MATERNITY CARE IN CAITHNESS & RAIGMORE HOSPITAL

Caithness General Community Maternity Unit, Henderson Wing

The midwife-led Community Maternity Unit in Caithness General offers a local birth service for mothers of low risk pregnancy and childbirth. The hospital has no special care baby facilities, no on-site paediatric services and no adult intensive care facilities, therefore any woman who has medical or pregnancy complications or whose baby is at risk of requiring specialist support, will be advised to give birth in the main maternity unit in Raigmore Hospital, Inverness.

Midwives provide care for all women on the maternity caseload throughout pregnancy and up until after the baby is born. If your pregnancy is uncomplicated and classed as low risk, then the midwife will be the lead professional for your care. If you have any medical or pregnancy complications the Consultant Obstetrician will be the lead professional for your care however the midwife will still continue to look after you and will work closely with the obstetrician regarding your pregnancy and birth plan.

There is a visiting consultant service for antenatal clinics as part of the Raigmore consultant team, so you will be able to see your Consultant Obstetrician at Caithness General Hospital.

The midwives who are based in the Henderson Wing or on-call from home (overnight) will contact the obstetrician in Raigmore for advice and support when necessary, at any time of day or night.

While local midwifery, nursing and medical team at Caithness General are trained to deal with maternity and neonatal emergencies they do not have the specialist skill or equipment to provide any prolonged intensive treatment that an acutely ill newborn baby requires.

In circumstances where a baby born in Henderson Wing becomes sick the Consultant Paediatrician (doctor who deals with babies) from Raigmore Hospital will be contacted and they will provide immediate support to the local team on the telephone or on video conference. The Caithness team will aim to stabilise the sick baby until the Neonatal Retrieval Team arrives and they will transport the baby to Raigmore or another Neonatal Care Unit. The Neonatal Retrieval Team is a National Response Team

Raigmore Hospital Maternity Unit, Inverness

The staff and facilities at Raigmore offer care for higher risk pregnancy, birth and after care for patients across Highland.

There is 24/7 access to Consultant Paediatricians, Obstetricians and other specialist staff. The hospital also has an intensive Neonatal Care Unit for sick or premature babies and intensive care unit for adults. Therefore any mother or baby in Caithness assessed as being at risk of potentially requiring special care, intensive care and the support of a paediatrician will be referred to the Maternity Unit at Raigmore Hospital to give birth. This decision is based on clinical risk assessment and aims to achieve the safest outcome for mother and baby. The risks can change and so ongoing assessment will take place.

If you are booked to have your baby at Raigmore your midwife will discuss with you the most appropriate time to travel to Raigmore. The midwife will also discuss when to contact staff in the Henderson Wing if you require to be assessed before travelling

Caesarean sections

All emergency and planned caesarean sections will be carried out at Raigmore Hospital.

Access to Patient Accommodation in Inverness

In preparation for birth, or for any clinical reasons, you may be required to stay in accommodation near to Raigmore Hospital. This would usually be for a short period of time close to when your baby is due. In such cases the Caithness maternity staff will discuss accommodation options available with you and once agreed make a booking in advance of your arrival.

Accommodation will generally be provided at Kyle Court, or the Ronald MacDonald Women and Family Centre in Raigmore. If there are no rooms available, alternative accommodation close to Raigmore Hospital will be organised in a nearby hotel.

Accommodation for your partner or the person accompanying you will also be organised if needed. Under the Highlands and Islands Travel Scheme usually two free nights of accommodation is provided by NHS Highland. However for maternity cases this has been increased to provide 3 free nights accommodation.

If your partner or person accompanying you requires accommodation when you are in Raigmore speak with your local midwife or with the midwife on duty at Raigmore who will make arrangements if required.

If you want further information about accommodation options or have any queries please discus with your midwife. Circumstances vary and we will try and be as flexible as possible to offer you the support you may need.

Child Care

If you have other children, arrangements will need to be in place to look after them when you go into hospital to have your baby.

Usually this will be organised with support from family, friends or neighbours. If this is not possible, for whatever reason, and you are worried about this, please discuss this with your midwife.

Family friendly accommodation is available on site at Raigmore Hospital and again if required this can be discussed with your midwife.

Getting to Hospital

It is also important to plan how you will get to hospital once your labour starts. If you think it is not going to be possible to come via

your own arrangements then an alternative plan will need to be discussed with your midwife.

It is important that you always phone the unit should you wish an appointment or to see a Midwife.

The Midwifery Unit Team

Midwifery Team Leader

Laura Menzies

Midwives

Tracey Ann McGeachin

Avril Andrews

Janice Flannigan

Rona Morrison

Christine McIlroy

Leigh Miller

Cara Birnie

Arlene Taylor

Gwen Gould

Tom Bown

Bank Midwives:

Caroline Steven & Pam Mcbeath

Maternity Care Assistants:

Janette Macdonald

Julie Banks

Infant Feeding Support Worker:

Kerri Ann Roberts

Health Care Support Workers:

Thelma Swanson

Lynn Mcadie

Kerry Anne Hooper

Booking with the Midwife

Your midwife will discuss your pregnancy with you at your booking visit. If you have no underlying medical conditions and your current or previous pregnancies have been straightforward, the majority of your care will take place in local midwife clinics, Henderson Wing or at home with one of the Caithness Midwifery Team.

