New mums in the UK are not presented with a bill when they leave the hospital, and they leave armed with lots of information too (info on contraception, safe sleeping etc, see below). Each baby is given an National Hospital Services (NHS) number and some hospitals have registrars on site where the baby’s birth can be registered for a birth certificate.
Advice is given on contraception, safe sleeping and post natal exercise. This advice is given from the midwife, the GP (at the six week postnatal check), physiotherapists and health visitors. Breastfeeding support is given at the hospital and many midwives prefer to discharge only when mother and baby are feeding well. Additional support can be sought from health visitors and the NHS itself ( see http://www.nhs.uk/conditions/pregnancy-and-baby/pages/breastfeeding-help-support.aspx), with advice and drop in sessions available in most areas, in addition to trained supporters who can be reached over the telephone. Once discharged, a community midwife will visit the family home the next day to talk to the mum and to check that all is well with the baby. After around ten days, the midwife will discharge mother and baby and the health visitors will take over the care, up until the age of five.
After all of this, I feel incredibly lucky to live in the UK and to have had my children here. My maternity experiences have not been perfect but the care that I have received has been mostly on par with any private hospital. Thanks to the NHS it has not cost me a penny to become the mother of three wonderful children. I have felt supported and cared for during my pregnancies and I firmly believe that our health care system will weather its current storm.
Once a woman is in labour, she is entitled to the very best of maternity care and in most cases, the National Health Services (NHS) provides this HOW?.
Unfortunately, there is a real shortage of midwives in the NHS in England at the moment and so sometimes labour and delivery wards can be very over stretched. This is one more reason why it is essential for pregnant women to know their rights.
Pain relief should be administered ONLY by request and once a woman is in established labour. Medical staff must give mothers ALL details of the RECOMMENDED pain relief should be it be necessary. Pain relief should not be given without consent. If a woman is unable to give consent at the time of an emergency, consent will sought from her next of kin. If a woman is given medication without medical consent, this is a breach of NICE guidelines and the woman has full rights to file a formal complaint which may bring a series of consequences against the medical staff and hospital.
In the UK, an organisation called the National Institute for Clinical Excellence (NICE) exists to provide guidance to medical professionals working in the NHS. Advice is given as to best practise for all areas of maternity healthcare and patients are encouraged to read and understand this if they have any concerns or issues. Currently, guidance exists for:
There is extensive advice for women who go over their due date or who need to be induced for other medical reasons. The guidelines state that “Treatment and care should take into account women's individual needs and preferences. Women who are having or being offered induction of labour should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals” (http://publications.nice.org.uk/induction-of-labour-cg70/woman-centred-care). Detailed information can be found on the site, including advice about when to induce labour and how to manage an induction.
The NICE guidelines advise that women should be entitled to choose their place of birth based on informed decisions. Women should also be advised of procedures that are in place should a hospital transfer be necessary. They should also be advised of the reasons why a hospital transfer might be best for a safe delivery. NICE acknowledges that women who give birth at home are more likely to have a normal birth but that they should be advised of the importance of a hospital environment if the pregnancy is deemed high risk. Ultimately, women should be free to make their own decisions about home births.
Vaginal Birth After Caesarean (VBAC)
NICE advises that good communication between women and their healthcare providers is essential so women wishing to have a vaginal delivery after a section, must meet with their obstetricians to discuss their birthing plans. Women must be informed that the “risk of fever, bladder injuries and surgical injuries does not vary with planned mode of birth and that the risk of uterine rupture, although higher for planned vaginal birth, is rare.” (http://publications.nice.org.uk/caesarean-section-cg132/key-priorities-for-implementation).
Women should be given evidence based information and all cases should be assessed individually. The risks of each type of birth should be presented and women should feel able to make an informed decision without pressure from her medical providers. Women should also be aware of the possible risks to the baby in each case. In some cases, NICE advises that “Consent for CS should be requested after providing pregnant women with evidence-based information and in a manner that respects the woman's dignity, privacy, views and culture, while taking into consideration the clinical situation.”. However, women are within their rights to refuse this and to opt for a vaginal delivery instead.
