Midwifery Care in the Hospital
Having a baby is an exciting time for you and your family and the team of highly trained midwives and doctors on the labour ward are here to ensure that you are cared for in the way that you wish.
The labour ward has 14 delivery rooms, a room with a pool and 2 Maternity theatres. We also have 2 bereavement rooms for families to use and 2 High Dependency rooms.
During your time on the Delivery Suite you will meet a variety of staff. The midwife allocated to care for you may be the only person you see, however she may be supporting a midwifery or medical student. If you do not wish for students to be present please inform the midwife caring for you, however they will not enter the room without your agreement.
It may be that you need to meet one of the labour ward doctors if the midwife refers you for some aspect of your care, and you may meet the anaesthetist if you decide to have an epidural or need to deliver your baby in the operating theatre. Please be reassured that your midwife will introduce you to everyone that you meet during your time with us.
Triage Assessment Area
The Triage assessment unit is based on the labour ward and this is where you will be seen when you are first admitted to the hospital.
The triage telephone number is 01752 430200 and is available to call 24hours a day to offer you advice and support.
You may call us for example, if you start to have contractions, if your waters break or for some reassurance. If you are worried about the amount of baby movement’s you have felt, or you are passing blood then these too are reasons to call us. Sometimes things just do not feel right and you may wish to call us to discuss this.
Please do not hesitate to call us.
We may not always invite you in straight away, but we can give you advice and support over the telephone. Research has shown that the longer women labour in a familiar environment the better they are able to cope with their labour. Make sure that you have someone with you at home and it is often a good idea to eat and drink before you leave for the hospital. You will need some calories to support your body through the labour process.
Central Delivery Suite
Please feel free to bring in personal items that you may wish to use in labour. We have a large number of birthing balls for your comfort but if you wish to bring in your own please do. Music is often a way of distracting yourself from the events of labour so you may wish to bring in your ipod or a small CD player. Refreshments can be obtained from the restaurant, cafe or one of the coffee shops, but we would advise that you bring in high energy drinks and snacks, and also food for your birthing partner.
We recommend a maximum of 2 birthing partners, however if there is a reason why you feel you need more that 2 please speak to your midwife. We also ask that you keep family calls to the labour ward to a minimum if possible. Please nominate a spokesperson who can keep your family updated on your progress.
The midwives on the ward are not allowed to give out any information over the telephone and we would not want to cause offense by refusing to give any news.
Wear clothes that are comfortable, but that are cool and light as the Delivery Suite can become very warm. Button fronted items are preferable as this will enable you to perform skin to skin with your baby as soon as he or she is born. As this item may get a little dirty, please don’t wear an item of clothing that has a sentimental value as it may need to be disposed of afterwards.
Birth partners are also advised to wear light loose clothing as they may need to support you in various positions whilst in labour.
Please try and keep valuables and luggage to a minimum as we would not wish for items to become misplaced. Your birth partner can always bring more items in for you after your baby has been born.
During your pregnancy it is important that you have had the opportunity to discuss your birth choices with your midwife, either in the Antenatal Clinic or at Great Expectations Antenatal Classes. It is advisable to write in the birth preferences page of your green hand held Maternity notes so the midwife caring for you is aware of your wishes.
It is ok if your wishes change during your labour, be guided and supported by your midwife and she will support you to achieve the birth that you want.
If you have decided to have pain relief during your labour there are many options open to you.
Firstly, the natural methods.
These are things that you can do for yourself at home. For example a warm bath, massage, rocking on your birthing ball or simply walking around the living room. Speak to your local midwife or Children’s centre about hiring a TENS machine. This is a machine that has small electrodes that are taped to the base of your back and sends small amounts of current through the electrodes. This is completely safe and is believed to stimulate the body to produce more endorphins which is the body’s own natural painkiller. Once you are in hospital the midwife caring for you will talk through your options if you require further pain relief.
Entonox ; commonly known as “gas and air” this in a mixture of 50% Nitrous oxide and 50% oxygen. You are able to inhale this gas either through a mask or a mouthpiece and the midwife will show you how to use it. Entonox will not take the painful contractions away completely but will make them more manageable. The gas takes about 15 seconds to reach its maximum effect so you will need to start breathing it in before your contraction is at its worst.
