Baby movements first become apparent at 20-22 weeks. They tend to start out as soft ‘fluttery movements’. As your pregnancy progresses, these movements will become stronger. From 28 weeks or so, the baby should move at least 10 times in twelve hours. If you ever feel that the movements are becoming more infrequent, you should talk to one of your health care providers.
At The Scotia Clinic, our patients carry their own maternity notes. We are, of course, fully computerised, and at the end of your first visit, you will receive an updated copy of your notes, including a Kerry General Hospital chart.
It is important that you bring these notes to each visit. It is even more important to bring them to the hospital at each and every admission or visit, and especially when you come to the hospital in labour.
If you are concerned about your pregnancy between scheduled visits, you should contact your GP, who can discuss your case with our staff. In emergencies, call the Foetal Assessment Unit in Kerry General Hospital for advice: Monday – Friday between the hours of 9-5pm (066 7184123) or the Delivery Suite (066 7184324) at any other time.
On arrival at the hospital, you should go to the Ardfert Ward. Ring the bell at the door and a midwife will come out to bring you in. It’s always a good idea to ring in advance so that we can prepare for your arrival and have your chart ready. A midwife will see you when you’re first admitted, the consultant will be informed of your arrival and a care plan will be put in place.
Dieticians see patients with diabetes, those who are overweight or have other dietary needs. Research now clearly demonstrates that women with a high body mass index (BMI) in pregnancy are at increased risk of miscarriage, pre-eclampsia and gestational diabetes mellitus.
Babies of women who have a high BMI at the start of their pregnancy also have significantly higher birth weights.
It is never too late to make dietary changes. We recommend weight loss through exercise and diet modification. The GI Diet, for example, is a healthy weight loss programme.
Consultations and specialist opinions are available for any patient with medical, surgical or orthopaedic problems which arise during pregnancy. Psychiatry provides support for postnatal depression or other problems, and ENT (ear, nose and throat) advice is also available in the hospital.
Visiting consultants include Neurology, Rheumatology, Dermatology and Cardiology. Full intensive care facilities are also available. Patients with high blood pressure (pre-eclampsia) or severe bleeding may be transferred to this area for intensive monitoring and specialised nursing care.
A variety of good books about pregnancy are available. We particularly recommend ‘The Irish Pregnancy Book’ by Peter Boylan is very informative. The Royal College of Obstetricians and Gynaecologists also provide excellent patient information on their website. In particular, they have specific information on:
- Induction of labour
- Antenatal care
- Caesarean sections
- Foetal monitoring in labour
Nowadays we are all very aware of the need to prevent the spread of infection in healthcare facilities. If you think that you have been in contact with any infection, including German measles and chicken pox, it is very important to let us know before visiting the clinic. If you are suffering from any of these infections, you should definitely not attend.
With regard to MRSA, this infection is prevented primarily by very good hand washing and hand hygiene. Separate leaflets about MRSA and how to prevent it are available on request.
We at The Scotia Clinic and Kerry General Hospital operate best practice hygiene standards, but in ensuring a safe environment for all patients and staff, the public also has a role to play. You should, for example, discourage your visitors from lying on the hospital beds, and from over-handling your baby, particularly if they may have an infection.
Approximately 30% of the population carry MRSA but do not exhibit symptoms. MRSA normally does not cause problems for people other than those who may be at risk i.e. very premature babies or those whose immune systems are not working effectively.
There are a limited number of private rooms at Kerry General Hospital, and they may not be booked in advance. The usual lengths of stay are as follows:
- First baby: Three – four days
- Second baby: Two – three days
- C-Section: Four days
Please check your level of cover with your insurance company to find out exactly what you are entitled to with your existing health policy.
If you wish to leave the hospital early, you should discuss this with staff on the ward. Special postnatal physiotherapy classes are held on the wards prior to your discharge from hospital. These classes teach you about pelvic floor exercises and are very important if the second stage of labour was long, and/or if you had a forceps/vacuum delivery. Parenting classes and breastfeeding support is also available.
A six-week post natal check-up will be organised for you at The Scotia Clinic to address issues including future family planning and physiotherapy. At this visit, you will also have the opportunity to discuss the outcome of your pregnancy, labour and its implications for any future pregnancies.
Approximately 24% of babies in Kerry General Hospital are delivered by caesarean section. This figure is in line with the national average. C-sections are generally performed under spinal anaesthetic. While there may be medical circumstances which negate spinal anaesthesia, in general, it is regarded as the better medical option. Partners are welcome at caesarean sections.
Labour may begin spontaneously between 37 and 42 weeks of pregnancy. In certain circumstances however, labour may need to be started artificially (induced). This is usually because you are overdue, the baby is small for dates or you have high blood pressure.
Induction usually involves placing a gel into the vagina to soften the neck of the womb and/or ‘breaking the waters’ some hours later. Managed appropriately, it is not necessarily a more painful labour. A special leaflet which explains induction in more detail is available. Do take the time to read this leaflet if you are being admitted for induction of labour.
One birth companion may accompany you in the labour ward. Unless there is a medical contraindication, you will be encouraged to walk around as this helps labour to progress. You may also wish to have a bath, or use aromatherapy oils etc.
Unless there is a specific medical reason for it, continuous monitoring in labour may not be necessary. Once you are in established labour, you will be in a single room until the birth of your baby. Here, you will be under the care of two midwives, though in certain circumstances a paediatrician (a doctor who cares for children) may also be present.
Where possible, and where medically appropriate, we will facilitate your requests in relation to positions in labour, monitoring, ‘breaking the waters’, episiotomies and so on.
There are many options for pain relief at this stage:
- In very early labour, tablets may be enough.
- TENS is another option. You can hire TENS machines from Boots or Medicare.
- Entonox is a mixture of oxygen and nitrous oxide which is breathed through a mask during a contraction.
- Pethidine will provide sedation but it does not take the pain away and can have a negative effect; if given too late in labour, you may be too drowsy to push. It will also pass to the baby via the placenta. It can take a baby up to 36 hours to eliminate Pethidine from its system, and it can also affect a baby’s sucking reflex.
- Epidural & Spinal Anesthesia is a procedure performed by an anaesthetist where a special fine catheter is placed into the lower back and a local anaesthetic is infused around the nerves in the spine. The dose can be varied, and in the latter stages of labour, you should still have sufficient sensation to push the baby out.
- An episiotomy is a cut performed just before the baby is about to deliver. The decision to perform an episiotomy is made by the midwife or doctor based on the clinical situation at the time. Approximately 15-20% of women have an episiotomy.
Your baby will be handed to you immediately after he or she is born. Afterwards, the baby will be dried, weighed and given name bands. A special electronic baby tagging system is in place as part of hospital security.
Vitamin K is given to the baby to enhance their blood clotting, usually via injection.
Your baby will then be dressed and put in a cot next to you and your partner. You will be washed and given a welcome cup of tea and toast. Occasionally, the baby is transferred to Emly Ward (NICU) if the paediatrician feels it is medically necessary. If you require stitches, this is usually done while your baby is being weighed and dried.
Kerry General Hospital is a Breastfeeding Initiative Unit. Our aim is to encourage our mothers to breastfeed. To facilitate this, mothers are encouraged to ‘room in’ with their babies. We also encourage skin-to skin contact immediately after delivery to help to initiate breast feeding early. However, if you do not wish to breastfeed your baby, your decision will be respected.