What is Perineal Massage?

by Guest
Posted August 25 2010 03:41pm
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Perineal massage is a gentle massage of the tissues of the lower opening of the birth canal to prepare the opening for delivery and reduce the need for episiotomy or possible tearing.  It is commonly suggested for moms to do this themselves after they have passed their 36th week. Not all mothers may find this helpful. Your health care provider may also do this during the final stage of labour.

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Positions for Labour

by Maxine
Posted July 21 2011 03:16pm
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This handout provides images and descriptions of various helpful positions that you can use during each stage of labour including upright positions, forward leaning positions, asymmetrical positions, pushing positions and more.


Download the Positions for Labour handout (PDF)


This information was provided with permission by:

Mother's Advocate

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What Happens When I am Admitted to Hospital? The Delivery Suite

by Maxine
Posted July 7 2010 12:12pm
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The part of the hospital where you will birth your baby is called the Delivery Suite. A lot happens in this place even before the delivery of your little one.

The first person you will meet once you are admitted to the Delivery Suite is your nurse. She or he is the person who will accompany you to your birthing room. Birthing rooms vary in size and some have things like showers and rocking chairs, while others do not. However, just about all birthing rooms are private, quiet spaces. Your nurse will introduce her or himself and ask you some questions about your health and your pregnancy. That means you can feel free to share your wishes for your labour and delivery with your nurse.

By this time, you may have already started to have some contractions. Your nurse can be very supportive in assisting you with relaxation techniques while you explain some of the ways you would like to work through this part of your birthing experience.

Shortly after you become acquainted with your nurse, she or he will ask to take some blood from your arm. Most hospitals take at least two tubes of blood. The first checks what is called your CBC or complete blood count. Think of this test as telling an overall story about your blood. It checks for possible infections and deficiencies which can help determine the course of your care while in the Birthing Unit. For example, the results of your CBC let the doctors and nurses know whether it is safe for you to have an epidural.

The second tube checks for bacteria or viruses in your blood and for your blood type. This test is called a Blood Group and Antibody Screen test. It is important in the rare instance that you need to be given some extra blood while at the hospital. At this time, an IV may also be started depending on your medical need or the policy of the hospital in which you are delivering.

In addition to asking how your health and pregnancy have been, your nurse will take your vital signs (for example, your heart rate, temperature, and blood pressure). She or he will listen to your baby’s heartbeat and will ask to gently feel your abdomen to determine the general position of your baby. This procedure doesn’t hurt and is done while you sit back in your birthing room bed. Also, when you have a contraction, your nurse will ask to gently feel your abdomen. This is done to get an idea of how intense your contractions are. The nurse might ask you where the contractions feel most intense (for example, in your lower pelvis or lower back). Throughout this time, you should feel free to ask questions about your care while in the Birthing Unit.

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Medical practices (procedures) that may be used during labour

by Maxine
Posted August 25 2010 03:44pm
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The following medical practices may or may not be done depending on your labor, your caregiver's usual practice and the hospital's policies.

Common medical practices during labor include: monitoring your vital signs; timing the frequency and strength of your contractions and how you are coping; assessing the thinning and opening of the cervix and monitoring baby’s heart rate. 

The following medical practices may or may not be done depending on your labor, your caregiver's usual practice and the hospital's policies. Medical practices include, augmenting labor, inducing labor, continuous electronic fetal monitoring, giving intravenous fluids, giving oxygen to mom or baby, doing an episiotomy, using forceps or a vacuum extractor to help deliver your baby and or doing a caesarean section to deliver your baby. 

Talk with your healthcare provider about the practices that she uses before you go into labor.  Your healthcare provider can tell you about the policies or rules in the birth setting where you will deliver, or take a tour of your birth setting.  Taking a tour of your birth setting before going into labor allows you to see what the rooms and staff are like and to ask about their policies. This may help you and your partner or labour support person to feel more prepared for labour and birth.

What are vital signs?

Vital signs include blood pressure, heart rate, breathing rate and temperature.  These will be taken regularly during your labour by a nurse.  If complications arise with mom or baby these may be taken more frequently.  During labour your baby’s heart rate is assessed by using a doppler or using the electronic fetal monitor.

How does the labour staff assess my progress in labour?

Your health care providers will monitor your progress in several ways.  They assess the bloody show (the blood tinged mucus discharge) that occurs during labour.  They will time the frequency, length and strength of your contractions. They will do an internal examination by inserting two gloved fingers into your vagina to feel for the cervix at the end of your uterus.  The cervix must thin and open to 10 cm before your baby can be pushed down the birth canal.  Internal exams may only be done once or twice during your labour to prevent any bacteria from reaching your baby.

