Vaginal delivery
Having a baby is an incredible experience that you will remember for the rest of your life. Our philosophy is to create the right environment for this to be safe for you and your baby whilst at the same time to keep medical interventions to the minimum necessary. We aim to treat you with respect, to communicate clearly with you, to respect your choices and for this to take place in a calm and non-threatening atmosphere. Your birth-partner will be able to be present throughout your time on the labour ward and is encouraged to take part according to his/her wishes. You will be looked after by one of our excellent team of midwives and if you have organised for a physiotherapist to be present then he/she will be contacted. The medical personnel are all highly trained professionals. We have no medical students but occasionally there are student midwives present.
Early stages
Unless you have been told otherwise, it is best to stay at home in the early stages of labour. For a first baby, this ‘latent’ phase of labour can last for many hours during which contractions can come and go. During this time you can try having a bath, walking around and you may eat and drink as you wish. This is a very special time in which you and your partner can be alone with the anticipation of what is to come. You should come to hospital if;
- The waters break
- The contractions last 30 seconds, come every 5 minutes and continue for a period of at least 30 minutes (remember “30-5-30”).
- If you have fresh vaginal bleeding
Labour
Labour starts with the onset of regular uterine contractions that dilate the cervix and ends with the delivery of the placenta (“afterbirth”). It is divided into 3 stages
First stage – the ‘latent’ phase consists of regular painful contractions that push the head onto the cervix making it shorten and start to dilate. This part is often quite prolonged and frustrating unless you know beforehand that this will happen – patience and support from your partner are key. When the cervix is 3cm dilated, the ‘active’ phase of labour starts in which the cervix should dilate at around 1cm each hour.
Second stage – when the cervix is 10 cm dilated the cervix, this is called ‘fully dilated’. Often we wait for the head to descend (passive second stage) for up to an hour before pushing commences (active second stage). The average time to push a baby out for a first time mother is around 50 minutes and for subsequent babies it is shorter at around 20 minutes.
During the labour you will be looked after by one of the midwives. In the early stages you will be encouraged to mobilise and can eat and drink. Later, you may wish to use the bath for pain relief or to rest upright sitting on one of the large birth-balls. Once in established labour an intravenous cannula is placed but is left unconnected and your baby will be monitored (we have wireless monitors to enable you to move about freely). An anaesthetist is available 24hrs a day in case you wish to have an epidural. The midwife will contact me to let me know that you are in labour. I usually come and see you in the early stages of labour and then will be there for the second stage of labour and the delivery. Clearly, if there any concerns, I will be called to attend immediately.
Delivery – I believe that the delivery is a partnership in which those present (you, your partner, the midwife and myself) each participate. I encourage you to have an active role in giving feedback and choosing what feels right for you, enabling you to feel in control. I am very happy for you to choose whichever position you find best for the delivery (on the side, all-fours) and to adapt and advise according to how things go. I do not advise delivery in the bath.
I try to avoid an episiotomy if possible. I do not impose a strict time limit for the duration of pushing but prefer to discuss with you if it seems that you need some help in delivering the baby. The choice between ventouse and forceps to help deliver the baby depends on the clinical situation but usually the ventouse cup is preferred. Around 10% of women with their first baby require this assistance.
Third stage – after the birth, the placenta is delivered. Usually your attention is directed towards your baby and you notice very little.
Afterwards – you and your partner stay with your baby in the delivery room for around one hour before being transferred to the maternity ward. During this time you will be encouraged to have skin-to-skin contact and be shown how to feed your baby if you wish.
What to bring to the delivery room
It is a good idea to prepare a small suitcase for use in the delivery room and a larger on that can be left in the car and fetched later. You should remember to bring the ‘feuille de liaison’ and your camera. A list of necessary items can be found here.
Our rooms are very well equipped – most have a bath, there is a hi-fi system that accepts all i-devices (iPad, iPhone etc..), and special lighting can be adapted to your taste.