Labour Care Pathway for woman requesting VBAC outside
Labour Care Pathway for woman requesting VBAC outside the Delivery Unit Documented discussion of risks/benefits for VBAC under Midwife Led Care prior to onset of labour Positive VBAC POINTS On arrival absence of any new risk factors Baseline examination maternal/fetal wellbeing 1 st Stage Labour Fetal auscultation 15 mins BP and temperature 4 hourly Maternal pulse hourly, Contractions frequency& strength 4 hourly vaginal examination Urinalysis each void Monitor progress partogram 2 nd Stage Labour Fetal auscultation 5 mins Maternal pulse 15 mins, BP 4 hourly Contractions frequency& strength Urinalysis each void Maternal behaviour changes Confirm full dilatation with VE Confirm fetal position & descent Small PV fresh blood show External signs of full dilatation Expulsive contractions Lasts 60 -90 minutes 3 rd Stage Labour Consent for method of management Physiological or Active Management Follow routine guidance as MLC Any Deviation in progress of labour Transfer must be made to delivery suite as soon as possible P r o g r e s s E s s e n t i a l Spontaneous onset of labour Document using Partogram Consistent progress through labour is essential for successful VBAC Maintain upright positions or forward leaning Maintain Fluid Intake & energy levels Use of water in pool or shower Support at all times Successful VBAC
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