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Childbirth

Share experiences and get support around labour, birth and recovery.

Paediatrician at birth

38 replies

elliejjtiny · 23/03/2013 09:59

Has anyone done this? The midwife mentioned it at my appointment yesterday and we will be discussing it in more detail at my 36 week appointment. But I want to know now! (impatient emoticon). The midwife said he/she will sit in the corner and do nothing until baby is born. My baby (DC4) has a cleft lip (probably palate too) which as far as I know just means feeding problems. I know he/she might need to go to SCBU but I'm worried the paed will be over cautious and swoop in and take him/her straight away. I want to have a nice long cuddle, skin to skin and delayed cord clamping and then take baby to scbu if necessary when we're both ready to leave labour ward (ie after I've had a bath, toast and in my pj's). I also don't want someone sat there watching me in labour, sighing and looking at their watch, waiting to do their bit. Someone please reassure me that it will be ok. I've had 3 uncomplicated births with just a midwife and my DH there so this is all new to me.

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JumpHerWho · 23/03/2013 20:08

You've been told the paed will be there because they have to book him iyswim - if they waited til the birth then called for him, it might be hours before he can come. There are thousands of births that present as 'normal' and end up with a paed coming to check for whatever reason - be thankful that yours is pre-booked Smile

munchkinmaster · 23/03/2013 20:18

They will bleep the paed toward the end of labour (after hopefully calling up earlier in the day to let them know you are labouring). If there are probs the dr is then there on the spot. If he the dr is not present and the baby does have problems the midwife will have to try and care for baby, call another midwife who can bleep the paed and the paed will need to get to a phone, call midwife, establish roughly what is happening, which room you are in and then pelt it over there.

Surely much more sensible to get them down toward the very end of labour?

munchkinmaster · 23/03/2013 20:29

Or scenario 2. As above but when midwife bleeps the doctor s/he is in the middle of rescussitating a baby or some other procedure they can't give up half way through (which someone else would be doing if they were in the labour suite with op waiting). They have to get a midwife to call the ops midwife. The story is related. . The doctor can't leave so has to tell the ops midwife to bleep the registrar.

MiaowTheCat · 23/03/2013 20:34

This reply has been deleted

Message withdrawn at poster's request.

munchkinmaster · 23/03/2013 20:51

I asked DH. Apparently paeds attend 10% of deliveries. He says would attend a cleft sometimes and at other hospitals not. He says would be perfectly fine to ask to meet paed at a clinic appointment to discuss and put your mind at rest. He was not v impressed with the 'just cos it's high risk' explanation.

SlouchingPanda · 23/03/2013 23:01

Hi Ellie - Just to reassure you, I work in obstetrics and I have never ever heard of or seen a situation where a woman's labour is interfered with just so the paediatricians don't have to hang around.

As everyone else says, they are bleeped when delivery is imminent and wait either outside or discreetly inside the delivery room. If they are called too early they may go away for a bit and come back.

I agree with munchkinmaster that it would be reasonable to ask to meet with a Paediatrician during your pregnancy to ask questions about what you can expect from them at the birth.

Holidaysressential · 24/03/2013 14:33

Hi
I'm a Pediatrician and attend lots of deliveries - please don't worry that a paediatrician will interfere with the birth plan we are unanimously terrified of midwives so wouldn't dare !!!!!! I wouldn't complain that they are offering one to attend as it isn't routine in all trusts so you are getting an excellent service for the small chance that they are needed - don't worry they will come in for the last 3 mins and sneek off when they here crying. Then will prob pop back later to see how things are going. Clefts are related to an increase risk of other problems at birth which is why it is sensible to have one if offered. We don't generally attend deliveries unless necessary as are far too busy!
I hope it all goes well - if when you arrive in labour or before you want to chat to the paediatrician that normally should e easy to arrange
Ask if you have any more questions

