Our team of Consultants have extensive experience in delivering babies, they all continue to work in busy central London NHS hospitals where the populations are multilingual and multi-ethnic; where women choose natural childbirth but where high risk cases are also a frequent event. This ensures that they can all give the best possible care to low risk women but are also able to respond promptly and appropriately when emergencies occur.
Their delivery care is centred around choice and partnership with their clients.
They feel that women and their partners should have a choice in childbirth and that these choices should be respected. This choice is more often than not to reduce the amount of unnecessary medical intervention and to optimise the chances of a normal untraumatic delivery.
Where unforseen circumstances prevail they endeavour to guide their clients through the various interventions that may be necessary such as induction of labour, augmentation, epidural and Caesarean section. These may not be desired interventions, but sometimes they are necessary to improve the chances of a normal delivery or to ensure safe delivery for mother and baby.
It is important to be able to discuss these interventions and issues around them in a mature empathic way, to filter out disinformation and to put them in their proper context so that in partnership with their clients they can plan the best strategies to achieve the desired outcome.
During the ante-natal period they ensure that there is ample time to discuss all the various issues surrounding the delivery so that their clients have time to prepare themselves for the birth and make the best choices appropriate to their individual circumstances. This, in partnership, allows the formation of a realistic birth plan tailored to each individual.
Issues that might need to be discussed in advance are to name but a few, how long to allow the pregnancy to continue, induction and augmentation of labour, epidural aneasthesia and other pain relief options, positions in labour and childbirth, the use of the pool, intermittent or continuous fetal heart rate monitoring, episiotomy, pelvic floor trauma, timing of cord clamping and Caesarean Section.
Immediately after the birth, couples may also have choices concerning issues such as early skin to skin contact, the use of drugs to deliver the placenta, when to first put the baby to the breast and whether or not to give vitamin K. Women and their partners may have strong feelings about any one of these and our Consultants understand this and will try wherever possible to ensure that these wishes are respected.
From experience they also understand that it is not always possible to achieve the desired outcome, perhaps because the baby gets stuck in the birth canal or because the baby becomes distressed. Around one in 500 deliveries will also have a serious unexpected complication such as placental abruption, cord prolapse or excessive bleeding after delivery. They believe that these outcomes also require discussion in advance, to improve confidence going in to labour, and to reduce stress should an emergency situation arise.
In summary, out team of Consultants believe that delivery care is best individualised to each couple and that the safest and best way to manage the delivery is chosen in partnership with them whether this is a low intervention delivery in the pool, a carefully managed labour or an elective Caesarean section.
