Contraception FAQ

As tempting as it is to leap straight from contraception to conception, you may want, or need, to wait. For our reference and knowledge, let's share our experience or knowledge and discuss.

If you are trying to get pregnant, there are some changes you could make to prepare for a new baby. Whichever type of contraception you're stopping, make sure you take more natural food with healthily balanced nutrients as soon as you start trying for a baby.

When should I stop taking the pill?

If you're coming off the combined pill (combined oral contraceptive or COC), it's best to stop taking it when you've finished one complete cycle of pills.

Your period may return in two to four weeks, or it could take up to a few months. You'll be fertile again when you ovulate, two weeks before your period starts.

It's usually recommended that you wait until you’ve had one normal period before you start trying for a baby. This can help in giving you time to be in the best of health.

Don’t worry if you get pregnant immediately after stopping the pill. It won’t harm your pregnancy or your baby. This is also true if you get pregnant while still taking the pill.

When should I stop taking the mini pill?

If you're on the mini-pill (progestogen-only pill or POP) you can stop taking it at any time. It's often recommended that you wait until you have at least one normal period before you start trying for a baby.

There will be no harm to your pregnancy or your baby's health if you get pregnant just after coming off the mini pill. It also won't cause any harm if you get pregnant while you're still taking it.

How soon will I be fertile after my implant is removed?

The progesterone in your implant works by stopping your ovaries from ovulating. It thickens your cervical mucus so that sperm can't swim easily in it. These effects can wear off very quickly. You could become pregnant before you get a normal period.

You need to see a doctor or nurse at your surgery or family planning clinic to have your implant removed. Your doctor or nurse will feel around to locate the implant. Then they'll give you an injection of local anaesthetic, before they remove it.

How long will an injection take to get out of my system?

It depends which injection you've had. Each Depo-Provera injection gives you 12 weeks' contraceptive cover. Each Noristerat injection lasts for eight weeks. Once this time is up, it may take a little while for you to become fertile, particularly if your injection was Depo-Provera.

With Noristerat, you could start to ovulate again around the time that you'd be due for your next injection. You're unlikely to get pregnant immediately, though.

Depo-Provera can take at least several months to clear your system enough for you to ovulate.

There have been concerns that conceiving while the Depo-Provera hormones were still in your system could lead to birth defects and low birth weight. Recent studies have not backed this up. There have been no such concerns with Noristerat.

I’ve been using a coil. Will it affect my fertility?

Your normal fertility will return as soon as you have your coil or intrauterine device (IUD) taken out. To have it removed, make an appointment with your family planning clinic or GP.

You may be concerned that using an IUD may have increased your risk of pelvic inflammatory disease (PID). PID can lead to fertility problems if left untreated. It's true that your risk of PID is higher in the few weeks after you've had your IUD fitted.

However, the main risk of PIC is from a pre-existing chlamydia or gonorrhea infection. Before inserting an IUD you will be tested and, if necessary, treated for chlamydia. If your GP thinks there is a chance you may have gonorrhea, you will be tested and treated for this too.

Beyond the first few weeks of having your IUD fitted, your risk of PID is the same as other women not using an IUD. Your risk if PID also depends on your risk of contracting a sexually transmitted infection. Past chlamydia infection is associated with blockages to the fallopian tubes causing infertility, not past IUD use.

How long will the contraceptive patch take to get out of my system?

It can take a few months for your normal menstrual cycle to return when you stop using the contraceptive patch. It's probably easiest to stop at the end of a patch cycle. It’s usually recommended that you start trying to conceive after you've had one normal period. If you stop sooner, and get pregnant straight away, no harm will come to your pregnancy or your baby.

I've been using an intrauterine system. Will it affect how soon I conceive?

Your normal fertility will return soon after you've had your intrauterine system (IUS) taken out. If you're younger than 30, you have about a 90 per cent chance of getting pregnant within the year. To have it removed, make an appointment with your family planning clinic or GP. It can be taken out at any time, and you can start trying for a baby straight away.

The IUS is similar to the IUD in that it could increase the risk of an infection from bacteria already in your body. This is more likely in the first few weeks after you've had it inserted.