NICE also provide guidance and advice to medical professionals regarding the success rate of VBACs. It states that “continuous support during labour from women with or without prior training reduces the likelihood of CS” and that. “Women with an uncomplicated pregnancy should be offered induction of labour beyond 41 weeks because this reduces the risk of perinatal mortality and the likelihood of CS”. In addition, the guidelines also note that “Electronic fetal monitoring is associated with an increased likelihood of CS”, which indicates that women opting for a VBAC may request little or no monitoring whilst in labour. However, hospital policies tend to state that monitoring is necessary after a previous section; again, patients are within their rights to refuse. The following interventions are deemed to be of no affect to the likelihood of a c-section: walking in labour; adopting a variety of positions as opposed to lying on a bed; being in water; having an epidural and administering raspberry leaves.
Overall, the NICE guidelines provide women with lots of information as to the risks and benefits of both a vaginal delivery and a repeat c-section.
Pain Relief and Medication
NICE provides ample information and advice about pain relief in labour (http://publications.nice.org.uk/intrapartum-care-cg55/guidance#coping-with-pain-in-labour-non-epidural) and women are advised to discuss all options thoroughly with their midwife before the onset of labour. The guidelines advise of different strategies that have been found to be effective, such as breathing and relaxation; massage and labouring in water. In addition women should be advised that administration of Pethidine, diamorphine and other opoids will have an effect on the baby. Pain relief should not be denied if women have been given all the options and have made an informed decision. If requesting an epidural, women should be informed of all the risks and this should always be administered by an anaesthetist. NICE also advise that Oxytocin, the drug which is used to speed up labour, should not be given as a matter of course for women who have been given an epidural.
Elective Caesarean Sections
Recently, changes have been made to the documentation surrounding elective c-sections. This means that pregnant women are now being given more freedom to choose the way in which they give birth. Previously, a c-section would only be offered to women whose baby was breech or who had a life threatening (to herself or the baby) condition which prevented a vaginal birth. With the new NICE guidelines, women with emotional issues, such as arising from a previous traumatic birth, are now within their rights to request an elective c-section. However, all women are entitled to request an elective section and to have her request considered appropriately, whether or not she has suffered from a traumatic birth previously. The new guidelines also state that any obstetrician who is unwilling to agree to an elective section must refer the patient to a colleague who is. Obstetricians are required to take all concerns seriously and to respect a woman’s wishes in these cases. Counselling should also be offered in an attempt to empower women to feel able to give birth vaginally. (http://publications.nice.org.uk/caesarean-section-cg132)
The NICE Guidelines Are Just That- Guidelines
Some medical professionals may choose not to follow them, although this would be rare. The NICE guidelines are composed with the help from medical professionals in a bid to ensure good quality healthcare is provided to all patients. In cases where obstetricians or other medical practitioners do not adhere to the guidelines, patients may make an official complaint to their hospital. This means their case will be looked at and a full investigation will be launched.
Once a pregnant woman has been assigned to a General Practition (GP), midwife and obstetrician and has booked in with her hospital, she is entitled to regular antenatal checks. There are choices as to the type of antenatal care a woman wishes to receive and where to give birth too: women are entitled to give birth at home if they wish, even if they have previously had a c-section; women are entitled to give birth in a hospital, taking with them a birth plan to advise of her wishes regarding pain relief etc; women are entitled to share their care between a midwife and a GP. Ultimately, women are given the freedom of choice when it comes to having their baby. All women are entitled to pay time off work to attend antenatal appointments.
For those women who do seek the full antenatal care routinely offered by the National Health Services (NHS), the following should be offered:
A booking in appointment with a GP or midwife to take a full medical history; previous pregnancies and births will also be discussed.
A series of routine physical examinations: weight and height to assess physical fitness; regular growth assessment of the baby; regular blood pressure checks; examination of the baby’s position and regular checks of the baby’s heart beat.
Routine urine tests: these are for early detection of protein (an indication of pre-eclampsia); glucose (indication of diabetes) and bacteria (indication of a urinary infection).
Routine blood tests: these are to determine the blood group; to check for anaemia; to check Rubella status; to check for haemoglobin disorders and to check for infections.
Routine ultrasound scans: two are normally offered - a dating scan at 12 weeks and an anomaly scan at 20 weeks. Earlier scans can be given if there are concerns or if there is a history of miscarriage. Later on, growth scans may be offered if there are concerns about the development of the baby.
