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Maternity Information Booklet Portiuncula University Hospital Ballinasloe, Co. Galway Maternity Information Booklet Welcome Welcome to Portiuncula University Hospital and congratulations on your pregnancy! While having a baby is one of the most exciting things that can happen to you, we understand it can also be an anxious time. We hope that the information provided in this booklet will help you make informed decisions about your care and the care of your baby/s. Please do not hesitate do ask for more information or clarification from our staff. Our maternity unit was opened in 1943 by the Sisters of the Franciscan Missionaries of the Divine Motherhood and is now part of the Saolta Hospital Group. The maternity ward has 33 beds, a four bedded labour ward and an admission room. These together with the Early Pregnancy/Assessment Unit are located on the second floor of the hospital. The Special Care Baby Unit is situated on the first floor. Acknowledgements Portiuncula University Hospital would like to thank the many people who were involved in contributing and reviewing the information provided in this booklet, especially our General Manager, Director of Midwifery, Consultant Obstetrician, Clinical Midwife Managers, Staff Midwives, Midwife Specialists (Lactation and Neonatal Resuscitation), Physiotherapists, Dieticians and patient advocate. Maternity Information Booklet Contents Welcome General Information 4 • Important contact numbers 4 • Visiting hours 4 • Protected mealtimes 4 Antenatal Care 5 • Your first antenatal visit 5 • Midwives clinic 5 • Antenatal screening checks and tests 5 • Ultrasound scan 8 • Non-Invasive Prenatal Testing 8 • Your baby’s movements in pregnancy 10 • Vaccines and pregnancy 13 Your Health in Pregnancy 15 • Healthy eating for pregnancy 15 • Food pyramid 16 • Vitamins and minerals 17 • Take care with some foods 19 • Exercise and pregnancy 21 • Pelvic floor exercises 24 • Posture 26 • Optimal Fetal Positioning 28 • Common pregnancy symptoms 30 Lifestyle advice 36 • Pregnancy & Alcohol 36 • Smoking in Pregnancy 37 • Medicines 37 • Drugs in Pregnancy 38 • Travel during Pregnancy 38 • Domestic Abuse 39 1 Maternity Information Booklet Infections in pregnancy 40 • Group B streptococcus 40 • Sepsis 44 • Cytomegalovirus (CMV) 45 • Hand Hygiene 46 Pregnancy Complications 47 • Pre-eclampsia 47 • Gestational Diabetes 49 • Deep Venous Thrombosis 52 Getting ready for birth 56 • Antenatal preparation classes 56 • Hypnobirthing-antenatal preparation classes 57 • Breastfeeding workshop 58 • Birth after caesarean 59 • Preferences for birth (back page of booklet) 112 • Packing your hospital bag 61 Labour and Birth 62 • Signs of labour 62 • Stages of labour 66 Pain relief in labour 69 • Continuous one-to-one support in labour 69 • Comfort measures 69 • Cognitive strategies and hypnosis 70 • Transcutaneous electrical nerve stimulation (TENS) 70 • Entonox 73 • Pethidine 74 • Epidural 74 Induction of Labour 77 • Membrane sweep 77 • Prostaglandin gel/pessary 78 • Artificial rupture of membranes 78 • Oxytocin 78 2 • Risks associated with induction 79 Maternity Information Booklet Infections in pregnancy 40 Special Care Baby Unit (SCBU) 80 • Group B streptococcus 40 • Sepsis 44 After the birth of your baby 82 • Cytomegalovirus (CMV) 45 • Optimal cord clamping 82 • Hand Hygiene 46 • Skin to Skin contact 82 • Vitamin K 84 Pregnancy Complications 47 • Baby tagging system 83 • Pre-eclampsia 47 • Midwife’s check 86 • Gestational Diabetes 49 • Blood loss 87 • Deep Venous Thrombosis 52 • Breast changes 87 • Care of perineum 87 Getting ready for birth 56 • Bowel motions 88 • Antenatal preparation classes 56 • Mobility 88 • Hypnobirthing-antenatal preparation classes 57 • Deep Vein Thrombosis (DVT) 89 • Breastfeeding workshop 58 • Cervical screening 89 • Birth after caesarean 59 • Breast self-check 90 • Preferences for birth (back page of booklet) 112 • Postnatal exercise 91 • Packing your hospital bag 61 • Family planning 93 Labour and Birth 62 Care following Caesarean Section 96 • Signs of labour 62 • Abdominal wound care 96 • Stages of labour 66 Pain relief in labour 69 What to expect emotionally 98 • Continuous one-to-one support in labour 69 • Baby blues 98 • Comfort measures 69 • Postnatal depression 98 • Cognitive strategies and hypnosis 70 • Perinatal support group 99 • Transcutaneous electrical nerve stimulation (TENS) 70 • Entonox 73 Caring for your baby 100 • Pethidine 74 • Keeping your baby warm 100 • Epidural 74 • Feeding your baby 100 • Vitamin D 105 Induction of Labour 77 • Safe sleep 106 • Membrane sweep 77 • Tummy time 107 • Prostaglandin gel/pessary 78 • Screening tests for your baby 108 • Artificial rupture of membranes 78 • Immunisations 110 • Oxytocin 78 • Risks associated with induction 79 Going home 111 3 Maternity Information Booklet General Information Important Contact Numbers Portiuncula Hospital (090) 9648200 Labour Ward (090) 9648250 Maternity Ward (090) 9648233 Outpatients Dept. (090) 9648372 Physiotherapy Dept. (090) 9648279 Social Work Dept. (090) 9648306 Accident & Emergency (090) 9648248 Visiting Hours Portiuncula University Hospital is committed to providing a safe and secure environment for all our families who use the service. An’ Authorised Access’ approach is in operation on the second floor of the hospital. All visitors who wish to gain access to the Maternity unit, Labour ward, Early Pregnancy Assessment Unit and Private Consultant rooms will have to use the intercom system to gain access. Ward entrance to Maternity unit shall remain closed outside of visiting hours. 