PREGNANCY GUIDE

How much weight should I gain during pregnancy?

Pregnancy is accompanied by normal weight gain. In total, the pregnant woman gains 10 to 12 kilos. Most of this should be gained by the 7th week.The, 8The and 9The month, so you should be careful not to put on too much weight in the first few months. Overall, the weight distribution is as follows:

At 1The In the third trimester, the pregnant woman gains 2 kg.

At 2The In the third trimester, the pregnant woman gains 4 kilos.

At 3The In the third trimester, the pregnant woman gains 6 kg.

The extra weight is due to the increase in the size of the fetus, placenta, and the amount of amniotic fluid. The pregnant woman also increases the amount of adipose tissue and increases the weight of the breasts, due to preparation for breastfeeding. 

 

What should I eat?

This is the permanent question of the pregnant woman. There are many traditions that want the pregnant woman to want to eat a lot and persistently seek out strange foods. For many years, there has been the misconception that the pregnant woman eats for 2 people and it is common for her relatives to constantly bring her sweets and various snacks in order to help her.

 As you can see, all of the above is wrong. The key to proper nutrition for pregnant women is the intake of quality food. The additional amount of food that a pregnant woman needs corresponds to 300 to 500 calories and no more. 

 Quality nutrition during pregnancy significantly affects its outcome. In order to build the body and all tissues of the fetus, significant amounts of nutrients are required from the mother's food. 

 

 But what does quality nutrition mean during pregnancy?

 Quality nutrition means fully meeting the needs of the developing fetus and your body. 

 In short, your diet should contain:

1. Good quality proteins 
2. Good quality carbohydrates (mainly polysaccharides) 
3. Lipids (monounsaturated and polyunsaturated) 
4. Calcium and vitamin D 
5. Iron and folic acid 
6. Various vitamins and trace elements. 

 For many women, the terms carbohydrates, proteins, etc. are confusing. That's why we'll clarify them below:

 

What are proteins? Where can I find good quality proteins?

Proteins (also called albumens) are made up of amino acids. Proteins are building blocks for the development of the body, muscles, bones and skin of the fetus. They also contribute to the synthesis of the most important macromolecules of the blood and help reduce edema (swelling) in the mother. How do you get good quality protein? By consuming good quality meat, chicken, fish and dairy products and finally egg whites. Know that egg whites have the best quality protein.

 

What are carbohydrates?

Carbohydrates are sugars, substances that provide energy to the pregnant woman and the fetus. Carbohydrates are divided into polysaccharides (containing many glucose molecules) such as starch and disaccharides, such as sugar. Starch is ingested by the pregnant woman and broken down into glucose molecules, which is the main fuel for the fetus and the pregnant woman to perform multiple functions. Where is starch found? In rice, potatoes, cereals, bread, pasta and of course legumes. Be aware that sweets also belong to the same category (i.e. carbohydrates), which, however, do not have polysaccharides but disaccharides such as sugar. Sugar and sweets have no nutritional value for the pregnant woman and you should avoid them. Furthermore, excessive sugar intake can cause a disruption in glucose metabolism and thus cause damage to the fetus.

 

What are lipids? What do monounsaturated and polyunsaturated lipids mean? Are they essential for pregnant women?

Lipids are a component of the body. They are stored under the skin, storing energy and increasing body weight. In the fetus and later in a healthy newborn, there is a large amount of fat stored in the back, buttocks and lower extremities. This fat is easily broken down, generating heat and thus participates in thermoregulation. However, lipids also participate in other very important processes, such as the synthesis of cell membranes, the development of the nervous system and vision.

Lipids are composed of glycerol and fatty acid molecules. Fatty acids can be saturated (butter-fat), monounsaturated (olive oil) or polyunsaturated (sunflower oil, seed oil, fish fat with Ω3 and Ω6). What are good quality lipids? Monounsaturated and polyunsaturated, that is, olive oil and Ω3 and Ω6 fats from fish. So you should consume moderate amounts of good olive oil (e.g. two tablespoons daily) and fish twice a week. 

