The Antenatal Day Assessment Area (ANDA) at Poole Maternity Unit

The Antenatal Day Assessment Area (ANDA) at Poole Maternity Unit is changing the way it works from Tuesday 7 April 2021.

A new way of working to promote patient safety is being introduced by triaging patients as they arrive. This means that all patients will be seen within 15 minutes of arrival and brief details and listening to your baby’s heartbeat will be performed. You will then be informed how long it will be until all the care you require can be performed. This is a system that is similar to that used in Accident and Emergency Departments.

Maternity Triage is used to help us prioritise the safety of women and babies in our care and helps us to treat women who need urgent care first.

If you have any concerns about yourself or your baby, please call the Labour Line for advice and an appointment on 0300 369 0388.

Monitoring your baby’s movements

During your pregnancy, your midwife will talk to you about monitoring your baby’s movements. Every baby moves a different amount, so you will not be looking for a specific amount of movements. Instead you’ll be asked to learn your baby’s pattern of movement and seek advice if that pattern changes.

Monitoring your baby’s movements is one of the most effective ways of making sure that your baby is doing well. If you feel like your baby isn’t moving as they normally do, get advice from Labour Line right away. Do not wait until the next day, even if you’ve noticed this during the night – it’s really important to seek advice immediately.

It’s not just reduced movement that could suggest a problem – a large increase in movements can also indicate that your baby is distressed. To be safe, it’s always best to call Labour Line on 0300 3690388 if you are concerned about how much your baby is moving. The Labour Line midwife can refer you to the Antenatal Day Assessment unit (ANDA) at Poole Maternity Hospital for assessment (which is open 24 hours a day, seven days a week), or to the Day Assessment Unit at Dorset County Hospital.

If you are unsure whether your baby is moving normally, you should always call Labour Line. It’s not always easy to tell, especially if you are having twins or more. You might feel like you don’t want to make a fuss, but if you are at all concerned about your baby’s movements, we always want you to call Labour Line on 0300 3690388 right away.

Read more about what to expect if you report changes in movements or get more information on monitoring your baby’s movements from Kicks Count and Tommy’s.

During labour

Your baby’s heart rate and pattern will be listened to during your labour, with your consent. This can be done in the hospital, or in your home if you have chosen to have a homebirth.

The monitoring used during your labour will depend entirely on the specific needs of you and your baby. Their needs might change as the labour progresses, and so the type of monitoring needed may change. Some women will be advised to have continuous monitoring throughout their labour, such as those having twins or if their baby has reduced growth or movements.

If you haven’t discussed how your baby will be monitored, the midwife caring for you during labour will be there to support and advise you.

There are different ways of monitoring how your baby is reacting to labour. Please read this leaflet for more information.

If you and your baby have been well during your pregnancy, you will be offered intermittent monitoring. The midwife might use a Pinard (a small, trumpet-shaped tool that allows your midwife to listen to the heartbeat by placing it on your tummy) – this features a lot in Call The Midwife series! They might also use a small electronic machine, called a sonic aid – they are often used for listening to your baby in antenatal appointments, so you have probably seen one already. A waterproof sonic aid can be used if you are in the birthing pool. The midwife will listen to and record your baby’s heart rate and pattern every few minutes, making sure your baby is happy and responding well to the contractions. If they have any concerns, they will discuss these with you and suggest your baby is monitored continuously. If you are having a homebirth, this would mean transferring to a maternity unit.

Sometimes called external fetal monitoring, this is a way to check your baby’s heart rate and pattern. You will have two small round sensors place on your tummy, held in place by two soft belts. These are attached using leads to a machine that records and prints a digital reading known as a cardiograph (CTG). One sensor records the heart rate and the other records contractions.

Telemetry is a wireless continuous monitoring method, which enables you to remain more mobile during labour. It can even be used in the birthing pool. If you would like to use this method, let your midwife know and they will advise you as it’s not suitable for everyone (e.g. it wouldn’t be advised for women who have an epidural).

Sometimes it can be difficult to monitor your baby’s heart rate externally. If so, you will be asked to consent to a foetal scalp electrode (FSE), often referred to as a ‘clip’. This is a small electrode that is attached to your baby’s head – it is placed there via the cervix and stays in place until your baby is born. This is a much more accurate way of checking how your baby is coping. Women are often worried that the clip will hurt their baby’s head. It usually does leave a small red mark, but this will disappear in a few days.