Comfort measures in labour and birth

Labour can be categorised into the latent phase of labour and the active/established stage. The pain relief options will be slightly different for each stage. The Latent Phase This is the early phase of labour where your cervix will be softening and getting ready for established labour.  You may experience some period type discomfort and irregular tightening’s, the sensations you feel will most likely be in your lower abdomen and lower back as your cervix softens. For this stage of labour, there are lots of things you can do to help yourself feel more comfortable: Use a hot water bottle…

In preparation for your caesarean section Before your elective caesarean section, a couple of pre-operative tests will need to be undertaken. These will include a swab looking for MRSA. MRSA is a bacteria often found on the skin and in the nose of healthy people but can cause infections after surgery. This will be done 4 to 6 weeks prior to your surgery usually at one of your hospital appointments. A blood test needs to be carried out to check that you are not anaemic. A sample will be kept in case you need a blood transfusion during or after…

Inflammatory arthritis activity can vary and there will be times when it is manageable and other times when you may experience flare-ups. A flare-up of your inflammatory arthritis may include symptoms such as worsening of joint pain, swelling, stiffness, fatigue and general “unwell” feeling. Flare-ups are unpredictable and can start suddenly or after an illness such as a chest or urinary infection or a stressful period (physical or mental). Triggers may not always be identifiable. You must seek urgent medical attention if you have a joint that becomes red, hot, swollen, and painful and a fever, as this may suggest…

Before labour starts, the neck of the womb (cervix) is long, firm and closed. Even before labour begins, the cervix can be drawn up and gets thinner.  The ‘latent’ phase of labour is the very first part of your labour – the early part of first stage. During the ‘latent’ phase the neck of the womb thins and opens up to about 3 to 4 cm.  The latent phase can last several days or weeks before active labour starts. This is normal. Some women have bouts of contractions lasting a few hours, which then stop and start again later or…

Your perineum Your perineum is the tissue between your vagina and your anus.  During birth you can experience perineal trauma/tearing.  This can be classified into four degrees of severity: 1st degree – these only affect the skin, they usually do not require any repair and heal quickly on their own. 2nd degree – these affect the skin and the perineal muscle layer, repair is usually needed. 3rd and 4th degree – 3.5% of women will experience a more substantial tear which involves the muscle that controls the anus. This degree of tear will need to be repaired in theatre. Episiotomy…

The County Hospital has its own Angiography Suite where cardiac diagnostic tests, heart pacing, and the fitting of pacemakers are carried out. The Suite has its own dedicated staff, which assists the doctor and takes care of patients during their visit. It is managed by the heart and lung department. Coronary Angiography Coronary Angiography is a special x-ray of the coronary arteries. The coronary arteries do not show up on a plain x-ray. Coronary Angiography involves a dye being injected down the coronary arteries, which together with their smaller branches, then show up clearly on an x-ray “like a road…

There is now strong evidence to say that homebirth is as safe as giving birth in hospital with many other psycho-social benefits.  Hutton et al (2019) state that ‘The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital’. The Birthplace Study which involved 17,000 cases showed that homebirth is just as safe as giving birth in hospital for second or subsequent births. A possible explanation for this is that labouring in hospital is much more likely to involve interventions, which can interfere with normal physiology and cause further problems such as…

If you have previously given birth by caesarean section your care will differ slightly. You will continue seeing your midwife in the community setting, but will also be invited for a consultant appointment at 14 to 16 weeks and then again at 34 to 36 weeks.  A full discussion about your previous birth and current pregnancy will take place and the options for birth this time around.  Your consultant should go through the risks and benefits of both a VBAC (vaginal birth after caesarean) and an EL LSCS (elective caesarean section).  If you decide to opt for an EL LSCS…

Reasons you may be offered an induction of labour  The following circumstances in pregnancy may result in an induction of labour being offered to you: Post-dates pregnancy Advanced maternal age (40 years of age or more) Suspected big baby Suspected small baby Diabetes Pre-eclampsia Reduced fetal movements IVF If your waters break before tightenings start Obstetric Cholestasis Skip to the factsheet that is relevant to you, so you can start to make a fully informed decision on whether you would like an induction of labour.  Post-dates pregnancy A term pregnancy is classed as anything between 37 and 42 weeks. The…