Although pregnancy and birth is a perfectly natural process it is seldom naturally perfect! It can be said with certainty that inadequate preparation for pregnancy and birth is a major factor in the cause of complications which can be modified by preparation or conversely aggravated by lack of this. Factors associated with an unhealthy diet, stress, anorexia, bulimia, obesity, lack of exercise, sexually transmitted infections (STI s), effects of alcohol, smoking, drug abuse, over medication of “across the counter drugs” causes wear and tear on the body’s resources, adversely affect health and impact on fertility and pregnancy outcomes.
Many women feel well and believe themselves to be in perfect health, yet may have a lifestyle that has the potential to make them less well or even cause them to become ill. It is questionable how much healthier our babies would be if all prospective parents aimed for optimal pre conceptive health and how many would not suffer from miscarriage, stillbirth, birth defects, difficult births or other complications had their lifestyle (and that of their partners) being healthier before and during pregnancy. Knowledge is power and prevention is heightened by awareness.
‘Preparation for Pregnancy, Birth and Motherhood ’ is a health educational book and addresses many such factors.
Chapter 1 - Pre-Conceptive Care
The pre conceptive phase is a window of opportunity to establish health status and determine concurrent risk factors to mother and baby and in so doing facilitate positive health and lifestyle choices in order to achieve a healthy pregnancy outcome. Pre conceptive health checks are a necessary safeguard allowing time to resolve or treat adverse findings or conditions which could pose a risk to the mother or unborn child.
However, the relevance of pre conceptive care to the health of future generations tends to remain a minor component of health promotion even though the impact could positively affect the health potential of both women and children in the short and long term. Early detection of disorders whose roots may lie in influences such as genetics, poor nutrition, lifestyle, and exposure to toxic substances are amongst some of the challenges to health in modern day society.
Pregnancy and birth carries responsibilities for the remainder of a lifetime. Parents contemplating pregnancy ought to understand the significance of pre conceptive care and for some this may mean changing or modifying a lifestyle that is stressful, demanding or otherwise unhealthy.
Chapter 2 - Changes That Occur In Pregnancy
Many changes occur throughout pregnancy which causes disturbances and discomforts. Identifying common symptoms and knowing how to alleviate these helps the mother cope with the various demands of each trimester.
This section will help the mother to:
- appreciate the relevance of ante natal care; type and frequency of ante natal check ups to meet individual needs
- understand the need for clinical and biochemical assessment and become familiar with tests recommended
- develop knowledge of the different maternal and infant screening tests and the relevance of these
- identify the pregnancy changes that lead to disturbance and discomforts within the various body systems and the effects of common symptoms and how these may be alleviated
- recognize the importance of her own care during pregnancy and help her to cope with the changing demands in each trimester
- to enjoy this special time in her life and to look forward with optimism and hope for the future
Chapter 3 - Ante Natal Exercise
Antenatal Exercise prepares the woman physically and psychologically for pregnancy, birth and the post natal phase and enables her to work with the natural changes of pregnancy in terms of exercise and relaxation as well as achieving long term benefits.
This section provide safe guidelines and approaches to exercise at various stages of pregnancy and explains why certain exercises are beneficial to specific areas of the body particularly those which bear the brunt of physical weight in pregnancy.
Having a clear understanding of the physical structure and anatomy of the musculoskeletal system and the effect of pregnancy hormones on certain areas demonstrate the benefits of ante natal exercise.
Chapter 4 - The Art Of Relaxation
Of the many reasons why women attend antenatal classes the most significant one undoubtedly is “to learn the breathing technique for labour”. In my experience this class generates the most positive feedback. So much so that many women request a refresher relaxation class in a subsequent pregnancy.
The natural method of relaxation lends itself extremely well to the first and second stages of labour. Coping skills can be learned by both parents during pregnancy and practised regularly at home in preparation for labour.
Being able to use a relaxation technique in labour lessens painful contractions; induces comfort; conserves energy; reduces the need for pharmacological pain relief and has the immeasurable benefit of providing extra oxygen to mother and baby during labour. Women who are able to reduce tension to ease by using a relaxation technique tend to have a shorter and more comfortable labour and a healthier outcome all round.
The main tools are relaxation technique, breathing awareness and positions of ease all of which are interrelated. Once mastered the relaxation technique is a very useful asset in any situation compromised by tension e.g. the early days of parenting, feeding baby, to ease pain from stitches, after pains or other discomforts.
As a life long tool relaxation can ease countless challenges such as, interviews, school/college examinations, illness/hospitalisation, screening tests, social/public events etc.
Chapter 5 - Feeding The Newborn Infant
Human milk is the gold standard nutrition for the newborn infant and is a well devised follow-up plan by Mother Nature as a sequel to nutrition via the afterbirth.
This chapter gives non – judgmental, unbiased information on breast and bottle feeding; supports a mother’s choice of feeding and provide guidelines on the physical act of breastfeeding and encourage and support mothers who breastfeed. Assurance is given to mothers who may not breastfeed for whatever reason with guidelines on Formula feeding, various formulae available; equipment and sterilisation options plus management of formula feeding.
Chapter 6 - Co-Existing Conditions of Pregnancy
Pregnancy is a perfectly normal process but is seldom normally perfect. Certain abnormal conditions are associated with pregnancy which may compromise the health of mother and /or baby. These can pose possible consequences; therefore require appropriate treatment as early as possible.This chapter will help the mother understand such conditions and identify probable signs.
