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What is this information about?
This information is about how you can reduce the chance that you will get skin damage or pressure sores (pressure ulcers) while you are pregnant, in labour and after you have had your baby. It explains:
- what a pressure sore is
- what can cause pressure sores
- how some things that happen when you are pregnant, in labour and after you have given birth may increase the chances of you getting a pressure sore
- how you can reduce the chance that you will get a pressure sore
- how your midwife can help to reduce the chance that you will get a pressure sore
- what the signs that you may be getting a pressure sore are
- what you should do if you think you may be getting a pressure sore
Why have I been given this information?
You have been given this information because when you are pregnant, in labour, or you have given birth and there is a chance that you could get a pressure sore.
Getting a pressure sore can be painful and there is a risk that you could get an infection from germs getting into your body through the sore. Following the advice in this leaflet can help to reduce the chance that you will get a pressure sore.
What is a pressure sore?
A pressure sore is an area of damage to the skin and the tissue underneath it such as fat or muscle.
Pressure sores usually develop over parts of the body where your bones are just beneath your skin and that take your weight when you are lying or sitting down. These include, for example, your hips, shoulders, and ankles.
At first, a pressure sore may just appear as an area of redness on white skin or of purple or blue on black or brown skin.
Diagrams showing areas of your body where you are most likely to get a pressure sore:
What causes pressure sores?
Pressure sores can be caused by:
- pressure from the weight of your body pressing on the skin
- layers of skin sliding over another surface. This is called skin shearing
- friction caused by something rubbing against your skin
- your skin getting moist. This is like what happens in nappy rash.
Can anyone get a pressure sore?
Yes. Pressure sores can happen to anyone, at any age. You are more likely to get a pressure sore if:
- you are unable to move around for longer than usual
- your skin gets damp and stays damp
- you are not getting the right amount of nutrition from what you eat.
Why might I get a pressure sore when I am pregnant or in labour?
- Your skin can become damp in labour.
- You may be restless and move around when you are in bed. This can cause friction and shearing of your skin.
- Pressure can come from sitting or lying in one position for more than two hours.
- If you have had an epidural or spinal anaesthetic:
- it can be harder for you to notice if an area is becoming sore. This is because you cannot feel things as well in the lower half of your body.
- you may also find it more difficult to move around and so you could stay in the same position for longer. This means you are more likely to put pressure from your weight on one area of your body and get a pressure sore.
- Some procedures, such as having a catheter (tube in your bladder to drain your wee (urine), make it more difficult for you to move around.
What can I do to reduce the chance of getting a pressure sore?
Do:
- make sure that if you have a catheter, which goes over your leg and not underneath it.
- get out of bed and move around. Be aware, do not do this if you do not have feeling in your legs if you have had epidural, spinal or general anaesthetic.
- remember to change your position every two hours. If you have had an epidural, this does not have to be a big change. Tilting slightly to one side will be enough.
- move around (be mobile) as much as you can.
- change wet sanitary towels as soon as possible.
- ask your Midwife or another member of staff to change wet sheets as soon as possible.
How will my Midwife help me to avoid getting a pressure sore when I am pregnant or in labour?
Your Midwife will:
- assess the chance that you may get a pressure sore when you arrive in hospital and then at regular times during your stay
- encourage and help you to change position regularly
- change wet sheets and sanitary towels regularly
- encourage you to stay mobile
- ensure any catheter is over your leg not underneath it.
Can some types of birth increase the chance that I may get a pressure sore?
Yes. Some types of birth, such as a caesarean, ventouse or forceps assisted birth, may increase the chance that you will get a pressure sore.
These may reduce your mobility and ability to feel discomfort for a short time after your baby is born.
How can I help to reduce the chance that I may get a pressure sore after I have had my baby:
Do:
- change your position regularly to transfer pressure to another part of your body. For example:
- if you are in bed change between lying on your sides and your back.
- if you are sitting in a chair, change your position at least once an hour.
- take a short walk or stand up for two minutes.
Be aware
You can still get out of bed if you have a catheter in if your Midwife has told you that it is safe to do so.
How will my Midwife help me to reduce the chance of getting a pressure sore when I am in hospital?
If you are unable to change position yourself, your Midwife will help you to do this. They will also:
- get you out of bed 6 to 12 hours after your baby is born and your anaesthetic has worn off
- check your skin and how likely it is that you may get a pressure sore.
Which signs that I may be getting a pressure sore should I be aware of?
What to look for on your skin:
- red, bluish or purple patches that do not go away
- swelling
- cracks, calluses, or dry patches
- blisters
What to feel for:
- pain or discomfort
- patches of skin that feel unusually hard or spongy to touch
- skin over bony parts that feels warmer or cooler than the skin around it
What are the most important things to remember from this information?
- most women and birthing people will not develop a pressure sore.
- some things about being pregnant and being in labour can increase the chance that you may get a pressure sore. For example, having a catheter, not moving around so much, being in bed for a long time and having a spinal or epidural anaesthetic.
- the staff in the maternity unit will check how likely you are to get pressure sores and help you to avoid getting them.
Be aware
If you think you are getting a pressure sore inform your Midwife as soon as possible. Pressure sores can be resolved more easily if they are dealt with in the early stages soon after you get them.
Who should I contact if I have any concerns (including vision, mobility or access issues) or questions or would like further information?
If you are still in hospital, tell the Midwife looking after you.
If you are at home, contact the Maternity Triage service phone: 01903 285 269 or contact your community midwife, who will be able to advise or refer you as needed.