Thursday, January 15, 2015

Tajuk yang digugel hari ini - How to induce labour naturally


Induce Labour With Natural Methods – Bring On Labour Naturally

Chances are that if you’re reading this article, you’re late in your third trimester, overdue, ‘over’ being pregnant or trying to beat a planned induction date.
If you’ve reached or passed your baby’s guess date (only 2-5% of babies are born on their guess date and around 40% in the 2 weeks after that), natural methods of induction are a popular way to try and stimulate labour or to ripen the cervix, especially if this means beating a medical induction or caesarean (should you not go into spontaneous labour beforehand). Its important to remember that you’re not designed to be pregnant forever, so you can trust your body to do what its meant to do, when your baby says he/she is good to go.
Every development day your baby spends in your womb is important, especially when baby is preparing for life on the outside, particularly his or her lung development for breathing. Your baby doesn’t know that a date has been assigned for him to get out, and telling a healthy baby to get out before they are ready can result in all sorts of complications and interventions, when right now, they are safe, happy and warm inside of you.
But if you do decide to try and get things moving, you may find some of the below methods effective and others not – none of them have a 100% success rate. This is mainly because babies do like to come when they are well and truly ready, be it earlier or later than your estimated due date (which has been calculated based on averages, not specifics!). Some women buy into the idea of inductions because they are filled with fear about going over due dates and stillbirth, but know that the biggest causes of stillbirth are smoking and obesity. Recent research is also suggesting that sleeping on your left hand side can reduce the risk of stillbirth, as its less likely to restrict the flow of oxygen and nutrients to the baby. While it’s hard to get comfortable when pregnant, there’s no need to panic, just try and sleep on the left as much as you can. You can read more about this in our sleeping positions article.
Important points to note prior to trying the below-mentioned methods are:

1. Get the ‘all clear’

It’s important to have the all clear from your medical carer, especially if you have a pre-existing medical condition.

2. Make sure the therapist is qualified/experienced

It’s very important to ensure that the person treating you is qualified, and is knowledgable in pregnancy and labour aspects of their therapy. If they do not have appropriate training or knowledge of pregnancy and birth, this may be unsafe as extra care must be taken when women are pregnant and during labour.

3. Be informed

It’s also important that you make sure you are well informed in regards to the details of each method, as research is ever changing and some methods may not be suitable for you, especially if you have a pre-existing condition. A properly qualified therapist may have some information or recommended reading for you. Do not start any methods until you are at least at your estimated due date.

4. Remember that any form of induction is an induction

Once you stimulate labour either medically or by yourself, you potentially make yourself open to further interventions or complications. Please don’t take any form of induction lightly. Weigh up the pros and cons and opt for choices that are designed at relaxing you and opening your mind and body to labour. Please don’t get caught up forcing your body and baby into labour if its just not meant to be – your baby may not like it and could end up needing help.

Methods of Natural Induction

1. Sex

Sex is a commonly suggested method of natural induction due to semen containing prostaglandins – which help to ripen the cervix. Recently a study has found that intercourse made little difference to inducing labour and no cervical changes were evident. Personally I wouldn’t expect any changes to happen when you know you are part of a study and I don’t think I would find it very relaxing to know that I was to have sex, then report in for an internal! Our bodies are very sensitive to hormones and just like our blood pressure can shoot up when we go to see the doctor, labour can also be inhibited, stall, stop and even go backwards when we enter a hospital or somewhere unfamiliar or if we are feeling nervous or anxious.
The study also cited an analysis of 59 studies that found no association between sex and pre-term birth, pre-mature rupture of the membranes (PROM), or low birth weight in low-risk pregnancies, so rest assured it is safe to have sex throughout pregnancy unless you are high-risk or your doctor has recommended otherwise.
However, sex can a great way to relax, and contrary to the study, many mothers have found that they have gone into labour after having sex, especially during early labour – they found things to step up a notch. Even Ina May Gaskin, a long time natural and home-birthing advocate doesn’t think too much of this study as she has seen otherwise.
Another common method of natural induction, the female orgasm, may be more useful – I wonder if there will be any complaints about that one?!
When a woman experiences orgasm, she produces oxytocin – the labour hormone. So while having intercourse seems to not be of much help, it can still play a role in the bigger scheme of things!

