Labor and Delivery Recovery (Postpartum Recovery)

You’ve finally put 40 (or so) weeks of pregnancy and long hours of childbirth behind you, and you’re officially a mother. Congratulations! Now comes the transition from pregnancy to postpartum, which brings with it a variety of new symptoms and questions.

Your delivery may have been complicated or easy. You may have had a cesarean birth (C-section) or vaginal delivery. You may have labored for a few hours or a few days. No matter what your delivery looked like, your body has been through a trauma just the same. It is going to need time to recover.

How Long Does It Take to Recover After Giving Birth?

Your postpartum recovery won’t be just a few days. Fully recovering from pregnancy and childbirth can take months. While many women feel mostly recovered by 6-8 weeks, it may take longer than this to feel like yourself again. During this time, you may feel as though your body has turned against you. Try not to get frustrated. Remember that your body is not aware of your timelines and expectations. The best thing you can do for it is rest, eat well, and give yourself a break.

If you’ve had a vaginal birth, you’re probably also wondering how long it will take for the soreness to go away and your perineum to heal. Recovery can take anywhere from three weeks if you didn’t tear to six weeks or more if you had a perineal tear or an episiotomy. Wondering if your vagina will ever be the same after birth? Not exactly, though it will likely be very close.

If you delivered by C-Section, expect to spend the first three to four days postpartum in the hospital recovering; it will take four to six weeks before you’re feeling back to normal. Depending on whether you pushed and for how long, you can also expect to have some perineal pain.

Here is more of what you can expect during your postpartum recovery

Abdominal pain. As your uterus shrinks back into its normal size and shape, you will feel pain in your abdomen (lower belly). These pains are called “afterpains.” Most of these pains will be dull, but some will be sharp. You may feel more of these pains as you breastfeed your baby. That is because breastfeeding stimulates a chemical in your body that causes the uterus to contract (tighten). For many women, applying heat to the area helps control the pain. Consider using a heating pad or hot water bottle. Your abdominal pain should ease up over time. If these pains get worse or don’t let up, you should call your doctor.

Baby blues. You are so excited and happy to bring baby home. The next minute, though, you are sad. It can be confusing, especially to new moms. Know that many women (70-80%) struggle with feeling sad the first few weeks after having a baby. It is commonly called the “baby blues” and is caused by hormone changes. It is nothing to be ashamed of. In fact, confiding in a friend of family member can often make you feel better. If these feelings last more than a few weeks or you are not able to function because of them, you could have postpartum depression. Postpartum depression is more serious than baby blues. If you have severe feelings of sadness or hopelessness, you should call your doctor.

Constipation. It is very common to be constipated in the days following childbirth. There are several things that could cause this. If you received any pain-relieving drugs in the hospital, they could slow down your bowels. If you had anesthesia (a pain blocker) for any reason, that also can cause it. Sometimes, postpartum constipation is brought on simply by fear. This is true especially if you have stitches because you had an episiotomy (a surgical cut between the vagina and anus to widen the vaginal opening for childbirth) or tore this area during delivery. You may be afraid of damaging the stitches or be afraid that a bowel movement will cause even more pain in that area. To help ease constipation, drink plenty of water and try to eat foods that offer a lot of fiber. In many cases, you may want to talk to your doctor about prescribing a stool softener (such as Colace or Docusoft). If you haven’t had a bowel movement by four days postpartum, call your doctor.

Hemorrhoids. You may have developed hemorrhoids (painful swelling of a vein in the rectum) during your pregnancy. If not, you may have gotten them from the strain and pushing during delivery. They can cause pain and bleed after a bowel movement. They also itch. You can get some relief from the pain and itching by applying witch hazel to your hemorrhoids. This is especially effective if you keep the witch hazel in the refrigerator. Your hemorrhoids should shrink over time. If not, contact your doctor.

Hormonal shifts. Besides fueling your mood swings (see “Baby blues,” above), hormones are also responsible for other postpartum symptoms. You may be sweating more, especially at night when you sleep. Just make sure that your sweating is not accompanied by a fever. That could be a sign of infection. Hormonal changes also cause hair loss for many new moms. This is only temporary. When your estrogen levels increase, your hair will return to its normal thickness.

Perineum soreness. The perineum is the area between your vagina and anus. Many times, this area will tear during childbirth. Other times, your doctor may have to make a small cut in this area to widen your vagina for childbirth. Even if neither of these things happened during your vaginal birth, you perineum will be sore and possibly swollen postpartum. You may feel discomfort in this area for several weeks. While you recover, sitting on an ice pack several times a day for 10 minutes will help relieve the pain. This is especially good to do after going to the bathroom. During the first week postpartum, also use a squirt bottle to rinse the perineum with warm water after using the toilet. Notify your doctor if your perineum area does not get less sore each day or you have any sign of infection.

Sore nipples and breasts. For achy breasts, try using a warm compress or ice packs and gentle massage. Also be sure to wear a comfortable nursing bra. If you’re breastfeeding, let your breasts air out after every nursing session and apply a lanolin cream to prevent or treat cracked nipples.

