Each step of pregnancy, birth and the baby’s first months is set out with detailed information and clear diagrams. A remarkable set of full–colour photographs brings this journey to life, expressing feelings and emotions that are so much part of having a baby. Contemporary personal stories complement the text, offering readers insights into the joys and delights of this profound experience, and also the risks and difficulties. Women and men who have recently become parents share here some of life’s most intensely private and deeply-felt times – making this a very special book for New Zealand and New Zealanders.

Pregnancy, birth and early parenting are part of a continuous life process. This book describes not only the amazing physical and emotional changes that take place in a women’s body during pregnancy and birth, but also has advice on pre-pregnancy health, common problems and potential difficulties, pregancy care and birth choices, and caring for a new baby. There are practical sections on everything from exercise and nutrition to baby equipment and nappy-changing, not only for women but also for partners and support people.

The authors, GP Sue Pullon and midwife Cheryl Benn, draw on many years’ professional and academic experience in general practice and midwifery respectively. Together, they bring a rare depth and range of evidence-based knowledge to the project. They have worked closely with a wider group of experts, along with the publishing and design team, to create an accessible, practical and reliable guide for today’s new parents.

Contents                                                       

Preface
Introduction
Using this book
The people who made the book
Acknowledgements

Chapter 1: Planning for pregnancy

1. Being in good health

Nutrition for all women

Exercise

Smoking affects your health

Alcohol

The reproductive/menstrual/ovulatory cycle

Regular health care – having a primary care provider

Cervical smears

Sexually transmitted infections (STIs or STDs)

Breast examination

2. Sexuality and contraception

Commonly used methods of contraception

3. Deciding whether to have a child

Do I want a child?

Pre-conception health check

Stopping contraception

4. Trouble getting pregnant?

Body weight

Fertility awareness (natural family planning)

Intercourse

And if I’m still not pregnant?

Pregnancy for women not currently in a heterosexual relationship

Investigating infertility

Adoption

A Māori health professional’s perspective

Chapter 2: Suspecting and confirming pregnancy

1. What’s happening?

Fertilisation

Implantation

Hormonal changes

2. Finding out if you’re pregnant

Earliest symptoms and signs

Pregnancy tests

3. Normal pregnancy

How long does pregnancy really last?

What is antenatal care?

Education for pregnancy and parenting (antenatal education)

4. Unplanned pregnancy – your options

Going ahead with an unplanned pregnancy

Termination of pregnancy (abortion)

Adoption

A Pacific health professional’s perspective

Chapter 3: The first three months (weeks 1–13)

1. What’s happening?

Problems with development

Precautions that can reduce the risk of infections

2. Feelings and changes

Nausea and vomiting (‘morning sickness’)

The growth of the uterus and common problems

Hormonal changes

3. Helping yourself

Tiredness

Nausea and vomiting

Breast tenderness

Skin itchiness and dryness

Vaginal thrush and bacterial vaginosis

Urinary frequency and infection

Constipation

4. Miscarriage

Suspecting miscarriage

After a miscarriage: feelings

Pregnancy after miscarriage

Ectopic pregnancy

5. Choosing a system of antenatal care 

A midwife as your LMC

A GP obstetrician as your LMC

A specialist obstetrician as your LMC

How to decide?

Changing your LMC

6. The first antenatal visit with your LMC

Things your LMC will want to know

Tests for checking on the mother’s health 

Tests for checking on the baby’s development (prenatal diagnosis)

Ongoing pregnancy care

Ting’s story: Choosing a lead maternity carer

Chapter 4: The second three months (weeks 14–27)

1. What’s happening?

The baby

The placenta

Maternal changes

2. Feelings

Expansion

Movements (‘quickening’)

Travel during pregnancy

3. Helping yourself

Exercise during pregnancy

Essential pregnancy exercises

Nutrition

Sexual activity

4. Complications

Hypertension of pregnancy and pre-eclampsia (toxaemia)

Sugar diabetes (diabetes mellitus)

Intra-uterine growth restriction (IUGR)

Cervical incompetence/insufficiency

Very early premature labour and stillbirth

Coping with the death of a baby

5. Continuing health care

Continuing antenatal health care

Prenatal screening and diagnostic tests

Dental health

Education for parenthood

6. Planning for birth and beyond

Considering where you will give birth

Considering breastfeeding

Considering employment

Income support

What to wear?

