Counties Manukau Health Birthing and Assessment (B & A)
Public Service, Obstetrics and Gynaecology, Maternity, Maternity/Birthing Facilities
Welcome to your birthing unit. Most of you will only visit us when it is time to meet your baby for the very first time. We are delighted to share this exciting and special time with you.
Some of you will need to come and see us before it is time to have your baby. Whatever the reason for your visit, we are here to help you and make your visit as easy as possible.
Birthing and Assessment (B & A) fills the whole second floor of the Galbraith Building which is the large building across from the train station.
There are lots of reasons why you might need to come to B & A. This page will help you know what to expect.
Whether you go to B & A North or South depends on why you have come in and not where you live. Sometimes you will start on one side and move to the other. This is one big unit. All the midwives, nurses, doctors, healthcare assistants, cleaners and clerical staff work together.
B & A has:
- 17 birthing rooms, all with ensuites
- 4 birthing rooms with baths (there are no birthing pools at MMH)
- 5 assessment rooms
- 4 multi-purpose flexi-rooms; can be birthing or assessment rooms.
Do I have to call anyone before I come?
- You might have talked to your LMC or named midwife about the pain/symptoms you have.
- You might have called B & A and talked to a midwife.
- You may decide to come straight to B & A and speak to someone when you get here.
All of these are fine. B & A is open 24 hours a day, every day – we never close.
Why would I come to B & A if I am not in labour?
- There are a number of reasons why you may visit B & A before labour. We are like an emergency department for pregnancy problems from 20 weeks (about 4 ½ months) until 6 weeks after the birth. Women having their labour induced (started) also come here.
- And just like an emergency department, you can sometimes wait a long time to be seen. This is because the staff and rooms are all busy. Because this is behind a door it may feel like nothing is happening. You have not been forgotten and the staff know you are waiting.
You will find descriptions of the more common reasons to come to B & A when not in full term labour in the 'Procedures / Treatments' section of this page. Many have information pamphlets you can open for more information.
What are the rooms like?
When you are in labour you have a single birthing room with its own bathroom. The bathrooms have a shower and toilet and a few have a bath. We do not have any birthing pools.
When you are not in labour you may share a room with one other woman. The bathrooms are close by.
We have tried to make the rooms as nice as possible by keeping some equipment in cupboards but there are some things we have to keep ready.
The bed is in the middle of the room so that if you are on the bed your midwife can move all around you.
What should I bring?
You might want to have a bag all prepared for your hospital stay. A good idea is to have this ready from 36-38 weeks. You will need:
- your pregnancy notes
- any tablets or medicines which you take regularly including inhalers
- changes of underwear - bring lots
- clean clothing and nightwear
- something to wear in labour (or you can wear one of our nighties) - this should be something you do not mind getting messy and that opens up the front
- clothes to take your baby home in
- sanitary pads (maternity) - your blood loss is heaviest in the first couple of days
- car seat/capsule for baby
- toiletries for you
- formula, bottles and teats if you plan to bottle feed.
You may also want to bring:
- mobile phone
- loose change for vending machines
- pump bottle - we have plenty of cold water
- clothes for baby - we have singlets and wraps but you may prefer to dress baby. Make sure these do not get into our washing bags as they are never found again
- book, magazines, gameboy, puzzles
- pen and paper
- anything you have chosen to help in labour such as music, massage oils etc
- disposable nappies.
What you should not bring:
- anything valuable - theft is not uncommon in any hospital
- lots of stuff - there is limited storage space and you can always get things brought in later
- towels and flannels - we supply them
- toiletries for baby - plain water is best in the first few days.
Labour and birth
Labour can be a scary time for any about-to-be mother whether it is the first time or the tenth. We are here to support you. You may have a LMC midwife who is with you or you may have had care from one of our community midwives and so the midwives on duty will provide your care. Whatever the care and however you birth, our aim is to support you and make sure you understand what is happening.
Sometimes we may find you are in early labour, or we may think this when we speak to you on the phone. Early labour is a time when your body is building up to labour and it can last for some hours. We usually encourage you to be at home because we know that your labour is more likely to go smoothly.