Screening for Down’s Syndrome: there is more than one test that may be offered: a combined screening involves a blood test taken at the same time as the dating scan and a nuchal translucency scan between 11 weeks, 2 days and 14 weeks, 1 day of pregnancy; a serum screening is a blood test which takes place between 14 weeks, 2 days and 20 weeks of pregnancy. Every woman has the right to refuse these tests.
Diagnostic tests for Down’s Syndrome: should the screening test results return with a high risk, all women will be offered an amniocentesis or a Chronic Villus Sampling. Again, women are entitled to refuse either of these procedures.
All women are perfectly within their rights to refuse all tests and screening and these wishes need to be respected by all medical staff involved.
If a patient misses one of the diagnostic tests, she may not be able to re-book due to the delicate timings that are so important for obtaining accurate results. If a women has not been offered the tests or if she has been persuaded to refuse them, there are steps that can be taken. Likewise, not all hospitals offer the same tests. Women are able to book private tests which may give more comprehensive results due to the fact that private clinics also check for other chromosome abnormalities, Edwards’ Syndrome and Patau’s Syndrome. The Patient Liason Service (PALS) exists to assist patients if they wish to make complaints or if they have concerns about their healthcare provision. Their site has lots of information: http://www.pals.nhs.uk .
At any time during her pregnancy, a woman is able to call her midwife 24h hours a day, to receive advice and support. Women can also call the out of hours GP service to speak to a GP, although this will be whichever doctor is on duty at that time. Alternatively, she can contact NHS Direct, either by their website (http://www.nhsdirect.nhs.uk/default.aspx) or by calling. In addition, all women are provided with the number for both the early pregnancy unit and maternity triage at the hospital where they plan to give birth. There are schemes in place to help women to give up smoking, or to control alcohol consumption. There are schemes to help women learn about healthy eating and there are hospital run parent-craft classes which are excellent for first time mothers. These schemes are optional and may not always be offered as matter of course; women are entitled to ask for any additional support they feel is necessary.
This is all before the baby is born and this is all completely free to all women resident in the UK. There are private maternity hospitals where additional scans (such as 4-D) can be performed but these services must be paid for.
In addition to the antenatal care, pregnant women are also entitled to free prescriptions and free dental care with the issue of an NHS Maternity Exemption card. This card lasts until the baby’s first birthday. These cards are issued after a form is filled in, which will be given to the patient by their GP.
In the UK, we have the National Health Service (NHS), which was set up just after the end of the Second World War in a bid to bring good quality healthcare to all. A lot has changed since 1948 but the principles remain. This is our NHS. All UK citizens receive their National Insurance card once they reach the age of sixteen and as soon as they are employed, they pay into the system. This means that all UK residents are entitled to receive the same level of care, no matter how much money they have. I am only too well aware of how important the NHS is and I am extremely grateful to be living in a country where we are all entitled to medical attention, despite our bank balances. This doesn’t mean that the NHS always works the way it should, though.
There is a lot of debate at the moment about the new British government’s plans for the NHS. It has to be said that changes do need to be made, but not everybody agrees with the plans that have been proposed so far. But the fact that we get to voice our opinions is one of the great things about the NHS. It belongs to us all.
Maternity care in the UK has also been in the news in recent years, with some hospitals across England failing to provide adequate care for women. It is evident that care differs greatly from one hospital to another, and even from one patient to another. Despite the best intentions of Aneurin Bevan, the Health Secretary who opened the first NHS hospital in Manchester, not every patient in the UK receives the best care available. This is why it is so important for pregnant women and new mothers to know their patient rights.
There is plenty of readily available information regarding maternity care and patient’s rights according to the NHS and many social groups are already well informed. However, it tends to be those women from vulnerable social groups who don’t know, or who feel unable to pursue, their patient rights. It’s a sad fact that some women are let down by the NHS when they have their baby and private hospitals are reporting a rise in patients booking with them instead. See many of the resources listed below for reading resources. For women wishing to do so, a good place to start when looking for private healthcare is the Private Healthcare UK site (http://www.privatehealth.co.uk/private-healthcare-services/private-maternity-services/). A full list of all options available in the UK can be explored, giving women extra choices when it comes to having her baby.
