According to Alko, the Finnish state-run alcohol monopoly, a "reasonable" amount of alcohol can continued to be consumed by women during pregnancy. According to their brochure on Pregnancy and Alcohol, the top-end of a reasonable amount is ten drinks a week. Ideally, this alcohol consumption should be spread through out the week and not take place all at once on the weekend as this may slow the development of the fetus!!!
Yikes!!! What kind of advice is that -- from a company (or rather State) that stands to make money by selling alcohol to pregnant women??
Further, in the brochure:
> 9 out of 10 women in Finland cut back on the amount of alcohol they drink during pregnancy to 1 - 2 drinks a week; many quit entirely.
> About 10% of pregnant women consume more than the recommended amount.
> About 5% of pregnant women consume more than 10 drinks/week.
In the US, the guidelines for alcohol and pregnancy are very black & white and at the other end of the spectrum: no amount of alcohol is recommended for pregnant women. It is also believed that alcohol is the leading cause of birth defects. In the US, 5% of children born with birth defects are born with defects caused by alcohol consumption during pregnancy.
In Sweden, they estimate that 11% of school aged children with learning disabilities are suffering from the effects of alcohol consumed by their mothers during pregnancy.
In Finland, each year 200 - 300 children are born with severe defects due to mothers drinking alcohol during pregnancy.
And Norway recently decided to go for a zero tolerance recommendation for alcohol use during pregnancy.
With alcohol being an entirely optional item of consumption and the dangers to the fetus so thoroughly researched, I don't understand why Alko does not make the recommendation that no alcohol is ideally be consumed during pregnancy? Especially, in a country like Finland where alcohol abuse is high and the drinking culture does not frown upon drunkenness. Why not make it easy for pregnant women to simply say no and to give the fetuses more healthy environment?
More brilliant advice - alcohol and breastfeeding
Alko closes the pregnancy and Alcohol brochure with this information and advice about drinking alcohol and breastfeeding:
alcohol does pass into the mother's milk and the blood alcohol level of the mother's blood and breastmilk can be considered to be the same. So, if a mother is highly intoxicated (eg, 2.0 pro-mil), the amount of alcohol in the milk is 0,2 ml/1 deciliter - an amount so small that the baby would not get drunk (THANK GOODNESS!). However, even such a small amount may cause a child to be restless as they can sense the mother's drunken condition from her stumbling around, etc....and that's why you shouldn't nurse while drunk.
However, the midwives at Kätilöopisto were of a different opinion - don't drink alcohol when you are breastfeeding.
Hmmm, I wonder who knows better?
Showing posts with label katiloopisto. Show all posts
Showing posts with label katiloopisto. Show all posts
Monday, July 18, 2005
Thursday, July 14, 2005
What Delivery and Recovery are like at Kätilöopisto
Our Peanut was born at Kätilöopisto in Helsinki and a recent visit to friends who just had a lovely baby daughter reminded me of our stay there.
A few memories that came to mind
Delivery Preparation
> When we arrived, we went to a waiting wing since labor had not yet started. It was busy enough that we had to share a room with another couple also waiting for labor to progress. We chose to go take a walk to help us relax. The midwives asked only that we let them know when we leave and return. Sharing the room was rather uncomfortable and luckily for that night we were able to make use of another room they reserve for observation.
> During the time there, midwives check in periodically and used a machine to measure the timing and intensity of contractions and the babies heartbeat. Usually the measurements took about 20 mins during which you had to stay close to the machine (sitting or standing was fine).
> The doctors make their rounds in the morning and suggest actions (in our case it was a prescription for a move to the delivery wing and insertion of an oxytocin drip to help start the contractions and a fetal heartbeat monitor attached to Peanut's head)
> I was offered an enema.
Delivery!
> Our delivery room contained a delivery table and rocking chair as well as a bathroom with a shower. There was also a dispenser for nitrous oxide (laughing gas) and equipment again for monitoring the contractions and baby's heartbeat.
> The midwives also brought in a birthing ball at my request.
> When we met the midwives, we presented our birth plan and reviewed it with them. We had to do this with several shifts of midwives.
> You are welcome to labor in any position, posture, etc that you want. Even the delivery can take place either on the bed in whichever position is most comfortable or a on a birthing stool on the floor. The midwives were very helpful in trying out several options.
> If you want an epidural, be sure to make your wished known well in advance of when you think you will need it. It takes time to bring in the ansthesiologist and to prep you for its insertion. The epidural is not instantaneous, but takes effect over a few minutes (ie more contractions!). The epidural usually lasts for 1.5 - 2 hours after which the midwives like for it to wear off completely and letting you labor for a while before topping it off. After the third refill, we were beginning to wonder if it was time to consider a C-section since I was getting tired (and had a fever for which they gave panadol), but the midwives said they prefer to try and give it a bit longer. The big surprise was that they do not want to give you an epidural as you enter the final stretch (no pun intended)!!! The reason is that the actual pushing phase is more effective if you can feel the contractions and can push with them. And, honestly, the pain at that point was not 'pain' as much as a sensation of muscles working to move the baby.
