Glossary

a

• Active Birth

  An active birth is a type of natural birth where the mother is epidural-free and/or is not connected to any drips so she is mobile.

• Anaesthetist

  Anaesthetists are medically trained doctors specialising in pain relief and anaesthesia. During labour and birth an anaesthetist is responsible for providing epidural pain relief and anaesthesia during forceps and ventouse births and Caesarean sections.

• Ante-natal Ward

  If there is a complication with the pregnancy – for example a mother’s blood pressure needs a lot of monitoring or if she has diabetes that needs to be closely controlled – then mothers are admitted to the antenatal ward.

• Assisted Birth

  An assisted birth involves the use of instruments called forceps or ventouse.

b

• Baby’s First Wellbeing Check

  Within the first hour or two of birth a midwife will perform an initial well-being check of baby to make sure that his/her health is good. Baby will then be weighed and two hospital labels with baby’s name and birth details attached.

• Back to Back

  A baby is in the ‘back to back’ or ‘occipito-posterior’ (OP) position when he/she is lying head down but instead of the back facing frontwards it faces the mother’s back. About 10% of labours involve babies in the ‘back to back’ position and in over half of these cases the baby will turn around naturally. If the baby doesn’t turn naturally, labour can be longer and involve more back pain than usual.

• Breastfeeding

  Breast milk allows the mother’s immune protection to be passed to the baby.

• Breathing

  Rhythmic breathing involving deep, abdominal and shallow breaths can help control the pain of labour.

c

• Caesarean section

  A Caesarean section is a surgical procedure to deliver the baby through an incision in the mother’s abdomen and uterus. The mother’s recovery usually takes longer than a vaginal birth and doctors generally recommend no strenuous activity for at least two weeks, including lifting toddlers and carrying heavy shopping.

• Complications with the Baby

  Complications with the baby can occur during pregnancy or labour and can impact on the birth. To minimise complications labour may need to be induced, or an elective or emergency Caesarean section performed. Examples include gastroschisis, where the baby’s stomach wall has not closed properly so the intestines protrude and will require surgery after birth. During labour there can be a show of meconium, which means the baby’s heart rate needs closer monitoring or there can be a slowing of baby’s heart rate which, if serious enough can mean the need for an emergency Caesarean section.

• Complications with the Mother

  Underlying medical problems with the mother’s health or due to the pregnancy can impact on labour and the birth. Examples include diabetes or high blood pressure, having a low-lying placenta at full term or having a heart-shaped womb and these may all require labour to be induced or even a baby to be born by Caesarean section.

• Conception

  Conception occurs when a sperm fertilises an egg forming the first cell of a new life, which then goes on to divide and multiply over the coming days, weeks, and months becoming an embryo first and then a growing foetus.

• Contingency Plans

  Labour and birth are unpredictable so keeping an open mind and having contingency plans is important, just in case things change. It’s good to reflect on contingency options ahead of time, for instance if a home birth is no longer an option.

• Contractions & Dilation

  Contractions during labour bring about the dilation or widening of the entrance to the womb, called the cervix. At the beginning of labour the cervix is usually around 1-2 centimetres wide and by the end it is 10 centimetres. Because labour can be a lengthy affair it’s important for a woman to mentally prepare and pace herself at the beginning. Like a marathon race it involves a slow manageable build up; a long hard slog in the middle; moments when she has to dig deeper perhaps than she’s ever had to in her life and finally, a superhuman dash to the finish line as baby is born.

d

• Delivery of the Placenta

  The placenta is the baby’s ‘life support system’ inside the womb. It also needs to be born during the third stage of labour.

e

• Elective Caesarean

  A Caesarean section is ‘elective’ if it is planned before the due date, usually owing to medical complications involving the baby or the mother, including a low-lying placenta or a heart-shaped womb. In some cases the baby may be suffering from a medical condition that makes a Caesarean section the safest course of action.

