Being pregnant is a wonderful experience but, unfortunately, it also has its drawbacks. You may endure morning sickness, backaches, puffy feet, and other discomforts along the way.

One common issue pregnant women often face is the pain and distress of vaginal yeast infections. Although yeast infections do not normally present any severe dangers to mother or baby, the condition is uncomfortable and galling. With all the other discomforts of pregnancy, who needs the added burden of a vaginal yeast infection?

The problem is the medications a pregnant woman can take safely are severely limited. Fortunately, yeast is naturally occurring and there are natural remedies that can eliminate yeast infections without any risks during your pregnancy.

SAFETY FIRST – CONFIRM IT IS A YEAST INFECTION

Painful urination and pain during sexual intercourse may occur and the area may become inflamed and swollen. Yeast infections are not the only disorder that cause these symptoms so check with your midwife or physician to confirm the diagnosis.

WHY PREGNANT WOMEN ARE PRONE TO VAGINAL YEAST INFECTIONS

When that happens this microorganism begins to grow rapidly and soon grossly outnumbers protective bacteria. The result is a yeast infection.

Candida thrives in areas that are dark, warm, and moist, so the vaginal region is an ideal location for yeast to colonize. In order to relieve the yeast infection, the number of yeast cells living there must be reduced. So how do you accomplish that?

LIMIT THE FOODS CANDIDA THRIVES ON

Like all living organisms, fungi must have food in order to survive. Candida thrives on sugars, white flour, yeasts, processed foods, alcohol, many dairy products, caffeine, and soda pop.

By limiting your intake of these types of food and focusing your diet on lean meats and fresh vegetables, nuts, seeds, and legumes, you’ll take a big step towards starving the candida into submission.

The bonus is that this is also a healthy way to provide your growing baby with the best nutrition possible.

YOGURT PROVIDES TWO AVENUES OF TREATMENT

You can use yogurt as a topical treatment as well. Use plain yogurt that contains live cultures and no sweeteners, and apply it directly to the irritated area. Not only will it help fight the yeast, it will cool and soothe the itching. Other women put the yogurt on a sanitary pad and apply it.

Some women like to take an empty tampon applicator, fill it with plain yogurt, and freeze it. The frozen yogurt can then be inserted directly into the vagina and go right to the source of the infection.

GARLIC

It’s also a good idea to increase the amount of garlic in your diet. Garlic contains both antibacterial and antiviral properties and may help kill the candida.

HYGIENE AND GROOMING

Keep the area clean and dry. Sleep without panties at night to promote air circulation and wear cotton panties during the day. Cotton wicks moisture away from the skin and yeasts thrive in dampness. Don’t wear tight clothing and use unscented toilet paper.

Yeast can be transferred between sex partners so either refrain from sex until you are cleared of the infection or use a condom. Your partner may need to be treated as well.

About the Author: Eric Bakker, ND is a naturopathic physician from New Zealand. He’s spent the past 20 years of his life studying the causes of and treatments for Candida. Please visit him at www.yeastinfection.org for more information.

What is rib flaring?

Rib pain during pregnancy can be a persistent problem, especially during the third trimester. Your rib cage may feel mildly sore or extremely tender and bruised. You may have discomfort on either side, or both sides, though it is commonly worse on the right side of the ribs. Pain occurs in and under the ribs as your uterus grows.

What causes rib flaring?

The demand for oxygen is increased in pregnancy because the basal metabolic rate and the mass of the expectant mom increase as well. It is estimated that a woman will require about 20% more oxygen than normal at term. She also exhales more carbon dioxide which triggers the already sensitive respiratory system to increase the respiratory rate slightly. Hence, it is this lowering of the carbon dioxide that leads to pregnant women to becoming breathless on activity. Your diaphragm will have to work harder which may result in the feeling of ‘getting a stitch’ as the diaphragmatic muscles fatigue.

