Countdown to labor, pregnant mommy is ready! Nearly 10 months later, pregnant mothers finally have to "unload"! But when I am happy, with the baby getting bigger and bigger, my mother's discomfort is getting worse. While suffering from edema and constipation, I have to worry about the state of the production process. Want to deal with the labor problem slowly? Come and do your homework with us! Prenatal changes & pregnant moms may encounter various degrees of physical and mental conditions during pregnancy preparation, and these discomforts will be more aggravated about one month before labor. Usually, in addition to keeping your body in the best condition, you should always pay attention to the appearance of omens. Primiparas, in particular, are not familiar with the production process and are likely to be in a hurry at the first sign of delivery. Therefore, knowing the details of labor and production in advance will make the midwifery process smoother.

Countdown before delivery 1 month For many pregnant mothers, discomfort symptoms such as edema and constipation during pregnancy are often a big worry, which is unbearable until the 33rd and 34th weeks. These symptoms are more serious because the baby is getting bigger and bigger, which bothers many pregnant women. But at the same time, pregnant mothers should be reminded that in the key 30 days before delivery, in addition to closely observing their physical and mental changes, they should also start to do other preparatory work, such as regular prenatal examination and cleaning up the bags that have not been ready just now.

Maternal oppression increases with the increase of gestational age, the fetal position will gradually decrease around 36 weeks, and the baby's head will enter the pelvic cavity around 38 weeks. However, with the decrease of fetal head, the pressure on pregnant mommy will also increase, which will make the blood reflux worse, leading to more serious problems such as hemorrhoids and varicose veins than before. Common symptoms are as follows:

(1) Frequent micturition: The fetus squeezes downward and oppresses the mother's bladder, which makes the pregnant mother's frequent micturition more serious.

(2) Lower extremity edema: Although the edema problem will not cause too strong discomfort, if pregnant mommy is quite concerned about the edema problem, she can slightly raise her legs or gently massage them before going to bed. Shen Mengxun, an obstetrician and gynecologist at the Affiliated Hospital of Taipei Medical College, reminded that if it is just a simple edema problem, don't worry too much, usually it will automatically improve after delivery. But if it is systemic edema with proteinuria, it may be pre-epilepsy, so pregnant mommy should pay more attention.

(3) Varicose veins: In the third trimester of pregnancy, the blood return of pregnant women becomes worse, which makes the calves, thighs and vulva prone to varicose veins. It is suggested that pregnant mothers with this problem can wear special elastic socks to prevent varicose veins, or try to massage their feet to relax their legs. They can also raise their legs with pillows at night to help blood flow back.

(4) Constipation: In the third trimester of pregnancy, the uterus carrying the fetus is pressed into the intestine, which aggravates the constipation problem of pregnant mothers. Many pregnant women will still be constipated even after giving birth. It is suggested that pregnant mothers adjust their daily routine and eating habits in order to really improve constipation.

(5) Hemorrhoids: The hemorrhoid problem that plagues many pregnant mothers is mainly conservative treatment during pregnancy, and invasive surgery is not recommended. Generally speaking, a good routine and eating habits can avoid constipation and relieve the symptoms of hemorrhoids. As for medication, doctors usually prescribe painkillers, laxatives and detumescence ointments to relieve the discomfort of pregnant mothers. Usually, acute pain will be relieved within 2 or 3 days after taking painkillers, but swollen hemorrhoids will gradually become smaller after using detumescence ointment for about two weeks. It is suggested that pregnant mothers can wait until postpartum to continuously observe whether the hemorrhoid situation has improved. If postpartum hemorrhoids have not recovered, please ask a surgeon to assist in surgical treatment.

(6) Dyspnea: As the baby gets bigger and bigger, the maternal cardiac output will also increase the load, which makes pregnant mothers often feel poor breathing, easy breathing, and even insomnia. It is suggested that pregnant mothers sleep in the left prone position and raise their pillows slightly to help them breathe smoothly.

Put the pillow higher to help you breathe smoothly.

Countdown to labor, pregnant mommy is ready! In addition to the symptoms caused by the oppression in the mother's body, during pregnancy, the mother will change her body structure because of her pregnant posture, such as backache, pubic tightness and so on. Other physical changes include hormonal changes during pregnancy, increased pudendal secretion, and various difficulties have made pregnant women suffer enough.

