SMZ Süd – Kaiser-Franz-Josef-Spital
Facts and Figures
|Births per year||1784|
|Rate of episiotomy (perineotomy) in natural birth||15 %|
|cesarean section rate||28 %|
|Percentage of primary (planned) caesarean sections||42 %|
|Percentage of secondary (unplanned) caesarean sections||58 %|
|Rate of peridural/spinal anaesthesia (spinal block) during caesarean section||82 %|
|Besides doctors, carers and midwives, which other salaried personnel does your team feature?||available|
|Birth preparation courses|
|Psychological / psychosomatic walk-in clinic and counselling|
|Individual discussions with midwives|
|What is the standard of equipment?||available|
|own wetroom / WC|
|Are midwives able to assist with delivery in your department?|
|Are midwives of the patient's choice able to assist with delivery in your department?|
|Is there a neonatologist on site round the clock?|
|Is a peridural or spinal anaesthesia possible at any time?|
|Clinical baby examination|
|Laser treatment for sore nipples|
|Psychological care for post-partum problems|
|Single or double rooms||10|
|Rooms with three or four beds||0|
|Five or more beds||0|
1. Please describe your department’s obstetric philosophy
Healthy mother, healthy child, happy parents
In our new Mother & Child Centre, our hospital handles around 1800 births from the 30th week of pregnancy; in 2017, our service will extend to include births from the 28th week of pregnancy. We can offer you highly skilled and empathetic care. Your individual and cultural needs are important to us. We are a team made up of midwives, doctors, carers, psychologists, secretaries and a service team. Several members of this team come from a migrant background, so migrant issues are completely normalised for us, and we have much to learn from each other.
2. Please describe the process of a problem-free birth in your department, preferably from the woman’s point of view.
At the beginning of the birth, you (a woman at the due date with labour pains or waters breaking) will be admitted to the delivery room by the midwife. The child’s condition will be assessed with a CTG (heartbeat monitoring), and also with ultrasound if required. The midwife will assess how close you are to giving birth (vaginal examination), and a blood sample will also usually be taken. As we do not know whether you might need medication during labour, you will also be given a venous line. During the early opening stage of the birth, it may be the case that we transfer you to the ward in order to lengthen the waiting period until labour starts. If you have heavy contractions, you will be taken back to the delivery room. The midwife will continue to look after you there. The specialist doctor in charge will be informed about your admission. If you have an unremarkable medical history, the midwife alone will be in charge of the birth. Depending on the necessity, and after discussing it with you first, the midwife will take steps to alleviate any pain you may have (relaxation bath, massage, Pezzi ball, medication). The specialist doctor will be regularly kept informed about your condition, your child’s condition and the progress of the birth. Naturally, our anaesthetist will also be on hand to give you a local anaesthetic (epidural).
A doctor will be called in for the birth. You and your child will stay in the delivery room for another two hours. During this time, the midwife will care for you and your child, support you with bonding, and offer you extra support. After two hours, you and your children will be transferred to the childbed care unit.
3. How does your department handle caesarean deliveries on maternal request (CDMRs)?
Essentially, our department cannot carry out Caesarean sections on request. We only carry out Caesarean sections on medical grounds (maternal, or for your unborn child).
We are under obligation to look after your health and the health of your unborn child. A spontaneous birth is much healthier for you and your child during a normal pregnancy and birth process. A Caesarean section can increase the risk of the following conditions for your child:
Hayfever: between 37 and 78% (the highest figures for repeated sections)
Asthma: between 24 and 83% (the highest figures for repeated sections)
Coeliac’s disease: 80%
Type 1 diabetes: 19%
We take your worries and concerns very seriously and look for the possible reasons for wanting a Caesarean section. Through discussions with midwives, doctors and psychologists, we clear up all concerns about a normal birth not occurring, thereby ensuring that the experience of giving birth is a positive one. We ask for your understanding that we will only perform a Caesarean section for non-medical reasons in exceptional circumstances.
4. How is the birth companion included during the labour (incl. caesareans)?
For each birth, you can bring a person of your choice to accompany you. We are happy for this person to actively support you. In the instance of a Caesarean section, the person accompanying you will have to stay in the delivery room. After the initial treatment, the child will be brought to them as soon as possible. After the Caesarean section, you will also be able to see your newborn yourself as soon as possible. Afterwards, when you are feeling better, you and the baby will be looked after in the delivery room for a further 3 hours. You will then be transferred to the childbed together.
