What to do if you have to deliver a baby

How to deliver a baby

Sometimes it happens that babies are born before mom can get to the hospital. Babies have been known to be born in supermarkets, parking-lots, at home, in the taxi and even on the airplane. During the Mozambique floods a few years ago, a baby-girl was born in the tree – and survived to tell the tale.

Once the mouth of the womb (cervix) is fully dilated (open), babies are born very quickly. If you’re the only person around to help the woman about to give birth, you may have no choice but to ask someone to bring you a basin of hot water, some towels, cotton thread and scissors – and to call 911 or 0911, 10177 or Netcare 082 911 countrywide in South Africa.

Keep calm. Shouting and panicking is only going to make the situation worse! Remember that in most instances, babies are born on their own. Let nature do its thing and keep reassuring the mother.

Make her comfortable. Use newspaper, black utility bags or towels to spread over the area where the baby will be born. When the mother’s waters break, there will be a gush of straw-coloured fluid. Place a clean towel under mom’s bottom, use warm water to sponge the vulva. Wear disposable gloves – any type will do.

When the mother starts to push, encourage her to push slowly – especially if you suspect that the baby is premature. It may help her to get her into a squatting or onto all-fours. In this way, the baby’s head will simply slip out the vagina. This position also helps to minimize tearing the perineum (the area between the vagina and the rectum).

Once the head is out, support it with one hand while checking around the baby’s neck for the cord. It’s rare for the cord to be wrapped around the baby’s neck, but if it is, gently slip this over baby’s head. The cord is long and slippery so it’s quite easy to do.

While supporting the baby’s head, you will notice that the baby’s body will turn (it’s called the ‘dance of birth’). This is in preparation for the birth of the shoulders. Gently ease the shoulder out closest to you, then the second shoulder. After this, the baby’s body will slip out quite easily with a gush of remaining amniotic fluid (called the hind waters).

Quickly wrap the baby into a towel and place skin-to-skin between the mother’s breasts. Cover mom and baby with a blanket and give the baby a chance to recover and familiarize him/herself with mom. Baby will recognize mother by her smell – the newborn’s sense of smell is strongest immediately after birth.

If help has not arrived, don’t stress too much about the placenta (afterbirth). You can leave it in place, but it may come away on its own after about 30 minutes, or if the baby starts suckling. If the placenta comes away, you need to cut the cord. This is painless for mom and baby because there are no nerves in the cord. About a thumbs length from baby’s navel, tie cotton thread in two places, then cut the cord between the two ties. Wrap the placenta in a plastic bag. The doctor will need to see it.

Place a clean towel between the mother’s legs. If she is bleeding heavily, encourage her to suckle her baby. Make sure mom and baby keep warm when they are transferred in the ambulance to the hospital.

Ask somebody to make you a sweet cup of tea after the ambulance has left! You may feel significantly elated when it’s all over! The miracle of birth.

Life-skills for children

Sometimes parents are so worried about shielding their children from disappointments, they’re afraid to make commitments in case they ‘let them down’ or they shower their children with gifts and extravagant promises when things don’t turn out as planned.

Life is full of disappointments and we all have to learn how to deal with them. This begins in early childhood. A new sibling may turn out to be the ‘wrong’ gender, a play-date can be a disaster, birthday parties sometimes flop. It can rain when you’ve planned a picnic or there’s an electricity outage in the middle of your child’s favourite TV programme.

Children who always get their own way are in for a shock when they start school, and parents who bend over backwards to keep their children happy are only making life harder for themselves and for their child.

Adolescence can be a disappointing wake-up call when hormones tone-down a tween’s popularity status. School-leavers who have not learned to deal with disappointments can feel overwhelmed in the real-world where ‘nobody knows your name’, and they may become depressed.

When things don’t turn out as you anticipated:

• Be honest with your child when you give them the news, with a bit of space to think it through before you jump in with an alternative solution.
• Don’t just tell them the news and walk away. Be there to hug them and wipe away their tears or let them cry and stamp their feet.
• Tell them in an age appropriate way so that they understand – especially when the disappointment is permanent such as when a pet dies.
• Don’t create a new situation by making promises you may not be able to keep. “We can’t go to the zoo today, but I promise you I will take you to the circus the next time they’re in town.” (When did you last see a circus cavalcade?)
• Only make promises that you can absolutely keep.
• Give your child something constructive to do, or spend quality time with your child – bake, make something, go to the library or a book store. Distraction is a great pacifier.
• Make sure your child understands that the situation is not their fault. A child may have to miss a school outing because he has Chicken-Pox. He needs to understand why he has to stay at home because he can make the other children sick and is not being punished for being sick.
• Sometimes children just have to understand that they can’t have karate / dancing / music lessons because their parents can’t afford them. Children who grow up with little learn to appreciate everything they have in life when they’re older.
• Compensate them with hugs and kisses rather than with sweets and toys.