The main risk to your fertility, however, is from a pre-existing chlamydia or gonorrhea infection. Before inserting an IUS you will be tested and, if necessary, treated for chlamydia. If your GP thinks there is a chance you may have gonorrhea, you will be tested and treated for this too.

After that it's thought that you have lower risk of infection. This is because the progesterone in your system makes your cervical mucus thicker, stopping infections from getting in. Even so, it's best not to take the risk of contracting a sexually-transmitted infection.

Research has found that past chlamydia infection is associated with blockages to the fallopian tubes causing infertility, not past IUS use.

If I conceive while using a spermicide, will it affect my baby?

If you become pregnant while using a spermicide, either with a diaphragm, cap or condom, there's a very slight chance it may affect your baby. There's thought to be a slightly increased risk of your baby having a heart defect.

The heart defect is a hole between the left and right ventricle, which is treatable. However, we don't know for sure if spermicide causes this defect, or whether it is associated with it for another reason.

Can sterilisation be reversed?

Of all forms of contraception, sterilisation is the hardest to reverse. It is possible to have an operation to try to reverse it, but it is rarely available on the NHS. Arranging a reversal privately can be difficult and expensive.

Reversal can be less successful as you get older. How the sterilisation was done, and the method used to reverse it, can also affect the chances of success. If the sterilisation severely damaged your fallopian tubes, a reversal may not be possible at all.

If you had a clip sterilisation then the odds look better, as nine in 10 women become pregnant after a reversal of this method. A reversal is a major operation and will involve staying in hospital.

If your partner has had a vasectomy this can be reversed too. Success rates vary widely. Some men develop sperm allergy after a reversal. Their body produces antibodies that kill their own sperm. Fertility treatments are needed for their partner to conceive.

courtesy : Internet Source and www.babycentre.com

16 Simptom Semasa Hamil

Tak kira berapa banyak yang kita baca tentang kehamilan, berkongsi pengalaman atau telah hamil sebelum ini sekalipun, adakalanya it's kinda hard to know whether what we've been thru in our nine months of pregnancy is a normal. As for my experience, the first trimester were spent with jogging 2.4km daily. Not to mentioned walking up and down the stairs and memanjat bukit. I can't recall any morning sicknesses or throwing up thing, Alhamdulillah, except being too tired and easily fall asleep (tp rasanya tak pregnant pun mmg jenis senang tidur). 

Few symptoms were listed below but it's might differ, not only among individual but between each pregnancy as well..Just be alert of this few symptom, u might need to have a better check pr consult your gp.

• Have a pain in the middle

Severe or sharp pain in your middle or upper tummy, with or without nausea or vomiting, could mean any of several things. You could have:

• severe indigestion;
• a stomach bug
• food poisoning.

If you’re in the second half of your pregnancy, this pain could indicate pre-eclampsia, a serious condition that requires immediate attention.

• A pain in the lower belly

Severe lower pain on either or both sides or your belly could mean a number of things. You could have pulled a ligament, or it may be a sign of:

• an ectopic pregnancy;
• miscarriage;
• premature labour;
• a fibroid degenerating and bleeding into itself;
• placental abruption, where a part of the placenta becomes detached prematurely from the wall of the womb (the placenta is an organ which develops in the uterus during pregnancy, providing nutrients for the fetus and eliminating its waste products).

• Fever

If have a fever and your temperature is above 37.5 degrees C, but with no flu or cold symptoms, call your doctor on the same day.

If your temperature is more than 39 degrees C, call the doctor right away. You probably have an infection. Your doctor may prescribe antibiotics and rest. If your temperature rises higher than 39 degrees C for a long time, it could be harmful to your baby.

• Blurred visions and seeing flashing spots

Call your doctor if, in the second half of your pregnancy you have:

• double vision
• blurring
• dimming
• flashing spots
• lights that last for more than two hours

These symptoms can be a sign of pre-eclampsia.

• Hands and feet are swollen

Swelling or puffiness (oedema) of the hands, face and eyes is common, and in most cases it is not a cause for concern. But, if these symptoms are severe or sudden, and accompanied by a headache or problems with your vision, they may be symptoms of pre-eclampsia.

