-9 months old and older babies age 

10-16 months for discussion about the physical 

and emotional adjustments to motherhood. 

No older children please. 

Nursing Mothers Counselors | 221-6250 

A team of dedicated volunteers with 

breastfeeding experience who are available to 

give support and answer questions/concerns 

about breastfeeding. 

Nutrition Education | 221-6250 

A registered dietician is available to provide 

individualized nutrition education on healthy 

eating while pregnant or breastfeeding. 

37 


The Parent Review 

PinnacleHealth offers a free weekly email for 

expectant and new parents to help guide you 

through pregnancy, labor and birth, and the 

first year of your baby’s life. Receive customized 

information, including tips, support, news, 

advice and resources. Register online at 

www.pinnaclehealth.org and click on the icon. 

Perinatal Bereavement Services | 231-8844 

Education and support services provided to 

those dealing with grief and loss related to 

pregnancy or childbirth. A support group meets 

monthly at Community Campus. Please call 

782-5906 or 221-6268 for more information. 

Perinatology | 231-8472 

Perinatalogists provide care for high-risk 

mothers through pregnancy and delivery. They 

may be the primary care provider or consult 

with a woman’s obstetrician. 

PinnacleHealth Home Care | 231-6363 

At home follow-up care by a registered nurse is 

covered by some insurance plans. 

PinnacleHealth Internet Site 

Providing health information on the Internet at 

www.pinnaclehealth.org. Look for directions, 

physician finder, events calendar and specific 

information about hospital and outpatient 

services, and several e-newsletters on a variety 

of topics. 

PinnacleHealth Library Services 

We offer professionally staffed medical libraries 

open to the public. Consumer health library 

services provide health information sources, 

Internet access and research to meet individual 

needs. Childbirth and Parenting DVDs are 

available for home viewing. Located at 

PinnacleHealth Community Campus (657-7247), 

Harrisburg Campus (782-5510). 

PinnacleHealth Psychological Associates 

231-8360 

An outpatient psychotherapy practice offering 

services to adults, older adults, children and 

adolescents. Licensed, masters level, Psy.D. 

and Ph.D. clinicians provide individual, family 

or marital evaluations, therapy as needed. 

We also offer group therapy should you and your 

therapist determine it would be helpful. 

REACCH | 782-2363 

A comprehensive care program for HIV positive 

mothers and their HIV-exposed infants and 

affected children. 

Social Services | 782-5574 

Referrals for help with financial problems, those 

who need help with drug/alcohol or domestic 

violence, adoption questions, or other stressors. 

Tours | 221-6255 

Tours of the Birth Center are available on an 

ongoing basis. 

WomanCare Resource Center | 231-8975 

WomanCare Resource Center promotes healthy 

lifestyles for women at every age and stage of 

their lives. We understand the delicate balance 

women seek to achieve in this demanding 

world of careers, personal interests, home and 

family. It’s common that the needs of aging 

parents, young children, maturing teens, 

spouses, partners and grandchildren 

often take precedence over your own. 

We are committed to you. Registered 

nurses are available onsite and by 

telephone to answer questions and 

provide individual health consultations. 

Visit www.pinnaclehealth.org/womancare 

for more information. 

Women’s Outpatient 

Health Center | 782-4700 

Hospital based gynecological, 

prenatal care and family 

planning are provided regardless 

of ability to pay. 

Please call the PinnacleHealth OneLine at 231-8900 if you would 

like a free copy of our Look Inside service brochure. 

38 


Healthcare Provider Resources 

More than 60 obstetrician/gynecologists, family 

practice physicians, midwives, nurse 

practitioners and pediatricians provide care for 

their patients at PinnacleHealth. This enables 

you to choose the caregiver that’s right for you. 

When choosing a caregiver, be sure to find out if 

the practice philosophy, areas of special interest 

and qualifications meet your needs. Each 

caregiver’s office staff can answer your specific 

questions about hours of operation, location and 

insurance accepted. For additional help in 

choosing a physician that meets your family’s 

healthcare needs, visit www.pinnaclehealth.org 

and click on Find a Doctor, or call PH Oneline at 

(717) 231-8900 or 1-877-499-3299. 

Family practice: The medical specialty which 

provides continuing and comprehensive 

healthcare for the individual and family. The 

scope of family practice includes all ages, both 

sexes, and every disease entity. 

Midwife: A registered nurse trained to assist a 

woman during childbirth. Many nurse midwives 

also provide prenatal care for pregnant women, 

birth education for women and their partners, 

and care for mothers and newborn babies after 

the birth. A midwife may be a man or a woman. 

Midwives may deliver babies in the mother’s 

home, in a special birthing center or clinic, or in 

a hospital. 

Neonatologist: A specialist in the care of the 

newborn with complications. 

Nurse practitioner (NP): A registered nurse 

(RN) who has completed an advanced training 

program in a medical specialty such as 

women’s health, family practice, pediatrics, 

neonatal or internal medicine. A NP may 

function as a primary direct healthcare provider 

and prescribe medications. 

Obstetrician/gynecologist: A physician who 

both delivers babies and treats diseases of the 

female reproductive organs. 

Pediatrician: The medical specialty which 

provides continuing and comprehensive 

healthcare for the individual and children from 

birth to adulthood. The scope of pediatricians 

encompasses both sexes and every disease 

entity. 

Perinatologist: An obstetrical subspecialist 

physician concerned with the care of the 

mother and fetus at higher-than-normal risk for 

complications. 

Community Resources 

Contact Help Line | 652-4400 

Crisis Intervention 

Eastern Cumberland & Perry counties - 

763-2222 

Western Cumberland & Perry counties - 

243-6005 

Dauphin county - 232-7511 

York county - 851-5320 

Dauphin County Social Services for 

Children and Youth | 782-7200 

The department is responsible for protecting 

the health and safety of children and youth. 

Services range from in-home services including 

prevention, intake/assessment and 

counseling/intervention and placement services 

including foster family care, group home, 

adoption and residential placement. Referrals 

may be made by phone, in writing or in person. 

Emergency services are provided 24-hours a 

day, seven days a week. 

Dauphin County Department of Drug 

and Alcohol Services | 635-2254 

This program implements alcohol and drug 

abuse prevention, intervention and treatment 

programs. 

Dauphin County SAFE KIDS 

(car seat installation) | 531-SAFE 

39 


Domestic Violence Services 

Provides shelter services, counseling, support 

groups, accompaniment services, legal services, 

and preventative education program. 

Domestic Violence Services of Cumberland 

& Perry Counties: 800-852-2101 

YWCA/Domestic Violence Services serving 

Dauphin County: 800-654-1211 

Domestic Violence Intervention of Lebanon 

County: 866-686-0451 

ACCESS-York serving York County: 24-hour 

hotline: 800-262-8444 

Domestic Violence Services of Lancaster 

County: 800-932-4632 

La Leche League | 1-800-LaLeche; 

1-846-519-7730 

This organization offers community support 

groups for breastfeeding mothers. www.llli.org 

PA Department of Health 

1-877-PA-HEALTH 

This state-run service provides programs for 

women, children and families for the prevention 

and suppression of disease and injury. Visit 

them on the Web at www.health.state.pa.us. 

PA Quitline (smoking cessation) 

1-877-724-1090 

Secret Safe Place for Newborns 

1-866-347-4287 

“A Secret Safe Place for Newborns” program is 

offered at the Harrisburg and Community 

General Hospital Emergency Departments. 

The mission of this service is to rescue 

newborn infants, who would otherwise be 

abandoned, from injury or death by providing 

confidential emergency care and shelter. 

Of special note is a promise by the Dauphin 

County District Attorney not to prosecute a 

mother as long as the baby is unharmed. 

A special toll-free number has been established 

to provide information. 

South Central PA Highway Safety 

(car seat installation) | 717-766-1616 

WIC (Women, Infants and Children) 

1-800-942-9467 

Provides healthy foods at no cost; health 

nutrition information; health and immunization 

screenings; breastfeeding information and 

support; recipes, newsletters and educational 

materials; one-to-one nutrition counseling; 

referrals to community services. 

40 


Childbirth Education 

and Parenting Programs

Childbirth Education 

and Parenting Programs 

Welcome to Parent/Child Education! 

The birth of a baby is one of the most treasured experiences in life. To help families prepare 

for this meaningful event, PinnacleHealth offers comprehensive childbirth education and parenting 

programs. All sessions are taught by certified instructors, at a variety of times and locations for 

your convenience. 

Our classes help you take responsibility for your health and the health of your child. We want 

to hear about your expectations and concerns, and we want to share knowledge that will help you 

approach this experience with confidence. The information you receive may prove helpful when 

making medical decisions with your healthcare provider. Our classes offer an opportunity to 

ask questions and get answers. They also allow you to connect with others who are going through 

a similar experience. 

We are committed to making your pregnancy and birth the most memorable and rewarding 

experience it can be. Thank you for allowing us to be a part of this special time in your life. 

Questions about our programs can be answered by calling the PinnacleHealth Learning Institute 

at (717) 221-6255. 

Table of Contents 

Preparation for Childbirth 

Page 42 Lamaze ® Childbirth Series 

Page 42 Weekend Lamaze ® Seminar 

Page 43 Prepared Childbirth Series 

Page 44 Weekend Childbirth Seminar 

Page 44 Childbirth Refresher 

Page 45 Cesarean Birth 

Page 45 Twins, Triplets & More 

Page 46 Online Childbirth Education Program 

Page 47 Birth Center Tours 

Individualized Classes 

Page 48 Childbirth Preparation 

Page 48 Vaginal Birth After Cesarean (VBAC) 

Parenting 

Page 49 Baby Care Basics 

Page 50 Breastfeeding Basics 

Page 50 Pediatric First Aid 

Page 51 Heartsaver AED/CPR 

Page 51 CPR for Family & Friends 

Page 52 Prenatal Infant Massage 

Page 52 Postpartum Infant Massage 

Page 52 The Happiest Baby 

Family 

Page 53 Siblings: “Big Brothers and Big Sisters” 

Page 53 Becoming a Grandparent 

Other Services 

Page 54 Doula Services 

Page 54 The Parent Review 

Page 54 Wellness Phone Calls to New Moms 

Page 54 Perinatal Bereavement Services 

Page 55 New Mom Network I 

Page 55 New Mom Network II 

Page 55 New Mom Network III 

Page 55 Working Moms Network (Evening) 

Page 55 Moms Navigating Through Life 

Page 57 Lactation Services 

Class Registration 

Page 58 Registration Information 

Page 59 Registration Form 

PinnacleHealth Locations 

Page 60 Map & Directions 

Page 60 Harrisburg Area Map 

41 


Preparation for Birth 

Lamaze ® Childbirth Classes 

This six-week series provides information on the process of labor and birth, common medical 

interventions and options, and the important role of the dad/partner. Comfort techniques, including 

positioning, breathing and relaxation will be taught and practiced. A brief overview of cesarean 

birth, postpartum, and newborn are presented. These classes promote the Lamaze ® Philosophy 

of Birth and the Six Care Practices of the Lamaze ® Institute for Normal Birth. Additional time is 

spent practicing comfort measures, so these classes are a half-hour longer than Prepared Childbirth 

classes. They are taught by childbirth educators certified by Lamaze ® International. A tour of the 

Harrisburg Hospital Birth Center is included. 

Registration fee: $100 (includes partner) 

PinnacleHealth Harrisburg Campus, 

Brady Building 

205 South Front Street, Harrisburg, PA 17104 

Mondays, 6:30-9 p.m. 

January 3 – February 7 

March 7 – April 11 

May 2 – June 13* 

*(No Class – May 30) 

July 11 – August 15 

September 12 – October 17 

November 7 – December 12 

PinnacleHealth Cumberland Campus, 

Fredricksen Outpatient Center, 

2015 Technology Parkway, Mechanicsburg, PA 

17050 

Thursdays, 6:30-9 p.m. 

February 3 – March 10 

April 7 – May 12 

June 23 – July 28 

August 11 – September 15 

October 6 – November 17* 

*(No Class – October 27) 

Weekend Lamaze ® Seminar 

This seminar condenses the material taught in the six-week Lamaze ® Childbirth course. There is 

a one-hour lunch break on Saturday. This class does not include a tour. Birth Center tour dates are 

listed on page 47 of this booklet. 


The Community Center at Camp Hill 

GIANT Super Food Store 

3301 Trindle Road, Camp Hill, PA 17011 

Friday, 6-9:30 p.m. and 

Saturday, 9 a.m.-5:30 p.m. 

January 21 – January 22 

March 25 – March 26 

April 22 – April 23 

June 24 – June 25 

July 22 – July 23 

September 23 – September 24 

October 21 – October 22 

December 16 – December 17 

The Community Center at Linglestown 


2300 Linglestown Road, Harrisburg, PA 17110 

Friday, 6-9:30 p.m. and 

Saturday, 9 a.m.-5:30 p.m. 

February 25 – February 26 

May 20 – May 21 

August 26 – August 27 

November 18 – November 19 

42 


Prepared Childbirth Classes 

This six-week series focuses on preparation for childbirth, emphasizing the experience of labor and 

birth and the important role of the dad/partner. A variety of comfort measures are taught and 

practiced in class, including relaxation and breathing techniques. Medical interventions and 

options are discussed, as well as a brief overview of cesarean birth, postpartum, and newborn. 

Taught by certified childbirth educators, these classes will provide valuable information to help you 

prepare for your birth experience. A tour of the Harrisburg Hospital Birth Center is included. 


PinnacleHealth Harrisburg Campus, Brady Building 


Evenings, 6:30-8:30 p.m. 

