Saturday, March 19, 2011

Pregnancy Week 35
All About You

As my baby-to-be keeps growing, now my maternity clothes fit tightly. Clothes aren't the only things getting tighter—my body's internal organs are running out of room, too. I need to take more breaths since my lungs have less space and sometime I’d easily felt exhausted. My meal now is smaller in size but more frequent since my stomach doesn't have room to expand. Remember, only a few more weeks to go! There are tightening of the abdomen at times, especially if I've been on my feet all day. These false contractions, called Braxton Hicks, are normal.

Breastfeeding Basics

Breast milk provides your baby with the perfect food. Not only is breast milk filled with all your baby's nutritional needs such as disease-fighting antibodies, but it also comes at the ideal temperature and there's no measuring required. But just because breast milk is best for your baby, doesn't mean you or your baby will know how to nurse at first.

"Women should understand that breastfeeding is work," says Dr. Joanne Motino Bailey, PhD, and a certified nurse midwife. "Just because the body is made to [breastfeed] doesn't mean it doesn't involve some practice."

Babies and nursing: Babies love to suck. This sucking reflex is so strong that even if your baby's not hungry, you'll notice her smacking her lips. Before long you'll learn when your baby is sucking for practice and when she's ready to eat. It will take you a few days to get into a feeding rhythm with your baby. Expect to feed him every two to three hours since your baby digests breast milk easily.

Preparing your body for nursing: Before your baby arrives, talk to your healthcare provider about your desire to nurse. Your provider can examine your breasts to make sure you're ready. Some women have flat or inverted nipples that can be difficult for the baby to suck, but with some guidance, your provider can help you overcome these problems.

Your body readies itself for nursing by increasing the amount of breast tissue throughout your pregnancy. This tissue houses the milk production factory your body becomes to feed your baby. You'll notice your breasts leaking, especially in the last few weeks. This clear to whitish fluid, called colostrums, or foremilk, is packed with antibodies and will provide your baby with nourishment for the first few days of his life until your milk comes in.

Getting Started: Most hospitals have a lactation consultant on staff who can guide you through nursing. If you hope to breastfeed, a lactation consultant can help you get on track so you and Baby nurse soon after birth. Breastfeeding doesn't always go according to plan, though. Some women experience troubles (such as engorgement, infection, or nipple irritation) and some just can't seem to get it to work. Know that if you do have troubles nursing, it isn't your fault and you're not alone.

During nursing, your nipple and areola (the pigmented circle around the nipple) should be inside your baby's mouth. If your baby only sucks on the end of your nipple, your nipple will quickly become sore and nursing will be painful. At first getting this much of your breast into your newborn's mouth may seem awkward, but with practice both you and your baby will become pros.

There are several ways to hold your infant while she's feeding, including the classic cradle hold where her head rests at the crook of your elbow for support and her body is turned toward you. Your lactation consultant can explain several other positions until you find what's most comfortable to you.

All About Baby

At 35 weeks, your baby is considered full-term and she looks developed. The soft, fuzzy hairs that once covered her body begin to disappear. She continues to add fat layers, which will help her stay warm once she's out of the womb. During these last weeks, your baby is developed sleeping patterns (and they often have little to do with night and day!)

The baby weighs in a little over 5 pounds and stretches to around 18 inches (crown to heel).

I think my nipples are inverted. Will I still be able to breastfeed?

Yes, you should be able to breastfeed. In some cases it may require a bit of work and assistance from a lactation consultant, but it can be done! There are many tricks and tools we have to help moms whose nipples are inverted.

What are inverted nipples? An inverted nipple is one that does not stand out on its own. Some moms may have flat nipples and some may have truly inverted nipples. (You can do a pinch test during pregnancy or meet with a lactation consultant if you have questions about the status of your own nipples.) Using your thumb and index finger, hold onto your areola about an inch from your nipple and gently squeeze. Your nipple will do one of three things: stand out, remain flat or become inverted—kind of like belly button! When a woman's nipples are inverted, it is usually as a result of adhesions (acting much like a rubber band) holding the nipple back or pulling it in. Depending on how inverted the nipple is and how well your baby can latch will determine your ability to nurse. Many times after a baby gets started with nursing, the nipple will improve and stand out more easily.

Some of the strategies that may be used to assist you if you do have inverted nipples include:

ü Using breast shell periodically during pregnancy and also 30 minutes before you nurse to help your nipples stand out and loosen adhesions.

ü Manual stimulation before feedings to help the nipple "stand out" (rolling or gently tugging on nipple just prior to latching your baby can help).

ü Using a breast pump for a few minutes prior to nursing to help coax the nipple out.

ü Using a breast shield. This is different from a breast shell and is a thin, silicone nipple that fits over your own nipple. It has holes in the end to allow your milk to come through. This should be used with the guidance and support of a lactation consultant. (If not used properly it may affect how efficiently your baby removes milk from your breast and in turn decrease your ability to produce enough milk.

ü

Thursday, March 10, 2011

33 weeks pregnant

My baby now weighs about 4.2 pounds / 2 kilograms and measures approximately 17 inches / 44 centimetres from head to toe. He / She baby should already be getting ready for birth by turning upside-down - his head should be pointing down. From the past one month, every time I got scanned, his/her head is already pointing down. However, the doctor did mention that I have more water than I should have which brings me to my very first MGTT test. So, the appointment has been made and all I have to do is to go through the test and pray the best for me and the baby, of course.

The doctor now is paying more careful attention to my baby's position in the coming weeks - some babies do decide to turn back round again. The baby's skull is still quite pliable and not completely joined, so he/she can ease out of the relatively narrow birth canal. But the bones in the rest of his body are hardening. My baby's skin is as well gradually becoming less red and wrinkled.

