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pregnancy

I.PRE-NATAL CARE

Care Before and During Pregnancy--Prenatal Care
Getting early and regular prenatal care is one of the best ways to promote a healthy pregnancy. Prenatal care is more than just health care; it often includes education and counseling about how to handle different aspects of pregnancy, such as nutrition and physical activity, what to expect from the birth itself, and basic skills for caring for your infant.

Prenatal visits also give you and your family a chance to talk to your health care provider about any questions or concerns you have related to your pregnancy, birth, or parenthood.

Many health care providers recommend that a woman who is only thinking about getting pregnant see a health care provider about preconception health. There are steps she can take to reduce the risk of certain problems.

Folic Acid and Prenatal/Preconception Vitamins
Proper Immunizations for the Mother
Healthy Behaviors

Folic Acid and Prenatal/Preconception Vitamins

The U.S. Public Health Service recommends that women of childbearing age get at least 400 milligrams of folic acid each day, through food sources and/or supplements. For women who are thinking about getting pregnant, health care providers recommend supplementing the diet with folic acid for three months before pregnancy, and then for at least the first three months of pregnancy. Prenatal vitamins are a good way to get extra folic acid into the diet. Prenatal supplements often contain high amounts of folic acid and other compounds, such as iron and vitamin A. (But, women should take care in choosing a supplement, to make sure that no more than 5,000 IU of vitamin A is included.) Findings from research supported by the NICHD and other agencies indicate that the right amount of folic acid can help prevent certain types of birth defects and other problems during pregnancy.

Even though many foods available in the United States are fortified with folic acid, women who are thinking about pregnancy benefit from an extra boost of this important compound. It can be hard to get the full amount of folic acid from food sources alone, so preconception supplements are important. For more information about NICHD-supported research on this topic, read the news releases on folic acid research.

Proper Immunizations for the Mother

Women who are thinking about getting pregnant should make sure that they have been properly vaccinated and are immune to certain diseases, such as rubella (also called German measles). If a woman gets rubella while she is pregnant, the fetus is at increased risk for a variety of problems, including deafness, heart problems, cataracts of the eyes, and mental retardation, just to name a few. These problems, which together are called congenital rubella (kon-JENN-it-ul roo-BELL-uh) are much more severe than the effects of getting rubella as a child.

Health care providers often test a woman's blood for immunity to this infection, or they try to find proof of childhood immunizations from a woman's health history. If a woman is not immune to rubella, she should be vaccinated. The American College of Obstetricians and Gynecologists (ACOG) recommends that women wait at least one month after getting vaccinated before trying to get pregnant. ACOG also suggests that women take steps to prevent pregnancy during this time. This time period can protect against any lingering traces of the vaccine/illness that may affect the fetus.

A woman who is already pregnant should not get a rubella vaccination.

In addition, if a woman gets chickenpox while she is pregnant, the fetus is at increased risk for a number of problems, which together are called congenital varicella (vair-i-SELL-uh). The name varicella comes from the name of the virus that causes chickenpox, called varicella zoster virus. Congenital varicella is much more serious than the effects of getting chickenpox as a child. It can result in scarring of the skin, weakening or withering of the arms and legs, called atrophy (AT-row-fee), and eye abnormalities.

Just like they do for rubella, health care providers will likely test a woman's blood for immunity to varicella, or they will try to find proof of childhood immunizations from her health history. If a woman is not immune to varicella, she should be vaccinated. The Advisory Committee on Immunization Practices (ACIP), part of the Centers for Disease Control and Prevention, recommends that all non-pregnant women of childbearing age be vaccinated against varicella. ACIP and the American Academy of Pediatrics also recommend that women wait at least one month after getting vaccinated before trying to get pregnant. This time can protect against any lingering traces of the vaccine/illness that may affect the fetus.

A woman who is already pregnant should not get a varicella vaccine.

For more information, visit the Medem™ Website, and do a search for “Planning your Pregnancy” in the medical library.

Healthy Behaviors

Vitamins and immunizations aren't the only things that can help promote a healthy pregnancy. Things like diet, physical activity, medications, smoking, alcohol or drug use, and environmental factors can all affect pregnancy.

