Dr.Trupti Kaji Obs & Gynae Clinic

What is Labour?
Labour and delivery are demarcated by the end of the pregnancy when a woman delivers the child or more than one child and it leaves the uterus. Normally, the gestation period for humans is somewhere around 37 weeks to 42 weeks. In most developed countries, the deliveries happen in hospitals, where as in developing as well as under developed countries, births happen at home under the supervision of traditional birth attendant, called the midwife.

Stages of Labour:
Vaginal delivery is the most common form of childbirth. Labour consists of three stages

• The opening and shortening of the cervix: Lasts from 12 to 19 hours
• Coming down of the baby and its birth: 20 minutes to 2 hours
• Expulsion of the placenta: Varies from 5 to 30 minutes

In the first stage, your abdominal muscles will begin to cramp associated with back pain. These cramps can be of durations of half a minute, about 10 minutes apart. These contractions start coming closer and become more intense as the second stage starts closing in. During the second stage, you may have to push along with the contractions to help give birth to your baby. Most babies are born head-first, although there are cases, when the baby is born buttocks first or legs first. This is commonly called “breeching”. In the third stage, it recommended to cut the umbilical cord and ensure that the placenta is entirely removed from the uterus or it may cause complications later.

The onset of labour is marked by the expulsion of the amniotic fluid and  then the contractions begin to set in. Most women can walk around and eat food during labour, but when the contractions start to get too painful, it is suggested to get help and have someone around during that time. It is not recommended to push during the first phase, but then it becomes essential to push from the second stage onwards. Your gynaecologist will be able to tell you which stage of labour you are in by looking at the dilation of your cervix. As soon as you start to feel your contractions kicking in, you must contact your gynaecologist or your birthing attendant.

Maintaining proper vaginal hygiene is imperative to ward off any sort of STD or STI, even before any sort of irritation, infection or disease occurs. The normal vaginal pH balance helps cater to the growth of useful bacteria. Some useful tips to maintain proper vaginal hygiene can be:

1. Douching (spraying a mixture of water, baking soda, vinegar or iodine on the vaginal area) is strictly discouraged. It can interfere with the normal pH levels of the vagina and can make the area extremely acidic, which sets the stage for the growth of bacterial infections.

2. A balanced, healthy, nutritious diet is recommended for a healthy vagina as well as for good reproductive health. Certain fluids such as cranberry juice can help prevent the onset of any yeast infection.

3. Safe sex should be practised in order to keep harmful bacteria away. Using a condom during a sexual intercourse helps prevent the occurrence of any sort of STI or STD.

4. Gynaecological check-ups should be done every four months or so to be on the safe side regarding any doubts about unhealthy vagina. Prevention is always better than cure in the long run.

5. Petroleum jelly should not be used for lubrication during sexual intercourse as such fluids tend to damage the latex in the condom and may even lead to a possible infection.

6. Clothes should be chosen carefully to keep the vaginal area clean and dry. Cotton underwear is generally the best option in this regard as it can help prevent any bacterial infection by keeping the area clean and dry.

7. Certain simple sanitary habits such as changing of tampons or sanitary pads every four hour during one’s periods, proper washing of the genital area after relieving the bowels, can go a long way in nurturing the health of the vagina.

8. Opt for gentle skin care products to wash the vaginal area as that area is extremely sensitive. Avoid scrubbing the vaginal area as well.

Menopause is characterized by the absence of menstrual periods for 12 months. It is the time in a woman’s life when the ovaries stop functioning. The periods then stop forever. The normal period of menopause is 51 years of age, however, menopause may happen as ahead of schedule as the 30s or as late as the 60s. There is no solid lab test to determine when a lady will encounter menopause. Early menopause usually starts between the ages of 40 and 45. Untimely menopause begins significantly earlier, before the age of 40. Nevertheless, premature or early menopause is not that common with only about one percent of the women going through early menopause before the age of 40.

The signs and symptoms of early menopause are like the usual menopause. Some basic side effects include:

1. Irregular periods (amenorrhea)
2. Hot flashes
3. Night sweats
4. Vaginal dryness
5. Mood shifts
6. Mental fogginess
7. Diminished sex drive

Your specialist will suggest a treatment depending on your individual circumstances. Some common ways to deal with premature or early menopause are as follows:

1. Hormone Replacement Therapy
Supplements containing estrogen and progestin can help and replace some of your reproductive hormones in the body that can no longer make it all alone. They are frequently taken until the normal period of menopause (around 50) to help avoid bone loss. This treatment is not suggested for all ladies since it expands the danger of:

• Heart issues
• Stroke
• Blood clots
• Breast cancer

2. Supplemental Calcium and Vitamin D
Supplementary calcium and vitamin D can help in preventing osteoporosis in case you are not getting enough of these supplements from your normal diet. Women between ages 19 to 50 need to consume 1,000 milligrams of calcium for each day through food or supplements. Ladies over age 51 need to consume 1,200 milligrams for each day. A prescribed day-to-day measure of vitamin D has not yet been built up. For grown-up females, most specialists prescribe 600 to 800 global units through food or supplements. One should get a prescription from a doctor before ingesting the medication.

Other strategies to deal with Infertility
A few ladies with untimely menopause can at present get pregnant with no treatment. Ladies who want to have children, however, tend to become infertile after early or untimely menopause, need to consider in-vitro treatment, fertilization or even adoption.

Talk Therapy
Numerous ladies discover that having a conversation with a therapist can be supportive to adapt to their anxiety. It helps them release their pent up emotions and gives the clarity and satisfaction about their problems. Talk therapies like cognitive behavioral therapy are always beneficial since they help in addressing the symptoms and side effects that a woman may be going through emotionally when it comes to early menopause.