As I am a first-time mother, as from the doctor, my child's head may move into the pelvis this week and press firmly against my cervix. (This happens for about half of all first-time mothers.)But if you're a second-time mum, you can expect this to happen a week before labour - and for some this won't happen until the start of labour. I really hoping to manage my labour naturally and this is all I need to know about natural pain relief:

1. Warmth

People have used warmth to relax tense muscles for a long time and it can also be used to provide relief from labour pain. Warm your back, tummy or groin using a wheat bag or a hot water bottle. A wheat bag is a cloth bag filled with wheat husks which you heat up for a few minutes in the microwave; - they drape and shape themselves to you and will stay warm for an hour or more. You may have to order them online.

If you're going to use a hot-water bottle, fill it with hot (but not boiling) water, and carefully wrap it in a towel or soft cover before using it. Don't forget that massage provides warmth as well. Having someone rub your back will warm your skin as well as stimulating your body to release natural pain-killing substances. Using a birthing pool is another way to envelope yourself in all-encompassing warmth – see below.

When your baby's head is being born, a soft warm flannel or compress placed over your perineum (the tissue between the back of the vagina and the back passage) may make you feel more comfortable as the tissue stretches, although it won't necessarily prevent any tears to the area.

2. Breathing

Focusing on your breathing is a wonderful way of getting through each contraction. Take a deep breath at the beginning of the contraction and, as you breathe out, r-e-l-a-x. Then breathe in through your nose and breathe out through your mouth, keeping your mouth and cheeks very soft.

Don't worry too much about how deeply you're breathing; just keeps a good rhythm going. Breathe in through your nose, and out through a soft mouth. Concentrate as hard as you can on your breathing as the contraction builds up, and as it fades away. When the contraction's over, r-e-l-a-x.

3. Resting

In early labour, the best thing you can do to prepare yourself to cope with pain is to conserve your energy by resting. Make yourself as comfortable as possible in bed or on a chair. Tuck pillows all around yourself. Have a hot, sweet drink. Play some favourite music or put the TV on, and rest!

Later on, you'll find it much easier to cope with painful contractions if you're not exhausted because you were rushing around in early labour.

4. Changing position

Unless you are really tired, try to avoid lying down on your back once your contractions are regular and painful. Your labour will be slower if you lie down and, the longer your labour lasts, the more tired you'll become. Try to remain upright, but choose whatever position feels most comfortable. Your midwife should encourage and help you. You could:

· Stand up and lean on the bed or your labour partner.

· Kneel down and lean on the seat of a chair.

· Kneel with one leg raised to make lots of room in your pelvis for your baby to come out.

· Get on all fours to help ease backache.

· Sit for a while in a chair, then get up and walk around.

· Rock your hips as much as you can to get your baby moving.

5. Massage

Massage can help you cope with labour pain and can also help to relieve anxiety. Tell your labour partner where you'd like to be massaged. You might like massage at the very base of your back during contractions. Or you might like your shoulders massaged in between contractions to help you relax. Give feedback when you can, so that you get the best out of it.

A massage that starts slowly is best - frantic rubbing will make you feel panicky rather than relaxed! Firm pressure will help to stimulate your body to release endorphins, the "feel-good" hormones which make massage such a positive experience.

6. Being supported

A woman, who has someone supportive with her during labour, to comfort and stay with her, gives birth more quickly and easily than if she doesn't have continuous support. The evidence is strongest for having another woman with you, such as a close friend relative or doula. Surprisingly, there hasn't been much research on how much having your husband with you helps.

Think carefully about who you want to have with you during your labour and birth. You'll need someone who won't panic, who believes you can do it, and who is confident to talk to health professionals on your behalf. Your chosen labour partner may be your husband, or it may be your sister or your mum or a good friend. Or you might like to choose two birth partners.

Be aware, though, that some hospitals are reluctant to let you have two birth partners in the delivery room at the same time, because of lack of space. They may, however, agree to have one birth partner in the room at a time. Discuss this with your doctor and ask for your requests to be put in your notes well before your due date.

7. Using water

Labouring in water can make contractions more bearable, just as having a bath helps to ease tummy ache or backache. A review found that using a birthing pool significantly reduced the amount of pain relieving drugs in labour that women used and the amount of pain that they reported feeling. Women who spent some time labouring in water were far less likely to need an epidural or spinal than women who spent all their labour on dry land.

8. Midwifery skills

A kind, competent nurse midwife will keep you informed all the time about what is happening. If you want to use natural pain relief to cope with contractions, she'll help you, and if you choose an epidural, she'll support you.

A-Z of natural pain relief

Here's an A to Z of ideas to help you cope with pain and feel in control of your labour:

A: Ask for information: the more you know, the more relaxed you'll feel.

B: Breathe rhythmically, and relax as you breathe out.

C: Cuddle your husband.

D: Drink sips of isotonic drinks or water in between contractions.

E: Eat carbohydrate-rich foods little and often if you feel hungry. (Although research shows that eating and drinking in labour is safe, some doctors and hospitals still discourage it - check with your doctor about her preferences and hospital policy about this.)

F: Fan yourself with a small electric fan.

G: Groan and moan: making a noise is a great coping strategy!

H: Hold your husband's hand.

I: Imagine your baby moving down through your pelvis with every contraction.

J: Joke with your husband and your midwife; keep things in perspective!

K: Kisses (from your husband, mum, sister).

L: Listen to music to help you relax.

M: Move around to make yourself as comfortable as possible.

N: Nestle down in a large pile of pillows or a huge bean bag.

