Premature Birth

Survival outside the womb is possible (although not likely) as early as 22 weeks. Survival dramatically increases with continued gestation after this point. By 28 weeks, more than 90 percent of babies survive and by 34 weeks it's 99 percent.

Delaying birth after the onset of labour is difficult, but usually can be done for a few days. Delaying even for just a day or two can have large impacts on survival by allowing you to be moved to a more advanced hospital and giving time for steroid shots to improve the baby's lung function.

There is no evidence that bed rest will prevent pre-term labour.

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Expecting Better

Expecting Better

by Emily Oster

I'm going to be pregnant forever, right?

No one has ever been pregnant forever.

The majority of babies arrive within a week on either side of the due date.

Cervical checks are predictive of coming labour (althoug not perfectly); ask about effacement in addition to dilation to get a more complete picture.

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Labour induction

Best option: go into labour on your own.

Pre-birth foetal monitoring is a good idea, but beware of false positives. Fluid moitoring. Two easy ways to avoid false positives: 1. stay hidrated and 2. ask your doctor to measure the deepest vertical pocket rather than total fluid volume.

Non-stress test. Advice: just keep clapping (babies wake up and stay active)

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Labour Numbers

Labour times vary a lot. Average dilation time is 1 to 2 centimetres an hour after active labour starts.

There are three major categories of labour problems: 1. dilation is too slow, or stops altogether; 2. baby gets stucks and 3. baby is facing the wrong way, making it harder to push

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Epidural pros and cons

Pros: 

  • better pain relief

Cons: 

  • increased chance of unnecessary antibiotics
  • greater use of instruments (forceps or vacuum delivery)
  • greater use of Caesarean for foetal distress
  • longer pushing time (15 minutes)
  • higher chance of baby facing up at birth
  • greater use of Syntocinon
  • greater us of low maternal bloow pressure
  • less able to walk after labour
  • greater chance of needind a catheter
  • increased chance of fever

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Birth plan ideas

Broken water: Induce if labour doens't start on its own within 12 hours.

Eating and rindking during labour: Should be allowed, although probably most hospitals won't let you have them. Bring some Lucozade to keep your energy up.

Doula: Having a doule decreases the chances of a Caesarean and of using an epidural.

Continuos foetal monitoring: No evidence that is effective. If intermittent monitoring is available, do that.

Episiotomy: not a good idea.

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