Pain Management Options

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Here’s the thing. Labor and delivery hurt. Any woman who tells you they don’t either had effective medication or has a poor memory. There are numerous medications and other options you can use, most of which are detailed below, to make you as comfortable as possible.

Narcotics (Demerol, morphine, Stadol, Fentanyl, Nubain)

Given by injection into the spinal cord or arm, IV or self-administered pump (depends on the drug). These medications help you relax and take the “edge” off the pain without interfering with pushing or slowing labor.

Depends on the drug, but may cause drowsiness or breathing difficulties in babies and nausea and vomiting in you. Nubain, Fentanyl, Stadol and morphine have minimal effects on the fetus unless used in a spinal block.

Epidural-Injection

Epidural

The most common form of anesthesia used during labor and delivery. An epidural is regional anesthesia that blocks pain to a particular part of the body; in this instance, nerves leading to the uterus. You need to have an IV started before you can receive an epidural, usually before active labor begins. The epidural is typically inserted when the cervix has dilated to four or five centimeters. An anesthesiologist or nurse anesthetist usually administers the epidural. You need to arch your back while sitting up or lying on your side. After cleaning and numbing the area, a needle is inserted into the area surrounding the spinal cord, a small tube or catheter is threaded through the needle into the space around the spinal cord (the epidural space). Then medication is given through the tube as needed.

May result in sudden blood pressure drop and, rarely, severe headache if there is any spinal fluid leakage. May slow labor and make pushing more difficult. May cause some breastfeeding or respiratory difficulties in babies.

Spinal block

When narcotics are injected directly into the spinal column. The pain relief lasts about two hours. They are rarely used these days given the availability of epidurals.

The medication crosses into the placenta and may affect the baby. May cause low blood pressure, problems pushing during labor and severe headache.

Pudendal block

An injection of a local anesthetic such as lidocaine into the pudendal canal in the pelvis to provide quick pain relief to the perineum, vulva and vagina as the baby moves through the birth canal. Typically used in the second stage of labor when you’re pushing, just before the baby is delivered.

May cross the placenta; slight risk of blood clot or infection.

Local anesthesia Primarily used at the end of labor to provide pain relief for an episiotomy (a cut in the perineum to make it easier for the baby to come out). May also be used after birth for pain relief from episiotomy or perineal tears. Given by injection into the specific area of pain.

Rare allergic reactions.

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Patterned breathing

This nonmedical approach uses breathing patterns to calm and relax you while providing a sense of control during contractions.

Must be practiced before labor

Relaxation techniques

Listening to soothing music, surrounding yourself with a scent that soothes and comforts you, having your partner massage, kneed or put pressure on various parts of your body and focusing on an item like a candle throughout the contraction can all help reduce the pain and the feeling of being out of control.

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Vaginal Bleeding During the Second Half of Pregnancy: Should You Be Worried?

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Although vaginal bleeding can signal miscarriage, this is not usually the case after the first trimester. Bleeding in the later stages of pregnancy is more likely related to vaginal or cervical inflammation, which is treatable and poses no risk.

However, any vaginal bleeding in the second half of pregnancy deserves medical attention. If you experience light bleeding that goes away within a few hours, you should call your doctor the same day. If bleeding lasts longer than a few hours or is accompanied by abdominal pain, cramping, fever, chills or contractions, contact your health care provider immediately.

In addition to inflammation, unexplained bleeding can signal a risk for preterm birth or, less commonly, a problem with the placenta.

If bleeding occurs close to your due date, you may be going into labor a few days earlier than you expected. A normal sign of impending labor during the final weeks of pregnancy is the bloody show. This is a thick or stringy discharge that can be tinged with blood. In addition, you may feel pelvic or lower abdominal pressure, low dull backache, stomach cramps and uterine tightening. This is normal and is not a problem if it occurs within three weeks of your due date.

If it occurs sooner than that, it may be a sign of preterm labor, and you should contact your health care provider immediately. About 10 percent of births are considered preterm.

Another cause of light bleeding may be an inflamed cervix or growths on the cervix, which can be treated with medication. Sometimes sex causes the cervix to bleed. This slight bleeding usually stops on its own.

Heavy bleeding may signal a problem with the placenta, either placental abruption or placenta previa.

