Posts Tagged ‘Antibiotics’

In the development of the teeth, the relationship between magnesium and fluoride plays an important role hatachi lithium ion and charge time . Naturally, the proportion of magnesium is 32 times greater than fluoride in the teeth, which indicates how unbelievably powerful the effect of fluoride is, and explains why too much fluoride is unnatural and therefore not required penicillin for treatment of lymes disease .
These days, attention is paid above all to the hardening substance which inhibits life, fluoride simvastatin or crestor . Because of concern regarding caries, it is understandable that all children are advised to have fluoride wellbutrin long term effectiveness . Fluoride certainly does prevent the appearance of caries, but what else does it do?
On the basis of the relationship described above between enamel (fluoride) and dentine (magnesium), it is understandable that too much flouride in the dentine can actually have a harmful effect because the magnesium should predominate propranolol generic . In fact, one of the side-effects of taking fluoride for years can be damage to the dentine atenolol aternative .
However, fluoride also has an effect on the subtle link between the forces which form and harden the teeth and the development of the thought processes penicillin vk 250mg . By giving fluoride to young children the hardening processes are strengthened and accelerated throughout the whole body side effects of drug altace . This reinforcement of physical hardening also leads to an ac
celeration in the psychological development of the child; it encourages a premature development in the thoughts and feelings low cost ranitidine hcl . One of the consequences of this is that the child is ‘awake’ to the world at an earlier age cleocin topical acne treatment .
With a good diet, fluoride supplementation is unneccessary coumadin food list . Moreover, fluoride influences the movements of the gut in a negative way femara fertility bleeding cd 10 . So we do not recommend supplementing fluoride in toothpaste or otherwise cilostazol for intermittent claudication .
What can you do to prevent caries if you do not want to give fluoride?
Obviously diet (wholemeal products and small quantities of sweet products), learning to chew well, and oral hygiene all play a role the danger of caffeine . When the first teeth appear, it is a good idea to brush them with a soft toothbrush zoloft and heart . Shortly after drinking fruit juice you should not brush your teeth, but clean them with a sip of water lithium crazy facts . In our view, toothpaste is not really necessary (see also p side effects of stop taking cytoxan .78) prilosec otc used for illegal drugs . From the age of two and a half it is advisable to go to the dentist regularly rupture and tendon and cipro xl .
It is important to be aware of the relationship between magnesium and fluoride processes contraindicatons in use of salmeterol . For example, who are generally wide awake and alert, have their small teeth sooner under the influence of fluoride, while children who are rather dreamy often have large teeth as a result of the effect of the magnesium cleocin class of antibiotics . In fact, both types of children can develop caries penicillin a revolution . It may be useful to support the development of the teeth with the help of anthroposophical medication on the advice of an anthroposophical doctor or dentist estradiol norethindrone acetate . The magnesium processes can be reinforced in the diet by giving green vegetables no more than twice a week (because of the nitrate content, see pp losartan and hydrochilorothiazide .74f) strattera dialated pupils .
In summary, it can be said that the development of the teeth is an expression of the whole of the child’s development, and that fluoride plays a role in this, though not the only role cost of methotrexate . Brushing with fluoride toothpaste accelerates the hardening processes sulfur dexamethasone wikpediea .
Vaccinations
As the parent of a newborn child, you will inevitably be confronted with the issue of vaccinations sine off pseudoephedrine . It is possible to vaccinate against a whole range of contagious or infectious diseases vardenafil female . Some of these infectious diseases are also known as the traditional childhood diseases aricept clinical studies . Every parent has a free choice with regard to vaccination aha guideline 2006 warfarin therapy .
The infectious diseases for which there are vaccinations are listed below with a description of the advantages and disadvantages of vaccinating, and what the possible alternatives might be trimethoprim brand names . Because of a lack of space, the information provided here cannot be complete actos risks . However, we hope that a considered choice can be made in consultation
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with the doctor with regard to vaccinations, oil the basis of the information and the vision given here, and with the recommended additional information estradiol normal level . If your child should catch an infectious disease, always contact your doctor effexor xr and rash . Supportive treatment for different infectious diseases exists in anthroposophical medicine wellbutrin is a tiny pill .
Infectious diseases
In most countries, the immunization programme is comprised of vaccines against the following diseases: diptheria, tetanus, whooping cough (pertussis), polio, haemophilus influenza type B (Hib), as well as maningitis and later measles, mumps and German measles (rubella) nebivolol introduction marketing . The programme varies in different countries and is regularly revised same day viagra . There is an overview on p buy generic soma online .90 lithium evanescence .
Whooping cough, mumps, measles and German measles are known as the traditional childhood diseases diflucan on yeast . We will briefly mention the cause of the disease, the symptoms, the possible complications (which may appear but do not appear in all cases), the possible treatments and the protection provided by the vaccine cheap viagra online at .
Diphtheria
Diphtheria is a bacterial infection transmitted by coughing prednisone for cats . The disease mainly affects the area around the nose, throat and larynx, and can result in loss of breath and even suffocation keflex children . The disease can cause permanent damage to the heart, kidneys and nervous system, and the death rate is very high adalat cc . The diphtheria vaccine provides total protection against this disease carisoprodol bioequivalence study . The vaccination is usually given at 8, 12 and 16 weeks of age as part of a combined DTP or 5-in- l inoculation proper clomiphene dosing .
Whooping cough (pertussis) Whooping cough is an extremely contagious, bacterial, infectious disease, which is transmitted by coughing singulair pros and cons . The coughing fits usually occur at night and continue for about six weeks viagra sales online . After a coughing fit, the child usually goes back to sleep straightaway arimidex weight gain . and may be lively and cheerful during the daytime effexor xr no prescription . However, it can be a very tiring period, particularly for parents childrens motrin case .
In children under the age of one, there may be complications with periods when the child stops breathing, resulting in brain damage effexor xr wiki . The long and forceful coughing can also damage the lungs, an(> lead to middle ear infections enerdel lithium power system . Complications rarely occur in children over the age of one is celecoxib come in a liquid . At an early stage, whooping cough can be treated with antibiotics levaquin generic name . However, at that stage, it is not easy to tell whether the illness is a case of whooping cough or simply a bad cold natural testosterone research results .
The vaccination is usually given at 8, 12 and 16 weeks of age as part of a combined DTP or 5-in-I inoculation discogram metformin . After being vaccinated, some children still get whooping cough, though usually in a milder form zofran patient assistance program applications .
Tetanus (lockjaw)
It is possible to be infected with tetanus as a result of all sorts of injuries, as the tetanus bacteria are found in many places, indoors and outdoors nifedipine er . This disease is characterized by vehement muscular cramps including cramp in the respiratory muscles lithium ion battery development . The disease is difficult to treat and the death rate is very high depakote er migraine market research .
The tetanus vaccine provides complete protection against the disease synthroid retaining water . The vaccination is usually given at 8, 12 and 16 weeks of age as part of a combined DTP or 5-in- I inoculation 10 min viagra .
Polio (infantile paralysis)
Polio is caused by a virus, and is passed on through the faeces of an infected person intravenous terbutaline drip for preterm labor . In general, the disease is fairly harmless, accompanied only by diarrhea, but in a small percentage of people it causes permanent damage to the nervous and motor systems dilantin 1000 . As in the case of other viral infections, there is no regular medication, such as an antibiotic, for polio diltiazem diabetes . The vaccination is usually given at 8, 12 and 16 weeks of age, sometimes as part of a combined 5-in-1 inoculation rivastigmine tartrate .
Hib diseases
These concern serious, fairly common, bacterial infectious diseases, which are particularly prevalent amongst young children paroxetine and thyroid . The Hib bacteria are transmitted by coughing and sneezing and can result in a type of meningitis, swelling of the epiglottis and inflammation of the joints evista fossamax . The disease has acute symptoms and sometimes results in permanent damage, such as deafness, epilepsy and brain damage, though rarely resulting in death spironolactone libido women . The disease can be treated with antibiotics, but as it usually develops very rapidly it is not always possible to treat it adequately why is caffeine used .
The vaccine protects the child against all Hib diseases, but not against other forms of meningitis such as meningitis C (see below) barbara schmidt caffeine american . The vaccination is usually given at 8, 12 and 16 weeks of age, sometimes as part of a combined 5-in-1 inoculation atenolol and slow hearbeat .
Pneuynococci
As with Hib, this type of meningitis apperars most frequently in the first few months of life clomid infertility drug . As well as meningitis, pneumococci can also cause middle ear infections and pneumonia lithiums 2 natural state . The strain of pneumoccocus often varies from country to country and so vaccines tend to be country-specific cheap soma 32 . The vaccination is usually given at 8, 12 and 16 weeks of age effects of paxil on pregnancy .
Meningitis C
Many people carry this bacteria without any ill effects does cymbalta cause sore eyes . In rare cases it may lead to meningitis and septicaemia alternative health caffeine . First indications are similar to symptoms of flu but it quickly develops into a serious illness with high fever, and can lead to disorientation and lethargy side affects of diltiazem . Other symptoms
VACCINATIONS 89
include headaches, stiffness of the neck, severe headache at the front of the head and possibly a small, pimply rash amitriptyline hcl side effects . If symptoms appear, seek immediate medical advice tizanidine brand name .
The vaccination is usually given at 12 and 16 weeks of age bupropion qoclick .
Mumps
Mumps is a viral disease and is transmitted by coughing lithium and voltage delay . Mumps is accompanied by an inflammation of the salivary gland, located below each ear history of bayer asprin . Some rare and, in general, harmless complications include meningitis and inflammation of the pancreas withdrawing cymbalta . If this disease occurs after puberty, this occasionally has an effect on the testicles in boys, and the ovaries in girls, leading to problems with fertility in very rare cases drunk erection viagra . Deafness is another fairly rare complication paroxetine par .
The mumps vaccine provides almost complete protection against the mumps, and is often given from the age of 12 months onwards as part of the 3-in- I MMR vaccine allopurinol substitute .
Measles
Measles is a viral disease and is transmitted by coughing and sneezing tenta gel minocycline . In the initial stages, the disease is like a sort of flu with coughing and the symptoms of a cold wellbutrin sexual side effect . After that the measles really take hold and the child will feel very ill how much caffeine in chocolate . Some of the complications that can be treated include middle ear infection and pneumonia tadalafil cipla german . A low level of resistance, and giving fever suppressants, can increase the chance of these complications physiological response to intake of caffeine . The complication of encephalitis can cause serious permanent damage or even be fatal, although this is extremely rare lithium battery protector . The vaccine provides complete protection against the disease, and is often given from the age of 12 months onwards as part of the 3-in-1 MMR vaccine alcohol increase testosterone .
German measles (rubella)
German measles is a viral disease, which is fairly harmless in children pseudophedrine products . The symptoms include a red rash, swollen glands in the neck and a raised temperature drug study of diclofenac . German measles can cause defects in an unborn child, especially during the first few months of pregnancy pravachol intolerance .
The vaccine provides virtually complete protection against the disease, and is often given from the age of 12 months onwards as part of the 3-in-1 MMR vaccine neurontin libido .
Other vaccinations
There are also a number of vaccinations which are only given in special cases; for example, to specific at-risk groups owing to family history, country of origin or in instances of chronic disease lithium sources . These include vaccinations against tuberculosis and flu male menopause testosterone .
