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Pregnancyand Childbirth M O N T H S

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PREGNANCY AND CHILDBIRTH

SECTION 1PRENATAL PREPARATION . . . . . . . . . . . . 1

The First Trimester— Conception to 14 Weeks . . . . . . . . . . . . . . . . . 1

Your changing body . . . . . . . . . . . . . . . . . . . 1The Second Trimester—15 to 27 Weeks . . . . . . . . . . . . . . . . . . . . . . . . 1

Your changing body . . . . . . . . . . . . . . . . . . . 1The Third Trimester—28 Weeks to Birth . . . . . . . . . . . . . . . . . . . . . . 2

Your changing body . . . . . . . . . . . . . . . . . . . 2Pregnancy Do’s and Don’ts . . . . . . . . . . . . . . . 2Choosing a Health-care Provider . . . . . . . . . . . 3How Your Doctor Can Help . . . . . . . . . . . . . . . 4Finding a Prenatal Class Near You . . . . . . . . . 4

SECTION 2EATING AND EXERCISE . . . . . . . . . . . . . 5

Pregnancy Food Guide. . . . . . . . . . . . . . . . . . . 5 Getting extra nutrients during pregnancy. . . . . . . . . . . . . . . . . . . . . 5

Exercise During Pregnancy . . . . . . . . . . . . . . . 7General safety guidelines . . . . . . . . . . . . . . 7

SECTION 3PREPARING FOR THE BIRTH . . . . . . . . . . 8

Breathing Techniques for an Easier Delivery. . . . . . . . . . . . . . . . . . . . 8 Preventing hyperventilation. . . . . . . . . . . . . 8Relaxation Techniques Speed Delivery . . . . . . 9

Focal point concentration/ visualization. . . . . . . . . . . . . . . . . . . . . . . . . 9Massage increases your comfort level during delivery. . . . . . . . . . . . . . . . . . . 9Practising these techniques . . . . . . . . . . . . 9

What to Take to the Hospital . . . . . . . . . . . . . . 9 Hospital labour kit . . . . . . . . . . . . . . . . . . . . 9 Grooming items . . . . . . . . . . . . . . . . . . . . . 10

Personal items. . . . . . . . . . . . . . . . . . . . . . 10 For the baby . . . . . . . . . . . . . . . . . . . . . . . 10

SECTION 4GETTING YOUR HOME READY. . . . . . . . . 10

A Note About Second-hand Gifts . . . . . . . . . . 11Buying Clothing for Your New Baby . . . . . . . . 11 Diapers . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Buying Furniture and Equipment for Your New Baby . . . . . . . . . . . . 11 Bath equipment . . . . . . . . . . . . . . . . . . . . 11 Cribs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Mattresses . . . . . . . . . . . . . . . . . . . . . . . . 12 Crib bumper pads . . . . . . . . . . . . . . . . . . . 12 Bedding . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Mobiles and crib exercisers. . . . . . . . . . . . 12 Playpens . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Baby gates. . . . . . . . . . . . . . . . . . . . . . . . . 13 Strollers . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Walkers . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Infant carriers . . . . . . . . . . . . . . . . . . . . . . 13 Car seats . . . . . . . . . . . . . . . . . . . . . . . . . . 14

SECTION 5GETTING HELP . . . . . . . . . . . . . . . . . . 14

Key Sources for Help and Information. . . . . . 14 Alcohol and drug information . . . . . . . . . . 14 Block Parent programs . . . . . . . . . . . . . . . 14 Car seats . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Child care . . . . . . . . . . . . . . . . . . . . . . . . . 14 Children with disabilities . . . . . . . . . . . . . . 14 Enquiry B.C. . . . . . . . . . . . . . . . . . . . . . . . . 15 Health resources . . . . . . . . . . . . . . . . . . . . 15 Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Parenting . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Postpartum depression. . . . . . . . . . . . . . . 15 Safe Start . . . . . . . . . . . . . . . . . . . . . . . . . 15

Preparing for Pregnancy: The Importance of a Healthy StartBecoming a parent is an exciting life experience, especially if you are expecting your first child. Learning that you are

soon to be a mother or father can produce many feelings—satisfaction, happiness, surprise and anticipation, along with anxiety or concern about what lies ahead. Such feelings are natural, as pregnancy and the first few months of caring for a new baby are times of great change. This booklet is intended to be a source of practical information and advice for

expectant parents. Whether you are seeking information on what to expect during pregnancy or practical suggestions and support as you prepare for childbirth, here you will find valuable, up-to-date information.

EARLY CHILDHOOD DEVELOPMENT > PREGNANCY AND CHILDBIRTH > SEPTEMBER 2005

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Prenatal PreparationPreparing for the physical and emotional changes that occur during pregnancy and taking advantage of pregnancy information and support will help you safeguard the future health of you and your baby. This section is intended to help you by guiding you through the stages of pregnancy, alerting you to common health hazards and providing you with advice on finding a health-care provider.

The First Trimester — Conception to 14 WeeksThe first trimester (the first three months of pregnancy) is a critical time in the fetus’s life. It’s a time of rapid growth and development. It’s also the time when the fetus is most susceptible to hazards like smoking, infections, alcohol, drugs and X-rays.

Your changing bodyYour body will begin to go through many physical and mental changes during your first trimester. Your body will begin to experience hormone changes that may cause fatigue, change in breast tissue, headaches, and nausea and vomiting commonly described as morning sickness. Symptoms of morning sickness usually last eight to 12 weeks, but may persist longer. Hormonal changes will also stop your menstrual cycle in weeks one to four, so the uterine wall lining can build up to cushion and feed the fetus.