(1) Pubic pain: In order to cope with the upcoming delivery time, the pelvic structure of pregnant mommy will begin to change, which will make pregnant women feel a little bloated and cause some problems such as mobility inconvenience, but most pregnant women will heal themselves after delivery. If postpartum symptoms persist, rehabilitation treatment may be needed.

(2) Lumbago: When the pregnant mommy's abdominal load increases, in order to maintain the normal curve of the waist, part of the weight will be borne by the waist muscles, and the spine will also feel the pressure doubling, causing the pregnant mommy's lumbago.

(3) Hormone effects: During pregnancy, maternal hormones change dramatically, which makes pregnant mommy's vaginal mucosa easily congested. In addition, pregnant women's immunity is weak, and the genitals are prone to infection and inflammation, which increases secretions. In order to avoid bacterial infection, it is suggested that pregnant mommy can observe whether the secretion has odor or whether the secretion is yellow-green or gray. If it is abnormal, you should consult a doctor as soon as possible.

(4) Decreased fetal movement: In the third trimester of pregnancy, because the inner space of the uterus is almost completely occupied by the fetus, the baby's range of activities becomes smaller, so compared with the second trimester of pregnancy, fetal movement will be reduced a lot, but if there is no fetal movement all morning or all day, it is abnormal, and pregnant moms should pay more attention.

There is only one month before the due date. At this time, all aspects of the baby's physical and mental condition, such as the development of the main organs of the body, are mature, so if the baby reports in advance at this stage, don't worry too much. However, before delivery, pregnant mothers should still maintain weekly routine check-ups. Through routine examination items, pay attention to whether the baby has signs of coming out, observe the situation of the fetus, and discuss the most suitable delivery method with the doctor. Chen Yujing, an obstetrician and gynecologist at Changhua Christian Hospital, reminded that mothers who choose to give birth naturally should be screened for Streptococcus B in about 35-37 weeks in addition to the general examination items. Dr. Chen explained that for adults with good immunity, Streptococcus B will not produce symptoms, but the newborn's immunity is weak. During childbirth, if the newborn is infected when passing through the birth canal, it may lead to meningitis or septicemia, and even affect life safety.

Countdown to labor, pregnant mommy is ready! Check! Once there are signs of prenatal preparation, pregnant mommy is likely to go to the hospital for labor, so it is also one of the homework that pregnant women must do to deal with what has been decided in advance. For example, pregnant mothers of office workers should start handing over work-related matters with colleagues. Dr. Chen Yujing reminded that according to the provisions of Lao Ji Law, maternity leave can start four weeks before delivery, but it should be noted that maternity leave is eight weeks. If you ask for leave too early, you may not have enough time to rest and recover after delivery. Therefore, pregnant mothers should consider their own situation before taking time off. In addition, the preparation of bags just yet has also caused many mothers a headache. In this regard, Dr. Shen Mengxun said that in fact, most hospitals now provide basic supplies, such as puerperium. For other necessary articles for labor and postpartum, please refer to the list of articles specially compiled for pregnant mothers to evaluate whether it is necessary to carry them.

The bag is not yet 100% guide

Certificate category ※

□ ID cards of both husband and wife

□ Mom's medical insurance card

Handbook of maternal health

General articles for pregnant women ※

□ Postpartum pad

□ Look at the pads or lengthen the sanitary pads.

□ Wash-free pants or sanitary pants

□ Warm clothes (such as gloves, socks and hats). ) when I was discharged from the hospital.

-clean pajamas when I was in hospital.

Other things for mom by caesarean section. ※

□ Perineal irrigator

□ corset belt

□ Beauty tape

Hospital supplies ※

□ slippers

□ toilet paper

□ Toilet articles (towels, soap, facial cleanser, etc.). )

□ toiletries (toothbrush, toothpaste, mouthwash cup, comb)

□ Personal belongings (camera, charger, etc.). )

Breastfeeding products ※

-nursing clothes (underwear, pajamas, etc. )

□ Anti-galactorrhea pad

□ Ice hot compress pad (used when mammary gland is blocked)

□ nipple cleaning cotton

□ Nipple care ointment

□ breast pump

□ Breast milk frozen bag

Baby products ※

□ wrap the towel

□ tulle clothing

□ Diapers

□ Milk powder and bottle (to avoid milk shortage)

□ discharged baby clothes.