In time, the general range of vaccinations will probably be extended even further buy tramadol online cod cash . At the moment, research is being carried out into the possibilities of vaccinating against
VACCINATIONS 91
certain types of meningitis (other than those caused by the Hib bacteria) prolab caffeine .
Most countries do not vaccinate against illnesses such as chicken pox (apart from the USA and Canada), because they are very mild and there are few complications estrace breasts sore .
Most vaccination programmes include vaccines against diseases which hardy occur anymore in the developed world low dose cialis . The reason for keeping these vaccines in use is the belief that they will certainly return if no vaccinations are given against these diseases a drug called celebrex .
The principle of inoculation
The vaccines used to inoculate children contain traces of the disease concerned esomeprazole drugs . However, these traces have been altered in a laboratory, and have either been killed or weakened so that they can no longer give rise to all the symptoms of the disease ibuprofen gels . Therefore, the inoculated child receives the disease in a very weak, almost unnoticed form lithium production in nevada . This encourages the immune system to create antibodies against the disease for which the child was inoculated clemastine fumarate tablets .
If the child then comes into contact with the disease at a later date, the immune system can deal with the infection straightaway so that the child will not catch the natural form of the disease generics for buspar .
Are the vaccinations compulsory?
Although many people think vaccinations are compulsory for children, this is not the case prescription for macrobid . However, some childcare centres for children require vaccinations as a condition for enrolment why does caffeine dehydrate you . It is advisable to ask for information about this in good time accutane usage with other medications .
Side effects of vaccination
Just as there are complications with the infectious diseases described here, there can also be side effects resulting from the different vaccines cefuroxime pi . In the first place, there are harmless side effects, such as a slightly raised temperature, feeling unwell and redness in the place where the child was inoculated rimonabant has anyone lost weight . In addition, some vaccines can lead to more violent reactions lasix eye surgery in ocala florida . There may be a high temperature, vomiting, long periods of crying, listlessness, irritability, fainting and convulsions chewable zyrtec . However, these symptoms are not considered to be a reason not to vaccinate the child concerned again, since the damage is not permanent celexa change .
However, some parents have also told stories about children who were never ill until they were vaccinated, and who then struggled with constant fevers and colds levitra qu es . An association which has carried out some critical research into vaccinations, particularly the side effects, has come to some different conclusions than the officials do, but is difficult
to prove scientifically sumatriptan 85 mg rt . Ultimately, it is about parental choice pharmacy tech resume buy tramadol now .
If you want to make a considered choice with regard to vaccinations, we advise parents to read the vaccination booklets which are available from any health centre, as well as reading as widely as possible new mesalamine drug . The book, Vaccination: A Guide for Making Personal Choices, by Studer and Douch contains further information on this subject ribavirin respiratory tract infection . A Guide to Child Health by Glockler and Goebel has a thorough discussion on the pros and cons of each vaccine (see bibliography on p when should tricor be taken .117) dexamethasone acetate injection .
Practical tips
You should not let your child be inoculated if he has a fever or if you suspect that he is sickening for something accutane lawyer jacksonville . In principle, the common cold is not a reason not to have an inoculation air condition with lithium bromide .
From the day of the inoculation, and for a few days afterwards, the child may cry a lot, be unwell or ill and have a fever up to 40°C (104°F) lexapro side effects geriatric . The body has to assimilate the inoculation what is mirtazapine . Any extra rushing about, excitement, watching TV, going on a visit or on a trip etc, is not advisable during the days after a vaccination, nor is playing in bright sunlight actonel bad side effects . All this can be too much for the child testosterone cypionate vs testosterone enanthanate forum .
If the place around the inoculation is red and painful, a piece of cloth soaked in cold water or with some curds can provide some re-lief exelon address . It is also possible to put some arnica 20% (Weleda) in the water to reduce swelling study of adhd wellbutrin adult .
Immunity
When a child suffers from a number of the diseases described here he usually builds up a lifelong immunity feedback on use of testosterone gel . This applies particularly for the traditional childhood diseases, such as whooping cough, mumps, measles and German measles amitriptyline research .
As a result of a vaccination, the child is given immunity against the disease for which he was inoculated diltiazem intraveneous to oral . The question is whether there is a significant difference between the immunity acquired as a result of having the disease, and the immunity acquired as result of a vaccination seroquel drug interaction . In our opinion, this question deserves attention and further research glucophage fertility .
The question of the effects which inoculations have on the child’s health in the longer term, is also raised increasingly frequently vicodin motrin . There are indications that inoculating weakens, rather than strengthens, natural immunity, and it is not inconceivable that nature will create new manifestations of the disease if childhood diseases are otherwise eradicated ultram . The many unidentified rashes and allergies which a large number of children suffer from nowadays point in this direction i ranitidine hcl . The new variations may be worse than the original illness testosterone contraindicated . It is possible to see the emergence of the
many new allergic diseases in this light and possibly also the auto-immune diseases in which the body forms antibodies against parts of its own body can caffeine kill sperm .
The consequences of not vaccinating
When they progress normally, the diseases mentioned here are acute infectious diseases with a beginning, a peak and an end, which usually leave the child with lifelong immunity oral methotrexate . With all childhood diseases, some children will be very ill, while others are hardly ill at all teenager taking viagra . It is also possible to acquire immunity without appearing to have the illness hypoglycemia and celexa . It can happen that all the children in the family get a particular childhood disease, except for one child who does not catch it afrin compared to pseudoephedrine .
With all the diseases mentioned here, there can be complications, which mean that they do not progress in the normal way topamax for mood stabilization . The chances of this vary a great deal between the various childhood diseases zocor medication . It is not possible to predict which child will suffer these abnormalities warfarin atherosclerosis . This is what makes the decision about vaccinating so difficult cymbalta withdrawal causing arthritis symptoms .
Children who are not vaccinated still have a fairly high chance of catching certain childhood diseases clindamycin phosphate topical solution usp . It is only when the child has caught one of these diseases that the consequences of not vaccinating become apparent claritin d low back pain . This brings a confrontation between feelings of guilt and the re-marks and prejudices of other people flomax ocas . The consequences can be far-reaching; for example, the child can infect an adult, whose vaccination is no longer effective finasteride use in teen boys . It is impossible to anticipate all the consequences in advance plantar warts valtrex . Is this then a reason to vaccinate? Or is it a reason not to vaccinate? There are not many situations in which you take decisions without being able to oversee all the consequences clindamycin inhalation . On the basis of the information available at the moment, the examples you have seen around you, the practical considerations or the fear which you feel, you will make a decision and you cannot know how this will feel a month or a year later prograf hair loss .
Perhaps it helps to know that a decision which has been taken with a great deal of thought gives support and confidence, and contributes to the future of the child in a positive way mexico prozac without prescription . And a decision taken consciously makes it more possible to deal with any disappointments resulting from that decision drug interaction xanex and zoloft .
Alternative vaccination schedules
If you wish to change the time/age at which your child is vaccinated, there are other possibilities prozac being over presribed .
The chance of complications with whooping cough are greatest in the first year, and very slight afterwards canine testosterone after neutering . If you wish to vaccinate against whooping cough, it is thus advisable to do so in accordance
with the usual schedule nexium prevent ulcers gastric bypass . The same applies for the Hib vaccination, as this relatively rare disease is most common during the first year drinking alcohol and norvasc .
If you choose not to vaccinate against whooping cough, it may be possible to start with individual vaccinations against diptheria, tetanus and polio later led with lithium light . In this case, the fist vaccinations would be given at 12 months, the second 4-6 weeks later, and a third one six months after that, at around 19 to 20 months soma center new jersey . Altogether there would be one less booster because the immune system has developed much further spironolactone breasts .
It is also quite possible not to vaccinate against certain illnesses until after the childhood diseases, that is, between the ages of 12 and 14 for measles, mumps and German measles wechselwirkung cialis und propecia . This is because the possible complications of measles are more serious after the age of ten years cialis side effects eye .
Whatever you decide, it is important to discuss it thoroughly with your doctor lo ndose naltrexone . He or she will have to monitor your child when he is ill leg cramps and prednisone .
The purpose of illness and fever
The childhood diseases mentioned here are all accompanied by fever hyzaar sideeffects . A fever is the natural weapon of the organism to fight against germs amoxycillin plus clavulanic acid . It is well known that viruses and bacteria cannot multiply very easily at temperatures over 39°C (102°F) cat amoxicillin dosage . A fever activates the immune system so that it will also be able to respond to germs appropriately in the future naltrexone lupus . In this sense, a fever helps the organism to develop a good immune system dr cohen avelox .
People are afraid of fever and often try to find ways to bring the fever down as quickly as possible lexapro adhd . In our view, this fear of fever is unjustified, and by suppressing the fever, you prevent the organism from having a chance to build up a healthy resistance cymbalta for ptsd treatment . Thus we see fever as a friend, rather than as a foe reglan antidote . On p acs mi perindopril .97, we look at practical ways of dealing with fever cv side effects ibuprofen .
In general, it may be said that there are two sides to being ill can boniva cause tooth pain . On the one hand, illness is a disturbing factor; it interrupts the normal course of events in life, causes pain, discomfort, SOITOW, suffering, pressure on others, absenteeism and incurs costs iv amiodarone protocols and australia .
On the other hand, you can also say that illness leads somewhere clonidine otc . Looking back at an illness, you often see that it did not appear out of nowhere, but that this was a decisive moment in life gemfibrozil uric acid . In small ways, this can occur when you are exhausted, or in bigger ways, for example, when you have to make an important decision about your life desyrel overdose . Sometimes, the actual illness can help to reveal a new path effexor paxil .
Does this also apply to the infectious diseases in childhood’? From an anthroposophical point of view,
VACCINATIONS 95
these diseases are essential helpers in the development of the child lipitor europe . How can this be explained?
Every child inherits certain physical characteristics from his parents lotensin vs anapril in animals . This is like a sort of home in which he will live throughout his life information on prescription drug meloxicam . During the first years of childhood, it is important to move into this ‘home’ fully, and make it his own, as it were viagra burnout .
Sometimes, certain aspects of this physicality do not appear to fit very well mp flomax 10 . The child can make use of the infectious diseases to transform or rebuild these aspects can you lose weight using flomax . They help him to transform his physicality in such a way that he ‘fits’ better bleeding on clomid . Obviously, this is a better starting position for exploring the world from one’s own ‘house’ later on alcoholism naltrexone treatment naltrexone . In this way every infectious disease during childhood makes it possible to carry out a particular aspect of the ‘conversion prilosec and dizzy .’ Parents often observe that after having had one of the childhood diseases, their children really have become ‘better’ and have not really returned to their old selves escitalopram lexapro for depression .
Therefore, an infectious disease gives a child the opportunity of conquering a particular developmental barrier at the physical level diltiazem 240mg . Barriers which are not conquered have to be crossed in a different way after childhood, for example, through a process of self-education, and that is by no means always easy sustained release forms of clopidogrel .