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Placental abruption is when the placenta—the organ that connects the developing fetus to the uterine wall to allow your baby to receive nutrients—detaches from the uterine wall before or during labor. This occurs during the last 12 weeks of pregnancy and causes vaginal bleeding and stomach pain. If the placenta detaches, the baby gets less oxygen, so quick action is needed. Placental abruption only occurs in 1 percent of pregnancies, so consider talking to your health care provider to determine if you have any risk factors.

Placenta previa is when the placenta lies low in the uterus and either partially or completely covers the cervix. The main symptom is heavy bleeding, often without pain. This condition requires immediate care from a health care professional.

Vaginal bleeding may occur without any associated pain, so if you experience any bleeding in the latter half of your pregnancy, don’t hesitate to call your health care professional.

More babies being born too soon

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For the second year in a row, the preterm birth rate in the United States has gone up. Preterm birth is when a baby is born before 37 weeks of pregnancy. According to a preliminary report from the National Center for Health Statistics (NCHS), the preterm birth rate rose to 9.84% in 2016, up 2% from 9.63% in 2015.

 After seven years of a steady decline in the preterm birth rate, this increase is alarming.

Reduce your risk

We don’t know why this is happening. But we do know that there are some things a woman can do to help reduce her chance of giving birth too soon. Here are some of them:

  • See your prenatal care provider as soon as you think you’re pregnant. And go to all of your prenatal care appointments. Go even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
  • Don’t smoke, drink alcohol, use street drugs or abuse prescription drugs.Ask your provider about programs in your area that can help you quit.
  • Talk to your provider about your weight.Ask how much weight you should gain during pregnancy. Try to get to a healthy weight before your next pregnancy.
  • Get treated for chronic health conditions, like high blood pressure, diabetes and thyroid problems.
  • Protect yourself from infections.Wash your hands with soap and water after using the bathroom, caring for small children, or blowing your nose. Don’t eat raw meat or fish. Have safe sex. Don’t touch cat poop.
  • Reduce your stress.Exercise and eat healthy foods. Ask for help from family and friends. Get help if your partner abuses you. Talk to your boss about how to lower your stress at work.
  • Wait at least 18 months between giving birth and getting pregnant again.See your provider for a preconception checkup before your next pregnancy.

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Know the signs

If you have any of these signs or symptoms before 37 weeks of pregnancy, you may be having preterm labor. Call your health care provider right away if you have even one of these signs or symptoms:

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual
  • Pressure in your pelvis or lower belly, like your baby is pushing down
  • Constant low, dull backache
  • Belly cramps with or without diarrhea
  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.
  • Your water breaks

If you think you’re having preterm labor, call your provider. Call even if you have just one sign or symptom. There are several treatments that may help slow or stop preterm labor. And there are treatments, like antenatal corticosteroids (also called ACS), that can help reduce your baby’s chances for having health problems (like lung problems) in case he’s born early.

Ectopic Pregnancy

Picture1Generally, pregnancies develop inside your uterus, after a fertilized egg travels through your fallopian tube and attaches to your uterine lining.

Ectopic pregnancy is when a fertilized egg attaches somewhere else in your body, usually in your fallopian tube therefore it’s also called “tubal pregnancy.”

Ectopic pregnancies can also happen on your ovary, or somewhere else in your belly.

This is a very rare case it happens in about 2 out of every 100 pregnancies. But they’re very dangerous if not treated. Fallopian tubes can break if stretched too much by the growing pregnancy. This is sometimes called a ruptured ectopic pregnancy. This can cause internal bleeding, infection, and in some cases lead to death.

You’re in a risk of ectopic pregnancy when

  • have had an STD, pelvic inflammatory disease or endometriosis
  • have already had an ectopic pregnancy
  • have had pelvic or abdominal surgery
  • are 35 or older
  • smoke cigarettes

Symptoms

Normally an ectopic pregnancy happens within the first few weeks of pregnancy. You might not even know you’re pregnant and may not know you’re in a risk.

  • vaginal bleeding
  • pelvic pain
  • Nausea and vomiting with pain
  • Sharp abdominal cramps
  • Pain on one side of your body
  • Dizziness or weakness
  • Pain in your shoulder, neck, or rectum

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Treatments

As a treatment you may have to go for a surgery or medication.

A fertilized egg can’t survive outside of the uterus, the tissue has to be removed to keep you from having serious complications.

