Daftar Kategori Blog

Selasa, 23 Mei 2017

Adnan Newborn - 1 Bulan

cihuiii adnan udah sebulan aja. uda 40 hari kata orang jawa boleh jalan keluar. padahal udah jalan aja emaknya. cepet amat nak nggak kerasa sebulan yang lalu mami ni berjuang ngelahirin kamu lo.

Sebulan ini emaknya masih ngerasa nyeri di bagian panggul bawah. Dikasi obat juga sama bidan kayaknya ambeien dan pinggang sakit jadi nggak berani lama2 gendong. untungnya adnan anteng kalau ngantuk bisa tidur sendiri. Alhamdulillah nggak baby blues kayak waktu azka. happy2 aja bisa urus rumah sambil urus bayi. tapiii si azka jadi aq biarin jadi dah tabletnya keluar lagi liat video lagi. merasa bersalah juga si tapi ya sementara sampai emaknya enakan dah.

Azka seneng banget liat adiknya. kadang saking senengnya sampai nggak tau bahaya. adiknya dipukul, kadang digeret dan diloncati. Dibilangin pelan2 lama2 juga ngerti bahaya dan mesti diawasi. kadang emak ni sumpek sering banget si azka kena marah. abis capek juga urus bayi mana yang besar rewel kadang buat adiknya bangun dari tidurnya. padahal moment berharga loo bayi tidur itu buat emaknya. azka libur 2 minggu soalnya ayah ke indonesia dan emaknya nggak bisa anter jemput padahal kata midwife boleh aja anter jemput tapi nggak pede juga.

Proses menyusui selama sebulan ini penuh perjuangan. walau nggak parah2 juga. aq pikir menyusui karena sudah pengalaman nggak bakal sakit. ternyata sama aja sakit dah sampe pas awal bisa nendang2 apa aja yang bisa ditendang saking sakitnya. sama bidan dihitung sampe 10 hitungan kalau masih sakit bakal dicek. kalau nggak itu wajar aja. puting sakit pula lecet ahirnya dikasi minyak kelapa. daripada beli nipple cracking cream mahal dah.heee..Alhamdulillah da nggak lecet dan cepet keringnya. Si adik pinter nenennya.

Soal ASI, semua ibu pas awal asi nya banyak bener. banyak saking banyaknya sampai sakit dah. soalnya awal memang dipompa karena belum keluar, karena aq pikir biar aja dah dipompa tar disimpen. ternyata sakit boooooo..sakiitt..mendingan cukup buat bayi daripada banyak emaknya sakit kecuali kalau kerja memang perlu mompa asi. Lagian si adnan kalau asinya banyak awal2 nggak mau minum sampai kena ke muka juga. haaa..ampun dah ni anak nggak sama kyk masnya. kalau si azka walau banyak tetep aja dah nenen nggak pake marah.beda anak beda ternyata termasuk cara nenennya. Sempet kena masitis. awalnya ber 3 aja dirumah. rasanya menggigil panas dingin alhamdulillah si azka bisa dimintai tolong ambil obat dan si adik pas bobo jadinya bisa tiduran. Awal aq kasi paracetamol mendingan bisa berkurang. Sambil kompres air dingin. kaku dah ni PD. Besoknya bidan datang dan dikasi obat antibiotik disuruh habisin seminggu. Paracetamol, ibuprofen sama antibiotik. Ubah posisi menyusui dan pijat2 daerah yang bengkak. Sakitnya masa ampun dah dan Alhamdulillah seminggu enakan udah.

Midiwife visit sampai 6weeks dan tiap minggu datang. cepet juga sudah 6weeks. Ditanya masalah menyusui, pelekatan dan kondisi psikologis seperti bisa tidur tidak dan bagaimana dengan makanan juga apakah ada kemungkinan pospatrum depresion. Alhamdulillah aman dan nyaman aja selama 6weeks seneng banget ada yang dateng tiap minggu walau cuma midwife buat nengok 10 menit aja sekali datang.haaa..

Dalam sebulan adnan naik 1 kilo jadi 4,55 kilo. Dibandingkan si kakak dl waktu sebulan naik hampir 2 kilo padahal asi juga banyak. coba aja bulan ke 2 bagaimana ni kenaikan kakak.

Beberapa minggu setelah lahir, si adnan pipinya merah merona dan jadi seperti jerawat kecil2 banyak. Awalnya seperti di Indonesia mungkin karena kena asi jadi dibersihkan saja dengan air hangat tapi lama2 kok jadi banyak ya.hemmh..ahirnya tanya bidan disuruh kasi lotion untuk kulit kering dan itu hormonal aja jadi bakal hilang seiring waktu kecuali kalau sudah 2 bulan lebih nggak hilang harus cek sapatau penyakit kulit. Selain itu juga ada semacam ketombe (cradle crap) dikepala. dibersihkan juga hilang dan datang lagi. Dibersihkannya dengan minyak kelapa, jangan lama2 sebentar saja terus digosok dengan cutton bud dan dibilas dengan air.