Many expectant women will experience the baby beginning to press up under her ribs and chest. This is the uterus ascending as the abdomen becomes stretched upward and outward with the growing baby. It may also make you feel short of breath. This ascending uterus thus progressively obstructs the descent of the diaphragm, which is needed for deep breathing. It can force the diaphragm upwards by at least 4cm towards the end of pregnancy. Hence this rising pressure pushes the rib cage out sideways and forwards, resulting in pain in the front of the lower ribs, also known as rib flare. This pressure on your ribs and diaphragm may also result in shoulder pain, because there are nerves in the diaphragm which can refer pain into the shoulders.
As your breasts become larger, they also place pressure on your ribs. During pregnancy, your breasts may increase by one full cup size or more. The extra weight pulls your shoulders forward and down, and places strain on the upper back, neck, and often results in pain around the rib cage.

Interesting!

As the baby grows, motion of the ribs and thoracic spine becomes restricted affecting chest and diaphragm movement. The lymphatic system requires the diaphragm to work as a pump to aid the flow of lymph back into the venous system and heart. Fluid and electrolyte balance is affected leading to fluid retention in the body (as seen clearly at the ankles).

What can I do to get relief?

Rib pain during pregnancy can cause the greatest discomfort when you are in a sitting position. Practicing good posture is especially important. Try to make sure that you sit up straight with your shoulders back. Slouching will compress your abdomen and result in more pain.

Here is a really effective exercise for temporary relief. Stand facing a wall. With your feet 40cms from the wall, cross your arms in front of your face. Then lean your crossed arms on the wall sliding them up the wall above your head and stretching yourself up as far as possible. Hold the position for as long as comfortable. This lifts the diaphragm and rib cage up off the uterus. Practicing doorway chest stretches can also be helpful because they, too, will help rotate the shoulders up and back, which can also help lift the ribs away from the uterus.

It is especially important to have a supportive bra that is not too tight. Under wire bras may put too much extra pressure on your ribs. Now may be a good time to invest in a good nursing bra. They usually offer nice support without being too tight and will be useful once your baby is born. Stretching and prenatal yoga are great for keeping your body long and loose. The less compressed you are, the less your rib cage will hurt.

Breathing and relaxation exercises may also be effective. There are a variety of hands on techniques that can help to gently stretch and lift your ribs away from the uterus. Applying these techniques to your breasts, chest and abdomen, can really relieve a lot of pain and pressure from your body, though you will need a friend or partner to help you. Scheduling a visit to your physiotherapist may also help provide relief from rib pain during pregnancy. A combination of soft tissue work, gentle mobilizations, postural training, Pilates, and support/kinesiotape can be very effective.

NOTE: If you are having rib and flank pain that goes through to your back, and or burning or pain with urination, you should contact your health care provider. This could be an indication of a urinary tract infection.

Megyn Robertson (MSc Physiotherapy)
Broadacres Physiotherapy and Craighall Park

Email: megynrob16@yahoo.co.uk

Pelvic Girdle Pain or PGP is a term used to describe pain in the pubic bone region below the tummy, or pain across the low back or sacrum on one or both sides. It is a specific form of low back pain, and the term Symphysis Pubis Dysfunction, is included in the term PGP.

PGP can start around the 18th week, and reaches peak intensity between the 24th and 36th week of pregnancy. Usually in your first pregnancy it starts later into the third trimester but PGP occurs earlier in second and third pregnancies.

What are the symptoms?

Common complaints of PGP include difficulty in walking, pain when taking weight on one leg (for e.g. climbing stairs, dressing or getting into or out of the bath), turning over in bed and pain or difficulty during sexual intercourse. Some women with PGP can experience emotional problems, such as anxiety over the cause of pain, frustration and depression. In a study by Noren et al (1997), it was demonstrated that these women are three times more likely to suffer postpartum depressive symptoms

What causes PGP?

The exact cause of PGP is not understood. Initially it was thought that the cause of PGP was due to the release of the hormone Relaxin which allows the pelvic ligaments to stretch, leaving them more prone to stretch injuries. However the latest research by Damen et al (2002) shows that it may be due to asymmetric laxity of the pelvic ligaments. In other words, one side of the pelvis relaxes more than the other, so the pelvic girdle joints move unevenly.

How is PGP diagnosed?

The diagnosis of PGP is made once it is proven that the pain is not due to lower back pain. It is important to note that PGP must be reproduced by specific clinical tests, performed by a qualified physiotherapist.