Stitches. If you have stitches due to a torn or cut perineum it will take 7-10 days to heal. The stitches will absorb over time. It is important that you keep the stitches from getting infected by gently cleaning them with warm water after each time you use the toilet. Do this by using a squirt bottle to rinse the area and pat it dry. Do not wipe the area with toilet paper or you could irritate the stitched area. No matter how eager you are to check the healing progress, try to keep your hands off the stitches. If the area begins to hurt worse or the stitches seem weepy, contact your doctor. It could be a sign of infection.

If you have stitches from a cesarean birth (C-section), these heal in varying degrees. The stitches in the skin should heal in 5-10 days. The underlying stitches in your muscle layer will take longer to heal. These won’t completely heal for 12 weeks. For the stitches that you can see, make sure to watch for any signs of infection. These signs include if the incision area is red, swollen, or weeping pus; or if you have a fever.

Vaginal bleeding and discharge. After you give birth, postpartum bleeding (this is called lochia) can last for up to six weeks. It will be just like a very heavy period made up of leftover blood, tissue from your uterus and mucus. Bleeding is heaviest for the first three to 10 days, then it will taper off going from red to pink to brown to yellowish-white. If you spot large clots or you’re bleeding through more than one pad every hour, call your doctor right away to rule out postpartum hemorrhage. During this time, tampons are off-limits, so you’ll have to rely on pads.

Water retention. You may be eager for that swelling you noticed during your pregnancy to go away. It won’t, though, for a while longer. Also known as postpartum edema (swelling), your body will continue to hold on to water because of an increase in a hormone called progesterone. You may notice the swelling in your hands, legs, and feet. It shouldn’t last much longer than a week after delivery. If it does or if it seems to get worse over time, be sure to tell your doctor.

Postpartum Recovery Checklist

Here are a few things you’ll want to make your postpartum recovery go as smoothly as possible:

  • Acetaminophen. It can help with perineal pain and overall aches.
  • Maxi pads. You’ll probably need these for at least a couple of weeks until postpartum bleeding lets up.
  • Ice packs. There are lots of ways to ice your perineal area from frozen padsicles to your standard lunchbox ice blocks (wrapped in paper towels, of course, to avoid frostbite).
  • Witch hazel pads. This is often used in combination with ice packs to ease vaginal pain and help with hemorrhoids.
  • Sitz bath. This little tub is designed for you to just sit and soak away the postpartum pain.
  • Peri or squirt bottle. You’ll use this to rinse off your perineal area before/after peeing as the area heals.
  • Cotton underpants. Go for the “granny” or hospital gauze underwear, comfort is much more important for now than looking sexy.
  • Nursing bras. Invest in a few comfy ones that fit you well.
  • Lanolin. The cream works wonders to prevent and treat cracked nipples.
  • Nursing pads. If you’re planning to breastfeed, these will help keep leaky nipples under wraps.
  • Lidocaine spray. It helps ease the pain of postpartum hemorrhoids.
  • Stool softener. In case you get stopped up, this can gently help get things going.
  • Postpartum recovery belt. If you think you might want one, the Belly Bandit or other similar belts can help keep things in place as your belly shrinks back to size.
  • Heating pad. This can help ease aches and pains in your breasts.

Things to consider

Pay attention to your body after giving birth. If something doesn’t seem right, it probably isn’t.

Just because you’ve made it through delivery, you are not necessarily out of danger for health complications. There are life-threatening problems related to childbirth that can happen days or weeks after delivery.

  • Postpartum hemorrhage is rare but can happen. If your postpartum bleeding is filling more than a pad every hour, you should contact your doctor immediately. Without treatment, postpartum hemorrhage can be fatal.
  • Headaches that are severe and don’t go away can also signal an underlying problem, especially coupled with high blood pressure. You could be in danger of having a stroke.
  • Deep vein thrombosis (a blood clot in a deep vein) is a somewhat uncommon problem (1 in every 1,000 pregnancies) that can occur during or after pregnancy. Symptoms include leg pain or feeling like you have a pulled muscle. Your leg may also be red and hot to the touch. Left untreated, these clots can break away and travel to your lungs. When this happens, it can be life-threatening.
  • Postpartum preeclampsia is rare and can develop within 48 hours after childbirth or as late as six weeks after childbirth. It is similar to preeclampsia (also called toxemia), which can occur while you’re pregnant. Both preeclampsia and postpartum preeclampsia cause your blood vessels to constrict (get smaller). This results in high blood pressure and also distresses your internal organs. Sometimes there are no obvious symptoms unless you are monitoring your blood pressure. When you do have symptoms, they may include a severe headache, swelling of your hands and feet, blurred vision, and sudden weight gain. If you suspect you may have postpartum preeclampsia, call your doctor immediately.

When to see a doctor

You’ll usually visit your doctor about 6 weeks after delivery. She’ll check your vagina, cervix, and uterus as well as your weight and blood pressure. Once you’ve gotten the all-clear from her, it’s usually fine to start having sex again (ask your doctor about birth control first) and to get back to an exercise routine.

