Induction of Labour Suite

Welcome Pack

June 2017

Your dedicated team of midwives

Emma Frewin

Natasha Rapley

Karen Rouse

Samantha Bosley

Becky Jordan

Kathryn Sandell

The ward You are currently on level 4 of the maternity block within Iffley Ward. If you are in Bay 26 there is a patient bathroom located just outside the bay. Room 25 had its own bathroom. There is a bath located by the nurses station. The patient kitchen is on your left as you enter the ward. Visiting hours 24 hours for birth partners All other visitors are between 2pm and 9pm Menus This will be given to you on arrival depending on the time you are admitted Breakfast is in the dinning room on Iffley Ward between 8am and 9am. There is a league of friends shop located on level 2. The hospital restaurant is located on the ground floor in south block. Parking We will provide you with a parking permit for your stay with us, this should be given to you and your partner on arrival, if you have any questions please ask a member of staff.

Amenities

Shops within the hospital include:

The League of Friends shop

is on level maternity block.

8am – 5pm Monday to Friday

10am – 4pm Sat & Sun

Marks and Spencer is on

level 2 in the main entrance.

Open 8am-8pm

Lloyds Pharmacy is in the

concourse (corridor linking

maternity block with main

entrance of the hospital)

AMT Coffee Cart 6.30am-6pm

Pumpkin Café 7.30am-8pm

Both on level 2 in main entrance

Jamaica Blue 6.30am-7pm

Mon-Fri, 8.30pm-4pm Sat & Sun

South Block level 2

The Eating Hub Restaurant 7 days a week Breakfast: 7am to 11am

Lunch: 12noon to 2pm

Supper: 4.30pm to 7.30pm

Deli-ghts Café Mon – Fri 9am to 4.30pm

Both on level 1 in South Block

What to expect Induction of labour can be a slow process; it may take a couple of

days to get labour started.

We understand it can also be a very worrying time for new and existing parents.

At all times there is a midwife here to help you and your family. We are here to ensure that you are cared for safely and appropriately. We strive to meet the needs of you and your family.

Throughout your stay with us we will carry out regular observations on both mum-to-be and baby.

Longer periods of monitoring may be carried out on your baby, if required.

If you are on any long-term medication we ask you inform the midwife on your arrival.

If you have any questions that are not answered in the information leaflet, please do not hesitate to ask a member of staff for more information.

Your environment

You may be with us for a few days.

During your stay we will change your linen daily and provide you with clean towels.

We ask you keep your bed space clear in case of emergency.

Please get to know the other ladies in the bay; keep the curtains open. You are all in the same situation and can be a great support to one another. Please don’t worry, we will close the curtains during any examinations.

It can get very warm on the ward so the windows are open most of the time and all bed spaces have a fan.

Dads

The induction process involves you too. You can take your partner on walks around the hospital. Help with massage and also bring in or collect her favourite food from home or the shops within the hospital.

You can help keep the bed areas clear of bags and rubbish.

As the induction process can take some time you are welcome to stay on the ward with your partner. You will however have a chair to sleep in and will be expected to remain suitably dressed at all times.

You may find it better to go home and get some rest so that you are refreshed for what may happen over the next few days. We or your partner can call you should anything change.

Types of induction In order to commence the induction process your midwife will carry

out a set of observations on your arrival to the induction suite, including a scan of your baby to confirm their position and some monitoring of your baby’s heartbeat. Once all the observations are complete in order for us to start the induction process, your midwife will discuss carrying out an assessment of your cervix to establish if you require a pessary or if we can break your waters.

If you require a pessary, your midwife will insert it into the vagina and it will remain in situ for 24 hours. Some ladies just require one pessary to be able to break their waters. Others require a second pessary. Some ladies then also require a vaginal gel.

If we are able to break your waters we will inform delivery suite or Rushey Ward, depending on the level of care you require and await a midwife to be available to start your labour.

Please don’t worry, your midwife will explain things every step of the way.

The importance of mobilising

Mobilisation is really important during all stages of labour. Using the birthing ball and standing helps the baby's head to move down.

Mobilising can also help with coping with contractions in early labour.

You do not need to lie on your bed; please feel free to get up and walk around the ward or go off the ward. Using the stairs is also a really effective way of aiding contractions and encouraging labour.