Medication

Your doctor can give you an injection of methotrexate (Trexall) If your fallopian tube hasn’t ruptured and your pregnancy hasn’t progressed very far. It stops the cells from growing, and your body will simply absorb them. If you found it in early stage If you most ectopic pregnancies can be treated with methotrexate.

Surgery

If the situation is serious you must go for a surgery.  The most common one is laparoscopy.

Here the pregnancy will remove by using thin, flexible instrument (laparoscope). Your doctor will make very small incisions in your lower abdomen. If your fallopian tube is damaged, she may have to remove it as well. If you’re bleeding heavily or your doctor suspects your fallopian tube is ruptured, you might need emergency surgery with a larger incision. This is called laparotomy.

After surgery

Mainly keep your incisions clean and dry while they heal. Check them daily for infection signs, which could include.

  • bleeding that won’t stop
  • excessive bleeding
  • foul-smelling drainage from the site
  • hot to the touch
  • redness
  • swelling

better to follow below things also,

  • don’t lift anything heavier than 10 pounds
  • drink plenty of fluids to prevent constipation
  • pelvic rest, which means refraining from sexual intercourse, tampon use, and douching
  • rest as much as possible the first week post surgery, and then increase activity in the next weeks as tolerated

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How to avoid ectopic pregnancy

  • Reduce your risk of sexually transmitted infections

Sexually transmitted infections (STIs) such as gonorrhea or chlamydia may increase a woman’s chances of having an ectopic pregnancy. If you reduce your risk of contracting one of these diseases, you may reduce your risk of having an ectopic pregnancy as well.

Limit your number of sexual partners in order to reduce your risk of exposure

Always use a condom during sex to reduce your risk of contracting a disease

  • Get quick treatment for infections.

If you have a STI, it’s important to get treatment right away. The sooner you are treated, the less likely you are to develop inflammation. That can damage your reproductive system and increase your risk of developing ectopic pregnancies. It’s better to get tested regularly if you are sexually active.

  • Quit smoking

There is no clear researched evidence on how long a woman should wait to try to conceive after having treatment for ectopic pregnancy, but medical professionals advise you to wait for at least three months or two full menstrual cycles before trying to conceive for both physical and emotional reasons.

Teen Pregnancy

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To be honest been pregnant in teen age is a big challenge and it’s not going to be easy on you.

Women are able to give birth as soon as they begin menstruating but there are some possible risks when you have a child early on in your teen years. These things are not guaranteed to happen, but it’s good to talk to your doctor, if any concerning signs or symptoms for your body.

 

Here are some risks if you get pregnant before age 15.

  • Low birth weight (premature birth)
  • Low iron levels (anemia)
  • High blood pressure/pregnancy induced hypertension, PIH (can lead to preeclampsia)
  • A higher rate of infant mortality (death)
  • Possible greater risk of baby’s head is wider than the pelvic opening (cephalopelvic disproportion)

Choice

Being a teenager and finding out you are pregnant unexpectedly, can put enormous stress on a young woman and her family. However, once the pregnancy is confirmed the important thing is to support the young woman and to help her to make the wisest choice for her at this time.

There are 4 options to be taken if your pregnant

  • continue the pregnancy and raise your child with a partner
  • continue the pregnancy and raise your child on your own
  • continue the pregnancy followed by adoption
  • end the pregnancy (termination).

The law is different in each state around how you go about getting an abortion and the age at which you are allowed to make your own decision, without your parents. Speak to your doctor about this. If you decide to have an abortion, you usually need to have it before you are 12 weeks pregnant. About 50% of young women under 20 years old have an abortion if they become pregnant.

Before you take a decision, there are few things that you should think like your relationships, responsibilities and future plans.

If you decided to continue the pregnancy, congrats!!

Relationships

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Do you have support from family or a partner?

Can you work things out through the tough times?

Going through a teen pregnancy with your boyfriend can get tricky. It’s likely both his and your first experience with pregnancy, and if you are early in your relationship, you may not already have a solid foundation to fall back on. If you’re still learning basic

 

Things about each other will make more confusing while you’re pregnant.

Instead of keeping these thoughts inside and allowing them to grow and bother you, talk to someone you trust, and after taking the time to think things through, talk to your boyfriend. When talking to your boyfriend, don’t be sound like you’re accusing him of anything; that will just put him on defense.