In weeks six to 12, light-headedness and shortness of breath are common, but be sure to advise your doctor if these symptoms are severe or if you have a family history of heart problems. Also, in week 12 or after, you may notice a brownish “tan” on your face and/or a dark line running down from your navel. This tan is called chloasma or “the mask of pregnancy” and will disappear after you give birth. The dark line is called the linea nigra and may remain after you have your baby.

The Second Trimester — 15 to 27 WeeksDuring the second trimester (the second three months of pregnancy), the fetus’s brain develops considerably. In fact, most of the brain’s development occurs during the period from now until two or more years after birth. During this second trimester, the fetus cannot live outside the mother’s body because its lungs, heart, and blood systems are not developed enough.

Your changing bodyAs your body grows more accustomed to pregnancy during the second trimester, the nausea and fatigue should lessen and the pressure on your bladder should subside. At this stage, the chances of having a miscarriage or spontaneous abortion decrease. You may also feel your baby move for the first time after week 16.

You may not realize that it is your baby moving at first, but as the weeks progress, there will be no mistaking your baby’s movements. During this time your breasts may secrete a water-protein matter called colostrum, which is a precursor to breast milk, another sign your body is changing and preparing for your baby’s arrival. Lower back pain is common around week 20 and is caused by the stretching of ligaments that attach the uterus to the pelvis, and by the increase in the size of the abdomen.

Pressure in your abdomen can cause blood to pool in your legs and make them throb. If you have a history of varicose veins, you may find that they worsen. This pressure, along with hormonal changes and increased blood volume, can also cause your ankles, feet, hands and face to swell. Swelling of your feet and ankles is normal in pregnancy. Most of the swelling should be gone when you get up in the morning. If it does not decrease with rest, talk with your health-care practitioner. To help lessen the chance of leg cramps and prevent varicose veins, sit with your feet raised as often as possible. Changes in food habits and hormones, as well as changes occurring with your body, will slow bowel activity. Keeping active may help decrease backache, constipation and excessive weight gain.

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The Third Trimester — 28 Weeks to BirthDuring the third trimester (the last three months of pregnancy), the baby could survive if born before it is full term. The earlier a baby is born, the greater the need for special care to decrease the risks from a preterm birth. The closer to full term, the more able the baby is to cope with the birth process and life outside the uterus.

Your changing bodyAs you near the end of your pregnancy, you may feel increasingly tired. Again, this is due to hormonal changes and the demands placed on your body by the fetus.

Frustration with the limitations pregnancy imposes is very common at this stage. At such times, you may find it helpful to remind yourself of how close you are to the birth of your baby. It may help to talk to your birth partner or a friend who has experienced a pregnancy about the feelings you are experiencing.

In weeks 25 to 35, you may experience upper back pain as your uterus enlarges. Hormone activity and stretching skin may cause purple or red marks called striae to appear on your abdomen and breasts, usually after week 30. At this time you may also experience irregular, painless contractions of the uterus known as Braxton Hicks contractions. You may start to experience cramping in your leg muscles due to pressure on your abdominal nerves, fatigue or a calcium phosphorus imbalance.

As the top of your uterus presses against your diaphragm, you may experience shortness of breath, around week 36. You may also experience sudden groin pain caused by ligaments stretching with abrupt movements such as sneezing, coughing or standing up quickly. Heartburn, hemorrhoids, stuffy-nose/allergies (even if you have never experienced them before) and sleep disturbance are all minor ailments that commonly arise around the 36th week of pregnancy.

If this is your first pregnancy, you may experience “lightening” in week 37 or 38. This is the uterus settling down in the pelvic cavity, and it feels as if the baby has dropped. Tell your doctor when this happens. As the uterus increases pressure on your bladder, you will feel the need to urinate frequently. Three to four days before labour, Braxton Hicks contractions increase. Inform your doctor if the contractions become regular or uncomfortable.

Pregnancy Do’s and Don’ts If you are pregnant, breastfeeding or even thinking about having a baby, check with your doctor, pharmacist, or health-care professional for advice on your medication. If a health-care practitioner, including your dentist, wishes to prescribe or administer medication or carry out a procedure, ask what effect this may have on you or your baby.

Some medical tests may not be safe for pregnant and breastfeeding women. Before having X-rays, dental X-rays, CT scans, and other tests, be sure to tell the technician you are pregnant or breastfeeding. Taking a daily folic acid supplement or a prenatal vitamin supplement with 0.4 to 1 mg of folic acid (folacin) reduces the risk of neural tube defects such as spina bifida in your baby.

Folic acid is also important for healthy growth and development. Start this supplement after you stop using reliable birth control, continuing through pregnancy. Most multivitamins contain 0.4 mg of folic acid, and prenatal supplements usually contain 1 mg of folic acid. Check the label.

It is best to stop smoking before you plan to become pregnant. If you are pregnant and smoke, now is the time for both you and your partner to stop or reduce the amount you smoke. Every time you smoke tobacco, the fetus’s heart rate increases, and the supply of oxygen, which the fetus needs in order to develop, decreases.


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Plan to stop drinking before you become pregnant. If you are already pregnant, stop drinking as soon as possible. It is never too late to stop. When you drink during pregnancy, alcohol passes from your bloodstream to the baby. This can affect the baby’s development. Drinking alcohol during pregnancy can result in lifelong disabilities for your child.