Just let your midwife know if you are leaving the ward.

Positions Below are some pictures which can help aid labour and delivery

June 2017

Rebozo techniques

Rebozo is used as a seat for

squatting mothers.

The rebozo is used as a hammock to gently rock the

mother’s hips.

This position helps with pushing and engaging the body in squatting positions.

This sifting pose is one of the most famous rebozo positions. It has been used to reposition the baby.

This position helps the mother balance on the birth ball as well

as lift her belly.

Massage The woman being massaged may

be kneeling over bean bags, sitting

or standing.

Her birth partner needs to be

comfortable too.

During a contraction, and in time

with the woman’s breathing, the

birth partner moves his/her hands

up the buttocks to waist level

(during the in breath).

During the out breath, the birth

partner pulls the hands outwards.

Massage technique

Pain relief

If you require any pain relief during your stay on the induction suite please do not hesitate to ask your midwife.

Please ensure your midwife knows about any medication you may take and it is recorded.

Aromatherapy may help (see next page).

During the early stages of induction, paracetamol and codeine can be very effective.

The use of water can also help especially for backache. Please ask your midwife about water injections. There is also a bath or shower on Iffley Ward which can be used.

When contractions become regular we can also offer you the use of Entonox, also known as gas and air. Diamorphine injections are also available.

Aromatherapy What is aromatherapy?

It is a complementary therapy using essential oils - concentrated extracts from a wide range of plants. The oils work in two ways:

By stimulating the nasal/olfactory senses (smell) promoting relaxation.

The chemical components of the oils are presumed to work in the same ways as medicines, but are not suitable to be taken by mouth.

How are the oils applied?

The aromatherapy oils can be applied in a variety of ways, including:

In the bath.

By massage.

In a footbath.

As a compress.

By inhalation methods.

•

Aromatherapy Can anyone use aromatherapy?

If your pregnancy has been uncomplicated and it is expected that your labour will be straightforward, then you may be able to use essential oils during your labour. It will also depend on whether the midwife who is looking after you has been trained to offer aromatherapy. Because of the action of some of the essential oils it is not recommended for aromatherapy to be used in early pregnancy, so some members of the multidisciplinary team may not be able to care for you while using aromatherapy and it may be necessary to move you to a different room if you later require an epidural or assisted vaginal delivery.

The essential oils that we use in the Maternity Unit at the Royal Berkshire Hospital have been chosen for their safety and effectiveness in childbirth. The midwives will advise you on which essential oils and method of use will benefit you most.

In the Maternity Unit at the Royal Berkshire Hospital we only use a small selection of good quality oils. The carrier oil that we use for blending our essential oils for massage is grape seed oil.

Antenatal hand expressing Who may benefit from expressing colostrum from 36 weeks during pregnancy:

Women with diabetes.

Women with gestational diabetes.

Women who experienced previous problems with breastfeeding.

Women with polycystic ovarian disease (PCOS).

Women with high blood pressure and mothers taking Labetalol (beta blockers)

Women booked for early inductions of labour.

Women expecting babies who are expected to be born small for dates.

Women who are overdue.

How to hand express

Wash hands thoroughly.

Have a clean sterilised container/cup/syringe to use before you start.

Start by gently massaging the breast from the top working towards the nipple. Try nipple rolling. Have a warm bath first or a shower to help the flow.

Make a ‘C’ shape with your finger and thumb, cupping your breast, with your thumb above and fingers below about 2-3cms from the base of your nipple.

Press and release exerting gentle pressure, avoid sliding your fingers over your skin, build up a rhythm as at first a few drops will appear, keep going as your supply will build up over time and begin to flow more freely.

When the flow slows down, move your fingers round to a different area of your breast and repeat as above. When the flow slows or stops, swap to your other breast and start again.

If there are no signs of colostrum, try moving your fingers either nearer or further away from the nipple until you find the right spot, and try a gentle breast massage. It is normal for very little to be produced at first, no need to feel disheartened.

Start once a day and express for around 15-20 minutes on each breast depending on how easy it is for you. Some women express twice or more per day.

We hope you found this information useful and wish

you luck in your journey into parenthood.

The Induction Team