Where should I give birth?
home or hospital?
Do I have options for where I can give birth?
Yes you do Choosing where to have your baby is
a personal choice and knowing all the relevant facts can help you to make an informed decision. You can contact an organization called BirthChoiceUK for more information (see p.310) and talk to your midwife and other mothers in your area to widen your perspective. Where you live will affect your choice, as will the decision to have NHS care, go to a private hospital, or hire an independent midwife, who can arrange to deliver your baby in the local maternity unit If your pregnancy has been straightforward, you should be offered the option of delivering your baby at home, in a birthing centre (if one is available in the vicinity), in a hospital birthing unit (see p 154), or in the hospital obstetric unit itself
Is it safe to have my baby at home?
Research has shown that for healthy women who have had a normal pregnancy. a planned home birth attended by an experienced caregiver is as safe as giving birth in hospital. There are similar findings for
birth centres and GP units. Statistically, women who have home births are less likely to use drugs to cope with the pain and less likely to have an assisted delivery or Caesarean, even if they have to be transferred to hospital during labour. They are also more likely to use upright positions for giving birth compared to hospital births. Likewise, women who give birth in a birthing centre (see p 154) are less likely to use drugs for pain relief and less likely to have their labour speeded up artificially. They are also more likely to be satisfied with the care they receive.
Can I choose which hospital to give birth in or does it have to be the one nearest to me?
Although, technically, you have a right to choose any hospital in which to give birth, you should consider the practicalities of distance for attending antenatal appointments and scans at the hospital you choose, as well as thinking about how far you want to travel while in labour. A local facility is therefore probably the most sensible choice. You may have a variety of services nearby, including hospitals, GP units, or birthing centres Discuss all your options with your midwife and doctor and try to talk to other mothers locally to see if they have recommendations.
My pregnancy hasn’t been straightforward. Will I have to give birth in hospital?
There are several reasons why you may be advised to deliver in hospital. If this is a second baby and there were complications before, such as bleeding in pregnancy or a Caesarean, your midwife might suggest you deliver in hospital. Or if this is your first baby and there are complications, such as diabetes or high blood pressure, or it is a multiple pregnancy, you may be advised to have your baby in hospital

What additional things do I need to think about if I’m having a home birth?
It may be worth having all the items you need for the labour and birth gathered in the place you intend to deliver, and it can also be helpful to organize your items separately from the baby’s items As well as practical items, such as clothing, toiletries, and sanitary pads, you may also want to have to hand music phone numbers, and a camera It’s a good idea to have a well-stocked fridge to ensure that you have nutritious snacks to hand during labour as well as helping you and your partner in the first few days after the birth. Your baby will need nappies, cotton wool, vests, clothing sheets and blankets If you have other children, you may need to make arrangements for them with family friends, or neighbours, or have meals planned for them in advance and plenty of activities to occupy them.
Even though you are planning a home birth, there are occasions when things don’t go quite as you wish and you need to be transferred to hospital. This can happen before, during, or after labour and so even though you may not wish to contemplate this outcome, it’s a good idea to have an emergency bag packed for such an occasion.

