Accompaniment in labour
My job is to provide clear and reliable information so that each mother/partner/family can make a responsible decision about their preferred place of birth (NICE, 2014; Butchart et al, 2007).
Labour
Every woman should get the necessary support regardless of where she wishes to give birth, as birth will go best where she feels safest (Downe, 2007).
Many women prefer to go to hospital to give birth to their babies, for a variety of reasons. However, this does not prevent them, if they so wish, from starting labour in their own environment until they themselves no longer feel safe, or until the process is well advanced.
Scientific evidence shows that a woman's experience of the latent or pre-labour phase of labour and the onset of labour can have a major impact on the duration of labour as well as the duration of the second phase of labour: the birth of the baby (Baxter, 2007).
Often, both women and their partners are ill-informed or ill-prepared to cope with these early stages (Cheyne et al, 2007) as our society is not used to seeing women in labour and there is a belief that pain should be managed in hospital settings (Camann, 2002).
Many women go to hospital too early for various reasons: because the pain is less bearable than expected, because of pressure from family, friends and partners (Barnett, 2003). et al2008), and because their experiences differ from what they have read or heard in childbirth classes and from the experiences of family and friends (Hundley and Ryan, 2004).
When women do not receive adequate support during the onset of labour, they are more likely to go to the hospital very early, which increases the chances of unnecessary medical interventions (Miller, 2003). et al, 2020; Rota et al, 2017; NICE, 2014; Bailit et al, 2005; Klein et al2003; Holmes et al, 2001). Many women are unaware that presenting too early at the hospital may mean that they are not admitted and have to return home (Barnett, 2001). et al, 2008), with consequent fatigue and increased levels of anxiety that increase the perception of pain (Cheyne et al, 2007) due to a drop in oxytocin level in the presence of catecholamines and cortisol, which can also leave women demoralised, discouraged and exhausted (Carlsson et al, 2007). This, in turn, means that these women are in even greater need of psychological and physical support (Rota et al2017; Simkin and Ancheta, 2000).
That is why I offer this accompaniment during the onset of labour. My knowledge of the physiology of childbirth enables me to offer mothers and their partners the right advice for each situation, especially in the presence of pain (Fox, 2007). A woman is more able to relax when she receives reassuring support from a woman with knowledge and experience of birth, making it easier for her to find her own strategies for coping with each situation (Cheyne et al, 2007). Continued support from a trusted, experienced person increases the likelihood of a physiological birth, increases the mother's satisfaction, and reduces the risk of requesting analgesia, of having an instrumental delivery, of the baby's APGAR at birth being low at 5 minutes of life (Sandall, 2007). et al2016; Hodnett et al2012a; Hodnett et al, 2012b) and that the delivery ends in caesarean section (Hodnett et al, 2012b). Every woman is more likely to give birth physiologically if she stays in her own home for longer (Rota et al, 2017; NICE, 2014; Bailit et al2005; Klein et al, 2003; Holmes et al, 2001).
Objectives and Methodology
What do I offer as a professional?
- visits at 10, 16, 25, 25, 28, 28, 34, 34, 36, 38, 38, 40, 41 and 42 weeks (NICE, 2008)
- be on call 24 hours a day from week 37 to week 42
- telephone support or physical support if it is not necessary, in the pre-partum or latent phase.
- to be at home with the mother once labour has begun
- taking care of the ambient temperature
- ensure that there are no distractions or external stimuli
- promote high levels of oxytocin
- eliminate/avoid elements and situations that can cause stress, and therefore high levels of adrenaline and cortisol in the mother and baby.
- physical and emotional support
- monitoring the wellbeing of mother and baby
- monitoring the progress of labour
- promoting hydration and nutrition for the mother
- only if the mother requires it, offer the use of non-invasive analgesic methods such as: the use of water in the form of a bath, birthing pool or shower, mobilisation and change of positions, massage, the use of analgesic breathing, visualisations and aromatherapy.
- accompany the mother to the hospital when she so wishes or when it is clinically necessary to give birth in the hospital or when an anomaly is detected during the process.
- Once in the hospital, the health personnel of the centre will take care of the woman and the baby.
- be accessible by telephone for at least 10 days after delivery, or until final discharge.
- visit mother and baby at home, on days 1, 3, 5, 10 and/or until discharge. I adapt the visits according to the situation and if there are complications or specific needs.
- Assessment of the perineum before discharge with supervision of ergonomics, carrying and daily habits. Recommendation of personalised exercises according to each situation.
Testimonials
Midwife pregnancy monitoring
Contact me to clarify any doubts you may have, it will be a pleasure to help you resolve the concerns that arise in these important moments of our lives.
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