Tuesdays 



April 19 – May 24 

May 3 – June 7 



August 23 – September 27 


October 4 – November 8 


Wednesdays 



April 20 – June 1* 



August 17 – September 28* 

*(No Class – September 7) 



Thursdays 



May 12 – June 16 

July 28 – September 1 


November 3 – December 15* 

*(No Class – November 24) 

PinnacleHealth Cumberland Campus 

Fredricksen Outpatient Center 

2015 Technology Parkway, Mechanicsburg, PA 17050 

Mondays, 6:30-8:30 p.m. 



May 2 – June 13* 




November 7 – December 12 

43 


Weekend Childbirth Seminar 

This seminar condenses the material taught in the six-week Prepared Childbirth course. There is a 

one-hour lunch break on Saturday. This class does not include a tour. Birth Center tour dates are 

listed on page 47 of this booklet. 





Friday, 6-9 p.m. and Saturday, 9 a.m.-5 p.m. 

January 7 – January 8 

February 11 – February 12 

April 8 – April 9 

May 13 – May 14 

July 8 – July 9 

August 12 – August 13 

October 7 – October 8 

November 4 – November 5 

The Community Center at Linglestown 



Friday, 6-9 p.m. and Saturday, 9 a.m.-5 p.m. 

March 11 – March 12 

June 10 – June 11 

September 9 – September 10 

December 2 – December 3 

Childbirth Refresher 

This class is for expectant parents who have previously attended a childbirth education program. 

Class includes a review of labor and birth, medical interventions, and comfort measures, including 

positions, relaxation, and breathing patterns. A brief overview of cesarean birth, postpartum, 

and newborn will be presented. The important role of the dad/partner and preparing siblings for 

your hospital stay are also discussed. This class does not include a tour. Birth Center tour dates 

are listed on page 47 of this booklet. 


The Community Center at Camp Hill GIANT Super Food Store 


Tuesdays, 6-9 p.m. 

January 11 

April 5 

July 12 

October 11 

44 


Cesarean Birth 

A single class designed for expectant parents who are anticipating a cesarean birth. Focus is on 

the physical and emotional aspects of a cesarean birth experience and touches on relaxation as a 

coping skill. Class includes information about the reasons for cesarean birth, medications and 

anesthesia, postpartum recovery and newborn appearance and procedures. The important role of 

the dad/partner before, during, and after birth will be discussed. 




Wednesdays, 6:30-9 p.m. 

February 9 

May 11 

August 10 

November 9 

Twins, Triplets & More 

This two-evening class for parents expecting multiples is recommended for the second trimester. 

The class is intended to supplement a regular childbirth class, with information specific to your 

family’s unique needs. It is also for parents expecting multiples who already have children. 

Class includes information about the different types of twinning, the process of labor and birth with 

multiples, what you need “two or more” of, feeding multiple babies, and ways of supporting the 

new family postpartum. A tour of the Neonatal Intensive Care Unit (NICU) and Newborn Nursery 

is included. 




Tuesdays, 6:30-8:30 p.m. 

February 8 and February 15 

May 10 and May 17 

August 23 and August 30 

November 8 and November 15 

45 


Online Childbirth Education Program 

In Addition To A Traditional Childbirth Class: 

PinnacleHealth Parent/Child Education is offering a special addition to our face-to-face childbirth 

classes. A new online program, based on The Gift of Motherhood book which you will receive in 

class, is now available for a minimal fee to those registering for a Lamaze ® Childbirth or Prepared 

Childbirth Class, or a Weekend Lamaze ® or Weekend Childbirth Seminar. 

This web-based eLearning program is interactive and includes animated illustrations, videos, 

voice-overs, and games. This additional resource can be used as an enhancement to your 

childbirth class, as a review, and to reinforce what you have learned. Should you have any 

questions, you will continue to have access to your childbirth educator, with whom you have 

established a relationship, even after your classes have ended. 

When you attend your first childbirth class, you will receive The Gift of Motherhood book. When 

you register for the online program, you will receive a personal access code. This program will be 

available to you for three months after initial log-on. You decide when to first access the online 

materials. Some parents benefit from having the information available to review at home between 

childbirth classes. Others prefer to complete their childbirth classes and access the online program 

closer to their due date. This allows them to review what they have previously learned and have 

the information available for a period of time after their baby arrives. 

Register for one of the childbirth classes mentioned above and take advantage of this additional 

resource at a special reduced fee. 

Registration fee: $20 in addition to the in-person childbirth class fee 

As An Alternative To A Traditional Childbirth Class: 

The PinnacleHealth Online Childbirth Education Program is also available as an alternative for 

parents who cannot attend a conventional childbirth class due to bed rest, scheduling conflicts, 

or time constraints. 

When you register and pay for the course, an 

access code will be mailed to you with your 

confirmation letter. This code will be valid for a 

period of three months after initial log-on. You 

will also receive a copy of The Gift of Motherhood 

book in the mail. With this option, you will 

have access to a certified childbirth educator, 

who will answer any questions you may have. 

Registration fee: $120 

46 


Birth Center Tours 

This tour provides the expectant mother and father/support person an opportunity to visit Labor 

and Delivery, the Neonatal Intensive Care Unit (NICU), the Maternity Center and the Newborn 

Nursery. This will allow you to become familiar with Harrisburg Hospital and get answers to any 

questions you may have. You may tour the Birth Center at any phase of your pregnancy. 

Due to the areas being toured, we are not able to accommodate children on this tour. 

A tour especially suited for children is provided in the Siblings class. 

Pre-registration is required. There is no fee. 

PinnacleHealth Harrisburg Campus, Harrisburg Hospital Lobby 

111 South Front Street, Harrrisburg, PA 17101 

Wednesdays, 1-2 p.m. 

January 5 

February 2 

March 2 

April 6 

May 4 

June 1 

July 6 

August 3 

September 7 

October 5 

November 2 

December 7 

Evenings, 6-7 p.m. OR 7:15-8:15 p.m. 

Tuesdays 

Thursdays 

January 13 

January 25 

February 10 

February 22 

March 10 

March 22 

April 14 

April 26 

May 12 

May 24 

June 9 

June 21 

July 14 

July 26 

August 11 

August 23 

September 8 

September 20 

October 13 

October 25 

November 10 

November 22 

December 8 

December 13 

A Virtual Tour of the Birth Center is available online at www.pinnaclehealth.org. Click on 

“Women’s Health,” then “Pregnancy and Childbirth.” A “Quick Link” will take you to the Birth 

Center Virtual Tour. 

47 


Individualized Classes 

The following classes can be scheduled individually for expectant parents who need one-on-one 

instruction due to special circumstances. To schedule individualized classes, call the 

PinnacleHealth Learning Institute at (717) 221-6255. 

Childbirth Preparation 

This class focuses on preparing you for your birth experience. Course content includes information 

about the physical and emotional changes during labor, the important role of the dad/partner, 

relaxation and comfort techniques, common medical interventions and options, as well as a brief 

overview of cesarean birth, postpartum, and the newborn. Your instructor will address your specific 

needs and concerns. A certified childbirth educator will contact you to schedule two class sessions 

of two hours each. 


Vaginal Birth After Cesarean (VBAC) 

Instruction is available for parents who have previously had a cesarean and want a vaginal 

birth for this pregnancy. Guidelines for a vaginal birth and the additional needs of a VBAC 

mother are discussed. Parents are also encouraged to attend a refresher class (see page 44) to learn 

comfort techniques and medical options. 


48 


Parenting 

Baby Care Basics 

In this two-week series, expectant parents learn how to care for a newborn. Discussion, 

demonstration and class participation are used to teach basic information about baby’s bath, cord 

care, diapering, safety and feeding. Other topics include normal newborn behaviors, symptoms of 

illness, how to stimulate learning, parenting and issues around returning to work. Our Pediatric 

First Aid class (see page 50) compliments this series by providing instruction on health and safety 

issues. 




Mondays, 6:30-8:30 p.m. 

January 3 and January 10 


January 31 and February 7 


February 28 and March 7 

March 14 and March 21 

March 28 and April 4 

April 11 and April 18 

April 25 and May 2 


June 6 and June 13 


July 11 and July 18 

July 25 and August 1 



September 12 and September 19 

September 26 and October 3 

October 10 and October 17 




December 5 and December 12 

49 


Breastfeeding Basics 

This two-week series for expectant parents focuses on the joys and common concerns of 

breastfeeding. Information includes the benefits for mothers and babies, initiating feedings, 

maintaining a milk supply and other practical considerations. Discussion includes combining 

breastfeeding and working, expression and storage of breast milk, and use of breast pumps. 

Expectant fathers are encouraged to attend. Saturday sessions meet for one 3-1/2 hour class. 




Mondays, 6:30-8:30 p.m. 















Thursdays, 6:30-8:30 p.m. 

Saturdays, 9-12:30 p.m. 













February 19 

May 21 

August 20 

October 22 

Pediatric First Aid 

This four-hour certification course for parents and other caregivers of infants and children includes 

basic first aid and medical, injury, and environmental emergencies, such as choking, asthma, 

bleeding, burns, poisoning, etc. Instructors are certified by the American Heart Association. 

A certification card will be mailed to your home address approximately 30 days after completion 

of the course. 

Registration fee: $55/person 

The above fee includes a Pediatric First Aid textbook, which will be mailed to you approximately 

two weeks before the class date. We strongly suggest that you read this book prior to class. 



Saturdays, 8:30 a.m.-12:30 p.m. 

February 19 

April 9 

June 18 

August 20 

October 15 

December 17 

50 


Heartsaver AED/CPR 

This four-hour certification course focuses on use of an automated external defibrillator (AED), 

Adult/Child/Infant CPR, and techniques to use on a person who is choking. Individual skill testing 

with an instructor must be successfully completed for certification. Instructors are certified 

by the American Heart Association. An AED/CPR certification card will be mailed to your home 

address approximately 30 days after completion of the course. 


The above fee includes a Heartsaver AED/CPR textbook which will be mailed to you approximately 

two weeks before the class date. We strongly suggest that you read this book prior to class. 

The Community Center at Linglestown GIANT Super Food Store 


Saturdays, 8:30 a.m.-12:30 p.m. 

January 15 

March 19 

May 21 

July 16 

September 17 

November 19 

CPR for Family & Friends 

This non-certification class focuses on Adult/Child/Infant CPR and techniques to use on a person 

who is choking. This course is taught in a “watch and practice” format. 

Instructors are certified by the American Heart Association. A Family & Friends CPR participation 

card will be received in this class. 

Registration fee: $35/person; $50/couple 

Your CPR book will be mailed to you approximately two weeks prior to the class date for review. 




January 5 

March 2 

May 4 

July 6 

September 7 

November 2 




February 2 

April 6 

June 1 

August 3 

October 5 

December 7 

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52 

Prenatal Infant Massage 

This is a program of early touch experiences using the World Institute for Nurturing 

Communication’s (WINC) “Welcome Baby Massage” as the basis for the class. Parents will learn the 

value of touch to the newborn, as well as the connection between touch and baby’s adjustment to 

life outside the womb. How to interpret your baby’s behavior and identify his/her cues will be 

discussed. Why, when, and how to add touch strokes to early infant care, and the father’s important 

role will be covered in this two-session class. 




Tuesdays, 6:30-8 p.m. 



Postpartum Infant Massage 

Loving, nurturing touch between parent and infant has a positive impact on the child’s 

development. Bring your baby (six weeks to six months old) and learn the techniques and benefits 

of infant massage. This three-week series also offers an opportunity to meet with other new 

parents. Massage oil is provided in the class. 

Registration fee: $50 (includes parent and baby) 



Saturdays, 10-11:30 a.m. 

February 5, February 12, and February 19 

July 30, August 6, and August 13 

Although some of the course information overlaps, each program stands on its own. The prenatal 

sessions focus on the immediate postpartum time period, and the postpartum sessions focus on the 

older infant (6 weeks to 6 months) with the growing child in mind. It is highly recommended that 

both programs be taken, but it is not required to reap the wonderful benefits of infant massage. 

Register for both Prenatal and Postpartum Infant Massage together and receive a $10 

discount! Both classes for $75! 

The Happiest Baby 

Join the growing number of parents using Dr. Harvey Karp’s method to calm their crying babies. In a 

single class you will learn Dr. Karp’s secrets for making babies happy. Practice the 5 S’s used to engage 

your baby’s “calming reflex”. These techniques are most beneficial for babies birth to two months of 

age. Educators teaching this class have completed the Happiest Baby Certification Program. Class fee 

includes “The Happiest Baby on the Block” DVD and “Soothing Sounds” CD. 

Registration fee: $35 



Wednesdays, 6:30-8:30 p.m. 

January 19 

March 16 


May 18 

July 20 

September 14 

November 16

Family 

Siblings: “Big Brothers and Big Sisters” 

“Babies and Toddlers” 

This class is designed for two and three-year-olds who are about to become big brothers or sisters. 

Children will learn about newborns and how to interact with them. Some safety lessons will be 

shared. There will be a celebration of their role as big brothers and big sisters. A short tour of the 

Maternity Center and Newborn Nursery is included, but no video will be shown. 

Registration fee: $10/child 



Fridays, 6:30-7:30 p.m. 

January 7 

March 11 

May 13 

July 8 

September 9 

November 11 

“Babies and Big Kids” 

This class, designed for children four to nine years of age, includes discussion and a children’s 

video about birth and becoming a big brother or sister. Children also have the opportunity to 

practice holding dolls and learn how newborn babies look and behave. Class includes a child’s tour 

of the Maternity Center and Newborn Nursery. 

Registration fee: $10/child 



Fridays, 6:30-8 p.m. 

