Tips on how to manage your first maternity hospitalization.

No. Activities Stage Check List
1. Signs of Labour Ensure that you have signs of labour such as rupture of membrane and contractions.
2. Admission
  • Medicare card
  • Private health Insurance card (if any).
  • Pre-natal records from your doctor’s office.
  • Name of your baby’s paediatrician (if any).
  • Birth plan (if any).
3. Basic Needs
  • Mother’s clothing (Lots of underpants, loose & comfortable clothes, slippers, toiletries, maternity pads, breast pads, snacks, book to read, etc).
  • Baby’s clothing (Nappies, receiving blanket, mittens, socks, etc).
  • Newborn Nappies and wipes.
  • Mother’s food & snacks (Mineral water, juices, yogurt, chocolate bar, fresh fruits, etc).
  • Other things such as massage oil, lotions, music, medications, etc.
4. Hospital Stay
  • Most of the questions about your hospital stay will already be addressed when you choose your doctor and hospital. Make sure that you are well-versed on the hospital’s procedures and regulations. Seek help from the attending midwives should you need further assistance.

Check-up list

No. Check-up List Reasons
1. Confirm appointment date & time. Avoid miscommunication and long waiting hours.
2. Search for exact location of the hospital/medical centre. Avoid stress due to getting lost.
3. Health Insurance Card & documents (if any) OR cash / credit card. For ease of payment and coordination.
4. Medical history Inform doctor if you have any medical conditions such as allergy, high blood, diabetes, epilepsy or any condition that might pose a risk to you and your baby. It is also good for you to remember your menstrual cycle (the start and end of your last period).
5. Notes & list of questions you want to ask. Clear all doubts that you have related to pregnancy issues, health issues, emotional issues and any other matter related to childbirth including costs, emergency plan, etc.
6. Dress appropriately To avoid inconvenience and easy check-up.
7. Bring hygiene wipes & sanitary napkins. In case of bleeding, etc.

 

Normally on the first check-up, the doctor will perform the following tests:

  1. Physical Examination: Weight & height; Blood pressure, heart rate, lungs and breast are checked
  2. Urine test.
  3. Palpation & blood pressure.
  4. Internal examination (Pelvic examination). Pap smear is usually conducted to screen for Cervical cancer.
  5. Ultrasound (more at My First Ultrasound page) to verify due date and check baby’s hearbeat.
  6. Blood tests.

The doctor will discuss test results with you and advise you on steps to be taken to safeguard your pregnancy and care for both your health and your baby’s health. Always talk to your health care provider if you have any questions or concerns.

Types of check-up

There are two types of check-up commonly conducted:

  1. Internal examination: Insertion of two fingers into your vagina and pressing of abdomen to palpate your uterus. (Conducted on obese women or when scanning doesn’t provide any result.)
  2. Ultrasound: Normally conducted when the pregnancy reaches 18 to 20 weeks.

 

Why are these check-ups important?

Check-up is important to determine several key factors in your pregnancy and when you are about to delivery your baby such as:

  1. Estimation of due date.
  2. Monitoring of baby’s growth and health.
  3. Monitoring of mother’s past and present health and condition.
    You will be asked about any previous pregnancies, surgeries, medical conditions, current medications and exposure to contagious diseases.
  4. Recommendation of medication, supplement or changes in diet and lifestyle that safeguard both you and your baby’s health.
  5. To determine if there’s any life threatening conditions, diseases or other factors that may risk your pregnancy and childbirth.
  6. Recommendation on how you should delivery your baby (natural or C-Section) and type of medical options available.
  7. Sometimes a Pap smear is conducted to determine if there are any sexual transmitted diseases (rarely).

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Antenatal class tips

No. Pointers / Questions Reasons
1. Who should attend? First time mothers and parents-to-be.
2. Where are these classes conducted? The classes are normally conducted by maternity hospitals, private hospitals or even through private classes conducted by healthcare professionals.
3. Who will conduct the class? The classes are conducted by a facilitator with medical background such as midwives, doctors, dieticians, physiotherapists and other health specialists.
4. Are these classes expensive? Classes held by local maternity hospital – generally not expensive. Private hospital/ classes – will vary from moderate to expensive.
5. What’s the number of participants per class? Normally antenatal classes are conducted in small groups to give focus and a session will last for about 2 hours. They may run for 4-6 weeks (one session per week) or as day program (example: on a weekend)
6. What do they teach you in these classes? In general antenatal classes aim to:

  1. Impart knowledge on pregnancy.
  2. Prepare you for labour.
  3. Prepare you to care for your new baby.

These lessons will be conducted both in theory and practice, to give you hands on experience. You will also meet other expecting parents and you can share information and experience with them.

