Hospitality I Compassion I Respect I Justice I Excellence. Postnatal stay in hospital

Transcription

1 Hospitality I Compassion I Respect I Justice I Excellence Postnatal stay in hospital

2 Postnatal stay in hospital The birth of your baby Our aim is to recognise that the women attending the Maternity Unit have greatly differing circumstances and risk factors. We are able to care for most mothers delivering after 32 weeks gestation. We wish to respect your hopes and expectations of your care in labour. The Hospital offers a large range of options for pain relief in labour. The midwives are experienced in supporting women who wish to pursue non drug forms of pain management. These techniques will be discussed at the antenatal classes and your preferences will be recorded in your notes at the pre-admission interview. We have a roster of anaesthetists available in the Delivery Suite if required. Please note that there may be out of pocket expenses incurred from the anaesthetist. Women who are low risk and have their doctors permission may go into the Family Birth Suite when available, which is suitable for those planning a drug free labour. The bath in this room is currently being refurbished, which will allow for warm water immersion as an option for pain management in labour. When to come It is very important that you contact the Delivery Suite should any of the following events occur: Your membranes rupture (water breaks) whether you are having contractions or not (you may feel either a trickle or a large gush of fluid). Your contractions are occurring at regular intervals and/or causing distress. You are experiencing blood loss of a quantity greater than the size of a 50 cent piece which is not a show (this is mucous streaked with blood). You have continuous abdominal pain lasting several minutes or longer. You notice a decrease in activity from your baby. Please telephone the Delivery Suite on (08) or (08) , should you require advice or think it is time for you to come to hospital. 1

3 What to bring to hospital Antenatal shared care card from your GP/Obstetrician. This contains the information about your antenatal visits and all the tests you have had performed in the pregnancy. Health insurance details. Medications. Favourite music (battery operated player is recommended) if preferred for labour. Watch or clock. Toiletries. Nightwear and comfortable day clothes eg tracksuit. Slippers or comfortable footwear. Clothes for you to wear home. Clothes for your baby to wear during your hospital stay - this is important for security reasons. Please ensure that you keep the clothes with you at all times and send home for laundry. Include: Vests Socks Babygro (all-in-one suits) Small amount of change for newspapers etc. Do not bring large amounts of cash or valuables. Camera (ensure you check the battery). Nappy rash cream. Pen and notepaper. Child Health Record Book (All about me!) issued at pre admission visit. Breastfeeding Guidelines booklet (issued at pre admission visit if intending to BF). Telephone and address book to notify friends. Small purified lanolin (Lansinoh or similar) for nipples. Clothing/toiletries for support person. This booklet/information. Cardigan Hat or beanie One pack super sanitary pads and two packets of regular pads. Breast pads regular size. Box of facial tissues. Emery board for sharp nails for baby. 2

4 Support persons We recognise that the birth of your baby is an important event for your family. We strongly encourage your partner and/ or another support person to stay with you during your labour. Children are not permitted to remain with you or your support person while you are in labour in the Delivery Suite. Where possible, you and your baby will not be separated following the birth. Photography during birth of your baby Many parents like to take photographs of the special moment of the birth of their baby. To maintain safety and privacy for all, video recording of the birth, regardless of the type or place of birth (delivery suite or operating suite), is not permitted in St John of God Subiaco Hospital. You may only take still photographs for personal use as long as you are aware of guidelines to maintain safety and do not interfere with or hamper the work of the medical, nursing or midwifery staff. You may be advised to stop photography any time if necessary, for example, in an emergency situation. The Hospital does not accept any responsibility for loss or damage to camera equipment. Telephone calls partner or support person to contact the people you wish to keep informed. Each Delivery Suite has a telephone. Mobile telephone use is restricted in Delivery Suite and Neonatal Unit as it may interfere with sensitive equipment. Caesarean section Should you require a caesarean section, an operating room is available in the Delivery Suite. Most elective (planned) caesarean sections are carried out in general operating suites, allowing the Delivery Suite operating room to be available should an emergency arise. One support person only may accompany you to the operating room. Please ensure that support person wears suitable footwear ie closed shoes when accompanying to operating room. In the interests of your privacy, caregivers cannot give details about your progress of labour or about your baby s condition. Therefore, family and friends are requested not to telephone the Delivery Suite. Instead, it is better to arrange for your 3

