Frequently Asked Questions
Dr Bronwyn understands the many questions involved with pre- planning pregnancy, fertility and giving birth – especially with so many different stories floating around from friends, family members and articles online.
Whether it’s trying for the first time or planning for your fourth baby, Dr Bronwyn will help you by addressing specific issues, treat your individual situation, settle and reduce your stress to achieve the best outcome possible for you and your baby.
After having helped so many women, she has seen it all. Here are some of the most common questions patients have had to put you at ease.
Pre-planning and Pregnancy
Q. How long does it usually take to fall pregnant?
All pregnancies are different. Depending on your health, age and many other factors some ladies fall pregnant straight away while others take many months to conceive. Research shows that the probability of conception after six months is up to 80% and after 12 months is up to 90%.
Q. What are some of the things that increase the risks of infertility?
- Increasing age
- Tobacco smoking
- Sexually transmitted infections
- Health problems that cause hormonal changes
- Poor diet
- Athletic training
- Being overweight or underweight
Q. Is my medical problem going to affect me falling pregnant?
It is important to understand a medical problem may impact on your pregnancy but also how your pregnancy may impact on your own health. We advise seeing you before conceiving to ensure the correct medications and that you are in the best possible health to help to achieve our desired outcome…healthy mum and baby.
Q. We were not expecting it to take this long for us to conceive?
There can be several reasons why a couple may have difficulty falling pregnant. A number of tests can be done to work out the cause and correct it, but in some, very frustrating situations, it is not possible to explain the reason precisely.
Q. What are some of the reasons it’s not happening easily for us?
Where an egg is not matured and released at all by the ovary or is not matured and released at a regular time.
Where there is tissue, similar to tissue lining the inside of the uterus, occurring in places other than the uterine cavity. This can cause adhesions and distortion of anatomy as well as inflammatory changes that can affect fertility.
A blockage or damage to the specialised cells lining the fallopian tubes can occur from previous infection or surgery which then stops the passage of sperm or eggs.
Some differences in the shape and size of the uterus may contribute to difficulties falling pregnant or staying pregnant.
Some medical disorders can affect your hormone function in turn affecting your fertility. More commonly we see thyroid and weight related conditions having an impact here, but other conditions can be important as well.
For men, low sperm counts or abnormalities in the movement or shape of sperm can affect fertility. There are other factors that may be involved and these need to be ruled out as well.
Q. What can I do right now to improve my chances?
1. Start tracking your menstrual cycle
Ovulation occurs 14 days before you start bleeding. This varies depending on the length of your cycle but in an average 28-day cycle, it occurs between day 12 and 14. Sperm can survive for up to five days and the egg can be fertilised up to 12 hours from ovulation so you should be having intercourse every other day from day 8-16 of your cycle.
2. Take Folate one month before and 3 months after you conceive
It is most important to take Folic acid as it has been shown to reduce the incidence of foetal spine abnormalities or spina bifida. This is especially important in the early weeks when most people don’t know they are pregnant yet, so start taking it as soon as you start trying.
3. Managing your weight range
Being overweight or underweight can affect your chance of falling pregnant, increase your risk of miscarriage and increase your risks during pregnancy.
4. Healthy Balanced Diet
Ensure you have adequate vitamin and antioxidant levels along with a balanced diet with a mixture of fruit and vegetables. Prenatal vitamins will also help to ensure this but should not be a substitute for a balanced diet.
5. Keep up your fitness levels
Pregnancy can be physically demanding on a woman’s body. Help manage your changing body shape as well as the demands of pregnancy, birth and early parenting by having a good level of fitness.
Pregnancy and Each Stage
Pregnancy at 8 – 10 Weeks
You’ve done a pregnancy test and it is positive, Congratulations!
You are likely to feel all sorts of emotions mixed with excitement about what is ahead of you. Regardless of how experienced or how new you are to this, you may feel some anxiety and concerns about the months and years ahead. The is very normal
We are here to help plan for the months ahead and Bronwyn will make sure you are prepared in the best way possible, both physically and emotionally.