January 7 

February 11 

March 11 

April 8 

May 13 

June 10 

July 8 

August 12 

September 9 

October 7 

November 11 

December 9 

Becoming a Grandparent 

This single evening class focuses on the experience of the grandparent. New trends in medical 

practices and current recommendations for infant care and safety will be discussed. Suggestions 

on how grandparents can support the new family and play a valuable role in the lives of their 

grandchildren will be shared. A tour of the Harrisburg Hospital Birth Center is offered following the 

class. Participation is optional. 




Tuesdays, 6:30-8 p.m. 

January 11 

April 5 

July 12 

October 11 

53 


Other Services 

Doula Services 

Birth doulas are trained professionals who provide continuous physical and emotional support, 

encouragement, and wisdom to moms and their partners during labor and birth. Postpartum doulas 

provide emotional and practical support to families as they transition to life with their new baby. 

The Parent/Child Education office maintains a list of certified birth doulas who provide services at 

PinnacleHealth, as well as general information about birth and postpartum doulas. 

To request this information, or if you have other questions regarding doulas, please call 

the PinnacleHealth Learning Institute at (717) 221-6255. 

The Parent Review 

PinnacleHealth offers a free weekly email for expectant and new parents to help guide you through 

pregnancy, labor and birth, and the first year of your baby’s life. Receive customized information, 

including tips, support, news, advice and resources. 

Register online at www.theparentreview.com/pinnacle. 

Wellness Phone Calls to New Moms 

A registered nurse from the WomanCare Resource Center will call new moms approximately 

two weeks following their discharge from Harrisburg Hospital. She will talk to you about your 

physical and emotional health, as well as the health of your baby. She will answer any questions 

that you may have and offer support in your new role as a parent. 

Perinatal Bereavement Services 

Education and support services are provided to those dealing with grief and loss related to 

pregnancy or childbirth. Call (717) 231-8844 for assistance. 

“Heartstrings” 

“Heartstrings” is a perinatal bereavement support group for those who have experienced a 

pregnancy loss or newborn death. You are welcome to come no matter where you are in your grief, 

or how long it has been since your loss. You may choose to talk or just listen. Some meetings 

include brief presentations, as well as time for sharing. Two registered nurses, who are also 

perinatal bereavement counselors, will facilitate the meetings. 

PinnacleHealth Community Campus 

4300 Londonderry Road, Harrisburg, PA 17109 

Fourth Tuesday of each month, 7-8:30 pm - Second floor, Conference Room 3 

December meeting is third Tuesday 

There is no charge and no registration is required. Call (717) 782-5906 or (717) 221-6268 

for more information. 

54 


New Mom Networks 

An informal time of sharing and support for new mothers. These groups are facilitated by an 

experienced nurse in maternal/child health, infant massage and lactation. Join other new moms 

and parents for one of these groups. No older children please. 

New Mom Network I 

For new mothers and their 0-9 month-olds 

1-2:30 p.m. FREE 

Every Monday: Linglestown GIANT Super Food Store Community Center 

Every Tuesday: Camp Hill GIANT Super Food Store Community Center 

New Mom Network II 

For mothers and their 10-16 month-olds 

1-2:30 p.m. FREE 


New Mom Network III 

For new mothers and their 18-24 month-olds 

10-11:30 a.m. FREE 


Working Moms Network (Evenings) 

Informally discuss the challenges of returning to the workplace, along with some tips on how to 

adjust. For moms who work outside the home and their babies. Facilitated by working moms. 

6-7 p.m. FREE 

Fourth Wednesday/month: 

Linglestown GIANT Super Food Store Community Center 

For more information about PinnacleHealth classes, programs and upcoming events, 

please call (717) 231-8900. 

Moms Navigating Through Life 

This is a therapy group dealing with the transition into and through all stages of motherhood. 

Dealing with role adjustments in relationships within the family and at work will be addressed. It 

will offer problem solving solutions to the demands of mothering at different stages from birth 

through the terrible teens. It is an opportunity to connect with others and realize that you are not 

alone. This group is facilitated by a licensed professional counselor. 

PinnacleHealth Psychological Associates, Harrisburg Campus, Brady Building $45/session. 

Most insurance plans cover the cost of group therapy. 

To register or for more information, call (717) 231-8360. 

55 


56 


Lactation Services 

PinnacleHealth promotes breastfeeding as a baby’s 

best start in life. We offer central Pennsylvania’s most 

comprehensive breastfeeding support services to 

help new moms initiate and maintain breastfeeding. 

Here are some of the key services provided: 

• Our Maternity Center nursing staff has specialized 

breastfeeding training, and is available 24 hours 

a day to evaluate, assist, and support breastfeeding 

moms and their babies. 

• Lactation consultants, professionally trained in the 

technique and science of breastfeeding, are available 

upon referral by the Maternity Center nursing staff, 

to assist mothers having difficulty breastfeeding or 

dealing with special needs. Our lactation consultants 

are certified by the International Board of Lactation 

Consultant Examiners (IBLCE). 

Additional Lactation Services 

at PinnacleHealth 

• Breastfeeding classes 

• In-hospital assistance and support 

• Information and assistance for new families with 

sick or premature babies in the Neonatal Intensive 

Care Unit (NICU) 

• Electric breast pump rentals and sales, call (717) 782-5372 

• At home information and support available by telephone 

• Outpatient visits, by appointment only, at the Harrisburg Hospital Lactation Center 

• Corporate lactation program 

• Professional lactation education 

Additional Information about Breastfeeding 

• Lactation Consultants at Harrisburg Hospital - (717) 782-5372 

• Breastfeeding Education - (717) 221-6255 

57 


Registration Information 

Early registration is suggested. Some classes fill quickly. 

Please contact your insurance company before you register to find out if they will 

reimburse you for classes. 

Full payment is required upon registration. 

By Telephone: 

• Contact the PinnacleHealth Learning Institute at: (717) 221-6255 

Monday through Friday, 8 a.m. – 3:30 p.m. 

• Credit Card payment will be accepted at time of registration 

OR 

• Check should be mailed upon completion of phone registration. 

By Mail: 

• Complete registration form. 

• Make check payable to: PinnacleHealth 

• Mail registration form and payment to: 

Parent/Child Education 

PinnacleHealth 

P.O. Box 8700 

Harrisburg, PA 17105-8700 

• Registration confirmation will be sent to you upon receipt of payment. 

Note 

• Full payment is required for all classes upon registration. 

• Cancellations prior to scheduled class will be given a full refund or rescheduled. 

• No-shows will forfeit one-half the class fee. 

• There will be a $20 charge for checks returned for insufficient funds. 

58 


Registration Form 

Please register early, as some classes fill quickly. Contact your insurance company before 

registering to find out if they will reimburse you for classes. 

Name 

Home Phone 

Partner’s Name 

Child(ren)’s Name and Age 

(For Sibling Class) 

Address 

City State Zip 

Phone (Work or cell) 

Doctor 

Email 

Due Date 

Program Starting Date Location 

❑ Baby Care Basics ____________________________ ___________________________ 

❑ Becoming a Grandparent ____________________________ ___________________________ 

❑ Birth Center Tour ____________________________ ___________________________ 

❑ Breastfeeding Basics ____________________________ ___________________________ 

❑ Cesarean Birth ____________________________ ___________________________ 

❑ Childbirth Refresher ____________________________ ___________________________ 

❑ CPR for Family & Friends ____________________________ ___________________________ 

❑ Heartsaver AED/CPR ____________________________ ___________________________ 

❑ Individualized Childbirth Class ____________________________ ___________________________ 

❑ Individualized VBAC ____________________________ ___________________________ 

❑ Lamaze ® Childbirth ____________________________ ___________________________ 

❑ Pediatric First Aid ____________________________ ___________________________ 

❑ Prepared Childbirth ____________________________ ___________________________ 

❑ Prenatal Infant Massage ____________________________ ___________________________ 

❑ Postpartum Infant Massage ____________________________ ___________________________ 

❑ Siblings: “Babies and Toddlers” ____________________________ ___________________________ 

❑ Siblings: “Babies and Big Kids” ____________________________ ___________________________ 

❑ The Happiest Baby ____________________________ ___________________________ 

❑ Twins, Triplets & More ____________________________ ___________________________ 

❑ Weekend Childbirth Seminar ____________________________ ___________________________ 

❑ Weekend Lamaze ® Seminar ____________________________ ___________________________ 

❑ Online Childbirth Education Program ____________________________ ___________________________ 

FULL PAYMENT IS REQUIRED UPON REGISTRATION. 

Payment Date: ____________________Enclosed Check #: ___________Amount:_________________ 


59

PinnacleHealth Locations 

PinnacleHealth Harrisburg Campus 

Brady Building 

205 South Front St., Harrisburg, PA 17104 

Park in the Visitor’s Parking Garage on Mary Street 

and follow signs to the Brady Building for classes. 

Tours meet in the Hospital Lobby. 

PinnacleHealth Cumberland Campus 

Fredricksen Outpatient Center 

2015 Technology Parkway, 

Mechanicsburg, PA 17050 

Exit onto Wertzville Road from I-81. 

Go to the first light and turn right on to 

Technology Parkway. Turn left at the sign 

for Fredricksen Outpatient Center. 

Make first right into parking lot by the 

Physician Office Building. Enter building 

and proceed to Conference Room G08, 

the first room on the left. 




Take I-83 to 581West. Take 581 West to 

exit 5A- North 11 & 15/Camp Hill. 

Camp Hill Shopping Center is on the left. 

GIANT Super Food Store is at the end 

near the intersection of Trindle Road. 

The classrooms are located on the second floor in The Community Center. As you enter the GIANT Super Food Store, 

bear left, passing Bucks County Coffee and the Marketplace Café. You will see the Cooking School to the right and stairs 

and an elevator to the left, which will take you to the second floor. 



Take I-83 to I-81. Take I-81 to Exit 69, Progress Avenue. Turn left onto Progress Avenue at the bottom of the exit ramp. 

Follow Progress Avenue North to Linglestown Road (Route 39). Turn left onto Linglestown Road. The GIANT Super Food 

Store is on the right in the Blue Mountain Commons Shopping Center. The classrooms are located on the second floor in 

The Community Center. 

60 


Your Hospital Stay

Checklist for Delivery 

Please complete the following information and place 

with your belongings to bring with you when you come 

to the hospital: 

❑ Insurance cards 

❑ Name and phone number of pediatrician or family 

practice physician who practices at PinnacleHealth 

and accepts your insurance to care for your baby in the hospital: 

❑ Any changes in your name, address, telephone number, or insurance information 

to give to Patient Access (717-782-5734) when you are admitted: 

❑ Information for your baby’s Social Security number: 

Mother 

Social Security number 

Date of birth 

Father 

Social Security number 

Date of birth 

❑ Infant car seat: Bring to your room after you are transferred to the postpartum floor. 

❑ Personal items needed after delivery. Please keep your suitcase and car seat 

in your car when you are in Labor and Delivery. Your support person 

can bring your suitcase and car seat to your room when you are transferred 

to the postpartum floor. 

61 


62 


Your Hospital Stay 

PinnacleHealth Harrisburg Campus 

Labor and Delivery is located on the eighth floor. Use the North Elevators (overhead sign) at the 

end of the hallway. Please press the button on the call box outside the doors and a nurse will let you 

in the unit. 

If you are not in labor and do not need assistance and arrive at the hospital 

between 5 a.m. and 8 p.m.: 

Park in the patient/physician garage, enter the hospital through the lobby, proceed through the 

main hallway and take the North elevators (at the end of the hall near the Emergency Department) 

to Labor and Delivery on the 8th floor. 

If you are in labor and need assistance and arrive at the hospital between 8 p.m. and 5 a.m.: 

Your labor partner may temporarily park at the Emergency Department drop-off. He or she may 

escort you to the labor and delivery suite on the 8th floor and then re-park in the patient/physician 

garage, which is accessible from Front Street. 

If you need assistance at any time, please come to the Emergency Department. 

63 


Prenatal Checklist 

❏ Check with your insurance company to find out what costs will and will not be covered. 

❏ Mail your pre-admission forms to the hospital as soon as possible, but no later than your sixth 

month of pregnancy. Please notify Patient Access (782-5734) if there are any changes in your 

name, address, phone number or insurance information as soon as possible. 

❏ Register for a childbirth class. PinnacleHealth offers six different types of childbirth classes at a 

variety of times and locations, in addition to classes on the care of your baby and new family. 

Some community organizations also offer classes. 

❏ Choose a pediatrician or family practice physician to care for your baby. Make sure he/she 

accepts your insurance and practices at PinnacleHealth. 

❏ Decide if you want your baby circumcised if he is a male, and check with your insurance 

company to find out if the procedure is covered. 

❏ Consider if you and your partner would like to have a doula with you through your labor. 

❏ Pack your suitcase prior to labor. See the list on the next page under “What to Bring.” 

❏ Bring all insurance cards with you to the hospital. 

❏ For the baby’s social security 

number, you will need the 

following information about both 

the mother and father of the 

baby: social security number, 

date of birth and place of birth. 

A paternity acknowledgement is 

also needed if the mother and 

father of the baby are not married. 

Fill out the birth certificate 

information and return it to your 

nurse or unit secretary before you 

leave the hospital. 

❏ Get a car seat that is new or less than six years old and have it installed in your car before 

coming to the hospital (call 1-800-SAFE-KIDS or log onto www.seatcheck.org to find a 

car seat technician in your area). If you have a used car seat, make sure it has never been in an 

accident. Bring your car seat to your hospital room after transfer to the Maternity Center. 

64 


What to Bring 

Whether you pack your bags weeks before your due date or right before you leave for Harrisburg 

Hospital, it is easy to forget important items. We encourage you to bring anything that will 

make you feel comfortable during your stay. However, we don’t recommend bringing valuable items. 

