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, lower cesarean section rates than the local and provincial average, and breastfeeding initiation and continuation.

When a woman calls her primary midwife in active labour, the midwife will visit at home with a full set of equipment for a safe labour and birth. This equipment includes, but is not limited to:
• Oxygen for mother 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 with experienced clinical care and compassionate support.

Women are encouraged to be active and to eat and drink as they wish. There are many forms of non-pharmacologic pain management available in the home environment. This is discussed in prenatal classes and during prenatal appointments. Women are supported to give birth without the use of pharmacological analgesia. Women’s choice for an epidural for pain management in hospital is supported and will be facilitated by your midwife, according to client wishes and clinical circumstances.

During labour, the midwife will monitor labour contractions, check the dilation of the cervix, blood pressure and the fetal heart rate, assist with breathing and other techniques, including labour and birth positions. Your midwife will stay with you through your active labour. She will 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 maternity unit on Vancouver Island, with supportive services including lactation consultants, 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