2. Acupuncture

From one who has a fear of needles but dared to try acupuncture (and never even flinched during the process!), I would say to those who are considering acupuncture but are afraid of needles to definitely give it a go. The needles are very fine, you really don’t feel a thing – but I know it’s hard to imagine needles not hurting!
Acupuncture has been used very successfully for thousands of years to induce women who are over-due in their pregnancy.
Andrew Orr, a Traditional Chinese Medicine practitioner in Queensland, specialises in fertility, pregnancy and gynaecology. He has researched his findings extensively and had them published in several leading medical journals. He says, “Most of the time one treatment is all that is needed to get the process going. Sometimes a second treatment may be needed. Through continual research, we have found that induction using acupuncture generally works within 6-48 hours of having your treatment.”
There have been some studies on acupuncture and it’s effect on inducing labour – see an Australian research report here which showed that using acupuncture to stimulate labour in overdue mothers to be had a success rate of 88%.
Although acupuncture has been, and still is, a very useful tool for induction, Andrew admits that acupuncture isn’t effective 100% of the time. “Sometimes it just doesn’t work effectively enough. As they say in China: ‘When the fruit is ready, it will fall off the vine’. Sometimes this saying applies to pregnancy.”
Andrew says his 88% success rate with induction using acupuncture is mainly due to clients receiving regular treatment throughout their pregnancy and specialised expertise in this field. Andrew says that such fine tuning allows them a much easier and pain reduced birth, as well as making it easier for them when it comes to induction.
To be eligible for induction acupuncture you must be at your estimated due date or after, unless otherwise recommended by your doctor or midwife. Whilst there is no risk from having acupuncture for induction, it does help speed up your natural processes. Therefore you must consult with your doctor or midwife before any induction. This is to protect all persons involved, most of all your baby.
Check out the BellyBelly directory for acupuncture and Chinese medicine professionals listed by state.

3. Acupressure

Debra Betts has put together a brilliant document on acupressure for pregnancy, labour and post birth, with solutions for all sorts of situations, from encouraging labour to vomiting and nausea in labour. You can download a copy here and if you see a Traditional Chinese Medicine practitioner, they can show your partner how to apply acupressure as well as treat you at the same time with a variety of great techniques which TCM practitioners use.

4. Evening Primrose Oil (EPO)

Evening Primrose Oil is another ‘cervix ripening’ method. EPO helps by imitating prostaglandin can be used orally and/or internally.
A usual oral dosage is 2-3 of 500mg capsules daily from 36 weeks. If you are taking EPO internally, you can do this from 36 weeks – simply insert 2-3 capsules directly to the cervix before bed. You might like to wear a pad or liner as it can get messy when you get up.

5. Homeopathics

There are some homeopathic remedies available to help encourage labour, however you will need to consult a qualified homeopath for more information on dosages.

6. Nipple Stimulation

Nipple stimulation produces oxytocin and can produce some strong effects, so you can try stimulating your nipples (including your areola, as a baby would when sucking) with your fingers, massaging one at a time. An alternate option is if you are still feeding a toddler, let him attach and the sucking action will do the same thing.
Massage the first nipple for 5 minutes (when there are no contractions), then wait to see what happens (around 15 mins or so) before doing more. It’s a good idea to take your mind off things by getting on with your usual duties than sitting and waiting for something to happen – so try and keep busy!
Once labour is well established again, stop the stimulation. For more information, see ournipple stimulation article.

7. Castor Oil

BellyBelly does not recommend castor oil for labour induction. It causes diarrhoea (and sometimes vomiting) for some women, which is very unpleasant – and if you do go into labour, who wants to spend it on the toilet? Often in early labour you will already have diarrhoea, which is the body’s way of clearing out and making space for baby, but sometimes this doesn’t happen, especially if baby isn’t yet ready and given the signal for labour to start.
On the other hand, I have also heard stories where a post-dates mother had been suffering from terrible constipation and labour had stalled – upon taking the castor oil, she was able to go to the toilet, labour progressed and all went well. But is it safe? Take a look at our article: Castor Oil To Induce Labour – Is It Safe and Does It Work? for more information.

8. Sweeping Membranes / Stretch & Sweep

Sweeping the membranes involves your medical carer separating the membranes from the cervix by vaginal exam. This may be a little uncomfortable for some women and on the other hand, some have said they didn’t feel much at all. Some spotting or bleeding may occur as a result and some find they have irregular contractions after a sweep, which may be uncomfortable and still not progress into labour.
A sweep can be performed on women who are at term and have no other complications, e.g. placenta praevia.
Ideally though this method is more of a last resort of all of these methods, as it is invasive and not really natural. You also give bacteria the opportunity to grow when you have things unnecessarily inserted into your vagina, right up to your cervix.

9. Black Cohosh

Black Cohosh is a herb used to encourage contractions and facilitate labour. It should be avoided in pregnancy and is better taken in early labour. Please consult a naturopath before taking Black Cohosh as the wrong dose may cause problems.

10. Raspberry Leaf

Raspberry Leaf is a uterine tonic, which also has added benefits after the birth for breastmilk production.
Some women like Raspberry Leaf tea, however if you don’t like the taste or want a specific, stronger dose, you might like to buy some from your health food store. It’s generally recommended anytime after 12 weeks in a healthy pregnancy – make sure you check with your medical carer and a naturopath for doses and to see if it’s appropriate for you.

11. Spicy Food / Curry

Again, spicy food and curry gives some people the runs, so another one to think twice about if this is you! But some people swear by it for getting their labour started.

12. Induction Massage

As with induction acupuncture, induction massage can be given on or after your due date. The massage therapists (who should be experienced in induction massage) work on acupressure points which are normally avoided during pregnancy, which can trigger labour. As with normal massage, induction massage helps to relax and calm your body, easing tension and helping to create a clear and grounded space. The therapists also may use essential oils which can assist with labour induction. It’s generally a very successful form of labour induction if the body/baby is ready and the mother is willing.