2.00pm-4.00pm 6.30pm- 8.30pm Main entrance door of the hospital will be closed from 9pm to 7am, please use Accident & Emergency department entrance during these hours. If possible telephone the maternity unit in advance to let staff know of your impending arrival. Protected Mealtimes Portiuncula University Hospital has a Protected Mealtimes policy. This means that during, breakfast from 8am to 8.30am, lunch from 12.45 to 1.30pm and tea time from 5pm to 5.30pm all non urgent activities on the ward will stop. We ask visitors to try to avoid visiting or telephoning the ward during mealtimes unless absolutely necessary. 4 There are snacks available outside of these hours for pregnant and lactating mothers. Maternity Information Booklet Antenatal Care First Antenatal Booking Visit Antenatal care is important to support a healthy pregnancy and to prepare you for the birth of your baby by taking preventative steps to avoid or minimise problems. Antenatal care begins from the moment you know you are pregnant. Once your doctor confirms your pregnancy, he or she will discuss with you the arrangements that need to be made for your antenatal care. It is usual to have shared care between your doctor and the hospital antenatal clinic. The midwife and doctor will talk to you about your medical, surgical, obstetric and family history. Also, the doctor may carry out a physical examination, which includes checking your heart and lungs. You really need to set aside a few hours for this visit so that you can discuss all aspects of your pregnancy with the healthcare professionals. Midwives Clinics Following your initial hospital booking and early pregnancy dating scan, if you and your pregnancy is assessed to be low/normal risk seeing a midwife at the midwifery clinics will be considered the most appropriate pathway for your ongoing pregnancy. The midwives in the clinic work with the support of multi-disciplinary teams. If a problem arises at any stage during the pregnancy you will be referred to an obstetrician in the hospital and the responsibility for ongoing treatment decisions will lie with you and your obstetric team. Antenatal screening checks and tests Most pregnant women have between seven and ten antenatal appointments, sometimes more if they need extra care and support. At each antenatal visit your midwife will monitor your blood pressure, your baby’s growth, heart rate, baby’s position, and check on the general health of both you and your baby. Midwives/ obstetricians will discuss available screening tests (blood tests and ultrasounds) with you during your pregnancy, arranging these as required. Your midwife will provide lots of information about labour, childbirth and looking after your newborn baby. 5 Maternity Information Booklet Blood Tests at Your First Antenatal Visit With your written permission, several blood tests are taken. You will be happy to know that all these tests are usually taken at the same time. These blood tests will: • Check your haemoglobin level (iron) Your haemoglobin level (iron) which is the iron containing oxygen in the red blood cells. The baby will take as much of this iron as it needs from your body. This can often leave the mother anaemic and feeling very tired with no energy. The aim is to keep your haemoglobin level above 11. This test will be repeated at 28 weeks gestation. • Check your blood group. There are four types of blood group - A, B, AB or O. For each of the blood groups, there is Rhesus factor either positive or negative. The rhesus factor is very important in pregnancy because a rhesus negative mother carrying a rhesus positive baby could develop antibodies against the baby’s blood, causing anaemia and jaundice in the baby. This test will be repeated at 28 weeks gestation. • What does RhD negative mean? The rhesus factor is found in the red blood cells. People who are rhesus positive have a substance known as D antigen on the surface of their red blood cells - they are said to be RhD positive. People who are rhesus negative do not have the D antigen on their blood cells - they are RhD negative. Whether a person is RhD positive or RhD negative is determined by their genes that is, it is inherited from a parent. • Why does RhD status matter? RhD status matters if a woman who is RhD negative becomes pregnant with a baby who is RhD positive. This can only happen if the baby’s father is RhD positive but not all children who have an RhD-positive father will be RhD-positive, because the father may have both RhD-positive and RhD-negative genes.
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