How is it treated?

It is important to have a correct diagnosis of pregnancy-related PGP as opposed to pregnancy-related low back pain. Some treatments for low back pain may actually aggravate your pelvic girdle pain. The sooner it is assessed and identified, the better it can be managed

Pregnancy do’s

• A pelvic belt is a good idea for a really painful PGP. It can be fitted to see if it gives some relief of your symptoms, but must only be worn for short periods – usually the last months of pregnancy.
• Physiotherapy treatment can help to improve spinal and pelvic joint position and stability, relieve pain and improve muscle function
• Regular exercise benefits the psychological state of mind and the mental health of pregnant women (Fetih et al, 2008)
• Strengthen your stomach, back, pelvic floor and hip muscles - water aerobics is also proven to help PGP symptoms!

Good advice: A few simple tips!

1. Sit down to get dressed or undressed
2. Roll in and out of bed keeping your knees together
3. Sleep in a comfortable position (for e.g. lie on your side with a  pillow between your knees
4. Take the stairs one at a time (try going upstairs with your less painful leg and downstairs leading with the more painful one)
5. Be as active as possible within your pain limits and avoid activities that make the pain worse!

A great website to look at is http://www.acpwh.co.uk. The UK chartered physiotherapy society, provide a leaflet specifically for Mothers-to-be and New moms who suffer from PGP. The leaflet provides more in-depth information on PGP and gives advice on how to adapt your lifestyle and how you can look after yourself.

References:

• Vleeming, A et al, 2008. European Guidelines for the Diagnosis and treatment of pelvic girdle pain. European Spine Journal 17:794-8192.
• Noren et al, 1997. Reduction of sick leave for low back and posterior pelvic pain in pregnancy. Spine 22:2157-21603.
• Wu et al, 2004. Pregnancy related Pelvic Girdle Pain: Terminology, Clinical Presentation and Prevalence. European Spine Journal 13(6):460-54.
• Damen et al, 2002.  Reliability of sacroiliac joint laxity measurement with Doppler imaging of vibrations. Ultrasound in Medicine & Biology 28:407-145.
• Fetih et al, 2008. The state of mind of less physically active women in their second trimester of their pregnancies. Acta Univ. Palacki Olomuc. Gymnastika 38(3):37-43

Megyn Robertson, Broadacres Physiotherapy

megynrob16@yahoo.co.uk

Buying a home pregnancy test is almost as exciting as buying that first baby grow or socks, then seeing the positive result appear is a moment you’ll never forget, in fact I would not put it past you if you bought a second test just to make sure. The test detects a hormone called human chorionic gonadotrophin (hCG) in your urine, they are very accurate.

How early can I use one?

From the day your period is due, in theory, around two weeks after conception. The hormone will be more concentrated in your urine first thing in the morning, though you can take one at any time of the day.

How is it used?

Read the instructions carefully and make sure that you know what the stick should look like if you are pregnant or not. Some have blue/ purple lines.

Are they accurate?

Home test kits have become extremely reliable over the past couple of decades, so if it tells you that you are pregnant, then you almost certainly are. However, it is possible to still get a positive result if you have recently had a miscarriage, as the levels of HCG hormone in your blood will not have returned to normal.

Where can I buy one?

You can get this test from all pharmacies.

Car accidents are a leading cause of death and injury in children, so this is one to take very, very seriously. You can buy car seats suitable from birth to four years, or a backwards-facing baby seat suitable until nine to twelve months ( depending on the size of your baby ), then a car seat suitable from about nine months to four years. The backwards-facing baby seat is useful as you can clip it in and out of the car and carry or sit your baby in it when you’re in cafes or friends’ houses

THERE ARE CERTAIN CAR-SAFETY RULES YOU SHOULD ALWAYS FOLLOW:

• Always put your baby in a properly fitted seat, suitable for his age and weight.
• Be sure the car seat is genuinely a safe one. It should have a British Standard Kitemark or United Nations Standard Regulation 44.o3 and is the one piece of equipment you shouldn’t buy second-hand unless you know its history (i.e. no accidents) and have the instructions. Never fit an infant car seat in the front seat of a car with air bags.
• The back seat is the safest place (unless your car is, freakishly, without back-seat seatbelts).
• Never ever take your baby out of the car seat when the car is moving, even if is purple in the face and bellowing and your pulse is racing. We have been tempted to do this but it’s extremely dangerous. Always pull over somewhere safe before you get him out.

