Less common pregnancy complications

कम सामान्य गर्भावस्था जटिलताएँ

Heavily pregnant lady in hospital gown supports her bump with her hands यदि आपको गर्भावधि मधुमेह, प्री-एक्लेमप्सिया या गर्भावस्था के इंट्राहेपेटिक कोलेस्टेसिस के कोई लक्षण हैं, तो तुरंत अपने मातृत्व परीक्षण/मूल्यांकन इकाई को कॉल करें।

Miscarriage and the loss of your baby

गर्भपात और आपके बच्चे की हानि

Two pairs of hands on a table top with one pair holding the other pair in a gesture of comfort पहले 24 हफ्तों के दौरान गर्भावस्था की हानि गर्भपात होता है। प्रारंभिक गर्भपात गर्भावस्था के 13 सप्ताह तक होता है। गर्भपात के लक्षणों में रक्तस्राव, असामान्य योनि स्राव, पेट के निचले हिस्से में दर्द और गर्भावस्था के लक्षणों में कमी शामिल हो सकते हैं। पहली तिमाही कई कारणों से एक चिंताजनक समय हो सकता है, जिनमें से एक यह चिंता का विषय हो सकता है कि गर्भावस्था जारी रहेगी या नहीं। अफसोस की बात है कि पांच में से एक शुरुआती गर्भधारण गर्भपात में समाप्त हो जाएगें। गर्भावस्था के किसी भी चरण में बच्चे को खो देना माता-पिता दोनों के लिए दिल दहलानेवाला हो सकता है। इससे कोई फर्क नहीं पड़ता कि गर्भावस्था के कितने समय बाद ये हुआ, या गर्भावस्था नियोजित थी या नहीं, नुकसान की अनुभूति बहुत प्रगाढ़ हो सकती है। यह याद रखना महत्वपूर्ण है कि हर कोई हानि से अलग तरह से निपटता है और आपने बच्चे के लिए शोक करना ठीक है। ऐसे कई संगठन हैं जो हानि को झेलने वाले माता-पिता के लिए विशेषज्ञ सहायता और जानकारी प्रदान कर सकते हैं। हालांकि गर्भावस्था के सफल नहीं हो सकने के कई कारण होते हैं, पहली तिमाही में अधिकांश गर्भपात गुणसूत्रों की समस्या के कारण होते हैं, जिसका अर्थ है कि बच्चा कभी विकसित नहीं हो सकता था, न कि माँ के द्वारा किए गए या नहीं किए गए किसी काम के कारण । जिन महिलाओं को बच्चे की हानि होती है, उनमें से अधिकांश भविष्य में सफल गर्भधारण करती हैं। एक अल्ट्रासाउंड स्कैन द्वारा गर्भपात का निदान किया जा सकता है। आपको रात भर प्रसूति यूनिट में रुकने की आवश्यकता हो सकती है लेकिन अधिकांश महिलाएं उसी दिन घर जा सकती हैं। आपको एक डॉक्टर, नर्स या दाई से जो प्रारंभिक गर्भावस्था में विशेषज्ञता रखते है, अनुवर्ती कार्यवाही प्राप्त होगी। यह राय दी जाती है कि आप अपने प्रसूति देखभाल प्रदाता (प्रसव पूर्व क्लिनिक) को अपने गर्भपात के बारे में सूचित करें, यदि वे जागरूक नहीं हैं। आप अपने डिवाइस से मम एन्ड बेबी ऐप को हटाना चाह सकती हैं।

Coping with Covid

Coping with Covid

Two positive Covid test results and a single negative test result.

What should I do if get COVID-19 whilst pregnant?

If you test positive for COVID-19 outside of a hospital setting, you should contact your community midwife or maternity team to make them aware of your diagnosis. If you have no symptoms or mild symptoms, you will be advised to recover at home. If you have more severe symptoms, you might be treated in hospital. In most cases Covid during pregnancy is a mild viral illness. It is advisable to keep well hydrated and to monitor your temperature. Low temperature (less than 36 degrees) or high temperature (above 37.5 degrees) should be notified to your maternity team. If you feel your symptoms are worsening or if you are not getting better, you should contact your maternity care team, your GP, or use the NHS 111 online service/NHS 24 for further information and advice. In an emergency, call 999. If you develop more severe symptoms or your recovery is delayed, this may be a sign that you are developing a more significant chest infection that requires specialised care. This advice is important for all pregnant women/birthing people, but particularly if you are at higher risk of becoming seriously unwell and being admitted to hospital. This includes women who are in their third trimester, from a Black, Asian or minority ethnic background, over the age of 35, overweight or obese, or have a pre-existing medical problem, such as high blood pressure or diabetes. If you have concerns about the well-being of yourself or your unborn baby during your illness, contact your community midwife or, if out-of-hours, your maternity team. They will provide further advice, including whether you need to attend hospital.

Your baby: straight after birth

आपका बच्चा: जन्म के तुरंत बाद

New born baby lies on electronic weighing scales अपने बच्चे के साथ त्वचा से त्वचा के संपर्क के दौरान, वह समय से पहले फ़ीड कराने के संकेत दिखा सकता है। जन्म के कुछ समय बाद ही आपकी दाई आपके बच्चे को दूध पिलाने में आपकी मदद करेगी। कुछ बच्चे जन्म के तुरंत बाद दूध पीना चाहते हैं, जबकि अन्य को यह संकेत दिखाने में कई घंटे लग जाते हैं कि वे दूध पीने के लिए तैयार हैं। Some babies are alert after the birth, whilst others may become sleepy. When holding your baby ensure that their nose and mouth remains unobstructed by your body, towels or clothing. आपके बच्चे के वजन की जांच की जाएगी, और एक दाई या नवजात चिकित्सक किसी भी बड़ी असामान्यता को खारिज़ करने के लिए ऊपर से पैर तक उसकी जांच करेगा। आपके बच्चे को विटामिन K की खुराक दी जाएगी। कुछ दुर्लभ मामलों में, आपके बच्चे को विशेष उपचार के लिए कुछ समय के लिए नवजात यूनिट में स्थानांतरित करने की आवश्यकता हो सकती है। यह समय पूर्व जन्म लेने वाले, बहुत छोटे, संक्रमण के साथ या विशेष रूप से जटिल जन्म के माध्यम से जन्म लेने वाले बच्चों में अधिक आम है। यदि आपके साथ ऐसा होता है, तो आपको अपनी प्रसूति टीम से भरपूर सहयोग और सहायता मिलेगी।
Breastfeeding in the early days

