• Your Pregnancy: Early Signs, Stages of Labor, and Ways to Give Birth

    Everything you need to know from the time you find out you're pregnant until you bring baby home.
    by Rachel Perez .
  • pregnancy baby

    Congratulations, you're going to be a mom!
    PHOTO BY iStock

    Pregnancy is a gift for those who choose it. It's the beginning of a fulfilling but challenging journey to motherhood. Trying to conceive can be natural and spontaneous, or a carefully timed sexual intercourse during the woman's fertile period, especially for those who are eager to be parents.

    If you've been sexually active during your ovulation period and you didn't use any kind of contraception, natural or otherwise, you can get pregnant. If you suspect that you are, this guide will walk you through every stage of your pregnancy. Remember, the information here does not in any way replace any of your prenatal checkups. Aside from your partner or husband, your doctor is the most critical member of your birthing team.

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    Early pregnancy signs

    Most of us know that a late period is a pregnancy sign, but it can also mean something else. You can experience a delay when your period comes due to stress. Tenderness of the breast, more vaginal discharge than usual, cramps, and constipation can mean pregnancy, OR you are about to get your period.

    The "infanticipation" is real, though, and any sign of pregnancy is met with much hope. The more days pass without your monthly menstrual cycle, the higher the hopes you already have a bun in the oven. The expectations even become higher when you experience subtle signs of morning sickness, such as nausea, vomiting. If you suddenly have mood swings and food cravings you can't ignore, you may be pregnant. A home pregnancy test and a blood test at your doctor's clinic can confirm it. 

    Symptoms of pregnancy

    Every pregnancy is different, and not all will have the same pregnancy symptoms. Some women can have one or two symptoms, while others would have all of them. Even the morning sickness that many think are present in all pregnancies differs for every woman. You may not experience morning sickness at all. Or the severity of your  nausea doesn't happen every morning, but all day every day. This can make you lose weight, become dehydrated, and you can end up hospitalized.

    For some preggos, the food craving isn't as strong yet in the first trimester, but it isn't surprising if they develop an aversion to food that was not a problem before. Suddenly they can't stomach seeing or smelling a particular food item. You might start detesting scents like your partner's cologne or aftershave, which they bought and used before you got pregnant.

    What most women will certainly experience during pregnancy is how they quickly become tired, especially during the first trimester. Exhaustion can set in when they're accomplishing simple daily tasks. The fatigue is a result of the higher levels of the hormone progesterone in a pregnant woman's body, which is also producing more blood to sustain a developing baby's needs.

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    Managing pregnancy symptoms

    It might be tricky at first, but the first trimester is manageable. Tests such as ultrasound scans, blood sugar tests, and other routine laboratory exams help your doctor come up with the best prenatal plan to make sure you and your unborn baby are safe and healthy. She can give you tips on how to eat healthier but not necessarily more (it is easy to end up quickly packing on pounds that may not be good for you or your baby). You may need prenatal vitamin supplements to help you up your nutrient intake, which your developing baby needs.

    Your doctor is also the best person to ask what kind of exercises you can do to continue to be active, which could affect how your pregnancy progresses and how you deliver your baby. Unless you have complications, being active and doing low-impact exercises daily for 30 minutes is recommended for preggos. Yoga, swimming, and Pilates are other ideal fitness regimens for pregnant women.

    Your regular prenatal checkups are opportunities for you to get to know your baby and become updated on his developments, so try not to skip them. Pregnancy is the time to take better care of your health. Listen to your body and know when it needs to take a pause and rest. Getting sick during pregnancy may lead to health complications (yours and your baby), so it is best to follow your doctor's advice throughout the pregnancy.

    A lot of changes are happening in your body due to pregnancy hormones that are working hard to make sure your body can adequately support your developing baby. Most of the body changes, especially the weight gain, skin discolorations, and facial skin breakouts are temporary.

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    Warning signs and red flags

    An uncomplicated pregnancy is every woman's wish, but there are many things doctors still don't know why a complication happens with one woman and not with another. It means you may be doing everything he tells, and something can still go wrong. It's why it is vital to be well-informed. If you experience the red flags listed below, inform your doctor or head to the hospital as soon as possible.

    • Heavy vaginal bleeding
    • Severe abdominal pain
    • Sudden thirst
    • Decrease in the frequency of baby’s kicks or movements
    • Severe headache
    • Blurring of vision and other vision disturbances
    • Pain in the upper part of the belly that’s radiating from the back
    • Severe nausea and vomiting
    • High fever
    • Painful urination
    • Swelling of hands, ankles, and face

    If you feel that anything else is amiss, consult your obstetrician-gynecologist. Your doctor should be able to explain to you what it is or order tests to find out more about your concern. If there is indeed reason to be alarmed, even if it's a discomfort or a pregnancy complication, he or she can also help on how you can cope or best manage it. The key to addressing pregnancy complications is to catch it early and handle it well to prevent it from escalating.

