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labour

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A woman who has had a child before might hazard a guess; while the one who is a first-time mom might base her expectations on all the tales she has heard from other moms.

Yet, apart from the fact that each birth is unique and may not necessarily follow the same pattern when having another baby, individual experiences are never the same, as many factors such as age, genetics, finance and the expectant mother’s health all combine to shape the experience each person would have during child delivery.

Physicians say a lot could be achieved when pregnant women know what to expect during labour, as it will enable them to cooperate with their health care providers, thus making delivery a lot easier for everyone concerned as a newborn is being ushered into the earth.

Attend antenatal clinics religiously

Consultant Gynaecologist, Dr. Mosunmola Emmanuel, says no pregnant woman should miss any of her antenatal schedules because it is the avenue to learn many things about the progress of the pregnancy, while it also affords the opportunity to relate or socialize with expectant mothers.

“More important, it provides the patient the opportunity to see her doctor and to discuss her concerns, if any.

“It is also on such visits that the progress of the pregnancy is measured; while the expectant mother also uses the occasion to obtain her necessary medications such as folic acid and multivitamins,” the physician says.

She notes that a good hospital will let a pregnant woman how labour works and what to expect, without necessarily inducing fear, especially among first-time mothers.

Your body

To start with, you need to know how your body prepares for the eventual delivery.

According to General Practitioner, Dr. Moye Pariola, by the middle of a pregnancy, the pregnant woman sometimes experiences contractions, which seems to prepare the body for the real thing when labour actually commences in the ninth month.

He says, “This is medically known as Braxton Hicks contractions. As the pregnancy nears an end, these contractions may become more intense such that a pregnant woman can even mistake them for the commencement of labour.

“However, the difference between actual labour and the Braxton Hicks contractions is that Braxton contractions are not regular, they don’t last very long and although they can feel strong they should not feel painful.”

Pariola counsels that if you’re worried that the tightening you’re feeling might be the start of labour, it is necessary to contact your midwife, birth centre or labour ward for advice.

Have a fair idea about breastfeeding

Many women think breastfeeding is a walk in the park and that there is nothing to learn about it!

However, experts say even though breastfeeding a baby is a natural process, it is never an easy one.

Experts at baby.com advise that before you go into labor, you should take a breastfeeding class.

You and your husband should decide whether you want to do exclusive breastfeeding, which is highly recommended for the first six months.

“Beyond this, however, is the problem of engorgement that many new mothers sometimes experience.

“When breast is engorged, it may be difficult for the baby to feed, while the mother will also experience pain when the milk doesn’t flow.

“We always advise new mothers to have breast pump, which can be used to pump out milk and relax the pressure, thus enabling for milk flow, to the relief of mother and baby,” Pariola suggests.

Remember your EDD!

Dr. Emmanuel says pregnant women should be mindful of their Expected Day of Delivery, which their physician would have communicated to them in the first trimester of their pregnancy.

“For most women, EDD is exact, while for some, it is plus or minus a few days. Once you work with your doctor, there is nothing to fear,” she assures.

On the D-Day!

Physicians say it is advisable to eat light meal as you prepare to check into the hospital.

“Since you could vomit while in labor, it’s a good idea to have small snacks instead and drink plenty of water to stay hydrated.

“What’s more, some hospitals may not allow you to eat once you check in; so, it’s a good idea to give your body the energy it needs for labour while you can,” they suggest.

Experts also counsel that you are emptying your bladder every couple of hours.

“You may lie down, or take a warm bath; just as you may ask your caregiver for pain reliever if the pain gets unbearable.

“What is important at this stage is to listen to your nurse’s instructions and to cooperate. Standing, walking, kneeling, slow dancing, sitting and squatting, variously combine to help move the baby down and out. Explore the options,” Emmanuel suggests.

The bottom line: Labour and childbirth are hard work, manage them effectively.

PUNCH. 

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Malaria in pregnancy should be considered a medical emergency as it does more harm to the fetus than envisaged, the Head, Case Management Branch, National Malaria Elimination Programme, Dr. Godson Ntadom has said.

He noted that while malaria parasites in non pregnant persons feed on nutrients from the red blood cell of its host, that of pregnant women prefers to stay in the placenta where it feeds on the nutrients meant to supply the fetus because of its richness, thereby starving the fetus to death.

Speaking during the NMEP, Health Communication Capacity Collaboration and Health Editors interactive section in Lagos recently, he said, “during the period the parasites are feeding on the nutrients coming into the placenta meant for the fetus, the woman will not feel the signs of malaria because technically the placenta is not part of her body. It is when the parasites are full and satisfied that they now move into the woman’s blood stream, and at which point, she will start noticing malaria symptoms.”

Ntadom said it was a medical emergency because the point the woman starts noticing malaria signs means the parasites have starved the fetus of its needed developmental nutrients and are satisfied with the placenta.

“By this time they will then move to the woman’s blood where she will start filling the symptoms of the disease. There is a high possibility that at this point the damage may have been done to the fetus. That is why it is a medical emergency to see if the situation can be remedied,” he added.

He said contrary to popular belief that anti-malaria drugs were not good for treating malaria in pregnancy, the medical expert said it was the parasites that kill the fetus and not the drugs.

“Often times, pregnant women start treating malaria when they start noticing malaria signs, but what most people don’t know is that before a pregnant woman start noticing the symptoms, the parasites must have done damage to the fetus through feeding on the placenta. It is when the parasite is done with the placenta (probably damaged the fetus) that the woman can start noticing signs,” Ntadom said.

