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The e-pregnancy is designed on April 2007 in a logical fashion, and categorised chronologically. It is our desire to provide you with high quality on line information, about birth schedule of care how women can recognises the signs of labour, stages of birth and birth complications. each section provides links and resources and refernces informations.

We are more than happy to answer any question.

Please be free to contact us.

E-mail: kleopatra229@yahoo.co.uk

Kleopatra.Alamantariotou@chelwest.nhs.uk

Tel :0207 6862898

Birth Complications

Some of the main complications and problems during labour and birth are below:

-Postterm labour

-Preterm labour

-Slow labour

-Premature rupture of membranes

-Abnormal Position

-Multiple births

-Shoulder dystocia

-Perineal Damage

-prolapsed umbilical cord

-Maternal infection

-Bleeding

The information in this web page is presented in summarised and has been taken from :

Health on Net Foundation www.hon.ch/Dossier/MotherChild/

http://health.discovery.com/centers/pregnancy/complications/complications.html

stages during labour

First stage of labour
For most women is the longest. If this is her fisrt baby, the average fisrt stage of labour can last from 6-12 hours. For subsequent births, the first stage is often shorter, averoging anywhere from 4-8 hours.

Early labour:
Usually begins with mild contractions that are 5-15 minutes apart and last from a minute to a minute and half each. During this period the cervix dilates from 0 to 4 centimeters

Active labour:
Is charectirized by stronger contractions that start to come closer together (every 3-4 minutes).
The mother may break at this point, which will cause contractions to become even stronger. During this period of labour the cervix wil dilate from 4 to 10 centimeters. When you know that you are truly in active labour( contractions 3-4 minutes apart and each lasting a minute).
It is good this time to call your hospital or to phone your midwife.

Second Stage of Labour:when the cervix has dilated fully to 10 centimeters, the second stage of labour begins. This is when the woman will need to begin to "push" her baby out. She will feel the urge to bear down with each contractions and should do so when given the ''go ahead'' by her doctor to help to move the baby into the birth canal.
The birth of the baby signals the end of second stage of labour.

Third Stage of labour:This is the shortest stage of labour and can last from just a minute or two up to twenty minutes. The mother will still experience some contractions. They will be closer together than when she was pushing and usually less painful. These contractions help to get the placenta down into the birth canal.

The information in this page is presented in summarised and has been taken from: Health on Net Foundation www.hon.ch/Dossier/MotherChild/

How to recognise the start of labour

signs of labour:

The show: There is the plug of mucous in the cervix which has helped seal the womb in pregnancy.
If you notice dark blood mixed with jelly-like mucous, take no actions as labour may still be days or weeks ahead- or it could mean beginning of labour.

If the blood is brigth red and amounts to more than 3 teaspoons, telephone the labour wardfor advice.

You may also have these additional signs.
BACKACHE
NAUSEA AND VOMITING
DIARRHOEA

CONTRACTIONS
Mild, painless contractions occur during late pregnancy. These are called Braxton Hicks. When they become stronger as the date of your baby is due approaches, they may originate in your back and give slight backache. Early contractions of this type are irregular in strength and length. The phase could last for 24 hours before you go into labour. The contractions do not last more than 30-40 seconds each. At the time your baby's head is propably descending further into your pelvis and your servx is softening, but true labour has not begun.

Contractions in early labour are different. they are regular in strenth as labour progresses. The distance between contractions shortens.
In early labour at home keep active, change position frequentlyand relax in a bath or shower. Eat a light meal and your partner or your friend to keep you company.
When the contractions are strong and regular and coming at 5 minute intervals and lasting 50 seconds plus each or you own, consider your move to hospital.

Water breaking
Ring the labour ward. The midwife will ask you to come straightaway and even if you are douptful, it will be better for you to be checked. Please use a pad so that the midwife can see the 'evidence'.
Do not forget to bring your notes when you come in the hospital.
If you advice to come to hospital and you have difficulties with transport, ring 999 and ask for an ambulance.


The information in this page is presented and summarised and has been taken from:
Fraser-Cooper(2003) Myles Textbook for Midwives . 14th edition Churchill Livingstone

A guide to effective care in pregnancy

shape your care

Antenatal care refers to the care that is given to a pregant woman from the time that conception is confirmed until labour.

The aim of antenatal care is to monitor the progress of pregnancy in order to support maternal health and fetal well being.

Also to recognising complications of pregnancy and appropriately reffering women within the multisciplinary team.