It would be lovely to meet you and your partner around 10 weeks, or earlier if you have a history of miscarriage or ectopic pregnancy.
The first appointment lasts for around 45 minutes to allow Bronwyn to thoroughly assess you and plan pregnancy management based on your situation, as well as provide any advice regarding common issues and concerns in your early pregnancy stages.
Any potential concerns for both your physical and emotional wellbeing, will be discussed in the event it could have an impact on you and your pregnancy. Bronwyn will perform a physical examination, which will include blood pressure. We will also perform an ultrasound scan to ensure your pregnancy is viable, and confirm your dates.
There will also be discussions around screenings for chromosomal abnormalities and the options of screening or diagnostic testing available to you if you choose to have this done.
Q. How Frequent are the visits?
After your first visit you will have visits at 15, 19, 23, 26, 29, 32, 34, 36, 37, 38, 39 and 40 weeks..
Q. What tests do I take?
It is recommended that all pregnant women have antenatal screening. This includes:
- Complete blood picture.
- Blood group and antibody screen.
- Hepatitis B and C.
- Urine MC&S.
You may require additional screening tests depending on your specific circumstance, including:
- Screening for haemoglobinopathies: sickle cell or thalassemia.
- Bacterial vaginosis: as diagnosis and early treatment < 20 weeks may be beneficial for women with previous preterm birth.
- Varicella, parvovirus, CMV, toxoplasmosis.
- Ferritin and iron studies.
- Vitamin D and folate.
Q. What do I do if I have spotting or pain in early pregnancy?
- Bleeding in early pregnancy can be very distressing but it does not always mean you are having a miscarriage.
- It is very common, affecting about one in four women, many who will go on to have a healthy pregnancy.
- If bleeding is caused by a miscarriage, there is not treatment or therapy that can stop the miscarriage from occurring.
- Ectopic pregnancy, where the pregnancy is growing outside the uterus (usually in the fallopian tube) can also cause bleeding and pain. Without treatment an ectopic pregnancy can seriously impact on your health and fertility.
- If you experience bleeding or pain in early pregnancy, please contact my rooms or the hospital where you are booked after hours or on the weekend so the appropriate investigation and treatment can be started.
Q. What to take during my pregnancy?
- During pregnancy your body needs extra vitamins, minerals and nutrients. The best way to meet both you and your baby’s nutritional needs is to eat a wide variety of nutritious foods and be as healthy as possible as early as possible.
- In some individual groups additional supplementation may be necessary. We will let you know if you fit into one of those groups.
For more information see RANZCOG supplementation in pregnancy
Q. I feel sick a lot of the time, what can I do?
Nausea and vomiting are some of the earliest symptoms of pregnancy and can affect up to half of all pregnant women.
Sometimes your nausea and vomiting can be so severe that you are unable to keep anything down and need admission to hospital for IV rehydration and medications.
There are some medications available to you that can help to maintain adequate oral hydration including:
- Metoclopramide (Maxolon)
- Doxylamine (Restavit)
- Promethazine theoclate (Avomine)
- Prochlorperazine (Stemetil)
Here are some simple and natural things available to help make you feel better.
- Eating before or as soon as you feel hungry as an empty stomach can aggravate nausea.
- Eat small, frequent, high carbohydrate, low fat meals
- Eliminate spicy, fatty foods instead try dry, high protein foods
- Cold, clear and carbonated fluids are better tolerated (ginger ale or lemonade).
- Vitamin B6 and Ginger Powder taken regularly have both been shown to reduce nausea, dry retching and vomiting in early pregnancy.
Q. Are there any foods I need to avoid?
There are some infections from food that can seriously affect your pregnancy and for that reason some extra care needs to be taken. Sometimes during pregnancy, your hormonal changes lower your immune system, which makes it harder to fight off illness and infection.