Before your checkup, call your doctor right away if you have:

  • Heavy vaginal bleeding that soaks more than one pad per hour or vaginal bleeding that increases each day instead of decreasing
  • Passing large clots (bigger than a quarter)
  • Chills and/or a fever of more than 100.4°F
  • Fainting or dizziness
  • Painful urination or difficulty urinating
  • Vaginal discharge with a strong odor
  • Heart palpitations, chest pain or difficulty breathing
  • Vomiting
  • The incision from C-section or episiotomy is red, weepy (with pus), or swollen
  • Abdominal (lower belly) pain that is getting worse or new abdominal pain
  • Sore breasts that are red or feel hot to the touch
  • Pain in your legs with redness or swelling.

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

https://familydoctor.org/recovering-from-delivery/

https://www.webmd.com/parenting/baby/recovery-vaginal-delivery#3

Childbirth Delivery Methods and Types

Every woman’s experience is unique but most mothers would honestly say, yes, childbirth is painful. However, it is short-lived, and there are many types and methods to effectively reduce the intensity of childbirth pain. There are many choices in childbirth. Women can choose the method that makes them most comfortable, and that makes sense for their personal and medical situation.

Medical technology has made childbirth a much safer experience over the past century for both mother and baby. Hospitals have responded to trends in childbirth, such as the need for a more home-like environment in the hospital. Many hospitals now offer comfortable maternity suites that convert into state of the art delivery rooms.

An easy birth and a perfectly executed birth plan are ideal. But we know that even the most carefully planned birth can take twists and turns. In those cases, it’s important to be prepared for alternative delivery methods.

Different Kinds of Childbirth and Delivery Methods

Vaginal Delivery

In a vaginal birth, the baby is born through the birth canal. It’s hard to know when exactly you will go into labor, but most women give birth at around 38-41 weeks of pregnancy.

A vaginal birth without medication benefits both mother and baby. The microbiome, or bacterial environment, is established by birth method. There is some research that suggests the development of the infant microbiome is associated with the likelihood of developing allergic diseases during childhood, but the association isn’t clear.

 

Benefits of vaginal delivery:

  • Infants born vaginally tend to have fewer respiratory problems.
  • Quicker recovery for the mother
  • A lower rate of infection and a shorter hospital stay

Disadvantages of vaginal delivery

  • Tearing of the perineum
  • Sometimes, a vaginal birth may not be recommended for medical reasons.

Cesarean Section (C-Section) 

According to the Centers for Disease Control (CDC), about 1/3 of births are delivery by C-section, although rates are highly variable by hospital and region. The World Health Organization (WHO) says the rate of Cesarean deliveries should be about 10%-15%; the higher level is because of both elective Cesareans and overuse in the U.S.4 A C-section involves a horizontal incision across the lower abdomen through which the infant is delivered. The typical hospital stay is three days after a Cesarean to ensure the incision is healing. Full recovery can take 8 weeks. One advantage of a C-section is that the delivery date can be planned ahead of time.  In certain circumstances, a C-section is scheduled in advance. In others, it’s done in response to an unforeseen complication.

Events that may require C-Section:

  • Multiples (twins, triplets, etc)
  • A very large baby
  • Previous surgery, C-Sections, or other uterine conditions
  • Baby is in breech (bottom first) or transverse (sideways) position
  • Placenta previa (when the placenta is low in the uterus and covers the cervix)
  • Fibroid or other large obstruction
  • Medical conditions/complications

Water Birth

A water birth means the mother goes through some or all of the stages of childbirth in a portable tub similar to a hot tub. The baby can be delivered underwater or the mother can get out of the water and deliver in a different position. Women chose water births because it can be more relaxing, and less painful to be in the water. Birthing tubs can be brought into the home for a home birth, and they are often found in birthing centers. Some hospitals may have birthing tubs as well.

 

Benefits of Water Birth:

  • It allows the woman to move into a variety of positions that can feel more natural and less painful.
  • The partner can also get into the tub with the mother to support the delivery.

Disadvantages of Water Birth:

  • May increase the risk of infection, but as long as the water is fresh and clean, water births are not any riskier than non-water births.
  • Unless the water birth takes place in a birth center with established tubs, there are logistics involved in setting up the tub and warming the water for a water birth.
  • If the birth plan at home does not progress normally, it may require transport to a hospital.

Lamaze Method 

The Lamaze method is typically known for controlled breathing techniques but it includes a number of comfort strategies that can be used during labor. Breathing techniques increase relaxation and decrease the perception of pain. In addition to breathing, other information about preparing for childbirth is covered. Lamaze is taught in a series of classes attended by both the mother and her partner, when possible. The Lamaze method doesn’t explicitly encourage or discourage medications but seeks to educate women about their options so they can make a birth plan that suits their individual needs.

Benefits of the Lamaze Method:

  • Lamaze training prepares the mother and her partner with a number of tools to use to get through labor and delivery naturally.
  • The breathing and relaxation techniques reduce the perception of pain and keep labor moving smoothly.
  • The Lamaze courses help the couple be prepared with what to expect over the first few days and weeks together.

Disadvantages of the Lamaze Method:

  • Learning the Lamaze method takes time. The couple must plan ahead and attend classes starting in the second trimester of pregnancy.

Vacuum Extraction 

A vacuum extraction is a procedure sometimes done during the course of vaginal childbirth. A vacuum-assisted delivery involves attaching a soft cup to the head of the infant while it is in the birth canal and a hand-held pump is used to create suction to facilitate delivery.

