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Additional resources for Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth

Sample text

If the woman has a written birth plan, read and discuss it with her. • Assess the woman’s knowledge of strategies for coping with pain and provide balanced infor­ mation to find out which available approaches are acceptable to her. • Encourage the woman to adapt the environment to meet her individual needs. • Ask her permission before all procedures and observations, focusing on the woman rather than the technology or the documentation. • Show the woman and her birth partner how to summon help and reassure her that she may do so whenever and as often as she needs to.

Women should be informed that oxytocin will increase the frequency and strength of their con­ tractions and that its use will mean their baby should be monitored continuously. Women should be offered an epidural before oxytocin is started. Where oxytocin is used, the time between increments of the dose should be no more frequent than every 30 minutes. Oxytocin should be increased until there are 4–5 contractions in 10 min­ utes.

Clear pathways and guidelines should also be developed for the continued care of women once they have transferred. These pathways should include arrangements for times when the nearest obstetric or neonatal unit is closed to admissions. • If the emergency is such that transfer is not possible, open access must be given on-site for any appropriate staff to deal with whatever emergency has arisen. • There should be continuous audit of the appropriateness of, the reason for and speed of transfer.

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