PART 1: PREGNANCY, CHILDBIRTH AND THE NEWBORN
LABOUR AND DELIVERY
In Europe, women are being given a chance to have their babies in a hospital, at a maternity home, at a ‘birthing
centre’ or even in their own homes. Some women even in the urban areas in India are now opting to deliver at home.
I Would Go Along With Your Wish To Deliver At Home If
- You live next to a hospital;
- You have an obstetrician or a trained midwife living
in your building; or
- If an obstetrician is ready to be present at the
time of delivery.
Doctors Recommend That You Deliver In An Institution In The Following Cases
- If there is an interval of less than 2 years since
the last birth;
- If you are below 17 or over 35 years of age;
- If you have had 4 children already;
- If you have previously had a premature delivery;
If you have earlier delivered a baby that weighed
less than 2 kilograms at birth;
- If you have previously had a difficult or Caesarean
birth, miscarriage, abortion or stillbirth;
- If you weighed less than 40 kilograms or more than 70 kilograms before pregnancy; or
- If you are less than 145 cm. in height.
You Will Also Need Extra Care If:
- You fail to gain at least 6 kilograms in pregnancy;
- You are diabetic or severely anaemic, or have heart
or kidney disease, or high blood pressure;
- Your limbs and face are excessively swollen;
- You have had vaginal bleeding during the pregnancy;
- You have suffered severe headaches and vomiting, or persistent high fever;
- You are having twins;
- You are Rh negative; or
- You are scheduled to have a Caesarean for medical
Your doctor will guide you on choosing the hospital. It
may also have to be one she normally works with, and which she knows is capable of dealing with any medical emergencies
that may arise. Ask to visit the hospital if you like, and see the delivery room and the nursery to help you prepare
yourself for delivery there.
Most hospitals require you to register well in advance
of your due date; check with your doctor about this.
Choose A Baby-Friendly Hospital
The Baby-Friendly Hospital Initiative (BFHI) is a global
effort to protect, promote and support breastfeeding while providing good care to the mother before, during and after
delivery, treating her with dignity and supporting her with factual information and guidance. Country-level guidelines for
achieving baby-friendly hospitals have been developed and are now being put into action. In India, a task force has
been formed for this purpose.
Assisted by the government, UNICEF and WHO, this task force assesses hospital conformity with baby-friendly
criteria and certifies and designates hospitals that meet the
standards. Make sure your hospital or maternity home has been certified ‘Baby-Friendly’.
Names and addresses of such hospitals are available with the Convenor, National Task Force, BFHI, Indian
Medical Association, IMA House, Indraprastha Marg, New Delhi 110002.
Choose A Paediatrician
Ask your doctor to recommend a paediatrician for your
baby even before you deliver, if you don’t know one
already. It is important to exchange notes in advance, especially in
cases where there may be potential complications.
Getting Ready For The Hospital
Some hospitals have a list of requirements they would
like you to bring with you. Make sure you keep your suitcase packed well in advance with the following essentials:
- Items of personal use—toothbrush, toothpaste,
- 2 nightgowns with front opening (to make it easier
for you to breastfeed), and a wrap for when you have visitors;
- Well-fitting bras (nursing bras are not essential; they may get in the way of skin-to-skin contact between the breast and your baby’s face as you nurse her);
- A towel;
- Non-slip slippers;
- Clothes for you and the baby to wear when you are discharged;
- Some cash;
- A table clock; and
- A book of scriptures for daily reading, books or
You may also want to bring along a photograph of your older child or your husband, and a small picture or
statue of your favourite deity to keep on your bedside table in the hospital.
An Emergency Delivery Kit At Home
All the best-laid plans can sometimes go awry; even if
you have registered at a hospital, keep a delivery kit at
home in case of an emergency.
Make sure you have:
- A plastic sheet
- Cotton and gauze pads
- Cotton thread for tying the cord
- A new razor blade
- Cetrimide solution (1%)
Drugs In Labour
These should be avoided as far as possible. In general,
I encourage the process of natural delivery. I also
believe that a drug to relieve a woman of pain during labour is not a
good substitute for emotional support from a sympathetic
doctor or midwife, or even a husband, mother or mother-in-law educated in the process of
Besides being possibly addictive, the pain-relieving
drugs may also result in the mother being less cooperative in
the delivery. They may also depress the baby and cause
problems with breathing and nursing. Discuss the subject of pain management with your doctor. Read about it. Work with
your doctor’s advice to mutually decide on the best pain management technique for you and your baby.
7 March, 2016