Working on the Labour Ward Mercy Ughwujabo – Delivery Suite (Labour Ward) Matron University Hospital Lewisham

Background Nursing: American Baptist Hospital in a village in Nigeria. Midwifery: Federal University Teaching Hospital in a city in Nigeria. Worked in the NHS since 1990 as a nurse, midwife & Sonographer. Worked in Guy’s, STH, CUH & UHL Midwives in this country have 1st degrees. UK has 4 countries with differing cultures Some mws work in Ob led Units, others in BCs & others in stand-alone Units (In the community).

Introduction Why are you on the LW? To ensure that both mother & baby have the best possible outcome and a positive experience. Not just a delivery, but a ‘Birth’

Women centred Care "no decision about me without me“ Choice: Whose birth is it! Does the Dr know Best? Gain consent for everything you need to do Birth Plans. Explain when there is a need to deviate from it. Dignity & Respect Say what you mean & document what you say Debrief the woman & her partner Read the BPs & discuss with the woman

Department of Health 6Cs Communication (verbal & None verbal) Care Compassion Competence Courage Commitment No condescending mannerisms or tones

Documentation Dated Timed Facts Clear (e.g., Prescription – Form, route) Allergy status Name Signature Status Incident forms/ Safeguards No judgements Be aware of your own bias & opinions

Ethos on the LW Everyone is your colleague Inform staff what MTI means Respect & Politeness will get you far Expect to be challenged: don’t take offense. Don’t challenge inappropriately 2nd opinions may be sought Ask experienced midwives what they think Team handovers, briefs, meetings & discussions Teaching: This goes both ways Share your expertise, e.g.(Breech births) with gladness & modesty

Ethos on the LW (cntd) Great bedside manner will get you admired Cultural awareness: make no assumptions. Get to know the culture of the women you will be serving & the Staff you will be working with Share the load – you can’t do it all, but neither can the midwife Remember there is always someone who can help you, or who you can escalate to

Ethos on the LW (cntd) Remember the midwives have been in the system longer than you I don’t know is not a weakness Even when you think you know, ask what others think Make yourself likable Be helpful. Ask for help politely when you need it. Unacceptable behaviour Don’t come out of Theatre looking like you are the local butcher Be sensitive to the needs of others Goodies may help

Obstetric Emergencies PPH MOH Fetal Bradycardia Cord Prolapse Shoulder Dystocia Vaginal Breech Maternal Collapse Eclampsia

Team Player (MDT) Obstetricians (Con., SR, Reg, SHO) Midwives (Bands 5 to 8) Anaesthetists Neonatologists Medics Midwifery students Medical students Ward Clerk Maternity Health Care Assistants Theatre Staff

Midwifery Hierarchy on the LW Band 2-3 Band 5 -6 Band 7 Band 8 Matron Ward Manager Band 5 & 6 Mws MSW/MCA, Co-Ordinators

What is Labour Ward? Hungry Angry Stressed Tired Human factors