 

 Some secrets to good nutrition are as follows:

1. Eat 3-4 meals of vegetables and fruits a day (e.g. 2 fruits in the morning, lettuce salad with spring onions at lunch, boiled broccoli in the evening).
2. Eat fresh Greek fish twice a week.
3. Eat lean red meat (e.g. beef) or chicken 3 times a week.
4. Eat legumes 2-3 times a week.
5. Prefer lean meat.
6. Avoid fried foods. They don't offer you anything.
7. Wash vegetables thoroughly.
8. Do not eat raw or undercooked meats, because you may contract toxoplasma.
9. Do not eat raw chicken or raw eggs because you may be infected with the salmonella bacteria.
10. Avoid sweets and sugar in general. If you want something sweet, consume fruit or honey, but always in moderation.
11. Avoid soft drinks because they contain sugar and unknown chemicals.
12. Avoid dairy products of unknown origin, unpasteurized milk, and cheeses such as Roquefort, brie, and camembert, because you may get listeriosis.
13. Do not consume sushi and raw fish in general.

 

What foods are prohibited during pregnancy?

• Raw or undercooked meats

Raw or undercooked meat and poultry are prohibited. This means that the meat you eat will not have any blood residue (red color when you cut it). This way you avoid getting infected with germs such as coliform bacteria, salmonella, and toxoplasma.

• Minced meat of unknown origin

Minced meat of unknown origin (e.g. from restaurants) is prohibited. The minced meat you eat must be fresh, freshly cut and well cooked by you. Risk of infection with coliform bacteria, salmonella and toxoplasma

• Raw eggs

Raw eggs are prohibited. This means that you should also avoid creams or mayonnaise of unknown origin that may contain raw eggs. Risk of salmonella.

• Tuna, swordfish

Canned fish such as tuna and imported fish such as swordfish or other large fish that are not found in Greek seas are prohibited. Risk of mercury intake.

• Liver

Liver and liver paste (pâté) are prohibited, which are rich in vitamin A. Hypervitaminosis A causes teratogenesis in the fetus.

• Offal

Offal in general (intestine, liver, stomach, spleen, kidneys, etc.) is prohibited, because it has nothing to offer you. Foods that contain offal (kokoretsi, magieritsa, etc.) may contain large amounts of liver (hypervitaminosis A), coliform bacteria, etc. and are generally not recommended for consumption. Spleen was previously recommended for pregnant women because it contains a large amount of iron. However, a pregnant woman can get a corresponding and larger amount with a combination of red meat in the diet and an iron supplement.

• Unwashed vegetables

You will avoid eating unwashed vegetables. This is especially important when eating in restaurants. You should not trust easily since the best restaurant can accidentally serve an unwashed salad, e.g. lettuce. Risk of toxoplasmosis.

• Sushi, raw fish

Sushi and raw fish in general are prohibited. Risk of listeriosis.

• Milk of unknown origin

Dairy products of unknown origin and unpasteurized milk (e.g. from a local producer) are prohibited. Roquefort, camembert and brie cheeses are also prohibited.

 

Pregnancy, 1st month

Most of the first month of pregnancy is unnoticed by the woman. Often there are symptoms such as swollen breasts and easy fatigue, but the woman begins to suspect pregnancy, usually when her period is late. Most commercial pregnancy tests will indicate pregnancy the week after the expected missed period. The fetus is so small that it can only be detected by ultrasound towards the end of the first month.

When should I take a pregnancy test?; 

The best time to take a test is when you are 1 week late, although most tests report that they are positive from the first few days of delay. In order to get accurate results, you should pay attention to:

(a) The test expiration date must not have passed.

(b) It must not have been damaged (e.g. stored in a humid place)

(c) Use morning urine

(d) Read the instructions for use carefully.

Don't be discouraged if the test result is negative. It's probably a mistake, so it's a good idea to repeat it. Most tests also come in a double pack for repeatability.

How often does the month change?

The total duration of pregnancy is on average 40 weeks counting from the 1st day of the last period. The change of month occurs 10 days after this date. Therefore, if the last period is, for example, September 10, then the change of month occurs on the 20th of each month. So on October 20, the 1st month is completed, on November 20 the second, and so on.

What should I pay attention to in the first month?

You should know that pregnancy is not a pathological condition, however, it requires attention and care in order to achieve the desired result, which is none other than the birth of a healthy newborn while ensuring the health of the mother. Thus, it is forbidden to take medications without prior advice from a gynecologist. In addition, you should avoid smoking (even passive smoking) and alcohol, because both cause damage to the fetus. The 1st and 2nd months are characterized by intense proliferation of fetal cells and the formation of organs. This process is particularly sensitive to medications and exogenous harmful factors.

When should I go to the gynecologist?

