THE GOLDEN MINUTE- NEONATAL RESUSCITATION

This refers to the first minute a baby is born into the world.

Once a baby is born a quick assessment is done to ascertain the health of the baby. It is known as “APGAR SCORE”

It involves assessing a baby’s appearance , pulse, grimace, activity and respiration. A score of 0 to 10 is given.

If a baby has a low apgar or problem with respiration, activity or any of these vital signs, resuscitation is immediately started within the first minute.

Resuscitation can be as simply cleaning and stimulating the baby to using advanced methods to help baby breath. The lower the apgar the more advanced methods will be needed.

The earlier it is started the better. Delaying in initiating resuscitation can result in complications to the neonate, even brain damage.

It’s important that before the baby is born the midwife prepares for resuscitation, regardless of the situation

It can be traumatic to both mum, baby and the medical team when baby is born needs some form of resuscitation and items are not available

In choosing your hospital this is one thing you should consider. How ready is the hospital for neonatal resuscitation? How skilled is the team to provide this if need be.

Resuscitation saves the lives of babies and very effective if initiated in the first minute

Neonatal resuscitation involves methods and techniques used to help your baby breath

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LET’S FIGHT PRE ECLAMPSIA AND ECLAMPSIA.

Pre eclampsia is one of the leading causes of maternal death in Ghana as we speak. Claiming the lives of young women and their babies. But we can do something about it. Every pregnant woman should know this and stay alert. The earlier it is detected the better it can be prevented and controlled.

High BP above (130/90mmhg) during pregnancy is not safe… It’s not a friend of pregnancy. You may feel well but it will be causing more problems there.

Other signs you may notice.

🔴Severe headache

🔴Swollen hands and feet

🔴Epigastric pain

🔴Protein in urine

🔴Severe abdominal pains may also occur

🔴Dizziness/palpitations

🔴In severe cases you begin to feel nauseated start  to vomit

If not controlled well you may start to fit like an epileptic fit which is more severe with poorer outcomes.

If diagnosed with preeclampsia…

✔️Always take your prescribed antihypertensive and medications

✔️Report early when you have signs listed above

✔️Plan your birth with your doctor or midwife

✔️Healthy lifestyle, eat nutritious meals exercise and learn to rest between your activities

✔️Cooperating with your health care provider and following a treatment regime will go a long way to bring the best outcome of your pregnancy. Thanks.

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CAN I JUST TELL MY DOCTOR I WANT A CESAREAN SECTION TO AVOID VAGINAL BIRTH?

Lots of new mums have heard so much about birth.

There are lots of stories that make them fear the thought of giving birth vaginally.

Then the way out to them is to just have a cesarean section so they avoid all the issues that come with vaginal birth

The fact is just like vaginal birth comes with some risk, cesarean section also comes with its risk as well.

It is a procedure that was made to help mums who have issues or indications for it

Example

🔴Baby is too big

🔴There is fetal distress

🔴Baby can’t pass through mums pelvis

🔴Placenta previa

🔴Previous c/s+ short interval

🔴Prolonged labor

🔴Bad obstetric history etc

It’s not the best to just ask for a cesarean section without any indication or proper reason

Speak to your midwife or doctor. Make a proper birth plan that suits your condition. It should not be based on your fear or what people have said about birth

You can approach birth more confidently by preparing for it.

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KEY THINGS TO PAY ATTENTION TO DURING PREGNANCY!

