Onset of labour

When a patient in labour is admitted, she will be:

• Evaluated by a midwife and her doctor or gynaecologist will be contacted
• Shaved
• Kept nil per mouth
• Given I.V. therapy (i.e. put on a drip)
• Given an enema if less than 5 cm dilated

At a later stage the patient’s membranes will be ruptured. The patient will be assisted by a midwife at all times.

Epidural anaesthetic

The same steps are followed as for an induction but, in addition, a urinary catheter is inserted to keep the patient’s bladder empty after the anaesthetic has been administered. (This will be removed + 2 hours after delivery if not done during the delivery).

Preparation for and administering of epidural anaesthetic

The epidural anaesthetic is done either in the ward or in theatre. (The procedure explained here is specific to Dr. U. Mörs. Before proceeding, he will explain the procedure to the patient.)

• To numb the skin, an Emla patch is placed on the site where the infusion is to be inserted as well as the area on the patient’s back where the epidural is to be commenced.
• The anaesthetic is administered.
• A urinal catheter is only inserted when the epidural is already done; otherwise it is done in theatre.
• After the procedure the patient’s blood pressure is constantly monitored.
• The anaesthetist will be present until he is satisfied with that the patient’s condition is stable.

Preparation for and administering of general anaesthetic

• The patient is kept nil per mouth and shaved but no enema is given.
• Prior to the caesarean section taking place, the anaesthetist examines the patient in the ward. He or the midwife will commence the I.V. therapy.
• Pre-medication is given as prescribed The patient is taken to theatre Depending on the doctor’s regime, the midwife will insert a urinary catheter.
• The anaesthetic is then administered.