Our opinion is to visit a gynecologist immediately, in order to discuss the various parameters of the pregnancy and to obtain a complete history of the parents. The gynecologist can usually determine by ultrasound after the 5th week whether it is an endometrial pregnancy and advise the couple about the risks of miscarriage (the probability of miscarriage is usually higher in the first weeks of pregnancy (approximately 20-30% of pregnancies end in miscarriage).

 

Pregnancy, 2nd month     

Throughout the 2nd month of pregnancy (approximately until the end of the 10th week), all the organs of the fetus are formed. This process is very sensitive and for this reason, exposure to harmful substances (cigarettes, alcohol) and medications should be avoided without prior advice from the gynecologist. The fetus is clearly visible on the ultrasound, while its heart function is also distinct.   

The mother feels increasingly nauseous and vomits, especially in the morning. A few pieces of toast (dry food) in the morning may help the pregnant woman overcome the problem of nausea. There is generally easy fatigue, due to the increase in hormone levels in the blood. Even simple daily activities seem to require much more energy and effort than before pregnancy, leading the pregnant woman to exhaustion at the end of the day. It is necessary for the pregnant woman to sleep several hours during the night and to take advantage of some time periods during the day to rest. 

At this stage, it is useful to make the first visit to the gynecologist who will monitor the pregnancy until the end. Before visiting your gynecologist, it is useful to write down in notes all your questions, for which you want to get correct and documented answers. You should mention any illness you have had in the past and you should bring with you any medications you may have taken since the beginning of your pregnancy. The gynecologist will explain to you what tests you should undergo and will schedule you for the next visits and ultrasounds or any additional tests. 

 

Pregnancy, 3rd month

What shape does the fetus have? 

Most of the fetus's organs complete their form in the 3rd month. The fetus is a miniature human, its eyelids are closed and its skin is transparent. From now on, the fetus increases in size and the maturation of its organ functions continues.

How is my body changing?

By the middle of this month, your gynecologist can detect the fetal heartbeat with a special device. The uterus has already started to grow enough to be palpable from the abdomen. 

What tests are performed in the 3rd month?

It is advisable to have completed the prenatal check-ups at this stage in order to have a complete picture of the mother's condition. Anemia of pregnancy is a condition that occurs due to the continuous increase in blood volume and the dilution of red blood cells and becomes more and more intense as the pregnancy progresses. It is therefore important for the doctor to know at what hematocrit level the pregnancy begins, in order to determine the necessary treatment. It is also important to determine whether or not the mother has immunity to diseases such as toxoplasmosis and rubella.

What is a nuchal translucency ultrasound?

In this month, and specifically after the 12th week of pregnancy, the nuchal translucency ultrasound is performed, in which the thickness of the fluid in the fetus's neck is measured. If this is found to be increased, then there is an increased likelihood of Down syndrome. The probability is greater in women of advanced age. The sensitivity of the ultrasound for detecting Down syndrome is 80-82%. 

What is the PAPP-a test?

It is the determination of the PAPP-a protein and free beta chorionic gonadotropin in the blood. Women carrying fetuses with Down syndrome have low PAPP-a protein and high beta chorionic gonadotropin. If this measurement is combined with the nuchal translucency ultrasound, then the sensitivity of detecting Down syndrome increases greatly (over 90%).

The result is expressed as a probability of occurrence, e.g. 1/300 (one in three hundred). This is also considered the safety margin. If the probability of Down syndrome is higher (e.g. 1/150), then the woman is recommended to undergo one of the tests that provide an accurate diagnosis of the presence or absence of chromosomal abnormalities (including Down). These tests are chorionic villus sampling and amniocentesis.

What is the nasal bone and what is the significance of its detection on ultrasound?

Detection of the nasal bone from this gestational age is a very good prognostic factor, since the likelihood of Down syndrome is reduced by 3 times.

 

Pregnancy, 4th month

What shape does the fetus have?

In the 4th month, the fetus now has the familiar characteristics of a miniature human. Its weight is approximately 300-400 grams. Its genitals have formed and towards the end of the 4th month they can be seen with an ultrasound. The nervous and muscular systems of the fetus develop even more and the movements it makes are more intense, which the mother begins to understand around the 18th week of pregnancy. The fetus's eyelids are closed, but it can perceive light. As the head develops, the eyes acquire a more central position in the face.

How is my body changing?

The symptoms of nausea and vomiting have decreased significantly and the woman experiences this phase of pregnancy with relative calm since the risk of miscarriage has decreased compared to the 1st trimester. The pregnant woman's skin acquires a beautiful texture and appearance thanks to the increased blood flow it has, as do all the organs during pregnancy. 

