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Last weekend I had the privilege of supporting a couple during the birth of their first baby.
One of the most noticeable and dramatic changes is the involution of the uterus; when the uterus starts to return to its pre-pregnancy size, tone and position.
The collagen muscle fibres of the uterus which increased to 10 times their normal length and 5 times their normal thickness will also return to their pre-pregnancy state by the end of involution. The rate of involution varies between women but it tends to be slower if they have had several previous births.
As the uterus returns to its previous size, its lining is shed and passed in the form of bleeding called lochia for several weeks. Lochia Alba – Yellow-white discharge made up of cervical mucus and white blood cells. Use the right protection - In the first few weeks postpartum women are advised to use sanitary or maternity pads until the lochia finishes. Rest – It can be difficult with a newborn, but the advice is for women to try to take it easy and not to lift anything heavier than their baby for the first few weeks while healing.
Take extra bathroom breaks – After giving birth a woman may find that her bladder is less sensitive so she may be less aware of when she needs to pee. Changes to the breasts during pregnancy are often dramatic with their size and sensitivity changing wildly from their pre-pregnant state. In addition to the changes in the breast, a woman’s blood volume increases massively, by as much as 50% during pregnancy.
Muscles, ligaments and joints that were softened by the hormonal helper Relaxin begin to return to their pre-pregnant state in the first 3 months after giving birth.
Performing Kegels can help the pelvic floor to regain its tone and reduce stress incontinence. Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream. Having a baby is an emotional experience and it is very common to have up and down emotions both during pregnancy and after the baby is born. From around the 3rd or 4th day postpartum, around 70-80% of women will experience the Baby Blues where they become emotional and feel down.
The sudden and rapid decrease in progesterone on about the third day postpartum is thought to contribute to the Baby Blues. Many women feel ashamed of their feelings, which in severe cases may include thoughts of harming the baby or themselves and can feel very frightening. Whilst living in Bangkok offers many benefits to a family which include accommodation and childcare that is affordable, one aspect of life in Bangkok that many expat women find difficult is the thousands of miles that often separate them from the family and friends in their home country.
I hope we will get the opportunity soon to talk about it in more detail for a dedicated blog article.
My labor and delivery was very fast and unexpected, my husband and I ended up delivering our baby ourselves in our bathroom. Thank you very much for sharing your time and wealth of impartial knowledge with us – ‘bless you!
When I chose Fran as my Doula, all I wanted was someone to show up for me, without compromise, and with me in her mind.  She took our opinion into consideration one hundred percent, supported me one hundred percent, heard everything I had to say and amplified it.
Fran was my doula for the birth of my second child, but my first birth in Thailand.  I can honestly say that she provided me the type of support I was looking for in a doula. Rita and I found Fran’s approach to be educative and supportive with a sincere humanity to the birth process. Fran, Wes and I will never thank you enough for being with us during one of our most precious moments in our life. When I was preparing for the birth of my son, I wanted to work with a doula as she could help me navigate the seemingly complex childbirth experience (first-time Mom anxiety!). My doctor recommended that I get in touch with Fran, with whom she worked on previous occasions. Enter your email address to subscribe to this blog and receive notifications of new posts by email.
With so much emphasis on what will happen during pregnancy, some women have not yet considered all the physical and emotional changes she will go through in those first few hours, days and weeks once the baby has been born.
Enzymes start to digest the extra collagen muscle fibres of the uterus and the by-products are then excreted in the urine. Breastfeeding assists with this process since it stimulates the release of oxytocin which causes the uterus to contract. A new endometrium begins to form from around 10 days after the birth and is completed within 6 weeks postpartum. It is not recommended to wear tampons because there is still a wound at the site where the placenta joined the uterine wall.
Overdoing it can increase bleeding and it is common for women to have a return to the heavier red bleeding if she does a lot of activity. After she has given birth, a woman’s blood volume will rapidly return to its pre-pregnancy level, usually within 24-48 hours. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. These heightened emotions and mood swings are partly due to hormones and partly due to an overwhelming amount of new information coupled with a growing comprehension of new responsibilities. This is extremely common and is considered to be a normal emotional response to childbirth. In addition, the stress associated with being in hospital may increase the likelihood of symptoms as well as any complications experienced during labour. It is important for women to know that just having these thoughts does not mean that they are actually going to harm themselves or their children. Fran helped us feel prepared in the months and weeks leading up to my labor, as we met via Skype, and in person once we had traveled to Bangkok. Everything happened so fast that Fran did not make to our house for neither the labor nor delivery, but she was still very present as she conversed with us over the phone and helped us feel confident and reassured. That’s what I mean by showing up.  That to me was the greatest gift, and Fran was able to deliver it for me, and my partner. Fran was sensitive to my concerns, listened carefully to my needs, helped outline my options, and acted according to my decisions.
