Delivering your baby at JPMC Delivering your baby at JPMC

Delivering yourbaby at JPMCEMERGENCY: (673) 2 612 612

Congratulations on your pregnancy and thank you for choosing JPMC to look after yourmaternity needs. At JPMC Maternity Ward, we assure you a pleasant stay through yourlabour with tender loving care from our team of obstetricians and midwives. Please feel freeto ask the midwives for any assistance during your stay with us.At JPMC Maternity Ward, we want you to feel at home.What To Bring To Jpmc For Your AdmissionUpon admission, you will be given an admission pouch, which contains basis amenities, anda pair of bedroom slippers, but we recommend that you also bring your own personal items:Personal ToiletriesNursing Bra and Undergarments (we provide 4 pieces pf disposable panties for 2-nightstay, 6 pieces for 4-night stay)Breast PadsMaternity Pads (we provide 10 pieces for 2-night stay, 15 pieces for 4-night stay)Reading materials (books, magazines, personal stereo, etc.)Unrestricted clothing for departure from JPMCNB: It is advisable to leave valuable items and large sums of money at home.During Your StayDaily Routine In keeping with our motto. “Excellence in Healthcare”, a midwife will attend to all yourneeds and closely monitoring your progress throughout your stay. The doctors will visit you in the morning & evening, and can be contacted at any othertimes when the needs arises. Asian and Western meals (breakfast, lunch, high tea and dinner) are served daily. Extrameals can be purchased from the cafeteria (Level 1), at your own expense. Your room will be maintained daily by our housekeeping services.VisitorsAlthough visitors are allowed, it is advisable not to have too many people (more than three)visiting your room at any one time. Remember that you have just given birth and will feelquite tired, as well as tiring easily. If you have had a Caesarian delivery, we strongly adviseyou not to have visitors on the first day, except for your spouse. Your baby also needs to beprotected from risk of infection. Any visitor wishing to hold your baby should wash his/herhands first.There is a limited waiting area just outside the Obstetric Unit, but waiting in the corridors isnot allowed, due to regulations concerning restricted access.Smoking is not allowed within the hospital.There is a telephone for each bed; you can inform your relatives and friends of the direct line.Mobile telephones are not allowed to be used in the labour room as they may interfere withvital equipment, but you can use a mobile in your room after delivery.1 • Delivering Your Baby Women’s Centre

SecuritySecurity personnel constantly patrol JPMC within the Obstetric Unit. Close circuitsurveillance televisions, inventory alarm circuits on all access points and electronic securitydoors provide added security at all times.NB: After 21:00 hours the Obstetric Unit doors are locked. For security reasons, visitorsother than your partner are not allowed after this time.Language InterpretationJPMC Midwives and nurses have a range of language capabilities including English, Malay,Mandarin and some Chinese dialects. If you or your family are more comfortable with otherlanguages, please ask for assistance and we will do our best to accommodate.Registration Of Your BabyJPMC will complete the necessary documents required by law to register your baby; thesemust be submitted within two weeks. You may have to provide the following:Copies of both Husband and Wife’s Identification CardsCopy of Marriage CertificateThese will be issued on the day of your discharge or earlier (if needed).You will also receive the following documents on discharge:Take-home medicine prescriptionVaccination recordsFollow-up appointments for both you and your babyRelevant information leaflets, such as contraception advice & baby vaccinationleaflets, etc.The locations of Health Care Clinics in BruneiPregnancy and Discharge SummaryMaternity Leave Certificate (if required)NB: All care incorporated in our packages and billing prices are updated on a regularbasis.For your BabyWe provide the following during your stay, but we also recommend that you bring yourown: Disposable diapers (10 pieces for 2-night stay, 15 pieces for 4-night stay) Cotton Wool Baby Wipes (1 packet) Baby Toiletries Baby Clothes. You may wish to use your baby’s own clothes (a laundry service for this isnot available). JPMC is a baby-friendly hospital and we strongly recommend breast feeding and wewill assist you with breastfeeding, as you need. In the event of medical or personalreasons, where you wish to bottle feed your baby, we provide ready-made milk formula.However, should you wish to choose a specific formula, please provide your own milkpowder. Bottles and sterilising equipment are available.Delivering Your Baby Women’s Centre• 2

