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Normal Labor is a physiologic process during which the foetus, membranes, umbilical cord, and placenta are expelled from the uterus.
What is normal childbirth?
Childbirth can be described differently based on the level and type of assistance provided during the baby's delivery. Once the mother goes into labor spontaneously (this usually happens close to the due date between weeks 37 and 42 of pregnancy), she can have one of the following types of childbirth:
Natural childbirth: The baby is born head-first, through the vagina (birth canal), supervised by a health-care professional who ensures that mother and baby are well, but labor progresses without medical assistance.
Normal childbirth: The baby is born head-first, through the vagina (birth canal), but may include intervention by a health-care professional to support or help the birth.
Assisted childbirth: When there are signs that the mother and/or baby may be unwell or the labor is not going normally, medical intervention (for example, forceps, vacuum or C-section) is needed to assist delivery.
INTERVENTIONS CONSIDERED AS APART OF NORMAL CHILD BIRTH:
Sometimes, the mother or baby needs help during labor. Your doctor will discuss the need for a particular intervention before it happens, and include you in decision-making.
Augmentation of labor : Sometimes, especially in prolonged labor, contractions can weaken, fail to dilate the cervix, or do not help the baby come down the birth canal. Medication (such as oxytocin) can be given to stimulate contractions.
Listening to the baby's heartbeat : Monitoring the baby's heart rate is one of the ways to find out if the baby is well during labor and delivery.
Artificial rupture of the membranes : During labor, the amniotic (fluid) sac that surrounds the baby breaks so the baby's head can come down into the birth canal. In active labor, if this has not happened, your health-care provider may create a small hole in the sac.
This is also known as breaking the water.
Reducing labor pain: Most hospitals offer different options, some with medicine and some medicine-free, that help with pain in early labor.
Medicine-free methods include changing positions, movement, warm bath or shower, acupuncture, using a labor ball, hypnosis, and comforting touch and massage
Injectable painkillers (for example, morphine or fentanyl) may be given throughout labor
Freezing medicines (anesthetic) cause a total loss of feeling in the lower part of your body
Epidural involves inserting a needle into your lower back to inject medicine to numb the pain
Nitrous oxide is a gas, inhaled through a mask, which can be used in the second stage of labor
Active management, third stage of labor After birth, you will receive an injection of oxytocin, a medication that will help your uterus shrink and prevent too much blood loss (postpartum hemorrhage). This is a safe procedure done routinely.
Episiotomy used to be routinely performed at this time, but current recommendations restrict its use to maternal or fetal indications
The head is held in mid position until it is delivered, followed by suctioning of the oropharynx and nares
Check the fetus's neck for a wrapped umbilical cord, and promptly reduce it if possible
If the cord is wrapped too tightly to be removed, the cord can be double clamped and cut
The fetus's anterior shoulder is delivered with gentle downward traction on its head and chin
Subsequent upward pressure in the opposite direction facilitates delivery of the posterior shoulder
The rest of the fetus should now be easily delivered with gentle traction away from the mother
If not done previously, the cord is clamped and cut
The baby is vigorously stimulated and dried and then transferred to the care of the waiting attendants or placed on the mother's abdomen
For more detailed understanding you can watch:
Third stage of labor
The following 3 classic signs indicate that the placenta has separated from the uterus :
The uterus contracts and rises
The umbilical cord suddenly lengthens
A gush of blood occurs
Delivery of the placenta usually happens within 5-10 minutes after delivery of the fetus, but it is considered normal up to 30 minutes after delivery of the fetus.
What isn't part of normal childbirth?
Forceps or vacuum delivery
Vaginal birth after a previous Caesarean section (VBAC)
Obstetricians have divided labor into 3 stages that delineate milestones in a continuous process.
First stage of labor
Begins with regular uterine contractions and ends with complete cervical dilatation at 10 cm
Contractions become progressively more rhythmic and stronger
The active phase usually begins at about 3-4 cm of cervical dilation and is characterized by rapid cervical dilation and descent of the presenting fetal part.
Second stage of labor
Begins with complete cervical dilatation and ends with the delivery of the fetus. In nulliparous women, the second stage should be considered prolonged if it exceeds 3 hours.
Third stage of labor
The period between the delivery of the fetus and the delivery of the placenta and fetal membranes. Delivery of the placenta often takes less than 10 minutes, but the third stage may last as long as 30 minutes
For more detailed understanding you can watch:
The initial assessment of labor should include a review of the patient's prenatal care, including confirmation of the estimated date of delivery. Focused history taking should elicit the following information:
Frequency and time of onset of contractions
Status of the amniotic membranes (whether spontaneous rupture of the membranes has occurred, and if so, whether the amniotic fluid is clear or meconium stained)
Presence or absence of vaginal bleeding.