It is recommended that you limit your intake of caffeine to about 300 mg a day while you are pregnant or breastfeeding. If you are a heavy coffee drinker, cut down to three or fewer cups (1 1/2 half mugs) a day. Evidence shows that caffeine crosses the placenta into the baby’s circulation, and the baby’s system is unable to process it.

Avoid large meals if they make you feel nauseous. If you suffer from nausea or vomiting, try to eat small amounts of food every one to two hours, rather than larger meals three times a day.

Don’t sit for long periods. To help lessen the chance of leg cramps and prevent varicose veins, sit with your feet raised as often as possible.

Be sure to maintain good posture at all times and avoid wearing high-heeled shoes. This will help prevent backache. Also, lie down and stand up carefully and avoid sudden changes in position (i.e., from lying to standing). This will prevent lowered blood pressure (called postural hypotension), which may cause dizziness or fainting.

Don’t expose yourself to rubella (German measles). If you have had contact with anyone who has rubella, notify your doctor. If you contract this disease, especially in the first six weeks of pregnancy, there is a risk that your baby could develop congenital heart disease, blindness, deafness and/or mental retardation.

Don’t change cat litter. Cats may carry toxoplasmosis, a parasite that could harm your unborn child if you become infected while you are pregnant. Wear rubber gloves to change cat litter and wash your hands when done. Better yet, have someone else take care of the litter box during your pregnancy. Also avoid any raw or rare meats or unpasteurised milk while pregnant as they can also carry this parasite. Again, remember to wash your hands after handling.

Hot tubs and saunas can be relaxing and soothing, but it is important not to increase your inner body temperature. Limit the time you spend in a sauna, hot tub or hot bath to 10 minutes (less if you are feeling uncomfortable). It is also a good idea to reduce water temperature to below 38.9°C (102°F). There should be a second adult present in case you feel faint or dizzy.

Choosing a Health-care ProviderWomen in British Columbia can choose either a doctor or a registered midwife for their maternity care—both are covered under the Medical Services Plan. Midwives are licensed to provide care for healthy, low-risk pregnancies. It is important to contact a doctor or midwife when you are planning on becoming pregnant or as soon as you think you are pregnant. If you have special concerns or a history of medical problems, you may not qualify for midwife care. Please discuss this with your doctor or midwife. Here are a few ways to find a health-care provider:

> Call the College of Physicians and Surgeons, the College of Family Physicians or the College of Midwives for the names of doctors or midwives who are taking new patients in your neighbourhood. If you live in a larger community, you can also consult the local medical society.

> Ask another health-care professional (e.g., a nurse or childbirth educator) for recommendations. Ask your health-care provider about their policies regarding phone calls, home visits, frequency and length of office visits, and their on-call coverage, especially at the time of birth. Remember to ask about birth options, hospital facilities and any other concerns you have.

DID YOU KNOW?THAT AT SIX MONTHS YOUR CHILD MAY SLEEP UP TO 16 HOURS A DAY?

DID YOU KNOW?THAT NEW RESEARCH LINKS REGULAR USE OF SOOTHERS WITH FREQUENT EAR INFECTIONS? USE THEM FOR SHORT PERIODS OF TIME ONLY. STOP USING THEM AS EARLY AS POSSIBLE IN THE FIRST FEW YEARS OF LIFE.

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How Your Doctor Can HelpIn addition to checking your physical health and the health of your baby, your doctor may wish to discuss the following topics:

> Physical concerns and problems you may be experiencing.

> Eating and exercise habits.

> Stress in your life.

> Drug use during pregnancy (including over-the-counter drugs, cigarettes, alcohol, etc.).

> Prenatal information: It’s important to sign up for prenatal classes as early as possible in your pregnancy and to check out other resources in your community (e.g., single parent programs).

> Ultrasound: Ultrasound is a scan that uses sound waves to show the development of the baby in the uterus. Ultrasound is a routine procedure, and is given at 18-20 weeks of pregnancy. Its most common uses in pregnancy are to confirm pregnancy, to establish the estimated date of delivery, to detect certain developmental problems in the baby, to assess the maturity of the fetus, to detect the baby’s position, and to assess the condition and position of the placenta.

> Genetic counselling: If you have a family history of babies with congenital abnormalities, or if you are 35 years old or older, this is an important topic to discuss with your doctor.

> RhoGAM: This is an injection usually given to women who have Rh (rhesus) negative blood. It is given around the 28th week of pregnancy, after any vaginal bleeding in pregnancy or an amniocentesis, and after delivery. You will find out if you are Rh negative from the initial blood tests you have done. Your doctor will discuss your specific factors with you.

> Glucose screen: This blood test may be done between the 24th and 28th weeks of pregnancy to detect a form of diabetes (i.e., glucose intolerance) that may develop during pregnancy.

> Non-stress test: This test evaluates the baby’s heart-rate pattern by using an electronic monitor. A non-stress test is not routine but is commonly used if you are overdue, diabetic or have high blood pressure, or to check on the baby.

> HIV testing: The chances of a pregnant woman being HIV positive are low, but many women who have HIV are unaware they are infected. It is recommended that all pregnant women be tested for HIV. Your doctor, midwife or public health nurse will talk with you about having this test. If you are HIV positive, treatment during pregnancy dramatically reduces the chance your baby will become infected.

> Group B Streptococcus infection: Your caregiver may do a vaginal swab later in your pregnancy to ensure you are not carrying this bacterium. Although it is rare, this bacterium could harm your baby after birth if left untreated.