A healthy diet, weight level, and regular physical activity level can help to reduce problems for both mother and fetus during pregnancy. For this reason, many health care providers suggest that women who are thinking about getting pregnant take steps to improve or maintain their own level of health before they get pregnant. A healthy diet helps to ensure that the fetus has all the nutrients it needs to grow and develop normally. Maintaining a healthy weight, both before and during pregnancy, can help to reduce stress on the mother's body and lower the risk of certain disorders of pregnancy. Being active before and during pregnancy, if approved by a health care provider, can help women maintain their healthy weight and can improve the function of the circulatory, cardiovascular, and skeletal systems.

Just as important is keeping things that can be dangerous out of the mother's body. For instance, medications used to treat various diseases and conditions can affect the growth and development of the fetus. Certain herbal supplements and high amounts of vitamins can also make it harder for a woman to get pregnant, and can impact the fetus' health during pregnancy. Even being around certain materials, such as paint and pesticides can put the health of the fetus at risk. Women who are thinking about getting pregnant should discuss all of these factors with their health care providers. Some changes in medication or supplement use, or changes in environment may be recommended to prevent problems during pregnancy.

Research shows that smoking, drinking alcohol, or using drugs, even now and again or in small amounts during pregnancy can cause health problems for the fetus, some of them severe. Many of these problems can have life-long effects. Alcohol and drug use may also make it harder for some women to get pregnant.

To reduce the risk of problems during pregnancy, health care providers recommend that women stop smoking, stop drinking alcohol, and stop using drugs, completely, as early as possible before they start trying to get pregnant. They should maintain this tobacco-free, alcohol-free, and drug-free lifestyle throughout their pregnancies and after birth, as many of these substances can get into the baby's system through breast milk.

 

For more information, visit the Medem™ Website, and do a search for “Planning your Pregnancy” in the medical library.

If you are thinking about getting pregnant, talk to your health care provider about how best to promote a healthy pregnancy, in a way that takes your medical history and lifestyle into consideration.

 

For more detailed and authentic information click here.

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II.Pregnancy Calendar

Personalized Calendar

Create your own personalized pregnancy calendar and record milestones daily on our colorful calendar pages. These pages can be used during pregnancy and after. Our blank pages were especially designed with you in mind to record important details and symptoms concerning your blessed event.

Each page has a special place for questions for you to ask your physician at your next appointment as well as a place for baby names as you think of them. Most recent symptoms and layette checklist included. Remember to write down details of your doctor's appointment, too! Write down symptoms in early pregnancy and compare if and when you have another baby.

Just print and start writing your memorable milestones, today.

 
 

Pregnancy Due Date Calculator

Calendar/calculator is based on regular 28 day menstrual cycles. An average pregnancy is 280 days from the last menstrual period. Obstetricians allow two weeks on either side of the estimated due date and consider a baby on time.

Pregnancy Calculator for Due Dates

Enter the date of your last period:
Spell out the month, use numbers for the day and year
EXAMPLE: June 10, 2003

Month Day Year

Note:- Please use your browser's 'Back' button to come back here.

Click here to return back to Home page.

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III.Pregnancy Labor and Delivery

Signs of Labor

Braxton Hicks contractions are irregular contractions that prepare your body for true labor. They slow down when you move or walk around and are not as painful as true contractions. Braxton Hicks labor contractions are felt more in your abdomen. True labor contractions may be felt more in the back.

Before the onset of labor and delivery your body will give you signs that full blown labor is about to begin. One of the signs of labor is "Lightening" which is when your abdomen seems to drop thus the term. Your baby moves into position for birth. Indigestion will not be as apparent in labor.

Another of the labor signs is the release of the mucous plug. As the cervix begins to dilate or open up, there will be a mucous discharge. It may be tinges with blood or be pinkish in color. If you notice any bright red discharge call your health care provider immediately! You could be bleeding which could be a life threatening condition.

Just before labor begins you may experience "nesting", a sudden urge to clean or a burst of energy.

All of the above conditions can occur days or week before labor and indicate that labor is imminent.