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POINTS TO CONSIDER

• You need to think about how the name sits with your family name, and check to see if the initials will make a word when placed together.
• In some families it is traditional to pass on a name. If you are not happy with this, you could perhaps make it a middle name.
• An unusual spelling gives your child a name that is almost exclusively his, but think how annoying it could be for him to have his name wrongly spelt or mispronounced throughout his life.
• Remember that a name that suits your tiny newborn baby needs to suit a fully grown adult as well.
• Choosing a name that reflects the country of origin of the parents or another member of the family has become very popular in recent years.
• You may find that you and your partner just cannot decide. If this is the case, wait until he’s born and then see what he looks like! Even if you have chosen a name, sometimes it just doesn’t seem right when you actually meet your baby.
• You might want to think about a name that in some way links your baby to the circumstances of his birth, such as name that is local to the area in which he was born.

Life is always a rich and steady time when you are waiting for something to happen or to hatch.
E.B. White, Charlotte's Web 

All over the world, there is no single event more celebrated than the birth of a baby. When a woman is expecting, her friends and family members are eager to share in the celebrations of welcoming a new life into the world. For many cultures around the world, one of the most important events before a baby’s birth is the seventh month ceremony – held to rejoice in the birth to come and bring together the people that will play a role in the new baby’s life. In Western society, the baby shower or stork party serves a similar purpose and is usually also held around the seventh month. (There is no hard and fast rule about when to hold the baby shower, but holding it too close to the expectant mom’s due date could become problematic if baby decides to arrive ahead of schedule.)

If your sister or best friend has asked you to throw her baby shower you undoubtedly feel honoured, but possibly also a bit stressed about creating the perfect day. Here are a few tips that will allow you to plan a stress-free, memorable event.

Planning

The key to hosting any successful event is meticulous planning. In the case of a baby shower, always bear in mind that you are creating a special day for the mom-to-be and that the focus of the day should be about creating happy memories and the opportunity for guests to share in the new parents’ joy. Baby shower norms and traditions are all good and well, but are not carved in stone. Consider mom-to-be first and plan according to what would bring her joy – the last thing you want is for her to feel uncomfortable or out of place on the day.

Keep a notebook dedicated to the event and start by listing each individual element that requires your attention:

• Guest List
• Location
• Theme
• Décor
• Invitations
• Catering
• Gifts
• Games
• Thank yous

The Guest List

Traditionally baby showers were an all-girl affair. However, more and more people are opting for extending the invitation to men so that the equally excited dad-to-be can also be included. This depends entirely on the couple in question. When drawing up the guest list, the safest option is to ask the expectant parents. However, if you are planning a total surprise ask for input from other friends and family members so that nobody is forgotten.

Location

A baby shower is usually hosted by the person responsible for planning the party. This is preferable as a home-based shower is generally the most relaxed for all concerned; but if it is not practical, you could ask one of the other guests to open their home or make a booking at a suitable restaurant. If your party includes men it is a good idea to allocate an area where they can break away and socialise without feeling awkward. While men tend to enjoy the celebration of a new baby as much as any woman, asking them to sit through the opening of every gift or joining in with games is often too much!

Theme

Planning around a theme can make things easier if you are planning a more traditional or formal shower because you can then carry the theme through from invitations, to décor, to party favours etc. Themes can range from stars to teddy bears, from nursery rhymes to baby bottles. If you know the sex of the baby, you could simply opt for an ‘it’s a boy/girl’ theme. If twins are on the way, plan a theme around that. Again, if you choose to have a theme, bear the mom-to-be in mind and consider her likes and dislikes.

