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Birth Plan Guidelines: Second Stage of Labour

by Guest
Posted August 25 2010 10:15am

Now that you have completed your plan for the first Stage of Labour, you will want to consider some of the planning for the second stage of labour.

What position do you want to be in to push? Under what conditions will your doctor use forceps or a vacuum extractor? If you end up having a Caesarean, do you want to be awake during the procedure? There are many important things to think about.

Pushing

You have many choices for how you want to push your baby out. It's better to decide what you will do now, instead of waiting until it's time to push. Here are some of your options:

  • Choice of position: You can use different positions to aid her pushing efforts, such as squatting, lounge position, on hands and knees, etc. Your labour and delivery nurse may suggest other positions that can also be used for pushing.
  • Squatting: You can use a birth or squat bar to help push your baby out.
  • Leg Support: Your support people or the nurse support your legs.
  • Foot support: You can put your feet in foot pedals or stirrups.
  • Spontaneous bearing down: Once the healthcare providers have said that the cervix has opened fully; you listen to your body and pushes only when you have the urge to push. 
  • Directed pushing: Sometimes your only option for pushing is to do it only when directed to push by one the healthcare providers.
  • Mirror: The staff can position a mirror so your can see your baby's head emerge.

Episiotomy

You should both talk with your doctor or midwife in advance about when an episiotomy might be needed. Maybe you would prefer a small tear which may also be stitched after the birth. Also, decide if you want local anaesthesia for the episiotomy and its repair. This is usually given by a local injection in the area to be repaired.

Assisted birth

Some babies need a help to be born because of a medical concern that has developed with either you or your baby. In such situations, the doctor may assist in the actual delivery with one of the following devices.

  • Forceps
  • Vacuum extractor

Vaginal Delivery

If you have a vaginal delivery, consider the following options that may be available to you.

  • Choose a position in which to deliver your baby
  • Touch your baby's head when it crowns
  • Have your baby placed on your abdomen or chest right after birth
  • Have either your or your partner cut the umbilical cord 
  • Collect the cord blood (If parents have registered for a cord blood program, they need to bring the collection materials with them.)
  • Have you hold your baby during the delivery of the placenta
  • Breastfeed after the delivery
  • Take the placenta home (Some cities or towns may require you to obtain a special hazardous waste container.)

Caesarean section

If an emergency occurs, a Caesarean birth might be necessary. If this happens to you, what will you do?

  • Get a second opinion if time allows.
  • Have your designated support person with you during the Caesarean.
  • Ask if it is possible for to have an epidural so you can be awake for the birth.
  • Have your designated support person hold the baby after the delivery.
  • Breastfeed in recovery.

Continue reading Birth Plan Guidelines: Post Birth

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Sleep and Pregnancy

by Maxine
Posted August 25 2010 11:24am
Filed under:

Many new parents expect some difficulty in getting a good night’s sleep after the baby is born, but they never dream that it may be just as difficult to sleep during pregnancy. Some of the ways in which pregnancy can affect an expectant mom’s sleep can be seen below.

Research has found the following effects of pregnancy on sleep:
From as early as 12 weeks into pregnancy and extending to two months after the birth of the baby, women sleep fewer hours than what they slept before pregnancy.

An American foundation that studies sleep reported the following:

  • About 72% of pregnant women experienced nightmares in their second trimester.
  • Approximately 52% reported at least one weekday nap and 60% at least one weekend nap.
  • By the end of pregnancy, 97% of women in the study were awake an average of three times each night.

What exactly may be keeping you and other pregnant women from sleeping?

First Trimester

  • High levels of progesterone contribute to many of the changes in your sleeping patterns, causing increased tiredness during your first trimester.
  • Tenderness of the breasts and other aches or discomforts can make it difficult to get into a comfortable sleeping position. Try sleeping on your left side.
  • As your baby grows, there is more pressure on your bladder, causing you to urinate more often. This frequent urination can keep you awake at night.
  • Nausea in the morning may, in severe cases, cause you to wake up earlier than you care to.