Here are a few items to keep in mind when packing your bags: 

• Your Baby’s Birth notebook 

• Camera and /or hand-held video camera 

• Heavy socks or slippers 

• Bed pillows 

• Snacks for labor partner (coffee shop and cafeteria are available with limited day and 

evening hours) 

• Bottle of bubbly cider to toast the new baby 

• Robe or nightgowns and underwear (keep in mind these may become permanently stained) 

• Hard candy or sour lollipops—sugarless will keep you from getting thirsty 

• Tennis ball in sock 

• Lip balm 

• Talcum powder 

• iPod (music) 

• Shower cap 

• Toiletries: mouth wash, shampoo, toothbrush, toothpaste, lotion, bar of soap, deodorant, 

hairbrush, make-up, hair dryer, curling iron, along with any other beauty and hygiene items 

you use regularly 

• Small amount of change 

• Going-home outfit for mom: loose, baggy clothes will feel most comfortable, nursing bra if 

you are breastfeeding 

• Going-home outfit for baby: stretchy suit, T-shirt, booties/socks, hat, 3-4 receiving blankets, 

warm blanket in cold weather, and/or outfit for baby’s first photo taken at the hospital 

• Snow suits, sweaters, blanket sleepers and buntings are not safe to use with car seats. 

• Infant car seat (PA law states babies cannot ride in a car without a federally approved car seat) — 

have your car seat installed before coming to the hospital in the back seat of the car 

(center position is safest) facing backwards. You may call the State Police or Safe Kids at 

(717) 531-SAFE to schedule your appointment for car seat installation on Tuesday or Thursday. 

Leave your suitcase and car seat in your car until after you have given birth and are moved to 

the maternity floor. Take only what you need for labor and delivery. Bring your car seat and suitcase 

to the room once you are transferred to the Maternity Unit. 

65 


Call Your Physician/Midwife When: 

• If you are a first time mother—when contractions are five minutes apart, last longer than a 

minute and have been this way for at least one hour. 

• If you’ve already delivered a baby—when your contractions are seven minutes apart and have 

been that way for one hour 

• Your membranes (bag of waters) rupture—note the color. 

• You have bright red bleeding 

• Your baby is moving less than normal 

• You have sharp, steady abdominal pain that does not come or go 

• You have fever, chills, backache and/or burning when you empty your bladder 

• You have nausea and vomiting lasting more than 24 hours 

• You have a headache or blurred vision 

Signs of Labor 

• Contractions (labor pains) may feel like cramping or back discomfort with a tightening of the 

abdomen 

• You may feel contractions in the abdomen, lower back or both 

• The pain from the contractions will come and go 

• Ruptured membranes is a loss of fluid from the vagina as a gush or slow leak—note the color of 

fluid and the time rupture of membranes 

• If you are already having contractions, when they become stronger, walking and talking will 

be difficult 

• You may have spotting in early labor if you have had a vaginal exam 

• Bleeding like a period is not normal and you should notify your physician or midwife immediately 

Coming To Labor And Delivery 

Your partner(s) is welcome to stay with you the entire time. When you arrive, the nurse will ask 

about your health history and the onset of labor. The baby’s heart rate and contractions will be 

monitored by electronic fetal monitoring. Your blood pressure, temperature and pulse will be 

checked, and a pelvic exam will be done to determine cervical dilation. You will have a chance to 

discuss your pain management preferences and ask questions during this time. 

Parking 

Park in the Patient/Physician Garage, off of Front Street or Second Street. The main support person 

with the white bracelet can get in and out of the parking garage without charge. 

66 


Visitation Policy For Labor And Delivery 

Antepartum Assessment Center: 

• Each patient in the Assessment Center is allowed one family/visitor/support person with her. 

• This family/visitor/support person will be given a “Labor & Delivery Visitor Pass.” 

• The family/visitor/support person is responsible for keeping the people in the waiting room informed 

of the patient’s condition. 

• The family/visitor/support person may “trade off” their pass to allow another person to see the 

patient. “Trading off” is to be done only with the patient’s permission. 

Labor/Delivery/Recovery Rooms (LDRs): 

• Each patient in an LDR is allowed three (3) family/visitor/support persons, at a time. 

• Each family/visitor/support person will be given a “Labor & Delivery Visitor Pass.” Any 

family/visitors/support persons beyond three will be directed to the waiting room and given the 

phone number for the patient’s room. 

• Family/visitors/support persons are responsible for keeping the people in the waiting room 

informed of the patient’s condition. 

• “Labor & Delivery Visitor Passes” may be “traded off” to allow different people to visit the patient. 

“Trading off” is to be done only with the patient’s permission. 

Postpartum Maternity Unit (delivered mothers and babies) 

• Visitors are welcome to visit from noon until 8 p.m., grandparents from 10 a.m. - 8 p.m. 

• All visitors should enter Maternity on the 9th floor through the secured access north entrance. 

This can be accessed by utilizing the visitor elevators in the North Elevator Lobby. There is no 

public access from the main entrance elevators to the 9th floor. 

• One support person (father of the baby or another adult) is allowed to remain after visiting 

hours and may also stay overnight. 

Children under the age of twelve (12) are not permitted to visit unless they are the patient’s 

own children. 

Recording Your Labor, Birth, Baby 

• Recording/Broadcasting any part of your labor, delivery or infant care is allowed if you get written 

permission from everyone who will be present during the birth, including your doctor/midwife 

and nurses. Ask your nurse for a permission form. Due to Federal Privacy Rules (HIPAA), you may 

take pictures or videotape your baby only. Taking pictures of other babies is not allowed. 

67 


Guide To Labor 

What To Expect 

Early Labor 

What is happening with your body: 

• Contractions are five minutes apart or longer 

• Cervical dilation progresses to about three or four centimeters 

The healthcare team will: 

• Encourage you to labor at home unless your water has broken or complications were identified in 

your pregnancy 

• Have you come to the hospital when contractions are five minutes apart 

• Admit you to the hospital and orient you to your birth room 

You and your partner can: 

• Enjoy walking together while you are at home 

• Use relaxation and breathing techniques 

• Eat light foods and drink fluids 

• Rock in rocking chair or walk 

• Bathe (if the bag of water has not broken) or shower 

Active Labor and Transition 


• Contractions will be stronger and five minutes apart or less 

• Cervix dilates to a maximum of 10 centimeters 


• Assist you with comfort measures and emotional support 

• Monitor contractions and progress of labor 

• Watch for problems with you or the baby 

• Use medical interventions as needed (see descriptions later in this section) 

• Offer pain medication if desired (see descriptions later in this section) 


• Change positions frequently 

• Use relaxation/breathing 

• Apply comfort techniques learned in class 

68 


Second Stage - Pushing 


• Once the cervix is fully dilated, the baby comes down into the vagina as mother bears down with 

the contractions. 


• Adjust bed for your comfort 

• Clean perineum and inner thighs with warm water 

• Prepare for delivery 


• Work with the contractions to bear down effectively 

• Adjust your position 

• Use the squatting bar 

Second Stage - Birth 

What is happening to your body: 

• Baby’s head emerges first, then the shoulders and body are delivered. 


• Put the baby on your abdomen at birth 

• Monitor the baby’s condition 


• Enjoy the birth of your baby 

• Take time to bond with the baby 

Third Stage - Birth of the Placenta 

What is happening to your body: 

• Contractions continue but milder than before. 

• You will push with contractions until the placenta is passed, usually within 30 minutes following 

the baby’s birth. 


• Guide you to push with contractions. 

• Examine the placenta to be sure all was passed. 

• Repair your perineum if necessary. 

• Clean perineum and make you comfortable. 

• Assist with breastfeeding. 


• Celebrate your baby’s birth. 

• Bond as a family. 

• You are encouraged to breastfeed within the first hour and to have your baby skin-to-skin 

with you. 

69 


Medical Interventions 

There are a variety of medical interventions that may be ordered during your labor. Because we 

never know in advance exactly what procedures may be needed for your labor, it is helpful to discuss 

with your physician or midwife their thoughts about the need for these common procedures. 

IV 

An IV is inserted in the hand or arm to provide fluids and medication during labor. A pump is often 

used to control the exact amount given. 

Electronic Fetal Monitor (EFM) 

The External EFM is attached to the mother’s abdomen. One part of the monitor tracks the fetal 

heart rate and the other tells when the mother is having a contraction. This information is 

transmitted through wires to the main part of the monitor and printed on a graph. The Internal 

EFM is sometimes used instead of External EFM. The bag of water must be broken and the 

monitoring device inserted through the vagina to the uterus. There is a fetal scalp monitor, which 

attaches to the baby to monitor his/her heart rate. A separate catheter can monitor the strength 

of the mother’s contractions. 

Pitocin or “Pit” 

Pitocin is the synthetic form of the hormone oxytocin, which causes the contractions of labor. 

It is administered through an IV line. It is used to induce (or start) labor, to augment (strengthen) 

labor or given after delivery to keep the uterus firm. 

Episiotomy 

An incision may be made in the perineum between the vagina and the rectum at the time of birth. 

It is made by the physician or midwife to enlarge the vaginal opening and will be repaired with 

stitches after the baby and placenta are delivered. 

Vacuum Extractor 

A small suction cup can be placed on the baby’s head during the pushing stage. The physician 

applies pressure during the contraction to bring the head down for delivery. 

Forceps 

A metal “spoon-like” instrument can be applied on either side of the baby’s head by the physician, 

which can then be positioned and brought down for delivery. 

70 


Pain Management 

PinnacleHealth uses a pain scale (see picture below) to measure your pain levels. Pain relief is 

available to you during labor, including both medication and medication-free comfort techniques. 

Some women prefer the advantages of using pain medications, while others prefer the advantages 

of natural childbirth (without using drugs). Be aware that pain medications are not usually given 

until labor has progressed to a certain point. Discuss your options with your healthcare provider 

and labor partner before your labor begins to find out what pain relief may be best for you. 

Advantages of pain medications: 

• Provides significant pain relief 

• Allows you to rest or sleep late in labor 

• Promotes muscular relaxation 

• Pitocin can be given to strengthen contractions without increasing your discomfort 

Advantages of natural childbirth: 

• Allows you to move and position freely 

• Decreases use of other medical procedures which may be used with pain medications 

• Provides sense of personal accomplishment 

• Enhances early breastfeeding with the delivery of a more alert baby 

Medication Options 

• Pain Medication 

Medicine can be given through an IV once you are in active labor and your cervix is progressively 

dilating. Giving the medication too early may cause contractions to slow down and affect the 

progress of your labor. Many women find that a dose of medication, such as Stadol, can provide 

just enough relief to “take the edge off” the contractions and give them a rest period. 

• Epidural Anesthesia 

An epidural will provide numbing from your waist down so the contractions will not feel as 

painful, although you may still feel some pelvic pressure. This type of anesthesia, given only by a 

doctor called an anesthesiologist, is administered by inserting a catheter into the epidural space 

in your spinal column. Again, your labor must be progressing to receive this type of pain relief. 

The epidural may be allowed to “wear off” when you are fully dilated so that you can feel your 

contractions and know when to push. Once you’ve received an epidural, you must stay in bed. If 

you have an epidural for labor and are unable to deliver vaginally, the epidural can be used as 

anesthesia for your cesarean section. 

71 


Medication-free Pain Management 

There are many comfort measures you can use to relieve pain throughout your labor. Your labor 

support partner and/or a Doula can be very effective in helping to keep you focused and in 

control, despite the pain of the contractions. Here are some techniques which are especially helpful 

in easing the discomforts of labor. 

• Relaxation and breathing 

• Supportive labor partner 

• Walking 

• Shower or jacuzzi 

• Rocking chair 

• Massage 

• Counter pressure 

• Soothing music 

• Position changes 

• Birth ball 

• Aromatherapy (candles are not allowed in the hospital) 

Cesarean Delivery 

Sometimes a cesarean section is planned during the pregnancy and scheduled in advance. Other 

times, it may occur as a result of conditions that happen during labor. In either case, it is valuable 

for the mother to be fully informed of the reasons for the cesarean and be aware of what will happen 

during this procedure. Some common reasons for cesarean sections include: fetal stress, extended 

length of labor, unusual position of the baby or maternal conditions. 

A cesarean section is a surgical delivery of the baby through the abdominal wall and uterus. 

It occurs in approximately one in four deliveries and is done by an obstetrician in a surgical room in 

the Labor and Delivery suite. One labor partner will usually be able to stay with you during the 

surgery. Cesareans are usually done with spinal anesthesia while the mother is awake. In some 

cases (usually emergencies), general anesthesia may be used and the mother will not be awake. 

A neonatologist/CNP and obstetrical nurse will be available to care for the baby at delivery. 

After the delivery, the mother will be transferred to the obstetric recovery room for about one hour. 

The baby will stay with the mother as long as the baby is stable. The hospital stay after a cesarean 

is three to four days. 

Vaginal Birth After a Cesarean (VBAC) 

If you had a cesarean section with a previous delivery, you may be able to deliver vaginally with 

this pregnancy. This should be discussed early in pregnancy to be sure your physician is supportive. 

You will need to sign a specific consent form if you plan to attempt a VBAC. 

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Your Birth Plan 

Are you in the early weeks of your pregnancy, thinking about baby names, or nearing the home 

stretch of your pregnancy, getting your nursery ready Now is the time to be thinking about your 

birth preferences. 

What is a Birth Plan 

The term birth plan can actually be misleading. It’s less an exact plan than a list of your preferences 

concerning your labor, birth and hospital stay. A birth plan isn’t a binding agreement, but rather a 

guideline of your wishes for your healthcare providers. 