  • The advantage is that this assisted birth option has a lower risk than a C-section of prolonged fetal distress.
  • The risks of this method include minor scalp injuries or more serious trauma or bleeding of the head.

Forceps Delivery

A forceps delivery is a type of operative vaginal delivery. It’s sometimes needed in the course of vaginal childbirth. A forceps-assisted delivery means that curved instruments are used to facilitate the progress of the infant in the birth canal. Forceps cannot be used if the infant is breech, but it can be an option if the mother is too exhausted or if the infant has to be delivered more quickly than is naturally occurring.

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

https://www.medicinenet.com/7_childbirth_and_delivery_methods/article.htm#what_is_a_water_birth

10 Signs of Approaching Labor

While there are characteristic changes in the body with impending labor, every woman’s experience is unique and different. “Normal” can vary from woman to woman. The signs and symptoms of normal labor can begin three weeks prior to the anticipated due date up until two weeks afterward, and there is no precise way to predict exactly when a woman will go into labor.

“It’s the event you’ve been happily (and nervously) anticipating for months: Your baby’s birth! “

How will you know when it’s time to grab your hospital bag and get to the delivery room? Thankfully, your body will give you some solid clues.

Here are 10 common signs that labor is near.

  1.  The baby drops

Medically known as “lightening,” this is when the baby “drops.” The baby’s head descends deeper into the pelvis and is getting into position to make his exit. For some women, this occurs up to 2 weeks prior to the beginning of labor; other women may not notice this event at all. In subsequent births, this “lightening” doesn’t often happen until you’re truly in labor.

  1.  An increased urge to urinate

An increased urge to urinate can be a result of the baby’s head dropping into the pelvis. The low position of the baby’s head puts even more pressure on the urinary bladder, so many women approaching labor might feel a frequent need to urinate. As the baby drops, breathing can become easier since there is less pressure on the diaphragm from underneath.

  1. The mucus plug passes  

Passage of the mucus plug is a known sign that labor is near. Thick mucus produced by the cervical glands normally keeps the cervical opening closed during pregnancy. This mucus plug must be expelled before delivery. It can come out in one large piece (it looks similar to the mucus in your nose) or lots of little ones, though you may not get a glimpse of it at all and some women don’t lose it before delivery. Pressure from the baby’s head causes the mucus plug to be expressed from the vagina, sometimes as blood-tinged vaginal discharge (referred to as “bloody show”) and is a good indication that labor is imminent, but without contractions or dilation of three to four centimeters, labor could still be a few days away.

  1. The cervix dilates

Your cervix, too, is starting to prepare for birth. Dilation of the cervix is a sign that labor is approaching, although this is detected by the health-care professional during a pelvic examination. This begins in the days and even weeks prior to the onset of labor; “Fully dilated” means the cervix has dilated to a width of 10 cm. But everyone progresses differently, so don’t be discouraged if you’re dilating slowly or not at all yet.

  1. Thinning of the cervix

In addition to dilation, thinning (effacement) of the cervix also occurs. This occurs in the weeks prior to labor, since a thinned cervix dilates more easily. This sign is also detected by the health-care professional during a pelvic exam.

  1. Back pain

Contractions can often begin in the back and move forward to the pelvis. And some women do experience “back labor,” which is characterized by severe discomfort in the lower back that is most intense during contractions and often painful between contractions.  Women also notice loosening of the joints, particularly in the pelvic area, as the third trimester progresses, in preparation for delivery.

  1. Contractions

It’s inevitable—at some point, you’ll realize that crampy feeling you’re having might be more than just cramps. They’ll change to regular contractions, which indicate your body is beginning the process of a birthing baby. Contractions, which can vary among women and can be described as pounding, tightening, stabbing, or similar to menstrual cramps, increase in strength and frequency as labor approaches.

Irregular contractions, known as Braxton-Hicks contractions or “false labor” occurs toward the end of pregnancy during the third trimester. Braxton-Hicks contractions are usually milder than those of true labor, and they do not occur at regular intervals. The best thing to do? Relax, get comfortable or perhaps take a shower. Time the contractions and head to the hospital or birthing center when they become about five minutes apart.

  1. Burst of energy

Many women describe feeling a sudden burst of energy and excitement in the weeks prior to labor, in contrast to feeling extra tired as is typical of pregnancy. Often referred to as “nesting,” this impulse often is accompanied by a sense of urgency to get things done or make plans for the baby.

  1. Nausea and diarrhea

Just as the muscles in your uterus are relaxing in preparation for birth, so too are other muscles in your body, including those in the rectum. And that can lead to diarrhea, that pesky little labor symptom you may well have experienced at other times during pregnancy. Though annoying, it’s completely normal; stay hydrated and remember it’s a good sign!

  1. Your water breaks

Despite what movies will have us believe, how your water breaks (in other words, how the membranes of the amniotic sac burst) can vary a lot.

If your water breaks and you’re experiencing contractions, this is one of the biggest signs of labor. But if contractions haven’t set in yet, your doctor may want you to wait a few hours before coming in. Rupture of the amniotic membranes, or one’s “water breaking,” usually is a sign that labor has begun. Amniotic fluid should be colorless and odorless. It can sometimes be hard to distinguish from urine, but amniotic fluid does not have an odor.   If you are leaking amniotic fluid, it is essential to contact your health-care professional right away.