Finding Out About Patient's Rights When Pregnant
So what are the rights of a pregnant woman in the UK? Firstly, she is able to choose her own hospital and antenatal clinic. Recent legislation has been changed to make this possible, but not all General Practitioners (G.Ps) let women know. When a referral is made to the midwife, women are entitled to choose from any hospital in the country. Secondly, all pregnant women are entitled to access to a midwife or midwifery team. This midwife may be based at the hospital, at the GP’s surgery or in a health clinic/ children’s centre. If they don’t have one already, all pregnant women are also entitled to a GP, who may or may not provide antenatal care and delivery. Pregnant women are also entitled to an obstetrician based at the hospital of their choice. They may not need to meet with this obstetrician but they can request this.
All women are entitled to receive care from all three medical professionals throughout their pregnancies, although many will not actually need to meet with their obstetrician unless there is a specific problem. The midwife, GP and obstetrician will be assigned based on where the patient lives but if, for whatever reason, she wishes to change these providers, she is perfectly within her rights to do this. The easiest way to do this is to speak to the senior midwife at the hospital. There is a wealth of information on these basic patient rights on the Citizen’s Advice Bureau’s website, in their NHS Patients Rights section (http://www.adviceguide.org.uk/nireland/healthcare_ni/healthcare_nhs_healthcare_e/nhs_patients_rights.htm#Maternityservices).
Move over Tiger Mothers. In some families, a revolution is taking place as more and more dads are taking a more active role in parenting. Hands on dads certainly aren’t new- it’s the emerging breed of pushy dads that is catching the eye of teachers, psychologists and other child development experts.
No longer content to leave the after school activities to mum, some dads today are more involved than their own fathers ever were, keen to make sure that their child achieves as much as possible in their childhoods. Some of these dads will stop at nothing to push their kids to dizzying heights. But what effect does this type of pro-active parenting have on children? The experts are divided and research has provided some interesting results.
According to the National Child Development Study, which followed 17,000 people born in one week in the UK, education has always been a little one sided in many families. In the 1960s, it was found that half of mothers read to their children every day, compared with just one third of fathers. The same study also found that more than 8 in 10 mums took their children on outings every week, while only two thirds of dads reported doing this. Interestingly, the report also found that first born children are able to read better than their siblings, suggesting perhaps that parents invest a little more time and effort into the whole process when there is just one child to focus on.
So while parents have always had an interest in their child’s education and development just when did ‘Tiger Mothers’ and pushy dads begin to emerge? In his 2009 Independent Review of the Primary Curriculum (IRPC), Jim Rose found the majority of parents agreed that personal development was an important part of education and that they were better placed to teach it, rather than schools. The report also recognises the need for schools to understand a parent’s “increased expectations” (IRPC).
Lucy Quick is the Principal of Perform, prestigious performing arts school for children aged from three months to twelve years. She says that she often has to remind parents that “development happens at different ages for different children.” Lucy has seen many pushy parents throughout her time at Perform and says that dads seem to be emerging from the shadows as they begin to share in the traditional ‘mum duties’ of dropping off and picking up children. But how do pushy dads differ from pushy mums?
“Dads aren’t normally confrontational face to face, whereas mums will grab you at the class and discuss their child in front of other parents. Dads prefer to ring up later and can be quite direct in what they want for their child and why they believe their child is the best,” says Lucy.
She also speaks of an incident involving a three year old student whose father insisted upon daily one to one tuition to bring up progress and attainment to a level he felt was acceptable. “He said all of this in front of his child, which I feel is ill-advised and counter-productive.”
Perhaps fathers such as this are a one-off, but the fact remains that there are more and more dads who strive to ensure that their child achieves as much as possible throughout their childhoods. Dr Amanda Gummer is a leading authority on child development and has over twenty years’ experience in working with families and children. She agrees that a father’s interaction with his children differs from a mother’s.
“Generally fathers tend to be more focussed on results and less concerned with the process. Recognising issues from their own childhood can affect a father’s parenting in one of two ways. For example, fathers who were a bit lazy/naughty/high-spirited etc remember this and they tend to either clamp down on the children to ensure that they 'knuckle down' and don't make 'the same mistakes I did' or go in the opposite direction and take the 'I turned out ok' approach and are therefore very laid back with their children. Fathers tend to be less inclined to be sympathetic to excuses for failure at a task, whereas mothers may over-emphasise an excuse.”