> Fetal movement counting: This is done to check your baby’s health or if you notice a decrease in movements.

Finding a Prenatal Class Near YouTo help you adjust to pregnancy and prepare for the birth of your child, many communities offer prenatal classes. Pregnancy and birth information is also available at libraries, which carry books and magazines on the subject. Prenatal classes are run through your local health authority.

For information, contact your local health unit. The phone number can be found in the Blue Pages of your local telephone directory.


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Eating and ExerciseHealthy eating and regular exercise are important for the overall good health of you and your baby. Your baby benefits from the nutrients in the foods you eat, and you need the energy boost nutritious foods provide. Diet alone isn’t enough to keep you feeling your best during pregnancy; you need regular exercise too.

Women who exercise regularly during pregnancy experience fewer discomforts than women who don’t exercise. This section will help you make healthy eating and lifestyle choices while you wait for your baby to arrive.

Pregnancy Food GuideThe amount of food you need every day depends on your age, body size and activities you participate in. Canada’s Food Guide to Healthy Eating is designed to meet the nutritional needs of all Canadians during various life stages, including pregnancy. Published by Health Canada, the guide is online at www.hc-sc.gc.ca. It can also be ordered through the mail, by phone or by fax:

Publications, Health Canada, Ottawa, Ontario K1A 0K9Toll-free: 1 866 225.0709Tel: (613) 954.5995Fax: (613) 941.5366

Getting extra nutrients during pregnancyDuring pregnancy you need to increase your intake of calcium, vitamin D, iron and folate. This can be done by increasing the number of servings of milk products, meat and meat alternatives, dark green vegetables, whole grain and enriched grain products you eat each day. In general, remember to:

> Enjoy a variety of foods from the four food groups every day

> Eat regularly (three meals and three snacks) every day

> Enjoy eating well, being active and feeling good about yourself!

Here are the food guide’s recommended daily servings from the four food groups for pregnant women, along with some good food choices for making up those servings.

Grain products (five to 12 servings per day) Choose whole-grain and enriched products more often.

One serving:

> One slice of bread

> 175 mL cooked cereal (3/4 cup)

> 30 g ready-to-eat cereal

> 50 g pancake or waffle batter (1/4 cup)

> One tortilla or roti (15 cm / 6”)

> Small scone

> Four graham wafers

> Six soda crackers

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Two servings:

> One hamburger or hot dog bun

> One roll or muffin

> One bagel, pita or English muffin

> 250 mL pasta, rice or other grains (1 cup)

Vegetables and fruit (5 to 10 servings per day) Choose dark green and orange vegetables and fruit more often.

One serving:

> One medium-size vegetable or fruit (e.g., potato, carrot, tomato, peach, apple, orange or banana)

> 125 mL vegetables or fruit (fresh, frozen or canned) (1/2 cup)

> 250 mL salad (1 cup)

> 125 mL vegetable or fruit juice (1/2 cup)

> 60 mL dried fruit (e.g., apricots, prunes or raisins) (1/4 cup)

Milk products (three to four servings per day) Choose lower fat milk products (skim, 1% or 2%) more often.

One serving:

> 250 mL milk or buttermilk (1 cup)

> 50 g cheese (3”x1”x1”)

> Two slices processed cheese

> 175 mL yogurt (3/4 cup)

> 125 mL evaporated milk (1/2 cup)

> 75 mL instant skim milk powder (1/3 cup)

> 60 mL Parmesan cheese (1/4 cup)

Meat and alternatives (two to three servings per day) Choose leaner meats, poultry and fish as well as dried peas, beans and lentils more often.

One serving:

> 50–100 g cooked meat, poultry, or fish (2–4 oz.)

> 50–100 g canned fish (2–4 oz.)

> One to two eggs

> 125–250 mL cooked dried beans, peas or lentils (1/2–1 cup)

> 100 g tofu (1/3 cup)

> 30 mL peanut butter (2 tbsp.)

> 60 mL nuts or seeds (1/4 cup)

DID YOU KNOW?THAT 80 PER CENT OF ALL INJURIES TO BABIES HAPPEN IN THEIR OWN HOME? THEY MOST OFTEN INVOLVE FALLS, POISONING, SCALDS, BURNS, CHOKING AND DROWNING.

DID YOU KNOW?THAT CLEANING YOUR CHILD’S GUMS SOON AFTER BIRTH WITH A CLEAN WET CLOTH OR SOFT TOOTHBRUSH IS A GOOD START TOWARD A LIFETIME OF HEALTHY TEETH?


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Other foodsTaste and enjoyment can also come from other foods and beverages that are not part of the four food groups. Some of these foods are higher in fat or calories, so use in moderation. These include butter, cream, mayonnaise, sweets, cake, cookies, pastry and potato chips.*Adapted from Canada’s Food Guide to Healthy Eating

Exercise During PregnancyPhysical fitness and recreation are important parts of women’s lives. In pregnancy, women who exercise regularly have fewer discomforts, especially swelling, leg cramps, fatigue and shortness of breath. Keeping active may also help prevent or decrease backache, constipation and excessive weight gain. How active you can be during pregnancy usually depends on how active you were before pregnancy.

> If you are regularly active, you can probably continue, with certain adjustments as described below.

> If you are a competitive, well-trained athlete, you will need to reduce your level of exertion.