 

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Guide to help you make a decision.

Type of Facility Pros Cons
Public Hospital: State funded
  • Would normally have the medical facility and expertise to handle emergency medical cases (if you are in the high risk category).
  • Doctors are well trained and experienced.
  • No charge for labour and birth care.
  • Midwives visit your home after discharge from hospital.
  • Hospital arranges all tests, scans at no cost.

Additional services offered: Postnatal education, pregnancy exercise classes, and interpreters.
  • Most likely be in shared room for postnatal stay.
  • Longer waiting time for appointments as the number of patients can be quite high.
  • You might be assigned to doctors that you are not familiar with.
  • In some hospitals (university hospitals), student doctors or nurses will be present during childbirth.
  • Shorter postnatal stay.
Private Hospital: Patient-funded
  • More comfortable environment and more private.
  • More likely to have a private room for postnatal stay.
  • Doctors are well trained and experienced.
  • You will be dealing with an obstetrician (specialist Doctor trained in childbirth) that is assigned to your case – own personal doctor that you are familiar with.
  • Longer postnatal stay.
  • All antenatal visits are in the doctor’s rooms.
  • Shorter waiting periods to see doctor.
  • Additional services offered: Postnatal education, pregnancy exercise classes, lactation services.
  • Some hospitals offer postnatal home visits after discharge.
  • Hospital may not be fully equipped to handle emergency cases – do a background check first.
  • Hospitals vary in their Special Care Nursery Facilities for unwell or premature babies.
  • High cost.
Maternity Clinics /Birthing Centres (Home-like environment)
  • For uncomplicated pregnancies.
  • Smaller and cosier environment.
  • Emphasis is on minimal medical intervention and natural pain management.
  • More freedom to move around to reduce stress and pain during labour.
  • Most are attached to hospitals so medical care is available if need to be transferred out of the birth centre.
  • More personalised postnatal care due to familiar faces.
  • Less equipped and not prepared for medical emergency situation.
  • You need to know – how and where they will transfer you in case of emergency.

Notes:

  1. Ask around – Word-of-mouth is a GOOD way to gauge the performance of a hospital.
  2. Do research – Search through the Internet, magazines, brochures, articles or even make site visits to find out more about the facilities, equipment and postnatal services and other services that the hospital/medical centre has.
  3. Try to choose a hospital/medical centre that is close to your house. Convenient for visitation during pregnancy, fast and easy access when rushing for delivery and is convenient for post delivery care and medical treatment.

 

Making a Birth Plan & Delivery Options

A birth plan is a guide for both you and your caregivers during the labour process. It is very important that you discuss your birth plan with your health professional prior to the birth. It enables better management and engagement during childbirth according to your preference and expectations. Some of the things that you could list down in a birth plan are:

Type of Delivery Option Delivery Position
Vaginal Delivery Normal Vaginal Birth

  • Recommended for healthy mother and baby.
  • Mother lying on their back with feet up or lying by her side in a C-Position (more comfortable).

Sitting Down Position

  • Recommended for healthy mother and baby.
  • A restful position that conserves energy and maintains body-wide relaxation. Gravity will also aid the delivery process.
  • NOT many hospitals have this facility.

Freestyle Labour

  • Recommended for healthy mother and baby.
  • On hands and knees position that enables mother to move their pelvic in a rocking motion.
  • Great for delivering a large baby.
  • NOT all doctors practise this method of delivery.

Water birth
Some birth centre facilities offer water births.
Caesarean (C-Section) C-Section

  • Childbirth through surgery.
  • Recommended for delivery with complications.
  • Relatively safe but still carry risks.

