The management of your labour will be discussed in some detail from 36 weeks onwards after examination has determined the size and position of the baby. We can discuss your birth plan, pain relief during labour and any personal requirements you may have.
In the absence of any complications such as blood pressure or pre eclampsia one would normally await the spontaneous onset of labour to occur. It is quite safe to allow the pregnancy to go up to 7 days past the due date after which induction of labour is advised. Labour can often be induced in a gentle fashion through the use of prostaglandin gel which initiates the process over a period of 12 hours.
With the onset of labour you can ring the midwives in the Birthing Suite who will ask you to come in once your contractions are occurring every 5 minutes apart. If you have ruptured your waters then it is advisable to go to the labour ward within a short period of time particularly if you are positive for the Group B Streptococcus on the swab taken at 36 weeks. Shortly after your arrival at the hospital I will come to see you and usually perform an internal examination to determine the dilatation of your cervix, assess your progress and arrange for pain relief for you. Assuming all is normal with your labour we shall aim for a normal vaginal delivery. Should the labour not be normal we would need to discuss your options for management that are most suited for your needs.
Pain relief during labour is usually commenced with the use of inhalational nitrous oxide via a mask, progressing to injections of Pethidine on a 4 hourly interval and finally if the labour is prolonged or very intense, an epidural can be inserted by a specialist anaethetist for ongoing pain relief and also for any procedure that may be necessary such as a forceps delivery. For an elective caesarean section, a spinal block is inserted which is effective immediately and lasts for the duration of the operation.