Pregnancy information related to 21 - 28 weeks

Childbirth classes at 21 - 28 weeks

Childbirth preparation classes are designed to prepare you for labour and delivery and help you take a more active role in the birth process. Active participation makes birth a more enjoyable and rewarding experience. Our doctors and nurses will refer you to classes.

• Provides information about pregnancy, how your body is changing and how your baby is growing.
• Improves your ability to make well-informed decisions.
• Lessens your fears about childbirth by providing an understanding of the labour and delivery process.
• Provides you with breathing and relaxation techniques that will help you better cope with the labour process.
• Explains and provides instruction about the role of the birth coach.
• Provides information on the use of medication(s) during labour.
• Offers breast-preparation recommendations, if you plan to breast-feed.
• Provides opportunities for meeting other expectant couples.
• Provides information on comfort measures and coping with physical, emotional, and lifestyle changes.
• Offers information on general hygiene, such as bowel habits, etc.
• Offers information on alternative birthing methods (Caesarean birth and/or vaginal birth after Caesarean - VBAC).
• Tells you what to expect in the hospital.
• Provides information about the time after birth (postpartum).

Childbirth classes involve a combination of relaxation and breathing techniques, and some are a mixture of specific techniques from various methods. Refresher courses and special classes for pregnant women over 35 are sometimes available. Discuss the options available to you with our doctors and nurses.

• Lamaze

The alteration of the perception of pain in childbirth through the use of the mind, as well as breathing and panting techniques.

• Bradley

Focus is on partner-coached childbirth, as well as breathing techniques and mental relaxation.

• Grantly Dick-Read

Reducing the use of pain-relief medication through abdominal breathing and panting.

• LeBoyer

Emphasis is on gentle childbirth from the perspective of the newborn.

Childbirth classes are generally attended during the third trimester; however, if you wait too long, the classes may be full, plan ahead. If you are having any pregnancy complications or have been instructed by our doctors or nurses to restrict activity, tell your class instructor before beginning class.

Exercises for preparing for childbirth at 21 - 28 weeks

This period of the second trimester of your pregnancy is a good time to begin to prepare your body for giving birth to your baby. There are specific exercises you can do at home, as well as formal classes that will help you and your partner understand the labour and delivery process and prepare for it.

In addition to the overall benefits of participating in sports and exercise activities, improved general well being, self image, and relaxation, there are two exercises that specifically will help prepare your body for childbirth.

- Benefits
Strengthens abdominal muscles, relieves lower back discomfort.

- How to do the pelvic tilt:

• Position yourself on the floor on your hands and knees.
• Exhale as you tilt your pelvis up by pulling in your abdomen and then pushing your lower back up toward the ceiling.
• Hold this position while you slowly count to six. Then inhale and relax, returning your back to the initial resting position.
• Repeat 10 times, a few times each day, or as recommended by our doctors and nurses.

The pelvic tilt can be done anytime your back feels tired. It is a helpful exercise that relieves the tension in the lower back.

- Benefits
Strengthens, tightens, and tones abdominal and urinary tract muscles; increases tone and elasticity of the vagina.

- How to do the pelvic floor contraction (Kegel exercise)

• Sit, stand, or lie down comfortably.
• Think about your vagina and anal area, and tighten these muscles in the same way that you would to stop urinating in midstream.
• Hold this position as tightly as possible for a slow count of five while breathing normally. Relax completely.
• Do a few sessions of several repetitions every day throughout your pregnancy while watching television, at a traffic light, or at the office.
• In addition, when you urinate, practice starting and stopping the stream of urine, before emptying your bladder completely.

When to call our doctors and nurses at 21 - 28 weeks

Contact our doctors and nurses if you notice any of the following warning signs:

• Pain or burning during urination, or a decrease in the amount of urine.
• Unrelieved vomiting.
• Unrelieved diarrhoea or constipation.
• Chills or fever.
• Soreness or redness in one or both legs.
• Marked swelling or puffiness of the feet, hands, or face (oedema), or sudden weight gain.
• Severe or constant headache.
• Visual disturbances such as blurred vision, spots before the eyes, and flashes of light.
• Dizziness or mental confusion.
• Marked change in the baby`s movement.
• Something just doesn`t feel right.