Si adnan Alhamdulillah nggak bangun malam.bangun hanya nyusu 2 jam sekali. kalau pagi bisa 1 sampai 1,5jam sekali nyusu. Tapi ni bocah nggak terlalu suka pas PD kencang, jadi harus dipompa dulu sedikit.

Adnan latihan juga buat tegakkan kepala. Jadi sehari selama semenit ditengkurapkan dan belajar menegakkan kepala. awalnya ngeri juga ampun dah.haaa...ahirnya nggak rutin paling 3 hari sekali aja belajar tengkurapnya




Alhamdulillah adnan udah aqiqah kebetulan ayah pulang nikahan adik ipar jadi bisa diaqiqahin sekalian. Udah tuntas dah aqiqahnya nggak kepikiran lagi.4 juta untuk 2 kambing di aqiqahkan di magelang.

Karena disini nggak ada keluarga, positifnya nggak ada yang ngomel2 kalau si bayi diajak jalan.haaa..perdana ni si bayi jalan ke devonport naik boat sama si kakak. makan chips dan baca buku di perpus. Si bayi dikasi baju rangkep2 dah biar nggak masuk angin. stroller juga tertutup rapat.

Ada yang sedih selama sebulan ini ditelpon sama rumah sakit, si adnan waktu screening awal positif cystic fibrosis dan harus dilakukan tes ulang untuk mengetahui apakah benar positif atau hanya carrier saja. hemhh nunggu panggilan buat tes si adnan ini. Cystic fibrosis dibahas di blog ini juga.

aww dapet kado dari nipper buat si adnan, handuk dan boneka gajah. Thank you nipper. seneng banget dah selama ini didukung juga sama nipper family.

Adnan 6 bulan harus imunisasi dan dicek juga fisik keseluruhan mulai kepala sampai kaki. Imunisasinya rotavirus, IPD, hepatitis dan beberapa lainnya (3x suntikan) kali ini bareng sama kakaknya yang juga suntik di 4 tahun.

My lovely midwife marcella. Makasih buat dukungannnya.


Selasa, 02 Mei 2017

Baby Bjorn Merubah gendongan dari Non ergononomis jadi Ergonomis

Gendongan bayi memudahkan ibu2 untuk beraktifitas. Salah satu gendongan yang memudahkan saya yaitu babybjorn. Karena buat beli ergo mahal banget, second nya aja diatas $100. kagak mampu dah. belum lagi insert nya dijual terpisah. Angkat tangan saya. Ahirnya pakai yang babybjorn. Tapi memang babybjorn nonergonomis jadi kaki bayi nggak bentuk M shapes. Walau di web resminya dan FB resminya bilang aman dan nggak masalah selama bayi menghadap ke ibu menurut tim mereka yang terdiri dari dokter2. tapi herannya di webnya mereka juga jual gendongan babybjorn yang ergonomis.hemmh..Saya punya yang babybjorn awal yang kakinya menjulang kebawah. kalau yang ergonomis mahal bener. Baby bjorn juga ada sandaran kepala jadi bisa menopang kepala bayi buat newborn. Gendongan yang murah dan memudahkan walaupun nonergonomis. Tapi dengan sedikit tambahan bisa dipakai dan memudahkan.

Berikut keterangan dari Baby Bjorn :

