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How we support you during labour and birth
Our main aim is to provide every woman in labour with the necessary support and monitoring. A dedicated midwife will support and guide you throughout your stay. Your midwife will be able to explain exactly what will happen during labour and birth. She will also discuss with you what it is you want to happen during labour and birth as well as answer any questions you may have. For all women who have straightforward labours and deliveries with no complications, midwives will be the main point of contact throughout labour and birth. Midwives will inform the relevant doctor/consultant at regular intervals on how labour is progressing. If you have particular views on alternative approaches to labour and birth, please do not hesitate to discuss these with us. We will do our utmost to accommodate your wishes as much as this is possible, whilst still ensuring a satisfactory progress of your labour. The duty doctor will visit you at regular intervals. During delivery, you will have the support of both your midwife and your doctor. The team will only ever intervene if they anticipate potential problems or if delivery is not progressing as it should. Should any additional measures or procedures become necessary these will be explained to you in detail before they are carried out. Only in very rare cases will the urgency of the situation dictate that immediate action is more important than a detailed explanation. Please feel free to ask your midwife or doctor for support at any point if there is anything at all that you are unsure or concerned about.
We are available to you for help and support 24 hours a day. Please feel free to contact us if you are showing signs of going into labour, if you have notice that the baby is moving less, if you are in acute pain, if you have unexplained bleeding or if there is anything at all that you are concerned about.
You can contact the midwives on the labour ward at any time by calling 0621 503 3259. There is no need to let us know in advance that you are coming in.
Signs that you are going into labour can include your waters breaking, regular contractions between 3 and 5 minutes apart or a 'show' (when the plug of mucous sealing the cervix comes away). In emergencies, please also feel free to contact us should you be unable to contact your gynaecologist.
We look forward to supporting you throughout your labour and birth.
Labour and birthing positions
Progress of labour can be affected by the birthing position adopted and vice versa. In the absence of specific medical reasons which may call for a particular birthing position, women in labour can choose whichever birthing position they find the most comfortable. There are a number of labour aids available for this purpose. We will be happy to provide you with special types of chairs, beds and cushions. We even have Maya birthing stools available for you, as well as yoga balls, Roma birth wheels and birthing pools.
Many women find that spending time in a warm bath or pool is a good way to help them relax and many choose to give birth in a warm bath.
Far more important than the particular birthing position a woman might choose is her mental attitude to labour and how it progresses. Being able to accept that each labour and birth is different and accepting that not everything may go according to plan will make it easier to have meaningful input into what actually happens during labour and birth. In general, you can ask your midwife to help you try out different positions and decide which is the most comfortable for you and your baby. There is no such thing as the ideal birthing position that will work for every woman.
A number of women find they can cope with labour pain without requiring pain relief. In many cases, however, it can be helpful to reduce the intensity of the pain somewhat. In addition to sitting in a warm bath, moving around or massage can also be helpful in reducing labour pain.
If pain medication becomes necessary we will always discuss the options fully with you. We offer a wide range of pain relief options, which include the use of homoeopathy, acupuncture, essential oils, relaxation bath, antispasmodic drugs, analgesics and even epidural pain relief.
Epidurals represent a unique method of providing pain relief. Epidurals involve the injection of an analgesic into the epidural space of the spine. The analgesic is injected through a catheter, which is inserted into the space between the spinous processes of two lumber vertebrae. The surrounding area is numbed with a local anaesthetic prior to insertion of the catheter. The epidural catheter will be set up by an anaesthetist. Ludwigshafen Hospital has an anaesthetist on call 24 hours a day. Epidurals are particularly effective in reducing labour pain. The procedure is low-risk and complications are extremely rare. Should you have any questions regarding this method of pain relief, you are welcome to speak to us during one of our Information evenings for parents-to-be or, feel free to discuss the issue during one of your Appointments.
Surgical procedures and episiotomies
Sometimes surgical procedures become necessary. Should a caesarian section (C-section) become necessary, this will be performed in our surgical theatre, which is attached to the labour ward. Caesarian sections can be performed using different types of anaesthesia. If requested, the woman's partner may stay with her throughout surgery. In the unlikely event that external factors do not allow for this to happen, you will be informed of this.
