Stages of pregnancy (Pt 2)

SHE IS now 28 weeks, more than halfway through her pregnancy. She has completed her O'sullivan test - the screening test for diabetes of pregnancy.

Fortunately, it is normal. Her blood pressure remains normal. She is doing pretty well. By 32 weeks, she feels tired of being pregnant. She feels more pressure in her lower abdominal region, but the baby is moving well. She had already started her antenatal classes and they are going well. I remind her about reasons to visit the hospital, if her water breaks, if she has contractions, bleeding or if the baby is not moving well.

We discuss breastfeeding and whether she will have an epidural in labour. She wants to try to breastfeed her baby and is undecided about the epidural. I explain that an anaesthesiologist will place a small catheter in her back, which will provide medication to relieve the pain of labour. While it is the most effective form of pain relief, there are other injections that can be given. She decides that she does not want an epidural. She wants a natural birth process.

Due date is coming

She is almost at her due date and is a little nervous about when labour will happen. Her family and friends are all volunteering their favourite date. She wonders if she will recognise if her water breaks or know if she is experiencing contractions. I explain to her that she may experience her water breaking as a gush of fluid or a slower continuous leak. However, she may have labour without her water breaking. The contractions will feel like strong menstrual cramps and, if it is labour, they get stronger and closer together. I remind her to pay attention to the baby's movements.

I receive a call from the hospital that she has arrived. She is already six centimetres dilated but her membranes are intact (her water had not yet broken). She is coping well with the pain.

Baby arrives

I arrive at the hospital a little later. She is fully dilated and she is ready to push. She groans quietly with the pain. The nurse takes her to the delivery room. Her husband is by her head. We coach her on techniques to push only with the pain. She focuses and she is pushing well. I can see the baby's head. "Only a few more pushes," I assure her.

The head is out, but a cord is around the baby's neck. I ask her to stop pushing. I remove the cord and deliver the baby. I cut the cord and hand the baby to the nurse. It is a boy. He starts to cry. The nurse cleans him up and gives him to his mother. I see the tears of joy in her eyes. She lovingly calls him by the name she had chosen. Her husband takes some pictures. The pregnancy was long and sometimes difficult. Labour was painful, but he was worth every minute of it.

Merry Christmas, Mummy!

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.

HER HEALTH

Monique Rainford

In the article, 'The stages of pregnancy', published Wednesday, December 15, the second sentence under the subheading 'Too much weight gain?' should have read: "I remind her that since her weight was normal before her pregnancy, she only needs to gain between 11.34kg and 15.88kg (25 and 35 pounds).

We regret the error.