Katharine was very concerned that she might develop eclampsia during labour, which can lead to convulsions or seizures. In fact, as I explained to her, this is a rare condition that is unlikely to occur when pre-eclampsia has been diagnosed. Due to her high blood pressure and the weight of the baby (estimated at about 9 pounds/4kilograms),  Katharine agree to be induced when she was two weeks overdue.

THE LABOUR

Although it was long (17 hours), labour went relatively smoothly for Katharine. She was induced at 9:00 a.m. on Monday, and at 1:00 p.m. felt relaxed enough to send her husband Adam to her mother’s for lunch… on the condition that he bring her back some of her favourite cake. Katharine used a TENS machine, which is supposed to stimulate natural painkillers through the transmission of electrical impulses. She was put on it late, however, so she’s not sure whether it helped or not. At midnight, 15 hours later, she asked for an epidural – something she had sworn not to do – and after that everything was all right. At 1:45 A.M. on Tuesday she was given an episiotomy (which she didn’t feel at all), and about ten minutes later forceps were used to pull Natasha out.

FIRST REACTIONS

“ I got a bit of a shock when I saw her,” recalls Katharine, “because her face was very red and scrunched up, her head looked lopsided and indented because of the forceps, and she seemed to be gasping for air but not making any sound. I kept on asking, ‘Is she all right?! Is she all right?! The nurse turned away for a second and I was absolutely convinced that Natasha was dead. That was actually the worst moment during the whole labour, and I started to cry uncontrollably.

“In fact, the nurse was only doing the Apgar scores and, as it turned out, Natasha scored high. About 30 seconds later we were handed a perfect little baby girl breathing normally.

“I was quite surprised that she had her eyes wide open and seemed to be looking at me and Adam is very alert, quizzical manner. She just sat staring for about five minutes without crying at all. Natasha is my first child, and so I wasn’t prepared for the combination of sheer joy, love, and relief that flooded over me when she was placed in my arms for the first time.

“The placenta came out after only ten minutes, which I’m told is a bit unusual without the use of oxytocin, and then the nurse clamped the umbilical cord in two places and Adam cut it.”

LOOKING BACK AT THE BIRTH

The one thing Katharine regrets about the whole pregnancy is having had an episiotomy. She is sure she would have dilated enough had she been given another half hour. Although she felt no pain at the time, due to  the epidural, she says the episiotomy was the only physical problem associated with the birth that didn’t clear up in the first two weeks.

Three months later the episiotomy scar is still sensitive, and she says that the worry of tearing during intercourse has made her avoid sex completely. I explained to her that although this fear is genuine, it is almost certain she would have lost her sexual appetite for a time after giving birth, with or without an episiotomy. In any event, a forceps delivery almost always necessitates an episiotomy.

THE FIRST DAYS

Katharine found that despite her elation after the birth of Natasha, she soon got what are commonly known as the “baby blues,” a feeling of deep depression that stayed with her for three days. She found it very difficult to relate to all the people around her, including Adam. She also felt guilty because she had not expected these feelings to accompany the birth of a normal, healthy baby.

“Baby blues” are caused by the huge increase in hormones which occurs in a woman’s body during childbirth. It takes quite a while, sometimes weeks or even months, for the body to readjust completely, and in the meantime a new mother may have to deal with difficult bouts of depression.

In Katharine’s case, things improved when she arrived home from the hospital. Although she was physically exhausted, psychologically she felt much more in control.

“It was only when we walked through our own door with Natasha for the first time that I felt the three of us were a real family. Having said that, Natasha seemed to take up every last secondof our time, although I was lucky to have Adam there to help – he did about 40 percent of all the work.”

Weight Newborns differ greatly in weight. Nutritional, placental, and racial factors all have a bearing. The weight range for babies born around their expected time is 5 pounds 6 ounces to 10 pounds 8 ounces (2.4-4.8 kilograms). If you are till or heavy or if you are diabetic, your baby is likely to weigh more. Women who suffer from chronic hypertension, vascular or renal disease, or pre-eclampsia, and women who smoke during pregnancy are likely to have lighter babies. A woman whose pregnancy is shorter than 40 weeks is also likely to have a lighter baby. Girls generally weigh slightly less than boys, and twins or other multiple births weigh less than singletons. It is normal for your baby to lose weight in the first few days after birth as her body adjusts to new feeding requirements. She must now process her own food, and it will take a while for her to feed consistently. The usual weight loss at this time is about 4-6 ounces (115-170 grams). After five to seven days, you can expect your baby’s weight to begin increasing. The significance of a baby’s weight gain is what it tells us of her overall physical health. Steady weight gain indicates that her food intake is sufficient and is being absorbed, whereas poor or erratic weight gain or weight loss signals that food intake is insufficient or that it isn’t being absorbed normally. Your baby will be weighed frequently by the paediatrician. There’s no need to monitor her weight at home unless the doctor advises it.

Head circumference Your baby’s head is disproportionately large in comparison to her body size, and takes up one quarter of her entire length.The younger baby is, the larger her head will be in proportion to the rest of her body. The average circumference of a newborn baby’s head is about 14 inches (31.5-38 centimetres). Measuring head circumference is regarded as an essential part of the examination of a baby because the growth of the head reflects the growth of the brain.

Chest and abdomen The circumference of your baby’s chest will be smaller than that of her head. Her stomach might appear to be very large and even distended, but given the immaturity of her abdominal muscles, this is to be expected.

It is common for the mother to take prime responsibility for a newborn’s care, but the father should be encouraged to take an equal role. He should learn how to hold his baby and should build up a tactile relationship with her. Make sure he becomes involved with day-to-day routines such as bathing and diaper changing. Even if the baby is breastfed, he can bottle feed her using expressed breast milk. Although having two parents is the ideal, many babies are born to single mothers and into a variety of nontraditional family settings. Significant others, whether family members or other adults, can also establish a bond with a newborn.

As soon as your baby is born, you can put her to your breast. She will have a natural sucking reflex and the sucking action will encourage the production of the hormone oxytocin. Oxytocin makes the uterus contract and expel the placenta. Touch your baby’s cheek on the side nearest your nipple to stimulate her rooting reflex. Rather than just sucking on the nipple, her lips should be on the breast tissue with the whole of the nipple in her mouth.

Your baby’s lungs are still immature, which means her breathing is naturally much shallower than yours or mine. This is nothing to worry about, as her lungs will gradually mature.