Labour

Labour is defined as regular coordinated contractions that cause your cervix to dilate.

When to Contact the Hospital.

When you have contractions which become stronger and more regular - every 10 minutes, then you should phone Norwest Hospital Birth Unit (Tel: 02 888 28591) or the San Labour Ward (Tel: 02 947 9561). Contractions initially are often felt as low abdominal cramps similar to period pains, perhaps with backache.

Some women experience rupture of their membranes before the onset of labour. This can occur quite dramatically or as a small leak. If you suspect your membranes have ruptured you should phone Norwest Birth Unit or the San Labour Ward.   .

Labour is usually heralded by mucous streaked with blood from the vagina which is called a "show". If this happens you should phone the Labour Ward or the Birth Unit.

If you have bleeding more than usual then please phone the Birth Unit or the Labour Ward immediately.

Your Care in labour.

You can do a virtual tour of Norwest and the San Hospitals including theBirth Unit  / Labour Ward in the photo gallery of our Facebook site.

When you arrive a midwife on duty will be assigned to you to support you and your baby while you are in labour. This midwife will advise me of your admission. your progress in labour, the well being of you and your baby and of any significant developments as appropriate.

If possible I will attend while you are in labour. I will  attend as soon as possible if there is there is any significant problem in labour. I will attend when your delivery is imminent. Your assigned midwife will advise about there developments and when I am needed.

Unfortunately while it is  not possible for me to be with you during all of your labour I am personally responsible for your care and the well being of you and your baby. The midwife looking after you is highly skilled and experienced. She is a trained registered nurse with extra training in midwifery. As well she will be keeping me informed. So don't worry!

Birthing Positions.

I plan to keep your delivery as natural as possible. If all is progressing well you can adopt whatever labour and birthing positions you find more preferable. I do not have strict views about birthing position.You will find some positions are more effective for pushing in second stage than others. 

As well the use of drapes will be kept to a minimum. Your baby will be delivered on to your abdomen when possible with consideration of your birthing position. Also this may not be possible if there is concern about your baby's well being at birth or there is an unusually short umbilical cord this may not be possible.

Pain Relief in Labour.

You choose. All popular modern methods of pain relief are available in labour. These include the gas (Nitrous Oxide and Oxygen mix), Pethidine injection and an epidural block. A booklet on epidurals is available. You should wait until you are in labour before deciding your preference. You do not know how you will cope with the pain of labour or how your labour will progress. Keep an open mind. While an epidural usually gives good pain relief it can slow down your progress in labour and can make it harder for you to push your baby out. On the other hand an epidural gives you much more control at delivery and so can reduce the chances of perineal trauma with a normal delivery If you want to arrange to use a TENS machine I have no objections. Some patients find HypnoBirthing and other such relaxation techniques helpful.

Fetal Monitoring in Labour.

There will be an initial electronic fetal heart tracing at the onset of labour to assess your baby's well being. This is a routine hospital procedure. This monitoring can be discontinued and there will be intermittent monitoring of the fetal heart in labour as long as there is normal progress in an uncomplicated labour. If you have a high risk pregnancy, if there are concerns about your baby's well being, if you have had a previous Caesarean section, if you have an epidural for pain relief in labour or if there other significant complications then there will be indications for continuous electronic fetal heart rate monitoring. Even if continuous fetal monitoring is necessary, where possible we encourage you to be ambulatory and as active as possible in your labour.

Induction of Labour.

Sometimes there are very good reasons why your labour should be induced. These can include concerns about the risks of you going significantly overdue, concerns about your baby's or your well being, concerns about your baby's size being to big for your birth canal, etc.

Some inductions are done for social  - your request. This can be because your husband / partner's travel, your parents arriving form overseas, religious reasons, you are fed up and uncomfortable with being pregnant. I have no objections as long as the risk of a " failed induction" which will mean a Caesarean section is minimal and you are more than 37 weeks pregnant.

Your Perineum.

I prefer  you to have an intact perineum or failing that a small tear.

It is unlikely that you will need an episiotomy if you have a normal delivery or a vacuum delivery. An episiotomy may be required occasionally to avoid a very large tear.

Operative Vaginal Delivery.

This may be necessary because of developments in second stage such as lack of progress in spite of maternal effort or if there is fetal distress. I am highly skilled in both the use of the vacuum suction cap and forceps. Many  obstetricians do not have this range of skills.

What is most important?

I believe that mother and baby well being are the most important considerations and should not be compromised.

I want you to have a successful outcome for yourself and your baby with the minimum intervention necessary and for you and your husband / partner to have a memorable and joyful experience.

Your Husband / Partner.

Your husband / partner is encouraged to stay with you during labour and during the delivery (including operative vaginal delivery and Caesarean section with regional anaesthetic). He is usually your best support person.

He is encouraged to participate in the delivery of his baby unless there is a contraindication, e.g. an urgent vaginal delivery for foetal distress or a Caesarean section. At the very least this will be by him cutting the umbilical cord. I will also invite him to deliver your baby's body, as long as all is progressing well.