13. Eat Date Fruit!

Yes, and this one has a recent study behind it. According to this study on ‘the effect of late pregnancy consumption of date fruit on labour and delivery’:
“We set out to investigate the effect of date fruit (phoenix dactylifera) consumption on labour parameters and delivery outcomes… 69 women consumed six date fruits per day for 4 weeks prior to their estimated date of delivery, compared with 45 women who consumed none… The women who consumed date fruit:
  • Had significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers (3.52 cm vs 2.02 cm, p < 0.0005)
  • Had a significantly higher proportion of intact membranes (83% vs 60%, p = 0.007).
  • Spontaneous labour occurred in 96% of those who consumed dates, compared with 79% women in the non-date fruit consumers (p = 0.024).
  • Use of prostin/oxytocin (for inducing/augmenting labour) was significantly lower in women who consumed dates (28%), compared with the non-date fruit consumers (47%) (p = 0.036).
  • The mean latent phase of the first stage of labour was shorter in women who consumed date fruit compared with the non-date fruit consumers (510 min vs 906 min, p = 0.044).
It is concluded that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomised controlled trial."

Other things to remember

If you are in early labour or trying to get things moving, remember these things:
  • Rest at night as best you can. Use the day to get things moving, but don’t exhaust all your energy in early labour – it’s like sprinting in the first 5 kilometres of a marathon. You have a long way to go, and more energy will be required in the latter stages. Being exhausted later makes the seduction of pain relief or intervention stronger and more likely.
  • Walk – especially through contractions – it’s the best thing you can do!
  • Stairs – climbing stairs is a great way to get things going and to help get that baby down and into a good position.
  • Avoid the bath or swimming – it counteracts gravity. Jump in the shower instead and if you need to sit down on a chair in a shower that’s okay. If it’s comfortable to do so, sit on the chair backwards as it will encourage baby into a better position if you can get your hips higher than your knees.
  • Keep upright where possible – make use of gravity. When the uterus contracts, it contracts forwards, so lean into them, bend the knees and have your knees apart. Don’t lean forward so much that gravity wont help – about a 45 degree angle is good.
  • Keep yourself busy – find yourself a project to do to distract yourself to help with the anticipation. Sort your recipes in an album, store photos, have lunch / dinner with friends or family, do scrapbooking – anything to keep your mind off going into labour or it can drive you mad!
  • MOST IMPORTANTLY REMEMBER! That baby will come when he is ready – sometimes no matter what you will to happen, baby will not come when we would most like it! The greatest gift you can give your baby right now is the gift of choosing his own birthdate, should the both of you be healthy.

Thinking About a Medical Induction of Labour?

Don’t forget to check out our article on medical inductions – Induction of Labour: To Induce or Not Induce? for more information on whats involved in a medical induction.
Kelly Winder is a birth attendant (aka doula), the creator of BellyBelly and mum to three beautiful children. Become a fan of BellyBelly on Facebook here. Please note that all of my suggestions and advice are of a generalised nature only and are not intended to replace advice from a qualified professional.

Wednesday, January 14, 2015

Menunggu hari

Tgh menungguhari...mcm lmbt lg rasanya masa berlalu...☺☺

Friday, January 2, 2015

Berikut adalah Jadual Dan Tarikh Pembayaran Gaji bulanan tahun 2015 untuk Penjawat Awam atau Kakitangan Awam seluruh negeri Di Malaysia
Tarikh Gaji 2015BulanHariCatatan
22 Januari1Khamis
12 Februari2KhamisTahun Baru Cina 19, 20 Februari
25 Mac3Rabu
23 April4Khamis
21 Mei5KhamisPesta Keamatan 30, 31 Mei
25 Jun6KhamisHari Gawai 1, 2 Jun
09 Julai7KhamisHari Raya Aidilfitri 17, 18 Julai
25 Ogos8Selasa
17 September9KhamisHari Raya Aidiladha 24 September
22 Oktober10Khamis
25 November11RabuHari Deepavali 10 November
17 Disember12KhamisHari Krismas 25 Disember

Jadual Gaji Kakitangan Kerajaan

Berikut adalah Jadual Dan Tarikh Pembayaran Gaji bulanan tahun 2015 untuk Penjawat Awam atau Kakitangan Awam seluruh negeri Di Malaysia
Tarikh Gaji 2015BulanHariCatatan
22 Januari1Khamis
12 Februari2KhamisTahun Baru Cina 19, 20 Februari
25 Mac3Rabu
23 April4Khamis
21 Mei5KhamisPesta Keamatan 30, 31 Mei
25 Jun6KhamisHari Gawai 1, 2 Jun
09 Julai7KhamisHari Raya Aidilfitri 17, 18 Julai
25 Ogos8Selasa
17 September9KhamisHari Raya Aidiladha 24 September
22 Oktober10Khamis
25 November11RabuHari Deepavali 10 November
17 Disember12KhamisHari Krismas 25 Disember

Sabah Public Holiday Year 2015

Penting ni untuk perancangan tahunan kita sama ada yang bekerja atau pun tidak jom kita check :)

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