sallysparrow157 · 24/03/2013 15:07

I'm a paediatrician, don't attend deliveries any more but have attended several hundred in my time! As everyone has said, we are called at the last minute (usually - every now and then I would be the first one called to an emergency section, as in before the obs or anaesthetic teams and turn up to an empty theatre without even a mum in it yet - this did often cause theatrical sighing, watch looking at and ranting!!) and do not interfere at all with the actual delivery/cutting cord. Often if the baby comes out pink and screaming I won't even hang around to examine him or her, the only reason I would want the cord cut straight away would be if the baby was not breathing and needed resuscitation or was extremely premature and we needed to keep them warm (there is a benefit to delayed cord clamping in extreme preterm babies but there's also an increase in the mortality rate if they get cold so unless there's a reliable way to keep them warm til the cord's stopped pulsating (and that would include us being able to do the required resuscitaton) the risk/benefit ratio falls on the side of cutting the cord early).
Paediatricians are aware of the benefits of delayed cord clamping, even if they have not kept up to date with research it is taught on the neonatal resus course which is compulsory for us to do every few years.

In the case of the OP's baby, if I was called to the delivery, I would come at the last minute, stay out of the way but cast an eye as soon as the baby is born, if he or she looks in good condition I would be very happy and in fact would encourage delayed cord clamping and skin to skin. I would however want to do a quick examination at some point so once the cord was cut and you were happy for me to do so, I would take the baby to the resuscitaire which will be in the delivery room, look at colour and work of breathing which would take a couple of minutes, then give baby back, tell you everything looks ok and leave. Obviously if the baby needed breathing support or anything else we would do whatever was needed and in that case we may have to take the baby away a bit quicker and spend a bit more time doing stuff. However in my experience this is very rarely needed in cleft lip/palate babies as long as they don't also have a very small chin (ie Pierre-Robin syndrome).

When i need to take a baby to NICU I will, if at all possible, make sure mum and dad have had a cuddle beforehand, if the baby's too sick for that I will make sure they have at least seen baby before I go.

OP, if, when you come in in labour, you ask the midwife if you can speak to the paeds doc on call, it is part of our job to come and speak to prospective parents who may/will need NICU admission and you will probably speak to the actual person who will come to your delivery rather than a consultant in clinic who almost never attends deliveries - you and they can decide how much or little intervention you want as long as things are going to plan (and that may even be not having a paed in the room but having them called as an emergency if there are problems)

MyNameIsAnAnagram · 24/03/2013 15:52

I had a paediatric at ds's delivery, as he was in distress. she waited very quietly in the corner till he was born, them took him to check over. He was then well enough to come for skin to skin for quite a while before being taken to scbu for a more thorough check for an hour or so (i had a bath then, it was bliss!! ) . I was far too busy when pushing to notice her waiting. Of course i would rather he had been able to be delivered straight on to me, but it's not something that bothers me now.

Pudgy2011 · 24/03/2013 16:33

I'm overseas under private health care so I'm not sure how different this is, but I had a paediatrician at the birth of DS which was completely straightforward - she arrived once I'd transitioned and helped encourage me pushing (along with DH and my doula) whilst the OBGYN helped baby out. Baby came straight up on my chest and then once cord was cut, she took him to check him over.

I guess the reason they are present here is to check the baby over whilst the obstetrician makes sure mum is fine, both functions I think a midwife does in UK? Anyway, she checked DS over and brought him straight back to me for skin to skin and to help get him latched.

MiaowTheCat · 24/03/2013 19:15

This reply has been deleted

Message withdrawn at poster's request.

Chunderella · 24/03/2013 21:23

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elliejjtiny · 24/03/2013 22:18

Thankyou for the replies. I'll definately ask to speak to the paed beforehand. My babies tend to have an annoying habit of breaking my waters and then deciding they don't fancy coming out after all so I expect there will be time in between then and me getting high as a kite on gas and air to meet the paed and discuss what's going to happen. I'm hoping it will be DS2's paed who turns up as I know her already and I know she always stays well out of the way of any birthing action as she is squeamish! I may never be able to look her in the eye in the outpatients clinic with DS2 afterwards though Grin

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