![]() ![]() Explain the arrangements for transfer to the woman and her birth companion(s). The woman is made to feel as comfortable as possible before and during transfer.Īny ambulance staff or other personnel involved are aware that some positions may make the woman uncomfortable or afraid and could affect her labour, so she should be encouraged to choose how to move and what position to adopt if possible, in accordance with ambulance service protocols.Ĭommunication and companionship are maintained. Third‑degree or fourth‑degree tear or other complicated perineal trauma that needs suturing.īefore transfer, the woman is dressed, wrapped in a blanket or otherwise covered in a way that she feels is comfortable and appropriate. Obstetric emergency – including antepartum haemorrhage, cord prolapse, postpartum haemorrhage, maternal seizure or collapse, or a need for advanced neonatal resuscitation Request by the woman for additional pain relief using regional analgesia Temperature of 38☌ or above on a single reading, or 37.5☌ or above on 2 consecutive occasions 1 hour apartĬonfirmed delay in the first or second stage of labour Pain reported by the woman that differs from the pain normally associated with contractionsĪny risk factors recorded in the woman's notes that indicate the need for obstetric led care. The presence of significant meconium (see recommendation 1.5.2) Rupture of membranes more than 24 hours before the onset of established labour (see recommendation 1.15.25) Temperature of 38☌ or above on a single reading, or 37.5☌ or above on 2 consecutive readings 1 hour apart ![]() Pulse over 120 beats/minute on 2 occasions 30 minutes apartĪ single reading of either raised diastolic blood pressure of 110 mmHg or more or raised systolic blood pressure of 160 mmHg or moreĮither raised diastolic blood pressure of 90 mmHg or more or raised systolic blood pressure of 140 mmHg or more on 2 consecutive readings taken 30 minutes apartĪ reading of 2+ of protein on urinalysis and a single reading of either raised diastolic blood pressure (90 mmHg or more) or raised systolic blood pressure (140 mmHg or more) Involve the woman in any handover of care to another professional, either when additional expertise has been brought in or at the end of a shift. When leaving the room, let her know when you will return. Show the woman and her birth companion(s) how to summon help and reassure her that she may do so whenever and as often as she needs to. If the woman has a written birth plan, read and discuss it with her.Īssess the woman's knowledge of strategies for coping with pain and provide balanced information to find out which available approaches are acceptable to her.Įncourage the woman to adapt the environment to meet her individual needs.Īsk her permission before all procedures and observations, focusing on the woman rather than the technology or the documentation. Knock and wait before entering the woman's room, respecting it as her personal space, and ask others to do the same.Īsk how the woman is feeling and whether there is anything in particular she is worried about. Maintain a calm and confident approach so that your demeanour reassures the woman that all is going well. Greet the woman with a smile and a personal welcome, establish her language needs, introduce yourself and explain your role in her care. Ultrasound diagnosis of oligo‑/polyhydramnios Small for gestational age in this pregnancy (less than fifth centile or reduced growth velocity on ultrasound)Ībnormal fetal heart rate/doppler studies Malpresentation – breech or transverse lie Preterm labour or preterm prelabour rupture of membranesĪnaemia – haemoglobin less than 85 g/litre at onset of labourĪlcohol dependency requiring assessment or treatment Pre‑eclampsia or pregnancy‑induced hypertension Retained placenta requiring manual removal in theatre Primary postpartum haemorrhage requiring additional treatment or blood transfusion Previous baby with neonatal encephalopathy Unexplained stillbirth/neonatal death or previous death related to intrapartum difficulty Psychiatric disorder requiring current inpatient care Liver disease associated with current abnormal liver function tests Renal disease requiring supervision by a renal specialist Toxoplasmosis – women receiving treatmentĬurrent active infection of chicken pox/rubella/genital herpes in the woman or baby Hepatitis B/C with abnormal liver function tests Risk factors associated with group B streptococcus whereby antibiotics in labour would be recommended Immune thrombocytopenia purpura or other platelet disorder or platelet count below 100×10 9/litreīleeding disorder in the woman or unborn babyĪtypical antibodies which carry a risk of haemolytic disease of the newborn Haemoglobinopathies – sickle‑cell disease, beta‑thalassaemia major ![]() Asthma requiring an increase in treatment or hospital treatment ![]()
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