Why have a Birth Plan 

A birth plan isn’t a must, and it is fine if you don’t want to write one. Many couples don’t bother 

with a birth plan because they are comfortable trusting their healthcare providers to help them 

make appropriate choices as the need arises. Other couples have strong opinions and expectations 

they want to share with their caregivers. 

Where to start 

Spend some time together thinking about and prioritizing what you want. Consider the options 

available to you that may be discussed in your childbirth class or hospital tour. While forming a birth 

plan, you will also obtain more knowledge regarding the labor and birth process. 

What questions does a Birth Plan answer 

1. What are your preferences during a normal labor and delivery 

2. What are your wishes for your baby’s care in the first few days after birth 

3. What would you like to happen in case of unexpected events 

While in labor, be flexible and keep an open mind. Remember, a birth plan isn’t a guarantee that 

your birth will go just as you planned it. By educating yourselves in advance, you will be less fearful 

and more empowered to make the best choices for you and your baby. 

You may choose to use the following birth plan (on next page). 

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74 


My Birth Plan 

Date: 

I, ______________________, am creating this birth plan prior to my labor to make my wishes clear 

to my doctor/midwife, and the nurses at the hospital. These are the items I feel are important 

regarding the birth of my unborn baby, and would like them to be followed as closely as possible 

whenever possible. I understand a circumstance might come up where either I may want to 

change my mind, or my doctor/midwife suggests that it is in my best interest to deviate from my 

birth plan. I will be flexible, however request to be kept informed of every aspect of my labor 

My name: 

My due date: 

My provider’s name: 

My birth partners’ names: 

Environment: (Check all that are your requests) 

❏ To control the temperature, lighting and sounds/music in my labor room 

❏ Please allow all visitors to come and go as they please (up to three at a time) 

❏ I only want visitors during the early stages of labor 

❏ No visitors except for my birth partner(s) 

❏ Do not allow these people:__________________ 

❏ My doula/childbirth educator will be present. 

Comfort Measures: 

❏ Ice chips/clear liquids by mouth 

❏ Position changes/walking for comfort 

❏ Shower/jet tub to relieve pain 

❏ Massage/breathing techniques 

Pain Management: 

❏ No medication at all: I want a drug-free birth 

❏ Shots through the IV of medications such as Stadol 

❏ An epidural when in active labor 

Delivery: 

❏ To use the birthing position of my choice 

❏ To use self-directed pushing 

❏ To used coached/directed pushing techniques 

❏ An episiotomy only if necessary 

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Immediately After Delivery: 

❏ Lay my baby on my abdomen/chest immediately 

❏ Clean up my baby before placing him/her on my chest 

❏ Delay cord clamping until pulsation stops 

❏ My partner wants to cut the umbilical cord 

❏ We are banking the cord blood 

❏ To breastfeed my baby as soon as possible in Labor and Delivery 

❏ Delay antibiotic eye ointment up to one hour 

❏ I want visitors to see us in Labor and Delivery 

❏ Just the new family in Labor and Delivery 

Cesaerean Section: 

❏ I want to be awake for my C/S 

❏ _______________will be my partner for my C/S (one only) 

❏ Want to see/hold my baby in the operating room 

❏ Have my baby skin-to-skin in the recovery room so I may bond/breastfeed 

❏ Wait until I am situated in my room before my baby is brought to me 

Postpartum Care: 

❏ I__________________will be staying overnight in my room (one only) 

Newborn Care: 

❏ Breastfeeding only 

❏ Breastfeeding and supplementing with formula 

❏ Formula feeding only 

❏ No pacifiers or artificial nipples given to my breastfed baby 

❏ Circumcise my newborn son 

❏ No circumcision 

Other: 

Thank you for taking the time to read my birth plan, which I have shared with my healthcare provider. 

Please keep me informed of anything that comes up that might cause me to deviate from it. 

Sign 

Date 

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Care for You & Your Baby Following Birth 

After months of waiting, your baby is finally here and eager to adjust in his new world. Our doctors 

and nurses will do everything possible to make sure your baby’s adjustment to life after birth is a 

smooth and healthy one. 

Newborn Care in Labor and Delivery 

The first few hours of life are known as transition. After your baby is born, he will be placed 

skin-to-skin with you to help him during transition as he adjusts his breathing, heartbeat, 

blood sugar and body temperature after birth. You and your baby will snuggle and have the 

opportunity to breastfeed for the first time. You and your family can begin to bond to your baby 

and get to know him as you welcome him. 

While in Labor and Delivery, your nurse will continue to care for your baby including: 

• Assess baby’s transition to life after delivery 

• Weigh and measure baby 

• Help with breastfeeding 

• Test baby’s blood sugar, if needed 

Newborn Care on the Postpartum Unit 

You and your baby will be transferred to the Maternity Center on the 9th floor about two hours after 

birth to continue transition. Your nurse will care for both you and your baby. 

Your baby will complete his transition in your room and will remain with you until the time of 

discharge. There are many benefits of uninterrupted contact between baby and family: 

• Supports family centered maternity care 

• Nurtures baby’s transition to life after delivery 

• Supports skin-to-skin care 

• Helps baby and mother learn to breastfeed successfully, learn feeding cues, and feed baby as 

soon as he is hungry, especially at night 

• Allows mother and father get to know their baby, bond and develop their role as parents 

• Increases your self-confidence in caring for your baby 

• Provides quality time to learn how to care for yourself and your baby 

• Prepares you to go home and continue your life as a family 

After you and your baby are transferred to postpartum, your baby will have assessments, routine 

care supported by your nurse and his first bath in your room. Within 24 hours, your baby will have a 

physical exam done by your pediatrician. One benefit of your baby transitioning in your room is 

that your baby will remain skin-to-skin with your or your support person. In addition to helping your 

baby regulate his breathing, heart rate, body temperature and blood sugar, a baby who is skin to 

skin often cries less and can breastfeed when he is ready to eat. 

• Until you can walk independently, it is helpful to have a support person with you 

• It is important that you or your support person hold your baby skin-to-skin to maintain his body 

temperature 

• You or the person holding your baby skin-to-skin will need to be awake 

• Your visitors will be able to hold your baby once transition is complete 

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While you are in the hospital, your baby’s care will be done in your room. This allows you to watch, 

participate, and learn about his care without being separated from him. You can maintain 

skin-to-skin contact with your baby during rest, feeding, assessments and care as much as possible. 

Some care that we will provide in your room includes: 

- Newborn assessment 

- Monitoring of vital signs and adaptation to life after delivery 

- Promotion and support for breastfeeding 

- Newborn bath when his temperature is stable, and he has had at least one successful breastfeeding 

- Continued skin-to-skin after bath to keep him warm 

- Blood sugar monitoring, if indicated 

- Collection of newborn screen and other specimens 

- Hepatitis B vaccine 

- Promotion of parent-infant bonding 

Sleep is important for both parents and baby. We encourage you to sleep when your baby is 

sleeping, both in the hospital and after you go home. The Safe Sleep Initiative recommends that 

your baby sleeps on his back in the bassinet or crib. Anyone who becomes drowsy while holding 

your baby should place him in the bassinet to prevent injury and keep your baby safe. 

We encourage you to keep your baby with you throughout your hospital stay to help you to bond 

with your baby, know him, learn his routines and how to care for him. However, if either you or 

your baby has a problem at any time during your hospital stay, your baby may need to be cared for 

in the Newborn Nursery or in the Neonatal Intensive Care Unit (NICU). Your nurse will assist 

you to spend time with your baby in the NICU. Your baby will be brought to your room when the 

problem improves. 

Congratulation on the birth of your baby and becoming parents! 

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Visiting Hours on Postpartum 

Try to keep visitors to a minimum so that you and your partner can get some rest and get to know 

and care for your baby. 

Length of Stay 

The average length of stay is two days for vaginal delivery or three to four days for cesarean. If you 

are interested in going home before 24 hours, discuss early discharge with your physician or 

midwife and pediatrician in advance. You would need to arrange for help at home. A home visit 

from a nurse can be arranged through the agency of your choice. Some insurance plans may cover 

this. Check with your insurance company. 

Your Baby’s Stay 

Now that your baby is born, your baby is depending on you to care for his/her every need. Not only 

is this a time to bond with your baby, but also a time to learn your baby’s personality and to 

develop routines that work well for both of you. 

Your support person, with the white ID band, may visit any time. Brothers and sisters of the baby, 

grandparents and other visitors can come to see you and your baby between noon and 8 p.m. 

Visitors and family should use the elevators in the North Lobby of the hospital (near the Emergency 

Department) when they come to visit. Family or friends who are ill or have a cold should not visit. 

Remind your visitors to wash their hands before holding your baby. Children, other than brothers 

and sisters of the baby, who visit must be 12 years of age or older. 

Infant Treatments and Screenings 

There are a number of treatments that are done in the first hours or days after birth for every baby. 

Eye Prophylaxis 

Medication is placed in the infant’s eyes to prevent infection or blindness from gonorrhea and 

chlamydia infections. 

Foot Printing and Identification Bands 

This is done in the birth room or delivery room for the identification of the infant. 

Vitamin K 

An injection into the baby’s thigh muscle is given to prevent internal bleeding. 

Hepatitis B Vaccination 

Many pediatricians recommend starting Hepatitis B vaccine in the hospital. This is a series of 

three injections to immunize the child against Hepatitis B. The other two injections will be given at 

the pediatric visit at two and six months. 

Newborn Metabolic Screening 

A small amount of blood is taken from the infant’s heel and applied to a special card. It tests for 

these conditions: phenylketonuria (PKU), hypothyroidism, sickle cell, galacosemia and congenital 

adrenal hyperplasia, Maple Syrup Urine Disease and other genetic disorders. Many of these 

diseases can be treated before problems occur. 

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Bilirubin Screening 

At 24 hours of age, your baby will be screened for newborn jaundice. In the first two to five days 

after birth, some babies may develop a yellow to orange color in their skin and whites of their eyes. 

This color is caused by bilirubin, the normal product of the breakdown of red blood cells, which is 

usually harmless. Babies have extra red blood cells before they are born to make sure they get 

enough oxygen. After they are born, they do not need the extra red blood cells. When their bodies 

break down the extra red blood cells, their livers may not be able to excrete the extra bilirubin that 

colors their skin (jaundice). Sometimes jaundice is also caused by a difference in blood types 

between mom and baby or by illness. 

The physicians and nurses will watch for jaundice and will test your baby for her bilirubin level. 

They may use a light test on your baby’s forehead and/or may prick your baby’s heel for a blood test. 

If bilirubin builds up too high in the body, your baby will be treated with special blue lights 

(phototherapy) or a “bili-bed” and extra fluids to prevent damage to nerve cells in her brain. This 

treatment usually lasts a few days. If your baby needs light treatment, your physician and nurse will 

give you more information. 

If your baby goes home with jaundice, he should be seen by a pediatrician within one to two days. 

Your physician will tell you what to watch for and when to call the office. You should always call 

your physician if your baby seems sick, more yellow, or seems too sleepy to wake for feedings every 

two to four hours. 

Hearing Screening 

Some babies are born with hearing problems. The only way to detect a problem is through 

screening. Your baby will be screened in the nursery before leaving the hospital. If your baby 

passes the hearing screening, you do not need to do any more testing at this time. A small number 

of babies who pass the screening at birth can lose their hearing before one year of age or older. 

Some babies develop hearing loss later as a child. If you are concerned about your child’s hearing, 

talk with your child’s doctor. If your baby does not pass the hearing screening, you should get 

another screening. There may be several reasons why your baby does not pass the screening: she 

may have permanent or temporary hearing loss; she may be too active or awake during the 

screening; or the nursery may be too noisy to get good results. If you have any questions or 

concerns or need another screening for your baby, talk with your baby’s doctor. 

NICU 

A Neonatal Intensive Care Unit (NICU) is available for premature and ill infants. Neonatologists, 

specially trained nurses and respiratory therapists care for babies in the NICU. The family is given 

individual attention from a caring staff in a friendly atmosphere. Parents are encouraged to spend 

time with the baby, and mothers are encouraged to breastfeed. Breast pumps are available for 

nursing mothers. Skin-to-skin kangaroo care may be provided by parents, depending on the infant’s 

condition. You will be given more information about the NICU if your baby needs to stay there for any 

length of time. For more information about the NICU, call the clinical nurse specialist at 782-5282. 

80 


Your Going Home Guide

Your Going Home Guide 

Discharge Plans 

Discharge planning begins with the birth of your baby. Our healthcare team will work with you and 

your family to identify your needs to provide a smooth homecoming. 

On the Day of Delivery 

Infant Car Seat 

• Bring your car seat to your hospital room following transfer to the Postpartum Maternity Unit. 

• Make sure you are familiar with the operation and/or adjustment of your car seat before you come 

to the hospital. 

• Bring a baby outfit for your baby’s pictures. 

Day Before Discharge 

• Take home as many belongings as possible (flowers and gifts, etc.). 

• Turn in birth certificate and paternity papers, (if applicable). 

• Verify with your nurse that all baby’s blood work and vaccinations have been done (NeoGen and 

PKU screening, Hepatitis B vaccine). Make sure your baby’s hearing test is done. 

• A photographer will stop by your room with information about baby pictures. Please have your 

baby dressed in the outfit you want for the picture. 

Day Of Discharge 

• Your doctor will come to your room to discharge you. Your pediatrician will discharge your baby. 

• Your nurse will review discharge instructions with you. You will need to sign the instruction 

sheet, and your baby’s bracelet will be removed to keep with his hospital records. 