Fran was with us for the whole journey before, during and after the birth of our baby boy Maximilian Mathew. Your support was invaluable to help me prepare for Finley’s arrival and to deal with the early days as a new mother. When I first arrived in Bangkok from Phnom Penh, where we live, I wasn’t sure I would hire a doula but decided to after discussing the benefits with a friend. You are an amazing doula and a beautiful person… thank you from the bottom of my heart. She was ever helpful and consistent in providing the best service to help me ease  into motherhood. I held mama’s hand with tears of joy in my eyes as I watched the magic of her baby boy entering this world. By the end of the process of involution, the uterus will have returned to its pre-pregnancy weight at around 60g and be about the size of an orange. Every woman will experience this vaginal bleeding for several weeks whether she gave birth vaginally or by C-Section. It’s not unusual for postpartum bleeding to increase slightly at around day 7-14 days after the birth as the placental site tissue is cast off. During pregnancy, levels of the hormone Prolactin, which is responsible for lactation, has been steadily rising in the bloodstream. During this time she will normally pass large amounts of urine as her body eliminates excess fluids that were accumulated to increase the blood volume to its required level during pregnancy.
One of the more inconvenient and common things which can go hand in hand with having a baby is stress incontinence (passing small amounts of urine when coughing or laughing) with up to 50% of women affected after giving birth. Typically, Baby Blues pass fairly quickly; often within a week but in some cases can last up to 6 weeks. Whilst Baby Blues will typically go away relatively quickly with the right support and reassurance from those around you, it’s important to seek help if the feelings become scary or overwhelming. Reaching out for help can be extremely difficult, but by bringing these feelings into the open with a friend, family member or professional, women become less likely to act on these negative feelings.
Having a supportive network in the postpartum period is particularly important, especially for women who may be suffering from postpartum depression.
Better to use a hand held mirror to observe or a feel over the perineum and check for a lift during muscle contraction.
She even had a midwife friend of hers call us to help advise us as we faced the birth of our daughter on our own. During my pregnancy she helped me prepare questions for my doctor, educated me on how deliveries takes place in Thailand, and what topics to discuss with my doctor beforehand. Thanks to you this day will be forever special and without you I know it would have never happened this way… thank you!
The rate of involution can be tracked by measuring the fundal height (the top of the uterus).
When the baby is first born, the hormone HPL causes the mothers breasts to secrete colostrum, which is yellowish in colour.
A recent survey found that three quarters of women who experienced stress incontinence suffered in silence and did not seek help or advice from their healthcare provider due to embarrassment. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
Common symptoms include rapid mood swings, lack of concentration, anxiety, and feelings of dependency. It’s important to note however that it can begin at any time during the first year after childbirth. If you experience postpartum incontinence (pee, wind or poo), heaviness or dragging between your legs (beyond the first six weeks) or pain on any more than the first few attempts at post baby sex, consult your local women’s health physiotherapist for a physical assessment and some direction on rehabilitation for your pelvic floor.
She came with me to two checkup appointments to meet my doctor and make sure everyone was comfortable with her role. She is very resourceful and able to share helpful information, including specific information about doctors and different hospital birthing policies.
Immediately after delivery, the fundus is approximately 10 cm above the symphysis pubis ( the cartilaginous joint which connects both sides of the pelvis together).
As the uterus heals and returns to its pre-pregnancy size, the lochia will change colour and become lighter.
The colostrum contains everything that the baby needs in those first few days and consists of maternal antibodies, white blood cells, water, protein, vitamins, minerals and carbohydrate. In most cases the symptoms exist for around 3-8 weeks, although for some women it may last for many years.
As a doula she is tapped into a vast network of mothers, midwives and doulas in Bangkok which was also extremely helpful. May you be blessed for blessing our little family with your presence on Jacob’s special arrival! It decreases in height at around 1cm per day and takes around 10 days to return to its normal position. About 3 days after the birth, as prolactin levels increase, the mother begins to produce breast milk. There were some unexpected turns with my pregnancy as well as some challenges that I faced with my obstetrician; Fran was very supportive in helping me work through these.
Suckling of the baby promotes the release of prolactin and breast milk supply will be maintained for as long as the mother decides to continue breastfeeding. I highly recommend her services – having her by my side made all the difference to my birth experience.

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24.07.2015, author: admin
Category: Bv In Women 2016

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