Occasionally Entonox can make you feel a little dizzy an light headed and some women feel sick. The sick feeling often passes after you have been using it for a while. It is not always advisable to use Entonox in early labour but your midwife will advise you when the right time to use entonox will be.
Diamorphine Injection; this is an opiate based injection that is given in the top of your thigh or your bottom. The benefits of this injection can last up to 4 hours and it can be repeated during your labour. Again it can make some women feel sleepy and the midwife will give you an anti-sickness injection as well to prevent any nausea. As this drug can make you feel sleepy the midwife would advise that you rest on the bed once it has been given. If the drug is given an hour or so beofre the baby is born, it can make your baby a little sleepy and less likely to feed. This is only a temporary effect however be guided by your midwife as to the timing of this injection. It is also possible to give half doses if your labour is progressing quickly.
Epidural Anaesthesia; If you want the pain of labour to be completely taken away then you may want to consider having an epidural. This will be performed by a senior anaesthetist and is available 24 hours a day. However if they are busy with another patient there may be a small delay so it is often a good idea to tell the midwife caring for you in labour that you may be considering this option.
A drip will be put in your hand before the epidural is sited to ensure that your blood pressure remains stable throughout the procedure. Although we do not offer a “mobile” epidural service so therefore you cannot walk, depending upon the amount of anaesthesia is used you should still be able to move position in bed. However, the longer the epidural is working and the more drugs you receive the heavier your legs will become. The midwife will also need to insert a catheter into your bladder as you may find it difficult to pass urine.
Having an epidural will not necessarily prevent you going straight home from the labour ward; however it may take 2 – 4 hours before you are able to walk properly or empty your bladder. You will need to remain with us until this has happened.
For more information on pain relief in labour please visit the NHS Choices website.
Water is a very beneficial method of pain relief. There is a large pool within the delivery suite and the midwives are fully trained to support you to deliver in water. Not all women are suitable to deliver in water so please speak to your midwife who will advise you. The National Childbirth Trust has also produced some information on delivering in water which you may find useful. Read more about waterbirth.
Having your baby
Hopefully having your baby will be a fulfilling experience for you and your birthing partners, however things do not always go to plan and it is important that you are kept fully informed and are aware of some of the things that can happen.
Some women are unable to push the baby out through the birth canal, and this can be for a number of reasons. It may that you are simply too exhausted to push, your baby may be in a position that makes it hard for to you push effectively, your baby may be distressed or there may be a medical reason why the midwife would not want you to push for too long.
In these circumstances occur the doctors may recommend that you have an instrumental delivery. This is where a vacuum cup or forceps are applied to the baby’s head and the doctor will apply slight traction whilst you continue to push. This can be a worrying time for you and your birth partner but your midwife will stay with you throughout this time and support you.
During your pregnancy your doctor may advise you to have an elective caesarean section, either due to the baby’s position or a condition you have which may prevent you from having a vaginal birth.
We recognise that this may not be what you have chosen and we all do everything that we can on the day to support you. Only one birth partner will be allowed into theatre with you. There is small coffee shop on level 5 where your family members are welcome to wait for news.
It may be that you need to have a caesarean section whilst you are in labour. This may be as a result of your baby becoming distressed or another emergency. Please be reassured that Derriford Maternity Unit have a team of highly trained midwives and doctors working 24 hours a day to ensure we deliver you a high standard of maternity care.
Going home from labour ward
If you and your baby are well following delivery you will be discharged home straight from the Delivery Suite. We recognise that for new mums being at home with your family is where you will receive the rest and support that will be needed. You will be discharged home with all the relevant information to care for yourself and your baby and contact numbers in case you need to talk with us.
If you require a hospital stay because you need enhanced post natal care you will be transferred to Argyll Ward. This is a 26 bedded ward and you can read more about it here.
If your baby is unwell and requires admission to the Neonatal Intensive Care Unit (NICU) or the Transitional Care Ward (TCW), we actively encourage you to stay on the unit with your baby. If you are fit to go home however, you will not be treated as a patient, but as a carer for your baby.