Décor

Having a theme makes decorating your venue easy – several shops carry a host of stunning decorations ideal for creating the perfect environment for celebrating baby. When planning, consider things like tablecloths, serviettes and centerpieces. A nice idea is to create a centerpiece out of practical baby supplies that mom can take home at the end of the day. Balloons are also a fun and economical way of adding plenty of cheer to your decorations. Choose balloons and ribbons in colours in keeping with your theme and create interesting balloon weights for an extra special touch.

Invitations

Depending on the type of day you are planning, the invitation can range from a simple phone call to an email to a creative work of art that is to be printed and posted or hand delivered. Whatever the case, be sure to give guests plenty of warning, set an RSVP date and keep careful track of the responses. Once again, if you have chosen a theme you immediately have a starting point for the design of your invitation. If you are sending an invite via email and need a bit of inspiration, many websites offer downloadable templates to help you get started.

Ensure that your invite includes the following important information:

• The name of the host as well as the expectant mom/parents
• The date and time
• The location and directions
• RSVP – include phone number, email address and date due
• Gift registry details if applicable
• Dress code or theme
• A note of anything you may need guests to bring or do

Catering

If you’re hosting the shower at home, plan a menu and beverages according to mom-to-be’s wishes. Take into account budget, the time of year, time of day, number of guests and whether or not men are included, (they sometimes need something a bit more substantial than a finger sandwich). Make an impression with a variety of finger foods elegantly laid out on platters. Popular food choices included finger sandwiches, mini pizzas, crudités, cheese and biscuits, chicken wings, chips and dips and mini meatballs. When serving tea and coffee try to have a few varieties available as well as sugar and sweeteners. Arrange for an urn so that you don’t have to bother with boiling a kettle every half an hour. A punch is also a baby shower favourite – if you are serving alcohol make sure to have a non-alcoholic option for mom-to-be.

Gifts

Try to get a list of needs from mom-to-be herself or perhaps from dad or a family member. (Especially if this is a shower for a second or third child.) Keep the list handy as many guests will rely on you for this information. To make life a lot easier, many shops now offer a registry service much the same as a wedding registry. Some moms may find registering their needs a bit forward, but point out to them that guests will bring a gift regardless, and having a registry makes it easier for them to shop and guards against endless duplications and unnecessary purchases. You could also point out on the invitation that guests are welcome to bring a gift that does not appear on the registry if they prefer. If you would like guests to wrap the gifts in keeping with your theme (in receiving blankets, baby sheets, cloth nappies etc) be sure to mention it on the invitation.

Games

Games and activities are traditionally a favourite at baby showers and make for lots of laughs and happy memories - but are definitely not everyone’s cup of tea. Regardless of your personal preference, make sure that mom-to-be will enjoy playing games before you include them in your planning. Popular favourites include:

• Guess the number of safety pins/jelly beans etc in a jar. Person with closest guess wins.
• Guess mom’s tummy size. Each guest cuts a length of string that they think will fit around mom-to-be’s belly. Closest guess wins.
• Guess the baby picture. Each guest brings a baby photo of themselves and mom-to-be must guess who it is.

A wonderful alternative – or addition – to playing games is to create a baby shower memory book. Ask each guest to write a piece of advice to the new parents or a message to the baby. This will be treasured for years to come! You may want to mention that you will be doing this on the invitation so that guests can prepare something special to write beforehand. Take lots of photos on the day – these can be included in the memory book.

Thank Yous

Ensure that someone is making a note of the gifts being given – mom-to-be will never be able to remember every detail and will appreciate a reminder of who-gave-what when she is writing thank you notes. You can also thank each guest for being a part of the day by giving them a small parting gift - small picture frames, flowerpots with mini, fresh cut flowers or a party favour in keeping with your theme.

Lastly, when the big day comes, remember that your most important guest is mom-to-be. Make sure she is comfortable and has a relaxed day that embraces the true spirit of a baby shower – sharing in the joy and celebration of a new life.

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As a child, I remember my mom’s friend had a series of photographs on her bedroom wall of her pregnant belly. She was wearing a thin dress, her long hair was falling over her shoulders and a light was shining from behind her, exposing the swell of her tummy. She looked so serene and beautiful.