Your midwife will arrange to see you early in the pregnancy, to take a detailed medical, family and childbirth history and commence your hand-held maternity record. Your plan of care will be discussed with you at this time. Please be aware that this plan may change at any time during your pregnancy depending on your/your baby’s health needs. Once you have received your hand-held record please keep it safe and bring it to every antenatal and scan appointment as it is a continuous record of your pregnancy care.

If you are considering having your baby at home, please let your midwife know at the earliest opportunity, so that this option can be discussed fully with you and your partner.

Parenthood/Antenatal classes are available in the local area. Your midwife will discuss these with you at your booking. Classes will be discussed at your home visit at approximately 22 to 24 weeks. Ask your midwife for further details.

Once you are at home with your baby, Community Midwives continue to visit until you are discharged into the care of your Health Visitor. This is usually around 10 days after the birth.

What to do if you if you feel unwell

Contact your nearest maternity unit immediately if you experience any of the following:

·  Bleeding at any time in pregnancy

·  Contractions before 37 weeks of pregnancy

·  Waters breaking (rupture of membranes)

·  If membranes rupture and fluid is greenish in colour or heavily blood stained

·  Severe abdominal pain with or without contractions

·  Reduced movements of your baby

·  Headaches or flashing lights/ visual disturbances and or vomiting

·  When you think your labour is establishing

For non urgent matters or advice between 8am and 8pm please contact the Henderson Wing CGH on Tel 01955 880330. During the day midwives may be out on home visits however you can still contact your local midwife on mobile phone number (as per Henderson Wing answer machine).

Please note not all areas have mobile phone reception therefore if you do not hear back from your local midwife within a reasonable length of time and you require an immediate response to your query please contact Raigmore Labour suite Tel 01463 704374.

What does the community maternity unit (CMU) have to offer?

* Complete Antenatal care *

* Postnatal care *

* Care during labour *

* Birth Pool *

* Parent Education *

* Counselling & support for any pregnancy related problem *

*Hypnobirthing*

*Baby Massage & Yoga*

Your midwife will discuss all of these issues with you at an appropriate time in your pregnancy.

Our Midwifery team are able to provide tailor made and individual care for you and your family during your pregnancy, birth and in the postnatal period.

Contacts:

Henderson Wing,

Caithness General Hospital,

Bankhead Road,

Wick,

Caithness

Tel: 01955 880330

If you have any concerns about your pregnancy between 8am and 8pm you can contact the Midwifery unit and speak to a midwife on 01955 880330.

Out with office hours contact Raigmore Labour Suite 01463 704374 and a midwife will co-ordinate your care and contact the ‘on call’ midwife if appropriate.

If the problem is not urgent then it is best to wait until the morning.

Antenatal Screening Midwives – Monday + Thursday 0900-1700

Based in Henderson Wing – 01955 880415

Your GP continues to provide medical care throughout your pregnancy and after the birth as normal.

Out with normal surgery hours, medical advice and contact with the local GP is via NHS 24 on 08454 24 24 24

Your Choices for Birth

It is your choice where you wish to give birth.

If you have been assessed as ‘Low Risk’ during your pregnancy, you may wish to have your baby at the Midwifery unit, We always have two midwives ‘on-call’ who will support you during your labour and the birth, in a quiet, relaxed and homely environment, with facilities which include a birthing pool and various methods of pain relief, although we cannot provide epidurals.

Early discharge home is the norm for most women following birth in a CMU and this generally ranges from 2hrs – 6hrs post birth, your midwife will discuss this with you and your partner at the time.

In exceptional circumstances (e.g. adverse weather conditions late at night) you may require to stay longer and the midwifery team will support this based on assessment of the circumstances at the time, again this will be discussed with you and your partner.

If you or your baby are unwell following birth in the CMU and you require additional monitoring, then this will be discussed with the obstetrician and/or paediatrician at Raigmore Hospital, you may need to be transferred to Raigmore Hospital for ongoing care.

It is important to know that all the Midwives are trained in dealing with emergencies that can arise, but if labour is not progressing well or any problems are identified during your labour, we will advise you that we will need to transfer you to the Raigmore Maternity unit in Inverness, this can take up to 2 ½ hours. If there are problems which the baby develops the neonatal transfer service is used.

If you are ‘low risk’ you could also choose to have a ‘Home Birth’ (See Home Birth leaflet).

There are also certain circumstances where we would recommend that you give birth in the ‘Consultant Led Unit’ in the Raigmore. This may be advised if you have certain ‘High Risk Factors’. The Raigmore Maternity unit is specialist unit that is fully equipped for ‘high risk care’ including Obstetricians and Paediatricians and has facilities for epidural pain relief and Caesarean sections. They also have a birthing pool that can be used by ‘Low Risk’ women who wish to deliver there.

Post Natal Care

After you have delivered your baby, we will continue to see you once you are at home. If you have your baby in Raigmore hospital, we will be informed by them when you go home and we will visit you the day after you are home or sooner if you need to be seen. We are there to support you at home following early discharge. If you give birth in the Midwifery Unit, you will be able to go home as soon as you are clinically fit and feel well.

Once you are home if you need further support and guidance regarding baby care, feeding and other aspects of caring for a new baby, the Maternity Care Assistants (in addition to the midwives) will be happy to visit you and your baby at home or you can arrange to see them in Henderson Wing. You can discuss this with your midwife or contact Henderson Wing direct to organise.

Your Choices in Antenatal care.

During your pregnancy a midwife will need to see you regularly to make sure both you and the baby are well. This Midwife is known as your ‘Named Midwife’ and you will get to know each other during your pregnancy. As it is a small team you may be attended to by other midwives in the team in her absence.