Some information about your pregnancy should be at your finger tips
You should ask your midwife or doctor whether these specific things are within normal and what you can do
After reading take your antenatal book and check
Its not enough if you are just told all is ok!
Your blood pressure (BP)
Your Haemoglobin level (HB)
Your expected date of delivery (EDD)
Your placenta location
Your specific health condition, example previous c/s, diabetes, fibroids etc
Sickling status
Your weight gain
Add yours
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MY BIRTH STORY – AFTER 5 YEARS OF TRYING

For 5 years of trying to get pregnant, hallelujah the test  came Positive… The regular waist and abdominal pains were the only thing I could experience… MS always says, you are what you eat which I find this statement funny but true… Eating healthy, taking my prescribed drugs, going for AnC and exercising were what I’m proud of doing throughout this journey…

So at 39 weeks, the Doctor told me to add sex to the routine since I’m a 1st time Mom nanso Chairman says my tummy always scare him nti no sex🤣🤣. I could cry nyinaaa nanso no show…

Fast forward at 40 weeks 2 days with EDD as 1st April🤣🤣 and still strong with no labor signs, Doctor and Midwives advised me to be admitted on Sunday 4th April so i will be induced Monday Morning… 1st drug under my tongue was given at 5:35am eeiii Sister still with smiley face and no show hmmm… 2nd drug was given at 11am and still nothing oo..

Honestly all the vim tear my eyes eeii but still I was reciting my  Rosary, reading and meditating on Psalm 23, Psalm 121 and Isaiah 41:10… At 4pm, the 3rd dosage was given and after 30 mins chaaaiiiiii come see pains😭😢😭… They checked and I’ve dilated 4cm with pains eeii🤣🤣

… Around 5:30, I was checked and it was now 8cm and the pains were now abnormal😭😭 6pm and I was 10cm dilated and could feel the baby  coming… I was taken to the delivery ward and after some few pushes, the baby was out at exactly 6:30pm with weight 3.0😍…….. Nyame nhyira everybody for the love, advice, support and prayers🙏🏽😍🥰❤️…. May we all have a successful delivery😘

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HOW A COMMON HEADACHE DURING PREGNANCY RESULTED IN FITS (PRE ECLAMPSIA ALERT)

She started to experience headaches during pregnancy. She was told its a normal part of pregnancy by her neighbors. They encouraged her to take some paracetamol and that it will go away.

Days passed and it was still persist. One morning she decided to walk to the pharmacy to buy paracetamol. On her way she fell to the ground and thats all she remembered. She opened her eyes on the hospital bed when an emergency cesarean section had been done to save her life and that of the baby who was preterm.

She was told exactly what happened when she fell by a relative. She fitted. And was rushed to the nearest hospital for care. It was “Eclampsia”. On arrival to the hospital her blood pressure was very high and urine protein was +++3. This were indications that she had high bp which was causing the headaches but due to lack of knowledge she ignored all these signs.

Headaches during pregnancy should be investigated. Severe persistent headache which doesn’t go away with rest could be a sign of pre eclampsia together with other symptoms I will talk about later.

This can ruin your life. Pre eclampsia is a life threatening condition and should be taken seriously. Report to the hospital and also check your Blood pressure if you have persistent headaches.

Dont leave your pregnancy to chance!

This week will be going into details on how you can stay safe with preeclampsia during pregnancy.

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SURVIVING PRE-ECLAMPSIA – A REAL LIFE EXPERIENCE

It’s the hope of most ladies, after a beautiful marriage ceremony/relationship, to be blessed with the fruit of the womb, which we mostly expect to be uneventful. But this is not always the case for everyone.

The story of  Ama was no exception. 12 weeks after she got the fruit of the womb, severe headaches surfaced which she attributed to stress or probably something else. She had enough rest, took some analgesics on some occasions, but it looked like this frontal headache was persistent even at rest.

It was time to seek further help. She consulted her midwife who alerted her it could be a sign of pre-eclampsia and that she needed to be assessed, properly diagnosed and put on appropriate treatment.

On her first visit BP exceeded 130/90 mmhg. When a urine dipstick test was done protein was traced. She complained of dizziness, fatigue and breathlessness. She even felt  nauseated and vomited on her way back home from the hospital. She was allowed to go home on medication.