> If you are inactive, you may need to change your habits. Although pregnancy is not the time to start a strenuous program or to lose weight, you can begin a gradual and mild program of exercise. Walking is an ideal way to start. Talk to your doctor or midwife about your exercise program.

General safety guidelinesAvoid overexerting yourself. Because there is less oxygen available for aerobic exercise during pregnancy, you will need to decrease the intensity of your workout. Stop exercising when you feel tired, and never exercise to the point of exhaustion. Listen to your body—if it hurts, don’t do it. Use the “talk test.” You should be able to talk comfortably during your activity. Some of the best activities during pregnancy include walking, shallow water exercise, swimming, cycling, cross-country skiing on flat ground, low-impact aerobic classes, prenatal exercise classes with qualified instructors, yoga and tai-chi.

Avoid risky physical activities. As the breasts and the uterus grows, your centre of gravity is affected and it becomes easier to lose your balance. If your sport or activity is one that requires a great deal of balance, or if there is a risk of injury to your abdomen, wait until after pregnancy to continue the activity. Sports with a higher risk of falls and abdominal injury are downhill skiing, contact sports, horseback riding, heavy weight lifting, softball, water skiing and skating.

Avoid sprains. Pregnancy hormones may cause your joints to be looser, less stable and at greater risk of sprains. Avoid exercises that have jerking, jarring or jumping movements. Be careful with such activities as jogging, racket sports, golf or bowling. Wear comfortable, supportive shoes when doing any activity.

Eat before you exercise. Pregnant women use carbohydrates at a faster rate during exercise than non-pregnant women. Hypoglycemia (low blood sugar) is more likely to occur during exercise. It is wise to have something light to eat (e.g., whole-wheat bread or a muffin) about one to one-and-a-half hours before exercising.

Avoid overheating. It is important not to become overheated during exercise. Drink lots of water, and wear loose, lightweight, comfortable clothing. Exercising during hot, humid weather increases the chance of overheating. When exercising in pools, pool temperature should be 26 to 28°C (80 to 83°F). Women whose amniotic sacs (“membranes”) have ruptured must stay out of pools.

Avoid lying flat on your back. After your first trimester, avoid exercising in this position as it can decrease the blood supply to your uterus. Lie on a 45° incline or in a side-lying position instead.

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Modify your weight-training regimen. Strength training can be continued if you were regularly involved before pregnancy. Modify your training by using low weight and high repetitions, and decrease the weights as your pregnancy progresses. Use weight machines rather than free weights. Avoid exercises where you lie on your back or where the equipment puts pressure on your abdomen. Also, remember not to hold your breath. Heed your body’s warning signals. Warning signs include dizziness; frequent headache; nausea; vomiting; vaginal bleeding; sudden swelling of the ankles, feet, calves or hands; rapid heartbeat while resting; and contractions (some mild tightening of the uterus is normal after exercise). Speak to your doctor or midwife if you experience any of these signs.

Preparing for the BirthEvery labour is unique. There is no one right way to breathe, relax and get comfortable during labour. This section describes some relaxation techniques and breathing patterns that you can use, separately or in combination, to:

> Cope with pain by reducing your stress level.

> Work with your contractions so you can help with your baby’s birth.

> Ensure an adequate supply of oxygen for you and your baby.

> Conserve energy and prevent yourself from becoming needlessly tired..

> Deal with feelings of fear, anxiety or anger.

Breathing Techniques for an Easier DeliveryThe main purpose of using learned breathing patterns during labour is to maintain a good supply of oxygen to the baby and uterus. If possible, practise breathing and relaxation techniques with the person who will be with you during the birth. Don’t hesitate to let your support person know how to help you during your labour. Your birth companion will be able to:

> Help you with the relaxation procedures and with the various comfort positions you choose.

> Signal the beginning and ending of the simulated contractions.

> Help you stay relaxed by touching, massaging, talking, guiding your breathing and reminding you to move around.

When practising any breathing technique, remember that during labour you will want to:

> Match your breathing pattern to the intensity of your contractions.

> Start and end each contraction with a deep, relaxed breath.

> Breathe in a slow and relaxed pattern that is comfortable for you.

Preventing hyperventilationAs you breathe through the successive contractions in labour, you may suddenly find yourself over-breathing (hyperventilating). This can be caused by any type of rapid breathing when too much carbon dioxide is blown out. The carbon dioxide level in the body regulates the brain’s control of breathing. If hyperventilation occurs during labour:

> Keep your breathing shallow (in the upper chest, throat and mouth).

> Breathe into and out of a paper bag or your hands cupped over your nose and mouth (to increase the amount of carbon dioxide you take in).

> Hold your breath for a few seconds after a contraction, before exhaling.

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Relaxation Techniques Speed DeliveryBy learning to relax, you can reduce unnecessary muscle tension. Since labour can be made longer by the release of stress hormones, it is important that you learn to relax your mind and your body. It is helpful to learn relaxation routines with the encouragement and support of your partner, but it is equally important that you be able to relax by yourself. To start, quiet and pleasant surroundings will be necessary; however, as you develop skills, you will be able to relax even in busy, noisy places. Try some or all of the relaxation procedures suggested here two or three times a day. You can try them after your pre-natal exercises, at bedtime or when you’re feeling upset or tired. Before beginning, you may want to create a peaceful environment with music, loosen your clothing, remove your shoes and lie on your left side on a firm surface or propped up in an easy chair with pillows. Take a deep breath in and out, or even yawn.