Hospital birthing units

Unlike ‘’stand-alone” birthing centres, which may be some way from a hospital unit with emergency equipment a hospital birthing unit is situated in the hospital delivery suite, or nearby, but there is still little medical intervention and doctors are not in the unit. However, if there is an emergency or you want an epidural, instead of having to await transfer to a hospital, the midwife can transfer you rapidly to the delivery suite on site
Do I have a right to give birth at home?
The issue of a legal right to home birth has become a bit complicated recently because there is no right in law for women to give birth at home, and the Department of Health has issued advice to NHS Trusts saying that they should provide a home birth service ‘ where practicable ‘, rather than insisting that they provide one However, the bottom line is that in law no one can be compelled to attend a hospital for treatment or care, and that includes for birth. Your local services are likely to influence your choices greatly and the organization BirthChoiceUK can help to inform your decision (see p 310).
What’s the difference between a birthing unit and a maternity department in a big hospital?
Birthing units are run by midwives and the emphasis is on a natural birth. They can be situated next to a hospital maternity unit or on a completely separate site. Some hospitals have a birthing unit facility in the actual maternity unit, known as a hospital birthing unit (see left), where midwives provide total care in a dedicated area of the maternity unit
As the majority of women give birth without needing medical intervention, these units provide a good alternative to a more medicalized hospital environment. The environment in a birthing unit tends to be more relaxed and flexible, which may appeal if -you want a home birth atmosphere with added support. You will also have continuous support from midwives and may even be attended by the same midwife throughout your labour and birth Furthermore, the midwives in these units are very experienced at handling a birth without medical intervention All of these factors therefore increase your chances of having a straightforward birth.
To be eligible to give birth in such a facility, you would need to have had an uncomplicated pregnancy and be unlikely to require specialized medical care or monitoring in labour and birth. If complications do occur in labour or birth at a birthing unit you would need to be transferred to the nearest maternity unit, although this is a rare occurence as most women in birthing units have been identified as being ”low risk’
If you labour in a standard maternity unit, you can be subject to a range of policies and not enjoy the same degree of flexibility However, you will have access to an epidural and, if emergency intervention is needed, doctors will be close at hand.
I’m booked for a Caesarean as my baby is breech, but I want a natural birth. Is this possible?
You need to discuss this with your midwife and obstetrician and express your preference, as your feelings are an important factor when deciding how to manage your birth. You may be able to have a procedure called external cephalic version (which is usually done around 37 weeks) to try to turn your baby to a head-first position (see p.144) However, if you have this procedure and your baby still remains in a breech position, you may be advised to have a Caesarean, although some obstetricians will support you if you wish to try for a vaginal birth (see p. 183).
I don’t want to be monitored in labour. Will the midwives and doctors listen to me?
Unless there is a medical or obstetric complication, such a previous Caesarean section or high blood pressure, you don’t need to be strapped continually to a monitor to listen to the baby’s heartbeat Instead, a procedure called ”intermittent auscultation’, which means listening in regularly to the baby’s heartbeat with a sonicaid, should be sufficient to monitor the baby’s wellbeing. Ultimately, the choice of monitoring or listening in if all is well, is yours. If a midwife or obstetrician wants to monitor the baby’s heartbeat continuously, they should explain why
It’s a good idea to make a note of your wishes during pregnancy in a birth plan (see p.149) and discuss this with your midwife before you go into labour If you don’t have a chance to discuss this before labour when you do go into labour, the midwife on duty will first take a medical and obstetric history and ensure that you and your baby are well, and will then ask if you have a birth plan, or you can show her the plan.
Can I bring food and drinks into the labour room?
The latest NICE guideline recommends that all women should be able to drink in labour. Water may be refreshing, but isotonic drinks may be more beneficial, as they contain energy-boosting ingredients. If established labour is progressing well and you and your baby are well, you can eat light snacks to give you energy and help labour to progress. However, if you require pethidine or diamorphine, which can make you nauseous or sick, or need an epidural, or other risk factors develop, you may be advised to drink sips of water only. You may also be offered an antacid tablet to reduce acid build-up in your stomach This is a precaution in case you need an emergency Caesarean
Who will be with me while I’m in labour?
If you have a home birth, you will be allocated a midwife who will stay with you throughout your established tabour As you near delivery, she will contact the hospital and a second midwife will be sent to support her and you through the birth. Whoever else you have at your home delivery is
up to you Things may be different in hospital, where it is generally recommended that you have just two birthing partners, simply because the space in most labour rooms is limited. Once in established labour, NICE recommendations are that you are cared for by one midwife throughout labour. In reality although each unit will endeavour to offer one-to-one support, this may not be possible If this is the case, the midwife will be with you as much as she can, will show you how to contact her if she is not in the room, and will be with you for the delivery. It may be wise to organize one or two people such as your partner and a good friend, to support you during labour
and maternity support workers to support midwives Unfortunately, there have been times when maternity units are full If no beds are available, staff will find a bed for you at another hospital: many hospitals have “sister” units, to which they will transfer you. Most
maternity units are not full for long and will organize for you to be transferred back as soon as possible
I keep reading about infections like MRSA and now I’m worried about having my baby in hospital.
Although there is a great deal of media coverage of ‘ superbugs” such as MRSA, most people have
no problems at all with hospital infections. Infections are caused by germs, of which there are four major types: bacteria; viruses; fungi, moulds, and mildew; and protozoa. Hospital infections are bacterial There are thousands of different types of bacteria. Some bacteria, known as helper germs, are friendly or good bacteria, which aid the digestion and absorption of food in the gut. Others can cause infection and illness, methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C difficile) being two notable ones of concern in hospital.
MRSA is a bacterium that can live completely harmlessly on the skin of healthy people, but can lead to serious infection in vulnerable individuals. Good hygiene, particularly in the form of simple precautions such as hand washing, is an effective method in the prevention of MRSA infection and your chances of acquiring this in hospital are low. Even healthy relatives and friends of patients with MRSA
I’ve heard about hospitals
being understaffed and women not getting a bed. Is this true?
There are concerns about shortages of midwives and beds. Many hospitals now employ ancillary staff carry no risk If cutlery and plates are washed using soap and water (preferably hot) this removes MRSA, and the risk of acquiring MRSA through contact with curtains, sheets, and pillows is very low Healthcare workers use antiseptic solutions, such as alcohol hand rubs, and more recently many hospitals have alcohol gels for hand cleaning at the end of each bed.
C difficile is another type of bacterium mentioned frequently in the media Hospitals prevent and control the spread of C. difficile with antibiotics general hygiene measures such as hand washing, and by detecting cases early so that they can isolate affected patients to prevent it spreading further.
What measures can I take to prevent my baby or myself getting an infection in hospital?
Regular hand washing by yourself, staff, and visitors are likely to be adequate measures to prevent infection. Take your own soap, a flannel, and moist hand wipes with you. Always wash your hands after using the toilet and always wash your hands or clean them with a hand wipe immediately before and after eating a meal Make sure your bed area is regularly cleaned and report any unclean toilet or bathroom facilities to staff. Breastfeeding will provide your baby with protection against infection. A new innovation, silver-lined pyjamas designed to protect against MRSA, are now on sale in the UK! Silver is thought to have particular antibacterial qualities and to be an effective agent against infection. Hopefully these measures will help you feel in control You are unlikely to be in hospital for very long, and you and your baby should be safe
My partner can’t drive. Can an ambulance take me to hospital?
An ambulance can transport you to hospital in an emergency for example if you are bleeding heavily As this is an emergency vehicle driven by trained operatives it is expensive to provide. If you call an ambulance for a non-emergency you could be taking it away from an emergency situation and putting others’ lives at risk.
Part of planning for labour is finding out which facilities your local maternity unit provides and what you might need to provide yourself to help you through the labour and birth.
* Check if your local unit supplies
equipment such as birthing balls or TENS machines or whether you need to hire these in advance.
* Check in advance if the hospital has a birthing pool and midwives trained to deliver babies in water.
* Find out if your hospital has a dedicated birthing unit (see p 154)
be on call when you go into labour? Or can you call a minicab in early labour? If you can’t organize transport, discuss this antenatally with your midwife or, once in labour, call the labour ward for advice.
Can I ask for a private room in the hospital for me and the baby after the birth?
Unless you give birth in a private hospital, there are few hospitals that offer private postnatal care Many hospitals have postnatal ”amenity rooms”, which are usually single rooms, with or without ensuite facilities, on the postnatal ward These may be allocated to women who need a private room for medical reasons in which case they are free. Otherwise, they are offered on a first come, first served basis, so state in your birth plan if you wish to have one and remind your midwife after the birth.
The cost of these rooms and their facilities can vary between units and covers the room only The midwifery care is given by the staff on the postnatal ward and, in most units, your partner and visitors will still have to abide by the ward visiting times.

Although there are no guarantees that your labour will proceed in the
way you would like it to and it’s probably best to approach labour with a flexible attitude, there are things you can do to make it more likely that you will end up having the type of experience you would prefer Attending antenatal classes and being as informed as possible about labour and your choices will help you to prepare in advance Other things women find helpful are having a supportive birth partner, making decisions with the midwife, being positive, and using a birth plan.

Water births
Relaxing in labour
Some cultures have used water births for centuries to provide a gentle birthing experience. Today, there is evidence to support the fact that labour may be quicker and less painful in water.
How can it help with the pain? Possibly women feel more comfortable and therefore more confident and in control in water. It is thought that water sets off a surge of oxytocin (the hormone that triggers contractions), making contractions more effective Some women find they can move around more easily in water, which helps them find a good position in which to give birth. Some feel the benefits of immersion in warm water as soon as they get into the pool, but for others it can take 15-30 minutes before they relax. Water can
be a natural aid to relaxation as it soothes muscles and releases tension. When we feel less anxious, our bodies produce fewer ’stress” hormones. This encourages the brain to produce endorphins, the body’s painkillers, and promotes wellbeing Dimmed lights and relaxing music can further aid relaxation. Some studies suggest that women have a shorter second stage of labour in water, and there may be less exertion needed to push the baby out If contractions are too intense you can still use Entonox (gas and air).
Can the baby be monitored in water? Your baby can still be monitored by the midwife using a Pinard (ear trumpet) stethoscope or a waterproof hand-held electronic sonicaid.
Will I be allowed to have a water birth?
You can use a birthing pool providing your pregnancy is normal and there were no problems in previous pregnancies If -you want a water birth in hospital and are going to be induced (without a drip), or there are other complications with the pregnancy, you may need to negotiate this with your doctor or midwife. You can talk to a Supervisor of Midwives (who can be contacted via the maternity unit) during pregnancy to help you to make a plan to meet your wishes
Is it possible to have a water birth in hospital?
This depends on the hospital maternity unit Some units have their own birthing pool; some have facilities for you to hire a pool and bring it in; some units have only room enough for a pool to labour in; and others do not have the facilities for you to bring one in or the structural ability to have one in the unit as the amount of water in the pool would be too heavy for the floor to hold.
If your maternity unit does have a birthing pool. it is possible that the pool might be in use when you go into labour. To improve your chances of being able to use a pool, you may want to consider a home birth and to hire a pool (see p. 153).
Can I use the birthing pool for labour and birth if I’ve had a previous Caesarean?
Unfortunately, it is recommended that if you have had a previous Caesarean section, your baby’s heartbeat and your contractions will need to be continuously monitored throughout a subsequent labour and delivery which cannot be done in a birthing pool The reason for continuous monitoring in this situation is that there is a chance, although quite a small one, that your uterus may rupture. This often causes no pain and the only indication may be a change in your baby’s heartbeat. If you decide you do want to labour and deliver in water after a Caesarean section, this is your choice, but you should be fully aware of the risks.
When can I get into the birthing pool?
You can get into the pool whenever you want, but some midwives suggest that you wait until you are 4-5cm (tin) dilated or in established labour. This is because some people are concerned that the water can be so relaxing that it may cause the contractions to slow down or even stop, although there is little evidence to support this However, if this does happen, getting out of the pool and walking around for a while is likely to increase the strength of the contractions You will need to get out of the pool if your baby passes meconium (see p.252) or if the midwife has any concerns about you or your baby.
The water temperature can be whatever you find comfortable, although 37°C (98 6′n body temperature is usual, especially if you are giving birth in the pool, as babies can get cold quickly once they are born.
Most units have guidelines on this.
Can I deliver my baby in a birthing pool, or are these just for labour?
You should ask your midwife to find out if the hospital that you have chosen to deliver at provides facilities for you to deliver in the water, or just use the pool for most of your tabour This often depends on whether the pool is big enough for the delivery, Occasionally, there may not be a midwife available who has been trained in delivering births under water, in which case you may only be able to labour in water and will have to get out for the delivery.

Home birth
Planning a birth at home

Although only around two per cent of women in the UK choose to give birth in their own home, this number is increasing. Research has shown that mothers may have shorter and less painful labours in their own home. It is not known why this is, although it may be due to them feeling more confident and comfortable in their surroundings. You will generally have at least one midwife with you constantly once you are in established labour during a home birth. Many women hire a pool for use during labour at home, and this may progress to a water birth.
Will I be allowed a home birth? If your pregnancy has been classed as ”low risk’ - you are healthy and have not had any complications in this or any previous pregnancies - then a home birth is a definite option If you desire a home birth and have experienced some complications during the pregnancy, talk to your midwife or contact a Supervisor of Midwives at your local maternity unit who will be able to advise you.
How do I plan for a home birth? If your midwife is happy for you to deliver at home, you need to talk to her about the type of home birth you wish to have, for example do you want a water birth (see p.156) or to use a birthing ball, and how do you plan to manage the pain? If you would like a water birth, you will need to hire a birthing pool in advance You may want to set up a special area in your home to have your baby, which ideally should be near bathroom facilities. Plastic sheeting and old sheets are advisable to protect your flooring, and shower curtains make a good surface for giving birth You will also need a supply of dustbin bags for waste.
What will happen? Most community midwives carry a homebirth pack with them, which they will bring along when you go into labour The kit includes a blood pressure monitor; a stethoscope and/or sonicaid; a thermometer; gloves; a gas and air cylinder; pethidine; scissors; antiseptic solutions; and emergency equipment Some midwives like you to provide towels and plastic sheets. You can use your TENS machine, and the midwife will arrange for gas and air (Entonox) to be delivered The midwife can also ask your doctor or obstetrician to prescribe pethidine or diamorphine if you wish.
What if there is a problem? If the midwives are concerned about you or your baby’s health, they will discuss this with you and it may be necessary to transfer you to hospital. This transfer is usually done by ambulance, accompanied by paramedics, your midwife, and your birth partner.