• Severe headache that won’t go away

If you have a bad headache that lasts for more than two or three hours, along with vision disturbances and have sudden swelling in your hands, eyes and face, you may have pre-eclampsia.

• Vaginal bleeding

Spotting without pain may be a normal sign of implantation, when the embryo attaches itself to the uterus early in the pregnancy or breakthrough bleeding. But you should still call your doctor if you bleed during pregnancy because it could indicate a serious complication:

• Bleeding that is different from your normal period (heavier or lighter and often darker) with severe, persistent, one-sided pain in the abdomen can be a sign of an ectopic pregnancy.
• Heavy bleeding, especially when it's combined with persistent back or abdominal pain, can be associated with a potential or actual miscarriage.
• In the later stages of pregnancy, bleeding may indicate placenta praevia, placental abruption, or premature labour (labour that begins before 37 weeks).

• Having leaking fluid from vagina

Leaking of fluid from your vagina before 37 weeks means that your membranes have ruptured prematurely. Your doctor will want you to be admitted to hospital, so that you can have treatment to prevent an infection and to prepare your baby for possible premature birth.

After 37 weeks, you are probably about to go into labour. Call your doctor to discuss your options if your labour does not start within 24 hours.

• Sudden feeling extremely thirsty

If you're suddenly thirsty and are weeing less, this could be a sign of dehydration or gestational diabetes. Both of these increase the risk of complications for you and your baby.

• A burning sensation when wee

A painful or burning sensation when you do a wee, along with a fever, shivering and backache, may mean you have a urinary tract infection. See your doctor, as she can give you antibiotics to treat it.

• Can’t stop vomiting

Vomiting more than a couple of times a day could dehydrate and weaken you, although it won't hurt your baby. You need to speak to your doctor about severe and persistent vomiting (hyperemesis gravidarum) as you may need to be admitted to hospital.

Vomiting which starts later in pregnancy, accompanied by pain just below the ribs, may be a sign of pre-eclampsia. Vomiting accompanied by pain and a fever could indicate an infection. Either way, contact your doctor.

• Feeling faint and dizzy

Fainting or feeling light-headed may be a sign that you haven't eaten enough that day, but it could also mean that you have low blood pressure. Many women feel dizzy during pregnancy. If you do faint, see your doctor afterwards to make sure all is well.

• Baby's movements have slowed down

If your baby's movements stop or slow down for more than 24 hours after 21 weeks, it may mean your baby is in distress. If you have noticed that your baby is moving about less than usual, contact your doctor. Read more about your baby's movements, including when to seek help.

• Itch all over

Severe itching may indicate a liver-based condition, such as obstetric cholestasis (OC). If you have OC you may also have jaundice, and pass dark urine and pale stools.

Some itching is normal as your skin stretches to accommodate your growing baby. However, it's best to have it checked out, particularly if the itching is very intense, worse at night and involves the soles of your feet and the palms of your hands.

• Fell and hit my belly

Falls or blows aren't always dangerous, but call your doctor on the same day and explain what happened. If you slipped on the stairs and bruised your tailbone, you probably don't need to worry. Your baby is well cushioned by your uterus and amniotic fluid.

• Just don't feel right

If you're not sure about a symptom, don't feel like yourself, or simply feel uneasy, trust your judgement and call your doctor. If there's a problem, you'll get help right away. If nothing's wrong, you'll go home reassured.

Your doctor expects to get calls like these, and should be happy to give you advice. Your body is changing so rapidly that it's sometimes difficult to know whether what you're experiencing is normal.
In rare cases though, complications may arise. If you notice contractions, leaking fluid, or any bleeding, call your doctor right away, or head to your nearest accident and emergency department.

courtesy : internet source

TIPS : Isteri Hamil Perlu Di Urut

 Sebelum tidur adalah waktu relaks terbaik untuk Si Suami memanjakan Isteri yang sedang hamil. Walaupun dengan hanya urutan yang ringan dan lembut , ianya amat bermakna buat si isteri dan memberi kesan yang baik kepada bayi kelak. Urutan juga adalah sebagai satu cara terima kasih suami terhadap isteri yang mengandungkan zuriatnya.

Perlu diingatkan jangan diurut di bahagian perut dan sekitarnya , memadai dengan urutan di belakang , pinggang ,betis dan kaki.

