Maternal Newborn Health

This is the longest and easiest stage of labor. If fact, you may not even notice when it starts. It can happen in a few hours or a few weeks as your cervix dilates (opens) to 3 centimeters. You may or may not feel gentle contractions. Your contractions will usually last for about 30 seconds and start at 20 minutes apart. They may come in a regular pattern or be random. Other signs of early labor include backache, pressure in your lower belly, diarrhea, upset stomach, a little bloody fluid from your vagina, or your water breaking.

When you are in labor you may feel excited, relieved, or even fearful. This is a good time to surround yourself with good support and to rest as much as possible. You will need your energy for the last stage of labor.

Things to do:

• Rest!
• Eat lightly. Try toast, bananas, plain pasta or rice. Avoid anything heavy, fatty, or acidic.
• Drink small amounts of water.
• Go to the bathroom often. A full bladder can slow labor.
• Make sure your hospital bag is ready to go.
• Pay attention to your contractions. Time them so you know when they are less than 10 minutes apart.

Go to the Hospital Immediately:

• If you have bright red liquid from your vagina or if you think you are bleeding
• If your water breaks and it is not clear or it smells
• If you cannot feel your baby move

This is when labors starts to get serious. This phase usually lasts 2-3 hours but it can be very different for everyone. You cervix will dilate (open) from 3 centimeters to 7 centimeters. Your contractions will start to come in a pattern and they will become stronger. They will last about 30 to 40 seconds and come every 3 to 4 minutes. You may also feel backache, fatigue, heaviness in your legs, and have more mucus from your vagina. If your water hasn’t broken yet it probably will. During this stage you should go to the hospital, especially if you want an epidural or other help with pain.

Things to do:

• Rest!Focus on your breathing.
• Try doing things to help you relax.
• Ask for help! Ask for a back rub, a hand to hold, whatever you need.
• Ask for pain medications if you want them.
• Have small sips of water or even a light snack if your doctor says it is okay.
• Move around and change positions, this will help your labor go faster.
• Go to the bathroom often. A full bladder can slow labor.

You’ve made it to the end! This is last and most intense stage. It typically lasts for about 15 minutes to 1 hour, but can be longer for some women. Your cervix is opening from 7 centimeters to 10 centimeters. Your contractions will be very strong, lasting from 60 to 90 seconds and coming every 2 to 3 minutes. If you have an epidural or other pain medication, you may only feel pressure in your lower back and bottom. You may feel warm or cold, you may sweat or shiver. You may feel nausea or may even vomit. You may feel exhausted. This is the stage where you will begin to push.

Things to do:

• Relax and rest between contractions as much as possible. You will need all of your energy.
• Keep breathing! It is important for you and your baby.
• Ask for help, let the people helping you know what you need.
• Stay focused, your baby is almost here!

With so many changes happening in your body it can be hard to know what is and isn’t normal. You may feel silly calling the doctor all the time to report every ache, hiccup, or bladder leak. So what are serious concerns that you should call about? If you experience ANY of the following, seek medical care right away.

• Heavy vaginal bleeding
• Cramps or severe pain in your lower abdomen
• A sudden increase in thirst, or decreased urination
• Fever over 101 F
• Bloody diarrhea
• Pain or burning during urination along with fever, chills, and/or backache
• Sudden swelling of the hands or face, blurry vision, and/or headache
• Decreased fetal movement or a sudden burst of fetal movement
• Any thoughts of harming yourself or your baby
• Severe nausea and vomiting, inability to keep any food or fluid down
• Fainting or dizziness

At your first appointment ask your doctor what number to call if you have concerns. Some offices have a nursing department or after-hours number to call. If you feel you are in immediate danger, go directly to an emergency room.

This very common pregnancy symptom has a very misleading name! Morning sickness is a feeling of nausea that can last all day long. It usually starts around 6 weeks and ends by week 12 or 14. For some women it is simply an unpleasant feeling but for others it may cause severe vomiting. Don’t worry, it can’t hurt the baby but it can make you quite miserable. There are no actual cures, but there are some things that can be done to lessen the severity.

• Eat a little something as soon as you wake up, before you get out of bed if possible. Keeping a pack of crackers or a bag of trail mix on your nightstand makes it easy to get a little something in your stomach before you start the day.
• Eat whatever sounds good. Don’t try and force foods that make you sick. Try to eat nutritiously but remember that any food or fluid you can keep down will benefit you and your baby. Make sure you keep taking your prenatal vitamin.
• Keep your stomach busy by eating small meals and snacks through the day. Preventing your stomach from becoming empty will help with nausea. Keep easy snacks in your purse like nuts, dried fruit, pretzels, whole grain crackers, or a healthy cereal.
• Eat a small snack of protein with a complex carbohydrate right before bed to help keep your stomach full through the night.
• Avoid greasy, spicy, and high fat foods. These are harder for you to digest.
• Drink as much as possible. Take small sips of water or suck on a Popsicle if larger swallows make you sick. Try sipping soups and smoothies to get more nutrition.
• Avoid strong smells. Your sense of smell is even stronger when you are pregnant and strong smells (even ones you used to enjoy) may make you feel sick.
• Brush your teeth. Keeping your mouth feeling fresh and clean can help reduce sickness. It is especially important to do if you are vomiting.
• Try ginger, peppermint, or lemon. Ginger tea, candies, cookies, or ginger ale may ease nausea but be sure they are made with real ginger. Peppermint gum or smelling peppermint oil may also help. The smell and taste of lemons may work for some women.
• Relax! Rushing around and increased stress can increase that icky feeling. Take your time as you get up in the morning, make time during the day to complete your activities, and make sure you set aside time to rest.
• Consult with your doctor about trying acupressure, acupuncture, biofeedback, or hypnosis.