Contractions that lead to labor have the following characteristics:
May start as infrequently as every 10-15 minutes, but usually accelerate over time, increasing to contractions that occur every 2-3 minutes
Tend to last longer and are more intense
Lead to cervical change
For more details you can watch:
The physical examination includes following:
Maternal vital signs
Assessment of foetal well-being
Frequency, duration, and intensity of uterine contractions
Abdominal examination with Leopold manoeuvres
Pelvic examination with sterile gloves
Digital examination allows the clinician to determine the following aspects of the cervix:
Degree of dilatation, which ranges from 0 cm (closed or fingertip) to 10 cm (complete or fully dilated)
Effacement (assessment of the cervical length, which can be reported as a percentage of the normal 3- to 4-cm%u2013long cervix or described as the actual cervical length)
Just as your body went through many changes before birth, it will go through transitions as you recover from childbirth.
Physically you may experience the following:
Pain at the site of the episiotomy or laceration. An episiotomy is a cut made by your doctor in the perineum (the area between the vagina and the anus) to help deliver the baby or prevent tearing. If this was done, or the area was torn during birth, the stitches may make walking or sitting difficult. It also can be painful when you cough or sneeze during the healing time.
Sore breasts. Your breasts may be swollen, hard, and painful for several days as your milk comes in. Your nipples may also be sore.
Hemorrhoids. Hemorrhoids (swollen varicose veins in the anal area) are common after pregnancy and delivery.
Constipation. Having a bowel movement may be difficult for a few days after delivery. Hemorrhoids, episiotomies, and sore muscles can cause pain with bowel movements.
Hot and cold flashes. Your body's adjustment to changing levels of hormones and blood flow can cause you to perspire one minute and reach for a blanket to cover yourself the next.
Urinary or fecal incontinence. Muscles stretched during delivery, particularly after a long labor, may cause you to leak urine when you laugh or sneeze or may make it difficult to control bowel movements.
"After pains." After giving birth, you will continue to experience contractions for a few days as your uterus returns to its pre-pregnancy size. You may notice contractions most while your baby is nursing.
Vaginal discharge (lochia). Immediately following birth you will experience a bloody discharge heavier than a regular period. Over time, the discharge will fade to white or yellow and then stop entirely within two months.
Emotionally you may experience irritability, sadness, or crying, commonly referred to as the "baby blues," in the days or weeks after delivery. These symptoms occur in up to 80% of new mothers and may be related to physical changes (including hormone changes and exhaustion) and your emotional adjustment to the responsibilities of caring for a newborn.
If these problems persist, inform your doctor or other health professional; you could be experiencing postpartum depression, a more serious problem that affects between 10% and 25% of new mothers.
For more detailed understanding you can watch:
COMMON SYMPTOMS AND COMPLICATIONS AFTER CHILD BIRTH:
Some of the more common symptoms you might experience after childbirth include:
Pain and discomfort around the vagina
Pain around the incision if you had a cesarean
COMPLICATIONS AFTER CHILD BIRTH are rare. But it's important to be aware of your symptoms and to call your doctor if you experience anything unusual. Some symptoms that may indicate a problem include:
Heavy bleeding that lasts for more than a few hours
Large blood clots
Pain in the lower abdomen after the first few days following delivery
Nausea and vomiting
Sharp chest pain
For more detailed information you can watch:
Alarm signs to inform your doctor immediately
After having a caesarean section, contact your doctor straight away if you have the following symptoms:
Painful or excessive vaginal bleeding
A cough or shortness of breath
These symptoms may be the sign of an infection or blood clot, which should be treated as soon as possible.
Schedule for Consultations/Diagnostic tests: ...more
Physical activity with a baby
Activity can relax you, it can help your body recover after childbirth, keep you fit or improve your fitness, and make you feel better and more energetic. The following suggestions may help:
Keep up your postnatal exercises. They'll strengthen vital muscles and improve your shape.
Join a postnatal exercise class. If you're going to a class that isn't a special postnatal class, tell the person running the class if you've had a baby in the last few months. You'll need to take special care of your back and avoid exercises that could damage it.
Push the pram or buggy briskly, remembering to keep your back straight. Walking is great exercise, so try to get out as much as you can.
Play energetic games with older children. You can exercise by running about with them. Find outdoor space if there's no space at home.
Run upstairs. You probably go up and down the stairs several times a day, so think of it as good exercise!
