Childbirth

When to go to the maternity hospital

Birth begins unexpectedly, so there is no single answer to this question.

What are the recommendations?

  • Regular uterine activity - uterine contractions whose intervals are shorter, increase in intensity and cannot be stopped by any action (change of position, warm bath or shower). Uterine contractions should be at least 1-2 hours, 5 minutes apart.
  • Amniotic fluid discharge - in case of clear amniotic fluid, we recommend arriving at the delivery room between 2-4 hours. As soon as green or brown amniotic fluid drains, or if you have a positive result for streptococcus (GBS), go immediately.
  • Bleeding- if you are bleeding bright red, menstrual blood, on more than 1 pad, go to the nearest maternity hospital as soon as possible, ideally call155.
  • Changes in the baby's movements - if you feel unusual movements, or on the contrary, their intensity is reduced, visit the maternity hospital as soon as possible.

In case of any doubts, please do not hesitate to contact the staff of the delivery room at +420 26608 3299.

Admission to the delivery room

The midwife and the doctor will go to the delivery room with you. This includes a CTG monitor, vaginal examination, initial ultrasound and completion of paperwork. If labor is actively progressing, you are informed of the progress of labor and are placed in the appropriate room, with care provided by the midwife.

Course of labour

The birthing process is divided into three periods:

  • The first period of labour, or the opening period, involves the opening of the birth canal by uterine contractions. The intensity of uterine contractions varies, increasing during labour. During this time, active movement, positioning, and proper breathing are important. A woman can use a shower, a bath, a mat. We have aromatherapy or vaginal douching available.
  • Long labor, expulsion, the birth canal is fully open. The length of this time varies - we position the woman so that the baby rotates properly in the birth canal. We leave the final choice of birth position to the woman, as long as everything is fine. Here, monitoring the condition of the woman and the baby is very important.Episiotomy (incision of the perineum) is not routinely performed.
  • The third period of labour includes the delivery of the placenta, this period should be conducted (according to WHO this is a recommendation) so called "actively", when the woman is injected intravenously with oxytocin. This reduces the risk of severe postpartum haemorrhage, the need for blood transfusions and a stay in the Intensive Care Unit.

Pain management

The intensity of contractions during childbirth is individual, so we can offer you different options to dampen it.

  • Hydroanalgesia - the use of heat to control pain - thermophore, warm bath, shower, heating pads, watering can
  • Audioanalgesia - listening to music of your choice
  • Aromatherapy - pain relief using scented essences
  • Massage
  • Epidural analgesia - the most commonly used form of pain relief, Pain is relieved with the help of analgesics injected into the epidural space, uterine contractions do not cease, but their intensity is not felt as much by the laboring woman.
  • Entonox - "paradise gas", inhalation of a mixture of 50% oxygen and 50% nitrous oxide, has a relaxing and sedative effect, the service is charged at a price of 750,- CZK per ½ hour.
  • Nalbuphin - an intravenously administered opioid analgesic, used for pain control, its effect lasts 3-6 hours.

Specific situations during labour

Caesarean section (CS)

CS is an abdominal surgery that is performed either electively based on a pre-existing risk or acutely due to a current medical indication of the woman or child.  

  • Scheduled CS - admission to the delivery room takes place the day before or on the day of the scheduled procedure, as arranged with the doctor. The woman is then admitted to the gynaecology department and is ready for surgery the next day. Preparation includes insertion of a venous line, administration of antibiotics and necessary infusion solutions, insertion of a permanent urinary catheter, bandaging of the lower limbs and shaving. We recommend leaving all jewellery at home.
  • Acute CS - If an acute situation arises, we proceed to terminate the CS delivery, the preparation is the same as for a planned delivery but in a much faster version. The choice of anesthesia is decided by the obstetrician.

CS is performed under either general or spinal anesthesia. Under general anaesthesia, the woman in labour is put to sleep, while under spinal anaesthesia, the woman is conscious during the procedure, she just does not feel pain. This form is more convenient for both the woman and the baby. When the baby needs to be delivered quickly (e.g., when there is a lack of oxygen), we use general anesthesia for its rapid onset.

If the baby's postpartum adaptation is good, the baby can be placed at the mother's breast during the cesarean section. If the situation permits, the baby's father can bond. 

Induction, induction of labour

Induction of labour is performed in case of postterm pregnancy at week 41+0 - 42+0. In the case of pregnancy risks (e.g. high blood pressure, gestational diabetes, fetal growth disturbances in utero, various maternal diseases etc. earlier as per the doctor's opinion).  

The woman comes for induction of labour in the morning to the delivery room, with all the belongings. An initial CTG monitor is taken, a history is taken and a vaginal examination is performed. We prefer to insert a balloon catheter as the first step of induction of labour, which helps prepare the birth canal and can also initiate labour. Failing this, we then opt for the administration of prostaglandins in the form of vaginal tablets. The woman is in the gynaecology department for the time being.

Vaginal birth after caesarean section (VBAC)

We support VBAC in our maternity hospital if the conditions are met. VBAC is conducted as a traditional birth, any form of pain control and various positions of relief can be used. The birth is led by a physician, in collaboration with a midwife. Venous access is always provided during delivery.

Breech delivery

In approximately 3% of cases, the baby decides to adopt a pelvic-facing position in the womb. In our maternity ward, it is possible to undergo an external rotation by experienced doctors. During the turnover, the uterine activity is usually suppressed with an infusion. After the turnaround, a follow-up CT scan is recorded.

The delivery can be conducted vaginally or by planned cesarean section. If the conditions for vaginal delivery are met, we prefer this option. The delivery is managed by a physician in collaboration with a midwife. Various forms of pain control, either pharmacological or non-pharmacological, and positioning may be used during labour. Venous access is always provided during the delivery.

If the woman prefers to terminate the delivery surgically or if the conditions for a vaginal delivery are not met, the woman arranges a date for a cesarean section with the doctor in the pregnancy clinic.

Delivery of twins

Twins do not automatically mean a cesarean birth. If the twins are placed in the uterus in the longitudinal head position, and or the first child urges the head, and the second the pelvic end, the birth can be conducted vaginally. The approach is always individual.

Even in these situations, we try our best to accommodate women and provide for their needs. Venous access is always provided during delivery.