Labour and pain relief

Remember babies arrive at any time! Some come before they are due, some later, some in the middle of the night so be prepared. Have your case packed in good time and arrangements made for any other children to be looked after.

When do I contact the hospital!

Always if you think you need admission. Also there are certain reasons to contact the Central Delivery Suite. Please telephone if any of the following occur:

• Your membranes have ruptured (breaking of waters).

• Regular contractions have started.

• Any vaginal bleeding, no matter how small.

• If you are worried about any other aspect.

When you ring the West Suffolk Hospital (01284 713278 Central Delivery Suite) you will speak to a midwife who will want to know the following

• Your name and address

• Consultant and community midwife

• Estimated dare of delivery

• History of events

• What transport arrangements have been made

It would be very helpful if you could make sure that you have all this information to hand when you telephone.

How will I get to hospital?

You will be expected to provide your own transport. In an emergency an ambulance can be arranged by the staff on Central Delivery Suite. The hospital, however, cannot arrange transport to take you home.

Who can come with me?

Your husband/partner may come and remain with you in labour. If this is not convenient a relative or friend may stay with you. Visiting is restricted in this area. There are no facilities for children.

On arrival at the West Suffolk Hospital, enter through the main entrance and follow the signs to Central Delivery Suite. If you should go into labour during the night, the main entrance will be closed. Don't panic! Please use the Accident and Emergency entrance where someone will direct you to Central Delivery Suite.

At Central Delivery Suite reception, please use the intercom system. Your midwife will then accompany you to your allocated room.

Central Delivery Suite

In the West Suffolk Hospital we have eight individual labour rooms where you and your partner can stay together throughout labour and delivery. There is also a comfortable sitting room with a television which you and your partner may use.

What happens when I get to Central Delivery Suite

The midwife who cares for you will carry out a full examination and discuss your wishes regarding labour. An internal examination may be carried out if necessary.

Will I have anything to eat or drink?

Fluids and a light diet may be given if there are no contra-indications.

Care in labour

You will be encouraged to be as mobile as possible whilst in the early stages of labour provided there are no problems. Your baby's heart rate may be monitored by a machine periodically during labour, although sometimes it becomes necessary for the well-being of your baby to have the monitor attached throughout labour. It is very difficult to predict how long labour will last as it can vary from woman to woman. However, your progress will be observed very closely and discussed with you.

We want you to have as enjoyable experience as possible from the birth of your baby. The staff will make every effort to follow your requests as long as this does not affect the safety of you or your baby. Do discuss any fears or worries with the midwife allocated to your care.

Pain relief in labour

The great majority of mothers will wish to have some form of pain relief in labour. The following methods and techniques, briefly outlined here, are used at the West Suffolk Hospital.

Relaxation

Relaxation techniques are discussed during parent education classes. This helps to reduce and divert your awareness of pain sensations as well as helping you to relax between contractions. For some mothers this is all that is needed but, for the majority, other forms of pain relief are also required.

Use of water

If you would like to use the water pool, please discuss with your midwife.

TENS

TENS stands for Transcutaneous Electrical Nerve Stimulation. Rubber pads applied to your back are connected to a small electrical control box (about the size of a pack of cards). The box produces low voltage electrical pulses that cause a tingling sensation in your lower back. It works by reducing the number of pain messages going from the uterus to the brain. TENS is useful in the later weeks of pregnancy and in early labour, but often mothers find they need some other type of pain relief once labour is established.

BirthTENS machines may be hired. For information on cost and how to order etc. please telephone 0345 697364 (after hours 01733 311722). (Address: Bounty pain Management, FREEPOST MID21119, Northampton, NN1 3BR)

Entonox

This is a mixture of nitrous oxide and oxygen which you breathe through a mask or mouthpiece during contractions. Entonox is used at some stage by most mothers in labour. It is very effective as a pain reliever, but it does tend to cause drowsiness and make you feel a little light-headed. However, these effects wear off quickly once you stop breathing the Entonox.

Pethidine

This is another common way of relieving pain in labour. Pethidine is a strong pain killer given by injection. An injection will be effective for two to six hours. Although a good pain reliever, pethidine will tend to make you quite drowsy and in some cases, nauseated. It may also make the baby sleepy after birth.

Epidurals

This is the only type of pain relief used in labour that will give you very effective, if not complete, pain relief without causing drowsiness. The anaesthetist inserts a fine plastic tube into your back through which local anaesthetic solution can be administered, blocking the nerves that carry pain sensations from the uterus. Although very effective, an epidural will make your lower half feel numb and your legs weak. Most mothers can have an epidural if they wish the anaesthetic department runs a 24-hour epidural service for mothers in labour. If you want to know more about epidurals there is a separate leaflet available in the Antenatal Clinic.

If you have any further questions about pain relief in labour, please ask a midwife in your team she will be delighted to help in any way she can.

The birth of your baby

Most babies are born normally and are delivered by a midwife. However, sometimes it may be necessary for the birth to be assisted. You and your partner will be fully informed of the situation and your consent will be required for procedures and treatment.

Induction of labour

For most women labour starts by itself, but for some it needs to be started artificially called 'induction of labour'. There are many reasons for induction of labour which will be explained by your doctor and midwife. There is also an information leaner available.

Forceps delivery and Ventouse (vacuum) delivery

It is occasionally necessary for your baby's delivery to be assisted by the doctor applying forceps or a suction cap to baby's head. You may be transferred to a larger room to facilitate delivery. A midwife will be with you throughout.

Caesarean section

This is a surgical operation carried out usually under regional (epidural or spinal) or sometimes general anaesthetic. Some women are told in advance that they will need a Caesarean section tan elective or planned operation) but for others it is an emergency procedure which is carried out during labour. An explanation will be given at the time and an information leaflet is available. A midwife will accompany you to theatre and be with you at all times.

Please refer to The Pregnancy Book for details on types of birth and discuss with your midwife and at parent education sessions.

Vitamin K information for parents

Vitamin K is needed to help blood dot in all normal healthy people. For some reason that we do not fully understand, newborn babies have low levels of Vitamin K in their bodies and this makes them vulnerable to bleeding problems which, although rare, can be severe and sometimes even fatal.

Babies who are delivered by ventouse, forceps, breech or Caesarean section are more susceptible to bleeding. Breastfed babies receive less Vitamin K than bottle fed babies.

Since it was discovered in the 1950s that Vitamin K was needed for blood dotting, millions of babies throughout the world have been given Vitamin K and this has successfully protected them. The Department of Health recommends that every newborn baby receives Vitamin K. Our paediatricians recommend that this vitamin is given by injection.