Meanwhile, Ntadom has reiterated Federal Government’s earlier decision to ban the use of Chloroquine and mono-therapy drugs for the treatment of malaria in Nigeria.

He said the emphasis on the ban on Chloroquine and mono-therapy drugs were necessary as some persons still sell them to unsuspecting patients.

“Apart from mono-therapy injections which are used for treatment of severe malaria, its drugs and Chloroquine have long been banned by government. It is a criminal offense for any health personnel to sell them to patients,” he added.

In the same vein, he said Nigerians do not need medicines for the prevention of malaria, adding that only pregnant women and foreigners should be given such recommendations.

“The one presently recommended now is Malarone which is a combination of two medicines and it is for foreigners who probably would be staying in the country for a short time.

He said the citizens were free to visit NMEP website www.ncmp.gov.ng for informations on malaria in Nigeria.

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When you visit a new mother, especially if it’s her first child, you are more than likely to be assailed with horror stories about child delivery. The average woman would tell you that childbirth is a near-death experience. This usually drives fear into listeners who, in most cases, are women.

Of course, pregnancy and childbirth are not a cakewalk, even when the expectant mother has the best team of professionals to attend to her at delivery. As pregnancy progresses, a lot of issues crop up. In most cases, the expectant mother is able to carry the baby to term without much ado; others are not so lucky, as they may develop complications during the nine-month pregnancy duration.

In fact, experts say how a pregnancy period goes sometimes determines how the delivery would be. Hence, they advise expectant mothers to adhere to strict healthy habits to ensure safe delivery and sound health for the mother afterwards. But then, the fact that no two pregnancies are the same is of utmost concern to mothers. Even those who have had babies before still nurse doubts about a new pregnancy. This fear factor is what physicians condemn among women because, as they say, it sometimes affects their response during childbirth.

This much was corroborated by a research published in BJOG: An International Journal of Obstetrics and Gynaecology, by Norwegian researchers who claim that labour takes 47 minutes longer for women who fear childbirth. The scientists studied 2,206 women who were scheduled to give birth at a hospital in Norway between 2008 and 2010. Lead researcher, Dr. Samantha Adams, of Health Services Research Centre, Akershus University Hospital, University of Oslo, Norway, says her team discovered that the average duration of labour was eight hours for women with fear of childbirth, compared with six hours and 28 minutes for women who didn’t nurse any fear.

The study also found that women with fear of childbirth more often delivered by instrumental vaginal delivery (17.0 per cent versus 10.6 per cent) or emergency caesarean delivery (10.9 per cent versus 6.8 per cent), as compared to women without fear of childbirth. Why are women afraid of a natural process they are cut out for? We dare ask. Consultant obstetrician, Dr. Paul Abisoye, says young maternal age, being a first-time mother, pre-existing psychological problems, lack of social support and a history of abuse or adverse obstetric events are some factors that may make a woman fearful as time of delivery approaches.

Psychologist, Dr. Mary Jude-Ogidan, notes that in psychology, such fear is called enfantaphobia, which, she says, may also border on some psychiatric issues that physicians must not wave off as “one of those things. Again, the question: in particular, what do women fear about childbirth?

A teacher, Mrs. Teni Abiodun, says as a first-time mom, she was extremely fearful as her Expected Date of Delivery drew near. Having witnessed the elongated episiotomy her older sister had during delivery, she says, she was afraid she would have the same experience. She had a ‘normal’ delivery, though, and except for the usual labour pain, she and the baby were perfectly well.

Abisoye says episiotomy (surgical cut of the perineum) is usually done to hasten birth during an emergency when the baby or mother is becoming distressed or if the perineum is so tight that it is delaying the birth. “Hence, all expectant women should not think they will have it,” he assures.

Another mother, Mrs. Fatima Mojeed, says she feared losing her babies at birth. She never did, as all her five children are alive and well. Again, Abisoye says this fear is not abnormal. He says, “While it is absolutely normal for expectant mothers to be anxious, it should not be confused with premonition, which may even make them hypertensive or unable to cope with the instructions of midwives during delivery.”

The Norwegian researchers warn that anxiety and fear may increase blood concentrations of hormones called catecholamines (produced by the adrenal glands and released into the blood during times of physical or emotional stress). “This, in turn, may weaken the ability of the uterus to contract,” they say. The biggest fear most respondents express is that of possibly undergoing Caesarean Section.

In Nigeria, most women still view C-section with suspicion; and it is not unusual for pregnant women to be told by well-wishers, ‘They (doctors) will not use the scalpel to bring out your baby on the day of delivery.’

Jude-Ogidan says though this prayer appears good, it’s nothing short of psychological warfare, as the mom-to-be soon begins to picture someone in white overall, brandishing a scalpel, and wanting to bring out the baby! “It’s not a good picture at all and expectant women should not dwell on it, especially if their doctor hasn’t told them they would have a C-section,” she warns.

The other big fear is the intensity of the pain that may attend labour. Again, Abisoye counters this with medical counsel. He says, “Remember that the pain of childbirth is not that of an injury or of an illness, as there is no damage being caused by the contractions. It is just muscles working really hard to stretch and open for a baby to come out.”

He cautions that even if you fear pain, discuss with your physician, as there are various methods of pain relief available for women who require them.

PUNCH.