Countdown to labor, pregnant mommy is ready! Three birth signs, when the birth signs of a new life appear, mean that pregnant mothers are about to face production challenges. The three most common signs are falling red, breaking water and labor pains. Dr. Shen Mengxun reminded that no matter what kind of birth signs appear, you should go to the hospital as soon as possible. If the doctor thinks that they are not ready to enter the labor process after evaluation, pregnant mothers can be psychologically prepared, but if pregnant mothers don't pay more attention, it may increase the probability of emergency delivery.

Red-The cervix is hard when not ready for delivery, but as the fetal head stimulates the cervix to dilate, the capillaries on the cervix will rupture and bleed, accompanied by mucus such as secretions, which symbolizes the maturity of the cervix and gives a warning of labor. Dr. Chen Yujing pointed out that falling red is the most common omen, but some pregnant women will skip the falling red stage and break the water directly. Remind pregnant mothers that when dark red secretions similar to menstrual blood are found in the pudendal region, the amount is usually not as much as that in the menstrual period, which means that the cervix is about to open. If pregnant mothers are not sure whether they need to go to the hospital immediately, they can call the delivery room and ask the nursing staff to help assess the situation.

Breaking water-avoiding bacterial infection When the amniotic membrane breaks and the sheep in the amniotic cavity flow out, it is what we often call "breaking water". According to Dr. Chen Yujing, if pregnant mommy breaks water before labor pains, it is called "premature water breaking", which can be divided into "premature water breaking" and "full-term water breaking". For pregnant mothers who break water in the early stage of premature delivery, the biggest impact is premature delivery, and premature babies may be accompanied by many complications, so they should seek medical attention immediately once they find water break.

However, if "late water breakthrough" occurs after labor pains, most pregnant women will enter labor within 24 hours after water breakthrough. Dr. Chen said that because the breakthrough is more than 24 hours, the probability of mother-to-child infection will increase obviously. 10 of pregnant women will have intrauterine infection, and the umbilical cord may flow out with the pressure of breakthrough, making the fetus face the crisis of hypoxia.

Labor pains-regular contractions When pregnant mommy starts to feel labor pains, don't worry too much. It is suggested to observe whether the frequency of labor pains is regular before going to the hospital. If the abdominal pain is quite irregular, and the pain decreases with the change of body position, for example, after lying down for a short rest, it only means "fake pain". However, if the pregnant mother's stomach gradually hardens and the pain becomes more regular and intense, it means that the real pain is coming. Dr. Shen Mengxun pointed out that at first, the frequency of pain may be 10 minutes, and the pain lasts for about 30 seconds, and then the frequency of pain will gradually become once every 5 minutes and once every 3 minutes. It is suggested that primiparas who are pregnant for the first time should be within 10 minutes. If the multipara gives birth to a second child or more, when the frequency of labor pains is about 5 ~ 10 minutes, they should seek medical attention as soon as possible.

No matter what the omen is, you should go to the hospital as soon as possible.

Countdown to labor, pregnant mommy is ready! When there are signs of labor, after the pregnant mother arrives at the hospital, the nurse will evaluate whether the pregnant woman is ready to enter the labor process, and if she is about to give birth, she will invite the pregnant mother to the labor room to make preparations. Now let's "preview" the delivery situation that natural mothers will encounter in advance through the explanation of professional doctors.

Most of the benefits of natural delivery are that if there is no indication of caesarean section, most pregnant women will generally adopt natural delivery. Dr. Chen Yujing pointed out that choosing natural delivery mode is a better decision for both mother and fetus. On the one hand, naturally occurring wounds are smaller and heal faster, and many pregnant women can move normally on the day after delivery. On the other hand, caesarean section mothers have to go through a long period of wound repair. For the baby, many studies have pointed out that after the birth canal is squeezed, the fetal pressure resistance will be better in the future, and the squeezing process will also help to discharge amniotic fluid from the baby's lungs, effectively reducing respiratory problems.

