Dear mommy and daddy-to-be,
Congratulations on making it this far! You
are now about to embark on the final leg of this incredible journey which is
also the most exciting and miraculous part of it. By now you would have had a
detailed discussion with your doctor regarding the plan of delivery suitable
for you according to how your pregnancy has been and your preferences.
Signs of onset of labour/ when to call
your doctor?
If you experience any of the following,
it's time to call your doctor
- Pain
abdomen - usually regular, rhythmic, intermittent, increasing in
intensity& frequency
- Breaking
of waters - this will usually feel like a gush of urine-like fluid leaking
out of the vagina. May even begin by small amounts leaking intermittently.
- Show -
a dirty, sticky mucoid discharge may precede pain.
- Any
other symptom you may be concerned about depending on your pregnancy.
Labour is a slow and exhausting process.
The mouth of the uterus opens slowly from zero to ten centimetres (dilatation)
and then the baby descends. Any deviation from the normal may necessitate some
action on the part of the team caring for you. Your doctor will familiarise you
with the various situations that can arise commonly so as to ease the
communication and save time during those all important minutes, should an
emergency arise. Discuss options for pain relief available and have a plan
ready and documented.
Normal delivery
Your doctor will encourage you to push at
the right time. You may feel the urge by yourself too. A small cut at the
vaginal opening (called episiotomy) may be required to facilitate the delivery
safely. The umbilical cord is cut and the baby is handed over to the baby
receiving team. The after births are delivered. Some medicines may be
administered to reduce blood loss. Your doctor will stitch up the cut under
local anesthesia and apprise you of the care of the stitches.
Instrumental delivery
Sometimes, the delivery of the baby may
need to be aided with a vacuum cup ( Aamir Khan's character in the Hindi film,
3 idiots does one!) or forceps. Discuss the pros and cons of both the
instruments with your doctor beforehand and make an informed choice.
Elective Caesarean birth
Elective Caesarean birth
In case your delivery is by a pre-planned
Caesarean section, your doctor would have discussed the expected procedure and
recovery. Usually a spinal anesthesia is used wherein you are awake and pain
free and can hear your baby's cry! A different anesthesia may be needed
depending on your particular case. Drinking and eating may commence 4-6 hours
after the surgery. You will usually be able to get up and walk by the next day.
Depending on your recovery and preferences, discharge from the hospital may be
planned 1-3 days post surgery.
Newborn care
The baby will usually be cleaned,
examined, weighed and covered by the receiving doctor and team. They will let
you know about concerns, if any, and their plan of management. Most of the
babies can be shifted immediately to the mother's side and you may begin breast
feeding as soon as comfortable. If it is your first baby, do familiarise
yourself with newborn care with the hospital staff who would be happy to help
in all respects.
My best wishes for a safe delivery!
Dr Parul Chopra Buttan
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