During Labour

One of Access Midwifery’s areas of expertise is in keeping birth normal. We have many clients having homebirths, birth in water at home, vaginal birth after cesarean section (VBAC) in hospital. We have a high rate of breastfeeding initiation and continuation.

When a client calls the primary midwife in labour, the midwife will determine whether labour assessment at home or in hospital is appropriate. During a home labour assessment, we carry a full set of equipment for a safe labour and birth. This equipment includes, but is not limited to:

  • Oxygen for parent and baby
  • Resuscitation equipment for the newborn
  • Intravenous supplies
  • Medications for the treatment of hemorrhage
  • Delivery instruments and suturing supplies

Note: we do not carry pharmacologic forms of pain management in the home environment. We do not carry narcotics.

Once in established labour, the primary midwife will stay with you, supporting your ability to labour at home and/or in hospital with experienced clinical care and compassionate support.

Clients are encouraged to be active in labour and to eat and drink as they wish. There are many forms of non-pharmacologic pain management available in the home and hospital environments. These are discussed in prenatal classes and during prenatal appointments. Client choiceregarding pain relief options in labour are respected. The midwives will facilitate unmedicated labour & birth or pharmacologic pain relief (e.g. nitrous oxide, narcotics, epidural) as per client choice and medical indication.

During labour, the midwife will monitor labour contractions and check the dilation of the cervix. The midwife also monitors blood pressure and temperature of the client and listens to the fetal heart. Your midwife will assist with breathing techniques, labour and birth positions, and emotional & physical support. Your midwife will stay with you through your active labour, assist you to birth your baby, and will stay with you for several hours following the delivery to ensure a safe, family-centred transition. In the event you require a cesarean section or assisted delivery, your midwife remains with you and works collaboratively with you and with other care providers.

The midwives at Access Midwifery have hospital privileges at Victoria General Hospital (VGH). VGH has the largest labour & delivery unit on Vancouver Island, with supportive services including social workers, community liaison workers and obstetric and pediatric specialists. In hospital, you will receive the support of your midwife during your labour and birth. A nurse will be in attendance for the delivery and to provide assistance, as needed.

In emergencies, which are rare, we will work with you to respond quickly to these events. We will share information, community standards and clinical recommendations to the best of our ability. Lengthy informed choice decisions are not always possible during a time when the health of you or your baby may be at risk.

Next: Home Birth