Second Trimester

  • Generally, sleep disturbances are reduced in your second trimester.
  • Hormone levels change and there is a decrease in feelings of tiredness and nausea. Progesterone levels go down, so you may feel less nausea and tiredness.
  • Heartburn becomes an issue as your growing uterus presses against your stomach and intestines.
  • As your uterus and baby move upward, there is less pressure on your bladder, resulting in less urination.
  • Nightmares and dreams, which can seem real, may become more frequent because more of your sleep is REM. The more your sleep is interrupted, the easier it becomes for you to remember your dreams.

Third Trimester

  • As your baby grows, you may have more back pain, muscle aches and general discomforts. Joints and ligaments are also loosened by hormones in preparation for the birth of your baby. This may affect your posture and increase your discomfort during sleep.
  • Snoring may increase because of nasal congestion and pressure from the uterus on the diaphragm. Some women may develop sleep apnea during pregnancy. Sometimes, sleep apnea and snoring indicate other complications with the pregnancy. If you are having any problems with sleeping during your pregnancy, talk to your doctor or midwife.
  • Restless Leg Syndrome (RLS) and leg cramps may cause you to frequently wake from sleep in the third trimester. These are sometimes due to increased circulation in the blood vessels in your legs that affects the muscles and nerves, creating the discomfort. In some cases, it may be related to lower levels of iron, folic acid or calcium.

 

Ask Our Expert!
Do you still have questions about sleep and pregnancy? Our expert, Dr. Robyn Stremler, is a nurse scientist whose research is aimed at improving sleep for families. Ask Dr. Stremler a Question!

 


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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Lovemaking Positions and Pregnancy

by Guest
Posted August 1 2010 07:33pm
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During pregnancy, your relationship changes and grows in new ways. Your sexual relationship is no exception. Just as your relationship is a combination of your varied outlooks and ideas, your sexual relationship is also made up of a similar combination of views and beliefs. Some women complain of lower abdominal cramping and backache after orgasm during the first and third trimesters.

Keep an open mind about sex during pregnancy. The important thing is that you are comfortable and feel free to stop lovemaking if there is a problem. Be creative! There are a variety of positions and depending on what stage a woman is in her pregnancy, she may find some more comfortable. Look for positions that are both comfortable for you and enjoyable for both of you. 

Remember, when you are giving and receiving pleasure without intercourse, orgasm is not the only goal. Nurturing your relationship is the real target.

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Is It Safe to Fly Pregnant?

by Maxine
Posted August 25 2010 11:29am
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It is safest to fly pregnant during the second trimester (18 to 24 weeks). There is a lower risk of miscarriage or premature labour during this stage. Air travel is safe for most pregnant women up to 36 weeks of gestation, but consult your airline directly to find out if they have any policies around pregnant passengers.

Most obstetricians advise their patients not to travel beyond a 100-mile radius after 28 weeks due to an increased risk of premature labour, preterm rupture of membranes, development of hypertension and blood clots in leg veins (phlebitis or deep vein thrombosis).

Travel is not recommended at any time during pregnancy for women who have medical or obstetrical problems.

X-Rays and Radiation

Some women worry about the portal x-ray devices when going through airport security screening, but these are well shielded and do not pose a risk to your baby. Airport metal detectors are also safe.

Radiation during flying is sometimes a concern, but in 2001 the American College of Obstetricians and Gynecologists (ACOG) advised that occasional airline travel by pregnant women generally poses little risk of radiation exposure to developing fetuses.

If you are employed in the airline industry, however, you may need to modify your work schedule to reduce your exposure to radiation. This is something that you can talk with your health and safety representative about.

Aim for Comfort

Here are some special precautions that pregnant women should consider to help decrease the risk of clotting and dilated veins:

  • Ask for an aisle seat.
  • Walk about the cabin every 20 to 30 minutes if possible.
  • Stretch and perform isometric leg exercises (tighten and relax) every 15 minutes or so, especially during long flights.

Other precautions include:

  • Fasten the seatbelt under your abdomen and across the tops of your thighs.
  • Drink plenty of fluids (like water, juices or milk). Low humidity in the cabin has a dehydrating effect.
  • Avoid foods or carbonated drinks as they may cause indigestion or gas.

Fly Closer to Home

International travel is not advised within 30 days of your due date and you should consult the airline far in advance of your desired departure. During month 8 or 9 of your pregnancy, they may require a letter from your physician. You could also obtain clearance from the airline or you may be required to obtain Special Assistance Coordinator (SAC) clearance.

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