Valerie Gommon Midwife’s Blog

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Pregnancy

“The condition of having a developing embryo or fetus in the body.”
“The process by which a human female carries a live offspring from conception until childbirth.”

Pregnancy is referred to as a gestation period – the time between conception and birth. Approximately 40 weeks (280 days). Measured from the first day of the last menstrual period. For women who use a procedure that allows them to know the exact date of conception (such as in-vitro fertilisation IVF, or artificial insemination) the gestation period is 38 weeks (266 days) from conception.

Pregnancy is divided into three stages – called trimesters, each lasting about 3 months.

An embryo is a multicellular diploid (has two sets of chromosomes) eukaryote (an organism whose cells contain complex structures enclosed within membranes) in its earliest stage of development; from the time of first cell division until birth. In humans, it is called an embryo until about eight weeks after fertilization (i.e. ten weeks after the last menstrual period or LMP), and from then it is instead called a fetus.
Embryo is the term used to describe the developing baby in the first 8 weeks and the term Fetus is the term used after 8 weeks until birth (when all the structure of the baby and systems of the body such as the digestive and nervous systems have developed).

Facts at 24 weeks
24 weeks is the legal cut off gestational age for a legal abortion (although abortions or terminations can be carried out later in the pregnancy on medical grounds).

COMPLICATIONS OF PREMATURE BIRTH
Babies born after 34 weeks have a low risk of problems although they are sometime slower to feed.
A baby born before 33 weeks will have more serious problems such as immature lungs.
Very premature babies (born under 28 weeks) need to be delivered in a hospital with a neonatal intensive care unit.
Doctors have been able to improve dramatically the survival hopes for babies born as early as 22 or 23 weeks.
However, very premature babies face a huge battle at the start of life. They are at risk of serious conditions including:
* Hypothermia, due to lower levels of fat
* Low blood glucose, which can lead to brain damage
* Respiratory distress syndrome – which can cause blindness
* Brain haemorrhage
Long-term they may have cerebral palsy and have sight and hearing problems.
They are also more likely to have motor impairments and co-ordination and concentration problems.

Birth
Occurs at around 38 weeks after fertilization, so 40 weeks pregnant. Term is considered to be 37 – 42 weeks gestation. The fetus has developed enough to survive easily outside its mother’s body. Babies are usually born head first but occasionally are born breech.

http://www.babycentre.co.uk/v1027487/inside-pregnancy-weeks-28-37

There are a variety of birthing methods; the majority of babies are born by a natural vaginal birth but some labours might need help such as
Ventouse, Forceps, Caesarean section.

The process of natural birth involves what is known as “labour” the baby passing from the mother’s abdomen through the vaginal passage and into the world. There are three stages of labour:

Stage 1: The cervix has to open and stretch around the baby’s head until it is 10cm open.

Stage 2: The baby has to come out, either by the expulsive efforts of the uterus and the mother breathing the baby out, or by her actively pushing the baby out.

Stage 3: The placenta or afterbirth has to be expelled.

Linked blog posts:

https://midwifevalerie.wordpress.com/2008/12/07/so-you-are-pregnant-preparing-for-the-birth/
https://midwifevalerie.wordpress.com/2008/12/19/the-big-day-the-birth/

I was delighted to read Ulrika Jonnson’s article in today’s Daily Mail about Stress Incontinence.  How brave of this woman to admit something that most of us keep secret, Ulrika will have helped thousands of women with the public admission of her problem.  www.dailymail.co.uk/health/article-1160211/Ulrika-reveals-embarrassing-health-secret-TV-presenter-breaks-secret-taboo-incontinence-affects-millions-women.html

Stress incontinence is a large problem affecting 1:4 (or maybe even 1:3) women at some stage in their lives.

Urinary incontinence can be broken down into “frequency” (often associated with infection), “urgency” (usually caused by nerve pathway damage), “overflow” (when the bladder is atonic and has lost the ability to empty correctly) and “stress”.

Stress incontinence occurs when the intra-abdominal pressure rises abruptly when under stress, (e.g. coughing, laughing, sneezing).  Urine loss is likely to be small in volume, however it is not unknown for the stress to act as a “trigger” causing a complete void (perhaps when suffering from mixed “urge” and “stress” incontinence).

There are various theories and several predisposing factors to stress incontinence, these include the ageing process, denervation during childbirth, multiple pregnancy, multiparity, large babies, obesity, chronic cough, intra-abdominal mass (e.g. fibroids/tumour) and constipation.

Many women manage the problem day-to-day basis with the use of panty liners and by doing pelvic-floor exercises, but in many cases it can be treated, so speak to your GP about it or contact your local continence clinic – you can contact many of these clinics directly for a consultation www.bladderandbowelfoundation. org/continence-clinic-directory –  more than 70 per cent of cases can be helped, so it is very important to overcome your inhibitions and ask for help!  www.continence-foundation.org.uk is another really useful site.

Pelvic Floor Exercises

The first-line treatment for stress incontience is to do Pelvic Floor Exercises.  The muscles are in the bottom of the pelvis and form a sling that supports your pelvic organs (bladder, uterus and bowel) and are a vital part in preventing bladder and bowel incontinence. They also play a part in sexual function and are important during pregnancy and childbirth.

It is important to make sure that you are using the right group of muscles and contracting them in the right way. It helps to be lying down or sitting forward when you first try to do the exercises and you need to breathe normally.

Imagine that you are trying to stop yourself passing urine and at the same time trying to stop yourself passing wind. The muscles should feel as though they ‘lift and squeeze’ at the same time. The buttock and thigh muscles should remain relaxed but a gentle tightening in the lower part of your tummy muscles is quite normal.

You should try to do your pelvic-floor exercises at least three times a day. Most women aim for ten long squeezes followed by ten short squeezes. It can take three to five months before you notice an improvement.

Tighten pelvic-floor muscles and hold for several seconds and then relax for the same length of time. Repeat until muscles feel tired.

Tighten your pelvic-floor muscles for a second and then relax. Repeat until muscles feel tired.

One of the best booklets I have come across is “Fit for Motherhood” produced by the Association of Chartered Physiotherapists in Women’s Health www.acpwh.org.uk/docs/FitforMotherhood.pdf

There are also devices that can be bought to help you, for example www.tenscare.co.uk/index.php?action=products&product=75 or vaginal weights www.aquaflexvaginalweights.com however I really do encourage you to pluck up the courage and speak to your midwife or doctor first and ask for a referral to a physiotherapist.


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