5. To what extent is the woman free to choose the birthing position?
You can choose your own birthing position. As the baby usually wants to join in and shows its unease in a certain position with the heartbeats, the midwife must attend to your needs as well as your child’s welfare. We can offer you different birthing positions: lying on your back, lying on your side, sitting, on all fours, with a stool, water birth
6. Please describe how pain is managed.
Contractions are painful, but are still necessary in order to make the birth of your child happen. The contractions help to open the way for the child to be born through the vagina. The intensity of the contractions shows us the beginning of the birth, the progress of the birth, and the beginning of your child’s movement through the birth canal. It is important to us that you deal with the subject of ‘pain during birth’ during pregnancy. Different breathing techniques, as well as distraction through movement, heat or even massages, will help you to deal better with this situation. This subject is extensively discussed and practised in birth preparation courses. Every woman has an individual reaction to pain. Because of this, every woman needs individual measures that are tailored to suit you. Be it alternative pain relief through massage, heat, aromatherapy or homoeopathy, or pain relief and / or an episiotomy – the midwife will support you in choosing the right methods.
7. How is the “comfort factor” taken into account during the birth?
Pictures say more than a thousand words
Light, colour, smells, music
8. What is your department’s position on the use of complementary medical treatments (acupuncture, homoeopathy, aromatherapy etc.)?
Complementary medical methods such as acupuncture, homoeopathy or aromatherapy are a regular part of our service. We offer acupuncture for birth preparation from the 26th week of pregnancy onwards. Acupuncture can also be given for morning sickness in the early stages of pregnancy.
9. How does your department encourage bonding after vaginal delivery and delivery by caesarean section?
Your child will be transferred onto your stomach and / or breast directly after birth. This immediate contact with your skin helps your baby to get to know your heartbeat again and calm down. It will also get to know your voice again. It is the beginning of a life together. They are meaningful and unforgettable moments which you will often treasure forever. After a little while, we will support you in helping your baby latch on for its first attempt at suckling, to enable successful breastfeeding later.
In the instance of a Caesarean section, the bonding process is started as early as possible. This depends on the circumstances of the Caesarean section and the type of anaesthetic (local or general anaesthetic).
10. What kind support does your department offer for women who experience psychological or social difficulties during or after the birth?
Our department offers psychosocial support for pregnant women. On the registration of the birth, contact will be made with pregnant women who have psychological and / or social difficulties. Our individual offers of care for you will be co-ordinated in an inter-disciplinary team of doctors, midwives, psychotherapists, social workers and carers. In this way, we can help to lessen or prevent crisis situations around the birth. Psychosocial care can also be continued after the birth if needed.
11. What is your department’s position on rooming in?
Mother and child have been a fixed unit for our department since 2011. This unit may only be separated if the mother and / or the child is ill. Your child has a safe place with you. Specially trained and experienced childbed nurses will support and stay with you in this first, very special day of life.
12. What is your department’s approach to breastfeeding?
Most of our mothers breastfeed and also want this. We support every mother in breastfeeding. We try to make it possible for every mother, even in difficult conditions. Any advertising for formula milk and / or similar products is banned from our department.
13. To what extent does your department accommodate cultural wishes/requests?
Our staff come from different cultures, and we are well aware of a wide variety of cultural / religious needs. Naturally, we will take your wishes and requirements into account as much as possible. We ask for the understanding that all world religions are welcome here, and that every employee has their own personal boundaries. The Austrian Bundesverfassungsgesetze (federal constitutional laws) apply here, no matter what.
14. How does your department handle foreign languages?
Many of our employees are either speakers of a foreign language from birth, or have learned foreign languages through school / further education. We organise for all foreign languages which we do not speak.
15. What is your department’s position on outpatient birth and early (“premature”) discharge?
If you wish to have your baby as an outpatient, you are more than welcome here. Let us know early on if you wish to have your baby as an outpatient – ideally, on the registration of the birth – so that we can let you know immediately about the necessary arrangements you will need to make.