After her initial diagnosis, her midwife told her about the typical signs and symptoms of pre- eclampsia, which includes severe headache, swollen hands and feet, epigastric pains, high blood pressure , protein in urine and dizziness.

She started to read and empower herself with so much information especially online and also following blogs that related to maternal health. She also joined a support group for mums and midwives.

It wasn’t an easy journey.  She also made sure she took her medications as prescribed. She will report to the hospital or call her midwife or gynecologist immediately if she felt unwell or had any of the signs mentioned above. She did not want to be a victim of pre – eclampsia.

On one occasion she was hospitalized until Blood pressure was well controlled and then she was discharged.  Sincerely her midwife thought BP was too high and it had started too early within her first trimester, so was really wondering if this pregnancy will go to term or the baby could survive. Typically it begins to show around 20to 24 weeks, so this was too early and unusual.

In certain cases when BP is too high, uncontrolled and a threat to mums life. Pregnancy could be terminated to save the life of the woman

The problem here is that if a mum has high BP.. It reduces blood supply to the baby leading to problems like small for date, asphyxia , still births etc. Uncontrolled hypertension can lead to life threatening conditions in a mum. It is one of the leading causes of maternal complications in Ghana.

Little by little, days passed, months passed and mum together with her health care providers managed to keep BP under control. She also made sure she went for her appointment, ate nutritious meals and did some passive exercises at home.

On one faithful dawn, when pregnancy was just about 28 weeks, she woke up and realized that her headache was severe and persistent, she had epigastric pain and breathlessness was present. She knew something was definitely wrong. All she said was “Husby, kindly send me to the hospital immediately “ Husband did knowing that was an unusual request from her wife.

For about an hour she had to suffer all these till she was transported to the hospital. She had a good relationship with the health providers in the hospital.

BP was checked, it was High, 180/110 mmhg, protein was present in urine, all the symptoms showed that if the baby was not delivered immediately, the life of the mother would be in danger.

An emergency cesarean section was requested which she agreed to since she has already read a lot about her condition and her midwife has also prepared her mind that, baby could be born earlier. In severe pre- eclampsia most mums are not allowed to go to term, since placenta may not be able to support the baby till 41 or 42 weeks. Depending on the situation, pregnancy can be terminated at any time. If BP is well controlled pregnancy will be allowed to go to a maximum of 37 weeks if mum was diagnosed with preeclampsia.

Baby was born premature, weighing 1.2kg. 8 to 10 weeks earlier than expected. She was sent to the( neonatal intensive care unit) NICU where she was kept in the incubator for 6 weeks before finally being discharged. Baby was a real fighter. She survived. At 2 months old, her weight doubled baby was doing great.

Pre-eclampsia is real. It has become very common, but with careful management its complication can be managed

Sure her Gynaecologist and the team that delivered her promptly will also be overwhelmed with pride. They did a great job!!!

Yes we survived pre-eclampsia. Both mum and baby survived.

The cause of pre-eclampsia is unknown. It has risk factors, but can even occur in women who have no risk factor.  We all need to be alert once we get pregnant.

Pre-eclampsia definition… Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal.(Source-Google)

#Ama is sharing her story to empower other women going through the same problem to know that it is real, but can be controlled and good results achieved if both health workers and clients work together.

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And yes I had one on one sessions with Ama

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Written by Midwife Sally

CESAREAN SECTION: WHAT TO EXPECT

Cesarean section can be planned for an emergency. You may be wondering what to expect. This article is to help you get a quick overview of what you should expect

Before the surgery, you will have done some  laboratory investigations requested by your doctor to make sure you are fit. The anesthetist will also examine you to make sure you are fit

Some drugs will be requested and they have to be made ready before the surgery

In some cases you will be expected to donate some blood before the procedure so it can be used for you in case the need arises.

