Weekly Guide to Pregnancy: Week 32
How big is my baby?
Fetal size: crown-rump 29cm (11.6 inches), crown-toes 42cm (18.9 inches). Fetal weight: 1.7kg (4 pounds).
Your baby has continued to grow, and his/her lungs and digestive system have also continued to mature. Your baby's senses are functioning, and by week 32 the mind may even have started to function. Your baby still needs more time in the womb to continue maturation, and the build-up of fat stores.
What pregnancy symptoms will I be experiencing?
Keep a list of questions to ask your health care professional or antenatal class instructor each time you visit. It's important to feel relaxed, so if anything is worrying you, or if you are unsure about anything to do with your labour and birth, it's best to ask questions now and put your mind at ease.
Apgar score - this is a general well being assessment used to scale a baby's fitness immediately following birth. The apgar score is carried out between one and five minutes after birth, and assesses the baby's heart rate, breathing, skin colour, muscle reflexes and response to stimulation. The score is from 1 to 10 and the higher the score the better.
What to do during the early stages of labour - there are many ways to take your mind off the discomforts of labour, particularly early labour, as it can often be quite some time (up to a few days) before labour establishes (regular contractions). Good distractions include long walks, completing any last minute shopping, talking to close friends and having warm baths. Heat packs, showers and rest are also very helpful. In early labour it is important to provide your body with energy and hydration, so you should eat small regular snacks and drink lots of fluids (preferably water).
Pain relief during labour - it is inevitable that you will seek some form of pain relief during labour, be it natural or synthetic. Walking, showers, baths, heat packs and massage can be used very effectively throughout labour as pain relief. Other forms of pain relief that may be available to you include nitrous oxide gas, pethidine injections, and an epidural. These are usually available in all hospital maternity units.
Nitrous oxide is a form of pain relief that is inhaled through a mask or mouthpiece during a contraction. It works quickly and has minimal side effects. Some women state that it can make them feel nauseous but you can be nauseated during labour anyway. Nitrous oxide generates a "happy" feeling and can cause temporary dizziness, but it may help you relax a little more between contractions.
Pethidine Injections are a synthetic narcotic given as an injection into the muscle during labour. Pethidine has a similar effect to the Nitrous oxide, but it is stronger and lasts longer. Pethidine can also cause nausea and is usually given with an anti-emetic (anti-nausea) injection. Pethidine may help to ease the intensity of contractions and encourage you to relax more (or sometimes even sleep) between contractions. Pethidine can also have a similar effect on the baby, but its effects are usually worn off before the baby is born. If pethidine is given too close to the birth, a reversal drug (Narcan) may be given to the baby to prevent any side effects.
Epidural is a form of local anaesthetic used as a pain relief in labour. It works by numbing the nerves that carry the feelings of pain to the brain. It is often used if a caesarean section is necessary, because it allows the mother to be awake while the baby is being born. A specialist doctor (anaesthetist) is needed to give an epidural. A needle is inserted in between the bones of the spine, and then a plastic tube is fed down the needle to an area just outside the spinal cord (the epidural space). The needle is removed and the tube is kept in place with sticky tape. The anaesthetic is injected down the tube and begins to work after 15 to 20 minutes. "Top ups" can be given by injecting more anaesthetic down the tube. Although this form of pain relief offers an almost pain free labour, there are risks and disadvantages. It can delay birth, as a woman is unaware of her own urges to push unless the epidural is allowed to wear off. Consequently, women who opt for an epidural have a higher rate of intervention, for example forceps deliveries. There is a small risk of getting a headache following the anaesthetic.
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