> The laughing gas is available for your use as a pain reliever whenever you want.
> After the baby is born and her nose/mouth are cleared, she is placed immediately in your lap for you to hold her skin-to-skin as they (or dad) cut the umbilical cord and carry out a few other tasks (I'm not sure what all happened down there in addition to a sample of Peanut's blood being taken since I'm Rh negative).
> Dad and the midwife then moved to the other side of the room to bathe, measure and bundle her. Her hospital band was also put on and she receives her Vitamin K injection.
> Another midwife helped me to the hospital bed where the placenta was delivered with some assistance. You can have a look at it if you like. The midwives assess its condition and take it away.
> Then with the numbing assistance of an antiseptic spray, the midwife stitched me up.
> An assitant midwife came in to help me to the shower and to put on a clean set of hospital clothes.
> In the meantime, dad is encouraged to hold the new bundle of baby and in the background paper work is being filled out.
> The assistant midwife returned with a cart of food - sandwiches, yoghurt, cookies and juice. I was surprisingly not very hungry...
> Suddenly after all the hustle and bustle, we found ourselves alone with Peanut. They gave us about 30 - 45 mins of quiet time before asking if we were ready to move to the recovery ward.
> Our midwife escorted us and our rolling baby basket to the fourth floor.
Recovery Time
> it was also busy there so we did not immediately get a family room where dad could have stayed overnight and instead had to share a room with another mom and fresh arrival (with a set of lungs!). We did immediately put our names on the list for a family room when one became available.
> I remember laying in bed with Peanut in her clear plastic basket next to me watching her through the night. All babies room-in because they want mothers and fathers to get used to life with baby right off the bat rather than having a shock when they go home alone. On one hand a good idea, but it would have been nice to have one last night of rest! If the baby is particularily fussy and crying alot, you can request to have it moved to a 'nursery' for a few hours.
> A nurse came in to quickly review the basics, gave me the blue handbook to babies and brought me a canister of water.
> The call buttom was right next to the bed and help with anything was at the other end (from diaper changing to breastfeeding, etc).
> Meal time was held in the common area. An announcement over the intercom reminded you to come for breakfast, lunch, afternoon coffee (!!), dinner and an evening snack. At first I wasn't sure what to do with Peanut during the meals - most mothers roll their baby cribs with them. Peanut slept so I just went out and brought the tray to our room. After every meal you had to drop your namecard back in the box to make sure you got a serving of the next delicious course. If you have a family room, the dad also gets his own namecard.
> the hospital gowns and robes all new moms are wearing as they wander the halls. They come in three colors - hot pink, baby blue and hospital green - and have a nifty row of buttons all the way to the bottom, making it easy for breastfeeding. They also provide socks and slippers, but its recommended you bring your own slippers --> more comfortable :-)
> and the special underwear! How can I accurately describe them? Imagine these currently popular 'boyshorts' underwear made out of a stretchy white mesh fabric with thick green seams on the sides. Available for all new moms. They were comfortable and airy that's for sure. At Kätilöopisto they are not disposable, but once used are washed and available for pick up in the bins in the hallway.
> In the common area where baby kits from Libero diapers that you could pick up for free.
> Dismissal comes after you've been cleared by the doctor :-)
A few memories that came to mind
Delivery Preparation
> When we arrived, we went to a waiting wing since labor had not yet started. It was busy enough that we had to share a room with another couple also waiting for labor to progress. We chose to go take a walk to help us relax. The midwives asked only that we let them know when we leave and return. Sharing the room was rather uncomfortable and luckily for that night we were able to make use of another room they reserve for observation.
> During the time there, midwives check in periodically and used a machine to measure the timing and intensity of contractions and the babies heartbeat. Usually the measurements took about 20 mins during which you had to stay close to the machine (sitting or standing was fine).
> The doctors make their rounds in the morning and suggest actions (in our case it was a prescription for a move to the delivery wing and insertion of an oxytocin drip to help start the contractions and a fetal heartbeat monitor attached to Peanut's head)
> I was offered an enema.
Delivery!
> Our delivery room contained a delivery table and rocking chair as well as a bathroom with a shower. There was also a dispenser for nitrous oxide (laughing gas) and equipment again for monitoring the contractions and baby's heartbeat.
> The midwives also brought in a birthing ball at my request.
> When we met the midwives, we presented our birth plan and reviewed it with them. We had to do this with several shifts of midwives.
> You are welcome to labor in any position, posture, etc that you want. Even the delivery can take place either on the bed in whichever position is most comfortable or a on a birthing stool on the floor. The midwives were very helpful in trying out several options.