Other options that you should consider in your birth plan would include:

No. Options Notes
1. Pain Relief You can ask for pain relief drugs if need be. Consult with your doctor first.
2. Induced Labour Will be administered on special cases with complications or if the delivery has not begun after your due date. Your doctor will advise you accordingly as to how long after your due date induction will need to take place.
3. Aromatherapy A natural pain relief method through scented aromatherapy. Not many hospitals allow this practise. Consult health practitioner prior to using.
4. Shaving Used to be common practise believed to reduce the possibility of infection. However, it is not routinely practised any more unless you are required to do have a C-Section).
5. Enemas Not recommended as there is no evidence that it is necessary.
7. Episiotomy A surgical enlargement of the vagina opening during labour (a cut between the vagina and anus). Meant to reduce risk of pelvic tissue tear and ease childbirth. The use of an episiotomy is not routine and based on judgement of midwives/doctors at the time of the birth.

 

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Morning sickness tips

No. Question Answer
1. What causes morning sickness?
  • No one really knows why morning sickness occurs but it has been associated with:
    • High level of hormones.
    • Fluctuations of blood pressure.
    • Altered metabolism of carbohydrates.
    • Enormous physical and chemical changes in body.
2. Will morning sickness affect my growing baby?
  • Typically there are no adverse effects on the baby or mother despite all the vomiting, as long as you are able to keep some food and fluids down.
  • However in severe cases it may be associated with lower birth weight and pre-term labour.
3. When does morning sickness begin?
  • Around 6 weeks into pregnancy and will continue to about 12 to 14 weeks.
  • In some cases it may continue to 16 to 20 weeks and even beyond.
  • Affects 75-80% of mums-to-be.
4. What are the symptoms?
  • Nausea & vomiting.
  • Sensitivity to odours.
  • Food cravings or aversions to food.
  • Drowsiness (even with enough rest).
  • Headaches and cramps.
5. How do I cope with it?
  • How do I cope with it?
  • Eat small meals regularly (5-6 times daily).
  • Avoid spicy, greasy or fatty foods.
  • Avoid smelly foods that make you nauseous.
  • Eat more carbohydrates (white rice, potato, etc).
  • Eat bland food when feeling nauseous (jellies, icy poles, etc).
  • Eat some saltine crackers before getting out of bed to calm your stomach.
  • Drink more fluids to avoid dehydration. Try ginger ale/ginger tea.
  • Ask your doctor for Vitamin B6 (has been proven to reduce nausea).
  • Change in life routine (cook less, share household chores, etc).
  • Reschedule your work (talk to your boss and work out a schedule to do more when you are least affected by the symptoms).
  • Diversion (find a pleasant hobby to take your mind of the nausea).
6. Seek medical attention if you are experiencing these symptoms!
  • Persistent nausea
  • Uncontrollable vomiting
  • Vomiting blood or bile
  • Dehydration
  • Severe weight loss (at least 5% of pre-pregnancy weight)
  • Increased heart rate
  • Shivering
  • Extreme fatigue
  • Increased salivation
  • You may need hospitalisation and rehydration.

 

The good news is “morning sickness” doesn’t last forever and often improves by the time your pregnancy grows to mid-term.

 

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The changes that usually occur and how you can manage it better