Enter the delivery room. Are you going to give birth? After the pregnant mother reports to the hospital, the nursing staff will first evaluate the changes of the cervix by detecting the frequency of uterine contraction and internal diagnosis. To determine whether the pregnant woman has entered the labor process and is ready to give birth. Dr. Shen Mengxun explained that the process from waiting to delivery can be divided into the following four stages:

The first stage is the incubation period of regular uterine contraction, until the cervix is completely opened to about 4 cm, and then it enters the rapid stage, that is, the contraction frequency changes rapidly.

The second stage: the cervix is fully open, from labor to fetal delivery.

After the third stage, the placenta is delivered. If the placenta is not delivered after 5 minutes, it may be a problem of placenta implantation.

The fourth stage of postpartum care.

After evaluation, pregnant mothers who are close to delivery can be arranged to be hospitalized, but if they fail to achieve the goal of delivery, they can go home to rest first, or go for a walk or activity nearby and then come to the hospital for evaluation. It is worth mentioning that even after entering the labor process, the progress of each pregnant mother's labor process is different due to different personal constitutions. Generally speaking, primiparas may have to face the labor process of 18 hours to 1 day, while the labor process of multiparas is about 10 hours.

Many pregnant women will hesitate whether or not to face the pain caused by childbirth. Should we consider an injection for pain relief and childbirth? Dr. Shen Mengxun believes that labor pain can be reduced by more than 80%. If you want to make the labor process easier and more comfortable, pain-reducing delivery is a good choice. It's just that not all constitutions are suitable for the application of analgesic delivery drugs. For example, pregnant women with abnormal blood coagulation function or easy pain in their spine should avoid using drugs. Dr. Chen Yujing added that the timing of injection for analgesia delivery is also very important. Generally speaking, it will be given when the pregnant woman enters the labor process and the cervical opening is about 3 cm wide. If you give it too early, it may cause the production schedule to stagnate. However, many pregnant women are also worried about whether the analgesic delivery needle will have side effects or sequelae. Dr. Chen explained that because the drug is injected from the spine, local hematoma may appear during the injection, but there is almost no other effect. Even pregnant women who have not been injected with analgesic delivery needles may still have backache after delivery, which is not directly related to the injection of drugs.

Enema-shaving, pregnant mommy decided that in the past, in order to make the production process smoother, nurses would give pregnant mommy an enema and shave the hair on the perineum, but in recent years, it has been found that whether these processes are carried out or not has little effect on the production process, so now many hospitals will consult pregnant mommy first. Pregnant moms don't want to or hurt, but many moms are constipated for a long time during pregnancy. If they pass the enema, they will be released. In fact, you can communicate with the nursing staff and clearly show your position and wishes.

Countdown to labor, pregnant mommy is ready! When the pregnant mother's cervix has been completely opened, the medical staff will guide the mothers to forcibly deliver the fetus during the contraction. If they don't exert their efforts at the right time, even if they do their best, it will be in vain. Dr Chen Yujing explained that when pregnant women feel pain, they can take a deep breath first, then hold their breath, and then push down. In the process of exhaling, spit down slowly, not all at once, so as not to prolong the labor process and increase the difficulty of production. Dr. Chen further reminded that if they make a sound when exhaling, or hold their breath to their faces, their faces may be red, their brains may be congested, and even their eyes may be broken. Although the congestion of eyes after delivery will gradually subside, in order to make the delivery process smoother, pregnant mothers can practice correct breathing more often in peacetime and better cooperate with medical staff during delivery.

At the last moment, when the pregnant mother successfully pushed the fetus down, the time for the baby to come into this world is getting closer and closer. However, at the last minute, due to the narrow vaginal opening of the parturient, the medical staff will give local anesthesia to the parturient, slightly cut the perineum, and sew it up after the operation, so that the baby can be delivered smoothly. Dr. Chen Yujing added that the pain caused by childbirth will be stronger than the feeling of perineum cutting. Therefore, if the situation is urgent, you can cut the perineum directly without local anesthesia, but there is no strong discomfort in clinic. In addition, if the head of the fetus is close to the vaginal opening, but the mother is too weak to push the baby down, the baby's head may be taken out with a vacuum aspirator, but if it is used too frequently, it may cause congestion and hematoma in the baby's head.

