Hello and welcome back! This is Episode #2, part of my introductory series covering the very basics of obstetrics and gynecology. The first few episodes of this podcast will focus on foundational knowledge—the essential building blocks you'll need when rotating on the OB/GYN services or ultimately practicing in the field.

Free Downloadable Resources

Before we dive in, I want to remind you that I have multiple free resources available on my website at:
➡️ drkcmiller.com/free-downloads

One of my newest resources is a SmartPhrase template for counseling perimenopausal patients with vasomotor symptoms. This template helps streamline documentation while ensuring a comprehensive discussion of treatment options, including risks and benefits. If you're interested, click here!

Understanding the Maternity Ward

Regardless of hospital size, every maternity ward consists of five key areas:

1️⃣ Labor & Delivery (L&D)
2️⃣ Postpartum
3️⃣ Antepartum
4️⃣ OB Triage
5️⃣ Labor & Delivery Operating Rooms (ORs)

1️⃣ Labor & Delivery (L&D)

L&D is where pregnant patients are actively laboring—either spontaneously or through induction. This is also where they deliver their babies and recover for a few hours before transitioning to the postpartum unit.

📌 A Personal Story:
As a brand-new MS3 on my OB rotation, my attending rushed out saying, "Meet me on L&D!" I panicked—I had no idea what 'L&D' meant! She stopped in the doorway, looked at me with a mix of empathy and pity, and said, "Oh, that's so cute—L&D is Labor and Delivery." I was mortified, but now I always remember:
💡 L&D = Labor & Delivery

Labor rooms can range from a few to over 15, depending on the hospital.

2️⃣ Postpartum Unit

This is where patients recover after delivery—typically:
✔ 24 hours post-vaginal delivery
✔ 48 hours post-C-section

💡 Important Note:

This unit does not house patients who had a miscarriage or termination—those patients are usually admitted to different areas.
The exact length of stay varies by hospital protocol.

3️⃣ Antepartum Unit

The antepartum unit is for pregnant patients who are NOT in labor but require hospitalization for other reasons. Some hospitals call this the High-Risk OB Service or MFM (Maternal-Fetal Medicine) Service.

👩‍⚕️ Common Reasons for Antepartum Admission:

PPROM (Preterm Prelabor Rupture of Membranes)
Preeclampsia with severe features
Uncontrolled diabetes (especially DKA)
Pyelonephritis
Multifetal gestations needing close monitoring
Placenta Accreta Spectrum Disorders

Most patients in antepartum are ≥20 weeks, but hospital policies vary—some may admit pregnant patients <20 weeks to med/surg units instead.

4️⃣ OB Triage (OB Emergency Room)

OB triage is essentially the ER for pregnant patients. Most hospitals only manage ≥20-week pregnancies here, while patients <20 weeks go to the main adult ER before being referred to OB/GYN.

💡 Exception:
Some hospitals, like mine, bill OB triage as a separate emergency department, meaning any pregnant patient—regardless of gestational age—goes there.

👩‍⚕️ Common OB Triage Visits:

Preterm contractions
Labor checks
Vaginal bleeding
Decreased fetal movement
Falls or abdominal injuries
General medical concerns that would normally go to the ER

5️⃣ Labor & Delivery Operating Rooms (L&D ORs)

Every L&D unit has at least one OR (usually 2-3). These ORs are exclusively for OB/GYN procedures—other surgical specialties do not operate here.

👩‍⚕️ Procedures Performed in L&D ORs:
✔ C-sections (scheduled & emergent)
✔ D&C / D&E procedures
✔ Post-op take-backs (e.g., wound dehiscence after C-section)

Final Thoughts

Now you know what to expect when you step onto the maternity floor for the first time! I hope this helps you feel more confident and prepared.

📌 Don't forget to grab your free OB/GYN resources:
➡️ doctorcaseymiller.com/free-downloads

🎙 See you next time!

The Maternity Unit Explained: Triage, Labor & Delivery, Postpartum, Antepartum, OR