> If you want an epidural, be sure to make your wished known well in advance of when you think you will need it. It takes time to bring in the ansthesiologist and to prep you for its insertion. The epidural is not instantaneous, but takes effect over a few minutes (ie more contractions!). The epidural usually lasts for 1.5 - 2 hours after which the midwives like for it to wear off completely and letting you labor for a while before topping it off. After the third refill, we were beginning to wonder if it was time to consider a C-section since I was getting tired (and had a fever for which they gave panadol), but the midwives said they prefer to try and give it a bit longer. The big surprise was that they do not want to give you an epidural as you enter the final stretch (no pun intended)!!! The reason is that the actual pushing phase is more effective if you can feel the contractions and can push with them. And, honestly, the pain at that point was not 'pain' as much as a sensation of muscles working to move the baby.
> The laughing gas is available for your use as a pain reliever whenever you want.
> After the baby is born and her nose/mouth are cleared, she is placed immediately in your lap for you to hold her skin-to-skin as they (or dad) cut the umbilical cord and carry out a few other tasks (I'm not sure what all happened down there in addition to a sample of Peanut's blood being taken since I'm Rh negative).
> Dad and the midwife then moved to the other side of the room to bathe, measure and bundle her. Her hospital band was also put on and she receives her Vitamin K injection.
> Another midwife helped me to the hospital bed where the placenta was delivered with some assistance. You can have a look at it if you like. The midwives assess its condition and take it away.
> Then with the numbing assistance of an antiseptic spray, the midwife stitched me up.
> An assitant midwife came in to help me to the shower and to put on a clean set of hospital clothes.
> In the meantime, dad is encouraged to hold the new bundle of baby and in the background paper work is being filled out.
> The assistant midwife returned with a cart of food - sandwiches, yoghurt, cookies and juice. I was surprisingly not very hungry...
> Suddenly after all the hustle and bustle, we found ourselves alone with Peanut. They gave us about 30 - 45 mins of quiet time before asking if we were ready to move to the recovery ward.
> Our midwife escorted us and our rolling baby basket to the fourth floor.
Recovery Time
> it was also busy there so we did not immediately get a family room where dad could have stayed overnight and instead had to share a room with another mom and fresh arrival (with a set of lungs!). We did immediately put our names on the list for a family room when one became available.
> I remember laying in bed with Peanut in her clear plastic basket next to me watching her through the night. All babies room-in because they want mothers and fathers to get used to life with baby right off the bat rather than having a shock when they go home alone. On one hand a good idea, but it would have been nice to have one last night of rest! If the baby is particularily fussy and crying alot, you can request to have it moved to a 'nursery' for a few hours.
> A nurse came in to quickly review the basics, gave me the blue handbook to babies and brought me a canister of water.
> The call buttom was right next to the bed and help with anything was at the other end (from diaper changing to breastfeeding, etc).
> Meal time was held in the common area. An announcement over the intercom reminded you to come for breakfast, lunch, afternoon coffee (!!), dinner and an evening snack. At first I wasn't sure what to do with Peanut during the meals - most mothers roll their baby cribs with them. Peanut slept so I just went out and brought the tray to our room. After every meal you had to drop your namecard back in the box to make sure you got a serving of the next delicious course. If you have a family room, the dad also gets his own namecard.
> the hospital gowns and robes all new moms are wearing as they wander the halls. They come in three colors - hot pink, baby blue and hospital green - and have a nifty row of buttons all the way to the bottom, making it easy for breastfeeding. They also provide socks and slippers, but its recommended you bring your own slippers --> more comfortable :-)
> and the special underwear! How can I accurately describe them? Imagine these currently popular 'boyshorts' underwear made out of a stretchy white mesh fabric with thick green seams on the sides. Available for all new moms. They were comfortable and airy that's for sure. At Kätilöopisto they are not disposable, but once used are washed and available for pick up in the bins in the hallway.
> In the common area where baby kits from Libero diapers that you could pick up for free.
> Dismissal comes after you've been cleared by the doctor :-)
Monday, June 20, 2005
Boy or Girl? We can't tell you...
Like many parents, we wanted to know if our Peanut was a boy or a girl before her birth.
Since I didn't have the amniocentesis test, the method open to us was to have an ultrasound.
In Helsinki (perhaps all of Finland), a woman has two ultrasound exams during her pregnancy to monitor the development of the fetus. The first one is around week 12 and the second around week 22. The ultrasounds are usually done at the maternity hospital where the baby will be born. In our case this was the Kätilöopisto.
The first ultrasound is to check the development and identify any potential issues, such as swelling or fluid at the base of the neck (a possible sign of Down's Syndrome). It also is used to determine the estimated due date by taking a measure of the femur to estimate the baby's age. We also saw the beginnings of the stomach and brain formation. In this exam, the used both an internal and external ultrasound device.
The second is more extensive and covers the development of the internal organs and the brain. In particular they check the position of the placenta; measure the head and femer; development of brain and its chambers; heart and its chambers; kidneys and urinary tract; stomach; backbone; umbilical cord and the amount of embroyotic fluid. Its at this age that the gender of the baby could also been seen.
