Pre-natal preparation

Useful hints and information

What to bring to the maternity hospital

The list can be downloaded in PDF HERE.

We want to prevent some complications, so we ask that you bring the following items with you to the hospital:

pregnancy identification
ID card or other identification
health insurance card
birth number of the baby's father
completed baby name questionnaire (available on the web, or at our pregnancy counselling service)
marriage certificate (only for foreigners and couples married abroad)
birth certificate (only for foreigners)
if you are single and the child's surname will be that of the father of your child, it is necessary to bring proof of paternity (handled by the registry office)
for divorced people, a divorce decree
toiletries (toothbrush, toothpaste, comb, soap, towel)
shoes to change into
mesh panties, maternity bras
a small carry-on bag to store these items

We recommend packing:
Toilet paper, pads, diaper panties (limited number per day), wet wipes for baby's own cosmetics. You will be given a nightgown at the maternity ward, but you can bring your own, even a bathrobe.
After receiving the birth certificate (after the baby is born), you must register the baby with a health insurance company immediately.

Accompaniment to childbirth

We welcome a supportive person at the birth, whether it is a partner, doula, friend or mum. The escort is primarily a psychological support for the expectant mother. The presence of a close person has a positive effect on the woman's psyche, reducing stress, worry and tension.

Birth wishes

The course of birth cannot be planned, but it is possible to prepare for it with the help of birth wishes. It is a good idea to discuss your birth wishes with your midwife, she will help you sort out your thoughts and visions. We try to respect the birth wishes if the birth is physiological.

Our criteria:

Cardiotocographic fetal monitoring during labour - CTG
We consider fetal monitoring by CTG to be an essential part of a safe birth. We perform CTG at admission to the delivery room and further according to the current situation. If the delivery is physiological, we restrict monitoring to the minimum necessary (once every 2-3 hours), and in the meantime the midwife listens to the fetal heart sounds at specified intervals.

Vaginal examination
Vaginal examination is used to assess the progress of labour. In case of uncomplicated delivery, the number of vaginal examinations is kept to the minimum necessary.

Premature amniotic fluid drainage
In case of amniotic fluid drainage, we follow the recommended obstetric procedure. After 18-24 hours of amniotic fluid outflow, we usually initiate prophylactic antibiotic administration. If spontaneous onset of contractions does not occur within 24 hours of amniotic fluid outflow, we initiate induction of labour.

GBS positivity
The presence of Group B Streptococcus (GBS) in the vagina is a common and non-serious finding. However, it can put the newborn at risk of developing infection during delivery, a rare but potentially serious complication. If the culture has shown that you have GBS, we will administer antibiotics prophylactically for delivery according to the recommended obstetric procedure.

Bladder pouch rupture
We do not routinely perform a rupture of the bladder pouch. However, a properly timed diruption can hasten labor, which can be beneficial in some cases.

Perinatal Pregnancy
The timing of labor is determined by the first trimester ultrasound (most often indicated on the first trimester screening). If you do not deliver by the due date, we will recommend (if it is not a high-risk pregnancy) more frequent follow-up in the pregnancy clinic (twice a week). Approximately ten days after your due date (week 41+3), we recommend scheduling an induction of labor. We consider week 42+0 as the earliest date for delivery. We prefer to induce labor by mechanical methods, not drugs. Induction of labor is done while the patient is hospitalized.

Enema
We have good experience with performing an enema prior to delivery. However, it is not an essential part of obstetric care.

Chest shaving
We do not require but recommend perineal shaving before delivery. Unshaved skin can complicate the healing process if it is injured during labor.

Position of the woman during labor
You can choose the position in which you want to give birth. There are birthing beds in the delivery room that allow for modifications of the birthing positions.

Food and drink during labour
We recommend eating and drinking in limited and small portions during labour, preferring a light diet rich in fast sugars. Childbirth is a demanding physical feat and excessive food intake during it causes feelings of nausea or vomiting.

Episiotomy - incision of the perineum
We only perform an episiotomy if we feel it is appropriate in the particular situation. It is difficult to estimate in advance whether an episiotomy will be necessary. The most common reasons for performing an incision are the need to hasten delivery (when fetal hypoxia-lack of oxygen is suspected) and the risk of serious injury to the perineum (especially a firm perineum and a larger head, etc.).

Administration of oxytocin
Oxytocin is a natural hormone that causes uterine contractions, thereby allowing labor to occur. The administration of oxytocin in infusion has its own indication criteria that we follow. These include, for example, non-progressive labour, weak contractions, short contractions, post labour bleeding, etc. Oxytocin can only be administered after the amniotic fluid has drained. When oxytocin is administered, the fetus should be monitored more closely by CTG. If the oxytocin-assisted contractions are painful, we offer analgesia.