NB: The making up of infant feeds in rooms is not allowed, due to safetyconstraints. Your midwife will make up feeds for you, and will also demonstratehow to do this.Electronic and hand breast pumps are available for use in the ward, but you may like tobring your personal one.To take your baby home, you will need baby’s own clothes, a wrap/blanket, and anapproved car safety seat. A midwife will escort you to your car to ensure that both motherand baby travel safely.We hope the information provided to you will assistyou during your pregnancy. Should you have anyfurther queries, please do not hesitate to consult yourObstetrician or midwives at JPMC Maternity Ward.We wish you a pleasant journey towards Motherhood!Early Signs Of LabourShow :This is a plug of mucous in the cervix, which helps to seal the wombduring pregnancy. Sometimes it comes away either before labour or earlyin labour. However, it is not a strong indication of labour. It is sticky, whiteor pink mixed with mucous and it should not be fresh bleeding. If youexperience a lot of bleeding, you must contact the hospital.Water Breaking :The bag of water in which the baby is floating may break beforelabour starts. If the waters break before labour starts, you will noticeeither a slow trickle from your vagina or a sudden gush of water thatyou cannot control. In this case, ring up the hospital and come in.Strong Regular Contractions :Initially, the contractions are irregular, but once they become regular and stronger, ring upthe labour ward and come in.Other insignificant signs are nausea or vomiting and diarrheoa.Please note if labour starts early.Sometimes labour starts early, even as early as 24 weeks. If this happens, get adviceimmediately from the hospital.Preparing for LabourIt is helpful to attend antenatal classes run by midwives who know about the hospital whereyou are booked. They can teach you about pregnancy and labour and caring for your baby.They will tell you what to expect when you go into hospital, what procedures may be needed3• Delivering Your Baby Women’s Centre

and the reasons for them. Understanding what may happen during labour will make you feelless anxious. It is also a good plan to visit the hospital where you plan to have your baby. Allthis will help you to relax and cope better.During pregnancy, midwives can teach you breathing exercises, relaxation and goodposture to help your back.At the classes, you can also learn about the types of pain relief that are in use. Ask to see ananesthetist if you want further advice about certain types of pain relief and whether they maybe suitable for you. Anesthetists are doctors who provide epidurals, and who can also adviseyou about other types of pain relief.Pain Relief During LabourWhat will labour feel like?Towards the end of pregnancy, you may notice your uterus tightening from time to time(Braxton Hicks). When labour starts, the tightening will become more regular and muchstronger. This may cause pain that at first feels like strong period pain, but usually it getsmore severe as labour progresses. The amount of pain varies. Your first labour is usually thelongest and hardest. Sometimes it is necessary to start labour artificially or to stimulate it ifprogress is slow, and this may make it more painful. Over 90% of women find they need somesort of pain relief.What methods of pain relief are available?There are several ways of helping you cope with pain. It is difficult for you to knowbeforehand what sort of pain relief will be best for you. The midwife who is with you in labouris the best person to advise you. Here are some of the facts about the main methods of painrelief that you may be offered.Simple MethodsPain in early labour can often be managed by simplemethods. A supportive companion is invaluable.Relaxation is important and moving around sometimeshelps. The types of pain relief available in JPMCMaternity Ward are:Transcutaneous Electrical Nerve Stimulation (TENS) A gentle electrical current is passed through two / four flat pads stuck toyour back. This creates a tingling feeling. You can control the strength ofthe current yourself. It is sometimes helpful at the beginning of labour, particularly forbackache. If you hire one, you can start it at home. It has no known harmful effects on your baby. It is unusual for this to be the only method of pain relief you wouldneed.Delivering Your Baby Women’s Centre• 4