Should I Call the Doctor?

It’s not necessarily your due date—that’s just an estimate, and there’s really no telling exactly when the baby will arrive. Keep in mind too that some women may deliver before 37 weeks (which would be considered a preterm birth); others, who go past 41 weeks, may wind up getting induced, depending on your doctor and your hospital’s policies.

If you think you’re going into labor, your practitioner should have advised you on what to do when your contractions become regular: “Call me when they’re coming about five minutes apart for at least an hour,” for example. Contractions won’t all be exactly spaced, but if they are becoming pretty consistent, more painful and longer (usually around 30 to 70 seconds), it’s time to check in with your doc. If you think you might be in labor but aren’t sure, get on the phone; your provider can advise you on what’s going on. Don’t feel embarrassed or worry about calling outside of office hours (your doctor or midwife knew this would happen when she got into the baby-catching business!).

You should always call if:

  • You experience any bleeding or bright-red discharge (not brown or pinkish).
  • Your water breaks — especially if the fluid looks green or brown; this could be a sign that meconium is present (which is your newborn’s first stool; it can be dangerous if your baby ingests it during birth).
  • You experience blurred or double vision, a severe headache, or sudden swelling. These can be symptoms of preeclampsia, which is characterized by pregnancy-induced high blood pressure and requires medical attention.

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:https://www.medicinenet.com/early_signs_and_symptoms_of_labor/article.htm#7_contractions

Premature Birth Complications

A typical pregnancy lasts about 40 weeks, yet some babies arrive sooner. Babies born before the 37th week of gestation are considered premature.  Premature newborns are sometimes referred to as “preemies”. Mothers who have their baby prematurely are often frightened and nervous. Premature newborns face an increased risk of one or more complications.

While some premature babies have serious medical complications or long-term health problems, many also go on to live normal healthy lives. With modern medicine and new technologies, babies are often able to survive when born earlier during the pregnancy.

The Most Common Complications of Premature Births

Breathing problems  

Breathing problems in premature babies are caused by an immature respiratory system. Immature lungs in premature babies often lack surfactant. This substance is a liquid that coats the inside of the lungs and helps keep them open. Without surfactant, a premature baby’s lungs can’t expand and contract normally. This increases their risk for respiratory distress syndrome.

Some premature babies who lack surfactant may need to be put on a ventilator (breathing machine). Babies who are on a ventilator for a long time are at risk of developing a chronic lung condition called bronchopulmonary dysplasia. This condition causes fluid to build up in the lungs and increases the likelihood of lung damage.

Transient tachypnea is rapid shallow breathing. This can occur in both premature babies as well as full-term babies. Recovery usually takes three days or less. Until the newborn has recovered, feedings may be altered, and in some cases, intravenous feedings may be done. There is usually no other treatment necessary.

apnea  and Bradycardia – Apnea is the absence of breathing. In the NICU an alarm will sound if a newborn develops an irregular breathing pattern of pauses longer than 10-15 seconds. Bradycardia is the reduction of heart rate.

An alarm will also sound if the newborn’s heart rate falls below 100 beats per minute. Usually, a little tap or simple rub on the back helps remind the preemie to breathe and also increases the heart rate.

Treatment: While being on a ventilator for an extended period of time may injure a baby’s lungs, it still may be necessary for the baby to receive continued oxygen therapy and ventilator support. Doctors may also use diuretic and inhaled medications.

Jaundice  

The most common type of jaundice among premature babies is exaggerated physiologic jaundice. In this condition, the liver can’t rid the body of bilirubin. This substance is produced during the normal breakdown of red blood cells. As a result, bilirubin accumulates in the baby’s blood and spreads into the tissues. Because bilirubin is a yellowish color, the baby’s skin takes on a yellowish tint.

Jaundice is usually not a serious problem. However, if the bilirubin level gets too high, it can cause bilirubin toxicity. The substance can then build up in the brain and cause brain damage.

Ask your doctor or nurse for your baby’s bilirubin level. Normal levels of bilirubin in a newborn should be under 5 mg/dL. Many preterm babies, however, have bilirubin levels above that number. Bilirubin levels are not dangerous until they reach levels above 15-20 mg/dL, but phototherapy is generally started before levels get that high.

Treatment: The standard treatment for jaundice is phototherapy. This involves placing a baby under bright lights. The lights help break down the bilirubin into a substance that the body can get rid of more easily. Usually phototherapy is needed for less than a week. After that, the liver is mature enough to get rid of bilirubin on its own.

Kidney problems

A baby’s kidneys usually mature quickly after birth, but problems balancing the body’s fluids, salts, and wastes can occur during the first four to five days of life. This is especially true in babies less than 28 weeks into development.

During this time, a baby’s kidneys may have difficulty:

  • filtering wastes from the blood
  • getting rid of wastes without excreting excess fluids
  • producing urine

Because of the potential for kidney problems, neonatal intensive care unit (NICU) staff carefully record the amount of urine a baby produces. They may also test the blood for levels of potassium, urea, and creatinine.

Staff must also be watchful when giving medications, especially antibiotics. They need to make sure that the medicines are excreted from the body. If problems arise with kidney function, staff may need to restrict the baby’s fluid intake or give more fluids so that substances in the blood are not overly concentrated.