Who will handle my care?
a guide to antenatal care

What types of antenatal care are available to me?
The options for antenatal care in the UK vary from one region to another, and sometimes according to the hospital you choose. so it’s worth asking your doctor or midwife early on about your choices. There are four main types of care (see p.76) The most common is shared care, where you are cared for by your doctor and community midwife with visits to the hospital limited to scans or investigations. In some areas, midwifery care is offered where you are looked after by a midwife or a team of midwives, sometimes called one-to-one care or team midwifery care. Women with pre-existing medical problems, or a more complicated pregnancy, such as a multiple pregnancy, may have consultant-led care with visits to a hospital-based consultant If you opt for private care, you will be cared for by an independent midwife Appointments will be timed to suit you and scans may be with a private obstetrician. The midwife will be on call for the birth, which may be at home, in a birth centre, or at the local hospital.
How many antenatal appointments will I need?
The exact number of appointments and how often you have them depends on your individual situation Usually, if this is your first pregnancy, you will have up to 10 appointments, whereas if you have had a baby before, you should have around 7 appointments.

When will I have my first antenatal appointment?
Your first ”booking’ appointment should be between 8 and 12 weeks, depending on the midwives’ preferences in your area. This is often the first time you will meet the midwife who will be organizing, and in most cases providing most of, your care.

I’m going for my first appointment next week - what will happen there?
The purpose of your first appointment with your local midwife is for her to obtain your medical history and exchange information so that your future care during the pregnancy and birth can be planned. This is also an opportunity for you and your midwife to get to
know each other and for you to ask any questions you may have and discuss the schedule for appointments, blood tests, scans, and antenatal classes. You will also be given booklets, information leaflets, and important contact telephone numbers
Your midwife will ask you about your medical history; your family’s medical history; your partner and your partner’s family’s medical history; about any previous pregnancies you have had; and how this pregnancy has been so far Your answers to these questions will help your midwife to build up a picture of your current state of health, and will also help identify any factors that may affect your pregnancy, for example if there is a family history of pre-eclampsia (see p.89).
Your midwife will also take your blood pressure, weigh you, test your urine (see below), and listen to the baby’s heartbeat if you are 12 or more weeks pregnant. She may also take some blood tests (see opposite). These observations provide a useful baseline for future antenatal checks

Why do I have to bring a urine sample to the clinic each time?
Your midwife is looking for the presence of protein in your urine. If protein is present, this could indicate that you have a urine infection that may need a course of antibiotics After around 24 weeks of pregnancy, protein in the urine is an indication of pre-eclampsia (see p 89), a potentially serious condition that needs close monitoring.
If you have a body mass index (BMI) (see p 18) over 35, you will be offered a glucose tolerance test, also done by testing -your urine. Glucose in the urine is a sign of gestational diabetes (see p.87) If glucose is present, you may be referred for blood tests to analyse your sugar levels. If diabetes is diagnosed, you would receive care and advice accordingly.

Why are some of my appointments with my doctor and others with the midwife?
The type of antenatal care you receive can vary slightly between different areas. If your pregnancy is straightforward, your care is usually shared between your doctor and midwife, or in some areas all your appointments are with your midwife. If you feel more comfortable with your midwife, you should be able to arrange to have the majority of your appointments with her, and the same applies if you feel happier seeing your doctor. Whichever way, it is important that -you feel able to ask any questions or discuss any issues, which may be personal or sensitive

Will I have to have an internal examination at my first antenatal appointment?
It is unlikely that you will have an internal examination at your first antenatal appointment. Twenty years or so ago, when home pregnancy tests weren’t as reliable and ultrasound scans were not so accurate or widely available, an internal examination was the
best way to confirm and ‘date” a pregnancy The midwife or doctor placed two fingers into the vagina, and pressed on the lower abdomen with the other hand to judge the size of the uterus
Nowadays, there are a few instances when an internal examination may be recommended during early pregnancy. If you have an infection, such as thrush, an internal examination enables the vagina to be visualized to check for any signs of infection and for a tissue sample to be taken with a swab (like a long cotton wool bud). The swab is sent to the hospital for testing so that the appropriate treatment can be offered
If -you have vaginal bleeding, you may have an internal examination with a speculum (an instrument shaped like a duck’s bill, used for smear tests) to allow the cervix to be seen: a small erosion on the surface is a common cause of bleeding in pregnancy Although internal examinations are not enjoyable, it is important to try and relax to help the muscles of the vagina to relax and loosen, which may prevent discomfort. Many women find it helpful to breathe slowly and steadily during the examination.

I’m very small and have tiny feet - will that be a problem when I give birth?
In the past, doctors used to measure a pregnant woman’s feet to assess her likelihood of needing a Caesarean section, as small feet were thought
to indicate a narrow pelvis Although there is some truth in the fact that small feet generally indicate that a woman is small-framed and therefore likely to have a small pelvis, small women also tend to grow small babies in proportion to their pelvic size. True cephalo-pelvic disproportion (CPD), where the baby’s head is too large to fit through the pelvis and be born vaginally is relatively rare
During labour there are other factors that help you to deliver your baby. The pelvis is not a fixed structure and the hormone relaxin helps to soften the ligaments that hold the pelvic bones together to help the pelvis to stretch and accommodate the baby
Also, your baby’s head is designed to mould into shape. The skull is made up from separate bones that are able to overlap each other slightly in order to reduce the overall size of the head as it travels through the pelvis during labour This is a normal part of the birth process. Labour positions also affect the dimensions of the pelvis. For example, squatting can increase the internal measurements of the pelvis by around 30 per cent. Sitting, or lying on your back can actually reduce these measurements by restricting the natural backwards movement of the tailbone (coccyx) during birth.

My midwife is lovely but she’s always in a hurry - how can I get her to answer my questions?
This is a common problem. Antenatal clinics are often very busy, with lots of women for the midwife to see. Asa  result, most clinics allow only a 10- to 15-minute appointment for each woman – barely enough time to go through the basic physical checks However, it is important that -your questions are addressed and it may be helpful to write them down so that you remember what you want to ask. If your midwife doesn’t have time to discuss the issues during your appointment, ask her to arrange to talk to you at a mutually convenient time This could be in the form of a phone call, or another appointment at the clinic Or she may be able to direct -you to other sources of information such as books, leaflets, websites, or other healthcare professionals.
It is a crucial part of your antenatal care that you feel comfortable with your caregivers and are given the opportunity to discuss any questions you have or issues that arise, and this is recognized by the National Institute for Clinical Excellence (NICE) in their guidelines for antenatal care (see p.310).

I’m four months’ pregnant and haven’t had many appointments. Will they get more frequent?
Yes, you will find that your antenatal appointments become more frequent as the pregnancy progresses. With your first pregnancy, you can expect a total of about 10 appointments but if you have had a baby before, you may only have 7. If you develop any complications, additional appointments would be arranged according to your needs. The schedule of antenatal appointments differs slightly from area to area, but as a general rule you can expect an appointment at the following stages of pregnancy: one to two appointments by 12 weeks of pregnancy, and then appointments at 16 weeks, 25 weeks, 28 weeks, 31 weeks, 34 weeks, 36 weeks, 38 weeks, 40 weeks, and if, your baby is overdue, 41 weeks If you are expecting your second or subsequent baby and the pregnancy is straightforward, you may miss out appointments at 25 weeks, 31 weeks, and 40 weeks.

I want a home birth. Will this make a difference to my antenatal appointments?
Usually women planning a home birth will have the same type of antenatal care as any another healthy pregnant woman in regards to frequency and location of antenatal appointments Midwives in some areas may provide a home visit towards the end of
the pregnancy if a woman is planning a home birth This is helpful as it offers an opportunity to discuss the preparations for labour and birth, such as what equipment to have ready and the intended place for the actual delivery. If your midwife cannot offer a home visit to discuss the arrangements for your home birth, you should be given an opportunity to talk about it together during one of your usual antenatal appointments.

Is it OK to bring my partner with me to the antenatal appointments?
It is absolutely fine to bring your partner with you to some or all of your antenatal appointments It is a good way for him to feel involved in the pregnancy, and also gives him an opportunity to ask questions that he may have. It is a legal requirement that you are allowed paid time off work to attend antenatal appointments, but your partner does not have this right, which may pose a problem as most antenatal clinics are during the day. Another way to involve your partner in the pregnancy is to attend birth preparation classes together Classes are often held at the weekends or in the evenings to make it easier for partners to attend This gives you both a chance to find out more about labour and birth and about babycare after the birth.

