Child birth labour

Nine months of weird cravings, swollen breasts, squished lungs and no waistline leads up to the inevitable climatic point of pregnancy; labour. There are many rumours, myths and old wives tales that might make you feel unsettled, unprepared and downright terrified of this time-honoured rite of passage to motherhood.

Knowing what happens during labour and delivery can help relieve any fear or anxiety. Huggies has collected the following information, hints and tips to help prepare you for what is probably the most momentous event in your life.

PREPARING FOR LABOUR

Your big day is looming and it’s most likely going to be a roller coaster ride – scary and exciting all at the same time. One of the best ways you can ensure your labour is successful is proper preparation. You need to decide on several things in regard to your labour, including whether you will have a home birth or a birth in a hospital. Many hospitals give you a choice of going into a labour ward or a birthing centre. Birthing centres are usually for ‘natural’ births requiring no intervention and where the mother doesn’t want an epidural. Some have baths for water births.

If you do have a home birth, you will need to arrange a midwife. You may go into labour before or after your due date so it’s a good idea to start preparing a few weeks before your due date. You should get a hospital bag ready; this bag should be prepped way ahead of time. Some hospitals are a little pedantic about what you are and aren’t allowed into the hospital so it might be a good idea to check beforehand.

You should also ensure you have a car seat fitted for your little one’s journey home as well as nappies and baby clothes so your tot is comfortable and warm. It is a great idea to do a labour test run, where you get everything together and make a trip to the hospital. Many women are unsure about when labour actually starts, there are a couple of warning signs that signal the imminent onset of labour, but these signs can differ between women. Check out these signs and indicators in the signs of labour page so you are aware of what to look for. You should also understand that there are some different indicators for a premature birth, all these signs and symptoms are covered in Premature Birth: Signs and treatment of pre-term labour.

Labour can last a long time, and if you are relaxed about it, you should try to stay at home for as long as possible. If your contractions are arriving with 5 minutes intervals or less, if your water breaks, or you are bleeding, then it is a good time to make your way to the hospital. You should also have a reliable birth partner available to help you through the labour process. Here are the qualities and responsibilities that you should look for in a birth partner.

STAGES OF LABOUR

There are three distinct stages of labour, all with their own unique qualities and characteristics. Your first stage of labour is characterised by dilation of your cervix brought on by contractions. Your contractions will change from a dull cramp feeling into rhythmically occurring pain that comes at regular intervals. Due to this your cervix will become softer and more stretchy during its preparation for the baby. You should try to relax as much as possible and settle into a position that is comfortable for you. You should also go to the bathroom as often as possible to make sure your bladder is empty.

The second stage of labour is when your cervix is fully dilated, you push your baby down the birth canal and this stage ends with the birth. It helps to get into an upright position so that gravity can help the birth process. Don’t forget to breathe either! If you have had an epidural and can’t feel much, you need to listen carefully for instructions from your doctor or midwife.

Did you know that you are still in labour even after your baby is born? This is known as the third stage of labour. Your contractions might stop for a bit, giving you some false hope, but will start up again so that the placenta can be delivered (although they won’t be anywhere near as intense as your contraction from the first two stages). Some hospitals can give you an injection to nudge the placenta out of your body making the process easier for you. After you have ‘delivered’ the placenta, your midwife or doctor will check that everything is ok and that will pretty much be the end of your labour. Huggies has more detailed information on each stage of labour, so explore and get all the information to put your mind at ease

Taking Folic Acid Before You Get Pregnant

Research shows that women who take vitamins

 that contain folic acid may lower the risk

 that their baby will be born with a birth 

defect called a neural tube defect. Between 2

 and 4 babies of every 1000 babies born in 

Canada have neural tube defects.

What is a neural tube defect ?

A neural tube defect happens when something interferes with the way the baby grows before he or she is born. The two most common conditions in which neural tube defects occur are spina bifida and anencephaly. These conditions may be prevented if women take enough folic acid before and while they are pregnant. Spina bifida happens when the spine does not develop normally. Anencephaly happens when the skull and the brain do not develop normally.

What is folic acid ?

Folic acid is a vitamin. Folic acid, also called folate or folacin, is found in some vitamin pills.

How do you make sure you get enough folic acid ?

All women should take vitamins that contains folic acid before they get pregnant. You can get some folic acid from eating some foods. But it is hard to get enough folic acid from your diet. It is better to take vitamins that contain folic acid.

Examples of foods that have a large amount of folic acid are:

• grains such as whole-wheat bread.
• dark green vegetables such as spinach and broccoli.
• meat such as liver.
• beans such as lentils and kidney beans.

Why take folic acid before you get pregnant ?

Neural tube defects occur 25 to 29 days after a woman gets pregnant. At that time, many women are not even aware that they are pregnant.

Because these defects form so early, you should begin taking vitamins that contain folic acid before you get pregnant. Begin taking folic acid when you stop using birth control.