The amazing thing about children is that they soon forget, are easily distracted and are very forgiving. They don’t hold a grudge against their parents or put into their memory bank every little thing that went wrong (even if it was your slip-up) e.g. when “the tooth-fairy forgets to come!”.

Understanding menstruation

We have recently celebrated International Menstruation Hygiene Day with the theme ‘Education’.

Mothers and daughters

It got me thinking. What did your mother tell you about periods? Everything – or nothing? Do you remember the day you had your first period? And, if you’re older than 45, your last when you went through menopause? Do you remember skipping periods and worrying …. am I pregnant?  Do you remember holding your breath when you were hoping to get pregnant and your period was late?

All my mother told me was how to wear a Partex – gauze covered cotton-wool pads with a loop at each end that hooked onto a ‘sanitary-belt’ worn around the waist. I never thought of asking Mom the questions that bothered me: why was the pain so bad sometimes that I had to be fetched from school? Why did I bleed such a lot with clots the size of my thumb? What was that sticky stuff that came from my vagina every now and then?

It was only in my fourth year of nursing, when I studied Midwifery, that periods began to make sense. It was only after having my first baby that period pain subsided. And it was only after I had been through menopause and diagnosed with Lupus (short for SLE or systemic lupus erythematosus) that I realised why my periods had always been so heavy, especially with clots. Luckily, I had never taken the contraceptive pill because this is known to aggravate SLE symptoms and increase the risk for thrombosis.

What I’ve learned over the years is that our bodies work hard to keep major organs in tip-top condition – especially the womb and other reproductive organs. To do this, all systems supporting these organs need to be balanced. This is possible when we live a balanced lifestyle. Eating right, getting enough rest and exercise with equal amounts of work and play. When we give our bodies everything that it needs in the right proportions, our hormones (or endocrine system) – that controls reproduction, metabolism, stress, immunity and sleep cycles – works like a well-oiled machine.  For women, this culminates in having predictable, hassle-free periods. 

What are cycles?

Natural periods come in cycles and not strictly ‘months’. A cycle is calculated from the first day of one period to the first day of the next period, which on average is about 28 days. This is different to a lunar month which is 29.5 days and a calendar month that varies between 28 and 31 days. Unless a woman is taking artificial hormones (contraceptives) to control her cycles, she shouldn’t expect her period to come on the same date every month. If she has a shorter cycle, her period will come earlier. If she has a longer cycle, her period will come later. It’s as simple as that. 

Cycles differ from woman to woman, and are often different for the same woman. Bleeding starts 14 days after ovulation (the ripening and release of an egg or ova). Ovulation is recognised when there is a clear, slippery vaginal mucous. Day one of a period marks the end of one cycle and the beginning of another.

In the past, all focus was on menstruation with ovulation taking a back seat. But today’s woman (ask those struggling with infertility) understands the importance of ovulation – the ‘ring master’ of hormones that balances oestrogen and progesterone and controls the menstrual cycle.

Women today are not shy not to talk about periods to her friends or partner. Women with daughters should not hesitate to tell them about the facts-of-life, starting with ovulation. Teaching women more about ovulation and learning to recognise the signs of this important event will help her to predict when her next period will begin. When women understand their bodies, they’re in-charge – not their gynaecologists.

For more information go to www.kotexsouthafrica.co.za

When your child get's sick this winter

Coping with croup this winter

Bugs abound in winter and bounce around nursery schools and creches like invisible little critters. Air-borne viral and bacterial infections spread quickly and little children, who are in close contact with one another, share infections. Then they bring them home. Little children also get sick very quickly – often overnight – and because working mothers can’t always make alternative baby-sitting arrangements, they go to school and spread their germs.

