Towards the end of pregnancy, there are certain signs that indicate commencement of labour. Contractions and show are some of these signs. The uterus of the mother is separated from the outside by a jelly like substance in the cervix known as the mucous plug. This helps protect the baby against the action of bacteria or other infections. As the mother approaches labour, the cervix begins to ripen due to chemicals released in the body. The cervix becomes softer and softer, resulting in dislodging of the mucous plug. This removal of mucous, jelly like pink substance is called show.
The show may come off as a single blob or in several parts. It’s a mixture of blood and mucous. The blood is due to breakage of capillaries during the process. Losing the bloody show towards the end of pregnancy is a good sign as it indicates that labour is starting. In some women removal of show may take place immediately before the beginning of labour, however, in some women it may come off a week before labour. Also, the quantity of the show that is discharged by each woman varies. Women who are pregnant for the first time often get their bloody show before the actual labour begins while those who have been pregnant before are expected to give birth within 24 hours of discharging show. There are several things that can be done to help women support the process after discharging show. These include:
1. Getting adequate rest to save energy for the actual labour
2. Doing relaxation techniques to stimulate the release of oxytocin. This hormone helps in labour
3. Breathing exercises
4. Take adequate fluids
Even though a show towards the end of pregnancy is a good sign, the release of the show in the first or second trimester is not a good sign and thus, it is wise to contact your doctor.
One of the many physical changes to a woman’s body during pregnancy is stretch marks. Stretch marks appear towards the end of pregnancy when the abdomen is expanding greatly to accommodate the growing fetus. Stretch marks are usually seen on the abdomen, buttocks, thighs, breasts, back, and legs. They are irregular and tend to increase in size along with the developing pregnancy. They are very common even in the general population and about 90% of the pregnant women will get them during the sixth or seventh month.
Stretch marks are mainly caused by an alteration in the underlying elastic tissue. The skin has insufficient time to adapt to the expansion and so it tears. Hormonal changes during pregnancy also play a role. The increased number of hormones attract more water into the skin which relaxes the bond between collagen fibers and makes the tearing of skin easier when stretched. Genetics is also said to be a factor in formation of these marks.
The colour varies according to the skin colour. After pregnancy, they fade away and get lighter, but never heal. Stretch marks are more likely to appear when there are multiples.There has been a lot of discussion on whether stretch marks can be prevented or not. These factors may help or lessen them.
1. Keeping yourself hydrated by drinking plenty of water
2. Applying some moisturizer or oil so the skin feels less itchy
3. Eating a healthy diet
4. Including gelatin, zinc and vitamin C in the diet for collagen formation.
Once the marks have appeared, it can be difficult to treat them. Laser therapy and topical ointments containing retinoid and glycolic acid may be of some use. Dermabrasion is another process to help renew the skin. Nourishing Herbal creams and oils may equally be helpful and worth trying.
This is harmless light bleeding experienced by some pregnant women in the first trimester, typically around the time they would be expecting their periods but the flow is lighter and colour is brown or pink. Approximately 20% of women have reported of spotting in their first 12 weeks of pregnancy. Some women don’t even know about their pregnancy until they experience spotting.It is most likely due to hormonal imbalance, high estrogen levels, the cervical polyp tends to bleed causing spotting.
Another important cause is implantation bleeding. This happens when the fertilized egg attaches to the uterine lining and causes bleeding. It might also be due to irritation of the cervix, vaginal infection or sexually transmitted infection may cause inflammation and bleeding of the cervix. Some spotting may also be seen after sexual intercourse or after a vaginal exam. There are several things your health care provider might encourage you to do to make you feel more comfortable and to manage your spotting. These include:
1. Taking naps or bed rest
2. Avoid lifting things that weigh more than 10 pounds
3. Avoiding strenuous physical activity
4. Elevating the feet when possible
It’s not a cause for concern as it is not the heavy bleeding of the menstrual cycle but lighter coloured bleeding. Most women who experience spotting continue to have healthy and normal pregnancies and healthy babies. However, health care provider should be seen if the bleeding is severe with clots present and associated with pain and backache. This might be indicative of a miscarriage or an ectopic pregnancy. Bleeding in the second or third trimester is also not a good sign. In this case, an ultrasound may be done or pelvic examination may be carried out.
