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Written by Maternity Team
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Homebirth
If you are healthy, are having an uncomplicated pregnancy and live within the area where we provide a community midwifery service, you may want to consider a homebirth as an option. Homebirth has been shown to reduce the likelihood of interventions in health pregnancies. Homebirth is not an advisable option should a complication arise in your pregnancy, or if you have either a medical or obstetric history that indicates that a hospital birth is more appropriate.
We aim to run a 24-hour service but very occasionally this not possible because the community midwives maybe attending another homebirth or it maybe due to staff sickness. On these very rare occasions your Midwife will keep you informed and explore other options with you.
Hospital Birth
If you have chosen a hospital birth you may receive care in the Home-Home rooms or the main Delivery rooms. The Home-Home rooms offer facilities to the women who have had uncomplicated pregnancy and wish to give birth naturally without the use of an epidural. Upright positions, moving around and the use of the birthing pool are encouraged. If you require an epidural you will be admitted to one of the main delivery rooms. Your Midwife will be happy to discuss the options with you.
The Labour Ward is situated on the 3rd Floor in the Abbey Wing
If you have chosen a Hospital Birth you will need to make your way in by your own transport. Only in an emergency should you ring a 999 ambulance. i.e Bleeding or premature labour. Ring the Labour Ward and the midwife will be happy to give advice.
Triage
If you are over 37 weeks of pregnancy and you have had an uncomplicated pregnancy it is more than likely that when you go into labour or if your waters break you will be assessed by a midwife in the Triage Unit. This is a Midwifery–led unit where a midwife is able to assess you in a timely manner, give you the appropriate advice and direct you either to Labour Ward or recommend if you are in early labour to go home with a plan and to await events.
The Triage Unit is situated on the 1st floor just inside the Joan Booker Ward
There are three stages of labour. In the first stage of labour the cervix gradually opens up (dilates).In the second stage the baby is pushed down the vagina and is born. In the third stage the placenta comes away from the wall of the womb and is also pushed out of the vagina.
Early signs and symptoms of labour
One of the first signs that labour may soon be starting is a “show” This is a blood –streaked mucous plug which is passed out of the vagina when your cervix(neck of your womb) begins to change .This is not a very reliable sign and not all women see this. For those women who do see a show, labour maybe as much as a week or so away. The most common indication that labour has begun is the start of painful contractions. These help soften the cervix, and then the cervix will gradually open to about 10 centimeters. The contractions can range in intensity from a mild irritating discomfort to a strong pain that maybe felt low in your back or like waves moving across your abdomen. It is important to time how often these come and for how long they last.
When contractions are regular (coming every 5-10 mins ) and lasting 45-60 seconds we would advise you to call the labour ward for advice before coming into hospital. Do bear in mind the distance that you live from the hospital (Hospital birth) or how long it may take for the Community Midwife to get to you (Homebirth) if you have had a baby before the next birth may be quicker.
The bag of water surrounding your baby may break before labour starts. If your waters break, you will notice either a slow trickle from your vagina, or a sudden gush of water you can’t control. If your waters break you will need to be seen and assessed by a midwife either in Triage or on the Labour Ward.
Call the Labour Ward if:
- You think you are in Labour
- Your Waters may have broken
- You have any vaginal bleeding
- Contractions are regular, every 5-10 minutes
- You are worried that baby is not moving as much as usual
- You have any other anxieties or queries
Labour Ward/ Triage 01932 722835.
Induction of Labour
Sometimes, labour must be started artificially. This is called induction. Labour may be induced if there’s any sort of risk to you or your baby’s health. For example, you have high blood pressure, or if your baby’s failing to grow and develop.
Induction is usually planned in advance, so you’ll be able to discuss the advantages and disadvantages with your midwife or doctor, and find out why they think you should have it.
Contractions can be started by inserting a pessary or gel into the vagina, or by a hormone drip in the arm. Sometimes both are used. Induction of labour may take a while, particularly if the neck of the womb (cervix) needs to be softened with pessaries or gels. Once labour starts, it should proceed normally, but it can sometimes take 24 to 48 hours to get you into labour.
Towards the end of pregnancy, most women want their baby to be born at the time it is due. Some even ask for their labour to be started then. If your pregnancy goes to 41 weeks, your midwife or obstetrician will discuss with you the benefits and disadvantages of induction. However, we strongly advise against induction before 41 weeks unless medically indicated.
Useful information
What to Wear
During labour we suggest that you wear loose clothing which allows freedom of movement. We do have hospital gowns should you require them but most women prefer wearing a large T-shirt or an old nightdress. You are free to wander around when you are in labour so you may want to bring in some warm clothing. Please bring in slippers or comfortable shoes for when you are walking about.
Pain Relief
Labour can be painful, so it’s important to learn about all the ways that you can relieve the pain. It’s also helpful for whoever is going to support you during the labour to know the different options, as well as how they can support you. Ask your midwife or doctor to explain what is available so you can decide what’s best for you. There are many ways of helping to relieve pain and discomfort during labour.
Keep moving. Your position can make a difference. Try kneeling, walking around or rocking backwards and forwards. We have both mats and birthing balls available. Ask if you can have a bath or use our birthing pool. If you decide to use the pool the water it will be kept at a comfortable temperature, but won’t be above 37 degrees. Ask your partner to massage you (although you may find you don’t want to be touched)
TENS stands for transcutaneous electrical nerve stimulation. You can hire your own machine. TENS has not be shown to be so effective during the active phase of labour (when the contractions get longer, stronger and more frequent).It’s probably most effective in the early stages when many women experience low back pain.
Gas and Air (Entonox). This is a mixture of oxygen and nitrous oxide. Gas and air won’t remove all the pain but it can help to reduce it and make it more bearable. Your midwife will show you how to use it. Another form of pain relief is an intramuscular injection (into a muscle) of a drug, such as Pethidine. This can help you to relax, which can lessen the pain.
An Epidural is a special type of local anaesthetic. It numbs the nerves that carry the pain from the birth canal to the brain. For most women, an epidural gives complete pain relief. It can be very helpful for women who are having a long and/or particularly painful labour, or who are becoming very distressed.
All women are different and a method of pain relief may work well for some and not for others. It is best to keep an open mind if something doesn’t suit you and is not giving the relief you need, try something else.
Please discuss the different methods of pain relief with your Midwife, Doctor or Anaesthetist.
Monitoring in Labour
Every baby’s heart beat is monitored throughout labour . We do not, as a rule continuously monitor the baby’s heart beat when you are in labour. We sometimes take a recording lasting 30-65 minutes on admission to Labour Ward. We will then listen in to the baby’s heartbeat at regular minutes intervals when you are in established labour using a Pinard or a hand held sonic aid. If you are having a homebirth the community midwife will again use a pinard or handheld sonic aid.
Eating in Labour
If all is well with in your pregnancy and labour we advise women that, if they feel hungry they should eat a light diet. i.e Tea, toast or a sandwich. We do advise that women avoid spicy and fatty foods. Isotonic (sports) drinks can also be of benefit.
If at any point your labour becomes complicated or if you have Pethidine or an Epidural, we recommend that you do not drink anything further. Your midwife will advise you.
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Last Updated ( Thursday, 14 October 2010 10:54 )
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Labour Care