BABYBJÖRN on Seven News - Medical FAQ’s
August 13, Seven News showed a clip with a chiropractor, Vanessa Harrington, talking about the risks of developmental issues in front facing baby carriers. As BABYBJÖRN baby carriers (and other brands) were shown in this clip, this has naturally raised a lot of questions from concerned consumers. Therefore, we have here put together FAQ’s around these issues. We have a long-term collaboration with leading paediatricians testing our products, and we always ask for their expertise in medical questions like these here below.
Are front facing baby carriers (BABYBJÖRN) harmful?
There is no risk as long as you use them correctly – and important to point out here is: BabyBjörn does NOT recommend carrying a newborn or small baby facing forward. On the contrary - our user instructions say it is important to carry your baby inwards (facing towards you) during the first months of age.
When your child’s is older and the hips, spine and neck are more developed (we say around 4-6 months of age) you have the possibility to turn your baby facing forwards in the BABYBJÖRN Baby Carrier, to meet the world together with you (something that most children love at this age).
Is baby’s spine correctly supported in a BABYBJÖRN Baby Carrier?
Baby’s position, and support from BABYBJÖRN baby carriers is the same as when you are carrying baby close to you in your arms - holding baby's back and head with one arm, and supporting baby's bum with your other arm/hand (baby facing towards you). This is an anatomically correct and safe way to carry your baby according to orthopedists:
”During the first few months of his or her life, the baby's spine has a rounded C shape from its little head to its toes. When the newborn baby is placed in a BABYBJÖRN Baby Carrier, the spine adopts the correct C shaped posture...” http://www.babybjorn.com/…/baby-carriers/dr-garcia-fontecha/
More about the infant's anatomical development in this video with Dr Amanda Kelly:
http://youtu.be/Q-TVqhs4UTA
What is hip dysplasia?
Hip dysplasia means that one or both of the hip joints are dislocated. This is something pediatricians examine regularly from birth. If baby’s hip joints are found to be dislocated, the pediatrician will order treatment in the form of a special harness to use 24 hours a day for several weeks. Learn more in this video with Dr Amanda Weiss Kelly, Pediatric Orthopedist, at the top ranked Rainbow Babies and Children's Hospital, Cleveland: http://youtu.be/Q-TVqhs4UTA
Can BABYBJÖRN Baby Carriers cause hip dysplasia?
No, there is no medical evidence that BABYBJÖRN Baby Carriers can cause hip dysplasia. BabyBjörn consults orthopaedists and neonatal experts and they recommend BABYBJÖRN baby carriers from birth. However, during the first months it is very important to carry your baby facing inwards (towards you), up to at least 4 months of age. Hip dysplasia is a medical condition that should be diagnosed and treated by paediatrician only.
Dr. García Fontecha, Pediatric Orthopedic Specialist at Vall d’Hebron (one of the largest and most renowned children’s hospitals in Spain) in Barcelona:
”In BABYBJÖRN baby carriers the hips are in a comfortable position, which favors the correct development of the hips from the first few months of the child ́s life...”
http://www.babybjorn.com/…/baby-carriers/dr-garcia-fontecha/
More info here: http://www.babybjorn.com/…/m…/baby-carriers/dr-amanda-kelly/
Dr. Allison Gilmore, Orthopedic Surgeon & Dr Amanda Weiss Kelly, Pediatric Orthopedist, are specialists at the top-ranked Rainbow Babies and Children's Hospital, in Cleveland, Ohio: ”BABYBJÖRN Baby Carriers are designed to provide proper support for a newborn’s head, neck, spine and hips...BabyBjörn Baby Carriers also hold babies’ hips in the optimal position — the abducted position (or spread legs)." http://www.babybjorn.com/…/m…/baby-carriers/dr-amanda-kelly/
What causes hip dysplasia?
It is not 100% known what causes hip dysplasia. The percentage is higher among babies born in breach position and girls are more often diagnosed with this condition than boys. There are some scientific studies that shows that the rate of hip dysplasia is higher among children that have been swaddled (usually a cultural practice). Therefore, swaddling a baby's legs tightly together for a longer period of time is not recommended by pediatricians. For a healthy child, staying in any fixed position for a long period of time is not recommended, why BABYBJÖRN Baby Carriers are designed to give baby the possibility to move legs and hips (and arms) while being carried.
Dr. García Fontecha, Pediatric Orthopedic Specialist at Vall d’Hebron (one of the largest and most renowned children’s hospitals in Spain) in Barcelona:“The design of BABYBJÖRN Baby Carriers also provides free movement of all the leg joints including the hips which further stimulates the correct nutrition and development of the joints...”
http://www.babybjorn.com/…/ab…/letter-of-recommendation-for- babybjorn-baby-carriers/
Learn more about the child’s hips in this video where Dr Amanda Kelly talks about the infant's anatomical development : http://youtu.be/Q-TVqhs4UTA
Is the BABYBJÖRN Baby Carrier correctly designed for a newborn/infant?
For newborn babies and infants, a proper support for head and back is important. They cannot hold their head up by themselves, and monitoring their breathing is essential. It is also important the hips are in a good position. The BABYBJÖRN Baby Carrier is therefore designed to give baby an upright position with a sturdy support for head and back, which also makes it easy for the parent to monitor baby’s breathing while carrying. The baby is carried facin towards the parent during the first months of age. Later, around 4-6 months of age, you have the option to carry your baby facing forwards.
Dr. García Fontecha, Pediatric Orthopedic Specialist at Vall d’Hebron in Barcelona:“When a baby is born the spine and neck muscles are weak and the relative size of its head with respect to the body is greater which increases the risk of damage to the neck caused by sudden movements. BABYBJÖRN Baby Carriers provide fantastic support for the nape of the neck and head, by positioning the baby facing towards the parents, the best position during the first few months of his or her life...”
http://www.babybjorn.com/…/baby-carriers/dr-garcia-fontecha/
Is there an unhealthy "pressure on the crotch" for baby in a BABYBJÖRN Baby Carrier?
There is no risk for an uncomfortable or unhealthy pressure on the child’s crotch, due to the design of all our baby carriers; a proper support for the neck, head and back and being adjustable in size. This together with the child’s center of gravity, body proportions (larger head, shorter arms and legs than an adult) and low weight, makes sure that the child’s weight is evenly distributed across the baby carrier’s seat area, back, head and neck support. When being carried facing forward, baby’s weight is distributed across the seat and front section.
To be entirely sure of this, BabyBjörn has undertaken pressure tests together with pediatricians that confirm that this is the case, with or without a diaper. More about this here : http://www.babybjorn.com/…/medica…/baby-carriers/preassure-/
Could it be psychologically unhealthy, "too much impressions", for baby when facing forwards in a BABYBJÖRN Baby Carrier?
During baby’s first months, you should not carry your child facing forward, as the child’s body is not sufficiently developed. But, from around five months of age, wanting to see what is going on around him/her and trying to turn around to see more is a natural phase in the child’s development. Therefore, we have designed our baby carriers with the possibility to carry baby facing forwards. See to what position your baby prefers the most. If she/he gets tired, you just switch position.
"As an infant matures, facing outward allows them to safely explore the world and satisfy their growing curiosity while at the same time they can still feel the warmth and hear the voice of their parent. It is a wonderful way to maintain secure attachment while promoting discovery."
Jonathan M. Fanaroff, M.D., J.D. Assistant Professor of Pediatrics, CWRU School of Medicine Director, Rainbow Center for Pediatric Ethics Associate Medical Director, NICU Rainbow Babies and Children’s Hospital, Cleveland, Ohio: http://www.babybjorn.com/…/baby-carrie…/dr-mark-brandenburg/

