Pioneers in patient care: consultants leading change
London
Innovation: An antenatal pre-assessment clinic to give pain relief information for pregnant women
Dr Geraldine O’Sullivan
Guy’s and St Thomas’ Hospital, London
Job title: Consultant anaesthetist
Specialty: Obstetric anaesthesia
For many pregnant women the thought of going into labour and what potentially might happen to them during childbirth can be frightening, especially if they have already developed complications before the baby arrives, says London consultant anaesthetist Geraldine O’Sullivan.
To help combat these women’s concerns and put their minds at ease about pain relief, Dr O’Sullivan has introduced an antenatal pre-assessment clinic at Guy’s and St Thomas’ Hospital in London.
She says: "The clinic makes mothers-to-be aware of what is available from the department of anaesthesia and obstetrics and all the options that are available. We are here to primarily provide advice on pain relief, and secondly to provide information on anaesthesia.
"We want women to know that as far as we can, we want to limit the amount of general anaesthesia we give and where possible keep mothers awake, pain-free to have the birth that they want," she says. "Every Thursday the obstetricians can send any women, they feel would benefit from the experience, to see our unit. The mothers can see what an epidural needle looks like, see how the machines work and meet the team who can hopefully ease their anxieties."
Dr O’Sullivan says: "Women feel more in control if they know what the options are rather than having a conversation when they are six centimetres dilated, already in pain, and less likely to feel in control of their decision," she says. "We don’t want to frighten people just explain the possible procedures and dissolve the myths."
"I think it is immensely reassuring and many of the women actually say: ‘It’s not as bad as I thought it would be’. They often attend with partners in tow, and can ask any questions they like. We can address any specific fears they might have about caesarean section, for example."
Dr O’Sullivan adds: "Our third role is to care for pregnant women who have already been hospitalised due to complications or who are expecting very complicated births.
She says: "These are people we know, due to certain factors in their medical history, could have problems with the birth. I agree a plan with the mother, which is recorded in her notes, so that if she comes into the hospital in the middle of the night and sees another doctor, there is no confusion about what sort of pain relief she wants.
"The women also carry a copy of their notes, and I will go through everything I have written to make sure they understand it. Once a month I also go along to patient craft sessions and give a lecture on pain relief.
"Midwives often send us women who are very nervous about the birth, whereas obstetricians tend to refer complicated medical cases to us. Women who are already inpatients in the hospital we see once a week during ward rounds to monitor their condition."
Dr O’Sullivan adds: "I wish I had more time to spend with patients but we are doing our best with the resources we have."