Your membranes may rupture. When this happens you may feel a gush of fluid coming from your vagina. Call your health care provider immediately. You are in true labor. You'll need to be monitored as infection can set in causing danger to your baby. If you think you are too early to delivery it will be too late to stop the labor. Labor contractions will increase in frequency and pain after the rupture of the amniotic sac. With most women this does not occur until they are about to deliver.
 

Stage I of Childbirth

Famous Quote: "I don't know nothing 'bout birthing no babies". Where was it from?

Early Labor

Early labor is exciting at first as you realize that it is now time to have your baby and that childbirth is imminent. It is the longest part of labor and the easiest. Your cervix will dilate to four centimeters during this period. Contractions will last between 30 and 60 seconds and be 5 to 10 minutes apart. When you think you are in labor call your health care provider. The early stage of labor may last from 2 to 10 hours. You'll be instructed not to eat just in case an emergency cesarean section is needed.

Active Labor

During Active Labor you will dilate from 4 to 8 centimeters. Your contractions will be about 45 seconds in length and be about 2 minutes apart. As time goes on you will want to focus on what you are doing and become increasing irritable. This is the stage when nasty things are normally said to a partner. You mind is on childbirth or "getting your baby out!".

Transition

This is your shortest but most intense phase of labor. Your contractions will last from 45 to 60 seconds and be 1 to 2 minutes apart. Your baby will be here soon. Don't be surprised to hear a groan come out of your mouth. It happens to most women and is quite normal during childbirth. You may have uncontrollable trembling or feel cold. You may feel like you want to vomit. You are less concerned about modesty at this point. You may feel a loss of control over the situation or feel like you can't take another contraction. If offered medication you are most likely to take it.

Before the onset of labor and delivery your body will give you signs that full blown labor is about to begin. One of the signs of labor is "Lightening" which is when your abdomen seems to drop thus the term. Your baby moves into position for birth. Indigestion will not be as apparent in labor.

Another of the labor signs is the release of the mucous plug. As the cervix begins to dilate or open up, there will be a mucous discharge. It may be tinges with blood or be pinkish in color. If you notice any bright red discharge call your health care provider immediately! You could be bleeding which could be a life threatening condition.

Just before labor begins you may experience "nesting", a sudden urge to clean or a burst of energy.

All of the above conditions can occur days or week before labor and indicate that labor is imminent.

Your membranes may rupture. When this happens you may feel a gush of fluid coming from your vagina. Call your health care provider immediately. You are in true labor. You'll need to be monitored as infection can set in causing danger to your baby. If you think you are too early to delivery it will be too late to stop the labor. Labor contractions will increase in frequency and pain after the rupture of the amniotic sac. With most women this does not occur until they are about to deliver.

Stage II of Labor

At this stage your cervix is completely dilated and effaced. You may here the doctor say that you are 100% effaced and 10 centimeters dilated (approx. 4 inches). Contractions are between 3 and 5 minutes apart and last between 1 to 1 1/2 minutes. This is called the pushing stage. When you feel like pushing be sure to let the nurse or health care professional know immediately so that they can get everything ready. Don't push until your health care professional tells you to push. Your baby is pushed through the birth canal at this stage. The pushing can be short or take up to 2 hours depending on how many children you have had before. When your baby comes through the birth canal your doctor may ask you to stop pushing. This is necessary as he may have to clean out the baby's airways before continuing. Your baby is here. The cord is clamped and cut.

Stage III of Labor

The placenta is delivered during this stage. Contractions will continue. Your nurse may push on your abdomen to help expel the placenta or your health care professional may ask you to push once more. He or she will examine it to make sure that is intact.

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Note:- Use your 'Back' button to return back to this page when click on the links below.

Top Ten Signs of Pregnancy

More on Pregnancy

  • MISSED PERIOD
  • TENDER BREASTS
  • NAUSEA
  • FATIGUE
  • FREQUENT URINATION
  • HEADACHES
  • SPOTTING
  • LIGHT HEADEDNESS
  • CONSTIPATION
  • HEARTBURN

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IV.STAGES OF PREGNANCY & FETAL DEVELOPMENT

Women's Health

Pregnancy

The Stages of Pregnancy

It's certainly exciting to "watch" your baby grow as you progress through your pregnancy. And it's just as important to know what these changes mean and to track the changes that are happening with your baby and inside your own body.