5 Baby identification Two name bands are placed on your baby immediately following birth. These are checked against your identification bands should you and your baby be separated for any reason. For safety reasons, it is necessary for the baby to be known by the same surname as the mother whilst in hospital. Birth registration Soon after the birth of your baby, a caregiver will give you a Birth Registration Form to register your baby s birth. It is your responsibility to post this legal document within 60 days of birth to one of the assigned addresses. Claim forms are also available for eligible parents to receive the family payment from the Department of Social Security. Postnatal stay what to expect Getting to know your baby Maximum close contact with your baby is an important part of relating to your baby and preparing to go home. For these reasons, we encourage 24 hour rooming-in (keeping your baby with you) and breastfeeding on demand. Our caregivers will assist with all aspects of your baby s care, including bathing, feeding and changing nappies. Midwives/ nurses on the postnatal wards will develop a plan of care tailored to your individual needs. Partners are also able to board with mother and baby, but please note charges will apply. Length of stay There are several factors that may influence the time you need to spend in hospital following the birth of your baby. As a general rule, if you and your baby are well you may be able to go home on or before day 3-4 after birth if you have had a vaginal delivery or on or before day 5-6 if you had the baby by caesarean section. Early discharge from hospital after your baby s birth may qualify you for visits from a Health Choices midwife. Please ask your midwife/nurse for details. Visiting hours and rest period Visiting hours are between 3-8pm but partners and children are welcome at any time. A rest period is set aside between 1-3pm each day. We encourage you to take advantage of this to get adequate rest and discourage visitors and telephone calls during this time. 4

6 Rooming-in Research shows that keeping your baby with you in your room at all times (night and day) is beneficial. It allows you to get to know your baby, improves your confidence in mothering skills and lessens the risk of infection between babies when in the nursery. It also assists with breastfeeding on demand during the night as well as through the day. Breastfeeding at night will help to improve your supply of milk and improve the quality of your sleep. Midwives/nurses are always on hand to assist you with all aspects of baby care including breastfeeding. During the night the midwife/nurse will regularly check on you and your baby in your room. Baby safety and security We recommend the following precautions to enhance the safety and security of your baby whilst in hospital: Ensure your baby is dressed in its own clothes at all times. Keep the baby with you in your room at all times. Never leave your baby alone. Always place your baby s cot in view. Ensure staff wearing correct identification are caring for your baby. Ensure baby has two identification bands on at all times and that they are checked with your own ID before and after any separation. Always transport your baby in a cot with the bassinette positioned flat. Do not take your baby away from the postnatal ward. Safe sleeping The safest place for a baby to sleep for the first 6 months is in a cot next to the mother s bed (as recommended by the Health Department). This applies in hospital and when you go home. Bed-sharing is defined as babies sharing a bed with their mother to breastfeed or to receive comfort. Co-sleeping is defined as where the mother and baby share a bed and either or both are asleep. Bed-sharing may transpire to co-sleeping when either the mother and/or baby fall asleep. St John of God Subiaco Hospital does not support the practice of co-sleeping and adopts the practices recommended by SIDS and Kids WA as follows: Baby sleeps on their back. Baby sleeps in a cot in your room. Baby is dressed appropriately (not too hot or cold) and does not have their head covered whilst asleep. Baby is in a smoke free environment. There are no toys, wedges or positioning devices in a baby s cot. Skin-to-skin contact between mother and baby is vital for the establishment of breastfeeding and the development of maternal infant attachment. For many, if not most women, this includes breastfeeding and settling their baby in their bed. 5

7 The Hospital requires that the mother places her baby back into the cot when either the mother or the baby needs to sleep. During your stay in hospital a midwife will regular check your room during the day and night to provide care and ensure that safe sleeping practices are adhered to. If you require any further information about safe sleeping practices or have any questions please speak to your midwife/ nurse, who will be able to answer your questions or, provide you with an information pamphlet. After the birth Following the birth of your baby you will be transferred to one of the postnatal wards with your baby as soon as possible. The wards consist of all single rooms (some with double beds if available), each with a telephone, television, tea/coffee making facilities, fridge, en-suite and baby care facilities. Your partner may stay overnight if desired to assist with and learn about the care of the baby. Please note a boarder fee will apply which may be available for rebate by your health fund. Boarders will be provided with an identification band which should be worn at all times when in hospital for safety and security purposes. Children are not permitted to board. Visitors or partners who are not boarders may order meals from room service after 5.30pm. Meals ordered will be charged to your hospital account. Alternatively, food may be purchased from one of our two coffee shops situated on Level 2. A midwife or nurse will show you around your room and the ward s facilities. A patient compendium can be found in every room, providing further information on the Hospital s facilities. There are many educational sessions and physiotherapy programs available as advertised on the poster in each room. We encourage you to take advantage of the relevant sessions. For the first 24 hours your pulse, blood pressure, temperature and blood loss will be checked on a regular basis. It is normal to have a heavy blood loss at first, which will settle over the next few days. There are various methods of pain relief available. Please let your nurse/midwife know if you are uncomfortable. If you have had an epidural do not get out of bed on your own for the first time, as you may not have all the sensation in your legs for a few hours after the birth. Please call your midwife/nurse who will assist you. In hospital, you will be given assistance and advice in all aspects of caring for your baby including bathing, cord care, feeding, and settling techniques. Over the next few days the aim is to prepare you for going home with your baby, allowing you to gain confidence in the day to day care of your baby. 6

