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Managing the transitional phase of labour

I have been very impressed by the midwives in Yeovil. This small hospital, where around 1200 babies are born each year, has a fine tradition of midwifery. Too small to have a neonatal intensive care unit, women with known complications before labour tend to book elsewhere, making the majority of women using this facility “low risk”.

The midwives seem to be a close knit group, well versed in midwifery know-how and keen to retain their skills and woman-centred approach. This would be an ideal unit for “midwifery-led”status.

One area we explored in some detail today was the management of the transitional phase of labour. We talked about the benefits of with holding medication during this turbulent and trying time in labour in favour of nudging women along, taking each contraction as it comes, in a “buying time” exercise. It can be hard to ignore loud demands for drugs and stay calm in the face of anxious and agitated dads.

The benefits, however, ca be amazing, as the woman struggles through the overwhelming sensations within her body to emerge ready, willing and able to tackle the second stage of labour. The moment of triumph straight after the birth, as she realises that she has mastered the hard-yards of labour is something to see, and the boost to her self confidence makes it all worthwhile.

Knowing that this outcome is possible and enabling it to happen is a cornerstone of midwifery care. I cannot imagine a better gift for a new mother: the knowledge and self-belief achieved through overcoming the rigours of labour. This is a gift that perhaps only midwives can bestow on birthing women - I hope they realise the importance of what they are offering and use every opportunity to make it happen.

Tomorrow I have a day in the office, then it is off to Hull for another workshop at the end of the week. I have been to Hull before and I am looking forward to hearing how they are doing in their new, combined midwifery unit.

Posted by andrea at October 19, 2005 08:15 PM