Focal point concentration/visualizationFocal point concentration may or may not be needed, but being able to redirect your attention away from an immediate cause of stress or tension can play an important part in helping you relax. During labour, you may find it helpful to focus your attention by looking at somebody or something in the room, thinking about a pleasant and soothing memory, or picturing the baby and the surrounding muscles of the uterus working together to open the cervix. When practising your breathing and relaxation before giving birth, you can try different focal points to see which you prefer.

Massage during deliveryTo increase your comfort level during pregnancy and labour, try massaging your face, neck, shoulders, back, thighs, feet or hands. You can do it yourself, or with a partner. Massage can be used with another relaxation technique, such as touch relaxation. During labour contractions, some women like their partner or birth companion to hold a hand over the tensed set of muscles until they relax. Others prefer firm pressure, which is gradually released as the muscles relax. Still others like to feel gentle massage stroking outward and away from the center of tension.

Practicing these techniquesFor step-by-step guides to using these relaxation techniques, refer to the Ministry of Health’s publication Baby’s Best Chance: A Parent’s Handbook of Pregnancy and Baby Care, which is available on the Web at www.healthservices.gov.bc.ca/cpa/publications/babybestchance.pdf

What to Take to the HospitalBelow are some of the things you might want to put on your packing list.

Hospital labour kit

> Massage oil or talcum powder

> Partner’s swimsuit (so he or she can accompany you in the shower)

> Camera, flashes, film and extra batteries

> Music

> Personalized focal point (a picture, design, figure or anything you find pleasant to look at)

> List of friends’ and family’s telephone numbers

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Grooming items

> Dental care products

> Hair care products

> Personal products, such as deodorant and skin lotion

Personal items (To be brought in after the baby is born)

> Bed jacket or sweater (front-opening if breast-feeding)

> Washable dressing gown

> Two or three nightgowns or pairs of pyjamas (front-opening if breast-feeding)

> Two or three nursing bras

> Panties

> Pyjama bottoms or slacks for postnatal exercises

> Socks and slippers

> Large sanitary pads

> Nursing pads

Going-home clothes should be packed separately and left for someone else to bring later as personal storage in the hospital is usually very limited. Your clothes should be loose-fitting and comfortable. If you are breast-feeding you should wear a top that opens in front. Many mothers wear maternity clothes home (not all of the weight gained in pregnancy is lost immediately, so pre-pregnancy clothes may still be rather snug).

For the baby

> Approved infant car seat

> Shirt and gown or sleepers

> Diapers and pins or disposable diapers (newborn size)

> Plastic pants (unless using disposable diapers)

> Sweater, bonnet and booties (if wearing a gown)

> Shawl or blanket, depending on the weather

Getting Your Home ReadyGenerally, it’s best to get only the essentials before your baby’s birth, and the most important considerations are safety and comfort. The baby equipment you choose will depend on such things as finances, availability of space, family and community customs and your own preferences. Some items can be homemade or obtained through friends, relatives, next-to-new shops and garage sales.

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A Note About Second-hand GiftsBe cautious and careful when acquiring second-hand items such as cribs, strollers and car seats, as they may not meet current government safety rules. Items only a few years old can be in poor condition or do not meet Canadian Safety Standards. When buying or receiving second-hand equipment, make sure the instructions are included. If you have any doubts, consider buying new. If you choose to purchase second-hand items, remember to be cautious and careful when buying. Make sure any used items come with instructions and meet Canadian Safety Standards. Baby walkers with wheels are dangerous and not recommended for use! They are not made in Canada any more, but some old walkers are still available. If you have an old one, it is recommended that you throw it out.

Buying Clothing for Your New BabyThe clothing you buy for your baby will depend on the time of year and on your laundry facilities. Because babies grow quickly, it is best to purchase clothes in infant sizes of six months to one year. Remember, any clothing that has been stored with mothballs must be washed until no smell remains when wet. Wash new clothing before putting it on your baby. Here is a list of possible purchases:

> Undershirts: four (shirts with front ties, grippers or extra shoulder-opening space are easiest to put on; avoid buttons or tight neckbands)

> Nightgowns, sleepers or stretch suits: three to four

> Diaper covers: three to four (available in polyester, wool or cotton should your child develop rashes with plastic)

> Sweaters: one

> Snowsuit with legs: one (depending on the season)

DiapersThe variety of diaper styles and materials available has expanded immensely. Some families are finding cloth as convenient as disposable varieties. Your baby will be in diapers for two to three years. Here are some considerations when choosing diapers;

Disposable diapers:• do not need to be worn with waterproof pants• will cost more than cloth diapers• come in a number of styles and sizes• are convenient, no laundering is needed• create a lot of extra garbage

Cloth diapers:• can be made or bought• can be fastened with diaper pins or Velcro • will need to be worn with waterproof pants• can be cleaned by a diaper service that picks up soiled diapers and leaves clean ones• can be laundered at home

Buying Furniture and Equipment for Your New BabyBath equipmentYou will need a basin or sink to bathe your baby, as well as two large, soft towels and two washcloths. It is also a good idea to prepare a box or tray for the baby’s bath supplies, such as:

> Mild soap in a dish (a soap bar cut into smaller pieces lasts longer)

> Cotton balls in a jar (avoid using cotton-tipped applicators, since a sharp poke can hurt the baby’s delicate skin)

DID YOU KNOW?THAT CHILDREN EXPOSED TO SECOND-HAND SMOKE HAVE HIGHER RATES OF SUDDEN INFANT DEATH SYNDROME, ASTHMA, PNEUMONIA, BRONCHITIS, COLDS, EAR INFECTIONS AND SORE THROATS?

