Up Close: Labour and Delivery
A birth has so many firsts: first breath, first touch, first kiss, first cry. Even for doctors and nurses who deliver tens of thousands of babies, each first can be as unique as the babies who are born.
Our staff are prepared for any change of plan by always staying a few steps ahead and anticipating what is about to unfold. This is one of the few situations in health care where there are two patients being cared for, but there is one you cannot see.
In this Up Close photo series, get a glimpse into
child birth at McMaster University Medical Centre.
During an induction where oxytocin is used, contractions can become very long. This can affect baby’s heart rate so it needs to be continuously monitored. Sometimes the placenta is in the front or the position of baby makes it difficult to get a heartbeat reading with an external monitor. In those cases, a monitor is placed directly on baby’s head.
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Nurse Danielle is helping coach mom through contractions. If mom’s goal is to either go without an epidural as long as possible or not to use one at all, one tactic is to keep mom as comfortable as possible. Regular position changes of the pelvis also helps labour progress more quickly and smoothly. This helps move the baby down into the pelvis.
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The Labour & Delivery (L&D) nurse, Sam, is monitoring the baby’s heart with a Doppler fetal monitor. This is used for intermittent monitoring. L&D nurses are on a one-to-one ratio with patients for active labours.
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The anesthesiologist is part way through setting up the epidural. First, a small needle is used to numb the area. Here, a catheter is being set up that will remain in place and deliver a steady flow of medication.
Epidurals are very safe. The anesthesiologist verbally goes through all potential risk factors before the procedure.
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Epidurals are a beautiful thing, allowing mothers to relax, watch the game and cheer on their team, or get caught up on the latest Game of Thrones episode, during what would otherwise be a painful labour process.
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When baby is being constantly monitored, there are two types of information available on the print out. One is the mother’s contractions and the other is baby’s heart rate. The important information gathered is what baby’s heart rate is doing in relation to the length and frequency of contractions.
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Dr. Dustin Costescu, an OB/GYN (left) and Dr. Valerie Bloomfield, an OB resident, (centre left) are in the room for the delivery. Typically, during the pushing process, it’s only the nurse and the family/support person of mom in the room. The doctors return once baby’s head is part way out. The L&D nurse, Sam (top right) is watching baby’s heart rate.
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During delivery, a second nurse comes in to help hang medications. This process is well-timed with the position of baby so that once they have one shoulder out, medication is delivered to mom.
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The doctors are helping the forehead, nose and chin come out. Dr. Valerie Bloomfield is also feeling for the umbilical cord to make sure it’s not around baby’s neck. Sometimes if the cord is very tight, they must clamp and cut it before the baby is fully out to allow mom to continue to push without potentially harming baby.
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This photo is seconds after baby Sadie was born. Immediately after birth, Sadie began squawking which is a positive sign that she can go straight on to mom’s chest. The goal is always to go to mom’s chest as fast as possible. Since baby Sadie is a bit wet and might get cold, she is dressed in a hat and blanket right away.
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Baby Sadie is getting weighed.
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Mom had some concerns with being able to latch but Sadie did very well.
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For a baby in good health, the resuscitation bay is used as a weighing scale and warmer.
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Moms are encouraged to feed baby right away to help regulate blood sugars. The first bit of breastmilk, called colostrum, is high in sugar, calories and fat.
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Uninterrupted skin-to-skin contact for the first two hours of baby’s life is ideal. This isn’t always possible if there are other medical care needs. This can be mom, their partner or any family support person.
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Women’s and Newborn Care section of the website.