Care During Early Labour
Your midwife is available by pager to answer questions and provide reassurance during early labour. When you think you may be in active labour, your midwife will either assess you at your home or meet you at the hospital. During your prenatal appointment, your midwife will provide instructions about when to page in labour.
If your labour is induced, your midwives will work together with the obstetrical staff to ensure you receive seamless care. Inductions involving oxytocin require a transfer of care to the obstetrician on-call, however your midwife will attend your labour and birth, and if all is well will catch your baby.
Care During Active Labour
During active labour, your midwife will:
- monitor your vital signs
- check your cervix and time your contractions to assess labour progress
- monitor the baby by listening to the baby’s heart rate
- work together with your support person/team to help encourage you
- keep you updated on assessments that we make so that we can discuss the plan for your care
- monitor for complications that can arise during labour and birth.
When the birth is imminent, your primary midwife will call a second midwife, second birth attendant, midwifery clerk or nurses to attend for assistance. At a normal birth, your midwife will catch the baby and pass the baby right to you for skin-to-skin contact. We encourage continuous skin-to-skin contact after the birth to promote mother-baby bonding and a good start to breastfeeding. Midwives will assist with the birth of the placenta, and can repair most perineal tears (with pain relief!).
If your baby needs to be born by caesarean section, one of your midwives will come into the operating room with you and your partner to provide supportive care. If mom and baby are well then we will put the baby skin-to-skin on mom’s chest as soon as possible (sometimes within a couple minutes of the birth) and then keep mom and baby together in the recovery room.
Immediate Postpartum Period
The midwives will monitor you after the birth, administer any medications that you or the baby need, complete a newborn exam and assist you with breastfeeding. Your primary midwife usually stays for 2-3 hours after the birth, and leaves once she is confident that you and the baby are stable.
If you have a home birth, a midwife will return to check on you and your baby within 12-24 hours and she is available 24/7 by pager for any concerns. In hospital, you may choose to stay overnight and go home the next day, or leave at 3 hours postpartum if you and baby are well.
Coping With Labour
Natural Pain Relief Options
• We encourage you to bring your partner and any other support people with you to help you during labour. You may want to hire a private doula for additional labour support.
• Frequent position changes, upright positions and walking often help women to better cope with labour, and make labour progress more quickly.
• In the hospital, showers are available for use in labour. At home, you may use your own shower or tub, or use a birth pool.
• We bring TENS machines and can administer sterile water injections – particularly helpful with lower back pain.
• Music can help encourage endorphin release – you may want to compile your own selection of songs.
• Your support team can assist you with massage, hot and cold packs, acupressure and guided visualization.
Medical Pain Relief Options
• Nitrous oxide (laughing gas) is available in the labour rooms in hospital. It takes about 1-2 minutes to prepare initially and becomes effective in less than a minute. Midwives can prescribe this for you.
• Narcotic medications are available in hospital with a physician’s order. These are given by injection or IV. Your midwife can call a physician to request an order for this and a transfer of care to the physician is not required.
• Epidural pain relief is available at Groves. Your midwife can consult directly with the anaesthetist who will place the epidural with the assistance of a nurse. The nurse will monitor the epidural and your midwife will provide all of your care during labour and catch the baby. A transfer of care to an obstetrician is not required.
Resources about Labour and Birth
- Reducing fear of birth in U.S. culture: Ina May Gaskin (Youtube video)
- Spinning Babies – Easier Childbirth with Fetal Positioning (Gail Tully)
- Resources for Childbirth Preparation (Penny Simkin)
- Childbirth Connection – Evidence-based maternity care
- Debra Betts – Acupressure for use in labour
- Why banking on cord blood isn’t necessarily a good idea (The Globe and Mail)
- Public umbilical-cord blood bank adds to parents’ options (The Globe and Mail)
- Public Cord Blood Donation (Canadian Blood Services)
- Late vs early clamping of the umbilical cord in full-term neonates: systemic review and meta-analysis of controlled trials (The Journal of the American Medical Association)
Please note that Grand Valley Midwives does not endorse or promote any of the information, products or services contained in any of the links posted on our website. We do not receive any compensation, financial or otherwise, for including these links on our website. Accessing information, products or services through any of the links provided is entirely at the user’s own risk. Information on these websites is not meant to replace advice from your midwife.