Evaluation of APGAR Score for Newborns After the fetus is delivered smoothly, the medical staff must immediately make a rapid and reliable overall evaluation of the newborn baby, and evaluate the health status of the baby through the indicators of APGAR score scale, such as heartbeat, breathing, muscle tension, reflex, skin color, etc. For example, judging from the baby's skin color whether there is hypoxia, the score is 1 *** 10. If the baby's score falls between 8 and 10, it means that the newborn is healthy and full of vitality; A score of 5 to 7 indicates that the fetus is slightly embarrassed, and a score below 4 indicates that there are serious heart and lung problems. If the baby is in good condition, the medical staff will clean the blood, water and other impurities, and put the newborn on the mother's chest, so that mommy can feel the first skin contact between parents and children.

Postpartum care is not sloppy. Although the baby has delivered safely, pregnant mommy should not take it lightly. In addition to paying attention to postpartum hemorrhage, we should also avoid too many actions, so as not to cause the perineal wound to split again. In addition, women should keep the perineum clean, observe whether the color and taste of lochia are abnormal, and reduce the chance of bacterial infection. Dr. Shen Mengxun reminded that since most mothers want to breastfeed their babies now, breast care is also the key to postpartum care.

Breast care is also the key to postpartum care.

Countdown to labor, pregnant mommy is ready! Preview the production situation-Caesarean section If you have had a caesarean section for the previous fetus, had surgery for diseases such as uterine fibroids, or the baby's fetal position is not correct, it is estimated that the fetal size is more than 4,000 grams, and the placenta previa, uterine fibroids and other obstacles make it difficult for the fetus to give birth smoothly, which is an indication of caesarean section subsidized by the government. Although the delivery process of caesarean section seems to be much easier than natural delivery, there are still many "eyebrow angles" to pay attention to!

Before admission, pregnant mothers who choose to give birth by caesarean section usually agree on the delivery date with the doctor at the prenatal clinic, so they have enough time to prepare related items for labor and hospitalization. Usually, pregnant women who have caesarean section must be hospitalized one day before the expected date of delivery, and complete medical record consultation, fill in the consent form for operation and anesthesia, and check their identity. It is convenient for medical staff to master the physical and mental condition of pregnant mommy and reconfirm the operation method. At the same time, it is also necessary to prevent various possible mutations in advance through urine and blood tests. In addition, in order to avoid the discomfort caused by anesthesia, pregnant mommy should fast for 8 hours the day before the operation, so that she can have a good sleep and make up her mental and physical strength for the next day's delivery.

I'm ready. On the day of entering the operating room, the medical staff will accompany the expectant mother to the delivery room. In order to be cautious, they will check their identities and medical records again, and then ask the mother to lie flat and start anesthesia. Generally speaking, if there is no emergency caesarean section, more half-body anesthesia is used, that is, only the lower body is anesthetized, and the maternal upper body is still conscious. Dr. Chen Yujing explained that half-length anesthesia was used to prevent the anesthetic from being absorbed by the baby by mistake through the placenta. After the anesthesia is completed, the medical staff will start to disinfect Mommy's abdomen and place a catheter to prevent the parturient from urinary incontinence during the operation or dysuria after delivery. Then the important moment comes, and the medical staff will take the baby out with a knife.

After everything is ready in the fluoroscopy production process, the medical staff will cut the knife horizontally about 10 ~ 15 cm above the pubic bone of the parturient, but Dr. Chen added that if it is an emergency laparotomy, a straight incision may be adopted. After the scalpel is cut, the medical staff will enter the subcutaneous fat layer from the surface down and open the maternal stomach layer by layer. In order to avoid affecting the production, other organs near the uterus, such as intestine and bladder, will be slightly pushed and fixed with gauze, and then the gauze will be removed after the production; Then the serosa layer of the uterus will be cut, and the muscular layer of the uterus will be cut. The midwife will also assist in gentle compression and help the delivery. However, Dr. Chen reminded that because women often use half-body anesthesia, midwives may feel a little uncomfortable when compressing their abdomen. After the baby is successfully taken out, the doctor will sew up the uterus of the parturient, remove all the blood in the body, then sew up the abdomen, and finally put on breathable tape and gauze to complete the whole operation.