Sumber : https://www.facebook.com/babybjorn.com.au/posts/408545035876258

Tetapi lebih amannya saya ganti posisi dan menambahkan kain panjang / pashmina di bawah pantat bayi agar kaki bayi membentuk M shapes sehingga gendongan jadi ergonomis. Walau katanya babyBjorn aman aja tapi lebih baik mencegah. Saya juga tanya kedokter pas adnan 6weeks katanya lebih baik memang kaki bayi membentuk M shapes atau seperti kodok. 

Caranya seperti gambar dibawah ini. saya dapet dari browsing internet 




Saya pakai cara yang bawah nggak ribet soalnya tinggal pasang dibawah aja beres. 

Pospartum Hemorrhage (Pendarahan setelah melahirkan)

Ini juga kejadian setelah melahirkan. Darah keluar banyak banget 750ml. Walau nggak ditransfusi tapi tetap dilakukan tindakan. Tangan dokter masuk ke rahim dan membuat rahim kontraksi sehingga rahim bisa kembali ke posisi semula dan pendarahan berhenti. Kalau pendarahan tidak berhenti maka harus dilakukan operasi. Alhamdulillah saya masih sadar dan setelah 2x dicoba tangan dokter masuk kedalam, saat itu saya diberi etonox lagi karena rasa sakitnya ruaaarrrrr biasaaaaaaaaaa, pendarahan berhenti dan tidak perlu dilakukan operasi. Lagi2 kejadian emergency. Ini bisa kejadian pada siapa saja. Midwife saya bilang setelah saya ada ibu2 yang melahirkan kehilangan darah hampir 2 liter.wakkkk...Masih beruntung dah saya. Karena kehilangan darah banyak dicek setiap jam tekanan darah dan kondisi darah apakah masih banyak atau berkurang.

Is it normal to bleed a lot after delivery?

All women lose some blood as the placenta separates from the uterus and immediately afterward. And women who have c-sections generally lose more than those who give birth vaginally. But because the amount of blood in your body increases by almost 50 percent during your pregnancy, your body is well prepared to deal with this expected blood loss.
Normal bleeding just after childbirth is primarily from open blood vessels in the uterus, where the placenta was attached. (If you had an episiotomy or tear during birth, you may also bleed from that site until it's stitched up.)
As the placenta begins to separate, these vessels bleed into the uterus. After the placenta is delivered, the uterus usually continues to contract, closing off these blood vessels.
Your healthcare practitioner may massage your uterus and give you a synthetic form of the hormone oxytocin (Pitocin) to help the uterus contract. Breastfeeding, which prompts your body to release oxytocin naturally, can also aid in the process.
Unfortunately, some women bleed too much after birth – sometimes due to placenta previa or placenta accreta – and require special treatment. This excessive blood loss is called a postpartum hemorrhage (PPH) and it happens in up to 6 percent of births.
It's most likely to occur while the placenta is separating or soon after. If it happens within 24 hours after giving birth, it's considered an early PPH (also called an immediate or primary PPH). If it happens in the days or weeks after delivery, it's called a late (or delayed or secondary) PPH.

What else might cause a PPH?