O: Open your pelvis as wide as possible to help your baby be born: kneel on one leg with the other out to the side.

P: Think positively: "Each contraction brings me closer to the birth of my baby".

Q: Question what you don't understand; being frightened will make the pain worse.

R: Rock your pelvis round and round and back and forwards with each contraction.

S: Sigh out gently with every breath.

T: Trust your body: you can give birth!

U: Understand the treatment being offered; understanding what's happening helps you feel more motivated.

V: Visit the toilet regularly; a full bladder will slow your labour.

W: Walk around to ease aches and pains and bring on contractions.

X: More kisses!

Y: Yell, loud and long, and then try to get back into a good breathing pattern.

Z: Zzzzzzz: doze off in between contractions

You may notice that your feet and ankles are quite swollen by the end of the day. Water retention, also known as oedema, is often worse in warm weather and late in the day. Surprisingly, keeping hydrated helps reduce water retention. Your body - particularly your kidneys - and your baby need plenty of fluids, so drink up. If you suddenly feel swollen or puffy in your hands or face, however, call your doctor - it may be a sign of pre-eclampsia.

Planning ahead

Make life easier for yourself. Stock up on basics - everything from can foods to beras - before shopping becomes too much of a chore. Cook up extra portions to freeze as ready meals for the early weeks - especially important when you're breastfeeding. Make a list of important numbers - your doctor and the labour ward - and pin it up by the phone. If your husband's difficult to get hold of, make sure he has a mobile phone on him at all times. What about your pets and older children? Sort out cover for them and you'll be more relaxed when the time comes.

Financial worries can mar your enjoyment of pregnancy and maternity leave. Work out if you're budgeting enough for your baby. Have you looked into how much childcare may cost when you go back to work? If you have hired a live-in maid, you need to factor in the increased costs of feeding and housing another adult.

Thursday, February 17, 2011

Pregnancy Week 30

Even though I am getting heavier, deep down in my heart I knew that the need for exercise hasn't quit. Swimming (haven’t started the class yet) and walking are wonderful forms of exercise for pregnant women. Thus, I keep myself go up and down the stair (even a bit slow) as my daily routine exercise instead of following my hubby for a jog every weekend (*grin* hope the walking to the kitchen, in mall as well as going up and down the stair will sufficient for me). In addition, I’ve learned few steps of exercise in the antenatal class attended last month, organised by KPMC which is very helpful. I am planning to go for another class by Azzahrah Islamic Medical Centre that arranged only for those who have done regular check-ups with them. Besides, many community centres and dance studios host pre- and postnatal exercise classes. They're fun, gentle, can help you feel energized, and offer a great way to meet other expectant mothers!

All about Me

I am now have only few more weeks to go! The baby weight is starting to impact my lifestyle. From walking pace, sleeping time to emotion related matter; all are more or less influenced. Bending over is tricky if not impossible. And tying my shoes? Forget about it. As my baby-to-be crowds my internal organs more heartburn, indigestion, and flatulence experienced. By this stage, breathing sometimes being a sore as my lungs has less room to expand.

Tired of Being Pregnant?

By this point the novelty of my baby bump may have worn off—I’ve getting downright tired of being pregnant. In a few weeks your aches and pains will be a distant memory as I stare into my newborn's face, but for now there are a few simple things I could do to make my last few pregnancy weeks more comfortable.

Complaint: No sleep. My baby bump makes it hard to find a comfortable sleeping position. Add to that the discomfort caused by the internal organs making room for the growing of baby-to-be: My lungs have to work harder to provide the extra oxygen that the body needs, creating shortness of breath. Stomach is pushed up, making heartburn and indigestion likely. And the bladder—well—I’m already used to going to the bathroom several times a day, and making similar trips at night can be frustrating.

Solution: I did positioned pillows around my body for support. Have my hubby massage the sore body before bedtime especially with Vitamin E oil. For fewer bathroom breaks, I don't drink water an hour or so before going to bed (but I have to make sure to drink plenty of water during the day).

Complaint: Swelling can become a real problem late in pregnancy. The body retains water to supply the increased of blood production (which goes up by 50 percent during pregnancy). You may find your face, ankles, and fingers swell to the point your shoes don't fit and your rings won't go on (or come off!). Fortunately for me, my feet don’t badly swollen till my 3rd trimester (as I could still wear my heels!!).

Solution: Drink lots of water to push fluids that can ease the swelling. Also, be smart about what you do during the day. I’d avoid from standing on my feet or stay in any position too long or the blood will pool, making swelling even worse. Change positions frequently and put the feet up as much as possible to increase circulation. Talk to your doctor if swelling becomes severe.

Complaint: Potty breaks. Frequent urination is a common complaint during pregnancy. It can become a nuisance to find a restroom any time you go somewhere. As the baby-to-be continues to grow, the pressure on the bladder will too, meaning the potty breaks will keep increasing until the baby's birth.

Solution: The only real solution is to have the baby. Don't limit your visits to the bathroom—holding in urine for too long can lead to urinary or bladder infections.

Complaint: No clothes. Toward the end of my pregnancy those cute maternity clothes that once neatly covered my baby bump may barely fit. Plus, I am wearing the same outfits over and over again, since non-maternity clothes are out.

Solution: Having something new to wear can brighten your mood. As I don't want to sink more money into a wardrobe that will last only a few weeks, I asked friends and relatives if they have any maternity clothes they're willing to lend. As the result, I got few pieces from my friend as well as my aunts. Spice up and mix-and- matching my own maternity clothes by buying non-maternity, button-down shirts or sweaters to pair with my maternity wear.