Entonox (50% nitrous oxide and 50% oxygen) You breathe this through a mask or a mouthpiece. It is simple and quick to act, and wears off in minutes. It sometines makes you feel light-headed or a little sick for a short time. It does not harm your baby. It does not take the pain away completely but it helps to ease it a little. It can be used at any time during labour.You, yourself, can control the amount of gas you use, but timingis important. You should start breathing the gas as soon as youfeel a contraction coming so that you can get the full effect whenthe pain is at its worst. You should not use it betweencontractions or for long periods as this can make you feel dizzyand tingly. Also, breathing very hard is not very good for yourbaby. In some hospitals, other substances may be added to thegas to make it more effective, but these may make you sleepier.Pethidine An injection available for pain relief (it can be given up to two doses). It makes you drowsy, but may make you less worried by the pain and helps you torelax. It can make you feel sick, but you should be given something else to reduce this effect. It can make your baby drowsy, but an antidote can be given. If pethidine isgiven only shortly before delivery, the effect on your baby is very slight. It has less effect on pain than gas.Though pethidine has a limited effect on pain, some mothers find it makes them more relaxedand able to cope better with the pain. Others, however, find it disappointing. It is usuallygiven as an injection into a muscle by midwives, or it can be given directly into a vein forquick effect, and some hospitals use a machine (called a Patient Controlled Analgesia, PCA),which allows you to press a button to give yourself measured small doses. It can also be givenin conjunction with an antiemetic should you feel nauseated in labour.Other injected drugsIn some hospitals, other drugs, such as diamorphine or meptazinol, may be used asalternatives to pethidine. They act in a similar way.EpiduralsGiven into a very small tube in your back (back bone).Performed by an Anaesthetist.Little effect on your baby.Small risk of headache.May cause a brief drop in blood pressure.Most effective method of pain relief.5 • Delivering Your Baby Women’s Centre

Who should have an epidural?Most people can have an epidural, but certain complications of pregnancy and bleedingdisorders may make it unsuitable. If you have a complicated or long labour, the obstetricianmay recommend that you have one. In such circumstances, it will benefit both you and yourbaby.What does it involve?You will first need a drip to hydrate you. You will be asked to curl upon your side or sit bending forwards. Your back will be cleaned and alittle injection of local anaesthetic given into the skin, so putting in theepidural should not hurt. A small tube is put into your back near thenerves carrying pain from the uterus.Once the tube is in place, pain-relieving drugs can be given as often asis necessary, or continuously by a pump. While the epidural is takingeffect, the midwife will take your blood pressure regularly. Theanaesthetist and your midwife will also check that the epidural isworking properly.What are the effects?An epidural should not make you feel drowsy or sick, nor does it normally delaystomach emptying.Occasionally, it drops your blood pressure, which is why you have the drip.It sometimes makes you shivery at first, but this usually stops quite soon.It may prolong the second stage of labour and reduce the urge to bear down, butwith time, the uterus should push the baby out. You are more likely to have a normaldelivery.It removes much of the stress of labour, which is good for the baby. In this country as a whole, there is about a one in 100 chance of you getting a badheadache after an epidural, but hospitals vary in their headache rate so you mightenquire about this. If you develop a headache afterwards, it can be treated.Backache is common during pregnancy and often continues afterwards when youare looking after your baby. There is now good evidence that epidurals do not causelong-term backache, though you may feel local tenderness for a day or twoafterwards.What if you need an operation?If you should need any operation such as caesarian section or forceps delivery, you may notneed a general anaesthetic, as the epidural can often be used instead. This is safer for you andthe baby.What about spinal?Epidurals are rather slow to act, particularly in late labour. If the pain-killing drugs areput directly into the bag of fluid surrounding the nerves in your back, they work muchfaster. This is called a spinal. In some hospitals, spinals, or a combination of spinalsand epidurals, are used for pain relief in labour, and spinal anaesthesia is often used forelective caesarian section.Delivering Your Baby Women’s Centre• 6

