It’s difficult to sometimes get our clients to understand that labor is a natural process.

You only need to be #guided

Your body will do the work

A typical example from a client..

” Midwife… Give  me some medicine so baby will come fast

Push my tummy. Give me fundal pressure…”

Hmmm.. Labor has stages you will go through

It takes time. You don’t need to intervene unnecessarily. It can lead to further complications

You need to prepare from day 1 when you are pregnant

1.Learn how to ease your labor

2.How to cooperate with your midwife

3. Don’t push your midwife to intervene when its not needed

4. Educate yourself about birth before you get there

Ask all the questions you don’t understand before labor sets in.

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The leading cause of maternal deaths during delivery is hemorrhage (Bleeding)

It’s important that women do well to keep their blood levels high above 11g/dl HB. During pregnancy before labor sets in

Also make sure you choose a hospital ready for emergencies

In case you need a transfusion there should be a blood bank and blood products available

In case you need an emergency obstetric care when bleeding occurs  items should be available

Medication to stop bleeding should also be available

If you need a referral, there should be an ambulance and it should be available

Feel free to ask all these from your facility

It’s your life!

There is no second life!

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During labor, it is expected that your baby’s head drops and also cervix dilates as contraction goes on.

A full bladder can hinder the cervix from dilating . If you cannot get up and urinate due to pain and discomfort a folley’s catheter will be inserted to empty your bladder.

During a cesarean section your bladder has to be empty to also prevent possible Injury during the procedure. A folley’s catheter will be inserted

It may be used to drain the urine and removed immediately or retained until the procedure is done or completed.

A full bladder can prevent the uterus from contracting after birth and this can cause bleeding.

Cooperate with your doctor or midwife during the process of catheterization.

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Having severe pains doesn’t mean you should push the baby out! 

When labor sets in you get strong contractions which can be felt on your abdomen, it becomes hard and comes with pain and back ache. These contractions help the opening of the uterus (cervix) to open.  It opens gradually and with time. The stronger, longer and closer the contractions are, the likelihood of the cervix opening also increases.

Vaginal examination is done four hourly to determine the dilatation which is measured  in centimeters. From 1cm to 10cm. It takes on average an hour for each cm dilation. At 10 the cervix will be fully taken up and the baby can be born peacefully. Pushing before the cervix is fully dilated can cause cervical tear which is difficult to repair.

In new mums labor lasts longer than women who have already delivered. 

In some cases contractions can be adequate but cervix dilatation may not correspond. It leads to prolonged labor or fetal distress. Other measures are put in place to hasten birth or an emergency cesarean section is done.

Remember to stay hydrated and Cooperate with your midwife. Do not push through an undilated cervix. Communicate with your midwife throughout the process.

Lets help you prepare well for your pregnancy and birth

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EPISIOTOMY is a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician.

 Episiotomy is usually performed during the second stage of labor when the baby’s head is crowned  to quickly enlarge the opening for the baby to pass through.

It’s done so baby can quickly be delivered and also to prevent tears that can be difficult to repair

The midwife during labor will assess the need for it. If the perineum is not stretching enough and she anticipates it can cause a tear or delay in the birthing process she may decide to give an episiotomy after seeking your consent

Some other conditions that may necessitate an episiotomy include… Big baby,vacuum or force delivery , breech birth, prolonged birth, premature birth etc

It’s not a routine. Many women do not need an episiotomy.  Preparing your perineum can also help in reducing the need for it.

Self care after an episiotomy is also a necessity for proper healing !

Ask you midwife or doctor about it

 What has been your experience about it?

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🔴Have you ever wondered how you survived 9 months in your mums womb!

🔴Thanks to this magical organ which forms when a woman gets pregnant.

🔴It serves as a connection between mum and baby.

🔴It has three parts, the maternal surface that attaches to the mothers womb, the fetal surface which faces the baby and the cord which contains a vein and two arteries that transport oxygen, nutrients and other needed substances.

🔴The placenta during pregnancy attaches to the upper part of the uterus. It produces hormones that help to maintain pregnancy.

