They are often referred to impersonally: staff. The staff are midwives, doctors, orderlies - each of these people has a role in the delivery room. See who will look after you during your labor.
The most important task is of course ahead of you.Childbirthis primarily your effort, hard work crowned with a great reward. But you won't be on your own, the hospital'smidwivesand doctors are there to help you. What is the exact division of their tasks?
In the pre-delivery emergency room
The first contact with the hospital takes place in the so-called emergency room - the place where patients are admitted to the hospital. First you have to, unfortunately, take care of the formalities, but you can't do that without it. The midwife on duty here will ask you about your details and give you a hospital card, you should show her documents and test results. Then, in the office located in the emergency room, you will be examined gynecologically and - even for a short time - the baby's heartbeat will be monitored (so far no record, the only thing is to find out if the baby is okay). These tests are performed by a midwife or doctor. Based on the research, a decision will be made whether you return home, stay in the pregnancy pathology ward (don't let this name scare you - all women whose labor has not started yet), or whether you will go todelivery room. In the latter case, the emergency room midwife will take you - and your partner, if you intend to give birth together - to the labor block.
According to an expertPaweł Kubik, MD, PhD, specialist in obstetrician gynecology, Institute of Mother and Child in WarsawWho is present at the cesarean?
Currently, the vast majority of Caesarean section operations are performed under regional anesthesia while the patient is conscious. Who can expect in the operating room? A caesarean section requires the presence of two gynecologists - one is an operator and the other an assistant. They are assisted by an instrument nurse who gives and controls the surgical instruments. Of course, an anesthesiologist is required all the time, whose task is anesthesia before the procedure and constant monitoring of the patient's condition during and after the operation. The anaesthesiologist has an anesthesiology nurse to help. Immediately after the newborn is born, it is examined by a neonatologist.
In the delivery room
Depending on the hospital, you will either find yourself in the room where the whole labor will take place, or in the room where you will spend the first period of labor - there may be several women giving birth there at the same time. There are usually 2-3 midwives on a shift in the hospital and they take care of all the women in labor as needed - it is not so that you will be assigned one specific midwife for the entire delivery (unless you have made an appointment with the midwife individually - this is a paid service, available only in some hospitals). The midwife will help you "make yourself at home" in the delivery room (it's time to change into a shirt), ask a few questions, put a hospital card for your baby and with your documentation will go to the doctor's room, where she will briefly report the situation - tell him how far the delivery is going, giving birth, etc.
After receiving initial information from the midwife, the doctor will come to check you to have his own assessment of what is happening. The examinations take place behind a screen - they should not be performed in the presence of other women in the antenatal room. If your labor is going on at a normal, slow pace, your doctor will supervise it by appearing every now and then, but will not be with you all the time. The midwife will ask if you want an enema. If you so wish, it will. This is when fluid is introduced into the rectum, and after a few minutes you will feel the need to have a bowel movement - this will cleanse the intestines of stools, so no surprise will happen when you push out your baby.
Probably now, at the beginning of labor, the midwife will also insert a cannula (on the outside of the hand or forearm), i.e. insert a needle with a short and thin plastic tube through which, if necessary, drugs or body fluids will be introduced. A soft cannula (no longer needle) will stay there until the end of labor or even longer, but it shouldn't bother you in anything - you will probably quickly forget that you have one at all.
It is worth establishing good contact from the very beginning, especially with the midwives. The quality of mutual relations and the climate in which the birth takes place also depend on you.
1st stage of labor
It may take 6-8 hours or more for the cervix to dilate until it is fully dilated. If you want and feel strong, you can move around this time: walk around the hall and corridor, stand against the wall or against your husband and do hip circles, "ride" on a large ball, take comfortable positions on a bed, chair, sack or next to the ladders (they are in many delivery rooms). If possible, you can use the bathtub (it soothes sore contractions) or ask your husband to massage your back.
Nobodythe staff will not be with you non-stop during this time, the midwife will come in from time to time to ask about your feelings and to check the degree of cervical dilation through an internal examination. It is she who is the main person taking care of the birthing child during physiological labor - both during the 1st and 2nd period. Sometimes you can hear from new moms that "the doctor hardly showed up at all" - they say it reproachfully, convinced that they have been disregarded. Meanwhile, it is completely natural - in a proper delivery, when nothing disturbing is happening, the doctor doesn't have much to do, and the care of the woman in labor is the domain of the midwife. She accompanies you, follows the delivery, watches its course, and from time to time she will check the dilation, blood pressure and perform CTG tests. The latter is to assess the condition of the child. They are performed in such a way that two belts with sensors are placed on your abdomen: one monitors the strength of uterine contractions, and the other - the fetal heart rate. The record of the condition of the fetus can be observed on the monitor of the device. The CTG test takes 15-20 minutes and is performed every 1-1.5 hours.
