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36 weeks Pregnant Must Know: The 3 Stages Of Labour

36 weeks Pregnant Must Know: The 3 Stages Of Labour

At 36 weeks pregnant you will be very excited about the arrival of your new baby. This is a very special time for you and your baby.

It’s surprising to hear that this little baby has now grown to the size of a honey-due melon and could possibly weigh up to six pounds. This little bundle of fun could survive outside the womb, if you went into labour at 36 weeks pregnant – but it’s best to give them every chance to thrive and grow to full term at 40 weeks.

By now you have most likely stocked up on all of the necessary baby equipment – ready for the baby’s arrival home from the hospital. But lets not forget that you have a major life event to prepare for and that is the labour.

If this is your first time to have a baby, you will have many questions about labour. Read on to get a closer look at the three stages of labour.

36 Weeks Pregnant Labour Guide

First Stage of Labour

There are three phases to the first stage of labour early labour, active labour and transition.

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1. Early Labour

It can take time for the first stage of labour to really take off. In this stage the cervix dilates to 3-4cm and it changes shape – from a long tube to a much shorter one. Braxton Hicks or pregnancy cramps can sometimes be mistaken for labour contractions but you will know if it’s the real thing if the pains continue.

The contractions shouldn’t be too painful at this point and it is fine for you to stay at home and watch a movie or preferably try to get some sleep.

Early labour can vary in length from one woman to the next. For a first baby it usually takes quite a bit longer. For some women it can be a full day before they feel the need to go to hospital while for others it can be just a few hours.

Women who have had previous labours are usually quite calm at this point if not a bit excited, however first time mums who do not have the same experience to refer to often feel nervous during the first stage of labour. Labour is difficult, there is no doubt but is is also beautiful so stay focused on the end result and pamper yourself with nice treats.

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2. Active Labour

Your cervix will dilate from 4cm all the way up to 8cm during this phase of labour. The contractions will be much stronger, longer and will come more steadily.

You will be safe enough calling the hospital to say you’re on the way when your contractions are five minutes apart for one hour. Towards the end of this phase the baby begins to descend and you can assure yourself that you will see it soon.

For some women it is possible that the contractions will come as often as every  2-3 mins at this stage. You won’t be able to have a conversation throughout these contractions. Instead you will be focusing on your breathing. You may also be using pain medication at this point if you feel that you need it.

This stage can take up to 8 hours but maybe much less for a woman who has given birth before. The good news is that time really flies when you are focusing on you labour management. I would know as a mother of four. You really don’t notice the time passing during active labour and the birth itself.

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3. Transition

At the end of the active phase you will go through what is referred to as the transition phase. This is when the cervix moves from 8-10cm. There is no doubt this is the most difficult part of labour. You may feel that you need to push but the cervix isn’t dilated enough so you will be told not to.

Don’t worry if you feel nauseous or like opening your bowels, this is all normal and will pass soon. Your baby is making it’s way closer to you with every contraction. Just keep focusing on their little face and it will get you through this tough stage.

Second Stage of Labour

Finally, you get to 10cm. Now you get to push. Follow the directions of the doctor or midwife and only push as much as they say. If they say to push gently then just do as they ask and push gently. This will really help to avoid tearing and stitches later.

Sometimes referred to as the “pushing stage” this part of labour is calmer as a rule. The contractions don’t come as often and in some hospitals women are given a break at this point – to rest a little before they start to push.

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Sometimes the baby is still quite high up in the pelvis and the pressure to push is not so great. However the baby will move down a little more with each contraction and eventually the head will start to crown. You will see with a mirror the baby’s scalp peeping out of your vagina. It can be hard to believe they are so close.

The baby’s descent may be rapid or it may be slower with a first baby. Either way, find a comfortable position where you can push properly – bearing down as if you were doing a number 2!

This stage can take longer for women who have had an epidural as they don’t feel the same pressure to push. Sometimes babies are delivered in this stage in less than a half an hour while for others it can take more than an hour.

Trust in the experts and follow their directions and your baby will eventually make it’s way out, hopefully head first, then shoulders and finally their body.

Third Stage of Labour

At this point your baby will be well wrapped up and in your arms. You won’t care very much about the third stage of labour but the midwife or doctor will work gently asking you to push out the placenta. This won’t take long – just a few minutes. It’s not really painful and it won’t bother you at all.

You will probably be feeling elated at having your new baby in your arms – checking their fingers and toes – trying to figure out who they look like.

