SOME WAYS TO PREVENT PERINATAL DAMAGE AND DEATH
• The way that your labour is handled greatly depends on the obstetrician at your local hospital. There is no evidence that hospital is a safer place to have a baby (unless you are at high risk for some reason)-a home birth can be just as safe or even safer. Make a birth plan and discuss it with your obstetrician early on in pregnancy. If you want to avoid having an episiotomy, an epidural, and so on, say so and put it all in writing to the hospital. Surgical and other interventions can save babies’ lives but can produce problems too. The best way of ensuring that you have as trouble-free a birth as possible is to go to ante-natal classes to learn about birth and to prepare you for what is to come.
During the labour keep upright and walking around as long as possible and then give birth standing, squatting, kneeling or indeed in any position that keeps your body upright. This provably helps improve the blood supply to the baby, and makes labour shorter and less painful. Most women who give birth in this position are very loath or even refuse to deliver on their backs in subsequent labours. Because labour is quicker the baby is less likely to suffer from a shortage of oxygen. All of these factors contribute to a greater chance of having a normal, healthy baby.
Asphyxia (a shortage of oxygen) is the commonest cause of preventable death or handicap occurring at the time of delivery, but much of the danger can be avoided by giving birth in an upright position and by having trained staff with oxygen available in case a baby is born with asphyxia. Permanent brain damage can occur after a remarkably short period of time with an insufficient supply of oxygen to the brain.
• After low birth weight, congenital malformations are the next most common cause of infant death. In the UK 18 per cent of first-week deaths and 20 per cent of perinatal deaths are caused by congenital malformations. Some of these can be prevented by taking proper care before conception and during pregnancy.
• Treating neonatal jaundice is a way of preventing cerebral palsy (a diffuse group of neurological conditions that produce a ‘spastic’). There are six spastic babies born every day in the UK-over 2,000 a year. In some cases the recognition of a failing placenta, followed by appropriate action, is another way of preventing this heartrending handicap: babies who are suffering from poor placental blood supply can be delivered with the minimum of trauma and have their asphyxia (if any) treated so as to be born healthy and normal. The prevention of premature babies and their care in intensive nursing facilities can dramatically reduce the numbers of spastic babies born from this cause.
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