No. Changes Features How to Manage
1. My First Baby Bump
  • Usually starts showing as early as 3 months and as late as 5 months.
  • New mothers will generally show later compared to women with children.
  • Can cause back pain and discomfort.
  • Comfortable clothes.
  • Use a maternity support belt that suits your need.
  • Use of support belt can provide additional benefits such as:
    1. Reduction in lower back pain.
    2. Reduced pressure on bladder.
    3. Decrease varicosities and swelling.
    4. Improved circulation in the pelvic region.
    5. Greater comfort during exercise.
2. Stretch Marks
  • Affect 75-90% of pregnant women.
  • Appear around 6 months onwards.
  • Appear more concentrated around areas that store more fat.
  • Cause itchiness and nuisance.
  • Caused by stretching of skin as you gain weight.
  • Appear as pinkish, red lines on belly, inside legs, thighs and hips.
  • Stretch marks are permanent, however fade to silvery colour over time.
  • Eat a healthy diet and maintain weight gain at an optimum level.
  • Keep hydrated and drink plenty of water.
  • Keep skin moisturised.
  • There is no evidence that any particular products  will prevent stretch marks.
3. Sensitive Breasts
  • Become sore and seem swollen or enlarged.
  • Sensitivity often lessens after the first 12 weeks.
  • Some women may grow a cup more.
  • May leak colostrum or pre-milk.
  • Use a Maternity Bra that fits your breasts (you might have to change sizes as your breasts grow bigger).
  • Use nursing pads for colostrum or pre-milk leak.
  • Have a bra fitted by a bra specialist.
  • Look for maternity bras that provide these features:
    1. Good support.
    2. Deep band beneath the cups.
    3. Wide shoulder straps.
    4. Adjustable closure.
    5. Avoid underwire bras!
4. Sore Nipples
  • Feel sore or tingly.
  • Stick out more.
  • Crack and dry out.
  • Darken along with areola.
  • Use breast moisturiser.
  • Exercise breast massage to soften breast and promote milk flow.
5. Weight Management
  • Being underweight increases chances of having a low birth weight baby and carries higher risk of complications.
  • Being overweight increases higher risk of hypertension (high blood pressure) or diabetes.
  • The recommended weight gain during pregnancy is around 12 – 14 kg (gradually throughout the pregnancy term) broken down as below:
    1. Baby – 3.5 kg.
    2. Placenta – 0.6 kg.
    3. Amniotic fluid – 0.8 kg.
    4. Uterus – 0.9 kg.
    5. Breast tissues – 0.4 kg.
    6. Increase in maternal blood volume – 1.25 kg.
    7. Fluid in maternal tissues – 1.35 kg.
    8. Maternal fat stores – 3.2 kg.

Notes:
Pregnant mothers should not worry about their weight too much. Consult your doctor for advice on weight management and other care during pregnancy to ensure that both baby and mother are healthy and safe from any risk during delivery or post delivery. The best thing you can do is eat a well balanced diet. Sensible exercise is good for you. Consult your health professional regarding appropriate exercise for you.

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Basic information on an ultrasound that can be useful to first timers when choosing the type of scanning that you should go for:

No. Scanning Type Features
1. 2D (Dimensional) Scan
  • Least expensive.
  • Does not harm the baby
  • Safe and painless
  • Most common type of scan available.
  • Provides 2D images of baby.
  • Performed by scanning mother’s abdomen & pelvic cavity, or vaginally.
  • Able to capture image and monitor foetus growth and development.
2. 3D Scan, 4D Scan
  • Most expensive.
  • Does not harm the baby
  • Safe and painless
  • Scan upon recommendation by doctor or upon request.
  • Provide 3D or 4D images of the  baby (depending on machine).
  • Performed by scanning on mother’s abdomen & pelvic cavity, or vaginally.
  • More graphic and detailed visual of the baby.
  • Able to detect unseen abnormalities or problems compared to 2D scanning.
3. Doppler Method
  • Measures blood flow in different parts of the baby’s body
  • Used to detect ectopic pregnancy or other problems.
  • Probe will be inserted into vagina.
  • Better visual displayed due to the close proximity to foetus.
  • Suitable for obese mothers and early stage pregnancies in which it is more superior than other scanning methods.

Notes – Reasons for Ultrasound:

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What every mother needs to know

No. Understanding Your Baby’s First Kick
1. Can be felt around 18 – 22 weeks for First Pregnancy.
2. Can be felt around 15 – 18 weeks for Subsequent Pregnancy (as mothers can now detect baby’s movement better due to experience).
3. The feeling has been described as:

  • Little mice tumbling around your lower abdomen; or
  • Little flutter that stops just as it started; or
  • Gas bubbles, etc.
4. Quickening means the motion of the foetus in the uterus where a baby shows signs of life.
5. A healthy baby is an active baby. As your pregnancy grows, the kicking will also grow in intensity and frequency and become more vigorous.
6. Babies have their own rhythm (sleep and active time), so do not worry if your baby doesn’t move / kick for a few hours as your baby might be sleeping.
7. There’s no set amount of kicks to expect – as long as your back is actively moving on a regular basis, it should be okay! In the first 12 weeks, the jerks and jolts are not strong enough to be felt. After this the kicks are more stronger and regular. Movements are more likely to be felt when you are in a quiet position, sitting or lying down.
8. Communicate with your baby. Normally babies will respond to your touch and voice. If not, your baby is most probably sleeping.
9. Let your doctor know if you notice a decrease in your baby’s activity level. If you feel that your baby has not moved for a long period of time or that something is wrong, seek medical attention! Your doctor will most probably perform an ultrasound to determine your baby’s condition.