DID YOU KNOW?THAT AT SIX MONTHS YOUR CHILD WILL BE READY FOR SOLID FOOD?

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> Diaper pins with safety ends (so they don’t open unexpectedly), unless you’re using diapers that come with other fasteners

> Skin-protecting cream for the baby’s bottom

CribsWhether your baby sleeps in a crib, cradle or bassinet, the surface must be firm, not soft. Do not let your baby sleep on waterbeds, couches or sofas, recliner chairs, pillows, down comforters, or beanbag chairs. Most parents find a crib essential once their child becomes active, so you may want to consider getting one right at the start. You need to choose a suitable crib or cradle for your baby carefully. The federal government no longer supplies information on how to update an older crib.

> Parents should not use a crib that doesn’t meet the federal government’s Cribs and Cradles Regulations (1986).

> Make sure that each part of the crib is properly and securely in place at all times.

> Follow manufacturer’s instructions when assembling.

> Cribs should have double locks for securing the side that can be lowered.

> Check for manufacture date—most cribs made before September 1986 do not meet regulations and are not safe!

MattressesThe mattress for your baby’s crib should be firm, be no more than 15 centimeters (six inches) thick, fit the frame properly, and have no gaps greater than 3 centimetres (1 1/8 inches) along the sides or ends of the crib, otherwise your baby can get his head stuck between the mattress and the frame and suffocate. If the mattress is worn or has a tear, it is dangerous: do not use it. The mattress support should hold firmly and be checked often. You can do this by shaking the mattress support, thumping the mattress from the top, and pushing hard on the support from underneath. Make sure all screws, locks, and clamps are tight.

BeddingThe most important considerations when choosing bedding for an infant or toddler are safety, warmth and ease. Your baby can sleep in a crib, cradle, bassinet, basket or even a box as long as the surface is firm and not soft. When your baby becomes active, you may find that a crib is needed. Only use cribs that meet the federal government’s Cribs and Cradles Regulations. To protect the crib mattress, you can use either a quilted crib pad (one side waterproof) or a mattress cover, placed under the sheets. Do not use plastic sheets as they can get in the way of breathing. Pillowcases can be used as a bottom sheet for a bassinet or carriage mattress. Have some bottom sheets (can be fitted) for the crib mattress. A loose-knit receiving blanket or lightweight cotton blanket and a small baby blanket with a sleeper in a warm room should be enough to keep your baby comfortable. Your baby should be warm but not hot. Top sheets are not recommended until your child is an older toddler. Babies can get tangled in a top sheet. Never cover your baby’s face or head with blankets. Do not use sheep skins, pillows, comforters, stuffed toys or bumper pads. These things can stop air circulation around your baby’s face. Plastics, such as the mattress wrapping, may also prevent air circulation. These should be removed to reduce the risk of sudden infant death syndrome and suffocation.

Mobiles and crib exercisersMobiles (used for very young babies to look at only) strung across cribs or playpens should always be kept high and out of reach. Crib exercisers, used for a baby to reach and touch, must be removed as soon as the baby can sit up or push up on hands and knees, so there is no danger of the baby chewing on unsafe objects or becoming tangled in the mobile. It is time to stop using a crib when your baby is taller than 90 centimeters (36 inches) or is able to climb out.

PlaypensYou can avoid playpen accidents by being aware of the regulations for design, construction and performance of playpens under Canada’s Hazardous Products Act. It is illegal to sell a playpen, new or used, that does not meet the following specifications:

> All walls should be mosquito-type netting to prevent clothing, buttons or hooks from getting caught. Your little finger should not be able to pass through the mesh.

> Playpens should not have more than two wheels or casters.

> Playpens should be stable and sturdy, with walls at least 48 centimetres (19 inches) high.

> All parts must be free from rough or sharp edges. Hinges should be designed to prevent pinching or accidental collapse.


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> To prevent fingers from getting caught, any open holes drilled in metal, plastic or wood components should be less than 3 millimetres (1/8 inch) or more than 10 millimetres (3/8 inch) in diameter.

> All parts that are small enough for a child to choke on must be firmly attached.

> Vinyl rails and mattress pads should not be torn. A child may bite off small pieces and choke. An infant should not be left in a drop-sided mesh playpen when one of the sides is not fixed firmly in the fully raised position. The infant may become caught and suffocate in the space created between the floor pad and the loose mesh side.

> Don’t put scarves, necklaces, long cords, pillows or large toys in a playpen or crib.

> Once a child tries to climb out of the playpen, falls can occur and the playpen should no longer be used.

Baby gatesWhen choosing a gate, keep in mind where you will be using it and whether you will be able to secure it firmly. Gates with a pressure bar should be placed with the bar side away from the child. The Hazardous Products Act prohibits the sale of accordion-style baby gates. The banned gates, made of wood or hard plastic, have large V-shaped openings along the top and/or diamond shaped openings along the sides. These openings are large enough for a baby’s head to enter and get trapped. If you have this type of gate, it is recommended that you dispose of it immediately.

StrollersStrollers provide you with an opportunity to get some exercise, while showing your baby the sights and sounds of the world. Federal regulations governing strollers were passed in 1985. Accidents can be prevented if:

> The restraining straps are always used to prevent the child from falling forward and tipping the stroller over or setting it in motion.

> Care is taken to prevent injury to fingers when folding and unfolding strollers and when reversing the handle on reversible handle strollers.