• Your support person will take the last of your belongings to the car. Once you are discharged, 

your support person may bring the car around to the main entrance of the hospital and wait for 

the nurse to bring you and your baby down in a wheelchair. 

General Information 

• The average discharge time is between 10 a.m. 

and noon. Please ask your support person 

to be at the hospital by 9 a.m. 

• Remember, FREE parking is only 

available for the support person 

wearing an ID bracelet. All other 

visitors must pay for parking 

upon leaving the parking garage. 

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Layette and Nursery Needs 

The following list of items should only be used as a guideline. Your baby can get by with fewer 

than the number of clothing and bedding pieces listed. Keep in mind, fewer articles just mean more 

frequent laundering. 

Layette Needs: 

• 4-6 undershirts 

• 4-6 bodysuits (onesies) 

• 4-6 sleeping gowns 

• 2-3 pairs of booties or socks 

• 2-3 sweaters or sweatshirts 

• 4 bibs 

• 1 or 2 hats or bonnets 

Bath Supplies: 

• 4 washcloths 

• 2-3 hand towels 

• 2-3 bath towels 

• Brush and comb 

• Emory board for nail filing 

Toiletries: 

• Q-tips or cotton balls 

• Mild baby soap and shampoo 

• Petroleum jelly 

• Diaper rash ointment 

Diapers: 

A newborn needs to be changed 10-12 times a 

day for the first month. Be sure to cleanse your 

baby’s bottom with diaper wipes or a washcloth 

and warm water with every diaper change. 

• Cloth Diapers: four or more dozen. If you use 

a diaper service or combine with disposables, 

you will need half this amount. 

• Disposables: about 300 for the first month if 

you mainly use disposables. 

Layette and Nursery Needs 

For the safety of your baby, DO NOT use pillows, quilts, bumper pads and stuffed animals in the crib 

or bassinette. 

•Crib (if using an older crib, make sure the crib 

slats are no more than 2-3/8 inches apart and 

that it is painted with lead-free paint) 

• Mattress (make sure it fits snugly in the crib) 

- Do not use bumper pads 

- Do not place toys or stuffed animals in 

crib/bassinette 

• 2-3 crib sheets 

• 6 small waterproof pads 

• 4-6 receiving blankets 

• Dressing or changing table 

• Laundry hamper 

• Diaper pail 

• Infant carrier seat 

• Electronic thermometer 

• Diaper bag 

• Chest of drawers 

• An infant car seat that meets the Federal 

Motor Vehicle Safety Standard 213 

Miscellaneous extras include: 

• Record book 

• Nursery lamp 

• Crib mobile 

• Toys 

• Wall pinups 

• Birth announcements 

• Stroller or carriage 

• Portable baby bed 

• Baby carrier (sling/snugly) 

• Feeding equipment for the first few months: 

- If breastfeeding and planning to return to work, 

plastic containers and lids to store breast milk. 

- If formula feeding, eight bottles, nipples and 

bottle covers, bottle and nipple brush, and 

formula. Check with your pediatrician about 

which formula to buy. 

Please see Resource Section in the back 

of this manual for safe sleep practices for 

your infant. 

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How to Care for Your Baby 

Remember, your baby’s body is adjusting to its new environment outside the womb. Everything is 

new. Expect it to take time for your baby’s body to adapt to both you and its new surroundings. 

Eyes: Shortly after birth, babies can focus at a distance of 10-12 inches. At birth your baby’s eye 

muscles are not coordinated and so his/her eyes may appear crossed. By three months, muscle 

coordination and strength will improve, and your baby will be able to focus quickly. 

Sleep: Babies sleep an average of 15-18 hours a day in the first few months. A day and night 

schedule will be developed in about five to six weeks. When putting your newborn down to sleep, 

position her on her back. After about four to seven months when your baby can roll over on her 

own, she will select her own sleeping position. To help your baby adjust to the difference between 

day and night, keep late night feedings as low-key as you can. During the day if your baby naps 

longer than three or four hours, it is okay to wake your baby up to play or eat. 

Newborn Skin: Dry skin is normal for newborns. A small amount of mild soap may be used. Do not 

use baby oil. Many babies develop a “newborn rash” which goes away in seven to 10 days and 

needs no treatment. Some babies may have milia, tiny white bumps, usually on baby’s nose, 

cheeks or chin. These will disappear without treatment. Do NOT squeeze them or use acne 

medicine. 

Cradle Cap: This is a yellow, flaky, waxy buildup that sometimes develops on a baby’s head. It is 

usually prevented by shampooing two to three times a week and combing your baby’s hair. 

Stools: For the first few days your baby will pass thick, dark, tarry “meconium” stools. Stools will 

change to a greenish color and then to a normal yellow. If your baby is breastfeeding, stools will 

most likely be frequent and “seedy yellow.” 

Newborn Behavior: Your baby is born with natural reflexes that improve as she grows and develops 

better muscle tone and coordination. 

• Grasp: Most babies have a strong grasp reflex and will eagerly grip your finger. 

• Startle: Your baby may throw her hands up whenever there is a loud noise, sudden movement or 

flash of light. 

• Rooting: When you touch your baby’s cheek, he may turn his head in that direction. When 

breastfeeding, stroke his cheek with your nipple to get him to turn his head in the direction of 

your breast. 

• Crying: All babies communicate by crying. After checking to see if your baby is hungry, wet or 

tired, there are a few tips that can help calm a crying baby. 

- Hold your baby skin-to-skin, covered by a warm blanket 

- Rock your baby 

- Gently pat your baby’s back or stroke her head 

- Wrap or “swaddle” your baby snugly in a receiving blanket 

- Sing a song or tell your baby a story 

- Play soft music 

- Take your baby for a walk or drive 

- Burp your baby 

- Give your baby a warm, relaxing bath 

Babies tend to cry less when their needs are met quickly. Try to remain calm and relaxed, 

because babies can sense your emotions. Never shake or hit your baby. If you need a break 

from a fussy baby, call a friend or relative for help. 

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• Sneezing: all babies sneeze because they are unable to blow or scratch their noses. Dust, lint or 

mucus may be the cause. 

• Stepping: Newborns push their feet against surfaces their feet touch. This produces a “creeping” 

motion, allowing your baby to creep to your breast after delivery. 

The time you spend holding, bathing, feeding and diapering your baby will provide many wonderful 

opportunities to bond. Holding your baby correctly helps your baby feel safe and comfortable. 

Holding 

It is important for your baby to feel comfortable, secure and supported when held. There are many 

ways to hold your baby. You may want to try the following techniques: 

• The traditional cradle hold may help your baby fall asleep. Support your baby’s head by resting 

it in the crook of your elbow. 

• Snuggle your baby near your heart. Hold your baby so his/her body faces yours and his/her head 

is turned sideways. Use one hand to support his/her neck and the other to hold his/her bottom. 

• You may want to try the “sitting” position by supporting the baby’s back with your forearms and 

holding his/her head in your hands, resting his/her legs against your chest. This will let you stare 

eye-to-eye with your baby. 

• The “football” hold can also be used. Sit in an upright position, placing the back of your baby’s 

head in your hand and your forearm supporting the spine. The baby is bent at her hips with her 

legs behind your back. 

Bathing 

• Wash baby in warm water in a room without drafts. Test temperature before placing baby in water. 

• Bathe baby every 1-2 days. 

• Use plain water on face and eyes. 

• Wash with a mild, fragrance-free and lanolin-free mild soap. 

• Wash hair by rubbing gently with baby shampoo or mild soap. 

• It is not necessary to use lotions or oils on baby’s skin. 

• The use of baby powder and cornstarch is not recommended. 

Diapering 

Every baby needs to have his diaper changed often. The average baby needs his diaper changed 

about 10 times a day. Frequent changing helps reduce the chance of diaper rash and keeps your 

baby happier. Never leave your baby alone while changing him. Gather all needed materials before 

you begin. 

As a new parent, you must decide if you want to use cloth or disposable diapers. Cloth diapers are 

softer against a baby’s skin, are less expensive, and are less harmful to the environment. 

Disposable diapers are more convenient and their plastic liners do a good job of protecting your 

baby’s bedding and clothing. 

• Cloth Diapers: if you use a diaper service, you can have your dirty diapers picked up and clean 

ones dropped off on a weekly or biweekly basis. Individual services have different rules to 

follow. If you wash the diapers yourself, separate them from the rest of your laundry, wash them 

in soap instead of detergent, don’t use fabric softeners and double rinse each load. 

• Disposable Diapers: be sure to change your baby’s diapers often and dispose of the diapers in 

the trash or in a diaper pail. 

84 


To change a diaper, first remove baby’s dirty diaper and gently clean diaper area with a diaper 

wipe or warm, wet washcloth. Be sure to wipe from front to back to reduce the risk of infection. 

Apply Vaseline, cream or ointment when needed. Place a diaper on your baby and fasten it so it is 

snug, but not pinching. Do not use baby powder, since your baby may breathe in the powder. It is 

important to wash your hands after each diaper change. 

• Diaper rash: if your baby has small, red bumps on her bottom, genitals, thigh folds or lower 

tummy near her diaper, she may have a diaper rash. Use an over-the-counter ointment 

or lotion that contains zinc oxide to help clear up the rash and keep your baby’s diaper loosely 

fastened, sometimes letting her “air-out” without a diaper. Call your baby’s doctor if the rash 

does not get better. 

Umbilical Cord Care 

Keep your baby’s umbilical cord clean and dry. If the cord becomes soiled with urine or stool, 

cleanse it with water. Do not use alcohol or other materials on the cord. 

Be sure to fold the diaper away from the umbilical cord to allow air movement. Normal healing of 

the cord may have a “mucky” or mucus appearance. If the skin around the umbilical cord is red, the 

cord begins to drain, or the cord has a bad odor, it may be infected. Take your baby’s temperature 

and call your doctor. 

Special Care for Your Baby Boy 

Uncircumcised Boy 

Be sure to wash the penis with soap and water every day including the underside of the scrotum. 

No special attention is needed, so don’t use cotton swabs or special cleansers, and don’t probe 

under the foreskin or try to push the foreskin back during cleaning. 

Circumcised Boy 

• Comfort measures include swaddling, rocking, holding, feeding and sucking 

• Observe for signs of infection: redness and swelling towards the shaft of the penis, or greenish 

yellow discharge. Call your baby’s doctor if you see any of these signs or if your baby does not 

urinate for 12 hours. 

• If your baby has a plastibell circumcision, wash his penis with water only for 3-4 days. 

Do not use petroleum jelly (Vaseline). 

• If your baby has a surgical method circumcision, apply petroleum jelly (Vaseline) around the 

penis. Gently wash penis with water only for 3-4 days. 

85 


Is Your Baby Sick 

Risk of Infection 

During the first 6-8 weeks of your baby’s life, she is at higher risk for infections. Help reduce your 

baby’s risk by asking everyone who holds your baby to first wash their hands. Try to limit your baby’s 

visitors. Friends or family who have been exposed to chicken pox in the last 7-21 days or have had 

a cold or flu should not visit. It is also best to keep your baby away from large crowds. 

Paying close attention to your baby’s behavior will help you know when she isn’t feeling well. If you 

notice any of these symptoms, call your baby’s doctor: 

• Fever of 100.4°F (under the arm) or higher 

• Vomiting 

• Refusing food several times in a row 

• Excessive crying 

• Listlessness 

• Loose running bowel movements with mucus or foul odor 

• Rash 

• Persistent coughing 

How to Take Baby’s Temperature 

The ability to take your baby’s temperature accurately will help you determine when your baby is 

sick. You can take your baby’s temperature under the arm (axillary). 

A normal range for an under the arm temperature is 97.6°F to 99.6°F. Place the tip of the 

thermometer under the baby’s arm while holding her arm to her side. Wait the appropriate amount 

of time, then remove the thermometer and read your baby’s temperature. If you do not have a 

digital thermometer, wait one to two minutes before removing the thermometer. 

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Feeding Your Baby 

How you feed your baby, whether by breast or by bottle, is your choice. Research the issue with an 

open mind, and make your decision based on what is best for you, your baby and your lifestyle. 

Breastfeeding Baby 

Breastfeeding is recommended by the American Academy of Pediatrics for at least one year. 

Benefits of Breastfeeding 

• Healthier babies 

• Fewer colds, ear infections and diarrhea 

• Fewer allergies 

• Promotes brain development and higher IQ 

• Promotes close bond with mother 

• Convenient—milk is always ready 

• Saves money—breast milk is free 

The Basics: 

PinnacleHealth offers a prenatal breastfeeding course which will answer your questions and 

provide accurate information on getting started breastfeeding. Call (717) 221-6250. 

Breastfeeding is the natural way for baby to feed. Here are some simple steps that will help you and 

baby get off to a good start: 

• Put your baby to breast as soon as possible after birth. The nurses in Labor and Delivery can 

help. Babies who go to the breast during the first hour of life do not always latch on but seem to 

have an easier time learning to feed. 

• Provide lots of skin-to-skin contact the first few days. This helps reduce stress hormones in 

baby’s body and encourages breastfeeding 

• The first three to five days baby will get colostrum which contains substances that prevent 

infection. 

• Baby may be very sleepy the first day and then do many small feedings at night. This is normal. 

Feeding at night helps your body produce more milk. 

• Keep baby with you as much as possible. Baby will give feeding cues, smacking his lips, 

hands to mouth or rooting when he needs to breastfeed. 

• Most babies lose weight the first few days. A loss of 8 to 10 percent of body weight is usually 

all right. 

• The more you breastfeed, the more milk you will make. Do not give formula unless ordered by 

your baby’s doctor. 

• Ask for help when needed. The nursing staff will help you learn to breastfeed. 