Ou r Se r v i c e sANAESTHESIOLOGY & INTENSIVE CARE▪ Perioperative Care ▪ Post-Operative Care & Pain Relief ▪ Labour Pain Relief ▪ Intensive Care Medicine▪ Anesthesia for Sleep/Paediatric Dentistry, MRI/ICT Procedures & Day Care SurgeryDENTALProsthodontics ▪ Endodontics ▪ Orthodontics ▪ Implantology ▪ Periodontics ▪ Oral Surgery▪ Professional Teeth Whitening ▪ General Dental ProceduresDIAGNOSTIC IMAGING▪ MRI (1.5 Tesla) with Cardiac MRI, MR Angiography, Spectroscopy, MR Mammography, Stroke Imaging▪ Multi Slice CT Scanner (64 Slice) with Cardiac CT, Coronary CT, CT Whole Body Angiography, pQCT▪ Digital Dental CT (Cone Beam CT) - Digital OPG, CEPH ▪ CR Radiography (X-ray)▪ Digital Flouroscopy ▪ Ultrasound ▪ CR MammographyDIETETIC SERVICES▪ Nutrition & Dietary Counselling ▪ Individualised Diet PlanFITNESS CENTRE▪ Gym ▪ Swimming Pool ▪ Jacuzzi ▪ Sauna Bath ▪ AerobicsGENERAL OUTPATIENT▪ General & Pre-Employment Health Screening ▪ VISA Medical Examination▪ Adult Vaccination ▪ Acute & Chronic Medical ConditionsLABORATORY▪ Biochemistry ▪ Haematology ▪ Serology ▪ Immunology ▪ Microbiology ▪ Blood Banking & Donation Services▪ IUI Procedure ▪ Semen Freezing & Semen AnalysisNURSING▪ Adult & Paediatric Medical Surgical Services ▪ Antenal Education ▪ Midwifery Services▪ Women and Child Health Advisory Services ▪ NICUOBSTETRICS & GYNAECOLOGY▪ Well Women Check-up ▪ Antenatal Classes ▪ Antenatal & Postnatal Clinic▪ Laparoscopic & Hysteroscopic Surgeries ▪ ColposcopyORTHOPAEDICS▪ Surgical & Non-Surgical Treatment ▪ General Orthopaedics ▪ Sports Injury ▪ Ligament & Joint Arthroscopic Surgery▪ Fractures & Management ▪ Osteoarthritis ▪ Total Joint Replacement Surgery ▪ Back & Neck Pain ▪ Spine Surgery▪ Osteoporosis Package ▪ Hand Shoulder & Foot Disorders ▪ Paediatric OrthopaedicsPAEDIATRIC▪ General Paediatric Consultation ▪ Immunization ▪ New Born CarePHARMACY (Retail & Wholesale)▪ Prescription and Non-Prescription (Over the Counter)PHYSIOTHERAPYRehabilitation: Musculoskeletal & Sports Injury, Neorological, Cardiopulmonary, Women’s Health, VestibularREPRODUCTIVE MEDICINE▪ Ovulation Induction ▪ Intrauterine Insemination ▪ Infertility ▪ In Vitro Fertilization ▪ Male InfertilitySPECIALIST MEDICAL SERVICES▪ Internal Medicine (Physician Clinic) ▪ Dermatology (Skin Care) ▪ Gastro-Enterology ▪ Haematology (BloodDisorders) ▪ Ophthalmology (Eye Clinic) ▪ Ear, Nose & Throat (ENT) ▪ Sleep MedicineSPECIALIST SURGICAL SERVICES▪ General Surgery ▪ Laparoscopic Surgery ▪ Urology (Genitourinary Problems) ▪ Oral & Maxillo-facial /Reconstructive / Cosmetic Surgery ▪ Paediatric Surgery ▪ Vascular Surgery ▪ NeurosurgeryJerudong Park BG 3122 Brunei DarussalamTel.: +673 2611 433 ext. 3000/3002 • Fax : +673 2612 461Email : marketing@jpmc.com.bn • Website : www.jpmc.com.bnOGDYB_0110