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What Should I Know About Premature or Preterm Labour?

by Maxine
Posted August 5 2010 10:52am
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The questions and concerns that expectant parents have about premature or preterm labour are many. What are the signs? Can something be done to prevent it? Will premature labour affect the baby? Who is more at risk? What can dad do if mom goes into premature labour? Here are some answers to these common concerns. Of course, you should also talk to your pregnancy care provider about any of your concerns.

What is premature labour?

Preterm labour is contractions or the rupturing of membranes that happens before 37 weeks of pregnancy.

How common is premature labour?

About 1 in 13 babies in Canada are born before 37 weeks.

Is premature labour a problem for the baby?

Premature labour can be a problem for your baby. The longer that your baby stays in the mother's uterus, the longer the baby has to grow and develop in this very special environment. A baby that is born too early may face many problems because some of the baby's body systems have not yet matured.

Some of these problems may affect a baby for life. A baby's lungs, digestive system, eyes, ears, skin and immune system can all be affected if the baby is born too early. Additionally, premature babies do not have many fat deposits and often have trouble staying warm.

What causes premature labour?

In many cases, it is still not clear what causes premature labour. About half of premature labours happen in totally healthy women with normal pregnancies. However, research has shown that there are some factors that may put women at risk for premature labour.

What factors can increase the risk of premature labour?

  • Not having regular prenatal care

  • Smoking

  • Not eating enough healthy food

  • Using street drugs

  • Having previous miscarriages

  • High blood pressure

  • Extra stress

  • Physical or emotional abuse

  • Being underweight, less than 45.5 kg

  • Constant illness such as high blood pressure or diabetes

  • Working more than 8 hours a day, working night shifts or changing shifts

  • Very tiring physical work

  • Having a previous preterm baby

  • Expecting more than one baby

  • Infections such as vaginal, bladder and kidney infections

  • Fibroids in the uterus or what is referred to by doctors as an "incompetent cervix" that opens early

It is important that you know the signs that indicate a potential problem with your pregnancy and that you discuss any questions or concerns with your doctor or midwife.

What are the signs of premature labour?

  • Contractions or stomach cramping

  • Fluid leaking from the vagina

  • Bleeding or clots from the vagina

  • Backache or pressure in the back

  • Pressure in the perineum as if the baby is pushing down

  • More discharge from the vagina

Are severe or constant headaches, change in vision or dizziness also signs of premature labour?

These are not signs of labour, but they may show that mom is developing pregnancy induced hypertension (PIH). These symptoms are signs that there may be a problem with the pregnancy.

Other signs that you should discuss with your doctor are sudden, severe or constant nausea and vomiting, sudden swelling of hands, feet or face, fever or changes in your baby's movement. It is very important that you know about and recognize these signs of pregnancy problems.

These are signs that your doctor needs to know about. Call your doctor or midwife if you develop any of these signs.

What should happen if mom does go into premature labour?

  • Call your doctor or midwife after you have arrived at the hospital.

  • If mom is having contractions or stomach cramping, rest a hand on her lower belly. When mom feels tightening or squeezing, time how long it lasts and how many minutes go by before the next tightening occurs. The staff at the hospital may ask how long the cramps last and how often they are coming.

  • Go to the hospital if you have any of the following signs of preterm labour: there is fluid or blood leaking from the vagina, if mom feels the baby is pressing down, if there are regular contractions or if there is a backache that comes and goes with a pattern of stomach cramping or there is more discharge from the vagina than normal.

What can you do to prevent premature labour?

  • Get regular prenatal care from a healthcare provider as soon as possible.

  • Get regular dental care from a dentist.

  • Brush and floss regularly.

  • Eat properly.

  • Quit smoking.

  • Stop using street drugs.

  • Reduce stress.

  • Avoid tiring work.

  • Ask for help if being abused physically or emotionally.

  • Ask for help to deal with smoking and drug use.

  • Take time to rest during the day.

  • Avoid overdoing it when exercising.

  • Learn the signs of premature labour; with prompt medical care, premature labour may be stopped.

  • Know what steps to take if you think you are in premature labour. Check with your doctor or midwife for advice.

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What is an Induction of Labour?

by Guest
Posted August 25 2010 03:46pm
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Think of an induction as a way of starting your labour. When an induction occurs, you go from not having any contractions to having contractions that help your cervix to open.

Think of an induction as a way of starting your labour. When an induction occurs, you go from not having any contractions to having contractions that help your cervix to open. In order to have your baby vaginally your cervix needs to open to 10 cm. This can take both time and patience. This is especially true if you are a first time mom because your body is not used to having a baby.

Labour induction is different from labour “augmentation.” Augmentation involves making your contractions stronger, longer, or more frequent. The difference is that when your labour is augmented you have already started having contractions. Augmentation is usually done with a medicine called oxytocin. You have to have an IV to get this medicine.
 
There are a number of reasons why your doctor might recommend an induction. Maybe your pregnancy has gone on for too long. It sounds strange, but there is an increased risk to your baby’s health if he or she stays inside of you for more than 42 weeks. Also, your water may have broken without the onset of contractions. Without the protective water around your baby, both you and he are at an increased risk for infection.  

Your labour can be induced in a number of ways. Your doctor will discuss what she or he feels is the best method of induction with you. There are specific reasons for choosing each method. One commonly used method involves intentionally breaking your water and waiting a couple of hours to see if contractions start. This is called an “artificial rupture of membranes.” The doctor will conduct a vaginal exam to locate the bag of water around your baby. Then the doctor will gently break this bag with a thin, plastic hook. While the vaginal exam is uncomfortable, breaking the bag of water doesn’t hurt at all. However, your cervix must be at least a couple of centimetres open for the doctor to insert the plastic hook.

