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PREGNANCY RESOURCES

Pregnancy Q&A
by Tenet Healthcare - Philadelphia

What can I do to help ensure a healthy pregnancy?
A healthy pregnancy begins with a healthy, happy, knowledgeable woman who will be able to provide her baby with an optimal uterine environment.

This can be achieved prior to becoming pregnant with annual physical and gynecological check-ups, a well-balanced daily diet, prenatal vitamin supplementation at least 3 to 6 months before conception, participation in a regular exercise program, avoidance of drugs, alcohol and cigarettes.

It is also important to take advantage of all prenatal educational opportunities available such as books, videos, and pre-pregnancy and early pregnancy childbirth education course. These educational tools will enhance your knowledge of the physical and emotional changes which accompany the childbearing cycle of pregnancy, labor, delivery, and short-term and long-term postpartum so that you and your partner can better prepare for and better participate in this major life event.

After becoming pregnant, it is extremely important to begin your prenatal care as soon as possible. This will provide early baseline information on the growth and development of your baby as well as the appropriate healthy progression of your pregnancy.

Throughout your pregnancy, you should maintain a healthy life-style, learn obstetrical terminology and language by reading and attending childbirth classes to prepare you to more fully participate in your obstetrical care plus your labor, delivery, and postpartum experiences.

Developing a Birth Plan with your partner for your baby's birth (e.g. using a Jacuzzi in labor, walking, squatting, massage and music for relaxation, breastfeeding immediately after delivery, etc.) can help to remove any fear and get you mentally and emotionally ready for birth.

Your physical and emotional well being throughout your entire prenatal period should be your daily goal. This will ensure a healthy, happy pregnancy!

Which signs or symptoms should prompt me to call my doctor?
Signs and/or symptoms which should prompt you to call your doctor or nurse-midwife are:

• Spotting or bleeding from your vagina or rectum
• Nose bleeds
• Pain or burning when you urinate
• Frequent headaches or a headache that does not go away
• Swelling in your face, hands or feet
• Nausea or vomiting
• Sharp stomach or severe abdominal/uterine cramping
• Blurred vision or spots before your eyes
• Dizziness or fainting spells
• A rash anywhere on your body that does not go away
• Sudden weight gain or loss
• Muscle contractions or tightening of your abdominal/uterine area that does not go away
• Lack of movement from your baby

Always contact your doctor or nurse-midwife if you feel the need to make sure that you and your baby are healthy!

After labor starts, how will I know when to go to the hospital?
Throughout your prenatal care, you should have an educational component to each prenatal visit. At your initial visit, you should be given the appropriate telephone number to call whenever you have any health changes ranging from the common cold to uterine cramping or vaginal bleeding.

Your healthcare provider should make you aware of the three major signs of labor. The first of which is the loss of your mucous plug or "blood show". The second is the rupture of your amniotic sac or "water breaking" and the third is regular or sometimes irregular rhythmic contractions.

After experiencing one or all of these signs you should telephone your doctor or nurse-midwife and be prepared to be a good "labor reporter". Have a notebook with the following facts written down:

1. The time of the loss of your mucous plug or "bloody show" with a description of the discharge and approximate amount of accompanying blood loss, if any. Try to describe the amount of blood loss in terms of coins. For example, quarter, nickel or dime sized amount.
2. Time your amniotic sac or "water" break, plus the amount of fluid loss as well as a description of its color. Also, describe the amount of fetal activity prior to and after the rupture occurs.
3. The frequency, strength and duration of the contractual event. Timing your contraction from the beginning of one to the beginning of the next will help determine frequency. Timing your contraction from the beginning of one to its end will help determine duration or length. A description of your perceived sensation of intensity of the contraction will help determine each contraction's strength.

After providing your doctor or nurse-midwife with your "labor report", he or she will either instruct you to proceed immediately to the hospital or to continue to labor at home. If you are told to continue to labor at home, your healthcare provider will instruct you to call back at a predetermined time or to call back if there are any changes in your labor pattern. You may experience an increase or decrease in contractual intensity, frequency or duration and in the amount of vaginal bleeding.

Call your doctor or nurse midwife after your water sac ruptures or if there is any sensation of an urge to push. If you feel the urge to push — DO NOT DO IT! Never just "show-up" at the hospital without telephoning your doctor or nurse midwife and receiving their expert labor guidance. Also call if you feel the need to make sure that your and your baby are doing well.

What are my options to control labor pains?
A laboring woman has many options available to her, which will enable her to have a positive, relaxed response to each uterine contraction ranging from meditation and relaxation techniques to analgesic drugs and regional anesthesia.

The first key to success in labor pain control begins to develop during childbirth education classes, which should thoroughly familiarize you and your partner with the process of birth. You will also learn relaxation, concentration, visualization, massage and breathing techniques which, if practiced on a regular basis, should not only elevate the woman's threshold for pain but aid in a positive attitude as well as confidence in your partner and your own ability to give birth.

Childbirth education classes in addition to your physician or nurse-midwife will also provide a thorough explanation of the analgesic, anesthesia and regional anesthetic drugs available for use during labor and delivery if a woman needs or desires medication.

During a woman's last trimester of pregnancy, she and her partner should take a tour of their birthing environment to familiarize themselves with their labor, birth, recovery and postpartum setting in order to learn what physical and emotional comforts are available. This may include separate labor, delivery and postpartum (all-in-one) suites with private showers and/or Jacuzzis to aid in labor pain relief and postpartum recovery.

Another way of preparing for labor discomfort and pain is to develop a Birth Plan. You should share your Birth Plan with your doctor or nurse-midwife prior to labor as well as giving a copy of it to your labor nurses when you enter the hospital during labor. This Birth Plan should highlight your special goals, needs, requests and pain relief choices for labor, delivery and immediate postpartum. You and your partner will then be able to actively participate in labor/delivery decision making for pain relief as well as personalize your childbirth experience, making it a happy and memorable life event for years to come.

Editorial provided by Tenet Healthcare in Philadelphia, Pennsylvania.