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Transition Between Pregnancy and Birth (1)

By Dr Gilbert Adimora

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The period between pregnancy and childbirth is usually full of anxiety, understandably so for several reasons. Labour has always been seen as a period when the life of an expectant mother hangs between life and death. However if we remember that in every situation in life we are at risk of death, many may become more relaxed and regard labour as a normal physiological process that must be experienced before a new life is brought into this planet.

In the womb, the baby's source of life (calories, proteins, fluid, oxygen and some other necessities of life) are supplied by the mother. This is through the umbilical cord which attaches the baby to the mothers' placenta on the womb through the umbilicus. The umbilicus has a network of vessels (arteries and veins) which transport these nutrients to the baby and also gets rid of the products from the baby in the reverse direction to the mothers' system. These by products are then excreted through the mothers' various excretory system.

At the end of labour, the baby's system is detached from the mothers' and the baby now has to learn to live an independent life. A lot of readjustments have to be made to achieve this and failure in any of these leads to some of the problems experienced by some babies shortly after or sometime after birth. Inability of the baby to breathe well (or cry) after birth may lead to lack of oxygen supply to the brain; a condition referred to as asphyxia. Asphyxia can also affect the kidneys, the heart and many other organs of the body. The duration of asphyxia in most cases determine the result or outcome of asphyxia. Permanent damage can occur in some cases especially in the brain and some people we see in the streets incapacitated especially mentally and physically may be as a result of this problem. This is referred to medically as cerebral palsy. The baby affected may not be able to sit, crawl or walk in good time leaving the parents very worried about their development. A number of them that survive become mentally handicapped and are slow in most areas of mental development. They will usually at school age need to attend special schools or care centres that are specialized in taking care of them. Needless to say, some of these babies die during delivery because of the problems earlier mentioned.

It is very important to note that the most effective way of avoiding this problem is prevention. Mothers should attend antenatal clinics when they are pregnant so that any problems that may arise during delivery will be anticipated and steps taken to avoid them. Many of the babies that develop asphyxia is because the baby is either too big to pass through the birth canal, or the mothers' birth canal is too narrow to allow the baby pass through making normal delivery difficult or even impossible. An operation or some other form of medical intervention is therefore needed to deliver the baby alive and well. We will continue next week.

Dr. Adimora is the medical director of Favouredchild Clinic, Enugu. A Consultant Paediatrician with the University of Nigeria Teaching Hospital, Enugu and Senior Lecturer in the department of paediatrics, college of medicine, University of Nigeria Nsukka, Nigeria. He is the author of the book 'Anxieties of a young mother'. Author’s website: www.authorsden.com/gilbertadimora E:mal: [email protected]


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