When will I hear my baby’s heart beat?
Your baby’s heart starts beating around 20 days after conception, and can be seen on an ultrasound scan at about six weeks of pregnancy It is usually not until around 12 weeks of pregnancy that it is possible to hear the heartbeat with a hand-held monitor, known as a sonicaid, as it is around this time that the uterus starts to grow upwards out of the pelvis, making it easier to detect the heartbeat When the heartbeat can be heard also depends a bit on your build; if you are very slim, it is usually easier to find the baby’s heartbeat than if you are overweight

Will I have my own midwife?
Midwives realize that it is important for a woman to develop a relationship with them so that they feel supported and able to ask questions, and continuity of care is provided if possible However, how many midwives you meet in pregnancy, labour, and birth and the postnatal period depends on how services are arranged in your area Generally, the midwife linked to -your doctor’s surgery provides the majority of care. Depending on your situation and common practice in your area, you may also meet other midwives if some of your appointments are at the hospital. When -you go into labour, you are usually cared for by hospital-based midwives who you may not have met In some areas, community midwives look after women in hospital. If this is the case, you may be familiar with the midwife caring for you in labour Midwives working on a labour ward work shifts, so it is likely that you will meet more than one midwife during your labour and birth. Your postnatal care is usually carried out by community-based midwives. This may include the midwife you saw for antenatal appointments at the surgery
I’ve only just found out I’m pregnant and I must be at least four months. What should I do?
One of the first things you need to do is to contact your local maternity unit and inform them of your pregnancy Women can refer themselves, although many still approach their doctor first. If you inform your doctor, he or she will send a referral to the hospital or to a midwife to arrange a booking appointment as soon as possible. You should also review your diet (see p.50) Depending on the number of weeks of your pregnancy, you may be due a scan, which may need to be done before the booking appointment Most units offer a scan around 10-14 weeks, and a second one around 20 weeks. You will be offered a range of blood tests (see p. 117) and should be aware of their purpose before consenting Each unit may have a slightly different schedule for care. The earlier you book in the better, so that you do not miss out on any aspects of antenatal care.

Antenatal jargon
Understanding your notes
Once your midwife has compiled your notes, you will be in charge of these and will need to take them to appointments. Abbreviations will be used for much of the medical information.
• BP Blood pressure.
• Hb Haemoglobin levels.
• Primagravida A first pregnancy
• Multigravida A subsequent pregnancy
• NAD Nothing abnormal detected (usually referring to urine sample).
FHHR Fetal heart heard and regular.
FHNH Fetal heart not heard.
FMF Fetal movements felt.
EDD Estimated date of delivery
iIc Ceph or Vx Baby head down
Br Baby is breech - feet down.
Eng/E Baby’s head is engaged for delivery * NE Baby’s head is not engaged.
* SFH Symphysis fundal height, size of the womb

Rhesus negative
Each person’s blood carries a Rhesus factor (Rh-factor), which is positive or negative Problems arise if a Rh-negative woman carries a Rh-positive baby who has inherited the status from the father. If the mother’s blood comes into contact with the baby’s blood during delivery, she may produce antibodies against the baby This does not usually affect a first baby. but may cause problems in subsequent pregnancies when a mother’s antibodies attack the cells of another Rh-positive baby
Preparing for visits
Getting ready for your antenatal appointments
Knowing what to expect at your antenatal appointments and having the necessary information to hand for the midwife will mean the allotted time is used efficiently.
At your first antenatal appointment, your midwife is gathering as much information about you as possible to build up a picture of your health and consider the most appropriate type of care for you. Make sure you have the date of your last menstrual period, as well as the dates of any previous pregnancies, including ones that ended in miscarriage You will also need to be clued up on your family’s medical history and your partner’s medical history, including any inherited abnormalities, so check before the appointment if you are unsure about anything Read any information sent by the hospital and make a list of any questions so that you don’t forget them.
Antenatal care options
Wno provides your care
The options for antenatal care in the UK vary from area to area, so this section will provide a general overview You will find out more when you go for your booking-in appointment, usually around 8-12 weeks Midwives are specialists in providing maternity care where there are no complications and they provide the majority of antenatal care to women. As they are specially trained to look after normal births, women should only have to see a doctor if a problem arises, or if they are at a higher risk of complications. Within the NHS there are three main types of care: shared care, midwifery care and consultant-led care. The Association for Improvements in Maternity Services (AIMS), has a useful website that provides plenty of support, advice, and information on maternity choices in the UK (see p. 310)
What is shared care? Most women have their antenatal appointments with their doctor or community midwife during pregnancy, with visits to the hospital only for routine scans or for investigating problems. Care is then transferred to the hospital midwives and obstetrician, if required, for the birth and postnatal stay
How does midwifery care work? In some areas, teams of community midwives provide continuous care throughout pregnancy, birth, and the postnatal period, and when this type of care
is available it tends to be a popular choice in low-risk pregnancies as it enables women to build up a relationship with their midwives The community midwives are responsible for your antenatal care, your care in hospital during the labour and birth, and then for home visits after the delivery. It is not guaranteed that you will have the same midwife all the way through your pregnancy and birth. For this reason, it’s a good idea to request antenatal appointments with different midwives within the team, so that you meet as many members of the team as possible during your pregnancy, and it will therefore be more likely that you will know the midwife who is with you for the actual labour and delivery of your baby,
When might you have consultant-led care? Women with pre-existing medical conditions, such as hypertension, or those with more complex pregnancy issues, such as twins or multiple births, may have the majority of antenatal care with an obstetrician. Most of their appointments may be carried out in hospital There are other conditions, such as diabetes or epilepsy, which may require the care of two specialists: an expert in the medical condition as well as an obstetrician. A hospital midwife will usually participate in this care too.
What about independent midwives? Outside the NHS, there is also the option of independent midwives Independent midwives are midwives who have chosen to work in the private healthcare sector. They charge a fee to provide antenatal care, care during labour and the delivery, and postnatal care Because they only look after small numbers of women, independent midwives can provide a continuity of care that is not always available on the NHS and they will also tailor care to suit your individual needs, for example timing antenatal appointments when most convenient for you You can find out more details by visiting the wesbite of the Independent Midwives Association (see p.310)
Does my care change if I’m having a home birth? As well as hospital delivery in a birthing or delivery unit, there is also the option of having a home birth within the NHS framework (see p 153). When a pregnancy is straightforward, research hasn’t found any difference in the safety of having a baby at home or in
hospital If you are having a home birth, your antenatal care will be provided by community midwives who are attached to a maternity unit. Once in labour, your midwife will stay with you until your baby is born, and she will visit regularly for between 10 and 28 days after your baby has been born, or you can attend a postnatal drop-in centre in your local area.
How will I choose my antenatal care? This may be partly dictated by the type of care that is available in your area. It’s worth talking to other local mothers with young children to see if they have any advice or recommendations. The type of care you receive may also depend on where you choose to give birth. If you have a low-risk pregnancy and decide to have a homebirth or to deliver in a birthing unit, then you will probably just see midwives and your doctor in your own home or the doctor’s surgery If there are complications, your care may be shared between your midwives and doctor and a hospital obstetrician.
Blood tests
How these contribute to your antenatal care
You will be offered quite a few blood tests during pregnancy and the results provide vital information that may affect your pregnancy and help your caregivers to plan your care. At your hooking appointment, you will be offered blood tests to check for the following:
• Anaemia (low iron levels).
• Your blood group
• Your Rhesus status (see p 79).
• Hepatitis B.
• Your rubella (German measles) immunity.
• HIV and syphilis
These are usually taken at the same time, so you won’t need a separate test for each!

Taking Medicines in Pregnancy

What is safe to take?
The advice to pregnant women is to avoid taking any medicines in pregnancy if at all possible. If you do need to take medication, check with your midwife or doctor first, or ask your pharmacist for information on over-the-counter drugs. The list below offers some guidance
Antiemetics: For women with severe morning sickness, an antiemetic drug may be suggested Your doctor will recommend one that is safe to take in pregnancy
Antihistamines: Most of these should be avoided in pregnancy. If you have hay fever, try to avoid known triggers and allergens or talk to your doctor about safe medications in pregnancy
Painkillers: If natural remedies, such as a head massage to relieve a headache, or a warm bath to ease backache, don’t work, then paracetamol is generally considered safe for short-term use in pregnancy although it should be avoided if possible. Ibuprofen should be avoided altogether. as should aspirin (unless specifically prescribed by your doctor)
Antibiotics: There are antibiotics that are safe for use in pregnancy. Penicillin-based ones are usually prescribed, or if you are allergic to these there are other safe alternatives The following ones should be avoided in pregnancy!
* Tetracylines can affect the development of a baby’s bones and teeth and may cause discolouration of the teeth.
* Streptomycin can cause damage to the ears of the growing fetus and result in hearing loss and so should be avoided in pregnancy
* Sulphonamides: These cause jaundice in the baby and should not be given in pregnancy
Laxatives: If you are suffering with constipation, try natural dietary remedies first, such as eating lots of fibre and drinking plenty of fluids If these don’t work, then over-the-counter laxatives are
safe to take in pregnancy. Ones that contain bulking agents are the best.
Antacids: Heartburn is a common problem in late pregnancy due to the pressure of the baby on the stomach. Antacids are generally safe to take, but avoid sodium bicarbonate as the sodium is absorbed into the bloodstream.
Diuretics: These should be avoided If you experience sudden swelling in the face, hands, or feet, you should talk to your doctor or midwife, as this is one of the signs of pre-eclampsia (see p 89)
Cold and flu remedies: As these remedies often contain a variety of ingredients, which can include antihistamines and other decongestants that are best avoided in pregnancy it’s important to check the label carefully and talk to your doctor or pharmacist before taking any of these Try natural remedies, such as steam inhalations, before resorting to medicines, or simply take paracetamol for a short time.
Steroids: Anabolic steroids should not be used in pregnancy. It’s safe to use mild steroid creams short term for eczema, although avoid using these over a large surface area. Steroid asthma inhalers are safe, as are steroids prescribed for other conditions if your doctor knows you are pregnant.