You can reduce your risk by:
Avoiding high risk foods
- Unpasteurised milk or food made from raw milk
- Pate, dips and soft cheese
- Raw eggs in food: mayonnaise, mousse, batter
- Raw or precooked meats or poultry
- Uncooked, smoked or chilled pre-cooked seafood
- Pre-prepared salads and coleslaws
Use safe food handling practices
- Keep it cold
- Keep it clean
- Keep it hot
- Check the label
Q. Why aren't all babies perfect?
Most of the time your journey through pregnancy will be smooth and problem free but occasionally things can go wrong. This causes anxiety and distress for expecting mothers. Statistics show 2 to 3 per 100 babies born in Australia and NZ have some kind of significant birth defect and an additional 2 to 3 per 100 have minor birth defects. Early detection through testing is important as it helps parents decide how to manage potential problems.
Q. What testing is available?
- Most babies are born healthy but there is always risk something can go wrong. The risk may be greater for some couples depending on age, lifestyle factors, medical history or a history of a previous problem.Testing is available to identify fetuses with increased likelihood of having certain chromosomal abnormalities, such as trisomy 21 and trisomy 18 and some structural anomalies such as neural tube defects.
There are two kinds of test that can be done in pregnancy:
- Screening tests: Can detect risks of a baby having a birth defect but will not give definite information about your fetus.
- Diagnostic tests: can tell you if your fetus has a problem.
- Ultrasound measurement of fetal nuchal translucency between 11-13+6
- NIPT: For T21, T18, T13, X and YAnatomical ultrasound
- Morphology ultrasound 19-21 weeks
- Growth and Wellbeing ultrasound. 32-34 weeks
Q. How much weight will I put on during my pregnancy
- No matter our body shape or size, pregnancy can and will challenge the way you feel about yourself and how you look.
- Weight gain during pregnancy varies but the average weight gain you can expect is between 11.5 and 16kg.
- The usual pattern is 1-2 kg during the first three months, followed by 0.4kg per week or 1-2kg per month during the final 6 months but not everyone follows this pattern.
- Your optimal weight gain during pregnancy will be different depending on your pre-pregnancy weight.
- As weight is often a source of stress and anxiety for women, I tend not to focus on normal weight changes, unless there is an issue of concern.
Q. What else should I consider now that I am pregnant?
Booking your appointment with us, and please bring:
- Any recent blood test or ultrasound results
- A list of your current medications and doses
Continue eating a variety of good food:
- Continue to eat a balanced diet with a mixture of fruit and vegetables to ensure you have adequate vitamin and antioxidant levels. Consuming Prenatal vitamins will help to ensure this.
Consult your health fund
- Consult your health fund to work out private costs, what you are covered for and what is out of pocket.
Avoid drinking, smoking, multivitamins containing retinol, and too much caffeine
- There is no safe level of alcohol in pregnancy so you should stop drinking now.
- Quit Smoking as it increases the risk of miscarriage and harms the growth and development of your baby. You should contact the Quit line on 137 848 for free information, advice and support to stop smoking.
- Retinol is a type of vitamin A that can be harmful. Avoid oral and topical products containing Vitamin A derivative.
- Large amounts of caffeine may increase your risk of miscarriage. You should try and limit your intake to three cups of coffee per day or less. Tea, coffee and cola drinks all contain caffeine.
Second Trimester: Pregnancy at 14 – 28 weeks
You have probably already told your family and friends, you may have even felt your baby move. It’s not only real but it’s exciting. Your morning sickness should be easing by now and energy levels are improving. Your baby bump is taking shape but you are not too big and uncomfortable yet. Now is the time for you to focus on yourself, eating well, sleeping well, spending time with your partner.
Q. What happens during my visits during my second trimester?
At your 15 week visit
- We will discuss the results of your investigations including your screening for chromosomal abnormalities and plan any follow-up that may be required.
- Look at your baby on our Ultrasound
- We will give you a screen for risk of postnatal depression and discuss strategies that need to be put into place early.