> Heavy packages that could upset the stroller’s balance are carried another way or at another time.

> The stroller is checked regularly for dangers such as sharp edges, tears in the upholstery, malfunctioning brakes or loose wheels.

> Older models are checked to make sure they don’t collapse when the baby is in them.

> The instructions that accompany new strollers and carriages are followed carefully.

WalkersBaby walkers are banned in Canada because they allow babies to move too fast and can cause serious head injuries. Instead, use an activity centre that doesn’t move around on the floor. Walkers are not made in Canada any more, but some old walkers are still available. If you have an old one, it is recommended that you throw it out.

Infant carriersBe careful when using infant carriers. Remember:

> Never leave your child alone, even if it seems safe.

> Use a carrier with a wide solid base, to prevent tipping.

> Secure wire supports that snap on the back.

> Always check to make sure the locking device on the handle is working well.

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> Fasten straps and restraining buckles. They should be adjusted to fit comfortably and to prevent your baby from turning in the seat.

> Never place babies in infant carriers on tables, especially active babies over two months of age. An active baby may lunge forward, tip the recliner and fall to the floor, causing a head injury.

> Never use a baby carrier as a car seat.

Car seatsUse an infant/child car seat every time your child travels in a car. Car seats are required by law and must meet Canadian Motor Vehicle Safety Standards. Infant seats are for infants from birth or 2.3 kilogram (5 pounds) up to 9 to 10 kilograms (20 to 22 pounds). Never place a front-facing child seat in a vehicle seat equipped with an active air bag. A rear-facing seat is safest. Use a rear-facing seat for as long as possible, at least until one year of age. Follow the instructions in your vehicle’s owner’s manual and the instructions that come with your child seat. They contain important information for safe installation of the seat. Some lap-shoulder belt systems will need a locking clip. Refer to the owner’s manual for specific information. The safest place for the infant seat is in the middle of the back seat. Refer to Transport Canada’s website (www.tc.gc.ca) for updates on car seat recalls and other important car safety information.

Getting HelpKey Sources for Help and InformationThe following services will help you through difficult times, or answer your questions. Please feel free to call.

Alcohol and drug informationAlcohol and Drug Information and Referral line: Toll-free: 1 800 663.1441

Block Parent programsBlock parents are volunteer adults who offer refuge and assistance to children in times of emergency. For more information, contact the B.C. Block Parent Society: Tel: (250) 474.2494

Car seatsFor information on child restraints, contact Transport Canada: Tel: (613) 990.2309www.tc.gc.ca

Child careInformation on child-care subsidies for lower-income families can be found on the Ministry of Employment and Income Assistance website. Resources on the site include the child-care subsidy estimator to help you determine if you are eligible for subsidy, and the child-care search tool to help you find child-care facilities in B.C. by city, by postal code and by licence category.

Children with disabilitiesServices are available if your child has developmental problems or a disability. Your doctor, public health nurse or Ministry of Children and Families regional office can help you locate these services.

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Enquiry B.C.If you are looking for a telephone number not listed here, contact Enquiry B.C.: Toll-free: 1 800 663.7867Tel: (250) 387.6121 from Victoria Tel: (604) 660.2421 from Vancouver

Telephone Device for the Deaf (TTY): Tel: (604) 775.0303 from VancouverToll-free: 1 800 661.8773

Health resourcesThe B.C. HealthGuide has B.C.-specific information on over 190 health concerns including prevention, symptoms, emergencies, home treatment, when to call a health professional and B.C. resources. To request a copy, call toll-free: 1 800 465.4911Or read it online at www.bchealthguide.org.

The B.C. HealthGuide also operates the 24-hour-a-day, seven-day-a-week BCNurseLine, which puts you in touch with specially trained registered nurses who can answer your questions about health conditions or concerns. Tel: (604) 215.4700 from Greater VancouverToll-free: 1 866 215.4700 from elsewhere in B.C.Deaf and hearing-impaired toll free in B.C.: 1 866 TTY.4700For general health inquiries, call the Health and Seniors’ Information Line toll-free: 1 800 465.4911

NutritionFor a copy of Canada’s Food Guide to Healthy Eating, get a copy from your local health unit or go online at www.hc-sc.gc.ca/hpfb-dgpsa/onpp-bppn/food_guide_rainbow_e.html.You can also talk with a dietitian on a nutrition and food safety line (Dial-a-Dietitian) toll-free: 1 800 667.3438

ParentingParent Help Line: Toll-free: 1 888 603.9100Foster Parent Support Line: Toll-free: 1 888 495.4440Federation of Aboriginal Foster Parents: Toll-free: 1 866 291.7091

For information about enforcement of maintenance orders, contact the Family Maintenance Enforcement Program in the Blue Pages of your telephone book or call toll-free: 1 800 663.3455

Postpartum depressionThe Pacific Post Partum Support Society is a non-profit society that provides support to women and families experiencing depression or anxiety related to the birth or adoption of a baby. For information about local postpartum depression support groups, call your public health nurse or the society at (604) 255.7999, or visit its website at www.postpartum.org.

Safe StartSafe Start is an injury-prevention program of B.C.’s Children’s Hospital. It provides information to parents and caregivers on how to make homes and vehicles safer. For more information, call toll-free: 1 888 331.8100.

Our commitment to early childhood development:The first five years are key to a child’s successful development. The Province of B.C. is committed to supporting early childhood development to give children and families a healthy start in life. For more information, visit AchieveBC.ca

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