Small for Gestational Age (SGA)
The term refers to a baby who is smaller than the expected size bearing in mind the timescale, SGA babies are either proportionately small or may have normal size and shape but with a lower body mass and weight. This mostly results due to insufficient nutrients being provided to the foetus for development of organs. Maternal issues like high blood pressure, diabetes, infection and substance abuse usually lead to SGA births. Babies usually suffer from oxygen deficiency, lower blood glucose levels and difficulty in maintaining body temperature.
Swollen Ankles Legs and Feet
Pregnant women are most likely to experience swelling in ankles, legs, and feet as there is increased retention and uptake of water in their body. The swelling, also called oedema, is due to the excess fluid that collects in the body tissues. This swelling accounts for approximately 25% of the body weight that women gain. Swelling increases towards the third trimester as the growing uterus and fetus put pressure on the pelvic veins and vena cava hence decreasing the venous return to the heart and leading to the accumulation of fluid in the peripheral regions. This swelling stays until birth. Women carrying multiples or those with excessive amniotic fluid experience more oedema.
Surprisingly, this swelling is needed to soften the body, which enables it to expand as the baby develops. The swelling helps to prepare the pelvic joints and tissues to open during delivery. Although this swelling is a physiological phenomenon, in some cases swelling may be indicative of some underlying disorder such as deep vein thrombosis, preeclampsia or cellulitis. In this situation, seeing your health care provider for further assistance is important. There are some factors that need to be taken into account to prevent excessive swelling:
1. Avoid standing or sitting for long periods
2. Avoid sitting with the legs crossed
3. Perform regular exercises such as stretching of legs and rotating ankles. Frequent short walks are also helpful.
4. Sleep on the side
5. Elevate feet whenever possible
6. Avoid wearing tight stockings
7. Eat a healthy diet and take plenty of fluids
8. Wear comfortable shoes
9. Limit the use of salt but don’t cut it out completely from your diet
10. Limit the consumption of caffeine
11. Use cold packs on swollen areas
Soon after the delivery, swelling disappears as the fluid is removed from the body so worry this swelling is temporary.
Sepsis in the Newborn
Preterm newborns are most prone to bacterial infections compared to full term infants, due to a lesser developed immune system. Sepsis is bacterial infection which leads to the baby having feeding difficulties along with lower body temperature. Treatment is done by using antibiotics. Long term sepsis can cause serious medical complications if left untreated.
A very common condition occurring in infants, sore throat can cause difficulty breathing and swallowing to the infant. Most likely causes of sore throats are infections caused by microorganisms. It is also likely to occur when the child is exposed to smoke and pollutants. Babies often show loss of appetite and irritability. Sore throats are best treated using antibiotics as prescribed by the physician.
For the first 3-4 months, eyes of a child wander and are not fixated to a single place. By the time they reach of 4-6 months this changes to normal. If by this period, one or both eyes continues to wander, it becomes evident the baby has strabismus. Most commonly caused by the inability of eye muscles to control eye movements and often runs in families.
Stomach ache is another very common condition caused by various underlying issues. This ache makes the baby fussy and irritable. There can be various reason for it which include colic (a condition in which babies cry a lot), gas pain, constipation, diarrhea, reflux (a condition in which contents of digestive cavities are expelled back), intestinal blockages and food allergies. Slight massage with three fingers occasionally relieves the stomach ache.
Usually soon after birth, both the testicles of a baby are swollen, most likely due to fluid from in utero life accumulating in the testes. The Baby flushes this out in a few days via urination. however if one of the testicles is swollen , it is most probably due to abdominal fluid accumulation. As testes develop in abdomen and then descend downwards, an unsealed connection leads to fluid from abdomen draining into the testes. Pressure increase in abdomen due to crying or coughing by the baby, a bulge is observed in the testes. It can be alleviated by surgical techniques.