Household matters

Baby clothes and equipment

Ngawari’s story: A first birth at home

Chapter 5: The last three months (weeks 28–40+)

1. What’s happening?

The baby

Maternal changes

2. Feelings

Practical problems

Looking forward

3. Helping yourself

Looking after your pelvic floor

Perineal massage

Looking after your skin

Sleeping, bending and lifting

Sexual activity

4. When pregnancy becomes complicated

Multiple pregnancy

Bleeding (antepartum haemorrhage)

Blood clots (deep vein thrombosis, or DVT)

Severe abdominal pain in later pregnancy

The Rhesus factor

Heart disease in pregnancy

Premature birth

Stillbirth

5. Continuing health care

Antenatal visits

Possible tests in the last three months

Antenatal admission to hospital

Going to pregnancy and parenting classes

Breathing and relaxation for birth

6. Planning for birth

Changes at the very end of pregnancy

A plan for birth

Preparation for birth

Who is going to help at the birth?

A couple’s story: A first birth

Chapter 6: Birth

1. The onset of labour

Definite signs of action

Helping yourself in early labour

2. What’s happening? The normal pattern of labour

The first stage of labour

The second stage of labour

The third stage of labour

3. Working as a team during labour

First stage of labour

Checking on your baby

Transition (the end of the first stage)

Second stage of labour

The birth

Third stage of labour

After the birth

4. Complications and interventions

When home birth is no longer advisable

Induction of labour

Augmenting labour

The ‘posterior’ baby

Breech birth

Forceps delivery

Vacuum (ventouse) delivery

Delayed delivery of the placenta

Post-partum haemorrhage (PPH)

Caesarean section

Actively assisting a baby to breathe (neonatal resuscitation)

When a baby is born with a severe abnormality

Rhiannon’s story: A first birth in hospital

Moana’s story: A first birth in hospital

Gabrielle’s story: Four home births

Chapter 7: The week after birth

1. The first few hours

Feelings

Checking on your baby

Checking on you

The first feed

Leaving the birthing area

Family and friends (for partners and support people)

Bonding – the mother-baby unit

2. What’s happening?

Your body – changes after birth

Your baby – changes after birth

3. Feeding your baby

Breastfeeding

Bottle-feeding

4. One day at a time (days 1–4)

First day

Second day

Third and fourth days

5. When a baby needs special care

The special-care unit

Treating jaundice (phototherapy)

6. After a Caesarean

Post-operative pain relief

Intravenous (IV) lines, drains and catheters

Feeding your baby after a Caesarean

Your Caesarean wound

Exercises after a Caesarean

7. Looking after a new mother 

Midwife visits

For partners and support people

Terri’s story: Four Caesareans

Chapter 8: The first three months with your baby

1. Feeding your baby

Breastfeeding in weeks 2–6

Breastfeeding in weeks 4–6 and beyond

Eating for breastfeeding

Expressing milk

Combination feeding

If a baby fails to thrive

2. What’s happening?

Your body – further changes

Your baby – growth and development

Your baby – ill health

3. Baby care

Nappy-changing

Clothes for your baby

Bathing your baby

Bedding

Some common problems in young babies

4. Feelings – and feeling in control

Coping with an unsettled baby

Asking for help (for all parents and support people)

Getting out of the house

Post-natal depression and related problems

5. Cot death, or sudden infant death syndrome (SIDS)

Reducing the risk of cot death

Cardio-pulmonary resuscitation (CPR)

Charlotte’s story: Cot death

6. Continuing health care

Home or clinic visits

Your six-week check

Contraception after childbirth

Vaccination programme

Having a regular primary care provider

Registering the birth

7. Life with a baby

Looking after yourself

Enjoying your baby

Anna’s story: Three small children

Appendix: Useful websites and organisations

Glossary and abbreviations

List of illustrations

References

Index