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Preparing for Childbirth: Care Instructions

Overview

You are getting close to the birth of your child, and you will start to notice common changes and early signs of labour very soon. For months, you've been taking care of yourself and the baby. Now you can still take steps that will help you have a healthy labour and birth. You can take classes to help prepare for the birth. You also can talk with your doctor about what you would like to happen during your labour.

In the last 2 months of your pregnancy, your baby becomes too big to move around easily inside the uterus and may seem to move less. At the end of your pregnancy, your baby probably will settle into a head-down position and your healthcare provider will be checking your baby’s position regularly. You will likely feel some pressure in your pelvis as you get close to the birth.

You may notice moments when your belly (uterus) tightens and becomes firm to the touch, then relaxes. These are called Braxton Hicks contractions, which sometimes occur as often as every 10 to 20 minutes. These contractions usually stop after a few hours. (True labour pains continue or increase if you move around.)

Rupture of your membranes ("breaking of the water") often is a sign that labour has started or is about to start. This happens when a hole or tear develops in the fluid-filled bag (amniotic sac) that surrounds and protects your baby. You may feel a huge gush of water or a steady trickle of fluid. Call your doctor, or midwife, or nurse advice line or go to the hospital if you think this has happened. Contractions may start, or if you are already having contractions, they may get stronger.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Eat healthy foods and stay active. Listen to your body, rest and sleep as needed. Take childbirth classes with your partner or coach. You will learn relaxation exercises that are helpful during labour. You also will learn what you can do to manage labour pain.
  • Practice self-care – take time to do activities you enjoy every day.
  • Mental Health – mixed emotions are normal at this stage of pregnancy. If you or your partner feel depressed or anxious, talk with each other and your healthcare provider about your feelings, anxiety, or worry.
  • If you have other children, take a class to learn how to help them adjust to the new baby.
  • Develop a written birth plan, if you choose to, keeping in mind that labour is hard to predict and your plan may change after labour begins. Some of what a birth plan may address includes:
    • Where you would like to have your baby. This includes the building and the room. It could be the hospital's birthing room, a separate birthing centre, or your own home. Discuss the pros and cons of each location with your partner and healthcare provider.
    • Who you would like to assist with delivery of your baby, such as your doctor or midwife. Some women prefer to have a doula to provide support before and after delivery.
    • You may want to have family and friends around you or only the baby's other parent or another support person, such as a doula, nurse, midwife, or childbirth educator to give you support from early labour until after childbirth.
    • What comfort measures you want. You may have to choose between walking around during labour or having the security of a heart monitor for your baby. You may want to listen to music during labour. You may know what position you want to be in (such as sitting, squatting, or reclining) for pushing. To learn more about ways to work with your body during labour, go to: Positions for Labour - Healthy Parents Healthy Children.
    • What pain relief you would like. There are several choices, so be sure to talk with your doctor or midwife about them.
    • How you want you and your baby to spend the first few hours after birth.
      • Holding your baby skin to skin as soon as possible after delivery for at least 1 hour of uninterrupted time helps with bonding and early breastfeeding.
      • You may want the hospital to delay some infant care steps, such as a vitamin K injection, so that you have calming time with your baby.
      • You may not want visitors, or you may want other family members there.
  • Know the early signs of labour, such as a steady ache low in your back, irregular contractions, and fluid leaking from your vagina.
  • If you are going to a hospital or clinic to have your baby, have your bag ready to go.
    • Pack pyjamas, robe, underwear, socks, slippers, soap, shampoo, brush, toothbrush, and toothpaste.
    • In your baby's bag, bring an outfit, small blanket, and diapers. Have your car seat ready to go.
    • Go to Healthy Parents Healthy Children website for a more complete Packing list for the birth centre.

When should you call for help?

Share this information with your partner or a friend and they can help you watch for warning signs.

Call 911 anytime you, your partner, or a friend think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You had a seizure.
  • You have severe vaginal bleeding.
  • You have severe pain in your belly or pelvis.
  • You have had fluid gushing or leaking from your vagina and you know or think the umbilical cord is bulging into your vagina. If this happens, immediately get down on your knees so your rear end (buttocks) is higher than your head. This will decrease the pressure on the cord until help arrives.

Call your doctor, midwife, or nurse advice line now or seek immediate medical care if:

  • You have signs of pre-eclampsia, such as:
    • Sudden swelling of your face, hands, or feet.
    • New vision problems (such as light sensitivity, blurring, or seeing spots).
    • A severe headache.
    • New right upper belly pain.
    • New severe nausea and vomiting.
  • You have any vaginal bleeding.
  • You have pain in your belly or pelvis.
  • You have a fever.
  • You think you are in labour or have had regular contractions (with or without pain) for an hour. This means that you have 6 or more within 1 hour after you change your position and drink fluids. See Preterm Labour: Care Instructions for how to check if you are having contractions.
  • You have a sudden release of fluid or leaking from your vagina.
  • You have low back pain or pelvic pressure that does not go away.
  • You notice that your baby has stopped moving or is moving less than 6 times in 2 hours.
    • Follow your healthcare provider's instructions about how often to count your baby's movements. To keep track of your baby's movements and for more information on how to count them, go to: Fetal Movement Count Chart.
  • You have severe nausea or vomiting – vomiting more than 3 times a day or are too nauseated to eat or drink (especially if you also have fever or pain).

Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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