- 19 Weeks, We will provide you with an ultrasound request for your 18-20 week morphology ultrasound. This is a detailed look at how your baby is forming as well as where your placenta is located. You may also be able to find out your baby’s gender if not already known.
- 19 Weeks, You will have completed the admission online for your chosen hospital.
- 19 Weeks, You will also be encouraged to book Antenatal classes, through the hospital you have chosen, to avoid missing out.
- Discuss how you’re feeling, and look at further strategies to manage persistent lethargy, nausea or vomiting.
At your 23 week visit
- We will discuss the results of your morphology
- We will ask about baby movements, check your abdomen to estimate how the baby is growing and do a fetal heart as well as checking your blood pressure.
At your 26 week visit
- In addition to your routine examination, we’ll give you a form to test for anaemia, diabetes and if you have negative blood group antibodies in your blood. If you are considered at high risk for diabetes and had an early glucose tolerance test which was normal, you will still require a repeat test to ensure no abnormality has developed. These blood tests should be done between 27-28 weeks. Other investigations may be necessary based on your individual situation.
- You will receive your Whooping cough vaccination ( Adacel), and you will start the conversation with family and friends updating their vaccinations ahead of baby’s birth.
At your 29 week visit
- In addition to your routine examination we will discuss the results of your blood tests.
- If you are found to have gestational diabetic we will explain the implications of this for you, your pregnancy and your fetus. We will discuss further monitoring that will be required and management strategies to ensure your best outcome.
- If you are found to be anaemic, depending on the cause further recommendations will be made .
- If you are a negative blood group you will have anti-D prophylaxis at this visit.
Q. My body is changing, is this normal?
As your baby grows inside of you, your body will need to continually change and adapt to accommodate them. This may lead to a variety of problems including:
- Back pain
- Separation of public bone with difficulty walking
- Swollen and sore breasts with nipple changes
- Needing to go to the toilet more often
- Skin changes, discoloration, itching
- Leg cramps
- Swollen ankles, feet and fingers
- Carpal tunnel
Although these are very normal they can cause great discomfort and as a result distress.
Talk to us and we can discuss strategies to assist with the changes occurring.
Q. What isn’t normal?
At this stage of your pregnancy, vaginal bleeding, regular painful contractions, severe constant pain, leaking fluid or decreased foetal movements are not normal. If you experience any of the above or are worried for another reason, ensure you contact our rooms or the hospital where you are booked as soon as possible.
Q. When should I start sleeping on my side?
You should try and lie on your side from about 24-28 weeks. Your growing baby is making your uterus heavy, which is placing pressure on one of your major blood vessels (called inferior vena cava), which lies on the right side of your body.
This acts to reduce the blood flow to your heart and other parts of your body as well as your baby. If you lie on your back for an extended period you may feel dizzy or breathless. This can be avoided by lying on your side, particularly your left side.
Q. When should I reduce or stop working?
- This is very personal and would depend on the type of work you do and how you’re feeling. Most women will work up until 36 weeks but some will feel very well and want to continue longer, while others may feel the need to finish sooner.
- Pregnancy is not a sickness but if you have a pregnancy related illness or injury you can take sick leave at any time.
- Please call Vanessa if your HR Department requires a letter confirming your pregnancy for your Maternity/Paternity leave application.
For more information about your rights at work click here.
Q. Can I travel by plane during this time?
- For domestic travel, most airlines will allow you to travel up to and even beyond 36 weeks, for international travel there are however, more restrictions. Policies will vary with each individual airline so you must specifically enquire before booking your flights. Don’t forget to consider how far along you will be on your return trip.
- For International travel, you should also consider what the health system is like in the place you are travelling to and ensure you have appropriate travel insurance that covers for pregnancy as well as birth or neonatal care.
- It’s also important to consider the potential risks of any countries you are travelling to, particularly infectious risk.
