THE SECOND STAGE OF LABOR

The second stage of labor starts when the cervix is fully dilated. In the fist stage of labor the cervix is still dilating.

At this stage the mum will be encouraged to bear down since the cervix is fully dilated. The cervix is fully taken up and it cannot cause a cervical tear

The second stage of labor can last between 30 minutes to an hour or two. If it last for too long we call it prolonged second stage of labor.

It can lead to maternal exhaustion, fetal distress and can even result in complications

If prolonged labor occurs an assisted birth or caesarian section will be recommended to prevent further complications

During the second stage of labor

🔴You will be positioned for delivery

🔴Push with contractions with the guidance of your midwife

🔴Rest in between contractions

🔴Cooperate with your doctor or midwife and communicate how you feel or your needs

The second stage of labor ends when your baby is delivered. This ushers in the third stage of labor which is the delivery of the placenta.

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THE MAGICAL ORGAN (PLACENTA). YOUR PREGNANCY SHOULD NOT GO BEYOUND 42 WEEKS

🔴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 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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CHANGES THAT CAN OCCUR WHEN YOU ARE ALMOST DUE/ THIRD TRIMESTER

🔴Baby’s head can put pressure on the bladder. You may urinate frequently

🔴Back ache may be more. Massage, use a bed that is firm. Exercise and rest in between your activities

🔴You may also feel tired. Rest when you can

🔴If there is contractions and it’s too painful even with rest then do report to the hospital.

🔴Vaginal discharge may me more. If it’s your water that breaks it’s not normal. Report immediately to the hospital

🔴You may experience Braxton hicks contractions. It’s painless and doesn’t last long. If contractions persists report it please

You will have to pay attention to your body and baby movement.

When it comes to your body. Assuming you are tired, rest. Backache- massage, go for your check ups and keep taking care of yourself. Manage yourself little by little. Report if its too much

Don’t wait if you bleed, stop feeling baby movement or having severe abdominal pains.

Pack your hospital bag. It should be ready. We can also help you pack😍 0242281957

It will be over soon.

Always make sure you take a last scan within your third trimester and also if you have any condition discuss the best mode of delivery.

Finally choose your hospital wisely.. It should be ready for emergencies

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SEEKING A SECOND OPINION DURING PREGNANCY LABOR AND DELIVERY

🔴During conception there are times when a couple doubt certain information’s given to them by their care providers.

🔴A typical example is when a woman is informed that she may need a caesarian section and that is what will be best for the survival of the mother and baby.

🔴It’s important to speak to the right people especially when you need a second opinion on what your doctor or midwife suggests

🔴Speaking to people who are not experts or do not have the experience may works on your situation.

🔴It’s important to get a second opinions with experts in an accredited hospital or health facility.

🔴Sometimes it could even be that you didn’t understand the information given by the first midwife or doctor.

🔴You can ask for explanation and also go with a support person who can help you understand better to make an informed choice.

🔴Asking for second opinions when you do not understand or in doubt from reliable experts can be helpful. It can save you from unnecessary interventions. Asking the wrong people can be detrimental to your health.

#Talk to the right people… a #gynaecologist or #midwife in a recognized health institution.

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HOW TO KEEP YOUR NEWBORN BABY HEALTHY AND STRONG

I find myself telling new mums how easy it can be to keep your newborn healthy and strong. With these basic and inexpensive tips, your newborn will be strong and healthy……

🚼Keep the baby in a clean and well ventilated room. Baby’s easily get infections and it is necessary to clean the home before the baby arrives.

🚼Baby should sleep in mosquito net to prevent malaria.

🚼Exclusive breastfeeding is recommended. Breast Milk has all the nutrients your baby requires. Breastfeeding is golden!!! Feed on demand. Breastfed babies do not easily get sick and are within the right weight.

🚼Baby should be protected from excessive cold and excessive heat. Keep the baby warm by dressing the baby in cotton cloths. Do not over dress the baby. The dressing should suit the weather.

🚼Wash hands before breastfeeding baby. Anyone who wants to touch a baby should wash hands and be in clean clothes before doing so.

