Our obstetric anaesthesia service primarily provides support to the Delivery Suite at Tunbridge Wells Hospital, as well as offering support and advice to the Maidstone Birth Unit and community maternity services.

Facilities

  • Two fully equipped obstetric theatres attached to the delivery suite
  • Dedicated recovery area for obstetric theatres
  • Maternity High-Dependency Unit (HDU) on the delivery suite
  • Intensive Care Unit (ICU) on site.

Staffing

A consultant anaesthetist is in charge of the obstetric anaesthesia service every day, with direct responsibility for elective caesarean sections. A duty anaesthetist is immediately available for emergency work on the delivery suite 24 hours a day. A consultant anaesthetist is also on call for emergency work on the delivery suite 24 hours a day.

Antenatal education and assessment

Antenatal education about all the types of analgesia and anaesthesia is available, including information about related complications. Further patient information is available at: www.oaa-anaes.ac.uk . A specialist anaesthetic antenatal clinic is held every week for women with conditions requiring antenatal review by the anaesthetist.

Care during labour and delivery

A range of options for pain relief in labour are available at the Trust, depending on where mothers choose to deliver. A 24-hour epidural service is provided on the delivery suite via the duty anaesthetist; approximately one third of women choose to have an epidural during labour.

Remifentanil patient-controlled analgesia (PCA), a strong type of intravenous painkiller, is available for women who are unable to have an epidural for medical reasons.

Spinal or epidural block is routinely offered to women having caesarean sections and other operations related to childbirth. Full equipment for the safe provision of general anaesthesia is also available where necessary.

The emergency theatre is fully staffed with a dedicated team 24 hours a day.

Critical Care

Critical care support is provided for patients with conditions which require a higher level of care, including those who are admitted to the Maternity HDU. An Intensive Care consultant is also available for advice and support 24 hours a day.

Postnatal care

Women who have received regional analgesia/anaesthesia or general anaesthesia for labour and delivery should receive follow-up prior to discharge.
A duty anaesthetist is available 24 hours a day for assessment and advice about pain-related problems and other anaesthetic complications post-delivery.

Education and Training for staff

The service provides an excellent training environment for trainee anaesthetists to gain experience in obstetric anaesthesia whilst ensuring appropriate levels of supervision.
Obstetric anaesthetists contribute to the education and training provided to midwives, obstetricians, and other members of staff, including through simulation-based exercises and multi-disciplinary courses.

Research and Audit

The obstetric anaesthetic service takes an active interest in research and encourages participation in both local and national projects.
An ongoing audit programme regularly monitors anaesthetic complication rates, delays in the provision of care, and patient satisfaction with the service provided.
If complaints are made about aspects of care relating to the service, a consultant anaesthetist will review and assess the mother’s complaint, which will be handled according to local policies.

Organisation and administration

Team briefing and the WHO checklist is used routinely on the labour ward to promote good communication and team working and reduce adverse incidents.
An obstetric anaesthetist regularly attends multidisciplinary ‘labour ward forum’ meetings and other bodies involved in the planning and delivery of obstetric and maternity services.