- If your airline requires a letter from your doctor, please call Vanessa and she will provide one for you.
Q. What precautions should I take if I need to travel by plane?
Being pregnant your blood is more likely to clot, this is exacerbated by being less mobile during prolonged periods of travel. Reduce your risk by:
- Keeping your circulation flowing by walking or moving around as much as possible. At least every 2 hours.
- Avoid dehydration by drinking plenty of water.
- Wear compression stockings.
Q. Can my partner and I still have sex during pregnancy?
- As long as there are no problems with the placenta or your cervix, you can have sex as often as you like.
- Don’t feel worried if you don’t really feel in the mood for sex while pregnant. Hormone fluctuations, fatigue and nausea ,evolving shape and discomfort may really affect your libido.
- On the other hand some women experience enhanced sex drive and orgasm.
Q. Are there times when having sex should be avoided?
There are times when you need to be cautious and avoid intercourse:
- If you have a history of preterm labour or premature birth.
- If you have unexplained vaginal bleeding.
- If you’re leaking fluid.
- If your cervix begins to open prematurely.
- If your placenta partially or completely covers your cervical opening.
- Talk to us and we can advise you about your specific situation.
Q. What should I be focused on?
Your focus now should be on staying healthy and happy and while you feel well with good energy levels try and prepare for the arrival of the baby. Here are some things to remember to do:
- Continue to look after yourself by eating a balanced diet, full of fresh fruit and vegetables, drinking 1- 2L of water per day, performing regular low impact exercise such as swimming, yoga, Pilates or walking at least three times a week and ensuring you get enough sleep while you can.
- Ensure you wear well designed and properly fitted maternity bras without underwire which allow ease of access during breastfeeding
- Enjoy plenty of baby free time with your partner and other family members
3rd Trimester: Pregnancy at 29 to 40 weeks
Q. What to expect during your visits during the 3rd trimester?
Our visits will become more frequent now as Bronwyn needs to keep a close eye on how both you and your baby are progressing. Your visits will increase from every 3 weeks to fortnightly and then weekly from 36 weeks until the baby arrives.
Bronwyn will continually assess your progress, both physically and emotionally. We will address any specific issues you may have, as well as gain an understanding of your expectations and plans. Our aim is to arm you with knowledge, to help you prepare as best as possible for labour, birth and the postnatal period.
At each visit we will assess the baby’s movements, ensure your blood pressure remains normal, check your baby’s heartbeat and perform an abdominal examination to measure size and position of your baby, through palpation and with our ultrasound.
Bronwyn will provide you with an ultrasound request for a growth and Wellbeing ultrasound, this assesses the fluid around the baby, the blood flow through the placenta or the position of the placenta..
At 34 weeks
If you are a negative blood group, we will give you anti-D prophylaxis.
At 36 weeks
We will recommend a low vaginal swab to check for Group B Streptococcus
- This is a common bacteria found in the vagina that can have an impact on the baby as it comes through the birth canal.
- If positive you will need antibiotics in labour.
- Review your Birth plan if you choose to have one
- What do I need to do in case of an emergency?
Contact the delivery suite at the hospital you’ve chosen for the baby’s birth if you experience any of the following:
- Painful regular tightenings
- Severe constant abdominal pain
- Leakage of fluid from your vagina
- Reduced or absent fetal movements
If you have any concerns, call sooner rather than later, midwives are available 24 hours a day. If they are worried they may ask you to come in and will notify Bronwyn of any problems.
Q. How do I know what I am feeling is normal?
- As your baby grows, your body will continue to change and the demands on you will continue to increase.
- It is very normal to experience the return of intense fatigue, Braxton Hicks contractions (false labour pains), pelvic ligament pain, shortness of breath, heartburn, constipation and haemorrhoids/
- Talk to Bronwyn at your visits or call Vanessa about how we can help improve the way you are feeling.
Q. Foetal movements
Feeling your baby move is one of the most amazing experiences you will have. You may first start to feel something around 18-22 weeks. In the beginning you won’t feel a lot but as your baby grows the movements will become more regular.