Occasionally, cervical lacerations, deep tears in your vagina or perineum, or even a large episiotomy may be the source of a postpartum hemorrhage. A ruptured or inverted uterus may cause profuse bleeding, but these are relatively rare occurrences.
Finally, a systemic blood clotting disorder may cause a hemorrhage. (A clotting disorder may be an inherited condition or it may develop during pregnancy as a result of certain complications, such as severe preeclampsia or HELLP syndrome or a placental abruption.) And a hemorrhage itself can cause clotting problems, leading to even heavier bleeding.

What's the treatment for PPH?

There are a number of steps that your medical team will take right away if you begin to bleed excessively. Since uterine atony (loss of tone) is the most common cause of PPH, your caregiver will massage your uterus to help it contract while you get intravenous oxytocin. (If you don't already have an IV, the nurse will start one immediately.) You will also be catheterized to make sure your bladder is empty since a full bladder makes it more difficult for your uterus to contract.
If your placenta hasn't come out yet, your practitioner will attempt to deliver it, which in some cases requires her to reach up inside your uterus and remove it manually. You'll receive some pain medication before the procedure, and if you're in a birthing room you'll be moved to an operating room.
If you start bleeding – or continue to bleed – from your uterus after the placenta is out, you'll receive other medications in addition to oxytocin while your caregiver continues to massage your uterus. In most cases, the medication works very quickly and the uterus contracts, stopping the bleeding.
If need be, your practitioner will insert a hand inside your vagina and place her other hand on your belly, and compress your uterus between her two hands. This measure in combination with medication is usually enough to stem the tide.
If you continue to bleed, you'll be transferred to the operating room and given pain medication to keep you comfortable. The doctor will carefully check to make sure that there are no lacerations that appear to be the primary source of your bleeding. She will also "explore" your uterus (via your vagina) to check for fragments of the placenta that may remain. In some cases, you'll need a procedure called dilation and curettage (D&C) to remove them.
If your bleeding is extensive and doesn't stop or your vital signs aren't stable, you'll get a blood transfusion. This is necessary only in rare cases. Even more rarely, you'll need abdominal surgery and possibly a hysterectomy to stop a hemorrhage.
Regardless of the cause of the hemorrhage, your blood pressure and pulse will be taken frequently to help your caregiver gauge how your body is coping with the blood loss. (This is done right after birth anyway to help determine the amount of postpartum blood loss.) An abnormally low blood pressure or high pulse will provide your caregiver with valuable information.
You'll also have blood tests to check for anemia and, if necessary, to see whether your blood is clotting normally.

What's the recovery like?

You'll continue to receive IV fluids and medication after the bleeding is controlled to help your uterus stay contracted, and you'll be watched very closely for further bleeding and to see how you're doing in general. You may feel weak and lightheaded. Don't try to get out of bed on your own.
Your recovery will depend in part on how much blood you lost and what your "reserves" were to begin with – that is, how much your blood volume had increased during pregnancy and whether or not you were anemic to begin with.

You'll probably develop anemia from the blood loss and will have to take it easy when you get home from the hospital. You'll need to get plenty of rest, fluids, and nutritious food. Your doctor will likely prescribe prenatal vitamins with folic acid, as well as additional iron supplements.
Sumber : https://www.babycenter.com/0_postpartum-hemorrhage_1152328.bc?showAll=true


Back labor dan Occiput Posterior (Posisi bayi membelakangi ibu)

Ini juga salah satu yang saya alami selama persalinan adnan. Kontraksi ada di tempat pup bukan di perut. Rasanya wowww sakit banget. aq pikir dah bukaan lengkap ternyata masih bukaan 3. Padahal sudah sering jalan, goyang2 di gym ball. Ternyata ini ada hubungannya sama posisi bayi. Umumnya posisi bayi ada didepan ibu, ini membelakangi jadi tekanan lebih kebelakang bukan pada perut saat kontraksi. Ini bisa dilihat pas USG. tapi pas kejadian saya USG di kehamilan 36weeks keatas tidak ada kecuali belum lahir di usia 41weeks. Ini bisa dicegah kalau pakai akupuntur diputar posisi bayi biar pas dijalan lahir.

Midwife bilang ini juga salah satu penyebab pingin ngejan pada saat bukaan belum lengkap karena posisinya yang membelakangi. Pas hamil azka nggak seperti ini padahal kata midwife biasanya pas kehamilan pertama kejadian. Alhamdulillah bisa melewati back labor yang menyakitkan dan bisa lahiran normal.

Posisi yang benar pas anterior, tetapi kejadian adnan pas posterior jadi menekan pinggul belakang si ibu. Saya nggak dikasi pain killer epidural, pas itu mau diepidural tapi nggak jadi dan hanya diberi morphine saja. Hebat tim dokter dan bidan bisa menyelamatkan saya dan bayi dan tetap lahiran normal.