If you are unable to keep any food or fluids down for more than two days, talk to your doctor immediately. There are some medications they can prescribe that may help. Do not take any medications without your doctor’s approval.

As your belly swells you may experience aches and cramping that can range from mild to severe. The pain can be in one spot or wrap around your whole middle. Some of this pain is expected as your body stretches to accommodate your growing baby. The weight of your baby bump can also contribute to discomfort. It is important to know if you have pelvic pain or pelvic pressure. Pelvic pressure can signal the beginning of labor. Pelvic pressure feels like cramping and often includes groin pain and a backache. It can be similar to menstrual cramping. If you are having pelvic pressure, call your doctor.

If you are experiencing normal pregnancy pelvic pain, try the following:

• Take a warm bath or get in the pool. The water helps decrease the weight of your belly
• Do pelvic tilts or other pelvic exercises
• Purchase a belly sling. This is a strap made of stretchy fabric that helps support the weight of your belly
• Get a prenatal massage. Make sure the massage therapist is trained for treating pregnant women
• Talk with your provider about alternative treatments such as acupuncture.
• If pain is severe, discuss possible medications with your provider

Upset stomach, hiccups, burning, and even throwing up a little into your mouth. Heartburn is a symptom that can start early and last all through a pregnancy. The cause of heartburn changes through the pregnancy but the pain and discomfort do not. At the beginning of pregnancy your digestion slows down so your body can get all the nutrition it can from the food you eat. At the end of pregnancy your big, beautiful baby (and bump!) are squishing your stomach which can push food back up. To help fight heartburn, try chewing gum about 30 minutes after eating. Peppermint gum may also help with feelings of nausea. Eating a few almonds or having a small glass of almond milk can help. Be careful with cow’s milk- the fat may actually make heartburn worse. Try a small amount of skim milk if you don’t like almond milk. Some momma’s find that papaya helps. Eat it fresh or dried. You can also use Tums or Rolaids to calm your stomach. These offer a bonus of extra calcium. If you are really miserable and just cannot find relief, talk to your doctor

To prevent heartburn, try the following:

• Avoid drinking with your meals. Having a lot to drink with a lot of food can definitely cause heartburn. Drink most of your daily fluids between meals and only take small sips when eating.
• Eat slowly. Remember, your digestion has slowed down. Take your time to eat your meal and chew your food more.
• Avoid foods that cause discomfort. Common troublemakers include fried or fatty foods, caffeine, spicy or highly seasoned food, chocolate, carbonated beverages, processed meats, and citrus.
• Wear loose fitting clothing. Having a tight band or belt across your middle will add to your grief.
• Avoid laying down or slouching after eating. Keep your head up and sit up tall while you eat. A small snack before bedtime should be okay but avoid eating a large meal.
• Stop smoking. There are so many reasons to stop for your health and your baby’s health and decreasing heartburn is one of them.
• Be careful with your weight gain. Having extra weight around your middle creates pressure that may push food back up.
• Relax and decrease stress. Try deep breathing, prenatal yoga, or meditation.

Have you noticed that your shoes don’t fit like they used to? Swollen feet and ankles are a normal part of pregnancy. This is also known as edema. You may notice it toward the end of the second trimester and even more in the third. Your body is holding a little extra fluid to help protect it as it changes. A little swelling is nothing to be worried about. If the swelling gets worse quickly and you also get a headache, blurry vision, and high blood pressure call your doctor right away. To help decrease swelling try:

• Getting off your feet. Sitting or standing for a long time increases swelling. Lay back and put your feet up.
• Move around. Light exercise is always good for pregnancy and can help with swelling. Try walking, water aerobics, or prenatal yoga.
• Avoid tight elastic around your legs and feet. Tight socks will keep fluid in your feet.
• Try support hose. Find a pair of maternity pantyhose or thigh-high stockings that provide a little pressure. These will help your body move the fluid out of your legs. If the swelling is mostly in your feet, you may be able to use knee-high support stockings.
• Drink lots of water and lay off the salt. It may crazy, but drinking water will help decrease the fluid in your feet. Eating too much salt, will make it worse.
• Wear comfortable shoes. You may be dying to wear those cute summer sandals, but anything tight or tall will make your swelling worse. You are also at a higher risk of falling when you’re pregnant because you’re not as coordinated. Pick a comfortable pair of flat shoes that fit your feet and give good support (your back will thank you!)

Tdap is short for the three infections this important vaccine protects against- tetanus, diphtheria, and pertussis (whooping cough)

Tetanus– Sometimes called “lock jaw,” this bacteria makes the muscles in the face and neck tight. This makes it hard to eat and breathe. It kills 1 out of every 10 people who get it even if they get good medical care.

Diphtheria– This bacteria makes a thick coating on the back of the throat which makes it hard to breathe. 1 in 5 children under the age of 5 years diagnosed with diphtheria will die.

Pertussis– This is also known as whooping cough. This bacteria causes really bad coughing and makes it hard to breathe. Newborns are most likely to get sick and die from it. Each year, up to 20 babies die in the United States from pertussis.

All pregnant women should get this vaccine in the third trimester of every pregnancy. This vaccine is safe. It protects the baby until they are old enough to get vaccinated. Anyone who will be around the baby such as the father, siblings, grandparents, or babysitter should also get a Tdap vaccine.