However, public hospitals are told specifically that they cannot tell parents the gender of the baby - even if the technician is able to see it. One reason is that these are publically funded hospitals and they don't want to waste money or time on a item that is not critical to the health of the baby. Time is certainly an issue - I was 'triple-booked' for my ultrasound slot, meaning my turn would come once the person who had the actual time slot and the person double-booked for it had their exams! Another reason is that ultrasounds are not a 100% accurate way to determine gender. They don't want the responsibility of giving parents the wrong information.
Each one cost me 22 EUR and we were given several "photo" print outs to take home. These we quickly scanned and emailed off to the anxiously awaiting grandparents and family for their first glimpses of Peanut.
How to Find Out
Well, we still wanted to know. So we had to go to a private clinic for another ultrasound.
We chose to go to Femeda, a clinic in Helsinki on the recommendation of a friend and also because they have 3D ultrasounds! I think Peanut's Dad was especially fascinated by the technology :-)
It was admittedly very cool to see a 3D image of Peanut. This was printed out and could be recorded onto a VCR tape or DVD. Both of which we forgot at home, but we re able to purchase at the clinic. During the exam we also saw more detailed images of the organs and could see that her facial features were forming normally (ie, no cleft lip). Every one of these visits is reassuring to expectant parents. Though the 3D peek was almost seemed to be a bit more than we should be seeing - somehow almost invading her privacy.
This visit was more expensive - around 150 EUR with a portion refundable by KELA.
Since I didn't have the amniocentesis test, the method open to us was to have an ultrasound.
In Helsinki (perhaps all of Finland), a woman has two ultrasound exams during her pregnancy to monitor the development of the fetus. The first one is around week 12 and the second around week 22. The ultrasounds are usually done at the maternity hospital where the baby will be born. In our case this was the Kätilöopisto.
The first ultrasound is to check the development and identify any potential issues, such as swelling or fluid at the base of the neck (a possible sign of Down's Syndrome). It also is used to determine the estimated due date by taking a measure of the femur to estimate the baby's age. We also saw the beginnings of the stomach and brain formation. In this exam, the used both an internal and external ultrasound device.
The second is more extensive and covers the development of the internal organs and the brain. In particular they check the position of the placenta; measure the head and femer; development of brain and its chambers; heart and its chambers; kidneys and urinary tract; stomach; backbone; umbilical cord and the amount of embroyotic fluid. Its at this age that the gender of the baby could also been seen.
However, public hospitals are told specifically that they cannot tell parents the gender of the baby - even if the technician is able to see it. One reason is that these are publically funded hospitals and they don't want to waste money or time on a item that is not critical to the health of the baby. Time is certainly an issue - I was 'triple-booked' for my ultrasound slot, meaning my turn would come once the person who had the actual time slot and the person double-booked for it had their exams! Another reason is that ultrasounds are not a 100% accurate way to determine gender. They don't want the responsibility of giving parents the wrong information.
Each one cost me 22 EUR and we were given several "photo" print outs to take home. These we quickly scanned and emailed off to the anxiously awaiting grandparents and family for their first glimpses of Peanut.
How to Find Out
Well, we still wanted to know. So we had to go to a private clinic for another ultrasound.
We chose to go to Femeda, a clinic in Helsinki on the recommendation of a friend and also because they have 3D ultrasounds! I think Peanut's Dad was especially fascinated by the technology :-)
It was admittedly very cool to see a 3D image of Peanut. This was printed out and could be recorded onto a VCR tape or DVD. Both of which we forgot at home, but we re able to purchase at the clinic. During the exam we also saw more detailed images of the organs and could see that her facial features were forming normally (ie, no cleft lip). Every one of these visits is reassuring to expectant parents. Though the 3D peek was almost seemed to be a bit more than we should be seeing - somehow almost invading her privacy.
This visit was more expensive - around 150 EUR with a portion refundable by KELA.
Sunday, June 05, 2005
Delivery from a dad's point of view
Sure, it is kinda late for me to post this now, Peanut is 7 weeks old. No, it did not take me 7 weeks to mentally recover from the delivery, we have recently moved and getting the new place up and running has taken quite some time. Anyway, this article is specifically for the non-physically-pregnant part of the couple. In most cases you will probably be "dad" like me - but this applies to anyone entering the maternity clinic to support a delivery.
So, in modern times in Finland, the dad is expected to play an active role in the delivery room. In all honesty, the thought of being there scared me. I don't handle blood well and the prospect of seeing my lovely wife in pain just made me feel like I did not want to be there. Which is silly really, because she probably needed my presence more than at any time before in her life [except for conceiving the baby :-)].