There are three stages of pregnancy called trimesters:

  • First Trimester
    The first trimester of pregnancy lasts for three and a half months or 14 weeks. During this stage of pregnancy you may experience the dreaded morning sickness (which can occur anytime during the day and sore and enlarged breasts. During this stage it's vital that you get enough vitamins, minerals and nutrients as they are essential for growth and development. It's a good idea to consult with your health care provider to determine what is best for you.
Nutrition and Exercise
  • 2200 calories/day
  • Well balanced, healthy diets with adequate fiber promotes baby’s growth and mother’s energy and comfort
  • Take prenatal vitamins as prescribed
  • Avoid the use of alcohol and tobacco
  • Small, more frequent meals may help a nauseous woman get good nutrition
  • Many women can continue to exercise regularly.
  • Daily exercise that suits your level of fitness can help decrease fatigue and stress
  • Discuss your exercise habits with your health care provider
  • Avoid overheating and maintain good hydration during exercise
  • Second Trimester
    This second stage of pregnancy lasts until the end of the seventh month and is many times the easiest stage of pregnancy as most women will start to regain some of their energy. During this stage your stomach will begin to expand and those around you will start to notice that you are pregnant. At this time any feelings of morning sickness should dissipate, although some women may continue to experience it (usually to a lesser extent). At this point you may also feel your baby beginning to kick and move. If you wish, you can find out whether you are having a girl or boy.
Nutrition and Exercise
  • 2500 calories/day
  • Continue to maintain a well balanced diet with plenty of fiber
  • Continue to take prenatal vitamins if prescribed
  • Continue to avoid the use of alcohol
  • Modify your exercise regimen if needed to protect weight bearing joints, back and abdominal muscles
  • Take care with lifting and carrying
  • Third Trimester
    As you enter into the final trimester of your pregnancy you may notice that you feel more sensitive, emotional and anxious. Be rest assured, these feelings are very natural. It's common to begin worrying about about what kind of mother you are going to be. Many times, the increased size and weight of your baby can cause increased pain (often in your back), making you feel more uncomfortable and anxious.
Nutrition and Exercise
  • 2500 calories
  • You may need to resume small frequent feedings to prevent heartburn
  • Continue prenatal vitamins as prescribed
  • Continue to avoid the use of alcohol
  • Adequate hydration and avoiding overheating are important to protect the baby and you
  • Further modify your exercise regimen as needed to protect muscles and joints
  • Shortness of breath is common on exertion-You may need to reduce the intensity of your exercise regimen if you are becoming too winded
  • Stretch and tone to prepare for childbirth

     

Tracking Fetal Development

Fetal Development Fetal Organs
First Month (Embryo) Vital organs are forming and the brain and beginning of the spine are evident.
Fifth Week Heart begins to beat and circulate blood; arm and led buds emerge; brain, spinal cord, and nervous system are established.
Sixth Week Digestive system is forming and arms and legs begin to grow.
Seventh Week The umbilical cord joins the embryo to the placenta; long bones and internal organs are developing.
Second Month
(Fetus)
Human face, arms, legs, fingers, toes, elbows, knees, eyelids and bone cells are forming.
Twelfth Week Sex is distinguishable; fingers and toes are moving; teeth buds are present and the kidney and bladder form. Baby is 2-4" long and weighs an once or two.
Sixteenth Week Baby moves and kicks, sleeps and wakes, swallows; hair forms, digestion becomes active; fetus is pick in color and has a large.
20 Weeks Spurt in baby's growth; internal organs are maturing; hair, eyebrows and lashes are present; baby increases storage of iron. Baby is 8-12" long and weighs 1/2 pound.
24 Weeks Baby's skin is wrinkled; covered by lanugo and vernix; and baby has an audible heartbeat.
28 Weeks Most rapid growth; red and wrinkled; eyelids can open and close; baby storing large amounts of calcium and iron; fetus has a chance of surviving if born. Baby is 15" long and weighs 3 pounds.
32 Weeks Weight gain and rapid growth; settles in favorite position; valuable fat increases.
36 Weeks Baby gains 1/2 pound per week; bones of head are soft and flexible; baby has developed immunities. Baby is 18" long and weighs 6 pounds.
Birth
38-42 Weeks
Organs developed; respiratory system is mature.

