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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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Why Might a Caesarean Birth Be Necessary?

by Guest
Posted August 25 2010 03:50pm
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A caesarean birth (also called a caesarean section or a c-section or C/S) is the medical term used when a baby is delivered through an incision made into Moms abdomen and uterus. A caesarean birth is a surgical birth. In Canada, this happens to about one in five women.

Sometimes this surgery is scheduled and done before labour actually begins and sometimes a c-section is done when labour is already in progress. Cesarean birth can be invaluable and even life-saving for Moms and babies. In such situations, most everyone would agree that the benefits outweigh the downsides. In other situations, however, the benefits of caesarean birth for Moms and babies may be smaller or questionable. 

Part of making an informed choice is to weigh the expected benefits against the risks of caesarean birth for both Mom and baby. Talk to your doctor or midwife prior to labour beginning about c-section.

Why may a caesarean birth be necessary?

Caesareans may be booked in advance for the following reasons:

  • Baby's position. A baby that is in the breech position (about 3-4% of pregnancies). The Society of Gynecologist and Obstetricians of Canada changed their guidelines in July 2009 about automatic C/S delivery of babies in the breech position. In some cases vaginal delivery of a breech baby is a safe option and a mother should be offered a choice.
  • More than one baby. If there is more than one baby most doctors will recommend a caesarean as birth becomes more complicated with more babies in the uterus. 
  • A piece of the placenta may be covering the opening of the cervix (Placenta Previa). The cervix must open before the baby can move out of the uterus and into the birth canal. This is not possible if the placenta is covering the opening. 
  • A placenta that separates from the uterus (Placenta abruption). Babies need the placenta to be attached to the uterus until they are born. If the placenta comes away from the uterus too soon there may be a lot of bleeding and your baby will not get the oxygen they need. A caesarean birth is necessary in these cases. 
  • To preserve a mother's health if there is a serious illness. Sometimes a c-section is needed if the mother has an illness such as toxemia, severe diabetes or a heart condition. 
  • Active herpes infection. To prevent herpes from being transmitted from the mother to the baby during the birth, the baby will be delivered by c-section. 
  • Non-medical reasons. Some mothers may arrange with their doctor to have a caesarean birth because of their fear or anxiety about labour or for reasons related to having the baby delivered within a certain time frame.
  • Previous births by c-section. This is the third most common reason why caesarean births are done. It used to be said that once a caesarean, always a caesarean, but this is not necessarily true today. The decision to do a repeat caesarean is based on the type of incision that was used with the previous caesarean and the reason for that caesarean. These days about 60-80 percent of moms who had a caesarean birth before will be able to deliver vaginally. Your caregiver will be able to give you more information about this.

Caesareans may also be done once labour has started and are also called emergency caesareans. They are done for the following reasons:

  • Failure to progress in labour. This is the most common reason why c-sections are done. This means that even though the mom is having good and regular contractions, her cervix stops dilating for several hours, or the baby does not move down into the pelvis and birth canal for delivery. If other ways to manage this do not work, then a caesarean birth is necessary.
  • Concern about the babys well-being. This is the second most common reason for a c-section. Usually, the concern is due to changes in the babys heart rate during labour. The best way caregivers can decide how the baby is doing is by taking a sample of blood from her scalp and testing how much oxygen she is getting. If either or both of these show that the baby is not doing well during labour, and that birth is not about to happen, a c-section may be recommended.

 

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Breastfeeding Keys to Success

by Maxine
Posted July 27 2011 03:23pm
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When they make the decision to breastfeed, many women think it will be easy to do. What could be more natural? But as many women who have breastfed can tell you, it’s not always easy – especially at first.

But while breastfeeding can take extra practice and patience, it is one of the best things you can do to care for your baby. So while you may feel that while you are sore, tired and adjusting to your new baby one more thing is just too much, look for guidance from the Breastfeeding Supports in your area. There are also lots of great books and articles that can help you.

Our experts have some suggestions to help make your breastfeeding experience a success:

Position and latch are the keys to successful breastfeeding, but what do they mean?

Cross-Cradle Hold

Football Hold

Side-Lying Position

Traditional Cradle Hold

 

Latch 

Once you are familiar with the four breastfeeding positions, next comes latch. A good latch means that your baby will feed well and you should not feel any pain when feeding. If your baby isn’t opening her mouth, hold your breast and tickle her upper lip with your nipple- your nipple should point towards her nose. Once your baby opens up wide with her tongue down, bring her onto your breast. Her chin should press into your breast first and then her mouth should cover a portion usually about 2-4 cm of the areola-the dark coloured part of your breast. If the latch is good, you will note:

  • her lips will be curled out
  • her chin will be pressed into your breast
  • she is sucking and swallowing
  • there is no smacking or clicking sound when she sucks
  • there is no milk showing around her lips
  • a slight tugging sensation as she begins to suck-you should not feel pain.

Remember—if you lean forward to put your breast into her mouth, your back will become tired and sore. 

When you are first learning to breastfeed or if your baby is struggling to breastfeed baby-led latching can be helpful.  Hold your baby skin-to-skin (with just his diaper) on your upper chest so that his face rests between your breasts. Support the back of your baby’s upper shoulders; he will begin to bob his head searching for the nipple. Once he finds your nipple he will open his mouth, push his chin into your breast and take a mouthful of areola and the nipple will then follow into his mouth. 

 

How frequently and for how long should your baby breastfeed?