Women need more folic acid during pregnancy and breastfeeding than they do normally. So you should continue taking folic acid all the time that you are pregnant.

How much folic acid should you take ?


The Society of Obstetricians and Gynaecologists of Canada (SOGC) and the Motherisk Program jointly released updated clinical guidelines in December, 2007, based on new research about the benefits of folic acid supplementation for women planning to have children. The guidelines were published in The Journal of Obstetrics and Gynaecology Canada (JOGC) which is Canada's peer-reviewed journal of obstetrics, gynaecology, and 
women's health.

The guidelines highlight more current research and clinical trials that further demonstrate the positive, preventative benefit of increasing the level of folic acid intake, along with a multivitamin, at least three months prior to conception. This research concludes that an increase in folic acid supplementation can dramatically reduce birth defects such as neural tube defects (e.g. spina bifida), and possibly other birth abnormalities such as congenital heart disease, urinary tract problems, oral facial clefts, limb defects, and some pediatric cancers.

Folic acid helps produce and maintain new cells, and is important during the early embryonic and fetal periods when rapid cell division and growth are occurring. The authors of the guideline estimate that the incidence of some birth defects could be cut in half if women of childbearing age consumed an adequate amount of folic acid, either by eating sufficient quantities of food fortified with folic acid or by taking vitamin supplements.

It is estimated that at least 5% of babies are born with some serious congenital abnormality, while another 2% to 3% have defects that can be recognized prenatally (e.g. by non-invasive screening test, through invasive diagnostic testing, or at birth) and 2% will have developmental or functional anomalies recognized during the first year of life. Due to prenatal screening and awareness programming about folic acid supplementation, the birth prevalence of neural tube defects has declined in Canada from a rate of ten per 10,000 live births in 1991 to 5.8 per 10,000 total births (live births and stillbirths) in 1999. The multidisciplinary panel that authored the guidelines suggests that adherence to new standards of folic acid supplementation could accelerate these improving rates dramatically.

Specifically, the clinical guidelines recommend that:

Women with no personal health risks, planned pregnancy, and good compliance require a good diet of folate-rich foods and daily supplementation with a multivitamin with folic acid (0.4-1.0 mg) for at least two to three months before conception and throughout pregnancy and the postpartum period (4-6 weeks and as long as breastfeeding continues).

Women with compromised health or particular health conditions such as insulin dependent diabetes, obesity, or those with a previous child in the family with a neural tube defect require increased dietary intake of folate-rich foods and daily supplementation, with multivitamins with 5 mg folic acid, beginning at least three months before conception and continuing until 10 to 12 weeks post conception. From 12 weeks post-conception and continuing throughout pregnancy and for four to six weeks after the baby is born (or as long as breastfeeding continues), supplementation should consist of a multivitamin with folic acid (0.4-1.0 mg).

Extra efforts need to be made to counsel more vulnerable women (e.g. those with a variable diet, no consistent birth control, and possible substance use) about the prevention of birth defects and health problems via folic acid and multivitamin supplementation. It is recommended that they also receive a higher dose of folic acid (5 mg) with multivitamin

All women who plan to have children are advised to start their folic acid supplementation as early as three months before they conceive.

Women taking a multivitamin containing folic acid should not take more than one daily dose of vitamin supplement, as indicated on the product label.

The federal government should consider increasing the fortification of flour with folic acid to 300 mg/100 g from the current level of 140 mg/100 g and additional fortification with multivitamins. Since 1998, there has been mandatory folic acid fortification of white flour, enriched pasta, and cornmeal in Canada.

Women of childbearing age are advised to maintain a healthy diet, as recommended in Eating Well With Canada's Food Guide (Health Canada), in addition to folic acid and multi-vitamin supplementation. Foods containing excellent to good sources of folic acid are fortified grains, spinach, lentils, chick peas, asparagus, broccoli, peas, Brussels sprouts, corn, and oranges. (NB: Despite this dietary advice, it is unlikely that diet alone can provide the levels recommended for those planning to have children.)

Health professionals such as physicians, gynaecologists, obstetricians, mid-wives and public health officials should increase their efforts to make women aware of the new facts about folic acid supplementation during the normal course of their interaction with women seeking health services such as a PAP test, an annual exam or the renewal of birth control prescriptions.

Are there tests for neural tube defects ?

All women can have either a blood test or an ultrasound to test for neural tube defects when they are 3 to 6 months pregnant. (An ultrasound takes a picture of the baby while the baby is still inside the mother).

Discuss which test you should have with your doctor. These tests will not harm your baby. Your doctor will know from the tests whether your baby has a neural tube defect.

Where can you get more information ?

Talk to your doctor about taking folic acid before you get pregnant. You can also visit www.sogc.org for more information about the new folic acid guidelines. Spina bifida and other conditions caused by neural tube defects can be prevented. Give you baby a healthy start on life.