Another common method of induction involves the placement of gel or a thin piece of mesh fabric against your cervix. The medicine in the gel or mesh can help stimulate contractions. Sometimes a long tube with a small balloon on it can be placed at your cervix. The balloon will be inflated to about the size of a loonie. Following this placement, you will be encouraged to walk to allow the weight of the balloon to open you cervix. While the placement of this balloon is uncomfortable, once it has been inflated most women don’t find it painful.
 
If these methods do not work, oxytocin is used to help the induction process. Oxytocin is a substance your body produces naturally to help stimulate labour. In the hospital you would get a synthetic version of it. Although oxytocin is always started at a very low rate, it is a strong medicine and many women find that their contractions come on quite intensely shortly after it is started. While you are receiving oxytocin your baby will need to be monitored all the time, so two silver dollar shaped monitors will be fastened to your belly. One of the monitors records your baby’s heart beat and the other records your contractions. Many hospitals have portable versions of these monitors. This means you can walk around your room while wearing them.

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Breastfeeding: Who to Consult for Help

by Maxine
Posted July 27 2011 03:21pm
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If you’re thinking about breastfeeding your baby you might have questions or concerns and need someone to talk to about these. There are many types of supports available for women who want to breastfeed or are trying to breastfeeding.

Our experts have created a list of some of the types of supports available.

Lactation Consultant

Almost anyone can call themselves a “Lactation Consultant.” However, only Lactation Consultants who have taken specialty courses and written the certification examination of the International Board of Certified Lactation Consultants can use the initials IBCLC after their names. This certification is considered the “gold standard” of quality breastfeeding consultation. Some Public Health Nurses, nurse practitioners and midwives are Board certified Lactation Consultants, but physicians and non-health professionals rarely have this certification. An IBCLC certified Lactation Consultant in your area, can be located through the International Lactation Consultants Association.

 

Breastfeeding Counsellor

Individuals who call themselves Breastfeeding Counsellors have usually taken a course in breastfeeding. This course generally covers the practical and theoretical aspects of breastfeeding, on-the-job training and information about consultation. Although this type of course is usually open to anyone, it is mainly taken by Public Health Nurses and midwives. Breastfeeding Counsellors provide support and advice to breastfeeding Mothers through clinics, hospitals or Public Health Units, but may also work through an organization, such as La Leche League, or work as a private business.

 

Public Health Units

Many Public Health Units provide breastfeeding support, and can visit you at home. These nurses are trained to address breastfeeding issues. For this type of support, contact your local Public Health Unit (the telephone numbers are listed in the government blue pages of your local telephone directory and can be found online).

 

La Leche League

Formed in the 1950s, this is an international organization providing local, peer support groups for breastfeeding women. They hold monthly meetings and are available for telephone support. The Mothers in this organization can offer you personal and practical experience. Their support materials are written by breastfeeding experts, such as Lactation Consultants, nursing professors and physicians.

 

Physicians

General practitioners, family physicians and paediatricians, most often, do not have special training in breastfeeding issues. However, they are trained to refer you to local expert resources in your area to help with any challenges that may come up, and are generally supportive in a team relationship with you and your breastfeeding specialist.

 

Maternity Ward

You can expect the staff at the hospital where you have your baby to provide support and advice in helping you initiate breastfeeding. Most hospitals will have a certified Lactation Consultant on staff, so if you are struggling with  breastfeeding, ask to speak to the Lactation Consultant.

 

Breastfeeding Centres/Clinics

Breastfeeding centres or clinics are located in and around urban areas. These clinics may be associated with hospitals or with local Public Health Units. Generally, the staff in these clinics includes certified Lactation Consultants, Breastfeeding Counsellors and physicians trained in breastfeeding issues. These centres provide support, advice and treatment to breastfeeding Mothers. To locate a breastfeeding clinic or centre near you, contact your local Public Health Unit.

 

What supports did you use when you were breastfeeding? What would you recommend to a friend who had questions? Share your experience with other parents just like you by leaving a comment below.

 

More information on breastfeeding »

Ask Our Expert!
Do you still have questions about breastfeeding? Our expert, Attie Sandink, is a Registered Nurse and International Board Certified Lactation Consultant. Ask Attie a Question!

 

 

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What Happens When I am Admitted to Hospital?

by Maxine
Posted August 25 2010 12:45pm
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Admission to the hospital may be a new and strange event for you as an expectant mom. Indeed, going to the hospital for pregnancy matters may be one of the first times you have ever been inside such a place which can seem strange and a little bit scary. The Birthing Unit of most hospitals has two sections: Triage and the Delivery Suite.

Triage is most likely the first place you will find yourself once you get to the Birthing Unit. It is often a big room with four or five small rooms inside it. Greeting you in triage will be a nurse.     

After being admitted to triage, the nurse will guide you to one of the smaller rooms where she will take your vital signs (for example, your blood pressure and heart rate) and ask you how your health and pregnancy have been. At this time, the nurse will also listen to your baby’s heart beat. The length of time spent listening to your baby will vary, but will be at least 20 minutes.

Once the triage nurse knows more about the reason for your visit, she will talk with the Birthing Unit doctor. This may take some time depending on how busy the Birthing Unit is and the reason for your visit, yet, you will usually need to see this doctor before leaving triage. This doctor will conduct a brief assessment and discuss a plan of care with you. This may mean being admitted to the Delivery Suite or may involve you going home.

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