Our Baby News

The most important are breast signs. These, in concert with a missed period (or a very scanty period), are very powerful evidence of pregnancy.The breasts become full, enlarged and tender, and, particularly in fair-skinned women, the blood vessels on the surface may appear very much more prominent. The areola – the pinky-brown part that surrounds the nipple – feels tender and may tingle (‘like someone is holding a match to them’ is a graphic and far from uncommon description!).

The part of the breast that lies just in front of the armpit often shares the swelling and may become quite tender, so that the woman finds it uncomfortable to rest her arms against her sides. And there will appear, on each areola, little white bumps, like whiteheads. These are called Montgomery’s tubercles (and the word has nothing to do with TB – it merely means ‘bumps’!) and will provide the extra lubrication material the nipple will need for the baby when he feeds. Gentle squeezing of the nipple at a later stage (16 weeks) may produce a bead or two of colostrums, the precursor of breast milk.

Other observable changes are in the skin, especially in brunettes. Darkening of moles is not uncommon, and some girls develop darkening of the skin across the forehead and over the cheeks – the so-called ‘mask of pregnancy’. (Incidentally, women using the Pill may also develop these skin changes; they are due to the same hormones.) In addition the line that runs from the umbilicus – navel – down to the pubis to meet the pubic hair may darken. Another color change affects the vulva and vagina which develop a purple-violet tinge.

DOES CATCHING VD MEAN THAT YOU CANT HAVE ANY CHILDREN?

Untreated venereal diseases of some types may indeed result in sterility. For example, infection of a woman by gonorrhea, which can invade the tubes, may lead to scarring of the tubes, and result in blockage of the fine channels which run through them.

If the tubes are blocked, then egg cells can’t get through and no baby can result. Similarly, gonorrhea in men can lead to acute inflammation of the testicles, resulting in scarring of the fine tubes along which sperm travel, and consequent sterility.

Untreated syphilis can also affect the woman’s ability to conceive, and also carries another hazard; a mother who is suffering from this illness can pass it on to her unborn baby (this is one of the few illnesses that can be transmitted in this way) and such a baby can be very ill indeed at birth.

Gonorrhea in the mother can also lead to damage to the baby; it may be infected by the germs in the mother’s vagina as it passes along it to be born, and these germs, if they enter the eyes, can cause such damage that the result is blindness.

Labor has been well named, because it is hard work. The baby who was just two tiny cells has grown in 40 weeks to be a 20 inch (51 centimeters) long, seven pound (3.3 kilogram’s) person of a far from symmetrical shape, with feelings and needs and body functions, who has to be pushed out of his safe dark watery home through a bony gateway and along a narrow pathway, to emerge unhurt and well. And since the gateway and pathway are made of living tissue they too must be left safe and well. Labor is the gradual process that enables this important journey to be made.

The first stage is the longest and during it the cervix, the ring of muscle which is the neck of the womb has to thin out so that it disappears, leaving a clear way for the baby to get out of the uterus and into the vagina.

It is pulled up by contraction of the muscle fibers of the uterus, and the gap widens gradually, until it reaches a diameter of about ten centimeters (approximately 4 inches). This stage usually takes about 13 hours in a first labor (though it may be longer) and about seven hours or less in subsequent ones (some women have been known to have a first stage of less than one hour, but that is rare). These hours, be they long or short, are by no means all agonizing. Once again, the dramatic film makers have got it wrong. While some of the contractions in the later stages may be strong and uncomfortable they need not be severely distressing and many women who have trained for ‘natural childbirth’ actively enjoy them.

The amount of stretching of the opening of the vagina that is needed at the moment when the baby’s head crowns – the point at which the head is ready to be born – is considerable.

The perineum is capable of such stretching, usually, but in some cases the muscles are rather more rigid than they should be, and there is a very real risk of damage to the tissues, even of a tear.

Since it is obviously much less easy for a tear to be repaired neatly than a straight cut, it is felt best to make such a cut which can be simply stitched afterwards.

This cut is called an episiotomy and is done with a local anesthetic and is therefore painless. It widens the opening considerably and helps to speed the delivery of the baby; it is almost always used to deliver a baby who is distressed (as shown by the state of his heartbeats during labor or by other signs for which the midwives watch carefully), for a forceps delivery or for the birth of the head in a breech delivery .

No two labors are the same but it is useful to know how they usually start so you know what to expect and how to interpret the signs. Above all, don’t worry that you won’t recognize when your labor starts as this very rarely happens.

There is one early sign of  labor that experienced mothers may be able to recognize easily; it is a psychological reaction that while it does not happen to all pregnant women is still quite common. The mother who has been a little tired and feeling very heavy suddenly finds she has an excess of energy and a wish to hurry about the house dong things she would otherwise not bother with. A very experienced old midwife used to tell her patients, ‘If you find yourself  in the last days of pregnancy scrubbing the kitchen floor because you actually want to, or baking a batch of bread because you’ve an irresistible urge to do it, make sure your hospital bag is packed – you’ll be in labor in the next few hours!’ It is a little like the ‘nesting instinct’ in fact.

More reliable signs of  labor, however, are physical ones. There may be an intermittent low backache, deep in the pelvis, but this is hard to identify, as it may come from the stretching ligaments of the sacroiliac joints rather than from the uterus. But if this backache is followed or accompanied by a change in the Braxton-Hicks contractions so that instead of starting gradually and lasting for about twenty seconds before wearing off equally gradually, they rise slowly to a rather higher degree of tension, which is maintained for between 30 and 50 seconds and then wear off quite quickly, labor has probably started. The contractions come at 15 or 20 minute intervals and are quite strong, though far from painful in these early stages.