After the 16th week, the skin of the forehead often begins to darken (chloasma of pregnancy). The midline of the abdomen and the external genitalia may also appear darker. These changes are hormonal in nature and in most cases subside after childbirth. The mother begins to experience fetal movements around the 18th week, which most describe as a particularly moving moment. Women who have been pregnant in the past begin to understand fetal movements a little earlier than first-time mothers.

What tests are done in the 4th month?

In the 4th month, the standard tests are performed, namely the hematocrit to check for anemia, fasting blood sugar, and a general urine test to detect any kidney disorder or urinary tract infection. 

What is the triple test?

This involves the determination of 3 substances in the mother's blood, beta-chorionic gonadotropin, alpha-fetoprotein and free estriol. It is used to determine the likelihood of Down syndrome, but also to determine other fetal diseases such as spina bifida. The triple test is performed in the 4th month and ideally between the 16th and 18th weeks of pregnancy. 

 

Pregnancy, 5th month

What shape does the fetus have?

The proportions of the fetus are now quite close to those of a newborn. It sleeps several hours each day (even 18-20 hours) and when awake it perceives the sounds of the environment much more easily. The eyelids begin to open and the fetus makes much more intense movements, which are felt by the mother. Sebum begins to appear on its skin, an oily secretion that protects the fetus from its many months in the amniotic fluid.

How is my body changing?

The uterus reaches a height of up to the navel and by now the pregnant woman has gained about 4-5 kilos. From now on, the weight will increase by about half a kilo per week.

If there is a problem of anemia, then from now on it is likely to become more intense since iron needs increase, while the mother's blood volume also increases, resulting in a dilution of the hematocrit.

From the 5th month onwards, many women experience painful cramps in their lower limbs, which are due to gradual weight gain. The cramp is treated by stretching the muscle group that is experiencing painful muscle contraction. Magnesium supplements are thought to reduce the frequency and intensity of these contractions.

What tests are performed in the 5th month?

In the 5th month, as well as in each subsequent month until delivery, the hematocrit, blood sugar are determined, and a general urine test is performed to check for possible preeclampsia or a urinary tract infection.

However, in addition to the established monthly examinations, a detailed level 2 ultrasound is usually performed in the 5th month. 

What is a level 2 ultrasound?

It is a detailed recording with the ultrasound scanner of all the systems and anatomical relationships of the fetus's body, with the aim of early detection of abnormalities in its development. The 5th month allows for a clear recording of abnormalities due to the size of the fetus, and on the other hand, due to the immaturity of the pregnancy, it gives the possibility of terminating it in case significant abnormalities are found.

How reliable is the second-level ultrasound for detecting abnormalities in fetal development?

The answer is that it is generally considered reliable, but not absolutely. There are structural abnormalities that are detected in a percentage of more than 90% (e.g. anencephaly, spina bifida) and abnormalities that are difficult to find (e.g. major cardiac anomalies). However, with current data, the second-level ultrasound is the most useful tool available for monitoring pregnancy.

What else is seen on a level 2 ultrasound?

In addition to structural abnormalities, the ultrasound in the 5th month will show us the position of the placenta, the quality of the placenta, the development of the fetus, and the blood flow in the placenta.

 

Pregnancy, 6th month

What shape does the fetus have?

The fetus has the proportions of a newborn, but has not yet accumulated fat under its skin and thus has an elongated shape. From the 6th month, subcutaneous fat begins to accumulate, which will give the newborn its familiar shape by the 9th month. This fat is also called brown subcutaneous fat and contributes to the thermoregulation of the newborn after birth.

As the nervous and muscular systems further mature, the fetus is able to perform more complex movements, such as sucking its thumb. It is common for the fetus to hiccups at this stage, which many mothers report as amusing.

How is my body changing?

The height of the uterus gradually exceeds the navel and the distension of the pregnant woman's abdomen becomes quite evident. As a result of the distension, many women experience itching (itching) in the abdomen. This is exacerbated when the skin is dry. One way to improve the symptoms is to moisturize the skin of the abdomen with special lotions and avoid synthetic clothing. 

From the 6th month, most pregnant women develop stretch marks on their skin as a result of the rapid stretching of the skin, as well as the effect that pregnancy hormones have on the biosynthesis of skin collagen. Moisturizing lotions and creams with vitamin E may help, but not with high success rates.

Due to the expansion of the abdomen and the shift of the center of gravity forward, most pregnant women experience back pain. To treat the symptom, it is recommended that the pregnant woman rest often, use auxiliary pillows when lying down, and take warm showers. In some cases, a gentle massage by a trained specialist is recommended.