🔴The placenta at a point during pregnancy, when baby is fully matured may stop functioning efficiently. It is important that all pregnant women do not allow their pregnancy to go beyond 42 weeks gestation. At 41 weeks you and your doctor should decide the mode of delivery if labor has still not set in.

🔴It can also have problems like placenta previa where placenta, is not in the right location. It can cause problems, but can be managed

🔴After delivery placenta is birthed. A retained placenta or portion remaining after delivery can cause bleeding. Report to the hospital immediately you have severe bleeding after delivery.

🔴After delivery, some cultures have different ways of handling it. If requested, it will be given to you under hygienic conditions. You decide what to do with it as your culture permits.

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🔴During pregnancy the baby is surrounded by fluid/water which is called #liquor. It protects the baby in utero.

🔴#Meconium is the first stool of the baby and it is also greenish in color

🔴In utero a healthy baby will not poo into the liqour that surrounds it.

🔴Several factors can cause your baby to go into distress in utero. Once your baby does not get enough oxygen in utero, with time if no intervention is given. The anal sphincter muscles and the other sphincter muscles of the baby will relax.

🔴Baby will start to poo into the amniotic fluid, and also aspirate. Meconium liqour can also get into the respiratory system. It gives the liqour that greenish color

🔴If your waters break and the liqour is greenish in color it shows that your baby may be deprived of oxygen and is struggling to survive. Delivery has to be as soon as possible to prevent further complications.

🔴The more greenish or thick the liqour is the worse the complications can be.

🔴Always cooperate with your midwife or doctor to expedite delivery. The earlier the baby is delivered the better complications are reduced.

In some cases an emergency Cesarean section can be done to save the baby. Other investigations will be done to ascertain whether the baby Is really in distress or not.

🔴If you get into labor pay attention to the liqour around the baby, if it’s greenish in color immediately alert the medical staff or report immediately to the hospital.

🔴Once baby is born, they may need additional care at the neonatal intensive care unit or help with breathing.

🔴Midwives are always be ready to resuscitate newborns that need help with breathing.

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A vacuum extraction, also known as vacuum-assisted delivery, is used to help move the baby through the birth canal during delivery when a mom’s labor has stalled.

How it is performed – A soft or rigid cup with a handle and a vacuum pump is attached to the baby’s head to help guide the baby out of the birth canal. This is typically done during a contraction while the mother pushes.

An episiotomy may be done to hasten the procedure

It’s usually done when the mum is in the second stage of labor but too tired to push, prolonged labor or when it’s considered risky for the mum to push. When the baby is in distress it can also be used to hasten labor

During the procedure you will be given some pain medication or epidural to reduce the pain

Vacuum delivery comes with its risk and therefore has to be done by skilled person when all other conditions in the mum and baby allows that

If the vacuum fails a cesarean section will immediately be done.

Cooperate with your midwife or doctor for the best results

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Some people will tell you, if you are pregnant wait a little or hide it till you are 3 to 4 months. Don’t let people know. Start antenatal late so by the time people realize you have given birth. Hmmmmm…. what a risk you are taking

As much as you want to  wait in announcing your pregnancy, do it with wisdom and caution! Assuming you do a home pregnancy test and it’s positive so you feel secured and think all is well.

No, never!…… There are other conditions that can as well make it read positive. If it is in the fallopian tube it will still be positive. If you don’t report early it can rapture and become life threatening. That’s why you need an early scan to confirm pregnancy.

Taking an early scan will as well help to determine the expected date of delivery which is more reliable if taken early.

There are many other conditions that can make pregnancy tests positive, for example blighted ovum, molar pregnancy etc.

Reporting early for other investigations and starting your prenatal medications can as well prevent complications.

Once you miss your period, report to the hospital or clinic and your doctor will request for an early scan to confirm pregnancy. Then you can start antenatal immediately.

Wondering what happened in the olden days without scan? …. Complications were higher. It’s better than it used to be. Let’s embrace new and modern ways of improving maternal health.

No point waiting to get a ruptured ectopic when an early scan could have prevented that.

If you also took an emergency contraceptive and you missed your period or had scanty flow. Kindly report it for further investigations.

A pregnancy test /scan will be done to rule out ectopic and other conditions

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