8 Days 1 3 Your temperature, pulse, blood pressure and blood loss will be checked but less frequently, as well as: your breasts and nipples. wound, perineal or abdominal (if any stitches). legs for varicose veins, swelling or pain. whether your uterus is returning to normal size. epidural and/or intravenous infusion site (if applicable). The nurse/midwife is skilled and competent to assist you with all aspects of establishing and maintaining breastfeeding. If required you may be referred to a lactation consultant for additional support. Care of your breasts and nipples will be explained to you. If you choose to bottle feed you will be provided with information on how to clean equipment and make up formula feeds. You may still require some pain relief. After pains, caused by the uterus contracting, are common when breastfeeding so some pain relief may be useful just prior to breastfeeding. It is necessary to have an approved baby car restraint fitted to your car. It is recommended to have the car restraint in place prior to coming to hospital. You will also be given forms for the registration of your baby s birth. It is advisable to continue with pelvic floor exercises. If you have had stitches or a wound to your perineum you will be advised of the most appropriate care. If you require rubella vaccination and/ or Anti- D these will be administered prior to discharge. Currently the Health Department of WA is recommending vaccination against Pertussis to new parents.this will be offered to all new parents. Please note that it is recommended that all who have close contact with a newborn baby are also vaccinated against Pertussis. This would include grandparents (arrange at GP). This is the best way of ensuring that babies do not contract Pertussis before they receive their first vaccinations It is important to eat a healthy diet, drink adequate fluid and be as mobile as possible. It is advisable to attend the following education sessions provided by the Parent Education midwives and the physiotherapist (please refer to the timetable in your room). 7

9 Parent Education The postnatal Parent Education talk offers you the chance to meet other mothers and share information. Midwives run the sessions in a warm and friendly environment in the Ward 54 seminar room. We encourage you and your partner to attend before going home. Talks include twice weekly Taking Baby Home and morning chats with a Lactation Consultant. Physiotherapy classes Genesis Physiotherapy Group conduct exercise classes in the Ward 54 seminar room. Caesarean section Following caesarean section you may return to the ward with some or all of the following: an intravenous infusion(iv). epidural catheter. urinary catheter. wound drain. abdominal stitches covered by a dressing. You will require regular pain relief, which may include: Patient Controlled Analgesia (PCA) allowing you to control your own level of pain relief through your IV infusion or epidural catheter. Intramuscular injections. Suppositories. Tablets. Combination of those listed above. You will generally require less pain relief as the days go on. The midwife/nurse will carry out checks as mentioned in days 1-3 above, continuing on to days 4-5 as recovery following caesarean birth takes longer. It is important to ask for assistance to get out of bed on the first few occasions. You are encouraged to be up and mobile as soon as possible to prevent deep vein thrombosis. Postoperatively you will receive a light diet or fluids only (according to your doctors instructions) until your bowel is working normally again. Once you have passed flatus (wind) you will be able to eat and drink normally. This may take a bit longer if you have had a general anaesthetic. The IV, epidural, and urinary catheter will usually be removed on the first day following the caesarean section. The midwife/nurse will check that you are passing urine well following removal of the urinary catheter. Stitches or staples will be removed as per your doctor s preference. A waterproof cover on your dressing will allow you to shower. Once the dressing is removed the midwife/nurse will check the wound daily. Ensure you report any swelling, redness or discharge to your midwife/nurse. If you go home early, removal of any stitches or staples may be carried out by Health Choices midwives who will visit you at home. 8