The midwife will examine you, observe you and help you in any way possible - massaging, explaining how to breathe or advising you to find a better position. It is important that you establish a good contact with her and talk about how you feel or if you are in a lot of pain. You should signal her when something bothers you and ask any questions that bother you.
Medical intervention during childbirth
Any medical intervention in the course of labor, such as the administration of oxytocin or an injection to relieve pain, is always the doctor's decision. It is the doctor who gives the order and the midwife carries it out. However, a midwife who knows what is going on can have some influence by telling the doctor what she is seeing. Therefore, if, for example, you do not tolerate the pain very badly and would like to receive an anesthetic injection or use an epidural, report it to either the doctor or the midwife who will forward your request to him.
When, despite the passage of time, your contractions are weak, contractions are short and irregular - they will offer you synthetic oxytocin. Under its influence, they should become more intense and effective. If you give your consent, your doctor will order you to administer the medicine and the midwife will connect a drip to the cannula that you used earlier. Unfortunately, this restricts mobility. Although the drip stand is on wheels and you can walk with it carefully, it is difficult to think about other positions or, for example, entering the bathtub. It is impossible to say how long oxytocin will be administered - sometimes it works quickly and the delivery is clearit speeds up, and for some women it doesn't work at all, and you may need a caesarean section. This is obviously a surgical operation performed by a gynecologist in the operating room.
If there are no indications for surgery, but the pain is so bad that you would like to use an epidural - and there is an option in the hospital - another specialist will appear, i.e. an anesthesiologist. He will administer the drug to the so-called epidural space in the spine. You then need to expose your back (take off your shirt), sit or lie down on the bed, arching your back, and stay still for a while in this position. All you will feel is a slight prick of the needle (anesthetic injection).
2nd stage of labor
When the pressure begins, i.e. the period of pushing the baby out, both the gynecologist and the midwife are always present with the mother in labor. It is the midwife who is delivering the physiological labor - she will tell you when you need to push, how to breathe, and cut the perineum if necessary to make it easier for the head to come out. At least a few people are present around the woman in labor at the pushing stage. There will also be a second midwife who will take care of formal matters: she records the course of the delivery on an ongoing basis, and then records the results of the child's examinations, puts a band with the name on his arm, etc. A gynecologist is present to supervise the delivery and - in case of any difficulties - decides to use obstetric tools (forceps, vacuum tube) or to perform a caesarean section.
There is also a neonatologist who examines the baby immediately after birth. In most hospitals, there will also be an attending lady to keep clean (wash blood, remove contaminants, etc.). There may also be a trainee physician at the time of delivery, and if it is a childbirth in a clinical hospital - you must also take into account the presence of gynecology students and obstetrics students. Of course, you should be asked for permission, and the staff should make sure that it is not a whole group of students, but 2-3 people at most, but you must be aware that in the clinic childbirth will be even less intimate than in other hospitals.
Moments after childbirth
After birth and cutting the umbilical cord (done by the midwife), the neonatologist examines the newborn, and then the midwife washes and dresses the baby. In many departments, the baby is placed on the mother's belly right after birth. This is a very important moment - a newborn, covered with a blanket, listens to its mother's heart, makes its first attempts to suckle the breast, feels good and safe with its mother. It is important that it lasts not 5 minutes, but as long as possible. In some hospitals, this is possible as long as the mother's perineum is undergoing inspection.Because after the baby is born, you still have to give birth to the placenta, and then - if the perineum has been incised - the gynecologist will put sutures there.
Sewing should not be painful, because this place is anesthetized earlier. After giving birth, you will stay in the delivery room for some time (approx. 2 hours), and then you will go to the postnatal ward. Many hospitals have a rooming-in system, which means that your baby will be with you all the time. However, it should not be that you are left without the care of nurses - when you feel tired or have a problem, you should be able to count on their help. Unfortunately, this is not the case, so if you have a choice, take the time to gather the views of other women as they mention the hospital. Childbirth is an important event during which you will need professional, but also kind, supportive care. So go wherever they provide it.