All About Baby

My baby's face looks much like it will when he's born. He still needs to fill out more to get the characteristic chubby infant cheeks, but he's on his way. He can move his head, open his eyes, and make breathing movements through his open nostrils (although no air comes in). The movement, as if he’s futsal-ing or somersaulting in there. But it’s great and enjoyable moment not to be missed. The bun now should be counted his movement using ‘foetal kick chart’.

How Big Is Baby?

If my little one were born today, he'd have a good chance for survival at about 3 pounds and a little over 15 inches long (crown to heel).

Most Common Pregnancy Questions

I have noticed some discharge from my nipples. Could I have an infection?

What many women think may be some type of breast infection during pregnancy is actually the leaking and/or crusting of early milk on the nipple. Colostrums, the initial super-charged, immunity-rich milk your baby will drink right after birth begins to form in your breasts early in your pregnancy. Some women will experience leaking during pregnancy, while others may not see anything at all. (This is no indication of your ability to produce milk.)

If you notice a discharge from your nipples, gently wash your nipples with a washcloth. In some cases, where there is significant leaking, you can wear a nursing pad to absorb moisture. Seeing this leaking is a good answer to the frequently asked "Is there anything in there?" question!

Some other changes you may notice in your breasts include:

  • · Tenderness
  • · Increase in size
  • · Darkening and increased size of the areola
  • · Larger, more prominent veins
  • · Stretch marks (due to increasing size)
  • · Itchy skin (due to stretching as your breasts increase in size)

If you have questions about your breasts or any other changes you may be experiencing as your pregnancy progresses, check with your doctor or midwife.

Have a bag to take with you each day filled with:

  • · your breast pump (if you're nursing)
  • · a clean shirt (you'll sweat a good bit in the initial days after delivery)
  • · a water bottle to stay hydrated
  • · some healthy snacks.

For Your Partner

A New Baby: A Gift for the Whole Family

Families rarely talk about the impact a new baby has on an extended family. Especially when Baby will be the first child to enter the fold, the change can be quite dramatic. You and your partner's parents will suddenly have new roles: Grandparents. This new position in the family is often anticipated with unrivalled joy. Grandparents have the luxury of being free from the baggage most parents carry, and for this reason find they feeling more excited, relaxed, and comfortable with the changes to come.

This is a great opportunity for families because the new grandparents want to help and most new parents need some. When a grandchild comes into the world, the focus of the family shifts from parents to the new baby; schedules work around the baby, and everyone wants to know how they can help out. This is a great opportunity for you to build a better relationship with parents and in-laws. It is also a good time to learn how to ask for help.

Many grandparents-to-be will offer to help out, while others want to help, but don't want to intrude on your new parenting time. Feel free to get the message out to the expecting grandparents that if they can baby sit one or two nights a month (or however many you want) so you and your partner can get some much needed time together, it would be a huge assistance. Remember you and your partner are the core of your growing family, the very foundation; and the healthier you two are doing together, as a team, the better your child will do, too.

Monday, February 7, 2011

The stages of labour

Labour is divided into first, second and third stages. The first stage of labour results in the neck of the womb - the cervix - dilating to a full 10 centimetres and consists of early, active, and transitional phases.

Early phase

The early phase is sometimes called the latent period or pre labour. The uterus starts to contract or tighten regularly. The contractions gradually become more painful, unlike your Braxton Hicks contractions which were irregular and didn't hurt. Each woman has her own rhythm and pace of labour. Some may not even be aware of the very early contractions and are several centimetres dilated before they realise they're in labour. As the cervix begins to open, its position in your pelvis changes, moving forwards. It softens and effaces which means that it gets thinner and springier. Feel your nose: it's firm and muscular. Now feel you lips: they're soft and stretchy. Your cervix starts out firm like your nose, and has to become soft and stretchy like your lips.

What you can do

You'll probably be able to potter around the house, go for a walk, watch a DVD, take a warm bath, or have a nap. Relax as much as you can. Have light snacks and plenty of fluids. Try to remember to pass urine regularly. If you find the contractions are hard work, try using massage, relaxation techniques, a warm bath and experiment with positions that you find comfortable. If you want to use a TENS machine, put it on during this early phase as it seems to work best when used from the very start of labour.

Active phase

Doctors say you are in active labour when your cervix has dilated, or opened, to four centimetres. Your contractions will be getting stronger and more frequent. They're also getting longer. Eventually they may be coming as frequently as every three to four minutes and lasting about 60 seconds - and feel very tense indeed.

What you can do

The time to go to hospital is when you and your birth companion feel you would be more relaxed there than at home. Contractions may start to feel as if they are coming one on top of another. Try to work with your body. What is it telling you to do? Would you be more comfortable in a different position? Do you need a drink or some food to give you energy? Would it help to go to the toilet? Do you need more information from your doctor to reassure you?

Breathing exercises and relaxation techniques really come into their own at this point, and your husband can help you remember how to use them. You could try some gas and air to see if it takes the edge off the contractions.

If your waters have not ruptured, consider taking a warm shower or bath - warm water can really help ease the pain of labour.

Sometimes, women reach a point in labour when the rate at which their cervix is dilating slows or even stops. Try a change of scenery; a walk down the hospital corridor may help (you may need help walking, and will likely need to lean on something during a contraction). If you are too tired to walk, you could also ask your husband to give you a massage to help you relax. Sit or lie down on your side. Sometimes a good cry releases the emotional tension and helps you "let go". If your waters haven't broken yet, your doctor may suggest breaking them to see if this will speed labour up. Be aware though that you may find contractions tougher once the waters have gone.

