Download When to come to hospital and planning to go home

Government of Western Australia
Department of Health
Women and Newborn Health Service
When to Come to Hospital
and Planning to go Home
WNHS
Community
Advisory Council
your
voice
Contents
WHEN TO COME TO HOSPITAL3
WHAT TO BRING TO HOSPITAL5
VISITORS DURING LABOUR IN HOSPITAL6
VISITING TIMES7
PLANNING TO GO HOME FROM HOSPITAL7
GOING HOME
8
TESTS AND MEDICATIONS FOR YOUR BABY
9
WHEN YOU ARE AT HOME
10
VISITING MIDWIFERY SERVICE10
COMMUNITY CHILD HEALTH NURSE
10
POSTNATAL CHECK
11
DAILY PRIORITES
11
OPEN HOUSE – POSTNATAL PROGRAM
11
BABY MASSAGE
12
BREASTFEEDING 12
TEN STEPS TO SUCCESSFUL BREASTFEEDING
12
THE PERRON ROTARY EXPRESS MILK BANK13
FORMULA FEEDING13
MEDICAL TERMS THAT MAY BE USED14
OTHER SERVICES AVAILABLE AT KEMH15
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When to come to hospital
Do not hesitate to phone the hospital for advice at anytime.
Please call Maternal Fetal Assessment Unit
before coming to KEMH
Phone: (08) 6458 2199
For women booked to Family Birth Centre
Phone: (08) 6458 1800
For women under Team Midwifery care
Phone: (08) 6458 2498
and ask the operator to page your team midwife
Ruby - pg: 3344 Jade - pg: 3417
Please telephone the Maternal Fetal Assessment Unit (MFAU) if
you experience any of the following:
Contractions
Your uterus (womb) has already been practising with toning up
contractions called ‘Braxton Hicks’ contractions. These contractions
can be either irregular or regular and may continue for hours without
changing in strength, frequency or duration. These contractions don’t last
very long but can be uncomfortable.
Contractions that mean labour has started are different. These early
contractions are usually (though not always) short and mild. They can
last 30 to 40 seconds (the gap between them may be as long as 15
or 20 minutes) and can be painful. However, some labours begin with
contractions closer together and rather intense. As labour advances
you will feel the contractions in your abdomen or in your lower back, or
both. This pattern varies between women.
The length of time between contractions is from the start of one
contraction to the start of the next. Contractions become stronger and
last longer as labour progresses.
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During contractions you usually have to concentrate and use the
relaxation techniques and positions of comfort you have learned at
preparation for childbirth classes.
What to bring to hospital
You may be asked to observe your contractions to see whether they
are getting closer together. If you would like to discuss how your labour
is progressing, please ring the hospital.
Do not bring valuables. The hospital will not accept responsibility for the
loss or damage to any property left in the ward. You may like to bring a
small amount of money for telephone calls, newspapers or magazines etc.
Your waters break (ruptured membranes)
For you:
This means the sac that your baby has been growing in has broken.
The water that has been surrounding your baby now starts to come
away. You may have either a sudden gush or a slow trickle. Once your
waters have broken, the baby’s barrier against infection is gone. It is
important to phone the hospital as soon as this happens. You will need
to come in for assessment even if your contractions have not started.
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Vaginal bleeding
It is not normal to bleed during pregnancy. If you experience any
bleeding it is important that you phone the hospital and come in straight
away. Please save and bring with you any pads or blood-stained clothing
so the midwives and doctors can check the amount you have lost.
Change in activity of your baby
If you have noticed that your baby isn’t moving as much as it normally
does please telephone the hospital.
Any persistent abdominal pain
Especially if this is associated with bleeding.
Symptoms of high blood pressure
Some swelling of the hands and feet is normal in pregnancy. If any
of the following occur please phone the hospital and talk to a midwife:
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Significant and sudden swelling of your face and hands
Headaches
Blurred vision
Upper abdominal pain
Valuables
Current medications
Medicare card and/or private health insurance membership information
Health Care Card (if you have one)
Loose, comfortable day clothes
Nighties or pyjamas, dressing gown and slippers
Nursing bras and one box of disposable breast pads
Maternity (large) sanitary pads – five packets
Toiletries including soap, shampoo, deodorant, toothbrush,
toothpaste, brush/comb etc.
For your baby:
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Nappies (newborn size) for use during your stay in hospital
Baby soap
A packet of cotton wool balls and cotton buds
Baby wipes - if you wish to use them
Clothes and a blanket to take the baby home in
• A baby car seat/capsule of your choice must be fitted into your car
before taking the baby home
• Formula – if you intend to bottle feed your baby
There is limited storage space available for your belongings
in hospital, please consider this when packing.