Squat down to pick things up from the floor. Hold heavy objects close to your body. This is also something you're likely to be doing a lot. If you squat rather than stooping, with your knees bent and you're back straight, you'll strengthen your thigh muscles and avoid damaging your back.
When your lochia (postnatal bleeding) has stopped, you can try swimming. Swimming is good exercise and it's relaxing, too. If you take your child with you, try to have someone else there as well so that you get a chance to swim.
Borrow or buy an exercise DVD. This is a good way to work out at home. You could get a friend or your children to join in.
When can I start exercising after birth?
It may be a good idea to wait until after your six-week postnatal check before you start to high impact exercise again. If you exercised regularly before giving birth and you feel fit and well, you might be able to start earlier. Talk to your midwife, health visitor or GP.
What should I be aware of before exercising?
Your lower back and core abdominal muscles are weaker than they used to be. Your ligaments and joints are also more supple and pliable, so it's easier to injure yourself by stretching or twisting too much.
Don't rely on your pre-pregnancy sports bra. Your back and cup size are likely to have changed, so get measured for a new one.
For more detailed information you can watch:
How do I know if I'm overdoing exercise after having a baby?
If you're doing too much, you'll experience extreme fatigue, feel run-down and take longer to recover from workout sessions.
If your lochia (the bleeding after birth) flows more heavily or changes colour (becomes pink or red) after activity, you could be overdoing it. Take it easy.
After a baby is born, an APGAR test is done and the score is used to quickly determine the health of a newborn. Things that will be assessed include:
Appearance (color of the skin)
Doctors recommend that you breastfeed your baby for the first year of life. Women are encouraged to start feeding as soon as possible after delivery. Breast milk is the optimal food for your baby.
Some of the many benefits of breast milk include:
Helps to prevent allergies
Passes on mother's infection-fighting antibodies, lowering the risk of certain infections
Strengthens the bond between mom and baby
Decreases risk of breast and ovarian cancer
Reduces a baby's chance of becoming obese as they get older
If you are breastfeeding, you will need to increase your intake of calories and get plenty of calcium. For more detailed information you can watch:
Postpartum depression is a form of clinical depression that usually affects women within the first few months after childbirth. While the fluctuations in hormone levels may be to blame for changes in mood and behavior after giving birth, there are also a set of non-hormonal factors that may contribute to depression.
SEX AFTER CHILD-BIRTH
Sex can typically be safely resumed about four to six weeks after childbirth. If healing is taking a bit more time, your doctor may recommend waiting longer. Sex can sometimes be painful the first time after delivering a baby, particularly if you've had an episiotomy or a tear.
QUIT SMOKING for you and your family
Here are some ways to help you stop:
Know why you want to stop. Make a checklist of your reasons for stopping smoking and read it when you're finding it tough. Good reasons include feeling healthier, protecting your children's health and having more money to spend on other things.
Change your habits. Smoking is strongly linked to certain situations and times, such as the first cigarette of the day, a cigarette with a cup of tea or coffee, or a cigarette when you're on the phone. Try to break the link by changing your habits. For example, drink orange juice instead of coffee for a while.
Be ready to stop. Choose a day and stop completely on that day. The day before, get rid of cigarettes, ashtrays and lighters.
Get support. Tell your family and friends you've decided to stop and ask for their support. Ask them not to offer you cigarettes and, if they smoke, not to smoke around you.
Plan ahead. If you know a situation's going to be difficult, don't just wait for it to happen. Plan how you will deal with it.
Take one day at a time. At the start of each day, congratulate yourself on having made it this far. Make it your goal not to smoke today and don't worry about tomorrow.
If you need to put something in your mouth, try sugar-free gum. If you need to do something with your hands, find something to fiddle with, such as a pencil, coin or anything other than a cigarette.
Self-care instructions: Do's and Don'ts:
In the first few weeks after giving birth, try to get as much rest as possible.
Avoid walking up and down stairs too often as your wound site may be sore. But take gentle walks daily to reduce your risk of blood clotting.
You should take regular painkillers at home for as long as you need them.
Look after your wound to prevent infection by wearing loose comfortable clothing and cotton underwear, and gently cleaning and drying the wound daily.
You will be allowed to consume fluids 12 hours after and gradually consume semisolid and lastly solid foods.
Exercise to stay fit and active. Walking is the best exercise
Rest enough and take things easy. Avoid unnecessary haste and prevent accidents
Abstinence for 2 months is needed. CONSULT your doctor before resuming
Healthy diet rich in protein, iron and calcium is to be taken
Wound care is a must. keep it dry and clean
Wear loose comfortable clothing and wear abdominal belts for support
Maintain sleep and mental health. Stay away from stress and be happy