Richard Gipson, 61, raised five daughters with his wife and believes that his method of parenting stems from his desires to ensure that his kids achieved more than he did. “I was pushy because I wanted to do the best for my kids, to make sure they all did well at school and got to university so that they could get decent jobs,” he says. “I pushed them to get part time jobs to realise the value of money and to know what it took to earn it. I brought them up, instilling good manners and values so that I could be proud of them when socializing with others and preparing for life in society. Like many parents I wanted them to take opportunities offered and aspire to better things, going as far in education as possible while given the chance.”
Dr Gummer believes that encouraging children to persevere when they find situations tough can be an effective way to raise kids. She acknowledges that “the term 'pushy' parent is usually associated with a style of parenting that is overly competitive and can be very damaging for a child's self esteem.” Richard does not believe that he was a ‘pushy dad’ and insists that his method of parenting was successful.
Dr Gummer believes that praising children is the best way to motivate children and Vivien Sabel, a mother and relational psychotherapist, agrees.
“Pushy parenting can be detrimental to children. A pressurised child can experience and embody many negatives self beliefs. Children may be left feeling insecure, not good enough, overwhelmed, anxious, resentful and even depressed! Encouraging your child and empowering them to make positive choices for themselves is a positive parenting tool. Push, and I believe you will all suffer as a result”
This is a view echoed by Trudi Butler, parenting consultant at Greatvine.com. Butler does, however, concede that a dad’s method of parenting may well have certain benefits that mums should consider adopting. “The male perspective of being clear and straight forward with the consequences of their child’s action or inaction, is one we mums could do well to adopt. Motivation is about encouraging effort so that has to be the focus for getting our kids to work hard on difficult tasks,” she says.
It seems the experts are in agreement that encouragement and praise is essential when raising kids. But where do parents draw the line between positive encouragement and downright pushiness? And how do parents decide which method of parenting is most appropriate for certain situations? Every child is different and every child responds differently to contrasting methods of parenting. All the tiger dads can hope is that their judgement serves their children well and that they grow to be confident, self-assured adults- ready to parent their own children one day.
I'm feeling pretty good today- I finally get to write my positive birth story! After two emergency c-sections, Isobel's birth story is so important to me.
My son was born in December 2009 via emergency section while I was out cold. I'd laboured for hours and when I came round, I was in pain and so upset that the same thing had happened again (Read his story here). My daughter had been born in 2004 via emergency section too and it seemed so cruel to have to go through it all again, only much worse. (Read her story here.)
I am lucky in that I was able to seek support following my son's birth and when I fell pregnant in June 2010, I made sure to put a survival plan into action. I changed hospitals and I saw a different community midwife. I also exercised my right to request an elective c-section on psychological grounds. Having had two previous sections also helped my case, but ultimately my consultant was keen to eliminate stress and anxiety for me- something which I will always be grateful for.
My elective section was booked for the 15th February 2012. On the 13th I went to the hospital for a pre-op appointment and left with some medication and a hopeful heart. This was really going to happen! I didn't sleep much the night before and my husband and I arrived at the hospital early. We were excited and nervous!
I met with the anaesthetist and the surgeon and talked about what was going to happen. I discussed my previous experiences and all were aware of my medical history. I was told to expect to have my baby by lunchtime. We were shown to the ward and left to settle in.
Less than five minutes later, the midwife was back with an announcement. We had been bumped to the top of the list and the team were in theatre waiting for us! There was no time to fret or even to text my mum! We were off.
This was the point at which my heart started to boom in my chest. My legs wobbled and my mouth went dry. The fear I felt as I walked into the operating theatre was immense. I had never walked into a theatre before; I'd never had the luxury of time to really take in my surroundings. Those places are intimidating- the huge lights, the machines, the beeping. I started to feel so overwhelmed.
And then I saw my name on the board infront of me. Beside my name someone had drawn a love heart. It was a simple left over from Valentine's day but it made me smile.
I wished I'd had time to put a hand over my bump and whisper to it one last time. As I laid on the operating table, waiting for the knife to descend, I wished I'd been able to do this a different way. I'd never wanted any of my babies this way, but some things just cannot be controlled. As we waited for my body to turn numb, I wished...