Fast forward twenty-odd years and there I was, clumsy and embarrassed, standing in front of a photographer in a skirt and white crop top. My ankles were swollen, my face was bloated and I felt plain awful.

I decided to have photo’s taken, with my two sons loving my belly. They were, after all excited about the arrival of their baby sister and I wanted to document that in her scrapbook.

I was embarrassed. I’d spent the last 36 weeks wearing baggy shirts and (those beautiful!) maternity pants to hide how big I’d become and now I was wearing practically nothing, baring my swollen, stretched belly to a complete stranger.

The photo shoot lasted for at least an hour. I posed for the camera holding my belly in my arms; I held a flower in front of my tummy; my boys each had a turn kissing my tummy and giving their baby sister a love.

As I put my baggy clothes back on, confident that I was now well and truly covered, the photographer came up to me and showed me some of the photo’s she’d captured on her camera.

I was beautiful.

Through the clenched teeth and forced smiles, getting up, getting down, turning this way and that way, I looked serene. I looked beautiful.

I couldn’t wait to show my family, my friends and more importantly my daughter my pregnant belly.

How do you prepare for a photo shoot?

Before the photo shoot:

• Do research. Get recommendations from friends and ask to see the photographer’s portfolio
• Set up a meeting with the photographer and explain exactly what you would like to capture
• Find out what the photographer expects from the photo shoot.
• Ask the photographer what clothes you need to wear. This is crucial if you want to create a certain mood. In many cases, you’ll be asked to wear one colour or different colours that compliment one another (white is preferable)
• Ask the photographer if you need to bring props or if he’ll provide them

On the day:

• Make sure that you had a good night’s sleep.
• Go to the salon to have your hair done. You’ll feel better about yourself and be more confident when standing in front of the camera
• Have your make-up done professionally, or if you’d prefer to do your make-up at home, make sure that you put your make-up on a little heavier than you normally would
• Don’t wear elasticised pants that will leave a mark on your belly. Rather wear a dress or loose-fitting maternity pants. You don’t want to have a line across your belly for your photos.
• Bring a selection of clothes with you, so that the photographer can play around with different looks.
• Try to do the photo shoot earlier in the day, rather than later. You won’t be tired and you’re less likely to have a swollen face and ankles.
• Talk to the photographer during the shoot. Tell her exactly what you’d like to do and what makes you feel uncomfortable.
• Be courageous! The photographer has probably done dozens of shoots and knows what is likely to look good.
• Have fun, after all, how often do get to be a model for a day?

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Foetal Presentation

In the third trimester you will see your midwife/ doctor fortnightly, then weekly from around week 36. At this stage, in addition to routine checks, she will be assessing your baby’s position right up until labour. If the baby is transverse lie (with his spine at a right angle to the mother’s), then a vaginal birth may be impossible. If he is breech (accounting for around four per cent of all births), this can also cause problems, as it may be difficult to deliver the head after the legs and bottom have emerged. Some hospitals are happy to still attempt a vaginal delivery; others prefer to deliver by caesarean.

If the baby is breech after 36 weeks your midwife/ doctor may try to turn him manually – a technique known as external cephalic version (ECV). This is carried out in conjunction with an ultrasound scan and the foetal heartbeat is monitored before and after turning. The success rate for ECV is 70 per cent, although some babies turn back again.

Another method of helping turn a breech baby is moxibustion, in which a cigar-shaped stick containing the herb mugwort is placed, smouldering, at an acupuncture point at the outer corner of the little toe. It may sound esoteric, but it has a pre-sorted success rate of about 60 per cent if carried out at 34 – 38 weeks. For a more conventional approach, you can adopt positions that will encourage your baby to turn: kneel with your head down and bottom in the air, or lie across a bean bag in the knee-to-chest position for 15 minutes, three times a day.

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Placental Function

If you pass your EDD (estimated delivery date), you are overdue. This is normal; seven out of ten babies arrive after their due date. However, if you go several days beyond your EDD, there may be concern that the placenta is not providing enough nourishment to the baby. The risk of stillbirth, which occurs in one per cent of pregnancies, doubles by 43 weeks and trebles by week 44.