Despite your active role, do not expect the maternity hospital or the delivery room to specifically cater to the husband. You will have to bring your own food and drinks. Make sure you get some filling foods that will slowly release energy. A delivery can take quite some time (36 Hours in our case). Some caffinated drinks such as coke/pepsi might be good. Don't eat only sugar based energy boosters. They will give you a sugar rush, leaving you more tired than you were before you took it. We had our baby in Kätilöopisto and they have a small relaxation room for dads with a microwave, coffee maker and some other basics. Check it out on one of their tours.
In case of a long delivery, you are also going to make sure you get a break and some rest. When Peanut's mom got an epidural during the delivery process, she fell asleep. I took that time to quickly go home, freshen up and call my mom to get some support. You need to be in shape to support your wife when she gets back to feeling pain and in the final stages of delivery, so you need to manage your own energy levels to make sure you can do that. If the hospital is very full, like when we were having Peanut, you wont be able to sleep in the hospital during your breaks in the birthing process or after the birth. If the hospital is far from home (>20 mins) make sure you can crash at a friend's place close to the hospital or book a nearby hotel. If you are going to Kätilöopisto in Helsinki, there is a Holiday-Inn hotel next to "Messukeskus", close to Hartwall Areena, about 10-15 minutes from the hospital by car.
In the delivery room there really is not that much you can do. The midwife will take care of all the essentials. Ask her to explain what she's doing so you know what is going on. Most midwives speak decent English. Note that a midwife in Finland is really an educated health worker. She's authorized to give injections, install drips etc.
Way before delivery, discuss with the soon to be mother how she would like to give birth. Go through the birth plan if she has one. If she doesn't have one, make one with her. See a previous article on this blog for details. This way you can help in directing the delivery in the way that the mother to be would like. Once the contractions start coming thick and fast, she wont be able to talk or concentrate much, but decisions will need to be made. Other than that, you can help with pain relief, for instance by helping her take the laughing gass in time, applying a hotpack to the lower back and wiping her forehead with a cold cloth.
Once in the pushing stage, your need to support her will depend on the birthing position. If she's on her back, there probably isn't much you can do. If she's ona birthing stool, you'll have to physically support her, which makes for an intense and involved experience. But let that not dictate what position to use, the most important thing is that the baby makes it out quick and safe, the 2nd most important that mom-to-be is as healthy and comfortable as possible.
Finally, giving birth is not a clean, clinical process. There is pain, blood, liquids, needles etc. But you will not be bothered by any of this. You will hardly remember it afterwards. I am probably the least suitable person to enter the delivery room when it comes to these things, but I survived and that means you can do it too. And it is a great experience!
So, in modern times in Finland, the dad is expected to play an active role in the delivery room. In all honesty, the thought of being there scared me. I don't handle blood well and the prospect of seeing my lovely wife in pain just made me feel like I did not want to be there. Which is silly really, because she probably needed my presence more than at any time before in her life [except for conceiving the baby :-)].
Despite your active role, do not expect the maternity hospital or the delivery room to specifically cater to the husband. You will have to bring your own food and drinks. Make sure you get some filling foods that will slowly release energy. A delivery can take quite some time (36 Hours in our case). Some caffinated drinks such as coke/pepsi might be good. Don't eat only sugar based energy boosters. They will give you a sugar rush, leaving you more tired than you were before you took it. We had our baby in Kätilöopisto and they have a small relaxation room for dads with a microwave, coffee maker and some other basics. Check it out on one of their tours.
In case of a long delivery, you are also going to make sure you get a break and some rest. When Peanut's mom got an epidural during the delivery process, she fell asleep. I took that time to quickly go home, freshen up and call my mom to get some support. You need to be in shape to support your wife when she gets back to feeling pain and in the final stages of delivery, so you need to manage your own energy levels to make sure you can do that. If the hospital is very full, like when we were having Peanut, you wont be able to sleep in the hospital during your breaks in the birthing process or after the birth. If the hospital is far from home (>20 mins) make sure you can crash at a friend's place close to the hospital or book a nearby hotel. If you are going to Kätilöopisto in Helsinki, there is a Holiday-Inn hotel next to "Messukeskus", close to Hartwall Areena, about 10-15 minutes from the hospital by car.
In the delivery room there really is not that much you can do. The midwife will take care of all the essentials. Ask her to explain what she's doing so you know what is going on. Most midwives speak decent English. Note that a midwife in Finland is really an educated health worker. She's authorized to give injections, install drips etc.
Way before delivery, discuss with the soon to be mother how she would like to give birth. Go through the birth plan if she has one. If she doesn't have one, make one with her. See a previous article on this blog for details. This way you can help in directing the delivery in the way that the mother to be would like. Once the contractions start coming thick and fast, she wont be able to talk or concentrate much, but decisions will need to be made. Other than that, you can help with pain relief, for instance by helping her take the laughing gass in time, applying a hotpack to the lower back and wiping her forehead with a cold cloth.