C-sections have been known since Roman times. Although the name Caesar comes from the Latin word for "cut" (lat. caesare) the explanation that Caesar was born by caesarian section is only a myth.
For the past 15 years, the European and US approaches to C-sections have been based on the gentle "Misgav-Ladach" method, which was named after the hospital in Jerusalem where it was developed. A special characteristic of this method is that only the skin is cut with a scalpel, while other tissues are simply pulled apart as gently as possible. This way, many of the underlying structures, tissues and nerves remain intact and, instead, are simply pulled out of the way. The resulting scar heals quickly and is hardly noticeable. This gentle method also allows for a quick recovery, meaning that you will be able to return home only four or five days after surgery.
Please be assured that we fully respect your decision to have an elective C-section.
We would still like to point out that the decision to have an elective C-section should only ever be made after careful consideration. This is a complex subject area and every individual case is different. As a result, advice should be sought and discussed in detail.
What we feel you should know:
There is no doubt that a straightforward labour and birth without any surgical interventions and with appropriate pain relief represents the ideal for both mother and baby and is the best way of ensuring a positive birth experience.
It is never possible to predict in advance whether a particular labour and birth will be able to progress without the need for surgical intervention. Thankfully, however, this will be the case for most women.
Of course, labour and birth can have a major impact on a woman's health. However, the same is true for surgery.
Every woman should be able to receive sufficient information on the pros and cons of the different methods of delivery available and then make up her own mind on whether she would prefer to have a natural delivery or a C-section. Complications associated with C-sections, including long-term effects, are rare but cannot be excluded. Recovery following C-section usually takes longer than following vaginal delivery without any surgical intervention.
Short stay deliveries
To ensure that both mother and baby are able to return home only a few hours after delivery, certain preparations need to be made.
If you are planning to have a short stay delivery, please contact your midwife approximately two to three months prior to your estimated delivery date to make sure she will be available on that day. You should also prepare your home for when you return from the hospital.
Immediate discharge following delivery is only possible if the woman is well enough to go home and if blood loss was normal. The woman should be able to get up and move about without any problems. The physical assessment of the child must not show anything untoward. Respiratory and cardiovascular systems must function normally. If you opt for a short stay delivery, you will need to make your own arrangements with regard to the required check-up, referred to as U2 (and to be scheduled for when the infant is between 3-10 days), as well as hearing screening and metabolic screening. You will need to have decided on a paediatrician by the time of your due date as we will require contact details.
If surgical intervention was required during delivery or if the infant was delivered early an early discharge will not be possible.
Giving birth in the water is a particularly gentle way to deliver a baby, something that has been known since time immemorial. Even the Ancient Egyptians knew of the soothing and relaxing effect warm water could have during pregnancy and labour. In 1960, Igor Tscharkowskij, who was both a behavioural scientist and swimming instructor, assisted with the first water birth ever to occur in Europe. According to Tscharkoskij's research, water babies learn to walk and talk sooner than other babies, have better immune systems and higher than average intelligence.
Water births are currently experiencing somewhat of a revival and, in Germany, more and more mothers-to-be opt to have their babies delivered in this manner.
We are pleased to be able to offer you this option at Ludwigshafen Hospital. Please let your gynaecologist know if this is your chosen option. In order to protect your baby's health, you will need to be tested for HIV and hepatitis C.
Postnatal care / Rooming in
We offer rooming in for mother and baby.
What this means: If you wish, your baby can remain with you in your room day and night. If you feel too exhausted to look after your baby following your delivery or C-section, the paediatric nurses in the baby room will be happy to do this for you.
You will receive expert support when starting breastfeeding. Should your breasts not produce sufficient milk after a few days, we will discuss with you what other options you have for feeding your child. Our specially trained breastfeeding advisors and midwives will be happy to assist you in any way they can, throughout the postnatal period and beyond.