Safe Motherhood

Birth and Postpartum

How to Define Birth and Types of Birth


Birth is the process of contractions in the uterus leading to the exit of the fetus, placenta and membranes from the birth canal. The process begins when the fetal position changes in the uterus so that the fetus’ head is facing down towards the cervix. The contractions of the uterus are regular and increase in frequency, duration, and intensity until the cervix is fully expanded and the fetus exits the uterus. These contractions are not voluntary; that is, they cannot be controlled. Doctors advise women to go to their nearest hospital at the earliest signs of labour to ensure a healthy birth under the supervision of qualified medical staff. We must all work to change the attitudes regarding gender and to spread a culture that focuses on welcoming and caring for a child, regardless of whether it is a boy or girl.




Necessary Pre-Natal Preparations: The Importance of Preparing for Childbirth


  • Preparation for delivery begins at the end of the second trimester
  • Decision of where to give birth (at which health institution)
  • Preparation of a bag with items that both the mother and baby need
  • Gathering baby clothes that are season/weather appropriate
  • Creating a safe home environment for the baby
  • Agreement between the spouses on the name of the child




Types of Birth


  • Natural Childbirth
  • Assisted Delivery (delivery with the use of medical instruments)
  • Cesarean Section (delivery by surgery)




Labour Signs and Typical Birth Stages


  • Delivery may take between 5-12 hours and birthmarks are
  • The sensation of pain starting from the lower back and moving down to the abdomen and genital area (a sense of downwards pressure)
  • Vaginal discharge (“muscus plug”) mixed with blood
  • Regular shooting pains or contractions every 15 to 20 minutes
  • A discharge of water from membranes breaking (“water breaking”)




Natural Birth Stages


  1. Spans from the beginning to the full opening (“dilation”) of the cervix
  2. Spans from the full expansion of the cervix until the birth of the baby
  3. Spans from the birth of the child until the membranes and placenta exit




Care for Newborns at Home


  • Newborns need to be bathed 24 hours after birth and daily thereafter. The best time to bathe them is before breastfeeding as the baby may take a nap after breastfeeding. Before the fall of the navel, it is possible to wash the child's head with water and shampoo especially for children and to rub their body with a wet towel.
  • Periodically breastfeed the newborn and pay attention to their cleanliness, safety, comfort and sleep.
  • Provide appropriate ventilation for the newborn’s room but keep it away from drafts and sources of smoke.
  • Dress the newborn in season, weather, and temperature-appropriate clothing. Avoid excessive clothing so as not to overheat the child.
  • Always use fresh towels so as not to cause the child skin infections.
  • Cut the child’s nails with round head scissors to avoid the child scratching themselves or their mother.
  • Take care to clean the child’s nose so as to avoid obstructions that make it difficult to breathe, feed and sleep.
  • Clean the umbilical cord with water and do not use a powder or a disinfectant.
  • Monitor the child’s vital signs to ensure that they do not require special medical attention.




Maternal Care


The post-partum period that begins after childbirth and lasts up to 6 weeks. During this period, there are many physiological, psychological and social changes. This period ends with the return of the women’s organs to their pre-pregnancy state with the exception of the breasts which continue in their enlarged state for the purpose of breastfeeding.




Periodic Medical Reviews


It is important that the mother does not neglect herself and her health. She must visit the gynecologist periodically and it is very important that the first visit is within the first week after giving birth.




General Tips


  • Avoid cold air currents
  • Pay attention to personal hygiene and breast care
  • Only take medications after consulting and gaining the approval of a doctor
  • Avoid smoking and consuming alcoholic beverages
  • Avoid lethargy and lying down excessively, which may increase the risk of stroke in both legs
  • Abstain from intercourse for forty days before childbirth
  • Consult your doctor when any emergency or complications occur
  • Utilize family planning methods to avoid another pregnancy shortly after giving birth




Proper and Balanced Nutrition


  • Maintain a diverse and balanced diet that includes all food groups: carbohydrates, proteins, fats, fruits, vegetables and dairy products
  • Drink plenty of fluids, soup, natural juice, and milk to help prevent constipation
  • Drink enough water daily (8 cups)
  • Diversify your intake of proteins between plant-based proteins, meat, and fish twice a week
  • Eat carbohydrates such as raw walnuts and almonds, which are good sources of vitamins and minerals
  • Following a restricted diet is detrimental at this time because it negatively affects the psyche and activity of women and the amount of milk they are able to produce
  • Eating spicy foods may cause irritation to the child in the forms of gas and colic




Exercise


  • It is recommended that women return to sport and exercise 3 to 6 months after giving birth when she feels that her body is ready for it.
  • Exercise should begin in a gradual manner according to the woman's readiness and physical fitness. Breathing and lengthening exercises are best followed by aerobic exercises such as walking and swimming for half an hour three times a week, with increasing duration and frequency as women regain their physical fitness.
  • Starting muscle-strengthening exercises is recommended to restore the shape of the body and to be better able to care for and carry the child as their weight increases. It is useful to wear braces for exercise and it is preferable to exercise after the breastfeeding, as the breasts are empty and movements become easier and more comfortable.




