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Looking after your skin

A guide to help prevent skin damage and the development of pressure sores, while you are pregnant, in labour and after you have had your baby.

When you are pregnant there may be times when you are unable to move as often or as easily as usual.

How is your skin affected?

Pressure sores/ulcers can happen to anyone, at any age, especially if you are spending longer than usual being unable to move and if your skin is damp or your diet is poor.

A pressure sore is an area of damage to the skin and the tissue beneath and can be caused by the following:

  • Pressure—weight of the body pressing on the skin
  • Shearing—when layers of skin slide over another surface
  • Friction—rubbing of the skin
  • Moisture—similar to nappy rash

The main areas that can be affected by pressure sores are over bony prominences (where bones are close to the skin) like the bottom, heel, hip, elbows, shoulder, back and the back of your head.

How can this affect you in pregnancy or labour?

  • Your skin can become damp when your waters break
  • Restlessness in bed can cause friction/ shearing of the skin
  • Pressure can come from sitting or lying in one position for long periods of time

In labour having an epidural or spinal anaesthetic can make it harder for you to realise if an area is becoming sore, because you have reduced sensation in the lower half of your body. It can also make it more difficult for you to move around. This may mean you stay in one position for longer than you would normally.

Some procedures during labour can also make it difficult to move around, such as having a catheter (tube in your bladder) to drain your urine. If you have a catheter, try to ensure it goes over your leg, not underneath it, and remember you can still get out of bed to move around if you have feeling in your legs.

What can you do to help?

  • Remember to change your position every 2 hours, if you have an epidural this does not have to be a big change, tilting will do
  • Keep as mobile as possible
  • Change wet pads as soon as possible

Please ask your Midwife or another member of staff to change wet sheets as soon as possible. .

Your Midwife will help by:

  • Assessing your risk of pressure sores when you arrive and then at regular times during your stay
  • Encouraging and helping you to change position regularly
  • Changing wet sheets and pads regularly
  • Encouraging you to stay mobile
  • Ensuring any catheter is over your leg not underneath it

After your baby is born

Some types of birth, such as a caesarean section, ventouse or forceps assisted delivery, may increase your risk of developing a pressure sore. This is because you are more likely to have had an epidural or spinal anaesthetic, which may reduce your mobility and the ability to feel discomfort for a short time after your baby is born. Your midwife or another member of staff will help by

  • getting you out of bed 6-12 hours after your baby is born and your anaesthetic as worn off
  • removing any catheter as soon as possible. Do remember you can still get up even if the catheter has to stay in for a longer period
  • assessing your risk at regular intervals and inspecting your skin

In summary, most women will not develop a pressure sore but certain procedures/activities/pain relief may increase your risk. The staff in the maternity unit can assess your risk and help you to take steps to help prevent pressure sores.

Your cooperation, help and understanding is important as you can do a lot to prevent these sores.