Once in the pushing stage, your need to support her will depend on the birthing position. If she's on her back, there probably isn't much you can do. If she's ona birthing stool, you'll have to physically support her, which makes for an intense and involved experience. But let that not dictate what position to use, the most important thing is that the baby makes it out quick and safe, the 2nd most important that mom-to-be is as healthy and comfortable as possible.
Finally, giving birth is not a clean, clinical process. There is pain, blood, liquids, needles etc. But you will not be bothered by any of this. You will hardly remember it afterwards. I am probably the least suitable person to enter the delivery room when it comes to these things, but I survived and that means you can do it too. And it is a great experience!
Wednesday, May 11, 2005
Baby advice to get you started
During our two day post partum hospital stay, the nurses and midwives made sure we were ready to face the world as parents.
Some of the advice we received:
> if you're breastfeeding- which it is almost assumed that you will -
- you can eat whatever you like - just do it in moderation and take care to see if anything gives the baby a reaction.
- demand feed your baby. Baby knows when she is hungry and will let you know.
- don't let the baby sleep through a feeding. Even at night you should wake the baby up if she's slept more than 4 hours.
- if you have an oversupply of milk, you can donate to the hospital's 'Milk Bank' that's used for babies whose mothers' can't feed them.
> Bathe the baby only after the umbilical cord stump falls off.
> Baby should go outside only after the two week visit by the midwife to your home. Then for 15 minutes for the first time and 30 mins the second time, etc.
> Baby can easily be carried around if you hook your thumb under its armpit and put her in the crook of your arm.
> This is also the ideal position to hold her when you rinse her between diapers. By rinse, I mean taking baby to the bathroom sink to clean her bum after a dirty diaper. Here we just splash water on her rather than using diaper wipes.
> Baby should wear about the same amount of clothing as you. Except, when you take her out. Don't overbundle,but dress according to what you would wear outside if you were just sitting in the elements. It was recommended that we use an outsuit until the outside temp is at least 20 C.
> be careful not to let baby overheat in the pram, especially during summer. It can get quite warm - put a themometer in there one day just to see for yourself.
If you've got more baby starter advice - pls post a comment!
Some of the advice we received:
> if you're breastfeeding- which it is almost assumed that you will -
- you can eat whatever you like - just do it in moderation and take care to see if anything gives the baby a reaction.
- demand feed your baby. Baby knows when she is hungry and will let you know.
- don't let the baby sleep through a feeding. Even at night you should wake the baby up if she's slept more than 4 hours.
- if you have an oversupply of milk, you can donate to the hospital's 'Milk Bank' that's used for babies whose mothers' can't feed them.
> Bathe the baby only after the umbilical cord stump falls off.
> Baby should go outside only after the two week visit by the midwife to your home. Then for 15 minutes for the first time and 30 mins the second time, etc.
> Baby can easily be carried around if you hook your thumb under its armpit and put her in the crook of your arm.
> This is also the ideal position to hold her when you rinse her between diapers. By rinse, I mean taking baby to the bathroom sink to clean her bum after a dirty diaper. Here we just splash water on her rather than using diaper wipes.
> Baby should wear about the same amount of clothing as you. Except, when you take her out. Don't overbundle,but dress according to what you would wear outside if you were just sitting in the elements. It was recommended that we use an outsuit until the outside temp is at least 20 C.
> be careful not to let baby overheat in the pram, especially during summer. It can get quite warm - put a themometer in there one day just to see for yourself.
If you've got more baby starter advice - pls post a comment!
And your total hospital bill will be --- 130 EURS
Only?! When will we be billed for the rest? I was pretty surprised when the hospital bill for Peanut's delivery arrived - and it was only 130 EURS!
We were in the hospital for several days before and after the delivery. I made liberal use of the pain killers available - including having an epidural and two additional injections. There was loads of monitoring equipment used during the delivery -- not to mention many other medications. Peanut's dad also stayed overnight in the hospital with us in a private room. We saw a pediatrician for Peanut and I had a post partum check-up with a midwife. We ate lots of hospital food.
Yet, it really all cost only 130 EURS - it was the food that got us in the end.
The bill really only was for the meals we ate - about 22 EURs a day for each of us. In addition to breakfast, lunch and dinner, we had afternoon coffee and a snacktime in the evenings. The fare was bland and seemed surprisingly low on veggies. But, I guess for breastfeeding moms you want to keep it simple, but filling. The afternoon coffee break seemed ususal since I thought we shouldn't have too much caffine, but in a country of ardent coffee lovers, it would be hard to imagine a day without a coffee break!
We had selected on of the public hospitals - the Kätilöopisito - and did not use any private health insurance. I can only imagine what all this would have cost in the US for someone without insurance! Here it was a case of a good return on the oodles of taxes we pay. I suspect we'll continue to see more benefits of the system as we venture with Peanut. So far, all of our pre-natal visits were entirely free and our post-natal vists will also be - as long as we make use of the public clinics and doctors.