Glossary
Abruption The detachment of part of the placenta from the wall of the uterus during late pregnancy, which may result in bleeding. Accelerated labour The artificial augmentation of contractions, after the cervix has started to dilate, by the injection of oxytocin through an intravenous drip Often used to speed up a long labour. Active birth An approach to childbirth that involves upright positions and movements during labour.
Active management of labour The constant monitoring and technical control of labour to monitor its duration
Alphafetoprotein (AFP) A substance produced by the embryonic yolk sac, and later by the fetal liver, which enters the mother’s bloodstream during pregnancy Alveoli Milk glands in the breasts, which produce a flow of milk when they are stimulated by prolactin and the baby’s sucking.
Amniocentesis The surgical extraction of a small amount of amniotic fluid through the pregnant woman’s abdomen. This procedure is usually carried out as a test for fetal abnormalities.
Amniotic fluid The fluid that surrounds the fetus in the uterus. Ultrasound scans may be done in late pregnancy to ensure that enough is present
Ammotomy The surgical rupture of the amniotic sac, often done to speed up labour This is referred to as ARM (artificial rupture of the membranes).
Anaemia A condition in which there is an abnormally low percentage of haemoglobin in the red blood cells, it is treated by iron supplements
Anaesthetic Medication that produces partial or complete insensibility to pain Anaesthetic, general Anaesthetic that affects the whole body, with temporary loss of consciousness.
Anaesthetic, local Anaesthetic that affects a limited part of the body
Analgesics Painkilling agents not inducing unconsciousness
Antenatal Before the birth
Anterior position See Occipital anterior Antibiotics Substances capable of
destroying or limiting the growth of micro-organisms, especially bacteria Antibodies Protein produced naturally
by the body to combat any foreign bodies, germs or bacteria
Anti-D An injection of antibodies given to women who have a Rhesus negative blood group if it is thought they may have been exposed to Rhesus positive fetal blood cells
Antihistamines Tranquillizers that are used in the treatment of nausea vomiting and certain allergies.
Apgar scale A general test of the baby’s wellbeing given shortly after the birth to assess the heart rate and tone respiration blood circulation, and nerve responses. Areola The pigmented circle of skin surrounding the nipple.
ARM See Ammotorny
Bile pigment See Bilirubin.
Bilirubin Broken-down haemoglobin, normally converted to nontoxic substances by the liver. Some newborn babies have levels of bilirubin too high for their livers to cope with See also Jaundice, neonatal. Birth canal See Vagina
Blastocyst An early stage of the developing egg when it has divided into a group of cells. Braxton Hicks contractions Practise contractions of the uterus that occur throughout pregnancy, but which may not be noticed until towards the end. Breast pump A device for drawing milk from the breasts.
Breech presentation When the position of the baby in the uterus is bottom down rather than head down
Caesarean section The delivery of the baby through an incision in the abdominal and uterine walls
Candida See Thrush,
Cardiotocograph (CTG) An electronic monitor that is used to measure the progress of the mother’s contractions and the baby’s heartbeat during labour.
Carpal tunnel syndrome Numbness and tingling of the hands arising from pressure on the nerves of the wrist In pregnancy it is caused by the body’s accumulation of fluids
Catheter A thin plastic tube that is inserted into the body through a natural channel to withdraw fluid from, or introduce fluid into, a particular part of the body This can be used to draw off urine from the bladder after an operation, or to maintain a constant input of fluids into a vein, or to introduce anaesthetic into the epidural space.
Cephalic presentation (Vertex presentation) The position of a baby who is head down in the uterus The most common presentation. Cephalopelvic disproportion A state in which the head of the fetus is larger than the cavity of the mother’s pelvis Delivery must therefore be by Caesarean section
Cervical dilatation See Dilatation.
Cervical incompetence A disorder of the cervix, usually arising after a previous mid-pregnancy termination or damage to the cervix during a previous labour, in which the cervix opens up too soon, resulting in repeated mid-pregnancy miscarriages. It is sometimes treated by suturing to hold the cervix closed. Cervix The lower entrance to the uterus, or neck of the womb
Chloasma Skin discolouration during pregnancy, often facial.
Chorion The outer membranous tissue that envelops the fetus and placenta
Chorionic gonadotrophin See Human chorionic gonadotrophin (HCG).
Chorionic villus sampling A method of screening for genetic handicap by analysis of tissue from the small protrusions on the outer membrane enveloping the embryo that later form the placenta.
Chromosomes Rod-like structures containing genes occurring in pairs within the nucleus of every cell. Human cells each contain 23 pairs. See also Gene
Cleft palate A congenital abnormality of the roof of the mouth
Club foot A congenital abnormality in which the foot is painlessly twisted out of shape. Colostrum A kind of milk, rich in proteins, formed and secreted by the breasts in late pregnancy and gradually changing to mature milk some days after delivery
Conception The fertilization of the ripened egg by the sperm and its implantation in the uterine wall.

Congenital abnormality An abnormality or deformity existing from birth, usually arising from a damaged gene, the adverse effect of certain drugs or the effect of some diseases during pregnancy
Contractions The regular tightening of the uterine muscles as they work to dilate the cervix in labour and press the baby down e birth canal
Cordocentesis A fine needle is passed trough the mother’s abdomen into the fetal –vein in the umbilical cord. The technique allows fetal blood to be tested, facilitates intra-urine blood transfusions, and enables drugs to be injected directly into the baby Corpus lutuem A glandular mass that forms n- the ovary after fertilization It produces progesterone. which helps to form the placenta, and is active for the first 14 weeks of pregnancy
Crowning The moment when the baby’s head appears in the vagina and does not slip back again.
CVS See Chorionic villus sampling.
D and C The surgical dilatation (opening) of the cervix, and curettage (removal of the contents) of the uterus
Dehydration A physical condition caused by the loss of an excessive amount of water from the body, often resulting from severe vomiting or diarrohea
Depression, respiratory Breathing difficulties in the newborn baby
Diabetes Failure of the system to metabolize glucose, traced by excess sugar in the blood and urine.
Diamorphine A narcotic opium derivative used as an analgesic.
Dilatation The progressive opening of the cervix caused by uterine contractions during labour.
Distress See Fetal distress
Dizygotic See Twins
Domino scheme A scheme operated by some hospitals in which community midwives provide antenatal care and are present at hospital for the delivery.
Doppler A method of using ultrasound vibrations to listen to the fetal heart
Doula A supportive woman helper who provides physical and emotional support during childbirth
Down’s syndrome A severe congenital abnormality caused by an incorrect number
of chromosomes that produces physical abnormalities and reduced intelligence. Drip See Intravenous drip.
Eclampsia The severe form of pre-eclampsia, which is characterized by extremely high blood pressure, headaches, visual distortion, flashes, convulsions and, in the worst cases. coma and death The condition is now rare since the symptoms of pre-eclampsia are treated immediately See also Pre-eclampsia.
Ectopic (Tubal pregnancy) A pregnancy that develops outside the uterus, usually in one of the Fallopian tubes. The mother has severe pain low down on one side in her
abdomen at any time from the 6th to 12th week of pregnancy. The pregnancy must be surgically terminated.
EDD The estimated date of delivery Electrode A small electrical conductor used obstetrically for monitoring the fetal heartbeat during labour.
Electronic fetal monitoring The continuous monitoring of the fetal heart by a transducer placed on the mother’s abdomen over the area of the fetal heart, or by an electrode inserted through the cervix and clipped to the baby’s scalp
Embryo The developing organism in pregnancy from about the 10th day after fertilization until about the 12th week of pregnancy, when it is termed a fetus Endometrium The inner lining of the uterus. Engaged (Eng/E) The baby is engaged when it has settled with its presenting part deep in the pelvic cavity. This often happens in the last month of pregnancy
Engorgement The over congestion of the breasts with milk. If long periods are left between feeds, or the baby is not well latched on painful engorgement can occur. This can be relieved by putting the baby to the breast or expressing the excess milk Entonox A mixture of 50 per cent oxygen and 50 per cent nitrous oxygen, breathed in through a mask during tabour, that gives pain relief as contractions peak
Epidural (Lumbar epidural block) Regional anaesthesia used during labour and for Caesarean sections, in which an anaesthetic is injected through a catheter into the epidural space in the lower spine. Episiotomy A surgical cut in the perineum to enlarge the entrance to the vagina.
External version (External cephalic
version, or ECV) The manipulation by gentle pressure of the fetus into the cephalic position This may be done by an obstetrician at the end of pregnancy if the baby is breech or transverse
Fallopian tube The tube into which a ripe egg (ovum) is wafted along after its expulsion from the ovary along which it travels on its way to the uterus
False labour Braxton Hicks (rehearsal) contractions, which are so strong and regular that they are mistaken for the contractions of the first stage of labour,
Fertilization The meeting of the sperm with the ovum or egg to form a new life See also
Conception.
Fetal distress A shortage in the flow of oxygen to the fetus, which can arise from numerous causes
Fetus The developing child in the uterus, from the end of the embryonic stage at about the 12th week of pregnancy until birth FH Fetal heart.
Fibroid A benign (non-cancerous) muscle growth in the uterus.
Forceps Metal tong-like instruments placed either side of the baby’s head during labour to help deliver the baby
Hormone A chemical messenger in
the blood that stimulates various organs to action.
Human chorionic gonadotrophin (HCC) A hormone released into the woman’s bloodstream by the developing placenta from about six days after the last period was due. Its presence in the urine means that she is pregnant
Hyperemesis gravidarum Almost continuous vomiting during pregnancy Hypertension (High blood pressure) During pregnancy this can reduce the fetal blood supply.
Hypnosis A state of mental passivity with a special susceptibility to suggestion. This can be used as an anaesthetic, and can be self-induced.
Hypotension Low blood pressure.
Identical twins See Twins
Implantation The embedding of the fertilized ovum or egg within the wall of the uterus
Induction The process of artificially starting off labour and keeping it going.

