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 the San Labour Ward (Tel: 02 947 9561) / Norwest Birth Unit (Tel: 02 888 28591). 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 the San Labour Ward / Norwest Birth Unit  .

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

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

Your Care in Labour.

The midwife on duty will advise you what to do and when to attend the Labour Ward / Birth Unit. Once you are admitted the midwife supervising your care will keep me informed of developments, your progress in labour and the well being of you and your baby as appropriate.

I will attend when possible during an uncomplicated labour and as soon as possible if there is there is any significant problem in labour. I will also attend when your delivery is imminent.

While it is unfortunately 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. So don't worry!

Birthing Positions.

I plan to keep your delivery as natural as possible. If all is progressing well you can adopt the labour and birthing positions you find more preferable. I do not have strict views about birthing position. As well the use of drapes will be kept to a minimum. Your baby will usually be delivered on to your abdomen. 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

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, etc. Some inductions are done for social (eg husband / partner away, parents arriving form overseas, etc) or religious reasons.

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. 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 fetal distress. I am highly skilled in both the use of the vacuum suction cap and forceps.

What is most important?

I believe that mother and baby well being are the primary considerations and should not be compromised by the mode of delivery.

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. I will invite him to participate in the delivery 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 cutting the umbilical cord. Please let me know if he would like to assist in dellvering the baby also.

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Make sure he brings the camera and that the battery is fully charged! He will also be the photographer on the day, though the midwife is usually keen to help.

Other Support People in Labour.

This should not be a problem as long as there are not too many!  Your request should be discussed with me and the Labour Ward / Birth Unit staff prior.