 

 

 

 

Changes in Your Body

Besides the obvious change in appearance, there are many changes that will happen during your pregnancy–both physically and emotionally. We don't want you to be alarmed by these paind and discomforts, so we will explain them here as well as offer some suggestions for relief.

Nausea (morning sickness)

Early in pregnancy, many women get morning sickness. This is a feeling of being nauseated (feels like you want to throw up) and can include some vomiting. Even though it is called morning sickness, some women may feel sick at different times of the day.

What to do:

Constipation

Constipation (hard bowel movements) also may develop during pregnancy.

What to do:

Backache and Leg Pains

 

 

As your baby grows, your muscles stretch, causing strain on your back.
What to do:

Emotional Changes

During pregnancy, your hormones are changing. This may cause you to experience ups and downs. You may feel excited, tired, worried, or like you need to talk about everything that is happening to you.
 
What to do:
Remember that having a baby is a very personal experience. Everyone may have different kinds of feelings. If you are concerned about how you feel, please talk about it with your health care provider.

Heartburn

 

 

Heartburn feels like a burning sensation in your throat. As your baby grows, your digestion slows down. Also, toward the end of pregnancy, the growing uterus puts pressure on the stomach. This can cause heartburn.

What to do:


Hemorrhoids (Piles)

Hemorrhoids may be caused by straining with a bowel movement, or by pressure on your rectum for the growing baby.

What to do:


Feeling Short of Breath

You may feel short of breath as the baby grows and fills up your abdomen. This puts pressure on your diaphragm, a muscle in your chest.

What to do:

Feeling Tired

Most women feel tired during the early and later weeks of pregnancy.

What to do:


Urinary Frequency

As the baby grows larger, your bladder will hold less and less urine.

What to do:

Vaginal Discharge

A vaginal discharge occurs normally during pregnancy, because of hormonal changes. A yellow or cheesy white discharge that is accompanied by itching or burning is not normal and needs to be reported to you health care provider.

What to do:


Swelling in Your Hands and Feet

Some mild swelling may occur from the increased weight of the baby and hormonal changes.

What to do:

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V.Labor and Delivery

Frequently Asked Questions About Labor and Delivery

1. How will I know when I'm in labor?

It is often difficult to know when you are in true labor. Your body will give you signals, but there is no guarantee that you will experience them. Here are some signs to watch for:

Do not wait for your water to break before calling your doctor–for most women this does not happen until the labor has progressed.

If you notice any bright red discharge call your health care provider immediately! Pinkish spotting (bloody show) is normal after 37 weeks, particularly after you have had a vaginal exam, have had sex, or are in early labor. Call your health care provider if you experience any bleeding that occurs before 37 weeks. This is not normal.

2. What should I expect when I get to the hospital?

Strong Memorial Hospital

When you first get to the hospital, you will go to the Birth Center or Labor and Delivery area, based on your birthing choices, room availability, and instructions from your health care provider. You either may walk or need to take a wheelchair, depending on how you feel. Go through the main lobby of the hospital to the red elevators. Take the elevator to the 3rd floor. There, you will be greeted by the secretary on the triage unit. At the triage unit, you will be checked and directed to the appropriate unit. When you arrive on the unit, you will need to change into a hospital gown and give a urine sample. The nurse will help you into bed, ask questions about your health history, and take your temperature, pulse, and blood pressure. A fetal monitor may be used to listen to your baby’s heart rate and to record any contractions which you may be having. The monitor is attached to a computer screen, so you can also see the tracing or recording of your baby’s heart beat. You may have a sterile exam with a speculum placed into the vagina to see if your water has broken. An exam can tell if your cervix (the opening to your uterus where the baby will come out) is dilating (opening).

