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Labour, Delivery and Postpartum Nurses

by Guest
Posted August 25 2010 12:52pm
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Labour and Delivery nurses are registered nurses who provide care to both moms and babies during labour and birth.  In most hospitals, Labour and Delivery nurses provide one-to-one care. This means that you are the only person being cared for by your nurse while in labour and for the time immediately following the delivery of your baby.

The benefit of this type of care is evident in the ongoing support provided by your nurse during your birthing experience. For example, your Labour and Delivery nurse closely monitors your baby before and after delivery, provides helpful education regarding breastfeeding, and advocates for your wellbeing while at the hospital. Labour and Delivery nurses are happy to assist you and your baby with breastfeeding immediately following birth provided you are both stable. These nurses work closely with the doctors, midwives, and doulas to ensure your comfort and safety for the duration of your stay in the hospital.

Postpartum Nurses provide care to mom and baby during the postpartum hospital stay.  These nurses also work closely with your other care providers.  They can assist you with breastfeeding and learning how to care for your new baby.

In some hospitals, the labour, delivery, and postpartum areas are combined and may be referred to as combined care.  In these hospitals the nurses provide you care in labour, delivery and postpartum – you may have the same nurse care for you for your entire stay.

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What Are The Concerns For Mom and Baby With Having A C-Section?

by Guest
Posted August 25 2010 04:13pm
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There are implications for recovery and for future pregnancies and deliveries should you have a c-section, even if it was done as a method to save mom and or baby.

In Recovery: 

  • Longer time in hospital. The stay in hospital is a day or two longer than a vaginal birth; if complications arise this stay may be even longer.
  • More pain: The pain may be more intense, longer-lasting, and require medication. 
  • Less likely to see and hold her baby soon after birth than a woman with vaginal birth. 
  • Greater chance of infection. Infection can occur in the incision and in the uterus. 
  • More likely to go back into hospital. Returning to hospital is due to complications such as bleeding. Excessive bleeding may result in an emergency hysterectomy (removal of the uterus). 
  • May have feelings of a poor birth experience. Feelings may happen early after the birth or later in the recovery period. 
  • Higher risk of emotional reactions to the birth. This may include anxiety or feeling depressed. 
  • More likely to have ongoing pelvic pain. This is possibly due to scarring.

In future pregnancy or delivery there is a greater chance of having the following compared to a vaginal birth:

  • May have difficulty conceiving another baby.
  • May be less likely to have another baby because of negative feelings and attitudes toward childbirth. 
  • May have a greater chance of having a tubal pregnancy in the future. Tubal pregnancies (ectopic pregnancy) result in emergency surgery. 
  • May have problems with the placenta and uterus in future pregnancies and childbirth. Women who have had a c-section may have a greater chance of having the placenta cover the opening of the cervix (Placenta Previa) or having the placenta separate before the baby is born (Placenta Abruption). There is also a greater chance that the scar can open during a future pregnancy or labour.

What are the limitations for babies born by C-section?

 

Babies who are born by c-section are more likely to:

  • Receive surgical cuts. Although great care is taken during the surgery, accidental cuts during the surgery can occur.
  • Have breathing and lung problems. This may happen if the baby is born before 39 weeks as their lungs may not be ready to function. They may also have slightly more secretions in their lungs that have not been pushed out by moving through the birth canal. 
  • Be transferred to the Neonatal Intensive Care Unit. This may depend on the reason for the caesarean. It may also be a policy of the hospital that babies born by caesarean be observed for a period of time in a special care nursery.

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Pre-Labour

by Maxine
Posted August 25 2010 12:56pm
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Signs that labour is approaching:

You may start to experience signs that labour is near three-four weeks before the birth, just before the birth or not at all – all of these are considered normal.

Lightening / Engagement - “The baby has dropped”

  • The baby settles down into the bony pelvis
  • This usually occurs two-four weeks before labour for first time moms and may happen at the start of labour with subsequent births.
  • You can breathe easier in this stage, as upward pressure on the diaphragm and ribs lessens
  • You need to pee more often. Pressure on the bladder occurs as the baby settles down into the pelvis, meaning more frequent trips to the bathroom.

