DOCTOR 9.
NORMAL LABOUR.
1. Diagnosis of labour.
2. Normal delivery.
3. Third stage of labour.
4. Puerperium.
5. Care of your baby.
6. Contraception
NORMAL LABOUR:

I know that you and many women are frightened from the word of labour, but I would like to reassure all of you that labour is a normal physiological phanomenon, and would like to emphasise that you will be very happy and glad for this unforgetable moment because you are going to have a present which you will never have one like this. Especially now a days all the doctor are well trained and equiped with very sophisticated electronic machines how much you will feel happy and comfortable while you are waiting to have your baby, more over these days your husband stand by you  hand by hand through all the time of delivery.


1.  DIAGNOSIS OF LABOUR:

I am sure that you will be very much pleased once I explained the diagnosis of labour in a very simple way for you. When you are at term you feel some pain in the abdomen and especially of this pain regular and comes every 10 minutes or even 30 minutes and each contraction lasting half a minutes or longer.
SHOW. Is a little blood and MUCUS discharged from the vagina. You should not to be worried because this is separation of the membranes. At this stage you call your hospital and in the hospital the doctor will put the real diagnosis of labour by finding the dilatation of the cervix and from now untill fully dilatation of the cervix is the first stage of labour.
Doctor will applly on you the electronic machine to control your heath and your baby life.

2.  NORMAL DELIVERY:

Just to make you relax and feel comfortable and happy
I am showing you one normal delivery from my Maternity.
As I mentioned that the first stage of labour is untill fully
dilatation of the cervix. Last about 6-12 hours. Then second stage
when the descends gradually towards the vagina and lasts about
1/2-1 hour and the head will appear and easily, nicely and
immediately you will him crying among your arms isn't it
wonderful as you can see in this picture.

Some women and you may suffer from pain, for this purpose the doctor will use either local or Epidural anaesthesia and sometimes you may need very small incision called (EPISIOTOMY). This to help and to protect the head of your baby easily during delivery.

3.  THERD STAGE OF LABOUR:

As you see that first and second stage of labour are now completed and the third stage has started. The placenta usually attached to the upper-anterior of the uterus. The placenta now descends gradually then expelled, usually with the aid of maternal and doctor efforts.
The third stage lasts about 30 minutes. The normal blood loss about 250ml(cc). The doctor will immediately give one injection of METHERGIN to prevent any bleeding.


4.  PUERPERIUM:

The puerperium is the period following childbirth and about
6 weeks.
And now you are having your baby infront of you looking at
him admering his existence which will bring the happiness to
you and to the whole family holding him between you and
your husband (as you you see this lady).
And you will remembre the moment of unforgetable
happiness of LABOUR.

This period is very important and delicat because the uterus is exposed to the
1. INFECTION and you must keep the HYGIENE the maximum to prevent any infection at this delicate stage.
2. LOCHIA (IS DISCHARGED OF CHILDBIRTH) and consist of blood and necrotic tissues from the placenta. It is sterile in the first 4 days and if you have un offencive discharge you must immediately informe your doctor.
3. MUSCLES muscles are of poor tone and ligaments week and slack after pregnancy and labour, therefor systematic exercises must be given during pregnancy and after delivery to prevent hernia and prolapse.
4. Control and observation of your PULSE and TEMPERATURE.
5. Control and observation of your BLADDER and CONSTIPATION. Frequency of urine and constipation are common, but this is normal during and after delivery, gradually go back to normal.
6. CONTROL HAEMOGLOBIN, THIS IS VERY IMPORTANT TO BE DONE AND IRON WITH VIT.C to be supplied.
7. SEX AFTER DELIVERY:
In the PAST the couple has to waite until 6 weeks passed after delivery to have their sex, but now in recent advanised medicine you may practising your love in 14 days after delivery and this will remind you the happiest moment of labour which will bring the happiness to your family, more info about sex position, etc... Click here
8. POST NATAL EXAMINATION (CONTROL 6WEEKS AFTER DELIVERY).
This is examination usually made about 6 weeks post partum.
The object: 1. To make sure that the genital tracts has RETURNED to normal.
                   2. To make sure that lactation is satisfactory, baby feeding well and gaining
                       weight well.
                   3. To deal with any other problems, baby care, sex and contraception.
                   4. Return of Menstruation Generally about 6 months, pregnancy may happen if
                       you do not take care of contraception.
                   5. Your doctor will informe you all about the general condition of BLOOD
                       PRESSUR, TEMPERATURE, PULSE, VULVA, VAGINA, CERVIX and
                       UTERUS. And also test for haemoglobine and TAKING A CERVICAL
                       SMEAR to exclude any bad disease.

5. BREAST FEED AND CARE OF YOUR BABY:

I would like to say that breast feed is much more better and safe for the health of your baby for the important folowing:
1. Your milk contain a special protein (GAMMA-GLOBULIN) which will supply your baby with ANTI-BODIES against the infectionsfor few months.
2. Your milk safe and easy and fast to be given to your baby, especialy when he cries.
3. Stopping breast feed, may lead into suppression of lactation and this will give you severe pain.
4. Vaginal bleeding irregular and this may disturbe the sex between you and your husband.

6.  CONTRACEPTION:

This is very easy subject but there are many methods, I am going to advise you the best and more advantage methods:
1. IUCD (INTR-UTERINE CONTRACEPTION DEVICES). A polethyline spiral, coil and SAF-T-COIL and others, this method is reliable easy and usually without complication, but sometimes may give vaginal bleeding for about 2 month and if it is not settled you must remove it or change it with another, you gynaecological control every 6 month.
2. ORAL CONTRACEPTION. There are many kind of pills and it is difficult to choose and the best are with little oestrogen. In the following condition you should not use the pills:
       1. Disease or history of thromboembolic.
       2. Liver disease.
       3. Breast CA or diseases.
       4. High blood pressur.
3. Husband to use the codom.
4. Safe period. As you know that the time of ovulation (click here) by avoiding at least the middle 10 days of your regular period.
5. Tubal ligation. But this is when you completed your family, this method also is not without complete problem you may suffer from heavy periods.
6. Sterilisation your husband. It is very easy and very simple operation under local anaesthesia by ligation the tube which carry the sperms from the testis to the penis called (VAS DEFENS).
from DR. Aboualrub
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PUERPERIUM:
1.INFECTION.
2.LOCHIA.
3.MUSCLES.
4.PULSE & TEMPERATURE.
5.BLADDER & CONSTIPATION.
6.HAEMOGLOBINE.
7.SEX AFTER DELIVERY.
8.POST NATAL EXAMINATION.
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