Highland Hospital

(need specific info about highland here)

3. What will happen during labor?

During labor, your uterus (which is made up of muscles) will tighten and relax. This causes your cervix to open. Once the cervix is fully open (dilate), you will start to push the baby down through the birth canal. Labor is hard work and can be uncomfortable.

Every labor is different, but labor usually starts out slowly, with cramps. The cramps become stronger and closer together. As you become more uncomfortable, you can try different ways to help make labor go smoothly.

Your amniotic sac (bag of water) may break on its own before or during labor. Sometimes, your health care provider may decide to break the bag of water if it has not broken on its own. This is not any more uncomfortable than a vaginal exam. The amniotic fluid may feel warm as it leaks out. The fluid will continue to lead during labor. Your contractions may or may not feel stronger to you after your water has broken. You may need to wear a sanitary pad if you are out of bed or walking.

First stage–During the first stage of labor uterine contractions begin. They will be relatively mild at first and they will increase in intensity and duration as labor progresses. Usually contractions will become more frequent after your water breaks. Throughout this stage your cervix thins (effaces) and opens (dilation) and by the time you are ready to deliver your baby your cervix will be dilated to 10 centimeters. The typical duration of this stage is 13 hours–if it's your first child.

Second stage–During the second stage of labor your cervix will open sufficiently and your baby begins to move down the birth canal. At this time you will push the baby through the birth canal and you'll finally be able to meet your new baby. The typical duration of this stage is 90 minutes.

Third stage–In the third stage you will deliver the placenta or afterbirth. This usually happens within 30 minutes after the birth.

4. How long will my labor last?

If it's your first child, labor will typically last between 12 and 24 hours, with an average of 14 hours. However, if you've given birth before, labor usually averages between 6 and 8 hours.

5. Is there anything I can do to lessen the pain of the contractions?

6. What if something doesn't go as planned?

Be assured, many women give birth to healthy babies with no complications at all. If complications do occur, they are many times related to timing and your doctor or other health care provider know exactly how to handle them. Serious problems are relatively rare and often can be anticipated.

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Labor

What is labor?
Labor is a series of continuous, progressive contractions of the uterus which help the cervix to open (dilate) and to thin (efface), allowing the fetus to move through the birth canal. Labor usually starts two weeks before or after the estimated date of delivery. However, no one knows exactly what triggers the onset of labor.

What are the signs of labor?
Signs of labor vary from woman to woman, as each woman experiences labor differently. Some common signs of labor may include:

If a woman feels unsure if labor is beginning, she should always call her physician.

What are the different stages of labor?
Each labor is different. However, labor typically is divided into three stages:

First Stage The first phase of the first stage of labor is called the latent phase, when contractions are becoming more frequent (usually 5 to 20 minutes apart) and somewhat stronger. However, discomfort is minimal. The cervix dilates (opens approximately three or four centimeters) and effaces (thins out). Some women may not recognize that they are labor if their contractions are mild and irregular.

The latent phase is usually the longest and least intense phase of labor. The mother-to-be is usually admitted to the hospital during this phase. Pelvic exams are performed to determine the dilatation of the cervix.

The second phase of the first stage (active phase) is signaled by the dilatation of the cervix from 4 to 7 centimeters. Contractions become longer, more severe, and more frequent (usually 3 to 4 minutes apart). 

The third phase is called transition and is the last phase. During transition, the cervix dilates from 8 to 10 centimeters. Contractions are usually very strong, lasting 60 to 90 seconds and occurring every few minutes. Most women feel the urge to push during this phase. 

In most cases, the active and transition phases are shorter than the latent phase. 

Second Stage The second stage of labor begins when the cervix is completely opened and ends with the delivery of the baby. The second stage is often referred to as the "pushing" stage. During the second stage, the woman becomes actively involved by pushing the baby through the birth canal to the outside world. When the baby’s head is visible at the opening of the vagina, it is called "crowning." The second stage is shorter than the first stage, and may take between 30 minutes to two hours for a woman’s first pregnancy.
Third Stage After the baby is delivered, the new mother enters the third and final stage of labor - delivery of the placenta (the organ that has nourished the baby inside of the uterus). This stage usually lasts just a few minutes and involves the passage of the placenta out of the uterus and through the vagina.

stages.gif (54425 bytes)

Each labor experience is different and the amount of time in each stage will vary. However, labor in a first pregnancy usually lasts about 12 to 14 hours. Labor is generally shorter for subsequent pregnancies.