B & A offers a number of different pain relief choices.
Types of birth
- Spontaneous Vaginal Birth – spontaneous means without help. This is when you push baby out by yourself. It is the most common sort of birth and it may also be called ‘normal’.
Ventouse, Forceps and Caesarean sections are performed by specialist doctors only.
- Ventouse – this is a small cup that applies suction to baby’s head when a good seal is made. This is often used for babies who are not too far away but need a little help. It can be because you are really exhausted, baby is becoming tired or baby is in a bit of a difficult position. Your baby will have a bruise on the top of his/her head for a few days.
- Forceps – this is a pair of metal ‘spoons’ which look a bit like salad tongs. They are curved to fit around the baby’s head. This may be chosen rather than the ventouse because baby is not quite as near to the exit or because he/she is unhappy. A forceps birth can be quicker than a ventouse.
- Caesarean Section – this is an operation where your baby is birthed through a cut in the uterus. The uterus is the muscle bag which holds the baby, placenta and the fluid. It is very good at growing and, in the later stages of pregnancy, a lower part or segment will form. This is where the cut is usually made and you may hear the operation called a lower segment caesarean section or LSCS.
It is important that everything is kept very clean during any operation to try and stop any infection. This is why we take you to the operating theatre. This is a big room with lots of equipment. There will be quite a lot of people too. On average there will be 8 to 10 people, each with their own job to do.
The bed is narrow and we tilt the bed to the side. This is so you can lie flat without it squashing the blood supply to your baby. Do not worry, we will not let you fall.
Most women stay awake for their LSCS and have an epidural type anaesthetic which makes you numb from the breasts down. While you may feel some pulling in your tummy, you should be pain free. Once the doctors begin it is a very short time until baby is born. As long as both you and your baby are well after the birth, you can hold him/her skin-to-skin. If you do not feel up to it, your supporter can have baby skin-to-skin.
Once the operation is over you will spend up to an hour in the recovery area. Often baby will have his/her first feed there. From here you will go to Maternity Floor.
Pamphlet - Caesarean Section
Some women have a planned or 'elective' caesarean section.
Placenta/whenua - Pamphlet - Third Stage
Your new son or daughter has arrived! Skin-to-skin together helps baby to get his/her breathing and temperature settled. Your baby will also start to look for the first feed. No matter what sort of birth you have, or how you want to feed, now is the time to start getting to know your little one.
You might choose to go home after 4 hours as long as all is well with you and baby and the birth has been normal. Or you may want to stay a while. There are only a limited number of beds on Maternity Floor. If you have no problems you may be encouraged to transfer to one of the three Primary Birthing Units; Pukekohe, Papakura and Botany Downs - see links below.
Pamphlet early discharge
Women who have had a normal birth usually stay anything between 4 hours and 2-3 days.
If vaginal swabs showed that you carried a bacterium called Group B Streptococcus after 35 weeks pregnant we will give you antibiotics into a drip in your arm when you are in labour. This is to protect the baby. This bacterium usually does mothers no harm but can make babies really sick. How many of the 4 hourly doses you have and how long before your baby's birth is what decides whether you can go straight to a Primary Birthing Unit or home. See more information and pamphlet below.
If you have had a LSCS you will usually have a total postnatal stay of about 3 to 4 days. You will go to Maternity Floor from recovery but some women transfer to a Primary Birthing Unit a day or so later meaning you can continue your stay in a quieter, more homely place.
After your baby has had a skin-to-skin cuddle and his/her first feed we will do a full check. This check makes sure baby has everything he/she should have in the right place! Your midwife will also check the heart beat, pulses and hips. If anything does not seem right your midwife will show you and explain what this means. Sometimes she will call a specialist nurse/doctor to check.
This is also the time when we will give the vitamin K if you would like baby to have it. Your midwife will have talked about this in one of your pregnancy checks.
Pamphlet - Vitamin K
What if I have questions or do not understand?