We were in the hospital for several days before and after the delivery. I made liberal use of the pain killers available - including having an epidural and two additional injections. There was loads of monitoring equipment used during the delivery -- not to mention many other medications. Peanut's dad also stayed overnight in the hospital with us in a private room. We saw a pediatrician for Peanut and I had a post partum check-up with a midwife. We ate lots of hospital food.
Yet, it really all cost only 130 EURS - it was the food that got us in the end.
The bill really only was for the meals we ate - about 22 EURs a day for each of us. In addition to breakfast, lunch and dinner, we had afternoon coffee and a snacktime in the evenings. The fare was bland and seemed surprisingly low on veggies. But, I guess for breastfeeding moms you want to keep it simple, but filling. The afternoon coffee break seemed ususal since I thought we shouldn't have too much caffine, but in a country of ardent coffee lovers, it would be hard to imagine a day without a coffee break!
We had selected on of the public hospitals - the Kätilöopisito - and did not use any private health insurance. I can only imagine what all this would have cost in the US for someone without insurance! Here it was a case of a good return on the oodles of taxes we pay. I suspect we'll continue to see more benefits of the system as we venture with Peanut. So far, all of our pre-natal visits were entirely free and our post-natal vists will also be - as long as we make use of the public clinics and doctors.
Monday, April 11, 2005
How overdue babies are monitored
Week 41 + 3 days
So, we're not officially overdue until week 42 according to the doctor today.
In Finland, once you are 10 days past your due date, you are sent to your maternity hospital for observation rather than your usual health center (neuvola). We are registered at the Kätilöopisito (Midwife University Hospital) or "Kättäri" in Helsinki.
http://www.hus.fi/default.asp?path=1,32,660,546,960
When I called to make my appointment last Friday, I was told it was very busy today and was asked if we'd be willing to have an intern participate in the interview and ultrasound. I agreed since I know its an important part of their education and was assured that the students would be supervised in the interview by the head doctor.
We first met with a midwife who used an external heartbeat monitor for about 20 mins to see if the baby was under stress. She also handled the usual clinic-visit tests: blood pressure, urine analysis and belly palpatations to check on the baby's position.
We were then passed down the hallway to wait for the intern -- or what turned out to be interns. First, a group of three males who were then joined by another two female students! It was quite an audience, but they were all very pleasant. One was acting as the examining doctor and ran through a routine list of questions about my current and past condition. The doctor himself came in towards the end of the interview and listened as the intern reviewed what he had learned.
I then moved onto the examing table - fully clothed since this was just an external exam and ultrasound. I found it interesting to listen to the doctor as he explained to the students what he was doing and why. He also did the routine palpatations to check the baby's position and head position (degree of engagement) and measured the size of the uterus.
He introduced a 'potato sack' move for guesstimating the weight. With his hands cupped on either side of the belly, he gave it a moderate shake to see how much moved and how much resistance it gave him. One of the students, later tried the 'milk carton' method where by eyeing how many liter sized milk cartons would fit across the belly, he came up with his own estimate.
Following the doctor, the interns lined up to have a turn nudging and measuring my belly. I had to draw the line at three of them as I began to feel a bit dizzy from laying down on back so long. They were all most concerned about having cold hands -- and one of them must have really been rubbing his hands together to warm them up before touching me :-)
Next up was the ultrasound examination. This was performed entirely by the doctor with him occassionally posing questions to the students. He first checked for the amount of amniotic fluid by scanning the four quadrants of the uterus for pockets of it. Next was a review of the health of the placenta which evidently begins to calcify and become porous as it ages. He then checked for 'breathing motions' - either by actually watching the diaphragm or stomach move. Following that was a review of the heartbeat and bloodflow through the heart. Last up was a birth weight estimate based on the circumfrance of the head, length of the femur and most importantly - the size of the stomach! This was a surprise to me, but evidently, its one of the most reliable measurements for babies and adults, alike. The ultrasound's automatic calculations were throwing up very odd estimated due dates and the doctor explained that the earliest ultrasounds are actually the most accurate and the later it gets, the less accurate this estimate becomes.
We picked up all sorts of extra details and information from the lecturing the doctor did during the examination, but it was a bit strange sitting there feeling more like a case study sub ject than the actual patient. I've decided against having any students attend the actual delivery and birth because of this - no need for an audience or anything that will take the concentration from us. After sharing this part of our pregnancy with a group of interns, I can with a clear concious refuse :-)
At the close of the visit, we as group discussed how ineffective estimated due dates actual can be. Only a very, very small percentage (around 6%) of babies are actually born on their EDD, yet the anxious parents-to-be (not to mention the equally excited relatives and friends) often watch the date come and go. Though we tried to prep ourselves that its plus/minus two weeks from the due date, being on the minus side was definitely easier. And, even if 'overdue' doesn't officially kick in until 42 weeks, we find ourselves constantly talking about Peanut being late and answering curious inquiries from family & friends who wonder if we've just forgotten to inform them about her birth. The doctor was proposing a 'birth month' as guidance for expectant parents rather than a date to be circled on the calendar. I think it would have relieved me of some anxities and the feeling of somehow being off schedule.