Induction of labor:
In some cases, labor has to be "induced," which is a process of stimulating labor to begin. The reasons for induction vary. Some common reasons for induction include the following:

Some common techniques of induction include the following:

Relaxation techniques to use during labor are often taught in childbirth classes. Especially in natural childbirth, which does not use medications to relieve pain, relaxation and breathing techniques can help a woman feel more in control and able to manage her pain.

Care at the hospital during labor:
When a woman arrives at the hospital in labor, the medical staff may perform a physical examination of the abdomen to determine the size and position of the fetus, and an examination of the cervix. In addition, the medical staff may check the following:

Intravenous fluids are sometimes given during labor to prevent dehydration. The intravenous line, a thin plastic tube inserted into a vein (usually in the patient’s forearm), can also be used to administer medications. Intravenous fluids are also needed when a woman has epidural anesthesia. 

The fetus, too, is carefully monitored during labor. A monitor placed over the mother’s abdomen will keep track of the fetal heart rate.

What are pain management options during labor?
A woman has many options for managing the discomforts that occur during labor and the birth of her baby.  Generally, mothers and their physicians want to use the safest and most effective method of pain relief for both mother and baby. The choice will be determined by:

There are three main types of pain management for labor and birth:

 

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Delivery

What are possible labor complications?
Although serious complications are rare during labor, some problems can develop during this time. Some of the more common complications include:

  • fetal meconium
    When the amniotic sac membrane ruptures, the normal color of the amniotic fluid is clear. However, if the amniotic fluid is greenish or brown in color, it may indicate fetal meconium, which is normally passed after birth as the baby's first bowel movement. Meconium in the amniotic fluid may indicate fetal distress. A woman should consult her physician immediately.

     
  • abnormal fetal heart rate
    The fetal heart rate during labor is a good indicator of how the fetus is handling the contractions of labor. The heart rate is usually electronically monitored during labor, with the normal range varying between 120 to 160 beats per minute. If a fetus appears to be in distress, immediate action can be taken, such as giving the mother oxygen, increasing fluids, and changing the mother's position.

     
  • abnormal position of the fetus during birth
    The normal position for the fetus during birth is head-down, facing the mother's back. However, sometimes a fetus is not in the right position, making delivery more difficult through the birth canal. There are several abnormal positions for a fetus, including the following:
  • positioned head-down but facing the mother’s front

     
  • positioned with the face down into the mother’s pelvis, instead of the fetus’ top of the head

     
  • positioned with the brow down in the mother’s pelvis

     
  • positioned breech (where the buttocks or feet are down first in the mother’s pelvis)

     
  • positioned with one shoulder in the mother’s pelvis

present.gif (31146 bytes)

Depending on the position, a physician may try to deliver the fetus as it presents itself, attempt to turn the fetus before delivery, or perform a cesarean delivery.

Delivery of the baby:
Delivery is the moment when the fetus, followed by the placenta, exits the mother’s body. In preparation of the delivery, a woman may be moved into a birthing room or delivery room, or she may remain in the same room for both labor and delivery. Fathers or partners are encouraged to be actively involved in the process of childbirth by helping with relaxation techniques and breathing exercises.

Positions for delivery may vary from squatting, sitting, to semi-sitting positions (between lying down and sitting up). With semi-sitting positions, gravity can help the mother in pushing the baby through the birth canal. The type of position for delivery depends on the preference of both the mother and the physician.

During the delivery process, the medical personnel will continue to monitor the mother's vital signs (i.e., blood pressure and pulse) and the fetal heart rate. The physician will examine the vagina to determine the position of the fetus' head and will continue to support and guide the mother in her pushing efforts.

Delivery can either be accomplished vaginally or by cesarean section (also called c- section).