My husband arrived by my side and the surgeon began. He talked to me throughout the surgery, mentioning that my internal scars had healed very well and explaining each step of the procedure. The room was quite full as we had chosen a teaching hospital, plus I had agreed to take part in some research so there were extra people present for that too. It was strange, being at the centre of it all... but it wasn't all about me for long.
At 9.25 am Isobel Marcia was brought into the world with an almighty cry. The relief was enormous; we cried together. She was brought straight to me before they whisked her away to weigh her and wrap her in a towel. 2.720kg. 5lb 15. Perfect.
Back on the ward, I was unable to believe it could be that easy. Where was the drama? Where was the panic, the fear and the tears? It was so strange, but in such a good way.
I've been a mother for seven and a half years and finally I know what it is like to be at peace with it all. Finally I know what a calm, peaceful birth is like. Finally, I can look at my daughter and have no regrets- no 'what if's' or 'I should've's'.
My family is now complete. I have three beautiful, happy, healthy children and I am the luckiest person alive.
This week, I attended a consultant appointment at my hospital, in preparation for my impending elective c-section. Despite the lengthy journey and even lengthier waiting time, I'm really glad that we had this appointment. It was an important opportunity for me to speak to my consultant before the surgery and to ease my worries a little.
My consultant checked my blood pressure (all fine) and listened to the baby's heart-beat- this was lovely as my son was absolutely delighted to hear the baby inside mummy's tummy! My consultant also confirmed that the baby is now head down, rather than in the breech position as has been the case for the last few appointments. This would explain the pressure I've been feeling low down!
Before the appointment, I wrote a few questions down so that I wouldn't forget to ask them at the hospital:
1. Will the surgeon cut along one of the two existing c-section scars or make a new one?
I've been told that the surgeon will try his best to keep as close to one of the scars as possible but they are not able to guarantee a third scar will not be made. On the other hand, there is a chance that they will 'tidy up' the scar area and leave me with just one scar. It will all depend on the surgeon who performs the operation and other factors that cannot be foreseen.
2. Are there increased risks for me, with this being my third section?
I have added risks with existing scar tissue which could result in excessive blood loss and the need for a transfusion. There could also be damage to my bowel, bladder and womb. The risks are small but they are there and I was required to sign a consent form to agree that I have been told and that I understand the risks.
3. Will I be awake during the surgery?
Yes, yes, yes! General Anaesthetic is, thankfully, only used in extreme cases. I do not want to miss the birth of this baby, as was the case with my son.
4. Will I be given pain relief on discharge if I am breastfeeding?
I explained that the hospital where my son was delivered refused to send me home with pain relief because I was breastfeeding. The agony I experienced contributed to the distress I was already suffering due to the nature of his delivery and I was not willing to go through the same again. My consultant confirmed that I would be given pain relief and to ask for him personally if it is refused!
5. Can I request a 'natural c-section' if circumstances allow it?
I have recently been told about the possibility of a natural c-section and it seems to be the closest to a vaginal delivery that I will ever experience. The idea is to allow the surgeon to make the necessary incisions and remove the baby's head before the screen is lowered. My husband and I can then watch the rest of the baby being born, discover the gender and have immediate skin to skin contact. I have never had skin to skin straight away and am hoping that the elective section will allow for this. I would also like delayed cord clamping for this reason.
Unfortunately, as my consultant will not be performing the surgery he was unable to answer this question. I am to return to the hospital in just over a week for the final pre-op clinic and perhaps I will find out who will be delivering my baby then.
During the appointment, I was require to give swabs for MRSA testing and will receive the results at the pre-op clinic. I found this a little uncomfortable as one of the swabs was taken from the perineum but I knew that it was important. The baby once more measured slightly small for dates, but as both my son and daughter also measured small and we have already had a growth scan which confirmed all is well, we were not concerned. All in all, we are fit and healthy!
All that is left now is to finish the decorating, find a double buggy and set up the new bed. There are now only 12 days left until we meet the baby- how exciting!
At 37 weeks, your pregnancy is officially classed as full term- well done! There could, however, still be up to five more weeks to go, so it's important to continue sticking to a healthy diet and to get plenty of rest. Your baby is still busy in there!
Your Baby's Growth:
This week, your baby weighs around 2.8kg and measures up to 48.6cm in length. It's most likely that your baby's head is now firmly positioned in the pelvis, ready for delivery. This position is also optimum for the essential leg and buttock growth that is now taking place.