If you find that the things you can do to help yourself aren't making contractions manageable, you can choose to have pethidine or an epidural.

Transition

During the transitional phase, the cervix dilates from eight to 10 centimetres. Contractions may last as long as one to one-and-a-half minutes and occur every two to three minutes. You might feel shaky, shivery and sick. (Or you might feel none of these things!) Many women report very intense contractions, rectal pressure and an urge to push down. It is usually at this stage that many also start to lose faith in them even if they were determined to have an active or natural birth. This is when lots of encouragement from your labour companion will be crucial.

What you can do

Hang on to the thought that you are nearly there. Make the most of the time in between contractions to rest and relax. During contractions, find the position that suits you best. Keep your breathing as rhythmical as possible (breathe in through your nose and blow out through a soft mouth), and if you want to shout, groan and make a lot of noise - go for it!

Second stage

Once the cervix has dilated to 10 centimetres, the work and excitement of the second stage begin. This is the stage of labour when your womb pushes your baby down the vagina (sometimes called the birth canal) into the world and, at long last, you meet him or her for the first time. There's often a lull at the end of the first stage when the contractions stop or come further apart, and you and your baby can rest for a while. When the contractions start again, you'll feel the pressure of your baby's head between your legs. With each contraction and every push, your baby will move down through your vagina a little, but at the end of the contraction, he'll slip back up again! Don't despair. As long as the baby keeps on moving on a little further each time, you're doing fine. When your baby's head is far down in your pelvis, the perineum (the area between the rectum and vagina) will begin to bulge. With each contraction the pressure of baby's head will further stretch the perineum and the opening of the vagina. You'll probably feel a hot, stinging sensation and your doctor will tell you that your baby's head has "crowned". As your baby's head begins to be born, your doctor may ask you to stop pushing and gently pant. This helps make sure that your baby is born gently and slowly, and should reduce the risk of you tearing.

If you have had a baby before, the second stage may only take five or 10 minutes. If this is your first baby, it usually takes an hour, but your doctor will likely want to actively manage this stage so you don't have to wait for an hour.

What you can do

Listen to your body and push when you get a strong urge. Try not to hold your breath when you're pushing. Push for as long as you want to. Then push again. You'll find that you push several times (not just once) with each contraction. Find a position you feel comfortable in, but remember to try to use gravity to help you by standing up, kneeling or squatting. You will most likely be very tired by now. If you need to lie down, lie on your left side. This makes more room in your pelvis for your baby than sitting on the bed because you're not pushing your coccyx (tail bone) forwards.

If you've had an epidural, listen to your doctor who will tell you when to push. She may suggest not pushing until she can actually see your baby's head.

Third stage

What happens?

In the third stage, you deliver the placenta - the baby's life-support system that has supplied your baby with nutrients, and taken waste products away. After the baby is born, contractions resume after a few minutes, but at a much lesser intensity. These contractions cause the placenta to peel away from the wall of the uterus and drop down into the bottom of your womb. You will probably feel that you want to push, but let your doctor or midwife guide you. The placenta, with the membranes of the empty bag of waters attached, will pass down and out of your vagina. Your doctor will carefully examine the placenta and membranes to make sure that nothing has been left behind. She will also feel your tummy to check that your uterus is firmly contracted in order to control the bleeding from the place where the placenta was attached.

Delivering the placenta usually takes from five to 15 minutes, as your doctor is most likely to actively manage this stage in order to avoid too much bleeding. Most women are surprised at how much easier it is to deliver the placenta than to push the baby out. You may like to have a look at this organ that has supported your baby throughout the pregnancy.

What you can do

You may hardly be aware of the third stage, as your focus has probably shifted to your baby. Seeing and handling your baby, and offering him or her breast will stimulate hormones that help the placenta to separate.

Now that the birth is over, you may feel shaky due to adrenaline and the adjustments your body immediately starts to make. Or you may simply be on a high, ready to pick up your baby and dance around the room. Some women find it hard to pay attention to the baby if they have had a long labour. There's nothing wrong with their maternal instincts; they're simply exhausted. If this happens to you, take your time. After a rest you will be much more interested in getting to know your baby. A lot of women are very hungry and ready for some snacks and drinks.

Admire your new baby. Count the fingers and toes. Hold him or her close to your body, preferably skin to skin. If you're too tired, your husband can hold the baby against his chest. If you're going to breastfeed, offer the breast as soon as possible: your nurse midwife will help you. Don't worry if your baby doesn't seem very interested. Even if he's only touching and nuzzling you, this will help you to get going with breastfeeding.

Pregnancy weeks: 29

How your baby's growing

Baby's brain is growing rapidly, and the head is getting longer to accommodate it. Baby’s weight now is around 2.5 pounds / 1.1 kilograms and measures about 15 inches / 38 centimetres from head to toe. Nearly all babies react to sound by 30 weeks. If you're having a boy, his testicles are moving from their location near the kidneys through the groin en route to the scrotum. If you're having a girl, her clitoris is relatively prominent because her still small labia don't yet cover it. That will happen in the last few weeks before birth.

Baby's lungs and digestive tract are almost fully developed. While the baby may soon slow up growing in length (he / she measures about 15.7 inches / 40 centimetres from crown to toe by now), he will continue to gain weight until he's born.

This week my baby continues to open and shut his / her eyes. He / she can probably see what's going on in uterus, distinguish light from dark and even track a light source. If I’d shine a light on my stomach, my baby may move his / her head to follow the light or even reach out to touch the moving glow. Some researchers think baring your stomach to light stimulates visual development. But don't expect 20/20 vision when your baby is born - newborns can see a distance of only about 8 to 12 inches / 20 to 30 centimetres. (Children with normal vision don't reach 20/20 vision until about age 7 to 9.) To complete the picture, your baby now has eyebrows and eyelashes.