Also be alert to symptoms of Preterm labour such as:

• Lower backache.
• Menstrual like cramping.
• Vaginal bleeding or a marked change in vaginal discharge (amount/odour/colour).
• Vaginal/pelvic pressure.
• Abdominal or intestinal cramping, pain, or tenderness (with or without diarrhoea or constipation).
• Contractions or uterine tightening (four or more within one hour).

You may notice other symptoms not included in this list, when in doubt, call our doctors and nurses.

The ideal outcome for all patients, of course, is to have an uneventful pregnancy that results in a healthy baby. However, some pregnancies do involve complications that may affect the mother, the baby, or both. Because these complications can be relatively minor to life threatening, it`s important to recognize possible warning signs.

Remember that you are the most important gauge of your body and, in turn, your pregnancy. Don`t compare your experience with those of friends or relatives. Even if you`ve been pregnant before, this pregnancy will probably be different. Trust your instincts, but don`t attempt to diagnose yourself. If something 'just doesn`t feel right', call our doctors and nurses.
 
When you call our doctors and nurses:
Write down the information you will need before placing the call, and keep pen and paper ready to write down our doctors and nurses instructions.

Always have the following information on hand:

• Our office and after-hours phone number.
• Hospital name, address, and phone number.
• Emergency room phone number.
• Ambulance service phone number.

Your body`s changes and baby`s growth at 21 - 28 weeks

Your baby`s skin is pink to reddish in colour and wrinkled. Although the baby is thin, his/her movements are becoming stronger. The baby`s eyes are closed, however he is capable of crying. The brain is undergoing rapid growth.

Your enlarging uterus will push your stomach upward, which can lead to heartburn. You may notice irregular, occasional contractions of your uterus (Braxton-Hicks contractions), which occur more often in late pregnancy. Due to hormonal changes you may notice darkening of the skin which can appear on the face (chloasma) or as a darkened line down the middle of the abdomen (linea nigra).

The second half of pregnancy brings more physical and emotional changes for you and a time of significant growth for your baby.

For many women, this time of pregnancy brings a renewed sense of well-being. You may have more energy and, despite your increasing size, you`re probably feeling more in control of the process. There may be some downsides, such as heartburn from your enlarging uterus pushing your stomach upward, but you`re learning how to manage these minor discomforts.

Hormonal changes may be causing some darkening of your skin. When it occurs in patches on your face, it`s called chloasma; when it`s visible as a darkened line down the middle of your abdomen, it`s call linea nigra. These patches may darken in prolonged sunlight, so you may want to avoid direct sun exposure and/or use a sunscreen.

Don`t be surprised if you begin to feel some irregular, occasional uterine contractions during this time. This is your body`s way of normally preparing for birth. A uterine contraction is defined as a tightness or hardness of the entire surface area of your uterus. Some women describe it as a 'balling up' feeling. Normally, these contractions may occur as frequently as three times an hour, timed from the beginning of one contraction to the beginning of the next contraction. Each contraction may last 45 to 90 seconds.

Because contractions can be subtle and are oftentimes painless when they occur, it is important that you become aware of what a contraction feels like and how often you are having them.

To help determine if you are experiencing contractions, lie down with a pillow propped under your shoulders, and with your body tilted slightly to the left side, place your hands on your uterus. Do this at 10-minute intervals, two to three times each day throughout your pregnancy. If you feel the entire surface area of your uterus "tighten" one or more times in this 10 minute period, continue to rest and place your hands on your uterus. If your partner has his hand on your uterus when you are experiencing a contraction, he will be able to feel a tightness similar to when he flexes his bicep (upper arm) muscle. When your contraction is over, your uterus will once again become soft and relaxed.

It is not normal to have frequent uterine contractions occur before you have reached 37 weeks of pregnancy. If your contractions are occurring regularly (more than 4 times in an hour) after resting, promptly notify our doctors and nurses.

By 24 weeks of gestation, your baby will weigh about 500 grams, and will be about 26 cm. in length. The baby`s skin is wrinkled, translucent, and pink to reddish in colour. Buds for permanent teeth are present, and the brain is growing rapidly, but eyelids remain closed. The baby now moves about freely in the amniotic fluid, and while he/she is still lean, the baby begins to gain weight by adding muscles and body tissue. He/she has a set "schedule" of sorts, sleeping and waking for certain periods of time each day. Twenty-four weeks of pregnancy is considered a time of viability. This means your baby could possibly survive with advanced medical treatment if born prematurely. Major organ systems, while formed and functioning, are still too immature, however, to work as intended.