Some women don’t feel their baby move as much, particularly if they are a larger body size of if their placenta is located at the front of the uterus. But foetal movements are a good indicator of your baby’s wellbeing. If you ever have concerns about your baby’s movements contact the delivery suite where you are booked.
Q. How can my partner get involved and help?
- Attend antenatal classes
- Install the car capsule
- Assemble the nursery furniture
- Take over the household chores
- Look in to their own paternity leave arrangements
- Make sure they understand what their role will be in your labour: bringing music or food ,drink or cups of ice/massage / helping you in the shower, bath or by getting you comfortable/cut cord
Q. What else can I do so I am ready for my baby’s arrival?
- Order nursery equipment well in advance: bassinet, cot, change table.
- Make plans for if you go into labour early:
– Have a bag packed
– Make arrangements for other children
- Make sure that bed linen, muslins, towns and baby clothes are washed and ready for use.
- Stock up on tissues and sorbolene cream. This is the gentlest combination to clean your baby’s delicate bottom and will help to prevent nappy rash in the early days. Also have a good barrier cream on hand, prevention is always better than cure.
- Get a baby capsule and ensure your capsule fits in your car.
- Continuing to eat well after your baby is born is so important, even more so if you are breastfeeding but the act of going to the shops may seem almost impossible for some time. Prepare by
- Starting online supermarket shopping where you can have what you need delivered to your door.
- Pre-prepare and freeze a selection of healthy homemade meals for you and your partner.
- Stock up on supplies of coffee, tea biscuits etc so you are prepared for unexpected guests.
Q. After 37 weeks - Do I need to do a birth plan?
- You really can’t plan all parts of your baby’s birth but there are things that you can do and think about to be more prepared.
- You may have particular ideas about the kind of birth you want – who you want there, how you want to manage your pain, what you would want if things don’t go as planned –Bronwyn will take the time to fully talk through these, understand your desires and help facilitate them.
- The most important thing to remember is that no two labours or births are the same. These are not events that anyone can have total control over. Even if we do everything in our power to prepare, your body and baby may have other plans.
- Your birth plan is best if it is flexible. If you aim to stick rigidly to a plan you may have a strong sense of disappointment if things happen differently, which they sometimes do. It is so much better to welcome your baby into the world feeling proud and happy rather than cheated of an experience you hoped for at all costs.
- Relax, listen to your body, trust that we have a good understanding and respect of your wishes and will guide you toward our common aim…healthy mum, healthy baby.You may have particular ideas about the kind of birth you want. Definitely feel free to discuss this with Bronwyn.
Q.What should I have to support me in labour?
- The support people you have around you during your birth can actually improve your experience of it. It is important to have support people who make you feel safe and free to express what you need in the moment, even if it means telling them to leave. There are times when you will need peace and quiet, so it may be best not to have too many people.
- Make sure your people understand their role and they are happy to provide this support for you.
Q. What do I need to bring to the hospital?
- Own pillow if desired
- Comfortable clothes that you don’t mind getting messy
- Thongs or slippers
- Oil, talc or lotion for massage
- Spray bottle for cooling
- Lip cream for dry lips
- Your favourite playlist
For your support person
- Bathers and towel for bath and shower
- Food – snacks, juice, celebratory drinks if desired
After birth for you and your baby
- Comfortable day time clothing, especially button front shirts. Shoes.
- Night wear, dressing gown and slippers
- Nursing bras and breast pads
- Nipple cream
- Extra underwear
- Maternity pads – at least three packets
- Capsule fitted in your car for the day of discharge
- Clothes and wraps to bring the baby home in.
- Jewellery, credit cards, other valuables or large amounts of cash
Q. What do I do when I am going into labour?
In most pregnancies, labour starts naturally between 37 and 42 weeks.
When labour starts a number of changes take place in your body:
- The cervix (neck of womb) softens and shortens.