Upper and lower respiratory-tract infections are common during winter. Symptoms of upper respiratory-tract infections include sneezing, snotty nose, sore throat and fever. These infections can spread to the ears and become otitis media (ear infections) or the brain and become meningitis (inflammation of the membranes that surround the brain and spinal cord) or encephalitis – inflammation of the brain itself. Severe complications can become systemic and attack muscles like the heart which can become fatal. These are rare.

Lower respiratory-tract infections involve the bronchi and lungs. Complications of these infections are bronchitis and pneumonia. Symptoms are coughing, fever and lethargy. Children with bronchitis from a common cold or even measles, can have episodes of croup. This is when the bronchi go into spasm and it’s difficult to breathe. Episodes can be mild or severe. Mild episodes can become severe.

Working in the admissions ward at the Children’s Hospital, I remember croup cases. Usually toddlers, pale, frightened, blue around the lips and fingertips, cold and crying. Their parents were equally distressed. The panic only added to their child’s distress and bronchial spasm. The oxygen tent, humidifier and separation from their parents into a strange environment where doctors and nurses told them what to do made the situation worse!

When my daughter was a toddler, she had a number of croup attacks. I had the confidence to nurse her through these episodes. First I gave her a bronco-dilator (prescribed by the doctor). This would help her breathe. Then I boiled the kettle in her room and left it boiling, watching the water-level carefully and topping it up when necessary. After that I calmed her with a story and distracted her with a flash-light that changed colour with its multi-coloured lenses. This gave the bronco-dilator a chance to work, breathing became easier with warmer, humified air and she was no longer frightened because she couldn’t breathe. Then I rubbed her chest and the soles of her feet with Vicks, tucked her up into a semi-sitting position, and she went back to sleep.

Had her breathing become worse, I would have taken her to the ER. I also took her for physiotherapy.

What can you do if your child has croup?

• Invest in a humidifier or a nebuliser
• When you take your child to the doctor, ask for a bronco-dilator
• Rub Vicks onto the chest and soles of the feet (the pores here are biggest so it is well absorbed) at bed time

If your child’s mouth and finger-tips become blue, and the breathing gets worse, wrap your child warmly, cover his/her head with a beanie – DON’T PANIC – and go to the ER. It may not be necessary to admit your child to hospital, because the doctor may want to do some follow-up investigations. 

Yes, you can afford to have a child

International Children’s Day has been celebrated on the 1^st June since 1923. This is not a day for parties and presents – it should be a day when organizations, who can make a difference, do something about improving the lives of millions of children around the world struggling to survive. I’m thinking of those in war-torn and poverty-stricken countries as well as those living in affluent countries where child neglect and abuse is different.

In my opinion, in the not-too-distant future, children and babies could become a rarity. This is because more and more couples are becoming childless – either by choice or circumstance. The number of infertility clinics is on the rise. While I’m not denying the benefits of child-spacing and child-affordability, my concern is that for decades now, families have become smaller, and by interfering with a woman’s natural fertile and infertile cycle, contraceptives are impacting negatively on a woman’s reproductive health.  

      

Making babies and children more affordable:

• Budget – Make an accurate analysis of monthly income and expenses. Stick to a budget.
• Buy second-hand – Thrift shops have amazing bargains.
• Where and when possible, do it or make it yourself
• Avoid impulse shopping. Ask yourself – do I really need this?
• Make a shopping list and stick to it
• Don’t take the children shopping with you!
• Teach your children not to waste
• Entertainment doesn’t have to be expensive – make do with what you’ve got and teach your children to enjoy the little things in life
• Don’t be too proud to accept hand-me-downs. I loved it when I was given clothes and books from older cousins when I was growing up
• Start saving for their education.

Children’s rights:

Children need to be loved, to feel secure and protected from dangers, the elements and disease. Children shouldn’t have to go hungry or be denied an education. Ideally children should grow-up in a balanced family where there is a mother and father. I understand that this is not always possible, but this is when the extended family and the community or village can step in and help.

How can you help disadvantaged children in your community?

Find out the names of children’s organizations, orphanages and homes in your area from your local newspaper or library. Contact these to find out what you can do to help. Join knitting or sewing circles where clothes are made for babies and children. Visit the children’s ward at your local provincial hospital with toys (these can be second-hand donations) and/or blankets. Volunteer to read in a nursery-school. Find out if your church has an organization to help children or volunteer to teach at Sunday school. Every little bit counts – especially when it comes to children!

Look on my Facebook page for the pattern of the knitted teddy-bear.