Your baby needs to feed at least 8 to12 times per day, or at least every 2 to 3 hours in the first 6 to 8 weeks after birth, with only one gap of 5 hours in each day. One reason is that your baby’s stomach is very small—the size of a cooked chickpea at 2 days of age and the size of a walnut at 3 to 4 weeks of age. Another reason is that breast milk is very easily digested. Mom, feeding your baby often gives your body the signals it requires to make the breast milk your baby needs. Feeding also gives your baby the fluids and food he needs to be healthy and to grow. It’s the idea of supply and demand.

Don’t be surprised if your baby needs to breastfeed more than 12 times a day, especially in the first weeks. This can be a normal part of early breastfeeding and can help your body produce breast milk. During growth spurts, you’ll notice that your baby will feed more frequently for several days. Growth spurts may occur when baby is about 2-3 weeks, about 6 weeks, 3 months and later-remember each baby is different some baby’s may have growth spurts before or after these times.  

Your baby will give you cues that he is hungry: you’ll hear or see him stir, notice him smacking his lips or see him bringing his hand to his mouth. This is the best time to begin the feeding. If you wait until he is crying to feed him, it may be a frustrating exercise for both of you. Another thing to remember is that some babies are sleepy in the first few days and make need your help to stay awake to eat.  Unwrapping your baby if he is swaddled, talking to him, and holding him skin-to-skin will help.  Your doctor may have you wake your baby every 2-3 hours if your baby does not wake himself. 

 

What tips would you give to breastfeeding moms? What was the best advice you received? Share your story with other parents 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 Can I Expect at My Hospital?

by Guest
Posted August 25 2010 12:47pm
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Preparing for the birth experience that you would both like to have requires learning as much as possible about all of the options available to you. Plan a tour of your hospital or birth centre – it’s a great opportunity to gather additional information that will help you prepare for your birth experience.

The list below contains several questions that you can ask at the hospital about care for both you and your baby during labour and delivery.

The Room and Staff

  1. Do moms labour and give birth in the same room?
  2. Do moms have a different room after the baby is born? 
  3. What accommodations does the hospital provide for dads in the labour area – easy chair, reclining chair, cot? 
  4. Are there rules that limit the number of people moms can have with them during labour? 
  5. Do rooms have private toilets, showers, tubs? 
  6. Is there an obstetrician, anesthetist, pediatrician, available in the hospital 24 hours a day? 
  7. Do midwives deliver at this hospital? 
  8. Do doulas provide care at this hospital? 
  9. Do you encourage the use of doulas? 
  10. Is there a birth centre in this hospital? 
  11. How does care in the hospital differ from the birth centre? 
  12. Are there rules about taking pictures or videos during labour or delivery?

Interventions and Pain Management
The questions below are good to ask if you want to know more about how the hospital will manage your pain during labour and delivery.

  • How will you monitor the well-being of our baby during labour?
  • What are your practices regarding Intravenous (IV) drips in labour? 
  • What are your rules about eating and drinking during labour? 
  • What are your practices regarding various positions for labour and delivery? 
  • Do you encourage walking or movement during labour? 
  • Are there rules about using the showers or taking baths? 
  • What drug-free measures are used to cope with labour pain? 
  • What medical pain relief options are used in this hospital? 
  • What is the epidural rate at this hospital? 
  • What is the pain medication rate at this hospital? 
  • What is the episiotomy rate at this hospital? 
  • What strategies are used to help deliver without the need for an episiotomy? 
  • What is the rate of assisted deliveries; for example, use of forceps or vacuum extractors? 
  • What is the caesarean section (C-section) rate at this hospital? 
  • Where are C-sections done in this hospital—labour area or a surgical area? 
  • Are partners or a support person allowed in the room for a caesarean birth? 
  • Are moms permitted to be awake during a caesarean birth?

Newborn and Postpartum Care
Keep these questions in mind when discussing postpartum care for you and your baby.

  • Does this hospital encourage breastfeeding immediately after birth?
  • Does this hospital encourage our baby staying in the room with mom? 
  • What procedures are routinely given to our baby after birth? 
  • Will we be separated from our baby immediately after birth? When and why would this happen? 
  • Is there a Newborn Intensive Care Unit (NICU) on site? 
  • In what circumstances would our baby be moved to the NICU? 
  • What breastfeeding resources are offered here—classes, Lactation Consultant, breastfeeding clinic? 
  • What educational classes are offered regarding postpartum care and adjustment? 
  • What is the average postpartum stay for a vaginal birth? 
  • What is the average postpartum stay for a Cesarean birth? 
  • Does the hospital have an early discharge program? (This allows healthy moms and babies to go home approx. 24 hours after birth. Arrangements are made for a community health nurse to visit the home.)
  • Does this hospital accommodate families that feel the need to stay in hospital longer?
  • What are the rules surrounding visitors? 
  • What types of accommodation are available for fathers during the postpartum stay? 
  • Do you make arrangements for follow-up contact by a Public Health Nurse?

The Room and Staff
The following list of questions will be helpful the first time you visit your birth centre.

  • Are the midwives here licensed?
  • What other staff will care for me during labour—a nurse, for example? 
  • Are there rules about the number of people with the mother during labour and delivery?
  • Do you encourage the use of trained labour support individuals, such as doulas?

Adapted from The Maternity Center Association (2001), Possible Questions when Touring a Birth Center and Possible Questions when Touring a Hospital Maternity Area http://www.childbirthconnection.org/

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