Giving birth in Bronovo. Welcome! Presentatie Verloskunde en Gynaecologie

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1 Giving birth in Bronovo Welcome!

2 Welcome to Bronovo Content of presentation Preparation The birth When it doesn't go to plan Pain relief Practical information

3 Preparation Medical care from the midwife or obstetrician

4 Preparation Everyone prepares in their own way group or individual course birth plan or intentions internet/books/magazines legalities if not married: registering legally as parents

5 The birth When? 37 to 42 weken Signs? show (mucous plug from cervix) bleeding/ thick bloody mucous leaking amniotic fluid contractions: regular/strength/length/ frequency

6 The birth Care and support during labour Medical Midwife Doctor and medical student Obstetrician Nursing Specialist nurse Specialist nurse in training

7 The birth Dialtion of cervix; first stage What is a contraction? Progression; latent and active phase Positions and posture; birth ball, stool Active pushing; second stage Transition Urge to push

8 Meeting your baby

9 The birth The placenta; third stage Cutting the cord Placenta Blood loss Cord blood donation

10 The birth And then.. Skin-to-skin; the golden hour Brestfeeding Perineal repair: episiotomy/rupture Baby check; head to toe

11 What if it doesn t go to plan?

12 What if it doesn t go to plan? Medical indications in pregnancy: Pregnancy induced hypertension Gestational diabetes Twin pregnancy Previous caesarean section.

13 What if it doesn t go to plan? Medical indications during birth Premature rupture of membranes No contractions hrs High blood pressure Intrauterine growth restriction Overdue Help to birth your baby during 2nd stage Help to birth placenta during 3rd stage

14 What if it doesn t go to plan? Induction method Balloon catheter Vaginal prostaglandin gel Breaking the membranes & IV to stimulate contractions

15 What if it doesn t go to plan? External or internal CTG to monitor baby s heartrate

16 What if it doesn t go to plan? Assisted Birth Vacuum Forceps Caesarean

17 What if it doesn t go to plan? Caesarean Elective or emergency caesarean Family friendly

18 What if it doesn t go to plan?

19 Pain relief options because giving birth is painful!

20 Pain relief How painful is birth?

21 Pain relief Being well prepared Reduces fear Stimulates endorphines Support

22 Pain relief Pain relief options Pethidine Epidural Remifentanil

23 Pain relief Pethidine I.M. injection sedative effect causes drowsiness short acting; maternal 1-2 hours baby sedated for 2-4 hours

24 Pain relief Epidural Sited by anaesthetist Most effective, but not perfect: 2% don t work at all 7% don t work enough contra-indications maternal pyrexia -> baby admission to neonatal unit

25 Pain Relief Benefits epiduraal Highly effective Reduces maternal and fetal stress Minimal risks

26 Pain Relief Disadvantages: Medicalises birth Temporarily unable to walk Bladder control Pyrexia Longer second stage of labour More assisted birth

27 Pain relief Remifentanil pump If you cannot have an epidural: Of a bloodclotting disorder Some medications Serious abnormality of spine

28 Pain relief Pain relief during the birth works best. when you know it is available if you need it, when you need it, and that is your choice...

29 Practical information

30 Practical information Delivery suite - route 54 Postnatal ward - route 53 (Amalia) Neonatal unit - route 55 (Willem-Alexander)

31 Practical information Delivery suites Please call before you set off from home! Contact via central number

32 Practical information A delivery suite

33 Practical information Extra care for the newborn baby

34 Practical information What to bring for yourself? Comfy loose T-shirt Comfy cotton knickers Toiletries Socks Snacks Music

35 Practical information What to bring for baby? Baby romper suits and vests 2-3 hats Warm coat and blanket (to go home) Car seat (please practice at home)

36 Practical information On delivery suite Taking photo s is allowed Filming must be discussed with staff Filming not allowed in theatre Use of mobile is allowed Wifi/CD player/ TV and radio available Refreshments for parents provided

37 Practical information Celebrate! Visiting on delivery suite after discussing with staff Discharge time to be discussed with staff

38 Practical information Postnatal Ward Amalia Route 53

39 Practical information A postnatal suite

40 Practical information

41 Practical information Family friendely care Partner can stay (costs) Baby stays with parents (rooming in)

42 Practical information Help to bath baby

43 Practical information Help with breastfeeding Nurse Lactation consultant advice available

44 Practical information Neonatal Unit Willem Alexander Route 55

45 Practical information Admission of baby to Willem-Alexander Maximum of 24 hour stay on Amalia Birth hotel on 4th floor

46 Practical information Neonatal room Parents are welcome during the day Parents cannot stay overnight

47 Practical information Familyrooms Limited One parent can stay overnight Birth hotel on 4th floor

48 Practical information Going home! Discharge information Letter for maternity nurse & midwife Registering the birth Postnatal check

49 Practical information Taking baby home in car seat

50 Questions? Maternity nurse Midwife Child health clinic Obstertician of midwife 5 weeks after birth

51 See you in Bronovo!

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