Treatment: The most common basic treatments are the fluid restriction and salt restriction. Immature kidneys usually improve and have a normal function within a few days.

Infections

A premature baby can develop infections in almost any part of the body. A baby may acquire an infection at any stage, ranging from in utero (while in the uterus), birthing through the genital tract, to after birth including the days or weeks in the NICU.

Regardless of when an infection is acquired, infections in premature infants are more difficult to treat for two reasons:

  • A premature baby has a less developed immune system and fewer antibodies from the mother than a full-term baby. The immune system and antibodies are the body’s main defenses against infection.
  • A premature baby often requires a number of medical procedures, including insertion of intravenous (IV) lines, catheters, and endotracheal tubes and possibly assistance from a ventilator. Each time a procedure is performed, there’s a chance of introducing bacteria, viruses, or fungi into the baby’s system.

If your baby has an infection, you may notice some or all of the following signs:

  • lack of alertness or activity
  • difficulty tolerating feedings
  • poor muscle tone
  • inability to maintain body temperature
  • pale or spotted skin color, or a yellowish tint to the skin (jaundice)
  • slow heart rate
  • apnea (periods when the baby stops breathing)

These signs may be mild or dramatic, depending on the severity of the infection. As soon as there’s any suspicion that your baby has an infection, the NICU staff obtains samples of blood and often urine and spinal fluid to send to the laboratory for analysis.

Treatment: If there is evidence of infection, your baby may be treated with antibiotics, IV fluids, oxygen, or mechanical ventilation (help from a breathing machine). Although some infections can be serious, most babies respond well to treatments, including antibiotics if the infection is bacterial. The earlier your baby is treated, the better the chances of successfully fighting the infection.

Heart problems

The most common heart condition affecting premature babies is called a patent ductus arteriosus (PDA). The ductus arteriosus is the opening between two major blood vessels of the heart. In premature babies, the ductus arteriosus may remain open (patent) instead of closing as it should soon after birth. If this occurs, it can cause extra blood to be pumped through the lungs in the first days of life. Fluid can build up in the lungs, and heart failure can develop.

Treatment: Babies can be treated with the medication indomethacin, which causes the ductus arteriosus to close. If the ductus arteriosus remains open and symptomatic, an operation to close the duct may be required.

Brain problems  

Brain problems can also occur in premature babies. Some premature babies have intraventricular hemorrhage, which is bleeding in the brain. Mild bleeding doesn’t usually cause permanent brain injury. However, heavy bleeding may result in permanent brain injury and cause fluid to accumulate in the brain. Severe bleeding can affect a baby’s cognitive and motor function.

Treatment: Treatment for brain problems can range from medication and therapy to surgery, depending on the severity of the problem.

Long-term complications

Some premature birth complications are short-term and resolve within time. Others are long-term or permanent. Long-term complications include the following:   

  • Cerebral palsy: Cerebral Palsy is a movement disorder that affects muscle tone, muscle coordination, movement, and balance. It’s caused by an infection, poor blood flow, or a brain injury during pregnancy or after birth. Often, a specific cause can’t be determined.  
  • Vision problems: Premature babies are at risk for retinopathy of prematurity. In this condition, blood vessels in the back of the eye become swollen. This can cause gradual retina scarring and retinal detachment, increasing the risks of vision loss or blindness.
  • Hearing problems: Some premature babies experience some hearing loss. Hearing loss can sometimes be total, causing deafness. Many times, the exact cause hearing loss in premature babies is unknown.
  • Dental problems: Dental issues can affect a premature baby later in life. These include tooth discoloration, delayed tooth growth, or improper alignment.
  • Behavioral problems: Children born prematurely are more likely to have behavioral or psychological problems. These include attention-deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD).
  • Impaired cognitive function: Premature babies are also at greater risk for long-term disabilities, which can be intellectual, developmental, or both. These children may develop at a slower rate than babies born full-term.
  • Chronic health problems: In addition, premature babies have a greater risk for chronic health problems. They are more susceptible to infections and may suffer from other problems such as asthma or difficulty feeding. There’s also an increased risk of sudden infant death syndrome (SIDS) among premature infants.

Survival Rate

The earlier a baby is born, the greater the risk for short-term and long-term complications.

Length of pregnancy and Survival rate:

  • 34+ weeks    = Almost the same rates as a full-term baby
  • 32-33 weeks = 95%
  • 28-31 weeks = 90-95%
  • 27 weeks     = 90%
  • 26 weeks     = 80%
  • 25 weeks     = 50%
  • 24 weeks     = 39%
  • 23 weeks     = 17%

 

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

https://www.healthline.com/health/pregnancy/premature-baby-complications#longterm-complications

http://americanpregnancy.org/labor-and-birth/premature-birth-complications/

 

What Happens To A Woman’s Body During Childbirth

The human body is an amazing thing. It’s ability to fend off disease, perform essential functions, and harbor life until birth are a few of the most important, and amazing, feats that the human body is capable of. From the moment of conception, a woman’s body immediately begins to change in order to accommodate the internal growth of a child. As the pregnancy progresses, a woman’s body adapts to the needs of both the mother and child.