Insulin A hormone produced by the pancreas that regulates the level of carbohydrates and amino acids in the system. It may be used as a means of controlling the effects of diabetes.
See also Diabetes.
Internal monitoring See Electronic fetal monitoring
Intravenous drip The infusion of fluids directly into the bloodstream by means of a fine catheter introduced into a vein Intravenous injection An injection into a vein
Invasive techniques Any medical technique that intrudes into the body
In vitro fertilization (IVT) A type of assisted conception where fertilization occurs outside of the womb and fertilized embryos are tranferred back into the womb.
Jaundice, neonatal A common complaint in newborn babies which is caused by the inability of the liver to break down successfully an excess of red blood cells See also Bilirubin
Lanugo The fine soft body hair of the fetus Lateral position Transverse lie or horizontal position of a fetus in the uterus (sometimes occurring if the mother has a large pelvis), where the presenting part is either a shoulder or the side of the head
Let-down reflex The flow of breast milk into the nipple.
Lie The position of the fetus within the uterus Linea nigra A line of dark skin that appears down the centre of the abdomen over the rectus muscle in some women during pregnancy
Lochia Postnatal vaginal discharge Longitudinal lie The position of the fetus in the uterus in which the spines of the fetus and the mother are parallel
Low-birthweight baby A baby who weighs below 2,5 kg (57 lb) at birth.
Meconium The first contents of the bowel, present in the fetus before birth and passed during the first few days after birth The presence of meconium in the amniotic fluid before delivery is usually taken as a sign of fetal distress
Miscarriage The spontaneous loss of a baby before 24 weeks of pregnancy
Monitoring See Electronic fetal monitoring Monozygotic See Twins.
Morula A stage in the growth of the fertilized
egg when it has developed into 32 cells. Moulding The shaping of the bones of the baby’s skull, which overlap to allow the baby to pass through the birth canal.
Mucus A sticky secretion.
Multigravida A woman in her second or subsequent pregnancy
Multiple pregnancy The development of two or more babies, See also Twins Mutation A damaged genetic cell. This can occur naturally or more commonly as an effect of outside agents, such as radiation. Neural tube defects Abnormalities of the central nervous system See also
Anencephaly, Hydrocephalus Spina bifida. Nicotine A highly poisonous substance that is present in tobacco During pregnancy this can enter the bloodstream of a woman who smokes and may affect the efficiency of the placenta, which often results in a lowbirthweight baby
Nucleus The central part or core of a cell, containing genetic information.
Occipital anterior The position of the baby in the uterus when the back of its head (the crown or occiput) is towards the mother’s front (anterior)
Occipital posterior The position of the baby in the uterus when the back of its head (the crown or occiput) is towards the mother’s back (posterior)
Oedema Fluid retention, which causes the body tissues to be puffed out.
Oestriol A form of oestrogen.
Oestrogen A hormone produced by the ovary
Opioids (Narcotics) Painkilling drugs that induce drowsiness and stupor,
Ovary One of the two female glands, set at the entrance of the Fallopian tubes, which regularly produce eggs until the menopause Ovulation The production of a ripe ovum or egg by the ovary
Oxytocin A hormone secreted by the pituitary gland that stimulates uterine contractions during labour and stimulates milk glands in the breasts to produce milk Palpation Feeling the parts of the baby through the mother’s abdominal wall. Pelvic floor The springy muscular
structure set within the pelvis that
supports the bladder and the uterus, and through which the baby descends during tabour,
Pelvis The pelvis is a solid ring of bone at the base of the abdomen: it shields the bladder and portions of the genital tract. Perinatal The period from the 24th week of gestation to one week following delivery Perineum The area of soft tissues surrounding the vagina and between the vagina and the rectum.
Pethidine See Analgesics
Phototherapy Treatment by exposure
to light, which may he used when a baby has jaundice
Pituitary gland A gland set just below the brain that among other functions, secretes various hormones controlling the menstrual cycle. In late pregnancy it releases a hormone, oxytocin, into the bloodstream, which stimulates uterine contractions and also the milk glands.
Placenta The organ that develops on the inner wall of the uterus and supplies the fetus with all its life-supporting requirements and carries waste products to the mother’s system.
Placental insufficiency A condition in which the placenta provides inadequate life support for the fetus, often after 40 weeks, resulting in a baby at special risk.
Placenta praevia A condition in
which the placenta lies over the cervix at the end of pregnancy. This part of the uterus stretches in the last few weeks of pregnancy, but the placenta cannot stretch, so it may separate, the result is bleeding during late pregnancy, A woman with a complete placenta praevia is delivered by Caesarean section
Posterior See Occipito posterior
Postnatal After the birth.
Postpartum After delivery.
Post-traumatic stress disorder Panic and anxiety experienced by some women after traumatic and disempowering childbirth Pre-eclampsia (Pre-eclamptic toxaemia or PET) An illness in which a woman has high blood pressure, oedema, protein in the urine, and often sudden excessive weight gain See also Eclampsia.
Premature A baby born before the 37th week of pregnancy and weighing less than 2.5 Ing (5 lb)
Presentation The position of the fetus in the uterus before and during labour,

lying directly over the cervix
Preterm See Premature
Primigravida A woman having her first pregnancy.
Progesterone A hormone produced by the corpus luteum and then by the placenta Progestogen A synthetic variety of the hormone progesterone used in oral contraceptives.
Prolactin A hormone that stimulates milk production for breastfeeding Prostaglandins Natural substances that stimulate the onset of labour contractions. Prostaglandin gel may be used to soften the cervix and induce labour
Proteinuria The presence of protein in the urine, which may be a sign of pre-eclampsia. See also Pre-eclampsia
PTSD See Post-traumatic stress disorder Pubis The bones forming the front of the lower pelvis.
Quickening The first noticeable movements of the fetus felt by the mother.
Respiratory depression See Depression, respiratory.
Rhesus factor A distinguishing characteristic of the red blood corpuscles. All human beings have either Rhesus positive or Rhesus negative blood If the mother is Rhesus negative and the fetus Rhesus positive, severe complications and Rhesus disease (the destruction of the red corpuscles by antibodies) may occur, unless prevented by anti-D gamma globulin.
Rooting The baby’s instinctive searching for the breast
Rubella (German measles) A mild virus that may cause congenital abnormalities in the fetus if it is contracted by a woman during the first 12 weeks of pregnancy
Scan (Screen) A way of building up a picture of an object by bouncing high-frequency soundwaves off it. The sonar or ultrasound scan is used during pregnancy to show the development of the fetus in the uterus. See also Transducer.
Show A vaginal discharge of bloodstained mucus occurring before labour, resulting from the onset of cervical dilatation. A sign that labour is starting
Small-for-dates Babies who are born at the right time but who for a range of reasons have not flourished in the uterus. See also
Placental insufficiency
Sperm (Spermatozoon) The male reproductive cell that fertilizes the female ovum or egg.
Spina bifida A congenital neural tube defect in which the fetal spinal cord forms incorrectly, outside the spinal column Spinal anaesthesia An injection of local anaesthetic around the spinal cord.
Steroids Drugs used in the treatment of skin disorders, asthma, hay fever, rheumatism, and arthritis. Because they alter the chemical balance of the metabolism they may very rarely cause fetal abnormalities if used extensively during pregnancy
Stillbirth The delivery of a dead baby after the 24th week of pregnancy
Streptomycin A broad-spectrum antibiotic that should not be taken in pregnancy See also Antibiotics
Stretch marks Silvery lines that sometimes appear on the skin after it has been stretched during pregnancy
Supplementary feeding Additional bottles given to a breastfed baby.
Surfactant A creamy fluid that reduces the surface tension of the lungs so that they do not stick together when deflated. Preterm babies may have breathing difficulties if surfactant has not developed sufficiently Suture The stitching together of a tear or a surgical incision.
Syntocinon A synthetic form of
oxytocin, which is used to induce or accelerate labour.
TENS machine See Transcutaneous electronic nerve stimulation
Term The end of pregnancy this is measured at 38-42 weeks from the first day of the last menstrual period. Tetracycline A wide-spectrum class of antibiotic that should be avoided during pregnancy. because it can affect the development of the fetal teeth and hones See also Antibiotics.
Thrombosis A blood clot in the heart or blood vessels.
Thrush A yeast infection that can form in the mucous membranes of the month, genitals, or nipples.
Toxoplasmosis, congenital A parasitic disease that is spread by cat faeces. If it crosses the placenta during pregnancy, it can cause eye or central nervous system damage in the baby
Transcutaneous electronic nerve stimulation A method of pain relief that uses electrical impulses to block pain messages to the brain.
Transducer An instrument that translates echoes of very high-frequency soundwaves bounced off the developing fetus in the uterus to build up an ultrasound image on a monitor. See also Scan.
Transition A phase between the first and second stages of labour when the cervix is dilating to between 7 and 10 cm
Trial of labour A situation in which, although a Caesarean section may be necessary, the mother labours in order to see if a vaginal delivery is possible
Twins The simultaneous development of two babies in the uterus, either after two eggs are fertilized independently by two sperm - dizygotic or fraternal twins - or, more rarely, after one fertilized egg divides to produce monozygotic or identical twins.
Ultrasound See Scan, Transducer.
Umbilical cord The cord connecting the fetus to the placenta
Uterus (Womb) The hollow muscular organ in which the fertilized egg becomes embedded, where it develops into the embryo and then the fetus
Vacuum extractor An instrument, used as an alternative to forceps which adheres to the baby’s scalp by suction and with the help of the mother’s bearing down, can be used to guide the baby out of the vagina
Vagina The canal between the uterus and the external genitals It receives the penis during intercourse and is the passage through which the baby is delivered
VE Vaginal examination.
Vernix A creamy substance that often covers the fetus in the uterus
Vertex presentation (VX) See Cephalic presentation.
Vulva The external part of the female reproductive organs, that includes the labia and the clitoris
Water birth Birth of a baby under water.