10 Diet Our catering department provides specialised meals to suit any dietary, religious or cultural requirement. A dietician is also available during business hours. Care of your baby On the day of the birth, the midwife will complete a full physical examination of your baby at birth including weight, length, and head circumference. An injection of Vitamin K will be given with your written consent. Usually a paediatrician will see your baby within the first 24 hours. A charge will be raised by the paediatrician for this service. On days 1-3, your baby will be assessed daily by a midwife/nurse to see that he/she is feeding well, passing urine and bowels working. Between hours the Hepatitis B injection will be given (you will have received information antenatally and written consent requested) and the newborn screening (Guthrie) test will be carried out. Some of these procedures may be carried out by Health Choices if you go home early. On the day of your discharge, your baby will have another full physical assessment including weight and head circumference, and will be reviewed by a paediatrician (this is sometimes carried out on the night before discharge). Vitamin K All babies are given Vitamin K shortly after birth to prevent a blood clotting disorder which can affect some infants. If you would like more information, please speak to your doctor. Hepatitis B The National Health and Medical Research Council (NHMRC) has recommended that all newborn babies in Australia are vaccinated against Hepatitis B. In accordance with Health Department of Western Australia guidelines, all babies born at St John of God Subiaco Hospital are offered free immunisation prior to discharge from hospital. Further information can be obtained from the Health Department of Western Australia. Jaundice Neonatal jaundice is a common condition occurring in 60% of term babies and 80% of premature babies. It is characterised by a yellow colouring of the skin that is most noticeable on the third or fourth day of life. This yellow colouring is generally first noticed in the baby s face, gradually spreading down the body in the coming days. The yellow colouring in the skin in caused by a build up of bilirubin, a naturally occurring product from the breakdown of red blood cells. It is important to understand that this breakdown of red blood cells and accumulation of bilirubin is a NORMAL process in newborn babies and does not usually indicate a problem. 9

11 The majority of jaundice is normal in newborn babies, and is not dangerous for your baby. If the jaundice is very marked, the midwives will ask a paediatrician to review your baby, to decide if any blood tests or treatment are required. Newborn screening test (Guthrie) Newborn screening tests are performed routinely on all babies born in Australia. A blood sample is taken from the baby s heel for the Guthrie test. This test is free of charge and detects metabolic disorders that can be treated. You will be notified only if your baby s test results are abnormal. Hearing screening This test is performed with a hearing measurement test device held externally to your baby s ear and detects congenital abnormalities. This is an optional test for which a fee is charged. We ask you to complete the request form well before your planned day of discharge. Feeding your baby All midwives are skilled in the establishment of breastfeeding and any issues that may arise. If necessary you may be referred to one of our lactation consultants for ongoing management. We encourage breastfeeding on demand. Breastfeeding at night is also encouraged to maintain successful lactation. We will not give your baby formula without your consent. If you choose to formula feed your baby our caregivers will advise you on preparation of equipment and feeds. Neonatal Unit The Neonatal Unit is a 26 bed, high dependency, level 2 nursery, which provides specialised care for babies from 32 weeks gestation. Premature babies (born before 37 weeks gestation) and unwell babies are clinically assessed and cared for in the unit until they are able to be transferred to the postnatal ward. Should your baby be admitted to the Neonatal Unit, you will be kept well informed regarding his or her progress. Please feel free to discuss any concerns you may have with our midwives/nurses. We recognise that parental involvement is a major part of your baby s care and encourage you to visit and participate as much as possible. 10

12 Paediatrician service The Hospital has a 24-hour consultant paediatric service. A paediatrician will attend all caesarean and pre-term births and is available for other deliveries or consultations at your doctor s discretion. (Please note that there is an additional fee for paediatrician services, as discussed at the preadmission visit). Pastoral Services Members of the Pastoral Services team offer emotional and spiritual support for you and your family. This confidential service provided by the Hospital is free and accessible day and night, including weekends. Pastoral Services also provide worship services in the Chapel. Please contact (08) for more information. Going Home Preparing to leave We request that you vacate your room by 10am on the day you leave hospital. The midwife/nurse will carry out your daily check for the last time and answer any questions you may have about going home with your baby. Before leaving, please check with the caregivers regarding medications, x-rays, future appointments or instructions and ensure that you have your child health record book and birth registration forms. It is a legal requirement, and your responsibility, to ensure that your baby is secured in an approved car restraint when travelling in the car, so ensure that you have one ready for your discharge from hospital. Discharge advice following epidural There is a very small chance that complications may not become evident until after your discharge from hospital. Therefore, it is very important that if you experience any of the following you report it to your anaesthetist, obstetrician or G.P. within 4 hours. Nausea or vomiting. Fever. Persistent headache. Back pain that is getting worse. Tenderness, swelling, or pain at the epidural site. Numbness in the legs or buttocks. Leg weakness. Loss of bladder or bowel control. 11