Your baby is likely to have a full head of hair by now and general growth is beginning to slow down. Now, your baby is beginning to practise for 'life on the outside' with new techniques such as breathing, sucking and sleeping being perfected.
When you see your care provider this week, they may do an internal exam to see how you are progressing as labour can begin anytime now. This exam is not comfortable but your practitioner will check three things: dilation (how open your cervix is), ripeness (how soft your cervix is) and effacement (how thin your cervix is). For baby to come on out, the cervix must be open to 10 centimeters, as soft as the skin on the inside of your mouth and 100 percent effaced.
After the exam, you may have a brownish spotting which is normal but if you notice any bright red discharge or consistent spotting, call your care provider immediately. Also, as you get closer to giving birth, you may find an increase in gooey discharge in the last few weeks.
You may find that you are feeling more tired this week- and it's no surprise considering the extra weight and low position of the baby! Make the most of your free time- get plenty of gentle exercise (walking or swimming) but make sure you get lots of rest too. You may also experience Braxton Hicks contractions. These are the body's natural way of preparing for the real thing and should not be too painful. Try taking a warm bath to ease any discomfort. If you're concerned about whether or not they are the real thing, Braxton Hicks tend to ease away in warm water.
Now is also the time when you may be going through a cleaning mode as you are preparing for the baby by nesting. You may find the urge to clean the house, organize closets and prepare last minute details before your baby comes. These are all natural but be weary of tiring yourself out too much.
From the Eyes of a TBS Mama...
This week, I am feeling very tired, which doesn't help when the toddler decides to get up extra early! I'm feeling the strain of lifting and carrying him in my back now so am I trying to limit the number of times I give in! My bump definitely feels a lot lower this week and a visit with my consultant has confirmed that the baby is finally head down- so this explains a lot!
Emotionally, I am beginning to worry about small things, such as will I find a suitable double buggy and will my co-sleeping cot be delivered in time? I'm also trying to prepare the toddler for the new baby as much as I can but I think it will still be a bit of a shock for him. My husband and I are taking about the baby a lot and he got to hear the heartbeat at the hospital this week, which is good.
In the meantime, I will leave you with a line from one of my favourite songs by Bob Dylan. This is something that I have been thinking about a lot lately, for both my children and the precious baby I am soon to meet!
At 36 weeks, your baby is continuing to gain weight at a rate of around 28g a day. Your baby can weigh almost 2.7kg (6 lbs) and measure 47cm long. No wonder you feel tired!
Another sensation at this time may be that it feels as though your belly is dropping. This is because the baby is settling down for delivery and this is often called engaging. You may feel that you have more room to breath and eat now as your organs become less squashed! One draw back to the baby engaging is that it may feel uncomfortable to walk at this stage. But rest assured that by the end of the week your pregnancy is classed as full term and the end is in sight!
By this point, your baby has fully hardened bones and developed organs and strengthening muscles. Wait til you feel that clenching power! Now your baby is also shedding most of the thin layer of hair similar to down, that covered her body as well as the vernix caseosa, the waxy substance that covered and protected her skin while in the womb.
From the Eyes of a TBS Mama...
This week I am feeling more and more tired. It doesn't help that my youngest son is not sleeping well due to a cold and I am feeling more uncomfortable in bed. I have also seen a return to the morning sickness, strangely enough, which is obviously a drag too.
On the up side, there is now only 18 days until my planned c-section date and I am looking forward to meeting my baby! My nesting instincts have well and truly kicked in this week and I have to stop myself from doing too much whilst my husband is at work.
I have an appointment with my consultant next week to find out whether or not the baby is still breech (I believe that to be the case as I am still feeling painful kicks very low) and to discuss the surgery. I have a few questions I want to ask with regards to the actual surgery, pain relief and other things. I'm going to write them down because my memory seems to be quite poor these days!
I will leave you this week with a quote from one of my favourite songs by an artist called Ben Folds. It's taken from a song called Gracie, where he sings about the birth of his beautiful daughter:
"You can't fool me, I saw you when you came out,
You got your momma's taste but you got my mouth."
This is particularly relevant to my husband and I this week as we have been discussing who the baby might look like!