Your work is finally done. That is your labour is done but the real work is only getting started! You’ll have to check back in with me for more tips on what to do next.

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Published on November 30, 2018

Signs of Postnatal Depression And What to Do When It Strikes

Signs of Postnatal Depression And What to Do When It Strikes

Postpartum depression (PPD) strikes about 15% of women around childbirth.[1] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[2] The causes of which are thought to be linked to hormonal changes, genetics, previous mental illness and the obvious change in circumstance.

The stigma of mental health – with or without support from family members and health professionals – often deters women from seeking help for their PPD. In this article, I will show you 10 ways to begin overcoming PPD.

Symptoms of Postnatal Depression

Postnatal depression is defined as depressive disorder, beginning anytime within pregnancy up to the first year of the child’s life. The symptoms of post natal depression are the same as those of depression. In order to receive a diagnosis from the doctor, 5 symptoms must be shown over a two week period. The symptoms and criteria are:

  • Feelings of sadness, emptiness, or hopelessness, nearly every day, for most of the day or the observation of a depressed mood made by others
  • Loss of interest or pleasure in activities
  • Weight loss or decreased appetite
  • Changes in sleep patterns
  • Feelings of restlessness
  • Loss of energy
  • Feelings of worthlessness or guilt
  • Loss of concentration or increased indecisiveness
  • Recurrent thoughts of death, with or without plans of suicide
  • Lack of interest or pleasure in usual activities
  • Low libido
  • Fatigue, decreased energy and motivation
  • Poor self-care
  • Social withdrawal
  • Insomnia or excessive sleep
  • Diminished ability to make decisions and think clearly
  • Lack of concentration and poor memory
  • Fear that you can not care for the baby or fear of the baby
  • Worry about harming self, baby, or partner

Should you, a friend or your partner be showing any of these signs, I recommend you to seek medical advice.

Causes of Post Natal Depression

It is worth noting here that there is a difference between what is commonly known as ‘The Baby Blues’ and post natal depression.

Postpartum blues, commonly known as “baby blues,” is a transient postpartum mood disorder characterized by milder depressive symptoms than postpartum depression. This type of depression can occur in up to 80% of all mothers following delivery. The Baby Blues should clear within 14 days, if not it is likely an indicator of something more in depth.

It is not known exactly what causes post natal depression, however there are some correlating factors. These factors have a close correlation and haven’t been shown to cause PPD:

  • Prenatal depression or anxiety
  • A personal or family history of depression
  • Moderate to severe premenstrual symptoms
  • Stressful life events experienced during pregnancy
  • Maternity blues
  • Birth-related psychological trauma
  • Birth-related physical trauma
  • Previous stillbirth or miscarriage
  • Formula-feeding rather than breast-feeding
  • Cigarette smoking
  • Low self-esteem
  • Childcare or life stress
  • Low social support
  • Poor marital relationship or single marital status
  • Low socioeconomic status
  • Infant temperament problems/colic
  • Unplanned/unwanted pregnancy
  • Elevated prolactin levels
  • Oxytocin depletion

One of the strongest predictors of paternal PPD is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD. [3]

Ways to Overcome Post Natal Depression

1. Seek Medical Help

As knowledge of PPD grows, more and more physicians are becoming aware of the indicators and risk factors. This means that health care providers are looking for signs as early as their first prenatal care visit.

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If you are at risk, letting your provider know early in your pregnancy means that you’ll be given extra support and care throughout the process. It is best to seek treatment as soon as possible.

If it’s detected late or not at all, the condition may worsen. Experts have also found that children can be affected by a parent’s untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.

2. Therapy

This is the first line of defence against post natal depression and will commonly be prescribed alongside medication. Around 90% of post natal depression cases in women are treated with a combination of the two treatments.

You don’t need to do anything special to prepare. Your counselor will ask questions about your life, and it’s important you answer honestly. You won’t be judged for what you tell, and whatever you talk about will be just between the two of you. Your counselor will teach you how to look at some things differently, and how to change certain habits to help yourself feel better.

Therapy is personalized for everyone, but women in counselling for postpartum depression often discuss topics including; who you’re feeling, your behaviour, your actions and your life. (If you need immediate support please call the San Diego Access and Crisis Line at (888) 724-7240. The toll-free call is available 24 hours a day, seven days a week.)

3. Medication

There have been a few studies of medications for treating PPD, however, the sample sizes were small, thus evidence is generally weak.