Please ask your questions or say you do not understand.
We may think we have explained something but it has not been in the best way for you. Tell us. We would much rather this than you feel scared or upset.
If you would like an interpreter, just ask.
Procedures / Treatments
Arriving at B & A to have your Baby
What happens when I get there?
When you get out of the elevator you will see the reception desk.… More
Change in your Baby's Movements
You will probably start to feel your baby moving by around 16 weeks.… More
Bleeding in Pregnancy
There are a few reasons why you might see blood.… More
External Cephalic Version
This is when your baby is bottom first and we turn it to be head first.… More
High Blood Pressure
Every time you have a pregnancy check your blood pressure will be checked.… More
Slow Growth in your Baby
You may be asked to come to B & A to see one of the doctors because your baby is small.… More
Induction of Labour
When we start your labour instead of waiting for your body to start itself it is called induction. … More
Rupture of Membranes before 37 Weeks - Breaking of Waters
Your baby is floating in a special liquid called liquor.… More
Rupture of Membranes after 37 Weeks - Breaking of Waters
Your baby is floating in a special liquid called liquor.… More
Group B Streptococcus
This is the name of a bacterium which is often found on swabs from the vagina. If it is there you would not know – you get no symptoms.… More
Pain when not in Labour
There are a few reasons why you might feel pain in pregnancy.… More
Premature Labour and Birth
Sometimes you will go into labour before baby is due.… More
If I need some pain relief what can you give me?… More
Elective Caesarean Section
If you are having a planned caesarean you will be admitted to Theatre Admissions and go to theatre from there.… More
Vaginal Birth after Caesarean
Vaginal birth after caesarean or VBAC is when one of your previous babies was born by caesarean but with this baby you plan a normal vaginal birth.… More
With Auckland moving to Alert Level 3 at 11:59pm on Tuesday, 21 September, visiting at Middlemore Hospital will be on essential and compassionate grounds, or for birthing partners. Full details are available here.
- One named key person as approved by Charge Nurse/Midwife during the hours of 8am and 8pm except for birthing (one person) and compassionate circumstances (stillbirth or extreme distress)
- Must also be the same person on all visits
- No visiting by any children
- Please do not bring any food items for patients
Birthing & Assessment:
- Only one key person with labouring women or women requiring acute assessment
- Additional support persons on compassionate grounds must be approved by Charge Nurse/Midwife
NICU (Neonatal Unit/Neonatal Intensive Care):
- Mother only
- For babies staying more than 48 hours - Father or one nominated support person for the mother ideally - the same person on all visits
Please visit Counties Manukau Health website for more detailed information for visitors.
Often it is important that you get from the car to B & A very quickly. You can park just to the right of the Galbraith Building doors (the Galbraith Building is on Hospital Road directly opposite the train station). Go straight to the elevators. There is a priority button which means the lift will come to Ground Floor and go straight to B & A.
The person who has driven will need to go to reception and get a pass for an hour of free parking in that space. After that, move the car into the main car park. You will then need to pay for parking.
All of our doors into clinical areas are locked. By doing this we can keep a check on who comes in and when. This is all to keep you and your new baby safe.
Please help us by not letting people through the doors if they have not gone to reception first. If you think anyone is behaving strangely let us know.
Our staff work to ensure that your care and treatment is of the best standard that we can achieve. If for some reason you are unhappy with any part of your care please let us know about it. Happy feedback is also welcomed.
For more information, please go to our Feedback Form on Counties Manukau Health website.
(09) 276 0000 or FREEPHONE 0800 266 513
Patient Enquiries (09) 276 5004 or 0800 266 513
Information or Visiting Hours (09) 270 4799
Outpatient appointments & surgical booking enquiries:
Ph (09) 277 1660 or O800 266 513
Emergency Department: Open 24 hours / 7 days, Phone (09) 276 0000 or
FREEPHONE 0800 266 513
Private Bag 93311
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This page was last updated at 12:48PM on September 22, 2021. This information is reviewed and edited by Counties Manukau Health Birthing and Assessment (B & A).