Well-prepared for your baby
ALONG with the excitement of welcoming a new life into the world comes anxiety over how things will go during the birth itself. Despite the joy and anticipation, the due date can loom over the expecting couple like an ominous D- Day.
However, if you have done everything you need to during your pregnancy, there is no cause to worry.
Preparing properly
“A successful delivery is the end of a successful pregnancy. With proper advice from the doctor during the pregnancy and positive support from family, the woman should go into delivery completely confident,” says Dr Arun Kumar Bag, consultant obstetrician and gynaecologist at a private medical centre in Selangor.
The best way to ensure a good delivery is to have regular antenatal check- ups. On top of this, during the nine months, you should have learnt everything you need to know about how to keep yourself and the baby healthy during the pregnancy, and about the birth from your doctor and your own research.
“Besides reading books on antenatal and prenatal care and motherhood, my husband, who is a doctor, and mother were my primary sources of information, alongside my father and sister. They provided me with all the additional tips and information I needed,” says first- time mother Ranjeeta Kaur, who gave birth to her son last month.
Your research should also include methods of delivery. New father T. E. Low and his wife Geng Yuling, for example, combed through comprehensive online resources, spoke to their peers about their delivery choices and got to know their mothers’ delivery experiences.
They also had a good discussion with their obstetrician about the choices available and the best one for them.
Low says that their research and discussions with their obstetrician about pregnancy, childbirth, delivery methods and parenting helped them tremendously, especially in the mental preparation of being new parents.
Preparation is important even if you are not a first- time parent; though you may know generally what to expect, every pregnancy and every baby is different.
“The second time is a little easier because you have experienced it before. I think it’s best to just remember what you wanted to do or should have done but didn’t during your first pregnancy and work out the best way to close the gap,” says Mavis Chor Yit Wah, who gave birth to her second child in June, three years after her first child.
The big day
Once in labour, you should go to the hospital at most a few hours after your contractions start, advises Dr Bag.
Your progress will be checked every two hours by the accoucheur ( person assisting with the birth – either a nurse or midwife) to see how your labour is advancing, including how much your cervix is dilating and how much your baby is descending in the uterus.
If you opt for epidural anaesthesia, the anaesthetist will probably administer it at this point, when you are in established labour, about the time when you have one contraction in two to three minutes and your cervix is dilated to more than three centimetres.
Typically, you will have your husband or partner in the delivery room with you, along with the obstetrician, the accoucheur and two assistants, who will ensure the delivery goes as smoothly as possible.
Immediately after
In the movies, most of the time you see the nurse immediately wrapping the newborn in a cloth and giving her to the mother, which marks the end of the whole process. This is far from the truth.
Once born, the baby is certainly held up and shown to you, but then she is handed over to the midwife or nurse to be taken care of. The umbilical cord will be cut.
At this point, if you have opted to store the cord blood, it will be extracted by the obstetrician or midwife; all obstetricians and midwives undergo mandatory training in the collection process.
“A needle is inserted into a vein in the umbilical cord while waiting for the placenta to become detached from the mother and the blood is directed into a collection bag, which will be filled within five minutes,” says James Then, managing director of stem cell bank CryoCord Sdn Bhd.
The obstetrician or midwife will collect as big a sample of the cord blood as possible to ensure that there is sufficient cell count in the sample. It is a quick, safe and painless procedure – neither mother nor baby will even feel it, explains Then.
As this is happening, your baby will be examined. “The baby will undergo an Apgar assessment immediately after birth to check how she is doing. The breathing, heart rate, muscle tone, reflexes and skin colour are tested and scored,” explains Dr M. Kumari, consultant paediatrician at a private hospital in Kuala Lumpur.
Meanwhile, you will be undergoing your own afterbirth process.
“The obstetrician will ensure the placenta is delivered and suture up any wounds necessary, as well as ensure the uterus contracts properly and there is no unusual bleeding,” says Dr Bag.
The doctor will take the mother’s blood pressure and pulse and make sure she is kept warm. Once the baby is cleaned and the nurse ensures she is warm, she will be passed to the mother.
Feeling a little awkward when holding your baby for the first time is normal; the midwife or nurse will show you how to do it comfortably. Newborn babies have a natural instinct to latch onto your breast and they should be allowed to do so.
“Breastfeeding immediately after birth means the baby gets the antibodies in the colostrum that will help protect him/ her against disease. Also, breastfeeding at this point not only helps your uterus contract, it also means that you are likely to be more successful with breastfeeding later,” says Dr Kumari.
The next 24 hours
After the monumental task of childbirth, some women feel tired and experience muscle aches; giving birth is somewhat akin to running a marathon.
Other women have reported feeling high on adrenaline and fully alert, though once the adrenaline wears off, they too feel weary.
You will experience bleeding like a heavy period, so stock up on maternity pads before your delivery.
If you have stiches in your perineum, you must ensure that they remain clean. The nurses or midwife will advise you on how to do this, and they will be checking on you a few hours after your delivery. You should also bathe at least once a day.
Dr Kumari explains that a few hours after birth, your baby will be checked by a nurse to determine how she is adjusting to life outside the womb. At this point she will be measured, her heart rate and temperature taken and her breathing monitored.
The nurse or midwife will show you how to give your baby her first bath and change her diaper after her first bowel movement.
“Within 24 hours, the baby will be administered vitamin K to prevent eye infections, her first dose of hepatitis B vaccination and the BCG vaccination,” says Dr Kumari.
By this time, your baby will be nursing every two or three hours. The midwife or a special lactation consultant will be on hand to talk to you about any problems you might have breastfeeding and to give you tips on how to do it successfully.
You may be discharged from hospital anywhere between 24 and 48 hours after delivery, and your doctor will tell you when your first postpartum check- up will be – usually in about six weeks.
Leaving the safety of the hospital may seem a scary prospect, but with a good support system from your family and friends, you will do just fine.
A successful delivery is the end of a successful pregnancy. With proper advice from the doctor during the pregnancy and possitive support from the family, the woman should go into delivery completely confident. Dr Arun Kumar Bag