 

Mood swings can cause tension in any relationship, and it’s made worse when you feel that you can’t control it. This emotional rollercoaster is fairly normal during any teen pregnancy, but your friends and boyfriend may never have been close to someone who was pregnant; they may not know what to expect. It might be a good idea to have conversations with your friends, family, and/or boyfriend and let them know that these mood swings may happen occasionally and give them tips on how to bring you back to normal

 

Parents

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Your parents may experience shock, disappointment, anxiety, anger and sometimes a sense of guilt or responsibility, because they know how responsible, hard and how much affect it to your life.

Some of the choices available could go against parents’ values. If their daughter does not tell them for a long time, they may feel great disappointment in that she feared their response so much.

They may be concerned about what friends and other family members think.

Major life events do not just disappear, and whatever the decision, there may be doubts and sadness for some time.

Also, find some activities that help keep you even-tempered like include a warm bath with music, meditation, slow breathing exercises, going for a walk.  A teen pregnancy is hard enough, you need time to think, rejuvenate, and plan.

AUTHOR 

Mrs. Ruwandi Fernando is reading for MPhil / PhD program in Physics and currently working as a Technology Entrepreneur in MAS Holdings. In her role as a Technology Entrepreneur, she explores new trends in the maternal apparel space, sustainable products, new technology trends that can be applied to the apparel sector. She is a mother of a newborn who is interested in Kandyan dancing, playing sports, working out, mentoring teenagers, lecturing during her leisure time.

Pregnancy Discomforts and Treatments

Most of the pregnancy symptoms are normal but some are not, so it’s better to have an idea about these discomforts and what are the treatment that we can do for reduce them.

 

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Morning Sickness

This is the most common one. You may feel nauseated at any time of the day, typically in the first trimester. Try eating frequent, small meals rather than three full meals. Keep your diet high in protein and complex carbohydrates, and low in sweets and fatty foods. Drink plenty of fluids, and eat fresh fruits and vegetables, which are high in water content.

Talk to your health care provider about trying 25 mg of vitamin B6 taken three times a day. Antacids sometimes help, especially if heartburn is part of the problem. In general, try to minimize stress in your everyday activities.

Heartburn

It’s better to avoid from heavy meals and spicy, greasy, sugary, and acidic foods. Stick to a bland, high-fiber diet, drink lots of fluids, and exercise daily. Small, frequent meals may relieve some of the symptoms.

Don’t lie down right after a meal.

Raise the head of your bed 2 to 4 inches with a stable support such as wooden blocks. Antacids can be helpful.

Cystitis (Bladder Infection)

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Bladder infections in pregnant women are more common and dangerous than in non-pregnant women. If you develop bladder irritation, like persistent burning when urinating, meet your doctor for appropriate treatment.

Many bladder infections are triggered by sexual intercourse. Remember to empty your bladder immediately after sex and watch for symptoms. Several glasses of cranberry juice a day may prevent urinary tract infections.

 Dizziness and Faintness

These are also common ones, slow down when you stand up or get out of bed.

Dizziness when you stand up too quickly from sitting or lying down is called postural hypotension. If you feel lightheaded, sit down immediately.

If you’re in a crowd and start feeling dizzy, step away and get some fresh air; if possible, lie down on your left side or sit with your head between your knees.

Sleep Problems

You may experience sleepless nights and daytime fatigue. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep.

Due to hormone level changing, such as progesterone, you’ll experience fatigue during the 1st trimester. Toward the end of pregnancy, some women find it difficult to sleep because they’re uncomfortable due to the size of a growing abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Sleep apnea, especially if it’s severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.

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Headaches

You should take enough rest, eat regularly, and drink six or more glasses of water daily.

It’s better to try stress-reduction techniques like yoga or meditation. Or you can take a hot bath with a cold pack on your forehead.

Leg Pains and Cramps

When a leg cramp gets worse, straighten your leg and slowly flex your ankle and toes while massaging your calf; or soak your leg in hot water. You may be able to prevent night cramps by wearing socks to bed. If painful cramps persist, meet your doctor about calcium or magnesium supplements.

Wear support hose during the day, and elevate your feet when resting, if possible. Use a heating pad or gentle massage on the back of your thigh to ease sciatica.

Leg Swelling

Maintain your weight throughout your pregnancy to control swelling in your legs and ankles, wear support hose and avoid standing for long periods.

Wear shoes that fit well and give good support or buy shoe inserts designed especially for pregnant women. Getting off your feet helps the most. Lying down is often more comfortable than sitting.

