Childbirth and postpartum
Childbirth is the final moment of the pregnancy process, in which the birth of the baby occurs.
Pregnancy lasts an average of 40 weeks counting from the first day of your last period, but a duration of between 37 and 42 weeks is considered normal. The onset of labor cannot be predicted, so this aspect should not generate anxiety.
beginning of labor
It is not known exactly what causes the onset of labor. It is triggered by a mix of action of uterine factors, hormonal factors, and fetal factors.
PHASES OF LABOR
Labor progresses in three stages:
- Dilation phase: the cervix thins and dilates enough to allow the fetus to pass from the uterus into the vagina.
- expulsive phase: the mother performs pushes that help the fetus exit through the birth canal. This stage ends at the birth of the child.
- Childbirth phase: It consists of the expulsion of the placenta and its membranes.
How to know when labor is approaching
The phase near labor called "prodromes of labor" occurs a few days to a few hours before delivery. Some changes are observed:
- Sensation that the fetus is pressing in the lower abdomen. It occurs a few weeks to a few hours before labor begins and signifies that engagement has occurred, when the fetal head is positioned within the pelvis.
- Output of mucous plug or vaginal secretions. It occurs several days before labor begins or at the time of initiation. It means the expulsion of the mucus plug formed in the cervix during pregnancy.
- outlet of aqueous fluids for the vagina It occurs several hours before the onset of labor or at any time during labor. It means that the amniotic sac that surrounds the fetus in pregnancy breaks.
Plans to go to the hospital
It is important, once the probable date of delivery approaches, to take into account a series of aspects:
- Distance: How far do you live from the nearest hospital?
- Transportation: do you have someone to drive you or will you have to call to find someone?
- The time of day: depending on where you live, the trip may take more or less time depending on the time.
- Household Arrangements: Do you have other children who need to be left in someone's care?
True labor versus false labor
During the last few weeks of pregnancy you may notice that the gut hardens and then softens again. This is likely to be uncomfortable and even painful. These irregular pains are called Braxton-Hicks contractions (they usually occur even in the second trimester, being more common in the third trimester of pregnancy) or false labor pains. They can appear more frequently with physical activity.
When the pregnancy is advanced, vaginal bleeding can be attributed to the beginning of labor. False labor is sometimes hard to tell from true labor. You should not feel ashamed of going to the hospital believing that true labor was beginning, as sometimes the difference can only be established by vaginal examination; however, there are ways that can help you differentiate them and the best way to do it is uterine contractions, measuring the time they last and the time that elapses between them in the course of an hour:
- During the true labor, contractions last between 30 and 70 seconds, occur at regular intervals y do not cease with rest.
- Su frequency increases over time.
- They usually feel from the back to the front.
Childbirth in public hospitals in the Community of Madrid
Below you can access the web pages of the main maternity wards of the public hospitals of the Community of Madrid.
- University Hospital Gregorio Marañón
- Severo Ochoa University Hospital
- Hospital Universitario La Paz
- University Hospital of Móstoles
- University Hospital October 12
- Henares University Hospital
- San Carlos Clinical Hospital
- Alcorcón Foundation University Hospital
- Jiménez Díaz Foundation University Hospital
- University Hospital of Fuenlabrada
- Rey Juan Carlos University Hospital (Móstoles)
- University Hospital Puerta de Hierro-Majadahonda
- El Escorial Hospital
- Infanta Leonor University Hospital
- Infanta Elena University Hospital
- Infanta Cristina University Hospital
- Infanta Sofía University Hospital
- Santa Cristina University Hospital
- Southeast University Hospital
- Getafe University Hospital
- Tagus University Hospital
- Villalba General University Hospital
- Torrejón University Hospital
Postpartum care
After childbirth begins a stage called puerperium. At this time, fathers and mothers are exclusively dedicated to caring for their new baby. But mothers who have just given birth must also take care of their bodies after childbirth and during the breastfeeding period. Doing so will help regain energy and vigour. Care at this stage makes new parents, especially in the case of women who have just given birth, able to provide better care for the baby and thus be able to enjoy it more.
During the puerperium the following are produced changes:
- Involutionary changes of the genital apparatus and the entire organism of the woman.
- At the same time, a new function is established, breastfeeding.
- Subsequently, ovulation and menstruation reappear.