While the cause of some conditions may be elusive and unavoidable; identifiable risk factors associated with others may help prevent or modify harmful effects. Whilst the overall management is at the discretion of the midwifery and obstetric team, being able to understand the correlation symptoms, assessment and appropriate treatment will help the mother’s resilience through a trying phase of her pregnancy.
Chapter 7 - The Course Of Labour
The aim of this chapter is to:
- Provide the mother with a realistic picture of labour which helps her to understand the course of normal labour
- Recognise the signs of labour and know what to expect
- Identify changes as labour progresses
- Provide guidelines that help the mother achieve comfort and enable her body’s resources for coping with labour
- Handle the emotional factors of labour
- Help her understand the need for care in labour; for midwifery and medical assessment and intervention as well as the support and help available to her.
- Give the mother confidence in her ability to participate in the different stages
Chapter 8 - Other Labour Considerations
This chapter discusses the many aspects of labour and and options available which maximises the health of mother and baby.
Some small few women “sail” through childbirth and have a normal straight forward delivery without the help of pain relief. However,
the majority of women need pain relief in labour while others require the implementation of additional safeguards to assist the birth by
means of medical or surgical intervention.
A number of procedures are available which generate greater comfort and safety for both mother and baby. Women ought to be aware of such safety measures for what they are, and not become alarmed, or worried that their labour has suddenly become complicated.
Chapter 9 - The Puerperium
The first six weeks following the birth is clinically referred to as the Puerperium.
The birth of the baby may be the “grand finale” of pregnancy, but is also the start of a new stage in life. The emotional and physical changes of pregnancy extend into the early days of motherhood. A woman’s emotional, physical and psychological needs are more pronounced than in pregnancy and recovery from childbirth and adjustment to motherhood takes time.
Health problems though rarely life threatening can occur as a result of childbirth which may need medical attention. It is important to identify the normal from the problematic and take appropriate steps to ensure the best quality of life is attained. Interrelated factors may include increasing maternal age, a long labour, perineal trauma, forceps, vacuum delivery or caesarean section.
Conversely, health issues following childbirth are not always specifically attributable to pregnancy and birth but due to life changes, current relationships, responsibilities and demands of parenting; pre existing health conditions or circumstances. Some issues may be totally unrelated to any of these factors and are unique to the particular mother or child. Support and guidance in a woman’s adjustment to motherhood is an essential component of the health professional’s role. A range of statutory and voluntary services provide specialist help and support to those in need. This ensures that children are safeguarded throughout their life; develop their full potential with equitable access to education and health services achieving optimal health and social gain.
Chapter 10 - Care Of The Newborn Infant
Each baby has their own unique traits some of which may be apparent in the first few days. The whole birth experience and transition to life outside the warm, wet, untouched boundaries of the womb is an unconscious period that remains unknown and mysterious territory. No baby is ever born smiling! Going by the harrowing facial expression and the body language it seems pretty certain that birth is rather an unpleasant experience.
Considering how the baby must feel during the transition to independent life and if s/he still feels attachment to its mother it is important to appreciate the newborn baby as an individual in his/her own right. There is no accounting for the phenomenon of genetics and familial traits with which a baby is born. Such legacies ought to be respected for what they are and while a mother has the privilege of giving birth and the joys of rearing her child she also has the responsibility to provide an environment for optimal growth and development which ensures the child achieves maximum potential in life.
Appendix 1 - Premature Labour
An inter play of multi factorial risk factors associated with premature labour makes it difficult to identify women at risk. Knowledge of implications of the circumstances helps parents come to terms with the reality of premature birth.
Appendix 2 - Twin Birth
Twins developed from a single ovum (egg) are known as identical or uniovular twins and are the only real twins in the biological sense. Babies developed from two separate eggs (ova) and two different sperm are not biological twins; are not identical and are known as binovular twins. Race, heredity factors, age and number of previous pregnancies are pertinent to the incidence of binovular twins. Incidence of uniovular twins appear to be independent of such factors.
Appendix 3 - Complimentary Therapies
Very few pharmaceutical products can be safely used in pregnancy, labour and the postnatal period. Access to natural remedies and alternative therapies empowers pregnant women and provides them with additional resources which are therapeutic, relaxing and calming.
Appendix 4 - Crisis Pregnancy
Any pregnancy which creates a crisis means an unplanned pregnancy which occurs at inopportune time and creates a degree of upheaval. Fortunately, society values human life and if a woman has no family or friends to help her there are many excellent statutory and voluntary organisations to respond to the needs of mother and baby.
Appendix 5 - Parenting Alone
Planning for Baby’s Future
Every expectant mother needs to plan a little ahead, however if parenting without the support of a partner or if the pregnancy is unplanned, it is best to start planning for the future and any decisions concerning your baby, early in pregnancy. This may well be a very difficult time but putting off facing the choices may result in hurried decisions later on and which may not the best for mother and your baby.
Appendix 6 - Loss In Pregnancy
A pregnancy that ends in miscarriage, ectopic pregnancy or stillbirth is a harrowing and heartbreaking event in one’s life. Loss of pregnancy is a cruel tragedy and dealing with the loss is mentally painful in the extreme. It takes a long time for your mind to heal and recover from the tragic loss of your baby.
Appendix 7 - Sudden Infant Death Syndrome
Unexplained deaths of infants have occurred for centuries and why some babies die suddenly is still obscure. Research in recent years has identified simple measures parents can take to reduce their child’s risk of cot death.
Appendix 8 - Contraception After Childbirth
Timing pregnancy with contraception allows time for pre conceptive care thereby minimising risk of complications in pregnancy and childbirth.