What is electronic fetal monitoring?

Electronic fetal monitor shows the baby’s heart rate and the frequency, length and strength of your contractions.  It may be used when you are admitted to the labour area to obtain a 20 minute reading or to obtain periodic readings during your labour to monitor your baby or it may be done continuously if there are concerns about how your baby is coping with labour.

Like any medical procedure there may be disadvantages to using it.  The disadvantages of this practice include:

  • Decrease in mom’s freedom of movement.
  • Limits mom’s ability to use the shower or bath for comfort or relaxation.
  • Sounds from the monitor can be distracting for some women and partners.
  • The Interpretation of fetal heart rate tracings is dependent on the expertise of the staff and there could be different interpretations made.
  • Continuous fetal heart monitoring has been associated with higher rates of Caesarean Section.

What is intravenous (I.V.) fluid?
These are solutions that may be given during labour to provide fluids for energy or as a way to deliver medication.  Solutions may be saline (salt – for fluids and blood balance) or dextrose (sugar – for energy). 

In some hospitals having an I.V. was routine for all mothers in labour; it is now considered an option to be used for medical reasons only, (such as having an Epidural, Labour Augmentation, Infection, Low blood pressure, Dehydration, Induction etc.). The main disadvantages to I.V.s are the possibility of infection at the site where the I.V. needle is inserted.

What is oxygen?

Oxygen is a gas that may be given to mom or baby if a medical concern arises.  It is given by mask or nasal prongs. Oxygen is used (by some hospitals) if baby’s heart rate takes a sharp decrease (called deceleration).  Oxygen is used during a caesarean section until the baby is delivered to insure that baby is getting sufficient oxygen.

What is augmentation of Labour?

Augmentation is the use of mechanical or chemical methods to strengthen contractions or encourage a labour that is going slowly.  Generally, care-providers start with the least invasive method and work up to the more invasive methods. Methods used include artificial rupture of membranes or use of oxytocin. 

Mechanical Methods:
Artificially rupturing the membranes that surround your baby is called an Amniotomy- it is also commonly called “breaking the water.” Your doctor or midwife inserts a sterile device which looks like a crochet hook into your birth canal, through the opening in your cervix and places a small tear in the membrane. The procedure feels similar to an internal examination of the vagina, and is almost painless. If the Amniotomy does not work another option will be decided on.

The disadvantages for this practice include:    

For Mom:

  • Some discomfort.

For Baby:

  • May result in changes in your baby’s heart rate.

For both Mom and Baby:

  • Once membranes are artificially ruptured, there is a greater risk of infection for Mom and baby.
  • If these procedures do not work, other ways to start labour are used.    

Chemical methods:
Giving Mom a drug called Pitocin, which is a synthetic form of oxytocin which is naturally released in your body during labour.  Your contractions will be monitored to help determine the appropriate dose.  Once strong contractions have started the Pitocin would be stopped. There are several disadvantages to this method:

For Mom:

  • Stronger contractions which may require pain control measures such as narcotic drugs or epidural.
  • May create cascade of subsequent interventions, such as the need for pain relief, continuous fetal monitoring and increased chance of forceps or vacuum extractors or Caesarean birth.
  • If the induction fails then an emergency Caesarean section would be needed.

For Baby:

  • Possible difficulty coping with the stronger labour contractions.
  • Possible Caesarean birth and the risks that go along with Caesarean.
  • May contribute to jaundice in baby.

What is an episiotomy?
An episiotomy is an incision of about 2.5 – 5 centimetres (1-2 inches) long, made to the bottom of your vagina to make the opening larger so your baby can be born. Your care provider would numb the area with a local freezing and then make the incision. Following delivery the incision will be stitched.  

Currently there is no sound research to support the use of episiotomies being done routinely.

The Society of Obstetricians and Gynaecologists of Canada recommends that “Episiotomies be done only if necessary, depending on the situation at the time of birth.”
The disadvantages of this practice for mom include:

  • Pain and swelling due to the cut
  • Possible infection
  • Possible Increased blood loss
  • Possible painful sexual intercourse over a longer period of time


Video Alert!
When you're in the process of delivering your baby, it is important to Avoid Unnecessary Interventions.
Watch this video to learn more


Talk to your health care provider before you go into labour to discuss when your health care provider would use this practice.

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