1. Shaving, catheter, I V line. You will be shaved to the level of your navel. In iv line will be secured for your blood samples and for iv infusions

2. You will fast for about 6 hours before the surgery if it’s not an emergency. You may be allowed to take your medications with little water if you have have conditions like Preeclampsia etc

3. Consent form. This is a legal document you sign to show you agree to the procedure and that you are aware of the risks and benefits of the surgery. Without your consent or signing this document, no doctor will perform the procedure. Make sure you really understand before signing the document

4. Anesthesia. This is given to you before the procedure commences. It is generally local spinal anesthesia. A general anesthesia is sometimes given depending on your situation. This makes you not feel the pain during the procedure. The anesthetist also makes sure you are fit throughout the procedure

5. Procedure will be done and the baby will be shown to you. The doctor will Carry out the procedure to deliver your baby. A midwife receives the baby and cleans her. She will show the baby to you so you identify the sex. Depending on the hospital they will initiate breastfeeding if baby and mum are fit

6. Pain relief. After the procedure you will continue with analgesics which will be given every 6  hours to relieve you of your pain. They don’t have to wait for your pain to commence before giving you pain medications. Always tell your doctor if you experience any form of pain

7. Lying on your back. After the procedure you will be made to lie on your back for some time. Do well to cooperate to prevent headaches and side effects that come as a result of the anesthesia. Move when you are asked to do so

8. Nil per os. After the procedure you may want to eat something before due to hunger. Wait until your doctor has confirmed that bowel sounds have returned and you can eat. You will start with some tea leaf, then light diet then later your normal diet

9. You will be encouraged to move around after the procedure. Within the first 24 hours you will be encouraged to walk about. This will help in the healing process.

10. Wound care and self care. Report if you are bleeding, having severe pain from the wound site or there is abnormal discharge. Go for wound dressing, take your prescribed medications and have passive exercise to promote healing.

11. Breastfeeding your baby. Breastfeeding is not easy. As you deal with the pain from your wound site you will have to deal with breastfeeding your little one. Get help when you need it. If your pain is well managed breastfeeding may be easier

12. Taking your medication. As I mentioned take your medications with care

13 Discharge from the hospital. All things being equal, when you are fit you will be discharged from the hospital. When you can walk around, your wound has started healing nicely mostly on the third day, your baby is fit and breastfeeding.

14. Go for follow up visits. Report if there is fever, wound infection or you feel sick.

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MY BIRTH STORY – A FIRST TIME MUMS BEAUTIFUL EXPERIENCE

💞💞💞💞💞💞💞💞💞💞💞💞💞💞💞💞💞💞💞

Lost my mucus plug at 37 wks 3 days on 24th June 2021 at 8am. Started feeling some strong pain in my lower back the evening before.

In the evening on 24th June there was a bloody show so I sent a message to my doctor and Midwife Sally and they asked that I wait till I have contractions.

So from Thursday through to Friday kept having different kinds of pain in my pelvic region but it wasn’t that intense but by Saturday morning woke up with intense pain in my abdomen and back that I couldn’t walk straight so I spoke to the Doc and she asked that I start timing the contractions to see if there was a pattern. I did for the first hour but there was no pattern really but I was in much pain.

So around 11:02 pm on Saturday 26/06/2021 I spoke to my Doc and she asked that I go to the hospital for them to examine if I was in labor or not. So I got to the Hospital around 11:40 am and I explained to the midwife on duty what was happening. Then she asked that I go to one room for examination. They checked and I had dilated 5 cm what a shock!! This God eh.

So they kept doing their tests and examinations and the contractions kept getting intense and in a matter of 2 hours I had dilated fully and ready to deliver.

I was taken to the delivery room and by God’s grace at exactly 2pm, my baby girl arrived💃🏽🎊

Isn’t God good? As a first time mum this is such a miracle. All team that attended to me were in shock as to how fast things progressed 😂😍

A big thank you to God, Midwife Sally and all other mummies here! This class helped me a lot! And oh prayers and declarations work! God is faithful 💞😘

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