• Emergency Caesarean

  A Caesarean section is classed as ‘emergency’ if it occurs after labour has begun. It is seldom life-threatening and is often the best remaining option for delivering the baby safely. Even in an emergency a Caesarean section is carried out with numerous safeguards in place and the team is used to working quickly and safely.

• Epidural

  An epidural is a spinal injection that numbs a woman from below the waist, making walking impossible. For a Caesarean section the epidural is stronger and the numbness will be from the breastbone down. The earliest it can be given during labour is when the cervix is dilated by about 4 centimetres and one disadvantage is that it can slow labour down. It is rarely too late to have an epidural except at the very end, at the pushing stage when the baby is about to be delivered.

• Episiotomy

  An episiotomy is an incision made by the midwife or obstetrician in the muscular tissue between the vagina and the anus, called the perineum to make more room for the baby’s head just at the point of birth. The skin around the vagina will usually stretch to maximum naturally but this can take minutes and if the baby needs to be quickly delivered or is being delivered by forceps, an episiotomy is usually performed. In the past up to 90% of women had episiotomies but today far fewer are performed in the UK – 14% in 2007 – and midwives actively work to try and avoid them.

f

• Feeding

  It’s a good idea to feed a newborn baby within an hour or so of birth so he/she has a full stomach.

g

• Gas & air (Entonox)

  Gas and air is a form of pain relief that is a 50:50 mixture of nitrous oxide (laughing gas) and oxygen, and has the advantage of taking only seconds to work and clearing from the system fast. As well as being under the control of the mother, it has no side-effects.

h

i

• Induction

  A mother’s labour is induced if she has gone over her due date by 10-12 days or if there is a medical indication like high blood pressure or diabetes. To prepare her cervix and to make it more favourable (i.e. opened and flattened) she will be given a prostaglandin pessary, which can take up to six hours and longer to work, followed by an oxytocin drip to start her contractions. Induction can mean that labour takes longer as the body hasn’t prepared itself naturally.

• IVF (In vitro fertilisation)

  IVF involves fertilisation of sperm and egg in a Petri dish in a laboratory. One or more of a woman’s eggs are taken from her ovary and introduced to sperm in a Petri dish. The fertilised egg(s) are then implanted into the woman’s uterus where at least one will hopefully continue to grow successfully.

j

k

l

• Labour Complications

  Complications during pregnancy can include a lack of progress or a delay in contractions. A hormone drip during the first stage of labour can speed labour up; during the second stage it may be necessary to use forceps or ventouse.

• Labour Ward

  This is a ward made up of several rooms for labour and birth and there is often a room with a birthing pool. Most rooms are en suite and contain a special labour bed that can be taken apart to have stirrups attached, and some medical equipment for monitoring baby’s heartbeat, the mother’s blood pressure and a supply of gas and air.

• Latent Phase

  The ‘latent’ phase of labour is the earliest stage when contractions first begin and many women describe the pain as similar to period pain. The mother is still usually lucid and able to chat and even laugh. Professional advice at this stage is to stay at home until contractions become more regular and are closer together – coming at least every 5 minutes regularly over about half an hour. The latent phase lasts until the cervix is dilated 3-4 centimetres after which the first stage of labour begins.

m

• Midwife

  Midwives are female and male health professionals who are experts in normal pregnancy and medically unassisted births. They look after women in pregnancy, during and after the birth. During labour the midwife is a woman’s advocate and as such tries to ensure she feels safe, and finds birth as rewarding as possible. Midwives are also experts at detecting any complications that call for medical intervention, including a referral during pregnancy to see a GP or an obstetrician. Ultimately midwives coordinate and give continuity to a woman during her journey through pregnancy and into early motherhood regardless of whether there are complications or not.

• Mobile epidural

  A mobile epidural is a low dose epidural that allows the mother to continue to move around.

n

• Natural Birth

  A natural birth is a vaginal birth that takes place without the need for instruments – with or without medication.