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Bringing food from home
For the safety of our patients, the Women and Newborn Health Service
Policy prohibits staff, patients or carers from reheating or storing any
food brought onsite. You will NOT have access to microwaves or ovens
and food will NOT be stored in ward refrigerators.
Shelf stable foods such as fruit, biscuits and chocolates can be kept in
patient’s rooms who wish to keep extra food in their rooms. However,
perishable items such as cold meats, custards, cream filled cakes,
or cooked vegetable or meat dishes must be eaten immediately, or
discarded in the bin.
During your stay the hospital or Birth Centre will supply:
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Sanitary pads and nappies for use following delivery only
Clothes for your baby to wear
Blankets for your baby
Towels and other linen
Visiting hours on maternity wards are between 3.00pm and
8.00pm. One nominated support person (i.e. your partner) may
visit from 8.00am to 8.00pm.
There are no visiting restrictions during your stay in the Family
Birth Centre.
KEMH is a teaching hospital and helps train WA’s future
health professionals. During your stay in hospital you may
have student doctors, midwives, nurses and allied health
professionals as part of the team caring for you.
With your support our students gain valuable knowledge
and experience for their future careers.
Visitors during labour
Planning to go home from hospital
Main hospital
Before the birth of your baby it is helpful to plan ahead.
Here are a few ideas:
You may choose to have up to two support people with you during your
labour and birth e.g. your partner, relative or friend.
Your support people may stay with you until you are transferred from
the Labour and Birth Suite to a postnatal ward or your home. It is not
possible for a support person to stay overnight with you unless in
exceptional circumstances.
Family Birth Centre
You may choose to have more than two support people with you during
your labour and birth.
After birth, one person may stay with you until you and your baby are
transferred home.
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Visiting times
For your baby
• Create a place in your home for the baby. It may be a nursery or it
may be in your bedroom close to you.
• Buy essential baby equipment i.e. pram, cot, etc.
• Wash all baby clothes with a chemical free soap solution, especially
new nappies and clothes that have been stored in mothballs.
• Arrange to buy or hire a baby capsule or car seat. Ensure this is
fitted correctly in your vehicle. Kidsafe WA offer a fitting service
phone (08) 6458 8509.
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Support at home
Tests and medications for your baby
When planning to go home from hospital it is a good idea to organise
an extra support person to be with you for the first week. Talk to your
partner and family about rearranging household tasks and making sure
you find time to be together with the new baby. Try to accept any offers
of help.
You will be offered a number of medications and tests for your baby
before you go home. You will be asked for your permission before any
special treatments or tests are done. If you don’t understand why the
test or treatment is needed, ask for more information.
Your partner or support person can help with:
• Answering the phone/door
• Keeping visitors to a short stay
• Ensuring you get enough rest during the day
• Caring for other children and keeping their daily activities
as normal as possible
• Preparing meals
• Shopping
• Housework
Going home
Childbirth is a natural process and one which mothers, family and friends
share together. Planning to go home as soon as possible means that the
experience of the new baby is shared in the comfort of your own home.
You can expect to go home around 24 hours after a vaginal birth and
72 hours after a caesarean birth, provided all is well. At the Family Birth
Centre you can expect to stay up to 24 hours following the birth.
You may be transferred home to the care of the Visiting Midwifery
Service (VMS) earlier if medically advised. During busy times, when
bed shortages exist within the hospital, you may be required to transfer
to another hospital closer to your home for postnatal care.
Once you and your baby have been checked, the doctor or midwife will
inform you of when you may go home. We ask that you plan to leave
your room by 11.00am on the day of discharge so that your room can
be cleaned.
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Newborn Vitamin K
It is recommended that babies be given a single dose of Vitamin K
within a few hours of birth. Newborns may be low in Vitamin K in the
first eight days of life. Vitamin K is needed to help the blood clot and to
prevent bleeding.
Hepatitis B immunisation
Hepatitis B is a disease caused by a virus that affects the liver.
Hepatitis B is spread by infected blood and other body fluids such as
saliva. It is recommended that babies are immunised soon after birth.
A Hepatitis B vaccine will be offered for your baby before you leave
hospital. To complete the immunisation, more vaccinations are given up
to four years of age.
Newborn screening test
It is recommended that all babies in WA have a test that checks for
some very rare diseases that can be present at birth and which may
cause serious complications. In most cases, if the diseases are found,
they can be treated and the baby will grow and develop normally.
Hearing screen
A small number of babies are born with a hearing loss that could affect
their speech and language skills. Hearing loss may not be obvious in
the first few weeks of life, but can be detected by a hearing screen. You
will be given the results as soon as the screen is completed. Ongoing
hearing tests will also be part of your care in the community via your
local Child Health Clinic.