Tips penting kepada suami, jika isteri mengandung, sewaktu bangun pagi, tanpa diminta atau isteri perlu merengek, cuba urut kaki dan betis mereka.

InsyaAllah, kehidupan seharian akan lebih tenang dan 'terkawal'.

Nota kaki: untuk yang tak mengandung pun boleh juga diamalkan..

courtesy : sumber internet

The Perfect Fan

RAHIM HANYA ADA SATU..TIADA GANTI LAGI..JAGALAH IA SEBAIKNYA......

• Tiada sesiapa memahami sakit senggugut, kecuali wanita.
• Tiada siapa memahami sakit mengandung, kecuali wanita.
• Tiada siapa memahami sakit bersalin, sama ada normal atau ceaser, kecuali wanita.

Adakah pengalaman ini terlalu enteng? Terlalu minimal? Terlalu sedikit? Lalu berhakkah satu2 pihak mengatakan wanita berpantang ini hanya melalui salah satu proses yang BIASA? Tidak perlu dijaga? Tidak perlu dimanja? Tidak perlu berpantang?

"Sekiranya wanita mati dalam masa 40 hari selepas bersalin, dia akan dianggap sebagai mati syahid."
Sungguh tinggi darjat wanita.

Lalu mengapa ada wanita sendiri yang mengabaikan darjat yang disediakan untuknya?
Mengapa ada suami yang dengan senang-lenangnya melayan ibu di dalam pantang seperti hamba?

Jangan hanya kerana sang ibu sudah boleh berjalan, boleh makan, boleh tersenyum, boleh ketawa maka dia dianggap sudah kuat. Sedangkan pertaruhan nyawa mereka dihujung jantung semasa melahirkan dan mengeluarkan anak dalam kandungan. Bagaimana rasanya perut dilapah 7 lapisan, termasuk rahim dihiris, satu persatu demi menzahirkan seorang anak.

Dan kepada wanita. Rahim anda hanya sebesar buah pear. Disitu anda melayan suami saban malam, mengeluarkan darah haid saban bulan, mengeluarkan bayi saban tahun. Sebiji buah pear, mengeluarkan seorang manusia?

Lalu, jika dapat difikir menggunakan akal, jika dapat dihisab menggunakan fikiran, betapa tenatkah rahim anda sekarang? Atau akan datang?

Maka, sayangilah rahim anda. Janganlah ditenatkan lagi rahim yang sudah bekerja keras setiap detik untuk anda. Berpantanglah.

Dan untuk suami yang menganggap ini semua perkara enteng. Bukan sesuatu yang enteng melahirkan anak yang tak tahu mengenang pengorbanan rahim seorang wanita, iaitu rahim ibu2 kalian. Jika tiadapun perasaan malu, sekurang2nya adalah sedikit perasaan kesian. Jika anda masih layak bergelar suami.

Ada sebab mengapa syurga di bawah tapak si pemilik rahim.

Hi all,

Inviting all of my relatives and friends whom are mothers, mother-to-be, not yet a mother and all women to celebrate International Women Day with a great activities. Come and explore a new world or gain more knowledge! It's worth to attend and great loss to miss it!

Happening on March 9 2013 (Saturday) from 1000-1900 in Grand Season Hotel, Jalan Pahang. Get more info from the poster attached.

courtesy : The Gentle Birthing Group Malaysia, Susuibu.com and few other organizer.

Laksa Oh Laksa

Pertanyaan paling kerap ditanya oleh ibu-ibu mengandung and ibu-ibu lepas bersalin. Kenapa LAKSA sejuk? Saya cuba tanya Aunty Google about this. Ada juga alasan kerana bunga knatan ini sejuk dan bisa so takut kembang atau anak mungkin atau kembung. Semasa dalam pantang (untuk sesetangah org la) ikan pun kena pilih jugak sebab ada juga ikan yang dipanggil ikan bisa yang boleh menyebabkan gatal or bisa. And ada juga kupasan mengenai pembuatan laksa itu sendiri.

Selain laksa, bihun juga adalah tergolong dalam kategori keluarga yang sama. Cuba kita tengok cara pembuatan laksa dan bihun ni.

