ALL ABOUT LABOUR AND BIRTH

Whether giving birth will be difficult or easy, painfull or pain free, long-drawn-out or brief, it is something where every one ends up with own unique experience. Perhaps the best preparation you can make is by being as knowledgable as you can about the labour process. What's a "normal" labor? A normal labor is one which: occurs between 38 and 42 weeks of pregnancy. Starts by itself. lasts between four and twenty four hours has no complications

Signs of Labor The signs that indicate that you're really in labor: Water Bag Breakage A quarter of labor starts when the amniotic sac surrounding the baby breaks and the amniotic fluid escapes. If labor does not start within 24 hours of rupturing of membrane, your doctor may induce contractions with oxytocin or prostaglandins. Contractions Contractions start slowly and feel a bit like a period pain, sometimes with a backache and diarrhea as well. They will increase in frequency and intensity, with the contractions interval reducing from 20 minutes to 5 minutes. You have to record the duration of contractions and gap between the two contractions before calling your birth centre. Having a record of your contractions, hospital staff will let you know when to reach there. Show It is a small bloodstained discharge as your cervix thins and the mucus plug drops out. Many times show passes unnoticed by the expectant mother.

Stages of Labor Labor is divided into three stages - the dilation of the cervix, the delivery of the baby, and the delivery of the placenta.

First Stage- Dilation of Cervix The first stage has 3 phases; Initial (latent) Phase- This stage is the longest and the least painful part of labor. The cevix thins and dilates to about 4 cm. The contractions intervals from 5-20 minutes and lasts from 30-60 seconds. Active Phase- The contractions tend to occur around 2 or 4 minutes apart and last up to a minute or so. The cervix dilates from 4 -10cm. Transition Phase- This is the phase that takes you from first to second stage of labor contractions are running into each other. You'll feel pressure in your bottom due to the baby's head moving down the birth canal. Second Stage - Delivery of the baby For the first baby this stage lasts between half to one hour, however for second and subsequent pregnancies it sometimes takes only few minutes. When the baby's head touches the pelvic floor muscles it triggers a reflex known as Ferguson's reflex which, creates the uncontrollable urge to push. Once the head has emerged, the delivery staff will turn the body to deliver the shoulders. The rest of the baby will then slip out. Third Stage - Delivery of the placenta The delivery of placenta usually happen five to 30 minutes later. It only takes few minutes for uterus to gently contract and push out the placenta.

OBGYN TERMINOLOGY AND DEFINITION

TPAL terminology= A system used to describe obstetrical history. T=term births P=preterm births (prior to 37 weeks gestation) A=abortions L=living children Example: a woman who has 2 living children born as preterm twins in her first pregnancy would be designated as: TPAL 0-1-0-2 - 0 term births, 1 delivery prior to 37 weeks gestation (preterm), 0 pregnancies ending in spontaneous or induced abortions, and 2 living children Separate TPAL numbers by hyphens. Obstetric history: 4-2-2-4 Alternatively, spell out the terms as follows: Obstetric history: 4 term infants, 2 premature infants, 2 abortions, 4 living children Sometimes, GPA terminology is combined with TPAL terminology.

The patient is gravida 3, 3-0-0-3. GPA terminology with GPA as the abbreviation for gravida, para, abortus. Accompanied by arabic numbers, G, P, and A (or Ab) describe the patient's obstetric history. Roman numerals are not used. G gravida (number of pregnancies) P para (number of births of viable offspring) A or Ab abortus (abortions) nulligravida gravida 0 no pregnancies primigravida gravida 1, G1 1 pregnancy secundigravida gravida 2, G2 2 pregnancies nullipara para 0 offspring Separate GPA sections by commas. Alternatively, spell out the terms, using lower case. Obstetric history: G4, P3, A1 or Obstetric history: gravida 4, para 3, abortus 1. When one or more of the numbers is 0, the preferred form is to write out the terms. gravida 2, para 0, abortus 2.