A pint and a half / around a litre of amniotic fluid now surrounds the baby but that volume decreases as he / she gets bigger and has less room in the uterus. As you and the baby continue to grow, don't be alarmed if you feel breathless, as if you can't get enough air; it's just your uterus pressing against your diaphragm. There is a light at the end of the tunnel though. At about 34 weeks (or just before birth, if this is your second or third pregnancy), your baby's head will move down into your pelvis as the baby gets into the right position for birth. That will make breathing and eating a lot easier.

Your baby's nutritional needs reach their peak during the third trimester. You'll need plenty of protein, vitamin C, folic acid, iron and calcium (about 200 milligrams is deposited in your baby's skeleton every day), so eat foods rich in these nutrients. The skeleton hardens even more and the brain, muscles and lungs continue to mature. So let’s take a look at the eating well guide to make sure you are getting the right minerals and vitamins.

Eating in the last trimester

In the last trimester, I am now officially allowed an extra 200 calories a day to match my baby's growth spurt. But try to resist eating too many cakes, sweets and fast food snacks. Two hundred calories is less than I could think - it's the equivalent of two slices of wholemeal toast and margarine or butter, a jacket potato with an ounce of cheese, or one slice of cheese on toast.

Coping with heartburn

As my pregnancy progresses, heartburn becomes all too common. It's caused by both hormonal and physical changes in the body. Though I’d may not be able get rid of it completely, I’ve taken some steps to minimise it by cutting out rich or spicy dishes, chocolate, citrus fruits, alcohol and coffee. Eat small, frequent meals, take small mouthfuls and chew your food well.

Vegetarian and pregnant

If you are vegetarian, you should take extra care to ensure you have an adequate intake of two nutrients that are particularly important during pregnancy - iron and calcium. Good sources of iron for vegetarians include fortified breakfast cereals (check the packet), tofu, wholegrain bread, dark green leafy vegetables, nuts, pulses, dried fruits and even plain chocolate.

Vegetarian sources of calcium are found in dairy products, chickpeas, kidney beans and baked beans, sesame seeds and almonds, plus fortified soya products. Generally speaking, calcium is not as well absorbed from non-dairy foods so, if you do not eat dairy foods, it may be a good idea to take a supplement.

Lunch: pitta bread with lamb's lettuce, Gruyère and grapes

Ingredients

1 large wholemeal pitta bread

1 handful lamb's lettuce or similar salad leaves, washed

50g grapes, halved

30g Gruyère cheese, sliced

balsamic vinegar, to serve

Method

Warm the pitta bread in a toaster or grill and slice open. Stuff it with the lamb's lettuce, grapes and gruyere. Drizzle over the balsamic vinegar and serve at once, with a fresh smoothie for added vitamin C.

Snack: strawberry milkshake

Making your own milkshake with fresh fruits is a delicious way to get calcium. Try this one with strawberries for a dose of calcium and vitamin C.

Ingredients

100g fresh strawberries, washed and hulled

150ml semi-skimmed milk

1 tsp sugar

Place all the ingredients in a blender and whizz until smooth. Pour into a glass and serve at once.

Dinner: creamy chickpea curry

This is a mild and creamy curry which is unlikely to upset your stomach. You may be surprised to learn that curry powder also contains some iron.

Ingredients

1 tbsp rapeseed or sunflower oil

1 onion, roughly chopped

1 clove garlic, crushed

2.5cm fresh ginger root, grated

2-3 tsp mild or medium curry powder

6 cauliflower florets, washed and halved

50g French beans, trimmed and halved

200g carrots cut into chunks

400g can chickpeas, drained and rinsed

400ml can light or reduced-fat coconut milk

1 tbsp chopped coriander

Method

Fry the onion and garlic in the oil until soft. Add the ginger and curry powder and cook for a minute, stirring all the time to prevent sticking. Add a little water if necessary.

Add the cauliflower, beans, and carrots and stir to coat with the spices. Finally add the chick peas and coconut milk, stir, cover and simmer for 25-30 minutes until the vegetables are tender. Just before serving, add the chopped coriander. Serve the curry with plenty of rice and a glass of pomegranate juice.

How your life's changing

My appetite increases (am I??even before pregnancy I’ve ate a lot) to match my baby's third trimester growth spurt. I have to make sure I’ve got enough of iron, which helps my baby make red blood cells. Iron supplements can make me constipated so it's a good idea to try to boost my iron intake first by including sources such as meat, leafy greens, and fortified cereal in the diet along with fibre-rich foods to help things move along smoothly.

If you haven't already adapted your exercise regime, now is a good time to introduce some activities to help your body to stretch and open up ready for the birth. Why not try to find a yoga class specifically for pregnant women? Not only will it help you to breathe deeply, but the instructor will show you stretch which may help you get into and maintain comfortable positions in labour. Even the occasional stretch and wiggle can help you avoid pregnancy niggles such as leg cramps - so get moving and stretching!

Pregnancy tip: have fun while you still can

"Banish the pregnancy blues by enjoying your last weeks of pre-baby freedom. Go to a film, have a facial or a romantic dinner - do all the things you may not have time for once your baby is here." - Bethany B.

Saturday, February 5, 2011

Pregnancy week 29

It’s a turn towards the homeward stretch! It’s time for me to start considering some big decisions. In addition to the breast or bottle question, what about circumcision? In some religions and cultures, circumcision, cutting a baby boy's foreskin, is a matter of custom and belief. In others, boy babies are never circumcised. For many people without clear cultural guidelines, circumcision is a difficult, but important choice to make.

