24 March 2010 | Dr Deirdre Guerin | Medical Director & Consultant Anaesthetist | The Portland Hospital
Having access to adequate pain relief during labour is a major concern for women who choose to give birth naturally. Tocophobia, the fear of childbirth and pregnancy is said to be increasing with more women requesting delivery by caesarean section as opposed to natural delivery, in part due to anxieties over not receiving adequate pain relief or analgesia during labour.
Dr Deirdre Guerin, Medical Director and Consultant Anaesthetist, explains the anaesthetic services offered at The Portland Hospital which help expectant mothers to make choices regarding pain relief during their labour and in the vast majority of cases to ensure a relatively pain free delivery.
Firstly, The Portland Hospital is the only delivery suite in the U.K. that provides a resident anaesthetic service 24 hours a day, seven days a week, staffed by specialist consultants in obstetric anaesthesia. This ensures immediate access to highly trained anaesthetists for all women during their labour without unnecessary delay.
Secondly, The Portland Hospital offers women a chance to discuss any concerns regarding pain relief or labour during their antenatal period with a Consultant Obstetric Anaesthetist. Normally pregnant women book into the hospital from 12 weeks of pregnancy, when they are then invited to see the midwives at the pre-assessment clinic. If there are any specific medical issues identified or if women express any concerns which may need specialised input the midwives will then refer women to the anaesthetic clinic where these can be explored in a friendly relaxed environment. These may include, for instance, the pros and cons of an epidural or to talk about the actual process of having an epidural if they have not had one previously. We are well aware that there are a lot of ‘urban myths’ out there regarding epidurals which may cause some women anxiety. Be assured that we are here to address all your concerns no matter how trivial.
Dr Deirdre Guerin comments “at The Portland Hospital we acknowledge that some women opt to have a complete natural childbirth with no epidural intervention and we fully support and applaud that decision. For natural deliveries we also have a birthing pool onsite and quite often women bring TENS machines to help with pain-relief, particularly in the early stages of labour. However we also recognise that it may be very difficult for a woman to make a decision about pain relief in labour before the event and recognise that women may change their mind during labour regarding pain relief. We are able to provide all women with the expert knowledge and advice in a non-judgemental manner should they wish during labour to utilise other options for pain relief prior to delivery. The Portland Hospital therefore offers, in addition to the epidural service, Entonox (gas and air) and strong opiate injections so there is a whole scope of pain relief medication on offer. The person who makes this choice is the expectant mother, in discussion with fully trained obstetric anaesthetists.
If a woman chooses to have an epidural, we are committed in the first instance to administering an epidural that allows women mobility during their labour and explore different birthing positions, the ‘mobile’ epidural. Since the anaesthetist is focused just on providing good pain relief on the delivery suite and they have no other obligations they can come back again and again to make sure the epidural is optimum and the patient is completely secure and pain free, and utilise different techniques in those women in whom the epidural is not completely optimal. People like that and that’s one of the reasons they come here, at the Portland we do our utmost to ensure that all women achieve their desired delivery.”
Dr Deirdre Guerin goes on to explain that she sees a lot of women who have had difficult experiences previously. “We appreciate that these women are understandably very anxious and quite a few of them may have delayed having another baby because of a previous birth trauma or because their original experience was somewhat traumatic. It is a great pleasure for us to work with women who have had a negative birthing experience previously and give them a good birth experience that they treasure for a lifetime.”
Thirdly, The Portland Hospital also provides a specialist anaesthetic service for the post-operative phase. All women who have undergone an anaesthetic intervention are followed up post operatively, so that any rare complications can be recognised and addressed early. For women who have had a caesarean section, we allow epidurals to stay in place for up to two days afterwards if necessary. Our midwives have the skills to top up epidurals with very dilute anaesthetic so the mother can remain mobile but completely pain free in the post operative period. After two days, the pain post-caesarean settles, we remove the epidural and mothers can continue their pain relief with simple oral tablets.
We are proud of the facilities at The Portland Hospital, which in addition to our highly trained staff are unparalleled for a private maternity unit in London .The Portland Hospital has three operating theatres, all of which have been completely renovated in the past two years and contain state-of-the-art equipment and technology. We also have a dedicated emergency theatre on the delivery suite, which is available 24 hours a day for emergency caesarean sections or operative deliveries for all mothers who need assistance delivering their babies.
Having a baby is a life changing experience and one of the most important memories in a mother’s life, here at the Portland we ensure that all our mothers have options available to them to enable a virtually pain-free delivery for their baby, supported by fully trained specialists in obstetric anaesthesia.
For any further queries please contact our Maternity Enquiry Line on 020 7390 6068.