13 Health Choices Depending on your health fund you may be eligible for visits at home by a Health Choices midwife. If you decide to leave hospital early after the birth of your baby or in some cases regardless of day of discharge, Health Choices is able to provide postnatal care in the comfort of your own home. For further information, please speak to your doctor, midwife or contact your health fund. St John of God Subiaco Hospital Health Choices can be contacted on (08) Breastfeeding support service Breastfeeding is a natural process but occasionally difficulties may be encountered. The breastfeeding support service can provide assistance with breastfeeding difficulties if they arise both while you are an inpatient and following discharge from hospital, if required. You will be fully involved in the planning of care. The aim of the service is to: Provide professional support and advice from International Board Certified Lactation Consultants (IBCLC). Provide information to increase the knowledge and skills of breastfeeding mothers. Assist mothers and their babies achieve successful breastfeeding. Increase the incidence and duration of breastfeeding. There are many reasons to use this service including difficulty attaching your baby to the breast, sore or cracked nipples, inverted nipples, too much or too little milk, mastitis, engorgement, breast pain, unsettled/unhappy baby, baby not gaining weight, refusal of breast by your baby, difficulty expressing milk, breastfeeding twins and breastfeeding a premature baby. Services provided are: Antenatal breastfeeding workshops (please contact Parent Education for details on (08) ). Support at ward level from experienced nurses/midwives. Ward consultations by qualified Lactation Consultants if breastfeeding difficulties arise. Support following discharge from Hospital. Support following discharge is provided by: Telephone service for advice (breastfeeding support service only) Simply call (08) In most cases you will be required to leave a message. A Lactation Consultant will return your call. Breastfeeding clinic The clinic is open between 8.30am 4.30pm, Monday- Friday. We encourage mothers to self refer. Appointments are necessary and are usually between minutes. All women experiencing breastfeeding problems of any kind may use the services of the Breastfeeding Clinic. The clinic is located on Level 3 adjacent to the Delivery Suite (note a fee will apply). 12

14 Breastfeeding day stay For those who require extra assistance to successfully breastfeed, there is the opportunity for mother and baby to spend a day with one of our Lactation Consultants. A fee applies but may be refunded through your health insurance fund. When attending the day stay program please wear comfortable clothes for ease of breastfeeding and bring your infant health record book, nappies, change of clothes for your baby, plastic bag for soiled nappies (if cloth nappies are used) and your pram. Lunch and refreshments will be provided. A Lactation Consultant may follow up your visit with a telephone call to provide further support, if necessary. Open House St John of God Subiaco Hospital provides ongoing support for mothers with the Sr Francesca Brennan Open House located in St John of God House. Wednesday 9.30am to 11.30am - for mothers with babies 5-12 months. Wednesday to 2pm - for mothers with babies 2-5 months. Thursday 1.30pm to 3pm - for mothers with babies up to 8 weeks old. Experienced midwives facilitate the sessions where mothers are able to meet and share their joys and concerns in a warm and caring environment. Parenting information and guest presenters are also included in the Wednesday sessions. Other Services Raphael Centre The Raphael Centre offers a support and information service for parents affected by anxiety or depression during pregnancy or in the three years following the birth of their baby. Our highly experienced and specialised team provides a family centred service (either while you are in hospital or at home) that aims to: Enhance the social and emotional wellbeing of women and their families. Support parents in their relationship with each other and their baby. Increase parenting satisfaction and coping skills. The centre also offers services such as: Telephone support and information Individual therapy and assessment. Postnatal anxiety and depression therapeutic groups. Parent-infant therapeutic programs. Referral to the Raphael Centre can be made by the obstetrician, midwife or the mother herself. Some services attract a fee which may be rebated through Medicare. Please call the Centre on for further information. For enquiries, please call (08) and ask for Parent Education or subiacoparenteducation@sjog.org.au. 13

15 Some of the other services offered at St John of God Subiaco Hospital during and after your stay include: Room service (in addition to normal meals). Postnatal and antenatal aquatherapy classes. Baby Dolphin Swim Classes (10 week program - for information contact ). Professional photographers are available for baby portraits and announcement cards. (Note: some of these services will incur a fee) Please refer to the patient compendium, located in your room for details on the full range of services available. Any further assistance or information can be obtained from your midwife/nurse. After you go home If you require advice or assistance after you go home the following may be useful resources: Your General Practitioner Your Obstetrician Health Direct Your baby s personal health record also contains a list of useful telephone numbers. We regret that we cannot provide advice via the telephone once you have been discharged from hospital. 14

16 About St John of God Health Care St John of God Health Care is a leading provider of Catholic hospitals, diagnostic and outreach services, basing its care on the values of Hospitality, Compassion, Respect, Justice and Excellence. 12 Salvado Road Subiaco, WA 6008 T F E. info.subiaco@sjog.org.au SGHSOBCH /12 Follow us on: facebook.com/stjohnofgodhospitalsubiaco