MEDICAL CARE: INTERNAL CHANGES OCCURING DURING PREGNANCY

So, day by day, the pregnancy advances. The outward physical signs develop. The woman suddenly discovers her periods have ceased, and she develops the typical indications of pregnan­cy.

Development in the early weeks is rapid. Cells continue to divide quickly. The vital internal organs of the new life take shape, and soon the heart and the blood-vessel system are in operation.

Movements occur soon after, and this is termed the time of quickening. Sensible women have long since checked-in with the doctor and are now taking the usual steps and precautions that will guarantee them and their developing baby every chance of a safe journey through the prenatal period.

Pregnancy is commonly divided into three segments. These are termed "trimesters," and each trimester is one-third of the total duration of the pregnancy, in other words, about thirteen weeks.

It is simply an arbitrary subdivision worked out for ease in describing the events that take place during the various sections of the pregnancy interval.

During the final segment of pregnancy, the foetus increases mainly in weight. Legally, the foetus is alive or "viable" when it reaches the age of twenty-eight weeks. But it is most unlikely it would survive if born at this stage.

For practical purposes, it must reach the age of thirty-six weeks, and even then, it will be premature and underweight. However, under certain pressing circumstances, when its life is endangered by complications, every effort is made to reach the thirty-six or thirty-seventh week before delivery is contemplated. Every day beyond this increases its chances of survival.

However, for the average baby (which equals at least 85 per cent of the total number born, and will most likely include yours), the average duration of pregnancy is 280 days (from the last menstrual period). This equals nine calendar months.

For many weeks, and indeed many months before this anticipated date (termed the E.D.C.—estimated date of confinement), pain­less contractions of the womb commence. These may be felt if the hand is placed lightly over the pregnant abdomen. These take place especially at night, and may occur every few hours. This is termed "pre-labour," and is aimed at preparing the womb for the actual onset of true labour.

Finally, as the important hour approaches, true labour actually sets in.

This is often heralded by one or more events:

•   (1) Regular, painful contractions occur in the abdomen.

•   (2) There is a sudden "show." This means a jellylike, blood-stained plug of material is discharged from the vagina. (This is the "plug" that has sealed the cervical canal, the narrow duct leading from the vagina into the womb itself.) Now that delivery is imminent, the canal is unsealed and made ready for the exit of the baby.

•  (3) Appearance of fluid. This is called the "breaking of the waters." It means the sealed bag of fluid in which the baby has been situated throughout pregnancy has burst, and the fluid is now flowing out via the vaginal canal. This may or may not occur at this stage. Indeed it may not occur until the actual birth is imminent. It varies.

With any of these signs, the mother is aware that the time of delivery is very close. It is a sign that she had better get her packed bag in hand and go to the hospital.

The abdominal pains quickly become more marked and more rhythmical and more uncomfortable.

Labour is traditionally divided into three stages. Each has certain characteristic events that take place.

 

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GENERAL HEALTH