Looking after your skin
Read our guide below to help prevent pressure damage in labour and the postnatal period.
You can also download a PDF version of this patient information by following the link on the right.
When you’re pregnant there may be times when you’re unable to move as often or as easily as usual.
What is a pressure ulcer?
A pressure ulcer, also known as a bedsore or pressure sore, can happen to anyone, at any age.
It’s a localised injury to the skin and/or underlying tissue, as a result of pressure being applied to that area for a prolonged period of time.
Pressure ulcers may cause pain and may increase the length of time you spend in hospital.
Pressure ulcers can affect any part of the body but are most common on bony parts such as the:
- back of heels
- shoulders
- back of spine
- buttocks (most common)
- toes
- elbows
- ears.
What causes pressure ulcers?
This includes:
- pressure – weight of the body pressing on the skin against another surface such as a mattress or chair
- shearing – when layers of skin slide over another surface, for example dragging against a mattress
- friction – rubbing of the skin against a surface
- moisture – caused by sweat, amniotic fluid once your waters have broken or blood loss.
Pressure
Body weight can compress the skin and other tissues and certain sitting/lying positions can increase this compression.
The blood supply to the area gets damaged which in turn causes tissue damage.
How can this affect you whilst in hospital?
Pressure can come from sitting/lying in one position for lengthy periods, for example, during the induction of labour process or following birth if you’re unable to move easily.
Restlessness in bed can result in friction/shearing of the skin.
Having an epidural or spinal in labour can make it harder for you to tell if an area is becoming sore. It can also make it difficult for you to move.
Moisture damage can occur when your waters break particularly if you’re sitting on wet sheets.
If you need a drip in labour or a urinary catheter these tubes may cause you to be reluctant to move.
How can this affect you once your baby is born?
Recovering from an epidural or spinal can increase your risk due to continued immobility for a period of time once your baby has been born.
This risk can increase following a caesarean section when your sensation and immobility may prevent you knowing you’re sore or needing a pad change.
Pain may cause you to be reluctant to move.
You can help by:
- keeping as mobile as possible at all stages of your admission to hospital
- moving regularly, ideally every 2 hours (minimum) if you plan on or have had an epidural. These do not need to be big movements. Changing the position of the bed or a slight tilt to the side can make a difference
- using sanitary pads and changing them regularly to reduce the moisture risk. Your midwife can support you with this and may prompt you if you have little or no sensation.
- moving as soon as safe to do so (your midwife can guide you with this) following your birth. This will help to relieve the pressure and encourage circulation. You can do this even if you have a urinary catheter in place.
- maintaining hydration and a good diet.
Please note that in some cases disposable underwear such as TENA can increase the risk of pressure sores. This style of underwear keeps moisture close to the skin increasing the risk of pressure ulcers.
Your midwife will help by:
- carrying out regular assessments during your stay to establish if you are at risk of developing a pressure ulcer and advising you accordingly.
- encouraging and supporting you to mobilise and/or change position.
- helping you to change your pads and bedding regularly during labour and after the birth of your baby.
- ensuring you’re not sitting on the tube of your urinary catheter (if you need one) which may cause pressure damage if there’s prolonged contact.
Diet and nutrition
Eating a healthy balanced diet that contains enough protein and a good variety of vitamins and minerals can speed up the healing process.
Drinking plenty of fluids to avoid dehydration is important because being dehydrated can slow down the healing process.
Diabetes
If you have diabetes it’s important that your blood sugar is well controlled; having high blood sugar can increase the chances of having a pressure ulcer or wound infection as this condition slows down the healing process.
Am I likely to get a pressure ulcer?
To reassure you, your risk is small. With greater awareness of the importance to remain as active as possible, or to ensure you regularly change position if mobility is reduced and look after your skin, you’ll help us to help you prevent pressure damage happening during your stay.
What to remember
Moving whilst you’re confined to bed is very important. The advice on this page will help to minimise the risk of damage to your skin.
Frequent changes of position will relieve pressure on your skin.
Ask a midwife if you’d like more information. We’re always happy to help.