All About You

As your baby-to-be grows bigger, you may find your pregnancy pains increasing. By the end of the day your back aches and your feet become swollen. Frequent potty breaks are probably becoming a nuisance as your wiggly baby presses down on your bladder. I faced swollen feet during the 1st week of my third trimester; try to get a massage to reduce it n it works!! I love to get massage during pregnancy cause it’s really soothing all the aches out...But get the pro one!!

Ready for Breastfeeding?

Increased breast size is one of the first signs of pregnancy. Even before my bump makes an appearance, pregnancy hormones send messages to the breast tissue to get ready to feed the baby come delivery day. If this is your first baby, or you've had trouble nursing in the past, breastfeeding may seem foreign. You may still be unsure whether or not you want to breastfeed. For me, I am really want to breastfeed my baby as long as I could, prayers to Allah for me to face this. Here are some things to keep in mind as you prepare to nurse your newborn.

When milk comes in: From the first days of pregnancy your breast tissue is building and readying to feed your baby. Between your fifth and sixth month of pregnancy you might notice clear to yellowish liquid occasionally coming from your nipples. This beginner milk, called colostrums, is made up of antibodies, the perfect diet for a newborn. After your baby's birth, your breasts will produce colostrums for three to five days until your milk comes in. Your breasts will most likely feel fuller and heavier as breast milk replaces colostrums.

Why breastfeeding is good for your baby: Breast milk is the perfect food for your baby—a carefully concocted mix of fats, proteins, and antibodies that help your child grow. The makeup of breast milk changes over time to meet your baby's growth needs and also changes during individual feedings. When your baby begins nursing, she first receives foremilk—a more watery, but still high-fat mix—which is replaced with regular milk in the middle of the feeding and then thinner milk as the feeding comes to an end.

Babies easily digest breast milk, which is why you should expect to feed your baby every two hours for the first few weeks. Her body breaks down the nutrients from your breast milk quickly and she's ready for more.

Why breastfeeding is good for you: When you breastfeed, your body releases a hormone called oxytocin, which signals your uterus to contract, explains Dr. William Camann, MD, director of obstetric anesthesia at the Brigham and Women's Hospital in Boston, Massachusetts, and coauthor of Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth. These contractions pull at your uterus; bringing it back into pre-pregnancy position (these contractions may be painful at first). Along with pulling your belly back into place, breastfeeding requires calories. Your body will use up fat stores to produce breast milk, meaning nursing should help you lose pounds and return to your pre-pregnancy weight.

Breastfeeding can also help you grow closer to your baby. During feedings you can stare into his eyes and memorize his features while he in turn looks at yours. Nursing gives you an excuse to slow down and spend a few quiet moments together.

Convenience comes with nursing as well. You won't need to measure the right amount of milk into bottles or mess with heating up your baby's breakfast. Breast milk comes at the perfect temperature, ready to eat, and is free.

Breast evaluations by your physician: "There are two reasons a doctor will examine a woman's breasts during pregnancy," says Dr. Camann. "First, to check for any abnormal growth. It's not common, but some women have been diagnosed with breast cancer during pregnancy." And second, your healthcare provider will be looking for any anatomical issues that may make breastfeeding tougher, for instance if you have flat or inverted nipples.

How to Get Started

You may want to attend breastfeeding classes before your baby's birth. For some mother-child pairs, nursing come naturally, but there are often difficulties for mother or baby. Learning more about how to nurse before your baby's birth will go a long way toward making nursing a success. In class you'll learn different ways to hold your baby for feedings and how your baby should be placed on the breast. This knowledge will help you feel more comfortable nursing from the start. Call your hospital's lactation consultant if you have any questions or concerns. The La Leche League is also a great resource for information and support.

All About Baby

My baby is filling out this week, adding fat to insulate his / her body for the day he / she leaves his / her cosy home. You can probably distinguish between feet and hands, head and bottom when your baby-to-be moves inside you. He / She takes practice breaths but won't breathe air until delivery.

The baby's growth has begun to slow down now, but he / she will still gain approximately four pounds between now and birth. If he / she were born now, he / she would be able to breathe, but might tire easily and need assistance. His / Her little eyes are sensitive to light. Baby is now weighing at 2 1/2 pounds and around 15 inches (crown to heel), the little one is growing fast!

For Your Partner

Nursing: Not As Easy As You'd Think!

Breastfeeding is one of the healthiest things parents can do for their baby. It is not only good for your little one's growth and development, but is equally beneficial for your partner. The World Health Organization (WHO) recommends mothers breastfeed at least through Baby's first year and preferably for up to two years (while giving complementary foods after six months).

However, nursing can be very difficult for some families. Many people think breastfeeding should just happen naturally, so when a new mother has trouble, she may blame herself and feel depressed and guilty. But the truth is that nursing is a skill both babies and mothers need to learn together. And this is where dads can help!

Help your partner nurse by making sure she has enough to drink during the day and especially during or just after she nurses. If she has trouble nursing, you can help her seek out a lactation consultant (a professional who can facilitate the breastfeeding process; many make home visits) by calling her OB office, the hospital where she delivered, or your newborn's pediatrician. But the most important thing you can do is to remind her that she is not at fault if trouble arises. Many women struggle with breastfeeding, and some are never able to successfully nurse. Listen to her and offer her lots of love and support throughout the experience.

Whether nursing goes smoothly or not, talk with your partner about pumping milk once breastfeeding is well established so you can do one or two feedings a day (or at night!). One of the most important ways fathers bond with their babies is by meeting their core needs. By feeding Baby, you're showing her that you're not just a supporting role, but a primary caretaker. This can make a real difference as you begin building a strong relationship with your child.