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When you are at home
This will contain information about:
Once you return home you can continue your care with the Visiting
Midwifery Service, child health nurse and your local GP.
• The address and telephone number of your closest child health clinic
This book is used to record details of your baby’s growth and
development, immunisations and health care.
Visiting Midwifery Service
The Visiting Midwifery Service (VMS) is available to women attending
KEMH and the Family Birth Centre who reside within approximately a
40km radius from the hospital. Women who live outside this limit can
see their GP or local hospital for postnatal support.
The VMS midwife will answer any questions you may have and provide
advice and support about care for you and your baby.
Postnatal check
It is important to see your GP six weeks after childbirth to check the
health of both you and your baby.
Daily priorities
The service operates seven-days-a-week including public holidays.
Please be available for the midwife’s visit between 8.00am to 4.30pm
each day. Due to distance and time constraints we are unable to give
allocated times for each visit. See page 15 for the VMS contact details.
When planning your day with a baby you should try to be practical and
flexible with your time. Some of the tasks you should plan to do each
day include:
• Have some resting time
• Making sure you eat regular healthy meals and drink plenty of water
• Setting aside time to breastfeed/feed your baby
• Washing clothes
Contact details
As your routine establishes, you can also enjoy some daily exercise.
The midwife will visit you at home each day until your baby is five days
old, or longer if needed. The community child health nurse will then be
available to continue your care at clinic visits.
Visiting Midwifery Service (08) 6458 1530
Open House Postnatal Program
Clinical Midwifery Manager
(08) 6458 2222 page 3488
After Hours Midwifery Manager
(08) 6458 2222 page 3333
An invitation is extended to all new parents and their babies up to nine
months old to join us to meet and socialise with other new parents and
share experiences.
We have a variety of guest speakers who cover a range of topics
relevant to parents.
The program is held at 1.30pm every second and fourth Tuesday of the
month in Agnes Walsh House which is located next to the main hospital
building.
For further details contact Parent Education on (08) 6458 1368,
Monday to Friday between 8.00am to 9.00am and 3.00pm to 4.00pm,
except Wednesday.
Community child health nurse
The role of the community child health nurse is to promote the health
and well-being of all family members. The nurse will help support you
as parents in the important and challenging task of raising children.
Before discharge you will be given a purple personal health record for
your baby.
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• Details of your baby’s birth
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Baby massage
9. No artificial teats or dummies are offered.
For further details contact Parent Education as above.
10.The establishment of breastfeeding support groups is fostered
and mothers are referred to them on discharge from hospital.
Breastfeeding
Breastfeeding is the healthiest way for you to feed your baby.
Uninterrupted skin-to-skin contact immediately after birth allows your
baby to follow their natural instincts to seek the breast. When medically
possible you will be encouraged to keep your baby skin-to-skin on your
bare chest as much as possible until your baby has fed well at the breast.
The Breastfeeding Centre is located on the ground floor, Agnes Walsh
House next to the main hospital building. Help is available if you are
experiencing breastfeeding problems. Contact details are on page 15.
Use breastfeeding to soothe your baby for injections and any blood
tests. Evidence shows that breastfeeding has a pain relieving effect in
babies, so offer the breast before or after any painful procedures.
Mothers producing more milk than their own baby requires may want to
consider donating their excess milk to the Perron Rotary Express Milk
(PREM) Bank located at KEMH.
Ten Steps to Successful Breastfeeding
Human milk is the best food for babies, especially when they are born
sick or premature. Giving these babies breast milk helps reduce the
number of gastro intestinal infections and supplies special immunoprotective properties to increase their chances of survival for long-term
growth and development.
The Ten Steps to Successful Breastfeeding is recommended by WHO/
UNICEF. These ten steps are followed to ensure that babies are given
the best opportunity of initiating breastfeeding.
1. A written breastfeeding policy is available and is routinely
communicated to all health care staff.
2. All health care staff receive training in the skills they need to
implement the policy.
3. All pregnant women are informed about the benefits and
management of breastfeeding.
4. Mothers are assisted to initiate breastfeeding within half-an-hour
of birth.
5. Mothers are shown how to breastfeed and how to maintain
lactation even if they are separated from their baby.
6. Newborn infants are given no food or drink other than breast
milk, unless medically indicated.
7. Rooming in is practised so mothers and infants can remain
together for 24-hours-a-day.
8. Breastfeeding on demand is encouraged.
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Breastfeeding Centre of WA
The Perron Rotary Express Milk (PREM) Bank
Before accepting milk from donors, we ensure they are healthy by
screening them through completing a questionnaire and undertaking a
blood test.