To test placental function you will be given an ultrasound scan to gauge the flow of blood through the umbilical blood vessels and to measure amniotic fluid. Electronic foetal monitoring will check whether the baby’s heart rate levels are normal during rest and active periods. If all is well you will be able to wait for labour to begin spontaneously, instead of being induced.

If overdue, be aware of your baby’s usual pattern of movements. If you do not feel him move over a six hour period, alert you midwife/ doctor.

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Twins & Multiples

Twin or multiple pregnancies are monitored frequently because they are associated with medical problems, such as high blood pressure. Twin pregnancies are usually shorter than singleton pregnancies, and labour can start a few weeks before your EDD. If the pregnancy is normal, you can give birth vaginally and without medical intervention if you wish. However, some hospitals prefer to induce twins at around 38 weeks. Although the birth of the first baby is usually straightforward, there is a risk the second will move into an awkward position, making an instrumental delivery or Caesarean birth more likely.

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Birth is an experience that demonstrates that life is not merely function and utility, but form and beauty.
Christopher Largen 

As your pregnancy progresses, you will start to give more thought to the birth itself. Thinking about labour often brings with it a fair amount of anxiety. This is usually due to little more than fear of the unknown – especially for first-time moms – and is a perfectly normal reaction. No one can deny that labour is an exhausting, and painful, process, but before you know it, you will be looking back in astonishment at what a minor effort it actually was for such an incredible result. Now is also the time that you will be hearing endless ‘birth stories’ from well-meaning friends and relatives. (Your hairdresser and local shop assistant will probably also have a tale or two to share.) Of course, there is a lot to be gained from the experiences of others, but tread cautiously. So much (dramatised) advice can be confusing and downright frightening. It is important to remember that every birth is as unique as the baby it delivers.

Here is some useful information to keep you and baby safe and comfortable as you take the final steps to becoming a mom:

Make informed decisions

Read as much as you can about the options available to you. Instinct will guide you to create a birth plan that you feel comfortable with and whatever makes you comfortable is the right choice for your baby. That said, always be prepared to be a bit flexible. Even the best laid plans don’t always work out; but just because a birth plan changes doesn’t mean it has gone wrong, it’s simply what was meant to be.

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Early labour

Early or latent labour is the first stage of the birthing process. In early labour, the cervix moves, softens, thins and begins to dilate. You may experience a mucus plug or ‘show’ coming away in early labour – this is as a result of the cervix moving and opening. Don’t panic or rush straight to the hospital as soon as your contractions start (unless your doctor has advised you to do so, you’re less than 37 weeks or your waters break.) Although your contractions may be fairly painful, early labour can take a long time and staying at home will help you stay relaxed and allow you to keep distracted. Rest as much as possible, you are going to need your energy in the hours to come. Keep eating and drinking – it is vital to stay hydrated and energised – and urinate as frequently as possible. Early labour ends when your cervix is approximately 4 centimetres dilated.

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Active labour

When your cervix begins to dilate more quickly, your contractions will become longer, stronger and closer together. If you are opting for a natural birth, now is the time to put into practice the breathing exercises and relaxation techniques you developed as part of your birth plan. Listen to your body to find the most comfortable positions – this may mean walking around, squatting or lying on your side. If there are no complications, you will be able to continue to move freely to keep yourself as comfortable as possible. Next, you will enter the transition period – when your cervix dilates from 8 to 10 centimetres. Contractions will now be very strong and you may feel sick or rather shaky. If you have made the decision to persevere without painkillers, now is when your resolve will most likely be tested. But keep reminding yourself that you have done a great job thus far and the end is in sight. Don’t hesitate to ask your partner for whatever will get you over this last hurdle – a cool cloth, music, a foot massage or perhaps just an extra dose of moral support.

When your cervix is fully dilated, you will begin pushing which will bring some relief. Follow your doctor or midwife’s guidance as to when to start pushing. Continue to change your position until you feel most comfortable. Before you know it, your baby’s head will crown and soon after you will be welcoming into your life the little soul you have been longing to meet. All that remains before you settle in to bonding with your baby is for you to deliver the placenta, which only takes a few minutes and is generally painless.

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