- The fluid filled membrane sac surrounding your baby tears (your waters break).
- The cervix dilates (opens).
- The womb contracts to push your baby out.
Signs you may be going into labour may include:
- An increase in vaginal discharge that is thick, mucus like and slightly bloody. This can happen days before labour begins and is very normal.
- A gush or ongoing trickle suggesting your waters have broken.
- Lower back pain or period-like cramps.
- Your uterus tightens painfully and your belly feels hard and then completely relaxes. This occurs more and more regularly and is not managed with simple pain relief like paracetamol, heat packs , or in the shower or bath.
If you are not sure, contact the hospital where you are booked.
Make sure you contact hospital immediately if:
- You are experiencing signs of going into labour and you are pre-term: <37 weeks.
- There is greenish fluid coming from your vagina.
- You are having vaginal bleeding, this would be much more than your bloody show.
- Baby movements have reduced.
Q. How do I stay prepared?
Remember you can go into labour at any time now. It takes time to pass from early labour into established labour, but by being as prepared as possible when the time comes you can calmly focus on what’s happening with your body.
- Make sure your bags are packed and ready for hospital
- Organise care for your other children
- Continue to talk to your support people and make sure they understand what their role is.
- Plan how you will announce the birth to family and friends
- In an emergency make sure you contact the delivery suite of the hospital you are booked into.
For every expecting mother, it’s always a relief when you have a better understanding on what to expect especially if it’s your first time.
Q. What are the stages of birth?
Understanding the stages of birth will better equip you with knowledge of the changes occurring in your body so you feel more in control and respond better to what is happening.
This is when the cervix starts to soften, thin out and open. It is complete when the cervix is fully dilated, around 10cm. This can go on for hours.
In early labour you may have:
- Blood stained mucus called a show.
- Lower back pain.
- Period like pain that comes and goes.
- Loose bowel motions.
- An urge to vomit.
- Sudden gush or slow leak of fluid from vagina which is clear or slightly pink: if it is green or bloody you should contact the hospital immediately.
Things you can do:
- Listen to and trust your body, it knows what to do.
- Stay at home as long as you are happy there.
- Have regular snacks so you are building your energy stores.
- Rest as much as possible.
- Try relaxing in a bath or shower.
- Go to the toilet regularly and empty your bowels if you can.
Eventually you will start feeling more restless and tired, any pain will be more intense and the time between each wave of pain will be shorter, this signals you are moving closer to the second stage.
When to go to hospital:
- If is not always clear if labour has started. If you are not sure, call the hospital and talk through your symptoms to gain some guidance.
- Your waters break.
- If you have greenish discharge vaginally.
- You have vaginal bleeding that is not a show.
- Small vaginal bleeding mixed with lots of mucus is called a show and is a sign that labour is progressing normally. You may also get a show if you have had a vaginal examination.
- Your contractions are regular, last more than 30 seconds and are closer than 5 minutes apart.
- You need pain relief.
- You do not feel the baby moving.
- If at any stage you are worried or unsure about what is happening.
This is the period of time from when the cervix is fully dilated to when the baby is born.
During the second stage you may have:
- Longer and stronger contractions.
- Increased pressure in your bottom.
- The desire or urge to push.
- Nausea and vomiting.
- Stretching and burning feelings in your vagina.
Things you should do:
- Allow your body to do what is needed, Stay calm and let go
- Concentrate on your contractions and rest in between.
- Try different positions.
- Keep your fluid levels up.
The pushing phase varies for each woman and when the urge arrives it can be overwhelming.
- You may feel pressure, a strong urge to go to the toilet, stretching and burning in your vagina or the baby’s head moving down.
- The best thing you can do is breathe, relax, and follow your body’s urge to push.
- Trust and listen to us and we will guide you.
- This begins after your baby is born and finished when the placenta and membranes have been delivered.
- During this stage you may feel more contractions to expel the placenta and a feeling of fullness in your vagina.