The PREM Bank welcomes all enquiries from women who are
breastfeeding or planning to breastfeed in the future. For more
information visit the website www.kemh.health.wa.gov.au and find the
PREM Bank listed under ‘Services’ or call (08) 6458 1563
Formula feeding
KEMH promotes and supports breastfeeding as advocated by the Baby
Friendly Hospital Initiative.
If you are intending to formula feed your baby, ask the midwives in
the antenatal clinic about what you need to bring with you to hospital.
Information will be provided individually to assist you in caring for your
baby.
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Medical terms that may be used
Amniotic fluid
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500ml to 1000ml of fluid contained within the membranes
(or sac) in which the fetus floats. The fluid acts as a “shock
absorber” and enables the fetus to move freely.
Other services available at KEMH
Service
Phone no.
Aboriginal liaison officer:
Available to help Aboriginal women.
(08) 6458 2777
Breastfeeding Centre:
For help if you are experiencing breastfeeding problems before
or after leaving the Hospital. This is via a telephone counseling
service or appointment system.
(08) 6458 1844
Continence adviser:
Offers advice and assistance for women who may have a ‘weak
bladder’ (leaking urine).
(08) 6458 1062
Antenatal OR
antepartum
Concerned with the care and treatment of the unborn child
and of pregnant women.
Caesarean section
Surgical incision of the walls of the abdomen and uterus for
the birth of a baby.
Cardiotocograph
OR fetal monitoring
OR CTG
Electronic monitoring of the fetal heart rate and maternal
contractions printed out onto a graph.
Cervix
Neck of the uterus (womb) that can be felt through the vagina.
Contractions
Spasmodic painful tightenings of the uterus that may or may
not cause the cervix to open.
Dietitian:
For help with maintaining healthy food choices.
(08) 6458 2795
Depression
A mood change or lowering of the spirits felt as sadness or
melancholy, continuing over a period of time.
Genetic counsellor
(08) 6458 1525
Fetus
The term used for babies from nine weeks gestation to birth.
Fundus
The top of the uterus, part of the womb that is furthest from
the cervix or opening.
Gestation
Length of time from your last menstrual period. The normal
gestation of pregnancy is 37 to 42 complete weeks.
Hypertension
High blood pressure.
Induction
The act of causing or bringing about labour.
Intrapartum
During labour.
Labour
Regular painful contractions of the uterus that open the cervix.
Membranes
Two thin tissues that surround the fetus and amniotic fluid.
Oedema
An excess of fluid causing swelling, usually seen in feet and
hands.
Palpation
Systematic examination by touch usually of the abdomen.
Pap smear
Collection of cells from the cervix that are examined for signs
of development of cancer.
Postnatal OR
postpartum
After the birth of the baby.
Speculum
An instrument used to hold open the vagina to allow the cervix
to be seen.
Spontaneous labour
Labour that starts without artificial assistance.
Women and Newborn Health Library
A public lending library that provides information on all aspects
of women’s health, including pregnancy, childbirth, infant care
and parenting.
(08) 6458 1100
1800 651 100
Occupational therapist:
Provides assistance with transfer home and care of a newborn
for or mothers with disabilities.
(08) 6458 2870
Pastoral Care:
Provides help with spiritual and emotional issues, whatever your
faith background.
(08) 6458 1036
Physiotherapist:
For help with back, pelvic or leg pain in pregnancy
Physiotherapy support is also available after your baby is born.
(08) 6458 2790
Psychological Medicine:
You will be referred to a psychologist at KEMH if you have had
postnatal depression or any depressive or anxiety-related
problems in the past or at present.
(08) 6458 1521
Social worker:
Contact for help with financial or welfare problems.
(08) 6458 2777
Visiting Midwifery Service:
A midwife may visit you in your home before or after you have
had your baby if necessary.
(08) 6458 1530
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NOTES:
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This document can be made available
in alternative formats on request for
a person with a disability.
Compiled by: Obstetrics and Gynaecological Clinical Care Unit
Email: [email protected]
Produced by: Women and Newborn Health Service
Website: www.wnhs.health.wa.gov.au
© October 2004 WNHS 0012b Rev 10
Revised June 2015
W O M E N A N D N EW B OR N H E A LTH S E RV IC E
King Edward Memorial Hospital
374 Bagot Road Subiaco WA 6008
Telephone: (08) 6458 2222
Disclaimer: The advice and information contained herein is provided in good faith as a public service.
However the accuracy of any statements made is not guaranteed and it is the responsibility of readers to
make their own enquiries as to the accuracy, currency and appropriateness of any information or advice
provided. Liability for any act or omission occurring in reliance on this document or for any loss, damage
or injury occurring as a consequence of such act or omission is expressly disclaimed.
Copyright to this material is vested in the State of Western Australia unless otherwise indicated. Apart
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