What is going on with your baby during week 36?

Changes in you at this stage Week 36

• Starting this week your doctor will check your cervix for effacement and dilation - signs that you may be going into labor soon.
• You may find yourself consumed with plans for your baby and new life.
• You may be obsessing about labor and the pains.
• Your concerns center around everything that is baby-related such as breastfeeding and parenting.

Good to Know in Week 36

Miscellany

• Some C-sections are inevitable no matter how healthy you are, how well you ate or how much you exercised.
• If you delivery vaginally, your vagina is going to be traumatized. Though not permanent but for few weeks at least it is going to hurt.

Unplanned C-section

• Some problems can arise which will make c-section necessary:
  1. Your labor stalls - if your cervix stops dilating or your baby stops moving down and your doctor's attempts fail, surgery becomes the alternative.
  2. Your baby's heart rate becomes a cause for concern.
  3. Your placenta starts to separate from the wall of the uterus
  4. You have an active genital herpes infection.

Recovery from a C-section

• You will be in pain and very sore for a few days - you will certainly need painkillers. The first morning after the op a nurse will take out your urinary catheter which is painless. Then she will make you sit up, get up and walk which is very painful. The first time is usually the worst but after the first 48 hours, you will make rapid progress. The more you move around the better you will feel.

Wholesome Advice in Week 36

• Your pain medicine causes constipation so take stool softeners when offered. Pushing is painful after a cesarean.
• Bonding is not always instant with your newborn - it has got nothing to do with delivery being vaginal or cesarean. So don't feel guilty if you don't bond instantly after your operation.

Your actions can impact your baby's growth at this stage

Position Matters III

Sitting on a Ball

It is easy and comfortable, just like sitting on any chair. The benefit of the ball is that it is much more flexible on your bottom and allows more movement in your pelvis. Besides, it frees your back for a massage. Other benefits include:

• Wide variety of uses in labor and birth
• When used in sitting positions, gravity helps the baby descend
• Encourages movement in mother

Sitting on a Chair backwards

Place a pillow over the back of the chair and lean onto it. This position allows you to open your legs and stretch as well being upright. Other benefits include:

• Use of gravity helps labor progress
• Your legs get to rest
• You get to have back massage from your supporters

An Upright position for Giving Birth

• An upright position will help use gravity to ease and speed the birth process. The most commonly used positions for birth include: squatting, hands and knees and sitting, leaning forward.
• Each of these positions helps to use your body to the fullest.
• These positions also feel better for many women versus reclining ones.
• The position you choose can actually help prevent complications or interventions such as episiotomy.

Common Concerns in in Week 36

How is the placenta delivered?

• After the baby is delivered and the cord is cut the mother will still have contractions, though not as painful. This part of labor is usually forgotten as the focus goes on the baby. As your placenta separates from the uterine wall, the mother may feel the urge to push or the doctor may instruct the mother to push or may massage your tummy and if all fails your doctor will reach in and take it out. For the curious-minded the placenta resembles a big raw piece of meat with a shiny membrane around it.

What is the buzz on episiotomy?

• Episiotomies used to be routine because it was always thought that a clean cut was better than multiple irregular tears. Now it is realized that if you allow the perineum to stretch slowly as the head delivers you will avoid a significant tear even with a first baby. An episiotomy can lead to excessive tearing all the way through the rectum. It is also more prone to infection and sexual problems later in life. The vagina is designed to stretch around the baby and then revert to normalcy. Sometimes a small tear is inevitable but it is usually less extensive than an episiotomy and often requires no stitching. There are certain situations that will call for the procedure such as fetal distress, a large baby or a forceps delivery. If you are without an epidural, a local anesthetic will be used.

Weekly Nutrition advice in Week 36

A Word on Iron and Anemia

• Many women (more than 90% are slightly anemic before they conceive), particularly those carrying more than one baby, are anemic.
• Anemia occurs if the level of oxygen-carrying hemoglobin in red blood cells drops below normal (when the hemoglobin level is less than 12.8g/100 ml blood).
• It is essential to increase your iron intake through prescribed tablets to correct iron deficiency anemia before you conceive.
• It is important to have healthy blood during pregnancy in order to prevent complications in labor due to fatigue and to reduce the chances of postnatal depression.
• There are three main causes of anemia: deficiency in iron, folate or vitamin B12; iron deficiency is the most common type as a result of baby's demands.
• Women with heavy periods are more susceptible to being slightly anemic when they enter pregnancy.
• If diagnosed with this condition you will be prescribed iron tablets. Anemia can occur even if you have iron-rich diet since it may be due to a lack of B vitamins.
• The following dietary guidelines will be helpful, and since iron cannot be stored in your system, ensure you eat good food sources every day.
  1. To prevent iron deficiency eat plenty of green leafy vegetables, pumpkin seeds, cherries, dried apricots, fish and poultry. Drink blackcurrant and cranberry juice
  2. To remedy vitamin B deficiency, eat eggs, milk, cheese, white fish and yeast extract
  3. To reduce folate deficiency, eat nuts and raw or steamed green leafy vegetables, wheatgerm and pulses
  4. To improve iron absorption, consume vitamin C such as in fresh orange juice with iron rich foods improves the mineral's absorption. Eat vitamin C rich foods with iron-rich foods
  5. Avoid calcium rich foods in excess as it comes in the way of iron absorption