Tuesday, February 1, 2011

Natural pain relief in labour

Warmth

A cloth bag filled with wheat husks which you heat up for a few minutes in the microwave and then drape over your back really helps ease contractions. The wheat-bag will stay warm for an hour or more. You may have to order one from online pregnancy stores.

Alternatively, hot - water bottle filled with hot (but not boiling) water, carefully wrapped in a towel can be placed on your back. Don't forget that massage provides warmth as well. Having someone rub your back will warm your skin as well as stimulating your body to release natural pain-killing substances.

When your baby's head is being born, a soft warm flannel placed over your perineum (the tissue between the back of the vagina and the back passage) helps ease the stretching sensation. Although this is not a common practice here, discuss it with your doctor and include it in your birth plan.

Breathing

Focusing on your breathing is a wonderful way of getting through each contraction. Take a deep breath at the beginning of the contraction and, as you breathe out, R-E-L-A-X. Then breathe in through your nose and breathe out through your mouth, keeping your mouth and cheeks very, very soft. Don't worry too much about how deeply you're breathing; just keeps a good rhythm going. Breathe in through your nose, and out through a soft mouth. And again. And again. Concentrate as hard as you can on your breathing as the contraction builds up, and as it fades away. When the contraction's over, R-E-L-A-X.

Resting

In early labour, the very best thing you can do to prepare yourself to cope with pain is to conserve your energy by resting. Make yourself as comfortable as possible in bed or on a chair. Tuck pillows all around yourself. Play some favourite music or put the TV on, and REST! Have a hot drink if you are at home (many hospitals don't allow women in labour to eat or drink). Later on, you'll find it much easier to cope with painful contractions if you're not exhausted because you were rushing around in early labour.

Changing position

Unless you are really tired, try to avoid getting on the bed once your contractions are regular and painful. Your labour will be slower if you lie down and, the longer your labour lasts, the more tired you'll become. Remain upright - but choose whatever position feels most comfortable. Stand up and lean on the bed or on your husband. Kneel down and lean on the seat of a chair. Kneel with one leg raised to make lots of room in your pelvis for your baby to come out. Get down on all fours to help ease backache. Sit for a while in a chair; then get up and walk around for a bit. Rock your hips as much as you can - that really gets your baby moving!

Massage

Tell your husband or birth companion where you'd like to be massaged. You might like massage at the very base of your back during contractions. Or you might like your shoulders massaged in between contractions to help you relax. Tell him to massage you slowly. If he starts rubbing frantically, you'll feel panicky rather than relaxed! He should use firm pressure in order to stimulate your body to release endorphins, the `feel-good' hormones which make massage such a positive experience.

Being loved

Research has shown conclusively that, when a woman has someone special with her during labour, to comfort and stay with her, she gives birth more quickly and easily than if she doesn't have that continuous loving support. So choose your birth companion carefully. Someone who won't panic; who believes you can do it, and who is confident to talk to health professionals on your behalf. This person may be your husband, or it may be someone else - your sister, your Mum or your best friend. Or you might like to choose two birth companions. It's up to you.

Be aware, though, that some hospitals are reluctant to have two birth partners in the delivery room at the same time, due to lack of space. They may, however, agree to have one birth partner in the room at a time. This should be discussed with your doctor and your decision put in your notes well before your due date.

Professional skills

Your obstetrician will not stay in the labour and delivery suite with you throughout your labour. She will check on you periodically, help you make decisions about pain relief, and will of course be on hand to deliver your baby. Most likely you will be attended to by the hospital's nurse midwives who will keep you informed all the time about what is happening. If you want to use natural pain relief to cope with contractions, she'll help you, and if you choose an epidural, she'll support you. If you don't seem able to establish a good relationship with the midwife allocated to you, ask for someone else. You won't cause offence. It might well be that the midwife you can't get on with is finding you pretty difficult as well! You'd both be happier if you had someone different.

A-Z of natural pain relief

Here's an A to Z of ideas to help you cope with pain and feel in control of your labour:

A: ask for information: the more you know, the more relaxed you'll feel;

B: breathe rhythmically, and relax as you breathe out;

C: cuddle your husband or birth companion;

D: drink sips of water in between contractions;

E: eat carbohydrate-rich foods when you feel hungry;

F: fan yourself with a small electric fan;

G: groan and moan: this is the one time you can throw modesty aside as making a noise is a great form of pain relief;

H: hold your husband's hand;

I: imagine your baby moving down through your pelvis with every contraction;

J: joke with your husband; keep things in perspective;

K: kisses (from your husband, Mum, sister, friend);

L: listen to music to help you relax;

M: move around to make yourself as comfortable as possible;

N: nestle down in a large pile of pillows or a huge bean bag (you may have to ask the hospital to provide extra pillows or bring your own);

O: open your pelvis as wide as possible to help your baby be born, eg: kneel on one leg with the other out to the side;

P: think positively: 'Each contraction brings me closer to the birth of my baby';

Q: question what you don't understand; being frightened will make the pain worse;

R: rock your pelvis round and round and back and forwards with each contraction;

S: sigh out gently with every breath;

T: trust your body: you do know how to give birth!;

U: understand the treatment being offered; if you understand, you can cooperate and make things easier;

V: visit the toilet regularly; a full bladder will slow your labour;

W: walk around to ease aches and pains and bring on contractions;

X: more kisses!;

Y: yell, loud and long, and then try to get back into a good breathing pattern;

Z: zzzzzzz: doze off in between contractions.