Why childbirth requires adequate preparation

Just like you need to plan for a journey or meeting, so do you for the birth of a baby. You probably have heard of tales of mothers who have delivered on the way to a health facility, or on arrival, while some mothers die because they failed to raise money for a caesarean section as a result of a complication that occurred during labour. Some of these constraints can be avoided with early and appropriate preparations.

According to Naomi Alobo Elimu, the in-charge of the labour suite at Mulago National Referral Hospital, childbirth preparation should start at the time of conception or even earlier.

“When you confirm that you are pregnant, you should start preparing for the coming baby. You should start planning financially and in terms of material items that you will need when the actual time of birth arrives,” Elimu explains.

She adds: “Even if you do not earn a monthly salary, you can save any little money that you have and start buying the required items.”

That is why it is recommended that an expectant mother should attend at least four antenatal visits where mothers can be educated on various pregnancy-related issues including diet, healthy living and how to take care of the incoming baby.

“First time mothers, especially those who are short may have a small pelvis, and this could hinder the birth of the baby. It is important for them to come early to a health facility so that any complications can be detected and addressed on time,” Elimu says.

Ruth Mukundane, a 23-year-old mother of one did not wait for the last days of her pregnancy to prepare. “The moment I confirmed that I was pregnant, I started saving money and buying clothes for my baby. I also never missed any antenatal visit,” says Mukundane.

When the labour starts…
In some cases, first time expectant mothers do not know how labour pains feel like, it is, therefore, important to keep in close contact with the health care providers.

“Regular visits to the hospital helped me because I quickly noticed the labour pains and went to hospital as soon as I could. I arrived at the hospital on a Friday afternoon and on Sunday morning I had my baby,” Mukundane remembers.

She adds: “I had the mama kit and that is all the midwife asked for. She had told me about it during the various antenatal visits.”

Elimu says an expectant mother also needs pocket money. “It is not only the birth materials needed, you need some money to buy food and drinks and any emergencies,” explains Elimu.

Mukundane says for instance, she had to buy her own stiches since the health facility had run out of them.

An early preparation also makes it easy for a mother to get help from the public in case labour starts earlier, or before they reach a health facility.

Dr David Ebalu of Community Laboratory and Clinic in Namuwongo, a Kampala suburb says if an expectant mother has a kit, it is easier to administer help in case she starts bleeding before birth.

The mama kit contains essential items such as gloves, razor blades, cotton wool and polythene sheets for the delivery. Elimu says some cultural beliefs make women delay going to the hospital even when the labour pains begin. She says this can be risky especially if the mother experiences complications as a result of prolonged labour.

“First time mothers need to be assessed to confirm their ability to have a normal birth or to prepare if they need special care which can only be done if they come early to the hospital,” Elimu explains. Mothers are usually assessed for conditions such as high blood pressure and general physical fitness.

For some mothers, taking birth classes can offer useful information that they can apply long after the baby is born. If you are a first time mother, it helps if you seek advise from women who have already had babies. This is important as they can give ideas and tips on infant care.

Elimu also advises expectant mothers to undergo regular exercise during pregnancy as it will keep your bodyweight in check and also strengthen pelvic muscles in proportion for pushing the baby during labour.

Multiple births
For mothers who have had four or more children already, health workers say their chances of experiencing complications during pregnancy are higher, and should therefore ensure they give birth in a health facility.

“Every time a child is born, a scar is left on the walls of the uterus and this means the more children a mother has, the more scars she will sustain. Therefore, when such a mother delays to come to a health facility, the strong contractions may push the baby through the birth canal causing rapture of the uterus. This can lead to over-bleeding, which can result in death,” Elimu explains. She however advises mothers to come to hospital as soon as they notice labour pains.

Do not go alone
“It is important for the husband to accompany the wife to the health facility, but if she cannot, they should identify a relative or friend who can accompany them,” Elimu says.

Patience Biryomuruwe, a mother of one says she made a few mistakes which she will not repeat. “Because I was giving birth for the first time, I just went with a friend who got scared when I went into labour. My mother and husband were far and neither could be with me,” she says.

“Next time I will go with an experienced person who will not run away from me,” Biryomuruwe says.

Biryomuruwe says it can be scary for a first time mother who has no one to comfort them. “I got scared when I saw blood coming out of me, I thought I was going to die, at least if my mother was there I would not have been worried.”

Elimu notes that some expectant mothers go to hospital with only clothes for themselves and not the baby. “Normally, the mama kit has the required material to use during labour but still the expectant baby needs a minimum of three bed sheets but you can still come with more.”

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