- The adaptation of the mother and the newborn to the new circumstances and the family environment must take place.
- The emotional level takes on great prominence at this stage of parenting.
The puerperium is divided into three stages:
Immediate puerperium. It assumes the first 24 hours after delivery. In it we can distinguish:
- A period of time of two hours after the completion of labor, during which it is advisable for the woman to remain in the delivery room.
- The first hour after delivery is an ideal time to start skin-to-skin contact and initiation of breastfeeding.
early puerperium It starts from 24 hours until the tenth postpartum day. During this phase occur:
- The most important involutionary changes.
- The establishment of breastfeeding.
Late puerperium. It starts from the tenth day until 40-45 days. Colloquially, in popular culture it is what is known as quarantine. The changes that occur in this phase are more subtle and take more time to carry out. The resumption of menstruation will depend to some extent on the time of exclusive breastfeeding.
Care in the puerperium (University Hospital October 12)
Recommendations for postpartum care of the pelvic floor (U. de Fuenlabrada Hospital)
After the effort of childbirth, flaccidity of the pelvic muscles occurs (involuntary urine leakage may even occur).
It is time to perform the appropriate exercises to recover muscle tone. Physical exercise stimulates blood circulation, relieves back discomfort, tightens the muscles in the genital area and abdomen, improves physical condition and recovers the figure.
If there are no contraindications, the woman should start walking 24-48 hours after delivery.
You can check with your midwife which exercises are appropriate for your particular situation to make a good postpartum recovery. Among them, the following:
- circulatory exercises
- Breathing exercises
- Exercises for the muscles of the perineum
- Exercises for the pectoral muscles (always after feedings)
- Back exercises
It is convenient to wear the bra during the day and at night, make it comfortable (do not press) and regularly change the nipple protectors to avoid macerations. To keep the nipples hydrated, it is enough to apply a little of your own milk after each feeding.
For the hygiene of the breasts, a daily shower is sufficient, using neutral and odorless soap.
After childbirth, couple relationships can be altered by the arrival of the baby, who must spend time caring for.
It is necessary to find (by the two members of the couple) a time, even if it is minimal, to continue maintaining good communication and demonstration of affection, as well as to talk about the fears, fears, joys, feelings and emotions produced before the new situation. Sexuality is not only focused on the coital relationship, but also on affectivity and communication.
Relationships with coitus will arise when both are ready and the woman has freed herself from fatigue and possible fears of discomfort. It is advisable not to have intercourse until 4-6 weeks after delivery and to use a condom to avoid infections of the placental wound that she is still healing.
The woman who breastfeeds has a delay in the presentation of ovulation, but the risk of pregnancy is not avoided, so every woman who has sexual intercourse, despite breastfeeding, must use a contraceptive method that prevents her from becoming pregnant. In the "quarantine" review, you must decide which contraceptive method you want and which best suits the needs and characteristics of the couple. The doctor or midwife can inform about them.
Lactation
The World Health Organization recommends exclusive breastfeeding for the first 6 months. Breastfeeding your newborn child can have multiple beneficial effects for both your health and that of your baby. In different circumstances breastfeeding is not possible and we must feed our baby with a bottle. Here you will find the information you need to do it in the best possible way, whether you choose breastfeeding or artificial feeding.
Breastfeeding your newborn child can have multiple beneficial effects for both your health and that of your baby.
The proper preparation and conservation of feeding bottles becomes the best way to prevent diseases, sometimes very serious for the baby.
The Aladina-MGU Regional Breast Milk Bank is an institution that promotes and supports breastfeeding.
videos of interest
Links of interest
What if I have adopted my child?
If the option followed by the parents has been adoption, it is important that they are aware of the existence of the International Adoption Consultation at the La Paz-Carlos III University Hospital.
The International Adoption Health Consultation of the Pediatric Service has been operating since 1997 and was created in response to the growing need to offer specialized pediatric care to children from adoptions in other countries.
In this way, the examinations carried out on children in this consultation are aimed at determining the state of health of the minor with special attention to the specific pathology of the country of origin of the child, including emerging diseases, an area in which they are specialists. Pediatricians in this Unit. To carry out the study of the health status of the child, it is necessary to carry out a face-to-face consultation at the Hospital.
In the following link you can access the most relevant information on this consultation.
