Labour and birth care for low risk women is provided at home and at the Bethlehem Birthing Unit. Birth care for all women is provided at Tauranga Hospital.
Women’s bodies are designed to birth their babies, but however you give birth, a healthy mum and baby equals successful birth
At around 31 weeks we go through your birth preferences and you make choices regarding your birth and where you would like to be. We talk about many scenarios because birth is never just black and white. Like the baby being born sometimes the journey takes some twists and turns. I don’t want any woman in my care to be uneducated or feel disempowered while she births her baby, so we explore possibilities and discuss them together.
I almost always see clients in their homes in early labour. This reduces unnecessary travel for the woman. It is illegal to move animals when they are labouring and so why would we move a woman unnecessarily? The natural flow of labour hormones can be disrupted by travel, bright lights and switching on our ‘thinking’ brain. A woman should feel warm, safe and secure, in her own space to encourage the labour process to flow and gain momentum. This promotes good outcomes. Once a woman is in good established labour we either stay and home birth (for well low risk women) or we transition to the birth facility and nest there.
Pain relief options
- Heat and massage
All of the above are pain relief options. At home and the birthing unit heat, massage, water, hypnobirthing, TENS and entonox (gas) can be used. Only at the hospital can morphine and epidurals be given. Pethidine, an older opioid drug, is no longer used.
As a primary care community midwife I do not provide epidural care. Epidural is usually the last resort for women in terms of pain relief and it certainly has its place. The reason I hand over to the secondary care midwives at the hospital for epidurals is that unfortunately in New Zealand there is no imposed limit on the amount of hours a midwife can work. This means a very tired midwife who has been awake for well over 24 hours can legally manage epidural and birth care and is expected to do so without question at times. Personally I do not think this is safe for anyone. If you require an epidural this is usually after we have been together for a long time and I feel a fresh pair of eyes is best to manage the equipment and machinery needed for this secondary care process with medication being pumped into the epidural space just outside your spinal cord. I stay with you until the epidural is in place and you are introduced to one of the great midwives that we have in Tauranga hospital and then I leave. I come back the next day and carry on care as normal into the postnatal period.
Sam was so calming and had a nurturing nature about herself which made me feel comfortable and in good hands. She allowed myself and my partner space during the birthing process and I had an amazing and healing birth compared to my first. Sam did all of my postnatal visits and was always informative and caring. It was a wonderful process thanks to her and she always turned up with a smile on her face and was lovely to be around. I felt in very good hands and felt comfortable to ask her any questions I had. Incredible midwife 🙂
Birth at Bethlehem Birthing Unit – August 2021