What is a vaginal delivery?
During a vaginal delivery, the physician will assist the fetus’ head and chin out of the vagina when it becomes visible. Once the head is out of the vagina, the physician usually rotates the fetus to the side and eases the shoulders out, followed by the rest of the body. 

In some cases, the vaginal opening does not stretch enough to accommodate the fetus. If there is a risk of tearing, the physician may perform an episiotomy - an incision through the vaginal wall and the perineum (the area between the thighs, extending from the anus to the vaginal opening) to help deliver the fetus.

After the delivery of the baby, the mother is asked to continue to push during the next few uterine contractions to deliver the placenta. Once the placenta is delivered, the episiotomy incision is stitched. The mother is usually given oxytocin (a drug administered either by an injection into the muscles or intravenously that is used to contract the uterus) and the uterus is massaged to help the uterus to contract, and help prevent excessive bleeding from occurring.

What is a cesarean section (c-section)?
If a woman is unable to deliver the fetus vaginally, the fetus is delivered surgically, by performing a cesarean section. Cesarean sections are usually performed in an operating room or a designated delivery room. Some cesarean sections are planned and scheduled accordingly, while others may be performed as a result of complications that occur during labor. 

Once the anesthesia has taken effect, an abdominal incision is made, and an opening is made in the uterus. The amniotic sac is opened, and the baby is delivered through the opening. The woman may feel some pressure and/or a pulling sensation.

Following the delivery of the baby, the physician will stitch the abdominal incision and the mother is given oxytocin (either by an injection into the muscles or intravenously) to contract the uterus, thereby preventing bleeding from occurring.

Conditions for a cesarean section:
There are several conditions which may make having a baby by cesarean section more likely. These include, but are not limited to, the following:

  • previous cesarean section

     
  • fetal distress

     
  • abnormal delivery presentation (i.e., breech, shoulder, face)

     
  • a labor that fails to progress or does not progress normally

     
  • placental complications (i.e., placenta previa, in which the placenta blocks the cervix and presents the risk of becoming detached prematurely from the fetus)

     
  • twins or other multiples 

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VI.POST NATAL CARE

After Delivery

Your nine months of waiting have ended. You have just given birth to your baby and now you are full of the wonder and excitement of caring for her! No doubt - you are also full of questions. In the hospital, with the nursing staff on hand to provide a lot of basic care (bathing, etc.) your immediate concern will probably be feeding the baby. Once you are home, you will begin the seemingly overwhelming task of caring for your baby full-time. This site is designed to answer many of your questions, and hopefully put your worries to rest.

Remember though, that your baby is not the only one who needs special care at this time. In the hours, days and weeks following your baby's birth, you may experience significant physical and emotional changes. The best way you can care for your new baby is to take care of yourself as well during this time.

What You May Experience Physically

Immediately following your baby's birth, your body will undergo a number of physical changes that will require special care. Below are some of the most common. Additionally, you will want to take good care of your body, so that you can more easily recover from the rigors of childbirth and labor. Be sure to schedule a postpartum followup visit with your health care provider approximately six weeks following your baby's birth (or whenever your provider recommends) and feel free to contact your health care provider for any concerns or questions you may have prior to that appointment.

Breast Care

Breastfeeding

Cesarean Section

Constipation

Exercise

Hemorrhoids

Nutrition

Pain and Pain Management

Rest and Relaxation

Vaginal Bleeding

Weight Loss

When To Call Your Health Care Provider

What You May Experience Emotionally

Having a baby is typically a joyful time in a woman's life, but the physical demands and hormonal changes cause many women to feel like they are on an emotional rollercoaster. Be rest assured - you are not alone! Following is information on some of the most common emotional aspects of childbirth, plus when to seek additional help.

Postpartum Blues (Baby Blues)

Postpartum Depression

Resuming Sexual Intimacy

At some point following your baby's birth, you and your partner will want to resume intimacy, but may have concerns regarding your health, recovery, and birth control. Following is information on the most common concerns. Be sure to consult with your health care provider before resuming sexual relations.

Postpartum Sex

Birth Control

 

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