Please find in this information pack some valuable reading material which will be informative and useful throughout the coming months of your pregnancy.
Your midwife will go over this pack with you at your 32 -34 weeks appointment. Please do not hesitate to ask any of the Doctors or Midwives any questions you may have.
It’s a good idea to write down questions and bring the list with you on your next antenatal visit.
We encourage and support women who are planning to have a vaginal birth to commence perineal massage from 35 weeks of pregnancy.
Please do not perform perineal massage if you have any of the following conditions:
If you have not experienced any of these conditions you may perform perineal massage from 35 weeks of pregnancy.
What is perineal massage? – Youtube video
Please note: Although this video states perineal massage may be performed from 32 weeks, current research states that it is not necessary to perform perineal massage at this gestation and that optimal benefit is obtained if commenced at 35 weeks of pregnancy.
Perineal tears: What you need to know during pregnancy – Australian Commission on Safety and Quality in Health Care
Third and fourth degree perineal tears – Australian Commission on Safety and Quality in Health Care
Perineal tears: How to reduce the risk – Australian Commission on Safety and Quality in Health Care
Optimal-foetal-positioning – Continence Foundation of Australia
What To Bring to Hospital – checklist
Group B Streptococcus (GBS) in pregnancy
What is an epidural?
An epidural is a form of pain relief to make your labour less painful.
A small plastic tube called an epidural catheter will be inserted into your lower back for the duration of your labour. Local anaesthetic is given through this to help numb the nerves carrying pain signals during labour. This should provide pain relief until your baby is born.
You should be able to move your legs and you may still be able to feel painless contractions.
It is your choice whether to have an epidural, but one may be recommended by your midwife or obstetrician if complications arise during your pregnancy or labour.
When you have your epidural will depend on the progress of your labour.
Some medical reasons may prevent you from being able to have an epidural. In these cases we will discuss other methods of pain relief with you.
What are the benefits of an epidural?
If the birth of your baby needs a forceps or emergency caesarean section, the epidural can often be used as an anaesthetic. Research shows that epidurals:
How is an Epidural put in?
An epidural takes about 15-20 minutes to insert and a further 15-20 minutes to work fully.
An intravenous drip will be placed in your arm or hand. You may need to have some clothing removed or change into a hospital gown so your back is more accessible. You will be positioned either sitting up or lying on your side for the epidural to be inserted, this may be either sitting up or lying on your side. The skin on your back will be cleaned with a cold antiseptic solution. Local anaesthetic will be injected into your back to help numb the area. It is normal to feel a pushing sensation in your back while the epidural is being inserted. You must keep still for this step. You may feel an electric tingle sensation in your back or down your legs when the epidural catheter is inserted – this is normal. After the needle is removed, the epidural catheter will be taped into place with a large dressing to prevent it from accidentally coming out. A sensation of warmth and numbness will gradually develop after the local anaesthetic is given.
How will an epidural affect me?
Once your baby is born the midwife will remove the plastic tube from your back. Once the epidural has worn off, your urinary catheter will be removed and you will be encouraged to get up and move around.
What are the risks of an epidural?
Epidurals are very safe but, as with any medical procedure, there are risks:
| Require further epidural pain relief | Common 1 in 8 |
| Fall in blood pressure | Common 1 in 20 |
| Severe headache | Uncommon 1 in 100 |
| Temporary nerve damage | Rare less than 1 in 13,000 |
| Epidural infection / Meningitis | Very rare 1 in 50,000 |
| Very high epidural block | Very rare 1 in 100,000 |
| Epidural blood clot | Very rare 1 in 170,000 |
| Severe injury / paralysis | Extremely rare 1 in 250,000 |