What is back labor?

Back labor refers to the intense lower back pain that many women feel during contractions when they're giving birth. Some women even feel it between contractions.
This pain is usually attributed to the pressure of your baby's head against your lower back, but other factors may be at work, too. One unproven but interesting theory is that the pain is "referred" to your lower back from your uterus.
That idea is supported by the fact that some women complain of low back pain when they have menstrual cramps – which clearly can't be blamed on a baby! One study found that women who had back pain during their periods were more likely to have back pain during labor.

Is back labor related to the baby's position?

Back labor has long been thought to be more common when the baby is facing up during labor, with the back of the baby's head pressing on the bony part of your spine. But research suggests that this assumption is wrong.
In a 2005 study of nearly 700 women in labor, moms whose babies were in this "sunny-side up" position when they were admitted to the hospital were no more likely to complain of back labor or more intense pain at that time than those whose babies were facing down or sideways. (Ultrasound was used to tell what position the babies were in.)
Unfortunately, the study produced no information about how the moms-to-be in the study felt later in labor because over 90 percent of them ended up choosing an epidural for for pain management.

What can I do to ease back labor?

You may not be able to prevent low back pain during labor, but you can try one or more of these tactics to help relieve it:
  • Get up on all fours. This position may reduce the pressure of your baby's head on your spine. (Take a look at our video on positions to ease labor pain.)
  • Do pelvic tilts. These simple exercises also may help minimize the pressure on your spine.
  • Ask your labor coach to rub your lower back between or during contractions – or both, whatever feels best to you.
  • Many women find that steady counterpressure on the lower back relieves some of the pain. Ask your labor coach to push on this area with his fists during contractions or massage it with a tennis ball.
  • Take a warm bath or shower, or apply warm compresses or a hot water bottle to your lower back. Heat may ease the achiness and bring you some comfort. On the other hand, some women find cold packs more soothing or that alternating heat and cold is helpful. You may want to give both a try. Just be sure to use a towel to protect your skin from direct contact with heat or cold.
Some women have found that sterile water injections provide some relief from back pain. This is a procedure in which small amounts of sterile water are injected just beneath the skin in four places on the lower back. The injections are temporarily painful, but afterward, the pain relief lasts for a few hours. No one knows for sure why it works, and it's not available everywhere.
Check out some other natural childbirth techniques that may help you deal with labor pain.

If you don't have your heart set on natural childbirth and nothing is helping you manage your back pain, consider getting an epidural. In most cases, it provides total relief from all kinds of labor pain, including back labor.
Sumber : https://www.babycenter.com/0_back-labor_1451580.bc

What does it mean that a baby is in the "posterior position"?

When a baby is head-down but facing your abdomen, she's said to be in the occiput posterior (OP) position – or posterior position, for short. The term refers to the fact that the back of your baby's skull (the occipital bone) is in the back (or posterior) of your pelvis.
You may also hear this position referred to as "face-up" or "sunny-side up."

How common is it for a baby to be in this position?

It depends on how close you are to delivery. Many more babies are posterior at the beginning of labor than when they're born. While as many as half are posterior when labor starts, only 4 to 10 percent of babies are posterior at birth. (The percentage of babies who are posterior at birth is higher among first-time mothers.)
It's common for a baby's position to change during labor, often more than once, and your baby may not assume his final position until shortly before birth.
A study published in 2005 used ultrasound to look at the position of more than 1,500 babies of first-time mothers over the course of labor. The results showed just how variable and unpredictable a baby's position can be.
The first ultrasound was performed when the mothers were admitted to the hospital in labor or to be induced. Close to a quarter of the babies viewed were face-up (posterior), nearly half were facing sideways, and the rest were face-down. Ultrasounds were repeated at one or two other points during labor and then at the time of birth.
Most of the babies were in the more favorable face-down position by the time they were delivered. Among the babies who were posterior late in labor, about 1 in 5 was still that way at the time of delivery. Among babies who were face-down later in labor, only 1 in 20 was born face-up.
A 2007 study of 270 women being induced found that more than a third of the babies were in the posterior position just before the induction started, but fewer than 1 in 12 were still that way at delivery. Of the babies who were posterior at birth, over two-thirds of them weren't posterior in the beginning.
Studies published since then (which also used ultrasound to confirm position) also show that a baby's position at the onset of labor does not predict his position at birth. Many babies who are posterior at some point in labor rotate on their own to the face-down position before birth.

f my baby is posterior during labor, does that mean I'll have back labor?

Back labor — the intense lower back pain that many women feel during labor – was long thought to be more likely when the baby is facing up. But research using ultrasound (much more accurate than a clinical exam, especially in the first stage of labor) suggests that this common assumption is probably wrong.
In the 2005 study above, nearly 700 of the women were asked about pain when they were admitted to the hospital. More than 1 in 4 reported having back labor at that time, but moms whose babies were face-up were no more likely to complain of back labor or more intense pain than those whose babies were facing down or sideways.
Unfortunately, the study produced no information about how the moms-to-be felt later in labor because over 90 percent of them ended up choosing an epidural for pain management.