A friendly, professional approach will enable the development of partnership between the woman and the midwife. The initial first visit focuses on the exchange of information. This helps health professionals and the women to get know each other and to continuing step by step the path of pregnancy.

The Scedule of care during pregnancy is below:

First appointment 12-13 weeks or late booking

Meeting the midwife for Booking medical history and family history will be discussed. Information and leaflets will apply.

It is necessary to do the first Blood tests(In particular we wil checked.

Full blood count: this is taken to observe the woman's general blood picture.

ABO blood group and Rhesus(Rh) factor: Rhesus negative women or women who have threatend miscarriage, amniocentesis or any other uterine trauma should be given anti_D gammaglobulin.

VDRL TEST(Venereal Disease Research Laboratory)

Early testing will allowed you to be treated in order to prevent infection of the fetus.

HIV antibodies. Routine Screening for detect HIV infection is recommended in pregnancy. It is important to gain informed consent form for any blood tests undertaken.

Rubella Immune Status: This test determined by measuring the rubella antibody. Women who are not immune must be avoid to be with anyone suffering from the disease and maybe wish to discussed termination of pregnancy if they have been exposed.

investigations for other Blood resources Sicle cell disease or Thalassamia.

If a woman has or is a carrier of one of these diseases her partner's blood should be tested.

Hepatitis B routine screening. This test performed to reduce the risk of perinatal transmission and associated morbidity and mortality in the infant.

Blood Tests including sugar lever. This blood test performed during pregnancy in order to investigate if you have any problems with Gestation Diabetis.

16 WEEKS

You Can arrange appoitment with your General Practitioner for a check up.

Check up including heart and lung Function.

20-21 WEEKS:

Midwife appointment. In this appoitment you can discussed blood test results after your routine anomaly ultrasound scan. You will received information about mini GTT test.(blood sugar test

Lucozade drink will supply for the 26 weeks appointment and blood tests will be performed

24 WEEKS:

You will have another appointment with your general practitioner in order to listen the Fetal Heart rate , to estimate your physical well being and to check your blood pressure .

26WEEKS:

Midwife appoinment. Routine procedures will be performed in every midwife's appoinment.

Listening Fetal Heart rate, Physical examinations mother's well being, Blood pressure check.

Also Blood tests including Sugar Level (mini GTT) will performed.

Reminder : is good period to arrange Antenatal birth preparation classes .

30 WEEKS: General Practitioner appointment for routine check.

34 WEEKS: Midwife's appointment. During this visit you will receive information about Vitam K for the baby and how to recogninise signs of labour. Blood test will performed including iron level.

36 WEEKS:Appointment with your midwife. Routine care and checks will be performed. You will have the opportunity to discussed your birth plan or any questions will arise.

38 WEEKS: Appointment with your midwife. Routine care practices.

39WEEKS: Appointment with your General Practitioner for observations and routine care practices.

Reminder: Have you pack your bag to take to hospital?

40WEEKS: Appointment with your midwife. You will received information about induction of labour.

41WEEKS: last appointment with your midwife if you have already not delivery your baby. During this meeting you will received information about the process of induction of labour and your midwife will be book a date for that.

The date of induction you are going with your medical notes and your bags in labour ward. The midwives will monitor the baby, and they are going to estimate your cervix dialation. If your cervix is closed then will give you a prostaglandin gel. After this process you can walk and the next 6 hours the midwives will check if you have any progress or if your contractions starts and you are in real labour.

On the other hand if your cervix is open for instance 2cm and you have no contractions , the midwives will break your waters in order to help you to be in established labour. If NOTHING of that works then the plan is to start intravenous syntocinon in order to start the contractions. During this process it is necessary the continues monitiring of the baby.

We wish you all the best and good luck

Do not hesitate to contact us if any questions or concerns.

introduction

'childbirth is the work of women as they labour and bear down with their uterine muscles to push their babies from the private inner world of their wombs into the larger world of society and culture '(Davis 1996).

Worldwide, it is estimate that 529.000 women die yearly from complications of pregnancy and childbirth about one woman every minute some 99% of these deaths occur in developing countries. In rich countries, women receive care from trained health professionals(Worldbank 2006).

Our website provides background information for mothers -families and health professionals. Our purpose is to give a guide to effective care step by step. To give information to women how to recognise the start of labour, to describe the stages of birth and birth complications during labour.

We wish you to enjoy your pregnancy and feel lucky for the care you received

The information in this page is presented in summarised and has been taken from the following sources: www.Davis-Floyd.com www.worldbank.org/