Epidural analgesia
Epidural analgesia is one of the most popular methods of pain relief during labour. It is well effective and low risk for the mother and fetus. We have good experience with it. In our maternity ward, its administration is available and is free of charge.

Bonding
Bonding is a close interaction between the mother and baby immediately after delivery. We encourage bonding in all premature, well-adapted newborns. The baby is placed on the mother's abdomen after fitting (so-called skin-to-skin contact). After breaking the umbilical cord and a brief examination by the pediatrician, bonding continues on the mother's chest, where the baby remains for the first 2 hours of life. During bonding, the baby is monitored (oximeter sensor on the arm) and the constant presence of an attendant is required.

Umbilical Cord Bonding
Late umbilical cord bonding is preferred. We place the newborn who is in good condition immediately after birth without breaking the umbilical cord on the mother's abdomen. Research shows that infants with delayed umbilical cord ligation have a lower incidence of anemia in infancy if they are left with unbroken umbilical cord 1-3 minutes after birth, which corresponds to the time when the umbilical cord is touching. The umbilical cord can be cut by the baby's father. If resuscitation of the newborn is necessary, the paediatrician who is present at the delivery will indicate an earlier ligation.

Administration of uterotonics after delivery
After the baby is delivered, we administer drugs to promote uterine contraction (uterotonics). According to our own and international recommendations, administration of uterotonics is to prevent excessive bleeding after delivery.

Examination of the newborn after delivery
The newborn will be checked by the paediatrician after delivery. If the newborn is fine, he or she is not taken anywhere and the examination takes place in the presence of the mother. Examination on the mother's body is possible. The paediatrician will briefly examine the baby and assess his/her adaptation. Further treatments, weighing and marking can be postponed after bonding.
If support for postnatal adaptation is needed (this applies to about 10 % of children and includes, for example, suctioning fluid from the nose and mouth, breathing through a mask with oxygen, etc.), takes place in an adjacent room that is equipped to do so.

C-section
In cases where it is necessary to terminate a pregnancy by cesarean section, we prefer an aqueous anesthetic over general anesthesia. We operate under general anaesthesia if a caesarean section is required immediately or if a water anaesthetic is medically inappropriate. An accompanying person may be with the parent in the operating room and after the newborn is fitted, may be present for his/her treatment. We show the baby to the mother immediately after treatment, and if she is interested, we attach the baby to the breast to start the breastfeeding process properly. Bonding - placing the naked baby on the mother's skin can be technically difficult with a cesarean section. In situations where bonding is not possible, we allow bonding in if the father wishes. After a cesarean delivery, the mother is usually in the ICU for one day. The baby remains in the care of the neonatologists and is brought to her regularly for breastfeeding.

Ambulatory delivery
Ambulatory delivery is possible in our maternity ward. If you wish to go home with your baby sooner than the recommended time of stay in the sixth-form ward (72 hours), it is necessary to discuss the details and further care with the gynaecologist and paediatrician present. Discharge of the newborn before 48th hour of life is handled by negative reversal. For early discharge of the mother, if all is well, reversal is not necessary.

Refusal of Recommended Care
If you do not want any of the what we offer, we will educate you about the benefits and alternatives of the proposed procedure and the potential risks associated with refusing it. We will then ask you to sign a "negative reversal" in which you sign that you are aware of the risks, have been informed and accept responsibility for your decision. In recent years, we have encountered parents who have misinformation or misrepresentations regarding some aspects of obstetric care, mostly obtained from non-expert sources on the internet. We therefore recommend that careful attention be paid to the lessons learned. We take care in communicating with the parent. In our experience, most ambiguities in the course of antenatal care or during delivery are explained and the mutual cooperation between the parent, midwife and doctor is good. If you already know in advance that you will not accept some of our standard procedures, please consult with the Pregnancy Clinic.

Evaluation of the physiology and pathology of labor
The midwife and/or physician will decide whether the labor is physiological, risky, or pathological. Accordingly, he or she determines further procedures, suggests investigations and treatment of abnormal conditions.

Communication with the birthing woman
All procedures, care and treatment suggestions are addressed directly with the pregnant and/or birthing woman.
We do not wish to have the woman's attendant communicate on her behalf. We consider direct communication between staff and the laboring woman to be the foundation of quality health care.

Consultation with a midwife

For those of you who need to speak to a midwife before giving birth and do not primarily fall under the CPA, we offer a free half hour consultation. Bring your birth plan, or "just" your unanswered questions, and our midwife will discuss everything with you.

An appointment can be made in person in the delivery room or by calling the midwife at +420 26608 3283 (Mon-Sat between 11.00-14.00).