Pregnancy Labour and Delivery

Frequently Asked Questions

When you experience any of the symptoms of labour, such as pain (due to uterine contractions) that is progressively frequent and lasting longer each time, bloody discharge or leakage of amniotic fluid. You should also report to the hospital if you experience a significant decrease of fetal movement over the last 24 hours or sudden cessation of fetal movement over the last 12 hours.

Where Do I Report?

You should report to the Delivery Suite located on level 2. If you are in too much pain to walk, your transport should alight you at the Women's 24-Hour Clinic at Basement 1, where our staff will assist to wheel you to the Delivery Suite.

What Items Should I Bring?

Your outpatient appointment card and your admission form. Please remove any jewellery and valuable possessions before coming to the hospital.

Who Will Attend To Me First?

Upon arrival at the Delivery Suite, you will be attended to by the doctor-on-duty, who will determine whether you are in active labour, early labour or not in labour. Based on the diagnosis, he will either admit you to the Delivery Suite / antenatal ward, or advise you to return home.

When Will My Obstetrician Attend To Me?

When you are admitted to the Delivery Suite, the doctor-on-duty will inform your obstetrician of your admission. Your obstetrician will see you personally as soon as he can. Meanwhile, the team at the Delivery Suite will review your progress regularly and keep your obstetrician informed

Will My Obstetrician Deliver My Baby?

Your obstetrician will try his or her best to attend to your delivery and is committed to deliver most of the pregnant patients who have booked him or her. However, there may occasionally be situations when he or she is not able to deliver your baby personally. These reasons may be that he or she is:

• Attending to another emergency
• Performing surgery In the Operating Theatre
• On leave
• Is unwell

In such cases, your obstetrician will try to arrange for another specialist to attend to you. Sometimes the baby may be delivered too quickly before the arrival of the obstetrician. In such a case, the nurse in the Delivery Suite will attend to your delivery first. All the nurses in the Delivery Suite are trained to perform a vaginal delivery. Upon arrival, your obstetrician will manage the 3rd stage of labour (delivery of the placenta and repair the episiotomy wound).

What Determines If I Will Go Through A Vaginal Delivery?

In most cases, we expect a vaginal delivery. There is, however, a 10% chance that you may end up delivering your baby by emergency caesarean section. The reasons may be :

• There is non-reassuring fetal status arising during the course of labour. A fetal monitor attached to your abdomen will detect the fetal heart rate pattern.
• There is failure to progress in terms of cervical dilation and descent of the fetal head. The team of doctors in the Delivery Suite will monitor the labour progress by regular vaginal examination of your cervix and your baby's presenting part. In most cases, the failure to progress is often difficult to predict before labour starts.

When Do I Need A Forceps Delivery?

Forceps is an instrument used to assist the delivery of the baby in the 2nd stage of labour. It is required when your baby fails to be delivered after prolonged pushing efforts. Sometimes it is also used when there is mal-rotation of the baby's head.

How Do I Ask For Pain Relief?

Pain relief comes in 3 forms. The doctor-on-duty will order the muscular injection of Pethidine (a painkiller) for you in the early stages of labour. In later stages of labour, the nurse will provide you with Entonox (a pain relief gas). Both methods will achieve up to 60% relief of labour pain. If you desire a more complete pain relief, the anaesthetist will give epidural anaesthesia upon request. The anaesthetist will discuss and obtain consent from you before administering the epidural

Can My Husband Stay With Me Throughout My Labour?

Yes, we encourage your husband to be with you so that he can provide you with the moral support.

What Are The Possible Complications Of A Vaginal Delivery?

There are a few complications that you should be aware of :

• Excessive bleeding due to failure of your uterus to contract. Intravenous infusion of a drug called oxytocin is often required and you are expected to stay in the Delivery Suite for a longer period of time after delivery to allow us to monitor you closely.
• Retained placenta due to failure of your placenta to separate. In which case, the placenta may be removed by the doctor's hand inserted through the cervix. This procedure, called manual removal of placenta, may be performed either in Delivery Suite or in the Operating Theatre under anaesthesia.
• Delayed profuse bleeding 1 - 2 weeks after delivery due to retained remnants of placental tissue. After the delivery, the placenta is normally carefully inspected to ensure its completeness. However, it is well documented that despite such a precautionary measure, small remnants of placenta tissue, or sometimes an extra lobe of placenta, may be present and remain undetected till bleeding recurs some time later. An evacuation of uterus is required to remove these retained remnants.
• Episiotomy wound breakdown. This may occur unexpectedly. It usually happens because of poor tissue healing resulting from infection. Poor suturing technique is rarely a cause.