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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

 

 


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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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The Four Stages of Labour

by Maxine
Posted August 25 2010 02:31pm
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There are four stages of labour and here's where you'll find a step-by-step explanation of the labour experience.

STAGE 1:

  1. Starts with contractions or membranes rupturing
  2. Ends with cervix fully effaced (thinned) and dilated (open) Cervix must open to 10 cm to allow baby to pass out of uterus
  3. Longest stage 2 – 24 hours with an average of 12.5 hours (first time moms)

 

3 Phases: Early, Active & Transition:

 

Stage 1 – Early Phase

Frequency of contractions: every 5 – 20 minutes

Duration (length) of contractions: from 30 – 60 seconds

Dilation (opening) of Cervix: up to 3 cm.

  • You may not recognize that you are in labour in the early phase as contractions may feel like a backache that comes and goes with a pattern, menstrual-like cramps or aches in the groin that come and go with a pattern.
  • Typically, contractions are manageable in this early phase
  • Cervix can only be checked by hospital staff - your nurse, midwife or doctor - by inserting gloved fingers into your vagina and feeling the opening of the cervix.

Stage 1 – Active Phase

Frequency of contractions: every 3 – 5 minutes
Duration (length) of contractions: from 50 – 75 seconds
Dilation (opening) of Cervix: goes from 4 to 7 cm

  • Contractions become longer, stronger and you may find it harder to cope with them.
  • Membranes probably rupture some time during this phase
  • You are usually admitted to hospital/birthing centre during this phase 
  • Pain relief measures, such as narcotic medication, epidurals or nitrous oxide gas may be offered if mom needs once she is in hospital.
  • Lasts approximately 3 – 6 hrs

Stage 1 – Transition - The SHORTEST phase

Lasts 1 – 1 ½ hrs.

Frequency of contractions: every 1 ½ - 2 minutes

Duration of contractions: from 60 – 90 seconds with multiple peaks.

Dilation (opening) of Cervix: goes from 7 to 10 cm.

  • The shortest – and the toughest phase!
  • Often it feels like there is no break between contractions
  • You may be flushed, but have cold hands and feet
  • You may experience nausea and/or vomiting
  • You may lose your focus
  • You may do or say things that are out of character for you
  • You may not know what you want or what will help you

STAGE 2: DELIVERY of the BABY

Starts with full dilation (opening) of cervix

Ends with birth of baby

Lasts up to 2+ hrs.

3 phases: Early, Active & Perineal:

Early Phase - Latent or Resting Phase
From complete dilation to urge to push: about10 – 30 minutes

Frequency (how often) of contractions: every 2 – 5 minutes

Duration (length) of contractions: from 60 – 90 seconds.

  • There may be a lull in the strength of the contractions.
  • Baby’s station refers to the measurement of how far into the pelvis your baby has moved:  Negative numbers would mean that baby head has not entered the bony pelvis the area above your pelvic bone, while positive numbers mean baby’s head is moving past the pubic bone.  In the early phase the measurement is 0 - 2+ Baby must descent to 4 + before they are born.

Stage 2 – Active

From to urge to push to crowning: time variable 

Frequency (how often) of contractions: every 2 – 5 minutes

Duration (length) of contractions: from 60 – 90 seconds

Active pushing with each contraction

  • Strength of contractions resumes
  • With each push more of the baby’s head is visible at the opening of the birth canal. When the contraction is over, the baby slips back a bit until the next contraction pushes them further
  • Baby’s station is +2 to +4 (crowning)

Stage 2 – Perineal

From crowning to birth: about 5 – 15 minutes

Frequency (how often) of contractions: every 2 – 5 minutes

Duration (length) of contractions: from 60 – 90 seconds

Active pushing with each contraction

  • Your perineum bulges and the skin stretches as you push.
  • This causes a stinging or burning sensation – often called the ‘Rim of Fire’. This does not last long, seconds only.

STAGE 3: DELIVERY of the PLACENTA

Starts with birth of baby and ends with delivery of placenta.

After baby is born, the uterus contracts and the placenta begins to separate.You may need to push to help deliver the placenta.

Duration: from 10 – 20 minutes.

If there is a tear or episiotomy, it will be sutured (stitched) once the placenta is delivered.

  • Placing baby on your abdomen, skin-to-skin, helps your body to release oxytocin (a natural hormone), which causes the uterus to contract. This helps to minimize bleeding. The skin-to-skin contact also has benefits for baby as it helps to keep them warm and helps their vital signs (breathing, heart rate, and temperature) to stabilize after delivery.
  • You will receive an injection of medication to help your uterus contract and prevent possible post birth haemorrhage
  • The nurse or midwife may also massage your uterus to keep it firm and contracted.

STAGE 4: RECOVERY

From the end of Stage 3 to approximately 2 hours

  • Comfort and monitoring for you
  • The nurse will check your breathing, heart rate, blood pressure, temperature and bleeding from time to time
  • The nurse will clean your perineum, apply a sanitary pad and an ice pack to reduce swelling
  • You may need a clean gown and a warm blanket. You may want something to drink and eat – ask the staff before eating or drinking anything.
  • Relax 
  • Bond with your baby
  • Skin-to-skin contact with your baby encourages breastfeeding during this stage. 
  • This is a special time for all of you to be together as a family, for the first time.

Find out more about the benefits of keeping your baby with you with this informative video.

 


Video Alert!
Learn more about labour and delivery with these informative videos.
Everyday Miracles: A Celebration of Birth Healthy Birth Your Way - Intro to Safe & Healthy Birth Keep Your Baby With Your After Birth

 

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Baseline Measurements

by Guest
Posted August 25 2010 04:19pm
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Your team of healthcare providers may encourage both you and your partner to be in the recovery room. This allows you both to be involved as the medical staff gather the baseline data. You’ll see exactly what is being done, plus you can be there to soothe your baby, if need be.

A nurse will record baseline measurements of your baby’s weight, height and head size. This helps assess the progress of your newborn, as well as determine growth patterns. Hospital staff is usually willing to delay this procedure for a few hours after birth, so you both have the chance to bond with your new baby.

 

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