What tests are done in the 6th month?

In the 6th month, the standard tests are performed every month: hematocrit and general urinalysis. Regardless of history, most pregnant women usually undergo a glucose test with blood glucose measurements before and after administering a specific amount of glucose (in syrup form) by mouth. This test has the meaning of a mass screening to detect those women who present disorders in glucose metabolism. 

If this test is abnormal, or if there is a history of diabetes in the family, then a glucose tolerance test is performed. 

Depending on the result, the woman may or may not undergo a program of close blood sugar monitoring, which may even include the administration of exogenous insulin to avoid the unpleasant effects that elevated sugar would have on the development of the fetus.

 

Pregnancy, 7th month

What shape does the fetus have?

In the 7th month the fetus increases significantly in size and by the time it enters the 8th month its weight exceeds 1.5 kg. At this stage the fetus's demand for nutrients iron and calcium increases dramatically. Its hair has already grown and nails have formed on its fingers. The fat under the skin continues to increase and the fetus takes on a fuller shape.

How is my body changing?

The increase in the size of the abdomen is quite obvious. The pressure on the stomach from the growing uterus combined with the effect of pregnancy hormones causes severe indigestion. Many women experience heartburn after a moderate meal, due to delayed gastric emptying. One way to deal with it is to eat small meals more often during the day. 

In the 7th month, the problem of constipation appears more intensely. Constipation generally bothers pregnant women, due to the increase in progesterone and is evident from the first months. In the third trimester, constipation becomes more evident, because the growing uterus presses on the intestine and makes its mobility difficult. 

Another problem that a pregnant woman may face in the 3rd trimester is the appearance of hemorrhoids, or their worsening. It is due to the increase in pressure of the venous network within the pelvis, due to pressure from the uterus. It is recommended to avoid standing for long hours, or staying in a sitting position. If there is itching (itching) or pain, the gynecologist should be informed for treatment and the possible administration of a topical preparation. Topical creams should not be used without the prior advice of the gynecologist.

From the 7th month until the end of pregnancy, the pregnant woman feels a feeling of fainting when lying down. This is due to the pressure that the uterus exerts on the inferior vena cava, resulting in a decrease in the return of blood to the heart. The pregnant woman should lie not on her back but on the left side of her body to avoid experiencing this symptom. Furthermore, when getting out of bed, this should be done slowly, in order to give time for the redistribution of venous blood and avoid hypotension that can cause a fainting episode.

What tests should I undergo in the 7th month?

Due to the rapid growth of the fetus, the possibility of developing anemia in the 3rd trimester is high. For this reason, the hematocrit should be determined, as is done every month. In addition, the pregnant woman should be checked for signs and laboratory findings of preeclampsia throughout the 3rd trimester. Therefore, her blood pressure should be determined and a general urine test should be performed.

If the glucose test has not been performed in the previous month, it should be performed in the 7th month. 

 

Pregnancy, 8th month

What shape does the fetus have?

The fetus continues to increase its weight to reach 2800g towards the end of the 8th month. The fetus's skin becomes less and less red and less and less wrinkled, as fat continues to be deposited. Day by day, the fetus's respiratory system becomes more mature, with the result that even if premature labor is induced, the majority of newborns can survive. The movements that the fetus can now make are limited in range (but not in frequency), due to the smaller available space it has inside the uterus. The sebum, the white creamy coating that has developed around the fetus, gradually falls off. The fetus swallows amniotic fluid with sebum throughout the pregnancy. All these secretions accumulate in the fetus's gastrointestinal system and are excreted with the newborn's first bowel movements. The material expelled with bowel movements is called meconium. 

How is my body changing?

The uterus continues to grow, gradually filling the entire abdomen of the pregnant woman. The pressure from the uterus on its neighboring organs causes intense indigestion, heartburn, difficulty breathing and frequent urination. The pregnant woman may feel more tired and exhausted, due to all the discomfort, which is contributed to by anemia that very often develops during pregnancy, as well as the difficulty she faces in sleeping. Many pregnant women describe having difficulty finding a position that allows them to rest in bed, due to musculoskeletal discomfort and difficulty breathing. It is useful to avoid the completely supine position. Lying on her side and placing a pillow between her legs can help. In addition, the woman should not suddenly return to an upright position, because episodes of orthostatic hypotension and fainting are common.

What are uterine contractions?