    Going into labor

    Waiting for your baby's arrival is as nerve-wracking as the time your pregnancy test kit revealed two lines. In nine months, you'll be responsible for a new life. But we encourage you to chill (as much as you can) and, as we like to call it, hibernate during these nine months. You will need a LOT of energy when your baby comes out and the sleepless nights you've heard once you bring home are all true.

    During your first prenatal checkup, your doctor will estimate your due date by asking when was your last menstrual cycle and calculating the size and weight of your unborn baby. It isn't exact. You can go into labor and give birth two weeks before or after your due date.

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    When to go to the hospital

    The first stage of labor is when you're feeling regular contractions at intervals that gradually decreases, but with an intensity that continuously increases. You may also feel discomfort on your back and abdomen (pain medication can help but not a lot). You may also experience bloody vaginal discharge or a sudden gush of water from your vagina. If you encounter one or more of the signs as mentioned above, call your doctor and head to the hospital immediately.

    Labor pain relief

    The contractions are a result of your cervix opening or dilating, which could take a few hours or even a day. It is the part of labor that women who have given birth warn many soon-to-be moms. There is no doubt that it is a painful stage, but there are ways to feel (a bit of) relief.

    For starters, changing labor positions, such as walking, leaning on your partner while standing, being on all fours, squatting or sitting on a birthing ball helps relieve the pain. Distractions, such as playing soothing music and getting a gentle back rub, helps, too.

    Pain medication is also an option, and just because you ask for it doesn't make you less of a mom. You should discuss this with your doctor beforehand if you want or might need general anesthesia, spinal block anesthesia, or an epidural. You can ask for it anytime during labor, but your doctor is better equipped to know when to administer it.

    Birthing your baby and the placenta

    The timing of your pain relief during labor is crucial because contractions are vital to giving birth. Once your cervix is fully dilated, you should simultaneously push as you're having a contraction. You'll feel an overwhelming urge to push and a tingling, stretching, and stinging sensation in the vagina as the baby's head is crowning. These sensations may lessen when you're on pain meds although it doesn't always mean you won't be aware of the contractions. Your doctor will coach you when to push as well. As your baby emerges, it will be a slippery wet feeling, often painless.

    When done right, this second stage of labor can take as little as a couple of minutes to push your baby out. Once your baby is out, you need to birth your placenta next. Your doctor will help you deliver it by pulling the umbilical cord gently with one hand while pressing and kneading your uterus with the other and asking you to push at the right time. It's like birthing all over again, but you may not even notice when the placenta is out.

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    Having a C-section

    Many, if not all, pregnant women aim to give birth via normal spontaneous delivery (NSD) or natural vaginal birth. Going through labor may be difficult and could take hours but recovering from a vaginal birth is still faster compared to a cesarean section or C-section, a major surgery, especially when it comes to postpartum recovery.

    No matter how you wish and pray for an uncomplicated birthing experience, it's good to be emotionally ready for situations when you have no choice but to have a C-section (CS). Having a birth plan is a good thing, but you have to understand and remember that your requests only stand as long as they do not endanger you or your baby. Doctors will have to consider both you and your baby's health and safety.

    The World Health Organization (WHO) and the American College of Obstetrics and Gynecology (ACOG) both acknowledge that as much as each pregnancy is different, so is every birthing experience. Many pregnant women need a C-section due to complications during pregnancy and childbirth.

    High-risk pregnancies are typically more at risk to develop complications. If a pregnant woman is older than 35, carrying multiples, conceived via assisted reproductive technology (ART) such as in vitro fertilization (IVF), she is also more prone to health and birth complications.

    Health complications in pregnancy

    Even when you've followed your doctor's orders from your first prenatal visit, some pregnant women are just more likely to develop complications due to their family or patient history. Gestational diabetes, for example, may result in a larger than usual baby who may not fit through your birth canal. Preeclampsia or high blood pressure during childbirth may cause seizures.

    Doctors can further prevent these health complications from unfolding or worsening during birth by opting for an elective or scheduled C-section. Barring any emergency situations, make sure your doctor sets you up for a C-section only when you are already full-term, or at least 38 weeks gestation.

    Childbirth complications

    The most common example of a birth complication is when your baby is not in the optimal position for a vaginal birth. If your little one's head is not facing downward toward your birth canal, then it's difficult to have a smooth vaginal delivery. A baby in a breech position, which means his bottom or feet will come out first, is risky, though vaginal births of breech babies are not entirely impossible. If your baby is in a horizontal position at the time of birth, then there's no other way to safely delivery him or her than via a CS.

    Other types of birth complications include having your placenta wholly or partially covering your cervix, which in both cases, your baby has no clear way out of your vagina. Vaginal delivery is risky if your baby has a cord prolapse, especially when the cord coil is around your baby's neck.

    If you are fated to have a cesarean section, you can still talk to your doctor about making it a more gentle birth as much as possible. And never forget that a cesarean delivery doesn't make you less of a mother compared to a mom who delivered her baby vaginally. Yes, there is mom shaming for those who deliver CS — go figure. Having a C-section doesn't make you any less of a mother.