If my baby is posterior at birth, how will it affect my delivery?

Mothers whose babies are face-up at birth tend to push longer, more commonly need Pitocin to stimulate contractions, and have a significantly higher risk of having an assisted vaginal delivery or a c-section. They also have a greater risk of a postpartum hemorrhage.
Those who do give birth vaginally to a baby who is posterior are more likely to have an episiotomy and severe perineal tears than moms whose babies are in the more favorable face-down position, even after taking into account the higher rate of forceps and vacuum-assisted delivery.
The posterior position at birth also is associated with a higher risk of short-term complications for the baby, such as lower five-minute Apgar scores, an greater likelihood of needing to be admitted to the neonatal intensive care unit, and a longer hospital stay.

Is there anything I can do to make it less likely that my baby will be in the posterior position?

You may have heard that being on your hands and knees during late pregnancy or labor helps rotate your baby face-down, but current research suggests that being on all fours won't reduce the likelihood that your baby will be in the posterior position at birth.

That said, if your back aches, you may want to give this position a try anyway. Research shows that being on your hands and knees during labor may offer some relief from back pain.

A 1983 study found that when moms whose babies were posterior at 37 weeks spent ten minutes on their hands and knees, it appeared to help turn the babies, at least in the short term. But a later study – in which one group did slow pelvic rocking exercises on all fours for ten minutes twice a day from 37 weeks on and a second group did nothing – looked at the longer-term effect and found that an equal percentage of women (about 8 percent) in both groups had babies who were posterior at birth.

Another study looked at women who used the hands and knees position intermittently during labor and found that it didn't significantly reduce the number of babies who were posterior at birth. It was associated with a significant reduction in back pain, however.

Some research shows a link between having an epidural during labor and having a baby who is posterior at birth. But it's not clear whether having an epidural makes you more likely to have a posterior baby or having a posterior baby (and often a longer and possibly more painful labor) makes it more likely that you'll request an epidural. And one study found that the percentage of women opting for an epidural was the same regardless of the baby's position at admission to the hospital.
Finally, some practitioners may attempt to turn a posterior baby by manual rotation. Once you're fully dilated, the practitioner reaches into your vagina, puts his hand or fingers on your baby's head, and tries to rotate it. It may take a few contractions to get the baby into a face-down position and it doesn't always work.
Sumber : https://www.babycenter.com/0_posterior-position_1454005.bc?page=2


Shoulder Distocia (Bahu bayi nyangkut di panggul)

Ini salah satu yang saya alami waktu melahirkan adnan. Waktu pembukaan 7 ternyata bayi nggak mau turun padahal udah mau ngeden aja. ternyata bidan bilang bahu nyangkut di panggul. Pas saya kejadian karena bayi yang besar (padahal cuma 3,45kg aja) dan proses labor yang lama.

langsung dokter yang nanganin karena ada prosedur yang hanya dokter yang boleh nanganin. Bidan memantau disebelah dokter. Setelah tau bahu nyangkut langsung tangan dokter masuk dan kerasa seperti ada yang digunting. Setelah itu bidan bilang flat, detak jantung bayi hilang. Dokter memutar bahu agar bisa keluar dan hanya 6 menit waktu yang diberikan buat bayi keluar karena ada resiko brain damage ( saya diberitahu sehari setelah melahirkan ). Langsung deh lemas..ya Allah kasiannya si adnan ya tapi Alhamdulillah saya bisa mengejan dalam waktu 3 menit dan adnan bisa dikeluarkan tanpa harus masuk ke Nicu.

Saya sudah berpikir ini bakal berahir dengan cesar karena tenaga juga udah hampir hilang. Lemas karena kena pain killer morphin dan proses kontraksi sampai lahiran yang lama. Tapi bidan dan dokter masih mempertahankan lahiran normal walau dokter bilang ini prosesnya termasuk emergency.


What is shoulder dystocia? Shoulder dystocia is when the baby’s head has been born but one of the shoulders becomes stuck behind the mother’s pubic bone, delaying the birth of the baby’s body (see figure below). If this happens, extra help is usually needed to release the baby’s shoulder. In the majority of cases, the baby will be born promptly and safely. Shoulder stuck behind mother’s pelvic bone Pubic bone Nerve, or area of nerve, stretching Umbilical cord 2 How common is shoulder dystocia? Shoulder dystocia occurs in about one in 150 (0.7%) vaginal births.