The uterus has the property of contracting, that is, making contractions that aim to expel its contents. This type of activity culminates in normal childbirth, where rhythmic contractions initially cause dilation of the cervix and then downward propulsion of the fetus and finally the birth of the newborn.

When does this uterine activity begin?

Light, subtle uterine contractions begin in the 7th month, but they are not rhythmic. These contractions become more pronounced during the 8th month and are intended to gradually prepare the position of the fetus for the upcoming birth that will take place in the 9th month. The contractions of the 8th month should not become rhythmic and certainly should not be so intense as to cause premature labor. If the pregnant woman feels rhythmic contractions (e.g. every 15 minutes) before the 9th month, she should seek medical help to treat a possible premature labor.

 

Pregnancy, 9th month

What shape does the fetus have?

The fetus continues to gain weight throughout the 9th month. It has now occupied the entire uterine cavity and in more than 96% of cases is turned head down. Now, the fetal respiratory system is considered mature enough that labor can occur at any time during the 9th month.

When does childbirth occur?

In 90% cases, the woman gives birth on a date that is very close to the expected date of delivery. However, any time within the 9th month, delivery is considered safe for the fetus.

How does labor begin?

In most cases, the woman experiences uterine contractions that are initially painless and infrequent and then become more frequent and painful. The rhythmic contractions of the uterus gradually cause the cervical os (the opening of the uterus downwards) to dilate and gradually push the fetus downwards. The gradual dilation of the cervix causes mucus and a small amount of blood to come out of the vagina, symptoms that are noticed by the woman and which should motivate her to contact her doctor or midwife. At some point, the membranes that surround the fetus and contain the amniotic fluid rupture and thus a quantity of fluid suddenly comes out of the vagina (“the water breaks”).

Can the membranes rupture first? 

In 10% of cases, the rupture of the membranes precedes the onset of uterine contractions. This means that the pregnant woman, at an unsuspected time (within the 9th month), feels fluid flowing from the vagina and getting wet (“the water breaks”). In these cases, the uterus is not activated immediately and usually a period of time passes before the contractions that will ultimately lead to labor begin. This period of time varies, but 90% of women finally begin labor contractions within the 2nd 24 hours. Depending on the case, acceleration of uterine activation may be necessary with medical intervention through the use of intravenous oxytocin.

How long does childbirth last?

On average, about 15 hours. In some cases, it can last more than 20. The longest period of time concerns the dilation of the cervix. That is, the uterus, through its rhythmic contractions, gradually opens in its lower part (cervix), in order to create a passage through which the newborn will pass. Childbirth in primiparous women lasts much longer than in second- or multiparous women.

How does a normal birth progress?

Normal childbirth has 3 stages:

• 1st stage - dilation of the cervix: Initially, rhythmic uterine contractions cause the cervix to gradually dilate, which usually lasts several hours. The intensity and frequency of the contractions are not the same all the time. Initially, the intensity of the contractions is low, as is the pain felt by the woman. The frequency of the contractions is also low (about 1 contraction every 5 to 7 minutes). This can last about 12 to 14 hours. Gradually, the uterine contractions become more frequent and more intense, and this results in the faster dilation of the cervix. 

Finally the 1st stage is completed with the full dilation of the cervix and the gradual transition to the 2nd stage which includes the descent of the fetus.

• 2nd stage-descending of the embryo: The fetus descends further and further through the cervix with each contraction of the uterus. The descent of the fetus into the vagina causes the pregnant woman to experience an intense feeling of being pushed out. The woman, with each contraction of the uterus, that is, with each pain (which now occurs every 1 to 2 minutes), experiences a strong desire to tighten and finally give birth to the fetus. The fetus's head eventually ends up at the opening of the labia minora. With 1-2 pushes by the mother under the instructions of the doctor or midwife, the head is initially born. At this stage, the doctor or midwife may need to perform an episiotomy, i.e. the skin and underlying tissues in the lower part of the labia minora are cut. Then the fetus's shoulders and finally the entire newborn will be born. The doctor or midwife will ligate and cut the umbilical cord and the newborn will be placed in a special area for its care. 
• 3rd stage-exit of the placenta: Shortly after the birth of the newborn, the uterus performs new contractions, resulting in the exit of the placenta and the various membranes that surround the fetus when it is inside the uterus. 

When the birth is complete, the doctor will check the uterus and repair with stitches any damage and tears that exist in the woman's cervix, vagina, and perineum.

 

With love & respect,

to the most precious good..!

Ioannis D. Kalogirou.