 

Childbirth is challenging and complications occur, but women’s bodies are designed to give birth. The shape of the pelvis, hormones, powerful muscles and more all work together to help you bring your baby into the world – before, during and after childbirth.

 

As you approach the time of birth, your contractions draw the cervix up into the body of the uterus, and it becomes thinner (called effacement) and opens (called dilation). When the cervix is fully dilated (about ten centimeters), contractions help the baby begin to move from the uterus into the vagina.

 

The First Trimester  

The first trimester is the time in between fertilization of the egg by the sperm (conception) and week 12 of a pregnancy. A woman’s body goes through many changes during the first 12 weeks of a pregnancy. a mother’s body is building storing nutrients and trying to keep up with the demands of a growing fetus. Fatigue is a normal reaction and is often the most inhibiting during the first trimester. Physical attributes may include constipation, heartburn, breast changes, and vaginal changes.

 

The Second Trimester  

The second Trimester is the best part of pregnancy. The span from week 13 to week 27 of pregnancy is called the “honeymoon period” for good reason: Typically, nausea subsides, emotions even out and sex drive returns. It’s also the time when you’ll start to feel the baby’s first movements.

The Third Trimester

The third trimester of your pregnancy is from week 29 to week 40 – months seven, eight and nine.Your baby continues to grow, and as the third trimester progresses she’ll have a better chance if she’s born early. The end of your pregnancy is in sight. It won’t be long until your baby arrives. Feelings at this stage of pregnancy tend to vary from tiredness and worry to excitement about the baby.

 

How does your body prepare for labor?

Braxton Hicks contractions

Braxton Hicks contractions are intermittent uterine contractions that start in early pregnancy, although you probably won’t notice them until sometime after mid-pregnancy. (Some women never notice them.) As your pregnancy progresses, Braxton Hicks contractions tend to occur somewhat more often, but until you get to your last few weeks, they’ll probably remain infrequent, irregular, and painless.

Changes to the cervix

As labor gets closer, your cervix softens and becomes thinner, getting ready for the dilation (widening) that will allow the baby to enter the vagina. You may also see a ‘show’ which is a pinkish plug of mucus, stained with blood.

Engagement

Your baby may move further down your pelvis as the head engages, or sits in place over your cervix, ready for the birth. Some women feel they have more room to breathe after the baby has moved down. This is called ‘lightening’.

Rupture of the membranes, or ‘waters breaking’

Rupture of the membranes is known colloquially as “breaking the water” or as one’s “water breaking”. A premature rupture of membranes (PROM) is a rupture of the amnion that occurs prior to the onset of labor. Sometimes, a child is born with no rupture of the amniotic sac (no rupture of membranes).

Some women find the sac of amniotic fluid containing the baby breaks before labor, contractions start and the fluid runs (or gushes) out of the vagina. If your waters have broken but you have not started having regular contractions within 24 hours, you may need your labor to be induced because there is a risk of infection. Your midwife or doctor will talk to you about this.

How the pelvis is designed for childbirth 

The female pelvis is the bony cradle that holds and even rocks your baby while she is developing in the uterus. It is amazingly designed for its functions, especially for giving birth.

The pelvis is well-designed to carry the weight of both the mother and baby. It connects the vertebrae and the lower limbs and protects the reproductive organs, the bladder, intestines, and rectum. It also provides attachment for the abdominal muscles and the muscles of the pelvic floor.

The pelvis is made up of four bones: the two large hip bones that form the sides of the cradle and meet at the front and the sacrum and coccyx at the back.

During pregnancy hormones cause the ligaments soften and stretch causing a slight separation of the joints, which allows flexibility for the baby’s head to pass through during birth. Sometimes pregnant women may experience some pelvic pain and discomfort as a result of this loosening of the joints.

The Childbirth Process

Childbirth, also known as labor and delivery, is the ending of a pregnancy by one or more babies leaving a woman’s uterus by vaginal passage or C-section. It involves three stages of labor: the shortening and opening of the cervix, descent, and birth of the baby, and the delivery of the placenta.

Cervical dilation occurs during active labor, making room for the baby to travel through the birth canal. The cervix dilates naturally when the body is ready to give birth, but when it’s necessary to move things along more quickly, dilation may be stimulated using medications or mechanical techniques.

The placenta is delivered as part of the afterbirth with a small gush of blood, from a few minutes to a half hour after the baby arrives. The doctor or midwife will examine it to make sure it’s intact and that nothing has been left behind in the uterus.

When childbirth doesn’t go to plan

Unfortunately, not everything goes to plan during birth. Sometimes your maternity team may need to intervene to assist in the delivery of your baby. Find out more about how your doctor or midwife may assist during your labor and what happens when your baby is premature or unwell.

Sometimes labor can be induced (started artificially) if your baby is overdue or there is any sort of risk to you or your baby’s health, for example, if you have high blood pressure or if your baby is failing to grow and develop.

In rare cases, a mother may experience cephalopelvic disproportion (CPD), which is when the baby’s head is too big to fit through the pelvis. A diagnosis of CPD is usually made when labor hasn’t progressed and synthetic oxytocin has not helped. A cesarean is usually the next step.

 

In conclusion, The stages of pregnancy and childbirth may seem daunting at times. However, they are some of the most rewarding phases of life. Bringing a child into this world is a beautiful labor.

