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Active Living
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Prehistoric Workout
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Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
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Bleeding in Pregnancy
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Delaying Motherhood
Blue after Baby or Postpartum Depression
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Getting a latch on breastfeeding
Group B Streptococcus
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Low Birth Weight Babies
Medication & Pregnancy
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Managing Your Own Labour
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Nausea & Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
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Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
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Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
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Asthma in Children
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Not Just Baby Fat
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When to go to the Doctor
Whooping Cough
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Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
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Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
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A Healthy Mouth
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Painless Dentistry
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Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
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Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
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Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
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Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
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C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
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Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
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Gastroparesis
Gestational Diabetes
Get Active
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The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
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Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
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Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
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Insulin - the Key to Energy Management
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Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
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Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
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Your Medication Expert
Medication Research Studies
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No Need for Insulin?
Not Snoozing
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Diabetes and OTC Medications
Pedicure Precautions
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Pet Diabetes
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Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
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Sharps Disposal
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Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
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Sodium
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Solving the Insurance Puzzle
Stress and Diabetes
Success in School
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Supporting Spouse with Diabetes
Sweeteners
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Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
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Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
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Understanding Diabetes
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Used Sharps
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World Diabetes Day
Your Medicine Cupboard
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Family Medicine
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ADHD in Children
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Aspirin Every Day?
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Back Pain Myths
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5 Tips to Manage Weight
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Challenging the Milk Myth
Diet Reality Check
Drink Up!
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Energy Drinks
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Healthy Ethnic Meals
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Feeding Your Kids
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Food Chemistry 101
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Healthy Eating for Teens
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15 Great Reasons to Breastfeed
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Family Health Online / Pharmacy at Safeway
Family Health Magazine - CHILDBIRTH

Manage Your Own Labour
It can be a positive experience

Labour, ending with the normal delivery of a baby, is one of life’s most magnificent events. Professionals have a role during the birthing process to ensure that all progresses normally. If all is well, nothing is needed from them. The labouring woman and her support team manage the event to themselves, with helpful advice as needed.

This article will suggest ways to help you avoid interventions during the birth. These interventions may include: episiotomy which is the surgical cutting of the perineum (the area between the vagina and the rectum) and forceps in labour. The suggestions are simple and appropriate for all low risk pregnancies.

Prenatal Classes

Prenatal classes are an important resource if you are a first time parent or you want a refresher course before this birth. They provide you with up-to-date information on ways to cope at each stage. They also let you know the local practices with regard to birth planning and the actual birthing process. Knowing these things will help you be less anxious and the result is a more positive experience for all involved.

Active Labour

Prenatal classes will teach you the signs and symptoms of active labour. You will learn about the correct time to go to hospital. This is often said to be when contractions are no more than five minutes apart and are lasting at least a minute. There are many other signs and symptoms you will learn, that indicate you should go in for assessment. Basically, when you are mentally or physically uncomfortable with what is going on, you should seek attention.

Often, even when contractions seem to be advancing, a vaginal examination will reveal the cervix has not changed enough to diagnose active labour. This usually means there is still more time before admission to hospital. As this is a normal and usually a very safe part of labour, it is often best managed in the comfort of your own home. Medical intervention to make labour proceed faster is called induction of labour and is not usually thought to be in the best interest of mother or baby at this stage.

One of the most inappropriate places to be, for a healthy, pregnant woman
not in labour, is the labour and delivery suite.

Don’t feel badly if you are told to go home and return when things change. This is probably the best way to manage your labour. Some people do receive pain relief at this time to help them cope.

Labour Support

The role of a labour support person (often in addition to a birth partner) is to provide soothing comfort and encouragement during your labour. This person is usually female and a relative, friend or professional doula. The Greeks used the word 'doula' to describe a 'woman’s servant' or 'one who mothers the mother.' Today a doula is a woman with experience in childbirth, who uses this experience to provide support to a mother, before, during and after childbirth.

The presence of a labour support person has been shown to help achieve normal birth outcomes. These include shorter labour, less need for pain relief, fewer episiotomies and reduced need for forceps and caesareans. The labour support person can provide you with soft background music, a calm atmosphere, and a cold drink to sip. She is there to offer help to the washroom or massage whenever desired. She encourages relaxation such as showering and bathing. Another technique she uses is general positive feedback with good eye contact and frequent light touches.

Most people know the symptoms of anxiety - a racing heart beat, fast breathing, tremors and a heightened awareness, among others. These are caused by stress hormones called catecholamines. Anxiety associated with labour and pain can result in an increase in these hormones. When the level is high, the uterus contracts less effectively. Perhaps this is why a soothing labour support person can be so comforting when you are in labour.

Use of Pain Relief

As mentioned, high pain levels and the associated high level of catecholamines may interfere with the progress of labour. Some types of pain relief may also interfere with the progress. This is why pain relief should be used when needed, but not automatically. When pain relief is used, you still benefit from emotional and physical support.

Some types of epidural anesthetics cause a motor block or temporary paralysis of the muscles. This makes changing positions more difficult, but not impossible. Even if an epidural is used, it is still important that you keep changing position. Once the cervix is fully dilated, epidurals often result in a longer period of time before you begin pushing. If total block has not occurred, you should still be able to sense how to push and be able to push instinctively.

Labour Positions

Movement of any form (walking, rocking or changing position) helps the progress of labour. Upright positions such as walking, standing, kneeling and squatting, have been shown to reduce the amount of continuous and intermittent pain experienced by labouring women. These positions may also help open the pelvis to allow the baby more room in the birth canal.

Even during the second or pushing stage of labour, you should continue to change position from time to time. Upright delivery positions can result in a shorter pushing stage, less use of forceps and fewer tears and episiotomies. There is no one correct position in which to give birth. When given the choice, a woman is likely to choose the position that is natural for her.

Instinctive Pushing

Sometimes a woman is encouraged to begin pushing before her body has signalled that the time to push has come. This is similar to trying to have a bowel movement when there is no urge to. Even once the cervix is fully dilated it may not be time to push for up to another hour.

If pushing is encouraged before the natural urge occurs, it is often coached pushing (since it is not instinctive at this time). Coached pushing may involve breath holding and bearing down for prolonged periods of time. Prolonged breath holding is associated with a higher use of forceps, more episiotomies and lower oxygen levels in baby.

Instinctive pushing is allowing you to decide for yourself the nature and type of pushing that should occur. You will start to push naturally after a contraction begins and will stop pushing before the contraction is over. Instinctive pushing may be accompanied by some of the breath escaping during the push and a shorter duration of each push. This type of pushing does not increase the time it takes to push the baby out and often results in a less traumatic delivery for mother and baby.

Perineal Massage

Some doctors and midwives recommend the use of daily massage of the perineum starting about six weeks before delivery. It is thought this may reduce tearing and the need for episiotomy at delivery. The massage is a gentle stretching of the tissues of the perineum. Women need to be highly motivated to stick with it, but are usually pleased they did. Instruction sheets may be available from your doctor.

The use of hot compresses, oils and perineal massage with the delivery of the baby’s head is also thought to reduce perineal trauma. No studies have been able to prove this. Studies have shown very clearly there is no indication for the routine use of an episiotomy. In general, a tear of this area heals better and is less painful than an episiotomy. It is best to discuss these delivery suggestions with your doctor before delivery.

Since labour and delivery are normal events, the goal should be to keep things as normal as possible. A woman in labour is a marvel to behold. If you can stay relaxed with helpful, supportive and comforting people around, you will keep positive memories of the miracle of childbirth.

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FAMILY HEALTH is written with the assistance of
College of Family Physicans of Canada
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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