Kedua-duanya diperbuat dari beras, ok la kan.. Kemudian, ianya  dimasak,dilenyek dan dibentuk menjadi laksa dan bihun. Ini pun proses biasa dan tidak mengundang masalah. Seterusnya laksa dan bihun ni dibiarkan kering which is still fine. Tapi bila kita nak consume as bihun/laksa, laksa dan bihun ni dimasak/direbus/direndam semula dalam kuah laksa/sup atau digoreng jadi bihun goreng. This is the part yang memberikan kemudaratan kepada ibu-ibu lepas bersalin / kepada mereka yang tidak kuat badan menahan angin. Bukan ibu lepas bersalin jer yang boleh angin, kadang2 anak dara yang tidak menjaga makan pun boleh mengalaminya.

Kenapa apabila bihun/laksa ini dimasak kali kedua menyebabkan pemakan mudah masuk angin? Sebab laksa dan bihun ni dah jadi seperti "nasi sejuk", dimasak 2 kali. So kandungan angin ketika masak kali kedua sungguh TINGGI. kalau tak percaya, cuba makan nasi sejuk yang dipanaskan banyak kali masa pantang. 

Ada org akan cakap..."Saya makan bihun and laksa...xde apa pun..." Jawapannya, "Alhamdulillah badan awak Allah jadikan kuat. Kalau jenis badan yang tak kuat? (Kebiasaannya badan ibu lepas pantang mmg masih lemah)." So, setiap orang lain penerimaan badannya, jangan bergantung pada hearsay semata. Teringat arwah opah saya, sangat pantang dari makan makanan dimasak dua kali (terutamanya nasi goreng) sebab ia juga kurang baik untuk mereka yang menghafal Al-Quran, wallah 'alam, sebab saya hanya hafal few surah tapi arwah opah memang hafal keseluruhan. (Ya Allah, moga dipermudahkan urusan hambaMu ini)

So, bagi saya, berpantang biarlah berlebih, jangan berkurang. Badan yang masuk angin ni lama2 akan sakit2 badan. Bila badan dah tak sihat, ganggu hormon n emosi, mula la asyik nak marah2, anak nangis lebih sikit kena tengking. Anak dah kena tengking, suami tegur. Suami dah tegur, kita lak sakit hati...bla...bla..bla...(panjang woo jalan cerita).Kesan mungkin bukan on the dot after u've eaten laksa, mungkin bertahun, mungkin bila dah tua. Pesan nenek n ibu saya, badan kita ni nak pakai lama hence how I pantang is quite extraordinary. Betul, kita sekarang dah maju, moden and banyak ubatan namun setiap perkara di dunia ni ada pros n cons. Same goes to petua2 and medicine.

courtesy : Facebook group Kami Ibu Berpantang

..::Understanding Your Uterus::..

By Teri Brown
Chances are you've already met your uterus in one form or another. Usually, it isn't a pleasant experience. It comes in the form of your period or painful cramps. Most of the time, the only occasion we really pay attention to our uterus is when we are trying to get, or have already gotten, pregnant.

Size of a Uterus
Dr. Deborah Wilson, an OB-GYN in Scottsdale, Arizona, says though the exact size of the uterus varies from woman to woman, it generally falls within a certain range. "The uterus is tiny when a girl is born, not much larger than an adult thumb," says Dr. Wilson. "Women who have never been pregnant generally have smaller uteri than women who have been pregnant. A normal uterus can weigh as little as 30 grams (.06 pounds) and as much as 100 grams (0.22 pounds).

What Is the Uterus Made Of?
According to Dr. Wilson, the uterus is made of smooth muscle lined with glands. The smooth muscle is designed to contract during labor, orgasm, and menstruation. "The glands grow thicker during the month with the stimulation of ovarian hormones and finally shed off during the menstrual cycle if no pregnancy occurs," says Dr. Wilson. "The cervix is the portion of the uterus that extends into the vagina. It is made of fibro-muscular tissue and is designed to dilate in order to allow the baby to exit the uterus."