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

https://www.pregnancybirthbaby.org.au/what-happens-to-your-body-in-childbirth

http://positivemed.com/2015/10/27/what-happens-to-a-womans-body-during-childbirth/

How to Prepare For a Vaginal Delivery

 

One of the biggest things pregnant women worry about as they get closer to their due date is labor and delivery. Every delivery is as unique and individual as each mother and infant. In addition, women may have completely different experiences with each new labor and delivery. Giving birth is a life-changing event that will leave an impression on you for the rest of your life.

 

Labor and delivery

Eventually, the cervical canal must open until the cervical opening itself has reached 10 centimeters in diameter and the baby is able to pass into the birth canal.

As the baby enters the vagina, your skin and muscles stretch. The labia and perineum (the area between the vagina and the rectum) eventually reach a point of maximum stretching. At this point, the skin may feel like it’s burning.

The process of labor and birth is divided into three stages: The first stage begins when you start having contractions that cause progressive changes in your cervix and ends when your cervix is fully dilated.Early labor: Your cervix gradually effaces (thins out) and dilates (opens).

 

Ways to Stay Calm and Prepare for Labor & Delivery

 

 

  • Choosing the right doctor: Of course, your doctor matters. But depending on your OB and her on-call schedule, she may not even be the one to deliver your baby. It could be another doctor from the practice or it could even be an ob-gyn who happens to be working at the hospital the night you go into labor——someone you’ve never met before.
  • Where to give birth: Not all doctors have the right to practice in every hospital. Just because the perfect doctor is only 30 minutes away does not mean he or she will be able to attend the birth at the local hospital in case of emergency delivery. The doctor will be able to offer a list of hospitals where he or she has practicing rights.
  • Talk to your doctor about any concerns you have: This is a great, easy way to help you stay calm and prepare for labor and delivery. Your doctor will have solutions to probably any fear you have about childbirth. And you’re presumably going to have them there during delivery, so communicating and being on the same page is very important. 
  • Practice breathing and meditation: Breathing properly helps to relieve pain during labor as well as increases the amount of oxygen for both mom and baby. When being stressed or panic, the breath becomes fast and shallow, which can make you lose control and soon exhausted. So, learning the proper breathing technique will help pregnant women during labor.  Read more https://sonoline.ca/proper-breathing-during-labor-and-delivery/
  • Write the birth plan: Beyond the must-haves, think about how you envision your birthing experience. Some hospitals are more supportive of natural childbirth than others. A birthing plan is not for everybody. A birth plan is a way for you to communicate your wishes to the midwives and doctors who care for you in labor. It tells them about the type of labor and birth you’d like to have, what you want to happen, and what you want to avoid.
  • Pack the hospital bag: The hospital bag is one of the highlights of waiting for baby. When packing the hospital bag, mom needs to remember the baby’s first outfit, diapers, wipes and any supplies needed to feed baby either by breast or bottle.
  • Preparing the body: Vaginal delivery is hard; there is no other way to put it. Mom needs to keep her body in top shape to keep up with the stresses and pains of delivery. This includes eating right and getting enough sleep every night.
  • Preparing the vagina: The vagina also needs to undergo some preparation. Mom can use Kegel exercises to prepare the vagina for the birth. The term “stretchy vagina” might not exactly sound like a good thing, but when you’ve got a small human inside your body needing to get out, and it can save a whole lot of pain and – hold your breath – tearing.When urinating, mom can practice stopping the stream several times during the urine flow. The muscles used to stop the urine stream are the same ones that need to be strong during a vaginal birth. Once mom feels the muscles, she will be able to do the exercises whenever she wants.
  • To breastfeed or bottle feed: Before going into labor, mom needs to decide whether she will be breastfeeding or bottle feeding. If breastfeeding is the choice, the first feeding can occur only moments after birth in some cases.Beyond that, breastfeeding is encouraged until at least 12 months, and longer if both the mother and baby are willing. Although experts believe breast milk is the best nutritional choice for infants, breastfeeding may not be possible for all women.The decision to breastfeed or formula feed your baby is a personal one.
  • Accept that you can’t control everything: Childbirth isn’t something you can guarantee is going to go perfectly. It’s okay if you can’t stick to everything on your birth plan, and it’s okay if you have to have a C-section instead of a vaginal delivery. The most important thing is your health and the health of the baby, and you have to accept that there are things that are out of your hands that you can’t control. Just let go a little bit and put your trust in the doctors and nurses taking care of you.

 

Childbirth is crazy and weird, but it’s also an amazing miracle. Pain during labor is caused by contractions of the muscles of the uterus and by pressure on the cervix. This pain can be felt as strong cramping in the abdomen, groin, and back, as well as an achy feeling.You shouldn’t be scared and you shouldn’t worry about the what if’s. You should be excited and feel confident in your ability to push that baby out! When the time comes, you’ll have a team of people you can trust on your side, and you’ll be ready to go. Good luck!

 

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

 

Resources:

https://www.babymed.com/12-steps/how-prepare-vaginal-delivery-during-pregnancy-12-steps

https://www.lifewithmylittles.com/ways-to-stay-calm-and-prepare-for-labor-and-delivery/