 Energy Level

  • Fatigue - can be related to many things: trouble sleeping; hormonal changes; response to carrying the extra weight of pregnancy etc.
  • Energy burst – If you have an energy burst you should be careful not to overdo it! You don’t want to wear yourself out before labour.

Vaginal Discharge

  • You may notice an increased amount and / or thickness of vaginal discharge.
  • Discharge should look and feel like the white of a raw egg.
  • It should NOT be: bloody, watery or foul-smelling.
  • Both bloody (unless it is the mucous plug, which is pink, not red blood) and watery discharge require immediate medical attention – visit the hospital immediately.
  • Any foul-smelling or unusual coloured discharge requires medical attention, as does itchiness and soreness – see your caregiver as soon as possible.

Mucous Plug/Bloody Show

  • The ‘cork’ of mucous forms a protective seals in the cervix (opening to the uterus),  as the cervix begins to efface (thin) and dilate (open), the mucous plug loosens and breaks free
  • This is a sign that cervix is beginning to efface (thin) and dilate (open)
  • The pinkish colour results from the rupture of microscopic blood vessels as the plug dislodges
  • This can occur several days, 24 – 48 hours before labour begins or just as labour begins, so don’t rush to the hospital just yet

Braxton - Hicks Contractions

  • The tightening and relaxing of the uterus as it tones in preparation for labour
  • Often called “False labour” or pre-labour
  • Increases in the last month of pregnancy. Some expectant moms are aware of Braxton-Hicks contractions throughout the last three months. Others are unaware until the last month or close to labour.

Other Signs

  • Loose or more frequent bowel movements, due to release of the hormone prostaglandin, which helps to ripen the cervix but also stimulates the bowel.
  • Low backache, which is the result of stretching of the broad and uterosacral ligaments. This backache will gradually subside during postpartum.
  • Relaxin, a hormone, loosens the joints during pregnancy, can create shifts in these joints. These can result in aches and pains that are not normally experienced 

Is This True Labour?

True Labour: 

  • Contractions get stronger, longer and closer together
  • Contractions become regular
  • Moving and using upright positions helps
  • Cervix effaces (thins) and dilates (opens)* 

Braxton Hicks:

  • Don't get stronger
  • No pattern
  • Not affected by rest or moving
  • No changes in cervix

Timing Contractions:

How frequently (frequency) are contractions coming?
Time from the start of one contraction to the start of the next contraction.  For example; first contraction starts at 10 a.m. and the next contraction starts at 10:10 a.m., the contractions are coming every 10 minutes.

How long is a contraction lasting (duration)? 
Time from the start of the contraction to the end of that contraction. For example; contraction started at 10:00 a.m. and ended 30 seconds later.  Contractions are usually timed in seconds. Initially they may be about 30 seconds and will gradually increase until they are lasting 90 seconds.

Occasionally your care provider will mention the interval between contractions.  This is the time from the end of one contraction until the beginning of the next contraction.  For example, contraction ends at 10:01 a.m. and next contraction does not start until 10:10 a.m. the interval is 9 minutes.

Go to the Hospital When:

  • Mom’s water breaks in a gush or her water is leaking steadily
  • Contractions are regular and five minutes apart for at least one hour. If the hospital is more than 30 minutes away, you may want to consider leaving before the hour is up.
  • If Mom is uncomfortable or not coping well with labour
  • If unsure, call the labour and delivery unit at your hospital
  • You may be sent home or for a walk if it’s early labour

 

 


If you're pregnant or thinking about having a baby, check out www.welcometoparenting.com. These interactive, online prenatal and parenting classes will provide information on pregnancy, labour and delivery, your relationship and a community of expectant and new parents just like you! Watch the overview video!

 

 

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What is a Vaginal Tear?

by Guest
Posted August 25 2010 04:15pm
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Tears to the opening of the vagina or birth canal may happen to some mothers.  At one time, routine use of episiotomy was done to help prevent tears.  Studies have shown that a tear will heal faster when stitched after birth and be less painful than an episiotomy.  Talk with your health care provider to learn when what size of tear they would stitch.  Some very small tears may not need to be stitched.

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