• Board certified lactation consultants are available and may visit during your hospital stay. If you 

have questions or problems, ask your nurse to notify them. 

• You may call the breastfeeding telephone warm-line with questions or concerns either before 

baby’s arrival or after discharge from the hospital at (717) 782-5372. 

Avoid use of alcoholic beverages because alcohol is concentrated in breast milk and its use can 

inhibit milk production. An occasional celebratory single, small alcoholic drink is acceptable, but 

breastfeeding should be avoided for two hours after the drink. 

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Feeding Baby: 

The time you spend breastfeeding your baby should be comfortable for both of you. Find a position 

that allows your baby to feed easily and for you to relax. 

• Cradle Hold: Sit comfortably with baby’s head in the crook of your arm and support your baby 

with your forearm. Your baby will lie tummy to tummy against you with her ear, shoulder and 

hip in alignment. 

• Football Hold: This is the best position for C-section moms. Sit in an upright position placing the 

back of your baby’s head in your hand with your forearm supporting her spine. The baby is bent 

at the hip with her legs behind your back. You may wish to use pillows to support baby. 

• Lying on Side: Lie on your side, supporting your head, knees and back with pillows. Lie your 

baby on her side facing you belly to belly. Place a blanket roll behind your baby’s back for support 

and either place your baby’s head on the bed or in the crook of your arm for support. 

Formula-feeding Baby 

Each baby develops different feeding habits. Don’t expect your baby to follow a textbook schedule 

and drink the same amount of formula, at the same time, every day. 

The Basics: 

• On average, after the first week, your newborn will take about 6-8 bottles a day with about 2 to 4 

ounces of formula in each. 

• There are several kinds of bottles and nipples on the market. Try different kinds until your baby 

finds one she likes best. Try to choose a nipple that matches your baby’s mouth size and level 

of development. The formula should be easy for your baby to suck without flowing too fast for 

your baby to keep up. 

Preparing Formula: 

• There are several recipes for formula. Check with your baby’s doctor to be sure that you’re giving 

your baby the best kind of formula for his digestive system. Be sure to follow the formula’s 

preparation and storage instructions carefully. Always wash your hands before preparing formula. 

It is best to boil clean bottles, nipples and equipment for five minutes to sanitize them before the 

first use. Boil water (including bottle or spring water) before using it to make formula from powder 

or concentrate; let it cool to 100°F. Be sure to accurately follow mixing instructions. Shake the 

bottle well before feeding. Warm the formula by placing the bottle in a cup or pan with warm 

water and be sure to test its temperature before feeding your baby. Never microwave prepared 

formula. Throw away any formula left in the bottle after your baby has eaten. Bottles at room 

temperature should be thrown away after one hour. 

Feeding Baby 

• Hold your baby close and cuddle during feedings. Rest your baby’s head in the bend of your 

elbow, facing your baby toward you. Touch the middle of your baby’s lower lip with the nipple of 

the bottle until she starts sucking. Tilt the bottle so the formula fills the nipple, to prevent excess 

air bubbles. Make sure your baby’s head stays slightly higher than her tummy, preventing the 

formula from draining into the ears and possibly causing an infection. Never prop the bottle 

in your baby’s mouth, because she can choke. Never put your baby to sleep with a bottle. The 

formula will stay in your baby’s mouth and cause damage to her teeth. 

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Burping Baby 

• Air bubbles may get trapped in your baby’s stomach. You may need to burp your baby once or 

twice during feedings and again when finished. Use gentle patting and rubbing motions when 

burping your baby and don’t forget a burp cloth — babies frequently spit-up while burping. 

There are three common ways to burp your baby. Try them all, and if one doesn’t work, switch. 

• The “classic” burping position is to hold your baby on your shoulder with her body facing yours. 

Gently pat and rub your baby’s back to burp. 

• Lay your baby facedown on your lap and gently rub her back. 

• Set your baby on your lap, supporting her chest and chin with one hand and lightly pat her back 

with the other. 

• Sometimes babies do not burp at every feeding. 

Spit-Up 

It is common and normal for babies to spit-up a little of their food with a burp. Babies will begin to 

hold down their food as they grow. If you think your baby is spitting up whole feedings or if her 

spit-up becomes forceful, call your baby’s doctor. 

Cereal and Solid Food 

Introducing cereal too soon can increase the chance of your baby developing allergies. DO NOT 

give your baby any cereal, solid food or liquids other than breast milk or formula until your 

pediatrician tells you. Most pediatricians begin babies on cereal at four to six months. 

Caring for Mom’s Body 

Follow-up Care 

You will need to schedule a follow-up appointment with your doctor or midwife between four and 

six weeks after delivery. Depending on your needs, your healthcare provider may check your blood 

pressure, weight, breasts for abnormalities, and your reproductive system to be sure your body is 

healing properly. 

Your Healing Body 

Your body has been through many changes during pregnancy. As your body heals after delivery, it 

will slowly return to how you remember it. It is important to remember that everyone’s body heals 

from pregnancy and birth at a different pace. Don’t expect too much, too fast. Keep in touch with 

your healthcare provider to be sure your body is healing properly. 

• Episiotomy or Tear Resulting from Vaginal Birth 

It takes several weeks for your episiotomy sutures to be absorbed into your body. To help promote 

healing, relieve discomfort and keep your perineum clean, sit in a tub of warm water twice a day 

for 10-15 minutes at a time. 

• Abdominal Incision Following a Cesarean Birth 

If you have staples in your incision, your healthcare provider will remove them from 4-7 days after 

delivery. If you have stitches, they will become less noticeable in 1-2 weeks and can take up to 

two months to absorb into your body. The steri-strips that may cover your incision will fall off on 

its own. To help keep the incision area dry and clean, wash gently with soap and water, rinse 

well, and carefully pat dry. 

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• Vaginal Bleeding 

Bleeding may last anywhere from less than one week to six weeks or more. Small clots (up to 

thumb size) are okay. The amount of bleeding should lessen each week and fade in color from red 

to pink then brown, tan and then white. Use sanitary napkins for the first six weeks. Do not use 

tampons during this time. Increased activity will cause increased vaginal drainage. If this flow 

persists and you soak two or more pads in an hour, call your doctor immediately. If your discharge 

becomes foul smelling or accompanied by a fever greater than 100.4°F, notify your doctor. 

• Menstruation 

Your body is going through a lot of changes. It may take time for you to adjust to your prepregnancy 

cycle. If you are bottle feeding, you will probably get your period 4-8 weeks after 

delivery. If you are breastfeeding your baby, you may get your period anywhere from six weeks to 

three months after delivery. It may take as many as 18 months for your body to return to a normal 

menstrual cycle. Keep in mind that your first menstrual period may be heavier and last longer 

than your pre-pregnancy cycle. 

• Constipation 

The following suggestions may help you avoid constipation: 

• Drink eight glasses of water a day. 

• Take dietary fiber (whole grain cereal, whole wheat bread) or supplemental fiber 

(Citrucel, Metamucil). 

• Eat citrus fruits, dates and prunes. 

• Avoid harsh laxatives. Laxatives such as Doxidan, Senokot and Milk of Magnesia may be 

taken as needed. 

Resuming Normal Activities 

Now that you have delivered your baby, you may be starting to feel better and want to resume 

your normal activity level. Don’t feel like you have to tackle the world again right away. It will 

take time for your body to return to your regular activity level (about four weeks after a vaginal 

birth and six weeks after a Cesarean birth). 

Avoiding the “Superwoman Syndrome” 

Gradually resume your household activities. Avoid lifting anything heavier than your baby. 

Avoid excessive stair climbing, bending and stooping. Accept offers of help from family and 

friends to prepare meals and help with housework. 

Slowing Down the Social Butterfly 

• Make a new message for your telephone and let callers know that you are resting and will return 

their calls later. 

• Put a note on the door saying that you are sleeping and to please call to set up a time to visit. 

• You may drive one week after a vaginal birth and two weeks after a Cesarean birth and are no 

longer taking narcotic pain relievers. 

• Avoid driving and traveling for long periods. 

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Time to Rest, Relax and Heal 

• Try to take naps when your baby is sleeping 

• Get plenty of rest during the first 30 days. Complete rest for these first few weeks will allow your 

body to recover more quickly and naturally. 

• Don’t feel hesitant to ask your doctor for pain relief if necessary. 

• Contact WomanCare Resource Center for information about perinatal massage to help you rest, 

relax and heal. 

Personal Care 

• You may find that the best time for personal care is after your baby’s first morning feeding. 

• You may take showers immediately after delivery. 

• You may take 15-minute baths following a vaginal birth and two weeks after a Cesarean delivery. 

Healthy Living 

Nutrition 

Maintaining good nutrition after delivery is important in helping your body return to normal and 

promote healing. Do not diet during the first six weeks. Eat a well-balanced diet including meats, 

fruits, vegetables, dairy products and breads. Try to limit sweets and high-calorie foods, but feel 

free to snack on nutritious foods if you get hungry between meals. Continue taking prenatal 

vitamins because they provide your body with the vitamins and minerals it needs to recover. 

Breastfeeding moms should continue taking prenatal vitamins until the baby is weaned. Bottle 

feeding moms should discuss with the doctor how long to continue taking prenatal vitamins. 

Postpartum Weight Loss 

• Wait six weeks before attempting to drop pounds - your body needs time to recover, and you 

need the energy to keep up with the needs of a new baby. You may lose some of the weight in 

these weeks without intentional dieting. 

• Follow the food guide pyramid - it will guide you to getting all the nutrients you need. If you are 

breastfeeding, be careful not to be too restrictive — your baby is depending on you. A drastic 

reduction in your intake may decrease your milk supply. Breastfeeding can require 500 calories or 

more per day, so you are likely to see weight loss without cutting back. 

• Focus on fruits and vegetables - these foods are a key to a healthy diet. They provide maximum 

nutrients with minimum calories. 

• Choose non or low fat dairy products and whole grain breads - these foods will meet your 

nutritional needs and help you to feel satisfied without empty calories. 

• Stay hydrated, drink water - your body needs at least eight cups of fluid per day, and water is a 

great choice. If you are nursing, it is likely you will need more, so let your thirst be your guide, 

and always keep a glass of ice water by your side when breastfeeding. 

• Avoid extra sweet and fatty foods - these foods are high in calories and low in nutrients. 

Use them as a treat rather than part of your everyday routine. 

• Eat four to five small meals per day - this may help you to keep your energy up with the new 

baby. Your schedule may be irregular and avoiding extreme hunger is wise. Frequent small meals 

can help you to avoid a binge during your baby’s nap. Keep healthy snacks on hand for a quick 

energy boost. 

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• Get active - when your doctor says you are ready, try to get regular physical activity into your 

routine. Take your baby for walks outside or at a local mall. Look for classes that include healthy 

postpartum exercises that can be done with your baby. 

• Ask about a supplement - your doctor may suggest that you continue taking your prenatal 

vitamin after delivery, especially if you plan to breastfeed. 

• Focus on health - remember that a healthier you should be the focus. Your body was pregnant for 

nine months, and you can’t expect to be back in those favorite jeans right away. You need the 

energy and strength to provide the best care for you and the new arrival. 

Exercise 

Exercise will help tone your muscles that were stretched and weakened with pregnancy, improve 

circulation and help you return to your normal weight. If an exercise causes you pain, stop 

exercising and check with your doctor. The following exercises are listed from the easiest to the 

most strenuous. You can do the first three (deep breathing, head lifts, and pelvic tilt) immediately 

after a vaginal delivery. Wait until 10 days after delivery to start the others (straight curl-ups, 

diagonal curl-ups and knees-to-chest). 

Deep breathing 

You can do this exercise standing, sitting or lying on your back with knees bent and feet flat 

on the floor. 

• Place your hands on your abdomen and take a deep breath through your nose. 

• Breathe out very slowly through your mouth, pulling in your abdomen towards your back, until 

you feel you’ve completely emptied your lungs. 

• Repeat five times, progressing to doing one repetition 10 times a day by the end of the first week. 

Head lifts 

This exercise helps prepare your abdomen for the later, more strenuous exercises. 

• Lie on your back with knees bent and arms crossed over your chest or at your sides. 

• Breathe in. 

• Slowly breathe out and raise your head until you can see your knees. Hold for a count of three. 

• Slowly lower your head. 

• Repeat five times, every four hours, increasing to 30 head lifts a day by the end of the first week. 

Pelvic Tilt 

• Start by doing this exercise lying on your back with your knees bent. Use other variations in a 

few days as you feel comfortable. 

• Lie on your back on a firm surface, knees bent, feet flat on the floor. 

• Tighten your buttocks and slowly flatten the small of your back. (With your hands on your hips, 

you should feel your pelvis tilt.) 

• Hold for a slow count of three, then relax. 

• Gradually increase the hold to five seconds and progress to doing one exercise 8-10 times a day 

by the tenth day. 

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Knees-to-chest 

• Lie on your back, knees bent and feet raised. 

• Tilt your pelvis to make sure your lower back is flat. You can help the tilt by placing your hands 

or fists palm down under both sides of buttocks. 

• Breathe in. 

• Slowly breathe out while slowly bringing your knees as close to your chest as possible. 

• Slowly breathe out and return to starting position. Repeat three times the first day gradually 

increasing to 10 times a day. 

Straight curl-ups 

• Lie on your back with knees bent and feet flat on the floor, about 12 inches apart, arms reaching 

toward knees. 

• Take a deep breath. 

• Slowly breathe out while flattening the small of your back (pelvic tilt) and curling your head and 

shoulders slowly forward, towards your knees. Reach as far as you comfortably can. 

• Hold this position for a slow count of five, then slowly roll down to your starting position. Relax 

the pelvic tilt. 

