What happens on the labor ward?
When you arrive on the labor ward you will be welcomed by a midwife or an assistant nurse. You will be asked how you are feeling, how labor started, and asked for any maternity notes from the antenatal care center.
When you have been given a room, the baby’s heart sounds will be checked with a CTG (cardiotocography 胎心监护仪) reading.
CTG is a method of recording the baby’s heartbeat along with the strength and frequency of the contractions. It usually takes about 20 minutes, after which the midwife will check the tracing to see how the baby is doing.
Delivery rooms vary in size and layout. They are often made homelier with pictures, textiles, and pleasant colors. At the same time, they have to contain safety systems for mother and baby, and the equipment needed for labor. There will be an adjustable delivery bed, a chair, an armchair and maybe a bed for your birthing companion. A beanbag, and possibly a wheeled walker, makes it easier for the mother to change positions. There are connectors for oxygen and nitrous oxide (笑气), a CTG monitor for keeping an eye on the baby, and various other pieces of equipment.
The midwife will examine you find out how far labor has progressed. She will put two fingers into your vagina to feel how far the cervix has opened and to determine the position of the baby’s head in the pelvis. your blood pressure and body temperature will be checked, and sometimes a urine sample is tested. The midwife will then let you know the findings of the first assessment and you will discuss what happens next, and you will have an opportunity to ask any questions and also to make your wishes known.
The midwife, aided by an assistant nurse, is there to give you help, support, and encouragement throughout the birth. But she does work defined shifts and hands over to colleagues at specified times. A midwife and assistant nurse will, however, always be available, and they will be there for you throughout labor. They always try to look after you as an individual, adapting the care of normal deliveries, but if she has any concerns about the progress of labor, she may ask an obstetrician (specialist doctor) to examine you. The midwife usually looks after more than one patient at any given time.
The progress of labor is followed by making repeated checks throughout the whole process. The midwife will listen regularly to the baby’s heartbeat, or check it with the CTG monitor. If everything seems fine and all the readings are normal, there is no need to use the CTG monitor all the time. A CTG recording is usually done every 2 hours during the opening phase. In between, the baby’s heartbeat can be checked with a hand-held Doppler or listened to with a fetal stethoscope. The midwife will carry out vaginal examinations regularly to see how labor is progressing. Naturally, we hope that everything will progress normally, without the need for any intervention (干扰措施), but sometimes this is unavailable. For example, sometimes it is necessary to spend things up if labor seems to be progressing too slowly or has even stopped. One way of achieving this is to simulate contractions by giving a drug called Syntocinon by intravenous infusion (drip).
CTG is a very good way of checking the baby during the course of labor. If the CTG graph looks normal, it means that the baby is doing fine.
If the CTG graph is abnormal, it may be necessary to use additional methods to assess the baby’s health more precisely. A blood sample may be taken from the baby’s scalp. This is done by making a small scratch in the baby’s skin and collecting a drop of blood for analysis. Lactic acid estimation is the commonest analysis we do, and it is also possible to measure pH, i.e. acidity.
A method called STAN is used in some labor ward to monitor the baby during labor. This means that the baby’s ECG (心电图) is recorded along with CTG monitoring. If the STAN is abnormal, a blood test can be taken from the baby, as described above.