At this point, the doctor said no internal exam was neccessary because whether the cervix was ripe or not was almost immaterial since there have been no contractions and everything looked normal. He went on to explain to the horror of the students that the US, they most likely would not let a pregnancy carry on so long and would force the cervix to ripen manually with a balloon sort of instrument.
In the end, the prognosis was that Peanut was doing just fine still and there was no reason to help her out yet. We have another appointment in three days for a similar examination.
Total cost = 22 euros
So, we're not officially overdue until week 42 according to the doctor today.
In Finland, once you are 10 days past your due date, you are sent to your maternity hospital for observation rather than your usual health center (neuvola). We are registered at the Kätilöopisito (Midwife University Hospital) or "Kättäri" in Helsinki.
http://www.hus.fi/default.asp?path=1,32,660,546,960
When I called to make my appointment last Friday, I was told it was very busy today and was asked if we'd be willing to have an intern participate in the interview and ultrasound. I agreed since I know its an important part of their education and was assured that the students would be supervised in the interview by the head doctor.
We first met with a midwife who used an external heartbeat monitor for about 20 mins to see if the baby was under stress. She also handled the usual clinic-visit tests: blood pressure, urine analysis and belly palpatations to check on the baby's position.
We were then passed down the hallway to wait for the intern -- or what turned out to be interns. First, a group of three males who were then joined by another two female students! It was quite an audience, but they were all very pleasant. One was acting as the examining doctor and ran through a routine list of questions about my current and past condition. The doctor himself came in towards the end of the interview and listened as the intern reviewed what he had learned.
I then moved onto the examing table - fully clothed since this was just an external exam and ultrasound. I found it interesting to listen to the doctor as he explained to the students what he was doing and why. He also did the routine palpatations to check the baby's position and head position (degree of engagement) and measured the size of the uterus.
He introduced a 'potato sack' move for guesstimating the weight. With his hands cupped on either side of the belly, he gave it a moderate shake to see how much moved and how much resistance it gave him. One of the students, later tried the 'milk carton' method where by eyeing how many liter sized milk cartons would fit across the belly, he came up with his own estimate.
Following the doctor, the interns lined up to have a turn nudging and measuring my belly. I had to draw the line at three of them as I began to feel a bit dizzy from laying down on back so long. They were all most concerned about having cold hands -- and one of them must have really been rubbing his hands together to warm them up before touching me :-)
Next up was the ultrasound examination. This was performed entirely by the doctor with him occassionally posing questions to the students. He first checked for the amount of amniotic fluid by scanning the four quadrants of the uterus for pockets of it. Next was a review of the health of the placenta which evidently begins to calcify and become porous as it ages. He then checked for 'breathing motions' - either by actually watching the diaphragm or stomach move. Following that was a review of the heartbeat and bloodflow through the heart. Last up was a birth weight estimate based on the circumfrance of the head, length of the femur and most importantly - the size of the stomach! This was a surprise to me, but evidently, its one of the most reliable measurements for babies and adults, alike. The ultrasound's automatic calculations were throwing up very odd estimated due dates and the doctor explained that the earliest ultrasounds are actually the most accurate and the later it gets, the less accurate this estimate becomes.
We picked up all sorts of extra details and information from the lecturing the doctor did during the examination, but it was a bit strange sitting there feeling more like a case study sub ject than the actual patient. I've decided against having any students attend the actual delivery and birth because of this - no need for an audience or anything that will take the concentration from us. After sharing this part of our pregnancy with a group of interns, I can with a clear concious refuse :-)
At the close of the visit, we as group discussed how ineffective estimated due dates actual can be. Only a very, very small percentage (around 6%) of babies are actually born on their EDD, yet the anxious parents-to-be (not to mention the equally excited relatives and friends) often watch the date come and go. Though we tried to prep ourselves that its plus/minus two weeks from the due date, being on the minus side was definitely easier. And, even if 'overdue' doesn't officially kick in until 42 weeks, we find ourselves constantly talking about Peanut being late and answering curious inquiries from family & friends who wonder if we've just forgotten to inform them about her birth. The doctor was proposing a 'birth month' as guidance for expectant parents rather than a date to be circled on the calendar. I think it would have relieved me of some anxities and the feeling of somehow being off schedule.
At this point, the doctor said no internal exam was neccessary because whether the cervix was ripe or not was almost immaterial since there have been no contractions and everything looked normal. He went on to explain to the horror of the students that the US, they most likely would not let a pregnancy carry on so long and would force the cervix to ripen manually with a balloon sort of instrument.
In the end, the prognosis was that Peanut was doing just fine still and there was no reason to help her out yet. We have another appointment in three days for a similar examination.
Total cost = 22 euros
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