🚼Reduce visitors and do not allow people who have cold or respiratory tract infections to hold the baby

🚼 If baby has any danger sign, seek medical care immediately example fever, diarrhea, jaundice, convulsions, vomiting, bleeding circumcision etc

🚼Take care of the cord as ordered by your midwife. If it bleeds report to the hospital as soon as possible

🚼Make sure your baby gets immunized against diseases as recommended

🚼Child Welfare clinic (weighing) is crucial as it will help to monitor the growth and well-being of your baby.

🚼Circumcise your male child at the hospital or within a sterile field. If there is bleeding circumcision visit the hospital immediately.
Ensure both mum and baby get enough rest.

Share with other mums as well.

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MY HANDS AND FEETS ARE SWOLLEN BUT MY GRANDMOTHER SAID I WILL GIVE BIRTH TO TWINS / A BABY BOY IS IT TRUE?

In our local settings when a woman gets swollen hands and feet, it is interpreted in many ways

🔴She is going to have twins

🔴It’s a male child

Many other interpretations. Most of these are myths and can be misleading
Swollen hands and feet can be a sign that something is happening

High blood pressure , protein in urine and headaches associated with swollen hands and feet could indicate the woman is developing pre- eclampsia

Edema can be as a result of pregnancy but should all be investigated just to be sure. Don’t stay at home assuming it’s normal. Confirm with your doctor

Pre eclampsia can have serious complications

Talk to your doctor or midwife about it

Don’t leave your pregnancy to chance.

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WHAT CAUSES YOUR PREGNANCY NOT TO GROW AGAIN OR THE FETAL HEART BEAT TO STOP IN EARLY PREGNANCY?

The most common cause of first trimester pregnancy loss is chromosomal abnormalities.

There could be other factor like infection, poor nutrition, diseases etc

Speak to your doctor about it

Also take your folic acid

Sign up for a pregnancy class in your next pregnancy

If it continues see a gynecologist for more investigations.

Also remember the fact that it had happened does not mean it will continue with every pregnancy.

You will be fine!

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🚺CARE FOR YOUR UTERUS/WOMB!!!🚺

Exactly how your uterus looks like…. How will you take care of your uterus? Let’s discuss. This organ carries your baby during pregnancy, plays a role in menstruation and many other things a woman can’t do without….

1. Prevent infection by wearing clean cotton panties.

2. Maintain strict perineal hygiene

3.Change pad frequently when menstruating

4. Avoid douching

5. Eat nutritious meals, reduce processed foods and increase fruits, vegetables and whole grain foods.

6. Plan your birth to prevent unwanted pregnancy. Talk to the family planning nurse

7. Treat infections promptly

8. Get a pap smear and other necessary investigations

9. When pregnant go for antenatal and adhere to your midwives advice

10.Avoid unsafe abortions.. talk to your health care provider

11. In case of any abnormal bleeding, fibroid etc. Consult your doctor. Avoid unprescribed medications and concoctions.

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SURVIVING PRE-ECLAMPSIA – A REAL LIFE EXPERIENCE (LONG POST ALERT)

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… Pre- eclampsia 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.

#Share to help another mum

And yes I had one on one sessions with Ama

Visit our channel for more videos

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Written by Midwife Sally

MEASURING TAPE – A CRITICAL TOOL USED IN OBSTETRICS

Have you ever wondered why your midwife or Gynaecologist will always measure your abdomen with a measuring tape during pregnancy ?

This is why.

The growth of your uterus usually gives an estimation of the maturity or growth of your baby

If it measures around any number it’s likely your pregnancy is that week old.

Example if you measure 20 cm, your pregnancy could be 20 weeks old. It could be + or – 2. Meaning at 20 weeks you could measure between 18 to 22 cm

Measuring your fundal height can reveal if there is any abnormality. Example

Fetal growth restriction. If you are 20 weeks but you measure 10 cm. Your doctor does more investigations

If you are 20 weeks and you measure 30 cm.. Doctor/midwife will ask if you have twin gestation, polyhydramnios or anything else.. More investigations will be done

It’s usually done after you have emptied your bladder and lie comfortably on your back for a short while. 

During early pregnancy it is usually not measured until your uterus grows and doctors can palpate it. 

Also watch how your bump grows and how it corresponds with your baby’s gestational age. Ask your doctor if there are concerns. Doing could help you save a situation early enough

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