• Start with 4-6 repetitions the first day, gradually increasing to 8-12. 

Diagonal curl-ups 

• Start in the same position as for straight curl-ups. 

• As you breathe out, slowly curl up, reaching diagonally. (Reach your right hand to the outside of 

your left knee.) 

• Slowly return to starting position as you breathe in. 

• Repeat, reaching left hand toward outside of right knee. 

• Start with 4-6 repetitions the first day, gradually increasing to 8-12. 

• More advanced: lift knee to opposite elbow with hands clasped behind head. 

Intimate Issues 

Your body is still healing from your delivery. Although it takes at least four weeks for your body to 

heal, your hormones may not have returned to normal. Now that you have given birth to your baby, 

you probably aren’t getting as much sleep as you used to, your hormones and energy levels are all 

changing, and your sexual drive may or may not have returned. Here are some general guidelines 

to follow when considering resuming sexual activity. 

• It usually takes about four to six weeks for your body to heal enough to resume sexual relations. 

Check with your healthcare provider to make certain the lochia from the placental site has 

cleared before having sexual intercourse. 

• You may notice vaginal dryness. A water soluble lubricant like K-Y Jelly may help. 

• Sex may be uncomfortable. If you have had an episiotomy or a laceration there may be painful 

discomfort for weeks to months after delivery. If you had a normal vaginal delivery or a Cesarean 

delivery you may also feel discomfort. Your doctor may be able to prescribe an estrogen cream to 

lessen the pain and tenderness. 

To prevent pregnancy you should decide on a method of birth control before having sex. There are 

several methods to choose from so choose one that best fits your lifestyle. Remember that women who 

breastfeed and women who have not resumed a regular menstrual cycle may still become pregnant. 

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Abstinence 

This means that you do not resume having sexual intercourse. This method is 100% reliable. 

Birth Control Pills/Oral Contraceptives 

Birth control pills are made of artificial hormones that stop the ovaries from releasing eggs each 

month. You must have a doctor’s prescription. The pills must be taken every day to be effective. If 

you are taking antibiotics, this may affect the reliability of birth control pills. Talk with your doctor 

so that you can avoid an unplanned pregnancy. This method is 97-99% reliable. 

Condom 

A latex condom is the most reliable condom. Condoms fit over the penis and prevent the sperm 

from entering the woman’s body. This method is 80% reliable when used alone and up to 95% 

reliable when used with contraceptive foam. Female condoms are another option. 

Contraceptive Foam, Cream or Jelly 

Contraceptive foams, creams and jellies work by killing sperm. These methods are 80-95% reliable 

if used with a condom. 

Depo-Provera 

A medication given by a shot every three months containing a hormone that prevents the ovaries 

from releasing eggs and changes the lining of the uterus. This method is 99% reliable after the first 

two weeks. 

Diaphragm 

A diaphragm is a small, rubber cap that fits over the cervix, keeping the sperm from entering the 

uterus. A diaphragm should be used with a contraceptive jelly or cream. Your doctor will fit you for 

a diaphragm. This method is 82-97% effective. 

IUD 

An IUD is a small device inserted into the uterus or womb. It prevents the fertilized egg from 

implanting into the uterus and growing. This method is 95-99% reliable. 

Natural Family Planning 

A woman must track vaginal mucous, days of menstrual cycle, and temperature daily to help 

predict when she is most fertile. Partners abstain from sexual relations during the fertile period. 

This method is 95% reliable. Detailed information on this method is available from books or your 

healthcare provider. 

NuvaRing 

A flexible ring inserted in the vagina once a month. The ring releases a continuous low dose of 

hormone to prevent pregnancy. The ring stays in place for three weeks and is then removed. One 

week later, insert a new ring. This method is as effective as the pill. 

Patch 

The patch is a thin stick-on medicated square that allows hormones to enter the bloodstream. The 

hormones stop your body from releasing an egg and provides protection from pregnancy. A new 

patch is used once per week for three weeks. On the fourth week, when no patch is used, you will 

get your period. 

94 


Caring for Mom and Dad’s Spirits 

Coping 

It is easy to become overwhelmed as a new parent. It is also completely normal to feel overwhelmed 

and exhausted. You may find comfort in talking with other new parents or joining a weekly parents’ 

group, like the New Mom Network, to meet parents who are experiencing the same joys and 

challenges of parenthood. 

Don’t be afraid to ask for help. It takes a first-time mother six months to a year to adjust to 

postpartum changes. And it takes new fathers just as long to adjust to parenthood. Let your family 

and friends know how they can help you around the house, with your baby or other children, or just 

to have someone to talk with and support you. Asking a friend or relative to watch your baby for a 

short time can help you recharge and gain some perspective. 

Parents should also take some time to spend with each other. Going out for the evening or even for 

a short walk can help you connect as a couple while adjusting to parenthood. 

Understanding Your Emotions 

From pregnancy to the birth of your baby you may experience a wide range of emotions from joy 

and excitement to anxiety and worry. After your baby arrives it is common to feel overwhelmed, 

uncertain and frustrated. Regardless of how prepared you were or how much you looked forward to 

your baby’s birth, you may experience some unexpected “highs” and “lows” after your baby is 

born. You may find time, patience and support from family and friends helpful during this period of 

adjustment. However, sometimes in spite of help and support, your feelings may overwhelm and 

concern you. 

If you are experiencing new and unpredictable emotions, you are not alone. Most women have 

never experienced anything like this at any other time in their lives. Any woman who is pregnant, 

had a baby within the past year or so, miscarried or recently weaned a child from breastfeeding 

can be affected regardless of how many previously uncomplicated pregnancies and/or postpartum 

adjustments she has made. 

The “baby blues” are the most common, least severe and the most well-known postpartum reaction 

and occur in 50-75% of all new mothers after delivery. Symptoms of the baby blues last a short time 

and usually disappear on their own (crying for no apparent reason, impatience, irritability, 

restlessness and anxiety). 

At least one in 10 new mothers experience various degrees of postpartum depression. Postpartum 

depression can occur within days of delivery or may appear gradually, sometimes taking up to a 

year. Your symptoms may make you feel either depressed or anxious depending on how your body 

is coping. Each symptom may come and go to varying degrees, and you may alternate between 

good and bad days. 

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Common Signs of Depression: 

• Sluggishness, fatigue, exhaustion 

• Sadness, depression, hopelessness 

• Appetite and sleep disturbances 

• Poor concentration, confusion, memory loss 

• Over concern for the baby 

• Uncontrollable crying, irritability 

• Lack of interest in the baby 

• Feelings of guilt, inadequacy, worthlessness 

• Fear of harming the baby 

• Fear of harming yourself 

• Exaggerated highs and/or lows 

Common Signs of Anxiety: 

• Intense anxiety and/or fear 

• Rapid breathing 

• Fast heart rate 

• Sense of doom 

• Hot or cold flashes 

• Chest pain 

• Shaking 

• Dizziness 

To help physical and emotional recovery after childbirth, you should get enough rest, eat a 

nutritious diet, and have help and support from family and friends. Consider participating in the 

New Mom Network, an informal time of sharing for new moms and their babies. This group is 

facilitated by a nurse experienced in maternal/child health, infant massage and lactation. Join other 

new moms and their babies in one of two groups—ages 0 – 9 months and 10 – 16 months—for 

discussion about the physical and emotional adjustments to motherhood. Please call WomanCare at 

(717) 231-8975. 

If you have any signs of depression and/or anxiety, talk with others about how you’re feeling. 

Treatment for postpartum depression and postpartum anxiety varies depending on the type and 

severity of symptoms. All symptoms, whether mild or severe, are temporary and treatable with 

skilled professional help and support. If you are having symptoms of postpartum depression and/or 

anxiety, talk with your healthcare provider to begin receiving medical treatment. Treatment may 

include medication and/or psychotherapy. Many antidepressants have been used by women who 

are breastfeeding. If you are breastfeeding and antidepressants are recommended to treat 

depression, talk with your healthcare provider, your pediatrician and a lactation consultant. 

Counseling is available through PinnacleHealth Psychological Associates (PHPA) at (717) 231-8360. 

If you need immediate help, contact Crisis Intervention Services in your county: 

Western Cumberland and Perry Counties 243-6005 

Dauphin County Crisis 232-7511 

Eastern Cumberland and Perry Counties 763-2222 

York County Crisis 851-5352 

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Baby Bonding 

As parents, the time you spend taking part in daily loving contact will help you bond with your 

baby. So take advantage of the time you spend changing diapers, giving baths, feeding, cuddling, 

singing lullabies, and holding your baby. 

Moms and dads can nurture their child’s emotional growth by giving her plenty of comfort, helping 

her feel secure by holding her when she cries, feeding her when she’s hungry, keeping her warm, 

and avoiding jarring movements and sounds. 

Engage your baby’s natural curiosity by providing lots of interesting stimulation. Babies love 

exaggerated expressions and gestures. Make funny faces by sticking out your tongue or smiling 

broadly. You can make your baby gurgle and smile by pitching your voice at different levels. Your 

baby likes to be touched, so gently stroke different parts of her body, starting with her legs and 

moving up. Your baby will let you know what she likes, so watch her expressions. 

Fathers, Too! 

At PinnacleHealth, fathers are important. Now that your baby has arrived, you have a special 

opportunity to get to know your baby, care for him, and become “daddy” as you bond as a family. 

There are many special ways that the bond between dad and baby can grow. Here are some 

suggestions for dads: 

• Talk and sing to your baby. Your deep voice can be soothing. Babies often relax when they 

hear a deep voice. 

• Skin-to-skin contact. Babies love being close to you. Your skin feels good to baby. Hold your baby 

on your chest and relax. 

• Bath time. Make this a special “daddy” time with baby. Bathing can be done anytime during 

the day to fit into your schedule. 

• Holding. Your strong arms and hands are great for holding, swaying, rocking, or dancing 

with baby. 

• Hanging out. Going for walks or car rides, watching TV, listening to music are all ways of 

spending time with your baby. 

• Play time. Playing with your baby can help baby’s motor skills, physical development and social 

interactions. 

• Reading time. Reading stories can be a special time for dads and babies. Babies love hearing 

the words and voice changes during a story. They also enjoy the pictures in the books. Reading 

with dad from an early age can help baby develop a life-long love of reading as well as a close 

father-child relationship. 

• Special dad-and-baby time. Just the two of you to look at each other, play and get to know one 

another. Have fun! 

Congratulations on the birth of your child and on becoming a dad! 

97 


Making Childcare Decisions 

When choosing childcare, it is important to find someone you trust, you can depend on, and with 

whom you feel comfortable. Start your search early. It may take a couple of months to find the 

right childcare provider and you may have to place your baby on a waiting list. Before you begin 

your search, ask your baby’s doctor or other parents for recommendations. 

There are several kinds of childcare settings to consider. So choose one that works best with your 

lifestyle, personality, budget and schedule. 

Group Day Care 

A group day care is often a licensed center featuring rooms and staff specifically trained to care for 

your baby’s age group. It is important to make sure the center is licensed, has a trained, 

experienced and healthy staff, a good caregiver-to-baby ratio, a loving and stimulating atmosphere, 

and strict health and safety rules. 

Family Home Day Care 

A family home day care setting provides a family setting in a private home, usually with only a few 

other children. Costs of home day care are usually lower than those of a center, and scheduling is 

often more flexible. Home day cares may or may not be licensed by the state. When your caregiver 

or her children become ill, you may have to find a back-up caregiver. Look for a family home day 

care that is certified by the state, meets health and safety regulations, and whose providers share 

similar parenting philosophies. 

In-Home Care 

Choosing a nanny or college student to care for your baby keeps your baby in familiar surroundings. 

Keep in mind that if your caregiver is sick or decides to quit, you will need to find another 

caregiver. In-home care is almost always more expensive, especially if you hire a nanny. Once you 

decide who your best candidates are, interview them and check references. Find out why the 

person is interested in caring for your baby and “test” his/her child care skills with questions 

about what he/she would do with your baby all day and how he/she plans to discipline your child 

as he/she gets older. It may also be a good idea to arrange a trial period to determine if you, your 

caregiver and your baby make a good team. 

Questions to Guide Your Search 

When looking for a childcare center, there are several topics to consider that can help guide your 

search. 

• The People 

Consider the personality and values of the child care provider. Do you agree on discipline, 

weaning, feeding and toilet training issues How does the caregiver(s) handle conflict 

How much one-on-one time will the caregiver(s) spend with your child and will his/her special 

needs be accommodated 

• The Place 

Are you comfortable with the environment where your child will spend a significant portion 

of his/her days Is the center/home sanitary, safe and well lit Are toys appropriate for your 

child’s age What is the caregiver-to-child ratio and group size for your child’s age group 

What is the procedure if your child becomes ill or hurt 

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• The Convenience 

The convenience of your childcare provider is important when determining if the provider 

matches your schedule and lifestyle. Is the location of the childcare provider convenient to your 

home or work Are the hours convenient to your schedule What happens if you pick up your 

child either early (partial day) or late What happens if the childcare provider goes on vacation or 

gets sick Are there days the center is closed 

• The Credentials 

It is also important to consider childcare provider’s accreditations. Is the program accredited by 

the National Association for the Education of Young Children or the National Association of 

Family Child Care Are the caregivers certified by the Council for Early Childhood Professional 

Recognition or do they have any post-secondary education credentials Does the caregiver have 

documentation of a criminal background check and/or child abuse clearance Does the caregiver 

have CPR and first aid training 

Once again, thank you for choosing PinnacleHealth. 

We hope this book has been helpful to you during this time. 

We welcome your feedback and suggestions. 

Call our Marketing and Public Relations Department at 231-8900. 

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