Can shoulder dystocia be predicted? Shoulder dystocia usually occurs unexpectedly during childbirth and most of the time it is not possible to predict when it will happen. However, it is more likely to occur if: • you have had shoulder dystocia before • you have diabetes • your body mass index (BMI) is 30 or more • your labour is induced • you have a long labour • you have an assisted vaginal birth (forceps or ventouse). Shoulder dystocia is more likely with large babies but nevertheless there is no difficulty delivering the shoulders in the majority of babies over 4.5kg (10lb). Half of all instances of shoulder dystocia occur in babies weighing less than 4kg (about 9lb). Ultrasound scans are not good at telling whether you are likely to have a large baby and therefore they are not recommended for predicting shoulder dystocia, if you have no other risk factors.

Can shoulder dystocia be prevented? In most instances, shoulder dystocia cannot be prevented because it cannot be predicted. If you have diabetes or have developed diabetes in pregnancy, you will usually be offered early induction of labour or planned caesarean section. This will reduce the risk of shoulder dystocia. If you don’t have diabetes, early induction of labour does not prevent shoulder dystocia, even if your baby is suspected to be large. Caesarean section is also not routinely recommended in this situation.

What happens if shoulder dystocia occurs? Your midwife and obstetrician will be aware that in every birth there is a possibility of shoulder dystocia. Shoulder dystocia is an emergency and therefore, when it does occur, speed is of the essence. The baby’s shoulder needs to be released quickly so that the baby’s body can be born and he or she can start breathing air into the lungs. Your midwife will push the emergency bell and three or four members of staff, including obstetricians, midwives and a doctor for the baby (paediatrician), are likely to come into the delivery room to help. Because it happens so quickly and lots of people come into the room, it may be frightening for you and your birth partner. However, it is important to remember that obstetricians and midwives who attend the birth are trained in how to release the shoulders using certain manoeuvres and in the great majority of cases your baby will be delivered promptly and safely. The obstetrician or midwife will usually: • ask you to stop pushing • reposition you to give your baby more room inside the vagina; you will be asked to lie on your back with your legs pushed outwards and up towards your chest (this is known as the McRoberts manoeuvre) • press on your abdomen just above the pubic bone to try to release your baby’s shoulder • consider making a cut (episiotomy) to enlarge the vaginal opening. 3 With these simple measures, the majority of babies are born safely. If the shoulder is not released easily with the above measures, either: • your obstetrician or midwife will put his or her hand within the vagina to try to free your baby’s shoulder, or • you may be helped to roll over onto ‘all fours’, which can also help to release the shoulder. Once the shoulders are free, your baby will be born, and a paediatrician will examine him or her. Your midwife and obstetrician will talk to you about what happened. If you wish to talk at a later date about your experience, ask to talk to your obstetrician, midwife, health visitor and/or GP.

What happens if I give birth at home or in a midwifeled unit? Wherever you give birth, your midwife is trained to deal with shoulder dystocia. If your baby is not born with the simple measures described above or by rolling over onto all fours, your midwife will call an ambulance to transfer you to hospital. If your baby is born before the ambulance arrives, your midwife may still suggest taking you and your baby to hospital to be checked over. What if I have chosen to have a water birth? If you are having a water birth, you will be asked to get out of the pool so that your midwife can assist you.

What could shoulder dystocia mean for me and my baby? For me Vaginal tears are more common after shoulder dystocia and may extend to the back passage (see RCOG patient information: A Third- or Fourth-degree Tear During Childbirth). Heavier bleeding than normal after birth (postpartum haemorrhage) is also more common and you may require additional treatment and/or a blood transfusion. For my baby About one in ten (10%) babies who have shoulder dystocia will have some stretching of the nerves in the neck (see figure on page 1), called brachial plexus injury (BPI), which may cause loss of movement to the arm. The most common type of BPI is called Erb’s palsy. It is usually temporary and movement will return within hours or days. Permanent damage is rare. It is important to remember that BPI can occur without shoulder dystocia. BPI can also occur in babies born by caesarean section. Sometimes shoulder dystocia can cause other injuries including fractures of the baby’s arm or shoulder. In the majority of cases, these heal extremely well. Even with the best care, in a very few cases, a baby can suffer brain damage if he or she did not get enough oxygen because the delivery was delayed by shoulder dystocia. What about future deliveries? If your baby’s birth was complicated by shoulder dystocia, there is an increased risk of shoulder dystocia in future pregnancies; around one in ten women will have shoulder dystocia again in a future pregnancy. In view of this, your obstetrician or midwife will discuss your options for next time taking into account your individual circumstances and preferences. 4 You may wish to consider a vaginal delivery if it was easy to release your baby’s shoulders, your baby was fine and you have no other risk factors. If it was difficult to release your baby’s shoulders, your baby had any injuries or the experience has affected you and your family, you may wish to consider a planned caesarean section.

https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-shoulder-dystocia.pdf
 

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