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    Welcoming your newborn baby

    As soon as your baby is born, four crucial steps will help set up your baby for lifelong health. WHO, together with health communities around the globe including our Department of Health, has set up the essential newborn or baby care protocol dubbed as "The First Embrace" (Unang Yakap) to help prevent neonatal deaths worldwide. It also sets straight a few old childbirth practices that shouldn't be done in the delivery room anymore.

    Immediate drying

    The first act that doctors should do is to gently pat him dry immediately after being born to help stimulate his breathing, keep him warm, and prevent hypothermia. Letting the vernix, or the substance coating a newborn's skin, stay as long as possible also helps the baby from potentially lethal infections. Delaying a newborn's first bath helps promote the baby's natural reflex to crawl to his or her mother's breast for some important skin-to-skin contact.

    Skin-to-skin contact

    When mom and newborn are bare-skinned and chest to chest, it transfers the mother's warmth and protective bacteria that helps keep the baby calm and healthy. Skin-to-skin contact has been proven to save the lives of babies and helps promote breastfeeding and initiate mother and baby bonding. Experts also recommend prolonged skin-to-skin contact, otherwise known as Kangaroo Mother Care, which can also be done by the new dad or the baby's older siblings.

    Delayed cord clamping

    Waiting at least 30 seconds to a full minute, or until after the umbilical cord's pulsations have stopped is hugely beneficial to your newborn's health. The additional blood flow from the placenta has been proven to contain essential nutrients and antibodies. The extra blood volume has also been linked to helping improve blood circulation and better red blood cell extent. It also lowers the baby's chances of suffering a brain hemorrhage and intestinal tissue damage.

    Breastfeeding

    There is a reason why the WHO and all other mom and baby institutes and organizations worldwide say that breastfeeding and breast milk is best for babies up from birth to at least six months up to two years and beyond. It's the only nutrition your baby will require — no need to give your baby water or formula milk—until you start introducing your baby to solid foods when he reached six months to supplement his nutritional needs.

    Aside from giving your baby the best nutrition, the antibodies that you pass on to your baby through your milk serves are your baby's first immunization to help keep illnesses at bay. Other benefits of breastfeeding for your baby include helping him develop a sleeping pattern helping him sleep better, reduce the risk of sudden infant death syndrome (SIDS) and fosters mother and baby bonding.

    Breastfeeding also benefit moms, too, as it helps shrink the uterus to its average size. Studies have shown that nursing moms are less likely to develop hypertension, heart diseases, breast and ovarian cancers, type 2 diabetes, and other illnesses associated with old age, such as Alzheimer’s disease, muscle degeneration, osteoporosis, and rheumatoid arthritis.

    Contrary to what many women think, it rarely happens naturally. Yes, your baby may have a reflex crawl to your breast and to suck when latched on to your nipple to nurse. It's the most natural thing for a mother and newborn to do, but it still entails a lot or information gathering to be able to do it right and a lot of practice so you can your baby can get the hang of it.

    Breastfeeding can be a struggle at first, but it's definitely worth it and manageable. Sore engorged breasts, sore nipples, low milk supply, and more — these challenges are not pretty or comfortable. But for every nursing challenge, you need only to ask for help and consult your doctor or a lactation counselor for tips on how to address them adequately.

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    Caring for a premature baby

    There are many possible causes of premature birth, including having high-risk pregnancies, pregnancy complications, and even experiencing stress during pregnancy. Unfortunately, there's no telling during pregnancy if you will have a premature birth.

    If you give birth before you reach the 38th to 39th week of pregnancy, your baby is considered premature, otherwise called preterm infant or preemie. A full-term baby weighs an average of seven pounds, while a premature baby weighs five pounds or even less on average. There is a chance that your baby will stay in the hospital's neonatal intensive care unit (NICU) even after your doctor gives you the order to go home.

    Before your preemie baby can "graduate" from the NICU, doctors need to check that all his vital organs are fully developed and functioning correctly. They need to make sure he can breathe oxygen unassisted, regulate his body temperature on his own, his digestive system can handle regular feedings, and his body can get rid of waste such as pee and poo, and more.

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    Ensuring that your premature baby receives the first four essential newborn care steps is a great start. These practices have been proven to help full-term babies thrive. Delaying cord clamping, skin-to-skin contact, kangaroo care, and breastfeeding as soon as your baby's pediatrician tells you it's okay all have an even more significant impact in improving your preemie baby's health.

    Even if your little preemie is staying in the NICU, you should be able to nurse and hold him or her. Aside from these, moms of premature babies are encouraged to talk, sing, and read to their baby.

    Taking your baby home

    When you bring your baby, whether full-term or premature, make sure that your baby's space is clean and calm. Make sure your hands are clean when you handle your baby. Limit visitors and take every necessary precaution to prevent your baby from getting sick.

    Pregnancy, birth, breastfeeding and baby care is only the start of your parenting journey. Do your research, listen to your doctor and absorb everything you can about being a mom. However, choose wisely what pieces of advice and techniques you adapt to your parenting style.

    Take it one step at a time, and remember that you are not alone. It takes a village to raise a child, so feel free to ask for help when you feel a bit overwhelmed or exhausted. A big part of being a great mom is also taking care of yourself. So enjoy and good luck!

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