The Function of the Uterus
Dr. Danne Young-Hawkins from Total Concept Healthcare in Logan, Utah, says the uterus is not only where babies grow, but it has other important roles as well. "It also plays a role in blood flow to the ovaries, support of the vagina, bladder, and rectum and, for some women, can be important for normal sexual function," says Dr. Young. "For instance, some women at risk of premature labor are asked to be careful about intercourse because the contractions of orgasm can trigger contractions. Those contractions can be an important part of a woman's sexual experience when she isn't pregnant as well."
The uterus has a lining that thickens up in response to hormones produced by the ovaries. If pregnancy doesn't occur, then one of the hormones that prepares the lining for a growing baby will also help the lining come off, which results in a period. "When a woman becomes pregnant, blood flow increases to the uterus and the uterus increases in size, continuing to enlarge with the baby," says Dr. Young. "After the baby is born, the uterine muscle fibers start to contract, and over the course of eight to 10 weeks it shrinks back to just a little bigger than it was before she got pregnant."
Think of the uterus as a baby incubator. It expands to accommodate the baby and also works with the placenta to supply the baby with nutrients. When it's time for the baby to be born, the uterus contracts to expel the baby and the placenta. It then shrinks back down and gets ready to start the whole cycle again.

Problems with the Uterus
"One of the most common problems that a woman has with her uterus is excessive bleeding," says Dr. Young. "A lot of women have to use a pad and a tampon every couple of hours lasting for days. For many women, their periods keep them from living a normal life."
Women can have problems with weakness of vaginal tissue, which causes other problems such as bladder leakage, the feeling that something is falling out, pressure in the vagina, and even problems with sex. "Another problem is pelvic pain that can be caused by infection, growths like fibroids or ovarian tumors, diseases like endometriosis, and/or pain from nearby organs like the bowel or bladder," says Dr. Young.
A uterus can also develop hyperplasia, which is the thickening and crowding of the lining cells. According to Dr. Wilson, this can cause heavy or irregular bleeding and generally occurs in women who are in their 40s and 50s. If not treated, hyperplasia can develop into cancer of the uterine lining. This is called endometrial carcinoma and can often be cured if caught early. Cancer of the uterine muscle is called leiomyosarcoma and is a very deadly cancer, although rare.

4 Tips for a Healthy Uterus
Dr. Wilson gives the following tips for keeping your uterus healthy:
  i) Regular physician visits are essential. A pap smear is done to check for abnormal cells on the cervix. An internal exam is done to check for abnormalities of the uterus such as fibroid tumors or cancer of the uterus.
  ii) Report any abnormal bleeding to your doctor. Abnormally heavy or irregular bleeding is often the first sign that a woman is developing fibroid tumors, adenomyosis, or hyperplasia.
 iii) Report any pain to your doctor. Fibroid tumors can affect up to 50 percent of women and, although they are generally benign, can cause serious bleeding and pain. Fibroids can affect women of any age but are most common in the 30s and 40s. We do not know what causes fibroids, but they tend to run in families. If your mother and sisters had fibroids, you are likely to have them also.
   iv) Uterine cancer occurs more frequently in women who are overweight. A low-fat diet and exercise are your best bet in preventing cancer of the uterus.

..::Pregnancy Symptoms You Should Never Ignore::..

No matter how much you read about pregnancy or talk to other mums, it can be hard to know whether what you're feeling during your nine months is normal. Here's a rundown of symptoms that should set off your warning bells. If you have any of these problems, call your doctor straight away.

You just don't feel right
If you're not sure about a symptom, don't feel like yourself, or simply feel uneasy, trust your judgement and call your doctor. If there's a problem, you'll get help right away. If nothing's wrong, you'll go home reassured.
Your doctor expects to get calls like these, and should be happy to give you advice. Your body is changing so rapidly that it's sometimes difficult to know whether what you're experiencing is normal.

Pain in your middle
Severe or sharp pain in your middle or upper tummy, with or without nausea or vomiting, could mean any of several things. It could be:

• severe indigestion;
• a stomach bug;
• food poisoning.

But it could also be pre-eclampsia, a serious condition that requires immediate attention.

Pain in your lower belly
Severe lower pain on either or both sides or your belly could mean a number of things. You could have pulled a ligament, or it may be a sign of:

• an ectopic pregnancy;
• miscarriage;
• premature labour;
• a fibroid degenerating and bleeding into itself;
• placental abruption.