How is labour induced?

How is labour induced?

Close up of a medical drip Around 30% of women are recommended an induction of labour for various reasons. Depending on assessments done throughout your pregnancy, you may be offered an induction. To enable you to make a fully informed decision, your midwife or obstetrician will provide you with information regarding the risks and benefits of induction. They will discuss the different methods of induction and suggest which may be best based on your personal circumstances. Considering the different methods will enable you to advise your healthcare professional of your preference. When you come into the maternity unit for your induction, a midwife will undertake a full assessment of you and your baby. This will include electronic monitoring (CTG) of your baby’s heartbeat and any contractions that you may be having. Your midwife will assess your cervix by undertaking a vaginal examination. You will have plenty of time to ask any questions, and your midwife will take you through your options and what to expect in detail. Some people may need only one of the steps below, and others will need a combination to go into active labour (4cm dilated with strong, regular contractions). Induction may be a long process which can be frustrating, however the aim is to mimic the body’s natural process in the best way possible.

Step 1 – Preparing (“ripening”) your cervix

Many find that their cervix is not quite ‘ready’ for labour yet. In that case, a step is necessary to ‘ripen’ your cervix to prepare it for labour. The aim of this step is not to start active labour, but to open your cervix enough to break your waters, ready for active labour to be induced. The different induction of labour options are listed below. Your hospital may only offer one method, or they may give you a choice. Depending on your circumstances, you may be able to go home for a period of time during your induction. Some people may not experience any changes during ripening and for others, it may be enough to start active labour. You may need more than one ‘round’ before your waters can be broken, in which case you may be offered more than one method one after the other. The order they are offered may vary between hospitals.

Option 1 – Mechanical methods

There are two mechanical methods available, which do not contain any drugs (artificial hormone). They help to promote your body’s natural initiation of labour – they won’t start contractions artificially and side effects are less likely. Some hospitals may allow you to go home with these methods.

Dilapan-S

This is a thin dilator that absorbs fluid from your cervix to gradually expand in diameter, helping to dilate your cervix and change its consistency for labour. The dilators remain in place for 12-24 hours and help your body release natural hormones associated with labour. Most people experience minimal pain during the process, and it doesn’t extend outside of the vagina, so you will be encouraged to relax or to go about your usual daily activities to help prepare your body. More information about: Dilapan-S.

Balloon catheter

This is a small balloon which is inserted into the cervix and inflated with water. By putting pressure on the cervix, it encourages the release of your natural hormones and dilation. The balloon catheter remains in for 12-24 hours to stretch and soften the cervix in preparation for labour. The catheter tube will be taped to your leg during that time to keep it in place.

Option 2– Medicinal Methods

Prostaglandins are medicines that use an artificial hormone to help ripen the cervix. There are two options available; a gel or a pessary that are inserted just behind your cervix. The gel works over 6 hours, while the pessary is released slowly over 24 hours. If you and your baby are responding well, some units may allow you to return home during this time, however, as with all medicines, side effects are possible, so your doctors may prefer to keep you in for continued monitoring. Cramps and pain can be common with prostaglandin methods, and your midwife will be able to discuss pain relief options with you.

Step 2 – Breaking your waters

Amniotomy

Some people (particularly those who have had a baby before) may be told that their cervix is favourable for an amniotomy or ‘ARM’. This where your waters are broken artificially. A midwife will insert a small sterile hook into the vagina to make a hole in the bag of waters that surrounds your baby. After the waters are broken, labour may start on its own. Your waters will continue to drain from the vagina for the duration of your labour.

Step 3 – Helping with your contractions

Oxytocin drip

A hormone called oxytocin may be offered to those who do not progress into active labour. Oxytocin is given continuously in small amounts until your baby is born. It is given directly into a vein through a cannula inserted into your hand or arm. The oxytocin aims to stimulate contractions and progress your labour. A midwife will be caring for you and your baby closely throughout your labour.
Understanding induction of labour – a video developed by clinicians, women and a local hospital charity in North West London.

Recovery from vaginal or assisted birth

Recovery from vaginal or assisted birth

A mother reaches for her baby moments after she has given birth Once you are admitted to the postnatal ward or discharged home from hospital to the care of the community midwife, you can expect that your body will need some time to recover from the birth. Midwives, maternity support workers or nurses may be involved in your care and will carry out routine checks to ensure that you are well. This will include a regular top to toe physical check, including inspection of sutures (stitches). If you have had a vaginal birth you will be offered pain relief. Read “Commonly used medicines” to find out what painkillers are routinely offered. Read “After pains” and “Perineal after-care” which explains how you can help yourself if you are experiencing after pains or if you have had an episiotomy (cut) or a perineal tear. If you have had an assisted delivery you may need to have a urinary catheter for a few hours. Read “Passing urine” for more information. It is important to eat well and drink plenty of fluids to promote health and wellbeing after any type of birth.