Mouth and Gum Discomfort

Make sure you get your regular dental checkup and cleaning because Pregnancy can be demanding on your teeth. Brush your teeth and tongue at least twice a day, and floss regularly. Sugarless gum can be substituted for an after-meal cleaning if it isn’t feasible to brush your teeth.

During the pregnancy you may find some foods unappealing and develop a craving for others, especially sweets. Iron supplements may leave a bad taste in your mouth; talk to your practitioner if this is a problem. Use mouthwash often. Chewing gum, mints, or hard candies can also chase away unpleasant tastes.

Skin Changes and Stretch Marks

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You may have rashes due to hormone changes. These may go away after the baby is born.

To prevent freckles or darkened skin on your face, called a “pregnancy mask” or chloasma, wear a wide-brimmed hat and use a sunscreen with an SPF of at least 30 when outside.

Apply a moisturizing cream on the dry skin around your abdomen. For heat rash, try to stay as cool and use cornstarch powder under your breasts, on your thighs, or wherever your skin tends to chafe.

Make your pregnancy more comfortable by following those relief methods for your discomfort abilities.

AUTHOR 

Mrs. Ruwandi Fernando is reading for MPhil / PhD program in Physics and currently working as a Technology Entrepreneur in MAS Holdings. In her role as a Technology Entrepreneur, she explores new trends in the maternal apparel space, sustainable products, new technology trends that can be applied to the apparel sector. She is a mother of a newborn who is interested in Kandyan dancing, playing sports, working out, mentoring teenagers, lecturing during her leisure time.

Make bond with your baby – During the pregnancy

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What will your baby be like? Will she have mom’s nonstop need for activity? Dad’s sense of humor? Grandpa’s short temper? Wondering about what your future baby might be like during pregnancy helps you feel connected. These “images” are a normal and healthy part of pregnancy.

First, sit on a comfy chair, set both feet on the ground, and form an image of what your baby looks like inside of you.

A picture of your baby’s scan on your phone or on your fridge door is a constantly remind that your bump is home to a little person.

You can take 3D or a 4D pictures. These scans can give you a clear view of your baby’s features. You may even be able to tell whose nose she’s inherited.

The best period to take this scan is in between 26 weeks to 30 weeks.

Make some quiet moments during your pregnancy to get to know your baby. The time you spend now helps you bond and connect as parent, child, and brand-new family.

Talk to your baby

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It’s not silly to talk, read, and sing to your baby before he’s born.

Between 18 and 22 weeks, your baby’s ears are developing and by 30 weeks, your baby may be able to hear and remember language. This means your little one is taking in the sounds around him, including your voice.

So, talk, sing, and read to your baby are great ways to connect.

You can put your head set on your bump and let her to listen to your favorite songs but be careful! Don’t give her very noisy and rush music, give her very calm and slow music to listen.

Start with your day by Saying Hi in the morning and good-night before you go to sleep, and chat about your day in between. It will be fun parts of being a parent.

Enjoy having chat with your bump.

React to your baby

Around 20 weeks your baby may start to kick and turn. The first move that you feel from your baby will be the most exiting moment of your pregnancy.

From her movements you can communicate with your baby. When she kicks you can give a little touch and see whether she’ll reply back by kicking. And when she turns you can rub your bump and let her know that you’re with her.

Get dad involved

You’re not the only one who wants to make the bond with your baby. Dad to be is also would like to connect with your baby before she come to this world.Picture1

You may be reminded that you’re pregnant by all the pregnancy symptoms you have to face. But until your baby is born, there is no such an experience for dad to be about the baby. Don’t worry there are plenty of ways that dad can make bond with your baby, before she comes.

After 30 weeks let him to talk with your tummy. This may help baby to recognize dad’s voice after the birth.

Also let him feel the movement of the baby.

Encourage your partner to attend prenatal classes with you, so he knows what to expect during labor and birth.

Parenting is a team work; these things will help you to get to know each other more and remember you’re in this pregnancy together.

AUTHOR

Leshani Samaradiwakara is a recent graduate with a BA in Economics and a minor in Psychology and Sociology. She is currently working as a Business Entrepreneur in MAS Holdings. In her role as a Business Entrepreneur, she explores new trends in the apparel industry, studies the consumer behaviour and conducts market research, especially in the area of women health & wellness. She is a enthusiastic individual who is interested in discovering new places, traveling the world, exploring new cultures and meeting new people.