Fever
If have a fever and your temperature is above 37.5 degrees C, but with no flu or cold symptoms, call your doctor on the same day.
If your temperature is more than 39 degrees C, call the doctor straight away. You probably have an infection. Your doctor may prescribe antibiotics and rest. If your temperature rises higher than 39 degrees C for a prolonged amount of time it could be harmful to your baby.

Vision disturbances
If you have double vision, blurring, dimming, flashing spots or lights that last for more than two hours call your doctor. These symptoms can be a sign of pre-eclampsia.

Swelling in your hands and feet
Swelling or puffiness (oedema) of the hands, face and eyes is common, and in most cases it is not a cause for concern. But, if these symptoms are severe or sudden, and accompanied by a headache or problems with your vision, they may be symptoms of pre-eclampsia.

Severe headache that lasts
If you have a bad headache that lasts for more than two or three hours, along with vision disturbances and have sudden swelling in your hands, eyes and face, you may have pre-eclampsia.

Light or heavy vaginal bleeding
Spotting without pain may be a normal sign of implantation, when the embryo attaches itself to the uterus early in the pregnancy or breakthrough bleeding. But you should still call your doctor if you bleed during pregnancy because it could indicate a serious complication:
• Bleeding that is different from your normal period (heavier or lighter and often darker) with severe, persistent, one-sided pain in the abdomen can be a sign of an ectopic pregnancy.
• Heavy bleeding, especially when it's combined with persistent back or abdominal pain, can be associated with a potential or actual miscarriage.
• In the later stages of pregnancy, bleeding may indicate placenta praevia, placental abruption, which happens when the placenta starts to separate from the wall of the uterus, or premature labour (labour that begins before 37 weeks).

Leaking fluid from your vagina
Leaking of fluid from your vagina before 37 weeks means that your membranes have ruptured prematurely. Your doctor will want you to be admitted to hospital, so that you can have treatment to prevent an infection and to prepare your baby for possible premature birth.
After 37 weeks, you are probably about to go into labour. Call your doctor to discuss your options if your labour does not start within 24 hours.

Sudden increase in thirst
If you're suddenly thirsty and are weeing less, this could be a sign of dehydration or gestational diabetes. Both of these increase the risk of complications for you and your baby.

Burning sensation when you wee
A painful or burning sensation when you do a wee, along with a temperature, shivering and backache, may mean you have a urinary tract infection. See your doctor, as she can give you antibiotics to treat it.

Severe vomiting
Vomiting more than a couple of times a day could dehydrate and weaken you, although it won't hurt your baby. You need to speak to your doctor about severe and persistent vomiting (hyperemesis gravidarum) as you may need to be admitted to hospital.
Vomiting which starts later in pregnancy, accompanied by pain just below the ribs, may be a sign of pre-eclampsia. Vomiting accompanied by pain and a temperature could indicate an infection. Either way, contact your doctor.

Fainting or dizziness
Fainting or feeling light-headed may be a sign that you haven't eaten enough that day, but it could also mean that you have low blood pressure. Many women feel dizzy during pregnancy. If you do faint, see your doctor afterwards to make sure all is well.

Slowing down of your baby's movements
Absence of, or slowing down of your baby's movements for more than 24 hours after 21 weeks may mean your baby is in distress. If you have noticed that your baby is moving about less than usual, contact your doctor.

All-over itching late in pregnancy
These symptoms may indicate a liver-based condition, such as obstetric cholestasis (OC). If you have OC you may also have jaundice, and pass dark urine and pale stools.
Some itching is normal as your skin stretches to accommodate your growing baby. However, it's best to have it checked out, particularly if the itching is very intense, worse at night and involves the soles of your feet and the palms of your hands.

A fall or a blow to your belly
Falls or blows aren't always dangerous, but call your doctor on the same day and explain what happened. If you slipped on the stairs and bruised your tailbone, you probably don't need to worry. Your baby is well cushioned by your uterus and amniotic fluid.
In rare cases though, complications may arise. If you notice contractions, leaking fluid, or any bleeding, call your doctor right away, or head to your nearest accident and emergency department.

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

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.

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 3^rd 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.

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.