• Neonatal Unit

  The Neonatal unit is where babies with special medical needs are looked after either because they are born early or are unwell. There is a lot of equipment including monitors that often make bleeping noises, and the temperature is kept high to protect the babies. There are three main areas within the Neonatal Unit – Intensive Care for babies who need the highest level of care; High Dependency for babies who have either improved from their time on Intensive Care or who don’t need that level of intensive care; and Special Care for babies who have improved from High Dependency or are in need of monitoring.

o

• Obstetrician

  Obstetricians are medically trained doctors specialising in pregnancy and birth who become involved when complications arise, for instance a labour that requires a hormone drip or a birth that requires forceps, ventouse or Caesarean section.

• Operating Theatre

  A dedicated operating theatre is usually very close to the labour ward and it contains a piece of equipment called the “resuscitaire” in case baby needs help establishing breathing.

p

• Pethidine

  Pethidine is a drug that acts as a sedative rather than a painkiller. It has the disadvantage of being transmitted through the placenta to the baby’s blood system.

• Post-natal Ward

  Many mothers come to the postnatal ward a few hours after giving birth and will stay her for up to 3 days before going home.

• Pushing the Baby Out

  When it’s finally time to push the baby out a mother-to-be needs to focus on pushing well by listening to her own body’s urges and listening to her midwife who will be stressing the importance of not wasting any of the push – to work with and augment her body’s own natural expulsive urge. She’ll need some energy in reserve here and to dig deep: an exhausted woman and/or one who can’t push well is much more likely to need medical intervention like forceps or ventouse.

q

r

• Reverse Vasectomy

  A vasectomy involves cutting two tubes – the seminal vesicles – that carry sperm from each testicle. Reversing a vasectomy involves reconnecting these tubes. Success rates are as high as 80% if reversal is done within five years.

s

• Skin to Skin

  Immediately after the baby is born – unless there are any complications – he/she will be placed directly on the mother’s naked skin. This skin-to-skin contact is important for regulating baby’s temperature and for bonding.

• Syntocinon & Syntometrine

  An injection of Syntocinon or Syntometrine induces the birth of the placenta in what is called ‘active management’ of the third stage of labour. The injection causes the placenta to be born faster than without. Sometimes syntocinon is used in a drip during the first or second stage of labour to speed up a labour that has slowed down, or as part of the induction process.

t

• Tearing

  Tearing during a woman’s first labour is more likely as her perineum is less flexible. For many women a natural tear is smaller and more superficial than an episiotomy – not involving the deep muscle tissue, it heals faster. There are four degrees of tear with a first degree tear limited to the skin, second degree involving the muscle and third/fourth involving the anus. Third and fourth degree tears are rare and always need surgical attention.

• TENS

  TENS or Transcutaneous Electrical Nerve Stimulation is a form of pain control that involves attaching pads to the body that send tiny electrical signals through the skin which may inhibit the transmission of pain impulses and may also stimulate the body to produce natural pain relieving endorphins.

u

v

• Vaginal Birth After Caesarean (VBAC)

  VBAC is used to describe a mother who gives birth naturally after a Caesarean section with a previous child. Many mothers worry about their ability to give birth vaginally after a Caesarean section but because no two labours are the same it doesn’t necessarily follow that a VBAC is impossible. In fact a Caesarean section is as likely for mothers who have had one in the past as for someone having their first baby. The more positive a mother is, the less she will feel in the shadow of her previous experience.

• Ventouse

  Ventouse is a medical instrument that uses suction to assist in the vaginal birth of a baby. A ventouse has a silicon suction cap that attaches to the top of baby’s head and once suction has been applied is pulled in time with the mother’s contractions. Ventouse can cause the baby’s head to be misshapen temporarily – marks will usually fade within a short time.

w

• Water Birth

  If a birth is judged to be ‘low risk’, a mother can choose to labour and/or give birth in water. Immersion in water can help control labour pains by making a mother feel lighter and helping to relax her muscles. The pool is deep enough to cover a mother’s bump and as warm as is comfortable for her.

x

y

z