Some evidence suggests that mothers with PPD will respond similarly to people with major depressive disorder. There is evidence which suggests that selective serotonin reuptake inhibitors (SSRIs) are effective treatment for PPD.

However, a recent study has found that adding sertraline, an SSRI, to psychotherapy does not appear to confer any additional benefit. Therefore, it is not completely clear which antidepressants are most effective for treatment of PPD.

There are currently no antidepressants that are FDA approved for use during lactation. Most antidepressants are excreted in breast milk. However, there are limited studies showing the effects and safety of these antidepressants on breastfed babies.

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4. Communication with Partner

Don’t blame yourself, your partner, close friends or relatives. Life is tough at this time, and tiredness and irritability can lead to quarrels.

‘Having a go’ at your partner can weaken your relationship when it needs to be at its strongest. It can be a huge relief to talk to someone understanding.

By spending time with your partner doing activities that you both enjoy, like going for a walk, can really help. This change of state, from moving location, can significantly elevate mood whilst providing ‘neutral ground’ in which to open up communication.

Be honest with your partner and show ways in which they can support you best through this time, even if it’s just talking or letting you have time to go take a shower.

5. Self Care and Rest

Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired. It’s common that women are the experts at ‘being busy’ and ‘doing it all’.

Rest whilst the baby is sleeping, and really take time to prioritise yourself. Throughout life, if you’re constantly giving out energy, you will be left feeling unbalanced. It’s important to become aware of one’s energy and making sure to give yourself energy first, before giving out is imperative.

Your body has just been through the trauma of the birth, which is very stressful. It therefore needs time to recover so taking time to yourself is important. Things as simple as a cup of tea, or shower or listening to music will really help.

6. Supplementation (especially DHA)

St John’s Wort is a herbal remedy available from chemists. There is evidence that it is effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side-effects.

One problem is that St John’s Wort can interfere with the way other medications work. If you are taking other medication, you should discuss it with your doctor. This is very important if you are taking the oral contraceptive pill. St John’s Wort might stop your pill working. This can lead to an unplanned pregnancy.

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It is also worth noting that fish oil (containing DHA) is being shown to correlate with lower instances of PPD. DHA consumption during pregnancy — at levels that are reasonably attained from foods — has the potential to decrease symptoms of postpartum depression,” conclude study researchers led by Michelle Price Judge, PhD, RD, a faculty member at the University of Connecticut School of Nursing.

7. Movement

Before starting any exercise program, you should consult with your doctor and find a fully qualified pre and post natal specialist. That being said, there is plenty of movement that can be done prior to ‘hitting the gym’, such as walking.

Not only does being outside positively benefit you by getting some fresh air and vitamin D. The same is said for your baby, who will likely sleep better once they’ve been outside. Exercise gets your endorphins going, which helps alleviate depression symptoms, It can also get you focused on something for yourself. In an analysis of data from 1996 to 2016, researchers discovered that moms who stayed physically active after birth experienced fewer depressive symptoms.[4] In contrast, one study found women who led a more sedentary lifestyle were, in general, more likely to experience postpartum depression in the first place. [5]

The type of workout doesn’t matter much. Yoga for pregnant women, stretching, and cardio are essentially equal in terms of making you feel better.

8. Socializing and Support Groups

Do go to local groups for new mothers or postnatal support groups. Your health visitor can tell you about groups in your area. You may not feel like going to these groups if your are depressed.

See if someone can go with you. You may find the support of other new mothers helpful. You may find some women who feel the same way as you do.

9. Accept Help

Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. Chinese women participate in a ritual that is known as “doing the month” (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare.

Whilst this may seem extreme, it’s worth noting that being able to accept help from your friends, partner and family can be extremely beneficial.

10. Avoid Smoking, Drink and Drugs

Which may seem common sense, however you may be tempted by the short term ‘fix’.

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Don’t use alcohol or drugs. They may make you feel better for a short time, but it doesn’t last. Alcohol and drugs can make depression worse. They are also bad for your physical health.

Final Thoughts

Most women will get better without any treatment within 3 to 6 months. One in four mothers with PND are still depressed when their child is one-year-old. However, this can mean a lot of suffering.

PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner. You may not look after your baby, or yourself, as well as you would when you are well.

PND can affect your child’s development and behaviour even after the depression has ended. So the shorter it lasts, the better.

Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault.

It’s never too late to seek help. Even if you have been depressed for a while, you can get better. The help you need depends on how severe your illness is. Mild PND can be helped by increased support from family and friends.

Featured photo credit: Derek Thomson via unsplash.com

Reference

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