Psychological Well-Being


  • Mothers may feel depressed after childbirth, which can present itself through various emotional and physical symptoms such as crying without a cause, headache, anxiety, fear, sadness, vulnerability, irritability, loss of appetite, stomach pain, poor vision, loss of sexual desire and insomnia.
  • This may be accompanied by concern for her personal health, the health of the child and the well-being of the family.
Causes of Psychological Stress:
  • Excessive, constant tiredness and lack of sleep
  • Hormonal changes
What to do if you notice the symptoms:

  • Share what is on your mind and express your feelings
  • Try to relax and take advantage of the time that the child is asleep to sleep yourself; rest as much as possible
  • Sit with newborn mothers and share your experiences
  • Ask for support from the child’s father and your family members
  • Maintain a healthy, balanced diet and amount of exercise
  • Consult your doctor if the symptoms persist
  • Participate in enjoyable events and watch entertainment programs




Causes of Psychological Stress


  • Excessive, constant tiredness and lack of sleep
  • Hormonal changes




What to do if you notice the symptoms


  • Share what is on your mind and express your feelings
  • Try to relax and take advantage of the time that the child is asleep to sleep yourself; rest as much as possible
  • Sit with newborn mothers and share your experiences
  • Ask for support from the child’s father and your family members
  • Maintain a healthy, balanced diet and amount of exercise
  • Consult your doctor if the symptoms persist
  • Participate in enjoyable events and watch entertainment programs




The Role of Men and Other Family Members


Psychological support for women at this stage is very important, especially by the husband and the rest of the family. A man can provide a lot, which makes him an essential partner in caring for the child. This assistance may be simple but is very important, such as providing care and compassion, helping the mother to carry the child and so on, as well as assisting in daily household chores.




Dangerous Signs that Require Immediate Medical Attention


  • Severe yellowing of the skin and the child's abstinence from breastfeeding
  • The child’s temperature is above 38°C (as measured by a thermometer and not by hand)





Breastfeeding

Breastfeeding


is the process of feeding the baby milk from the breast of the mother.




Artificial Feeding


This is the process of feeding a child special, artificial milk (usually referred to as formula) or cow's milk instead of breast milk, usually via a bottle.




The Importance of Breastfeeding for the Child and Mother


  • Colostrum is the first form of milk produced by the breast during the first days after birth. It contains the necessary nutrients for the child and contains antibodies to protect the newborn against disease and support the building of their immune system. The mother should breastfeed her baby within the first few hours after birth.
  • Colostrum delivers newborns sufficient quantities of nutrients and water in a concentrated, low-volume form.
  • Mother's milk is a whole food for the baby.
  • Mother's milk is available in the right amount and at the right time, when the child asks for it.
  • Breast milk is easy to digest and absorb.
  • Because milk passes directly from the mother's breast to the baby's mouth it is clean and not exposed to contamination
  • Protects against gastrointestinal sensitivities. Children who are breastfed by their mothers are less susceptible to other allergic conditions such as eczema and asthma
  • Protects against diseases such as diarrhea, ear infections and reduces the risk of diabetes, heart disease, high blood pressure, and cancer
  • Early entry, ie, before 6 months of age for foods and fluids, increases the risk of acute diarrhea and respiratory illness.
  • Creates a strong emotional bond between the mother and the child as the child feels secure and protected by his mother
  • Helps increase the level of intelligence in the child, supports proper growth of the jaw and teeth, and reduces the instances of tooth decay




Benefits of Breastfeeding for the Family


  • Saves money and effort
  • Reduces disease
  • Can be used as a means of family planning if certain criteria is met (menopause method of breastfeeding)




Benefits of Breastfeeding for the Community


  • Contributes to reducing child and maternal mortality rates
  • Reduces the financial burden and material costs of healthcare




Breastfeeding and the Working Mother


It is essential that the working mother ensure optimal nutrition for her child. She can breastfeed the baby when she is with him. When unable to breastfeed, she must squeeze the milk from her breast and store it in a clean, covered container. It may be stored in the fridge for 48 hours or outside of a fridge for 8 hours. Milk is then fed to the baby from a cup and not from a bottle. It is important to consult your healthcare provider on proper breastfeeding care before separating from the child and returning to work.




How to Breastfeed


  • The baby or newborn must be breastfed as soon as possible during the first hour after birth. The child should be kept with their mother in the same room and should not be separated from her for a long time.
  • Breastfeeding should be done at the time that the child or mother wants without restrictions on the duration of breastfeeding or the number of lactation times.
  • The mother breastfeeds from both breasts alternately to continue the flow of milk and must allow the baby to finish breastfeeding from one side before giving the second breast.




The Breastfeeding Process is Correct When


  • Most of the areola is inside the child's mouth
  • The child’s lower lip is upside down
  • The baby faces the breast with their nose touching. The child can breathe even with his nose touching the mother's breast
  • The child is calm and relaxed and the mother does not feel pain
  • The child's jaw moves clearly
  • The mother feels milk withdrawing from her chest
  • The mother hears the sound of the child swallowing regularly





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