What is the need for emergency laparotomy? If a pregnant mother is in labor, fetal heart sound monitoring shows that the baby's heartbeat is abnormal, such as the heartbeat is not within the average range and the heartbeat stops intermittently. In order to maintain the safety of babies, emergency laparotomy is often suggested. Other situations that require emergency laparotomy, such as labor stop, difficult delivery, and the inability of vacuum aspirator to deliver smoothly, will take emergency laparotomy to help the mother and baby tide over the difficulties.

Precautions after caesarean section After the caesarean section is completed, the medical staff will also make a preliminary assessment of the newborn and make parent-child contact, and then send the mother to the recovery room, and after observing for several hours, send the baby to the mommy ward. But the road to recovery after caesarean section is not as easy as natural delivery. Especially on the day of delivery, if the anesthetic does not completely subside, it may not be able to interact with the baby well, so we must pay more attention to hematuria, blood pressure, heartbeat and other items. In addition, due to the large wounds caused by caesarean section, inflammation is prone to occur. In order to avoid infection, it is recommended to keep dry for a week, and then take a bath after the doctor evaluates the healing situation to avoid pain, redness and other discomfort caused by contact with water. Dr. Shen Mengxun appealed that in addition to basic wound care, it is also suggested that caesarean section mothers can wear corsets or put beauty tapes on the wounds to pressurize the wounds on the one hand and prevent scar hyperplasia on the other.

Countdown to labor, pregnant mommy is ready! Mothers experienced many difficulties in the second and third delivery, and finally gave birth to their beloved baby smoothly. Although daily life and behavior need not be as cautious as before delivery, the seemingly healed wound is still recovering, so even after returning home from the hospital, there are still many aspects that need to be paid more attention to. For pregnant women who are about to give birth, doctors also provide some tips, hoping to help pregnant mothers relax and face childbirth in the best state.

The body is still recovering after delivery. Usually, a natural mother can be discharged from hospital in about 3 days, but due to the small perineal wound, she can resume her activities in about 4 ~ 6 days. However, caesarean section requires the parturient to be hospitalized for 5 ~ 10 days, and the stitches are removed on the seventh day or so. It takes about 2 weeks to resume prenatal activities. Although mothers don't think the uterus is abnormal, it actually takes 4 to 6 weeks for the uterus to return to its normal size and state before pregnancy. Therefore, even if the body does not feel particularly unwell, mothers should avoid lifting heavy objects during confinement and observe the amount of lochia. If there is a lot of lochia similar to menstrual blood, or the perineum and abdominal wounds are swollen, the abdominal condition is unknown, and mommy has a fever over 38℃, you should seek medical attention as soon as possible.

A reminder to mothers: Most primiparas may not be familiar with the situation and process of delivery, so if there is an emergency, they will often be very anxious. Dr. Chen Yujing suggested that if pregnant mothers have any questions, they can refer to the hospital delivery room number in the pregnant women's health manual and call professional medical staff. Dr. Shen Mengxun added that some pregnant mothers will want to say "wait and see" when signs appear, which will increase the risk of emergency delivery. In addition, pregnant mothers should be reminded to avoid makeup, nail polish and accessories, so as not to let doctors misjudge the physical and mental condition of pregnant mothers. For example, if an anemic pregnant mother covers her nails and lips with finger color or lipstick, it may affect the doctor's judgment. It is believed that pregnant mothers can safely spend their pregnancy and give birth to healthy and lovely babies through the advice of doctors and the preliminary preparation of the production process.

Shen Mengxun Education: Department of Medicine, Taipei Medical College Experience: Resident and Chief Physician, Department of Obstetrics and Gynecology, Taipei MacKay Memorial Hospital; Reproductive Infertility Research Physician, Affiliated Hospital of Taipei Medical College Current position: Attending physician, Department of Obstetrics and Gynecology, Affiliated Hospital of Taipei Medical College.

Chen Yujing Education: Department of Traditional Chinese Medicine, Institute of Integrated Traditional Chinese and Western Medicine, China Medical University. Master: Research Physician of Obstetric Infertility in Changhua Du Ji Education Hospital, Attending Physician of Obstetrics in Erlin Branch of Changhua Christian Hospital, and Expert of Taiwan Province Obstetricians and Gynecologists Association. Current position: attending obstetrician in Changhua Christian Hospital.