 

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‘Am I Pregnant’ Guide

No. Early Symptoms of Pregnancy Pregnancy Tests (Tips)
1. Late Menstruation

 

  • This is the most common symptom to detect early pregnancy, as a woman’s menstrual cycle will stop when they are pregnant.
 You can purchase and use any common pregnancy test kit available in the pharmacy:

  • Use your first morning urine if possible (or at least urine that’s already in your bladder for 4 hours as it is more concentrated).
  • Do not drink excessive amount of water prior to taking the test.
  • Read and follow test kit instructions carefully.
  • Avoid taking medications or drugs that may interfere with the result.

Test Results:

  • Home kits are accurate up to 97% of the time.
  • The most common reason for inaccurate results with home kits is testing the urine too soon after a missed period.
  • Is it Positive!
  • Congratulations, you are about to become a mother.
  • Is it Negative!
  • Wait for another 3 days before taking another test. Tests taken less than 10 days after conception might show negative results.

Always see your doctor for confirmation.
2. Sore Breasts and Sensitive Nipples

 

  • Another common symptom of early pregnancy. Breasts will become tender, swollen and sore as they prepare to produce milk for breastfeeding.
3. Nausea (morning sickness)

 

  • Some women will experience nausea in the morning or even throughout the day. The effects vary from one person to another or one pregnancy to another.
4. Extreme Fatigue

 

  • Exhaustion that happens within weeks after conception.
5. Frequent Urination

 

  • Due to a mother’s swollen uterus that is pressuring the bladder, thus the frequent trips to the bathroom might persist for the next 9 months of pregnancy.
6. Cramps (like having a period)

 

  • Triggered by the implantation of fertilised egg to the uterine wall that will stretch to accommodate the growing baby.
7. Skin Problem

 

  • Pimples and other skin problems might surface due to hormone changes.
8. Feeling Feverish

 

  • Your body temperature will be slightly higher.
 Blood tests:
Blood pregnancy tests used by doctors are 99% accurate. Blood is drawn from a vein in your arm.
9. Mood Swings and Irritation

 

  • Caused by hormone imbalance. Mothers-to-be will need all the support they can get at this stage.
10. Other Symptoms:

 

  • Headaches
  • Heartburn
  • Constipation
  • Blood Spotting

Let’s take a look at some tips on changing your baby’s nappy:

No. Tab Nappies Pants Type
1. Clean hands to avoid contamination. Make sure that you have everything you require within easy reach. If your baby is able to stand, let him / her hold on to a support like a table or your shoulder.
2. Never leave your baby unattended. If you take your eyes off your baby, always have one hand on them. Stretch your baby’s waistband and gently tear both sides of the seams.
3. Ensure that your baby is on a flat surface in a safe place. Clean your baby’s bottom from any urine or stool residue.
4. Unfasten tapes on disposable nappy. Wipe baby dry.
5. Check and wipe away residue of urine and stool. Apply ointment and check for chafing or redness or even rashes.
6. Clean the nappy area thoroughly, between creases and wipe from front to back (for baby girl) to avoid vaginal infection. With newborns, avoid separating your girl’s labia to clean inside. If there are marks from chafing, it may be time to change to a larger size.
7. You might want to cover a baby boy’s penis with cloth or nappy to avoid being sprayed with urine. Often babies pass urine when exposed to cool air. Take a new pants nappy, stretch the waistband and pull it up baby’s leg (one leg at a time) until it reaches the navel area.
8. Apply barrier cream to prevent against nappy rash and check for chafing or redness or even rashes. Ensure that pant is snugly and comfortably fitted.
9. Lift the baby up by the ankles and slip on a new nappy from baby’s behind. Make sure that all the ruffles are outside to avoid skin irritation and perhaps leakage.
10. Fasten the adjustable tape and ensure that the nappy is snug and comfortable (but not too tight!) and all the edges aren’t tucked under. Avoid covering the belly button with nappy in newborns. Better to leave this exposed to circulating air. Ensure that baby’s back area is fully covered and not rumpled at the groin area.
11. Once baby is down from change table or other surface, wash hands again to avoid contamination.