Q. What if my labour needs to be induced?
Induction of labour is the process whereby labour is encouraged to start artificially.
This can be done in a number of ways including:
- Sweeping the foetal membranes: with the aim of initiating natural labour.
- Artificially breaking the waters.
- Cervical ripening with medication – prostaglandin E2.
- Cervical ripening with a balloon catheter.
- Intravenous oxytocin.
Before deciding how labour is to be induced you will have a vaginal examination and based on this one or a combination of the above techniques will be recommended.
Q. What can I expect when going through labour?
Every woman’s labour has the potential to be completely different. Dr Bronwyn will help prepare you both physically and emotionally so when it begins you feel as ready as can be. You will always be fully informed throughout the labour and delivery so you have to ensure your best possible experience along with a clear understanding of what is happening at every moment of your labour to birth.
Q. When in labour, what pain relief options do I have?
The options for pain relief include:
- Being active, moving around, changing positions.
- Touch and massage can reduce muscle tension and act as a distraction during contractions.
- Music may also help you relax and as a distraction.
TENS or Trans-Electrical Nerve Stimulation
- A small portable battery operated device worn on the body that transmits electrical pulses to the body.
- Despite not a lot of evidence some women find them useful.
Gas: mixture of nitrous oxide and oxygen
- Inhaled during a contraction can help take the edge off the pain. You may feel lightheaded, nauseous with a very dry mouth.
- A strong painkiller given by injection to help reduce pain but doesn’t take it away altogether. It can take several minutes to work and can make your baby sleepy and contribute to breathing problems in your baby if given within two hours of birth.
- This is a local anaesthetic, injected into your back altering your sensation from the waist down. A thin tube is left in your back allowing it to be topped up.
- It takes the pain of contractions away for hours so during a long labour it can allow you to sleep and recover your strength. It can be increased in strength if you need an emergency caesarean and can be helpful if your blood pressure is high by reducing it. An epidural does not directly affect your baby or increase your chance of needing a caesarean section but it can make the pushing phase of your labour longer.
- Your anaesthetist will talk to you about the risks in your individual situation.
Q. What if my baby needs help being born?
Sometimes your baby will need help to be born. This help may vary from relatively simple procedures such as breaking your waters or performing an episiotomy (a cut in the tissue between the vagina and anus to make the opening bigger), or more assistance with forceps or a ventouse (vacuum cup) to more medically demanding procedures such as caesarean section.
Q. Can I have skin to skin?
Our aim is to facilitate skin-to-skin contact. This is allowing your naked baby to be placed on your bare skin and you both covered with a warm blanket.
You must remember there are situations where this will not be possible due to either maternal or neonatal complications and this is in the best interest of both mother or baby or both.
Things to Bring into Hospital
For The Mother
- Your Antenatal card
- All current medications
- Medicare / Health Insurance cards
- Comfortable clothing & shoes for daytime (keep in mind tops that you can feel comfortable to breast feed in i.e. button down)
- Nightwear – dressing gown, slippers
- Underwear & Maternity bras (extra underwear)
- Maternity pads (at least one full packet)
- Toiletries including soap, shampoo, tooth paste and tooth brush.
- Nursing pads
- Clothes for labour (old t-shirt, warm socks, old underwear, or you can wear hospital gown if prefer)
- Oil or Moisturiser (if you wish for massages from your partner)
- Heat / Cold pack
- Snacks such as muesli bars
- Lip balm
- speakers (if you wish to have music whilst in labour)
- Oil burner and essential oils of your choice (if you wish to bring one in it must be an electric burner, cannot have naked flame in hospital)
For Your Baby
- Bunny rugs aand baby clothes if you do not want to use hospital supplies
- Nappies an outfit, socks and blanket for bringing baby
- Car seat installed in car ready for drive home
It is advised to have your bag packed and ready from approx. 36 weeks. It would also be advisable to leave valuables at home rather than taking it to the hospital.
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