Friday, June 10, 2005

Waiting Game

... and now, i'm playing waiting game with my baby, waiting for the time she wants to be born...fyuh..

jangan nyesel kalo udah lahir ya de, ternyata dunia ini tidak seindah yang didenger dari dalem rahim, ternyata di dunia ini banyak korupsi.. hehe...

Thursday, June 02, 2005

The stages of labor

The stages of labor
Approved by the BabyCenter Medical Advisory Board

The process you'll go through during labor and childbirth can be divided into three stages. The first stage of labor consists of an early phase that begins with the onset of contractions and the gradual effacement (thinning out) and dilation (opening) of the cervix, followed by an active phase in which the cervix begins to dilate more rapidly and contractions are longer, stronger, and closer together (it's usually time to call your doctor or midwife at this point). The active phase ends with a "transition period" as the cervix fully dilates to 10 centimeters. The second stage begins once you're fully dilated and ends with the birth of your baby; this period is often referred to as the pushing stage. The third stage begins right after the birth of your baby and involves the separation and delivery of the placenta.

For first-time moms, the process of labor and delivery takes an average of 15 hours, although for plenty of women it lasts more than 20 hours, and for a lucky few it's over much sooner. For women who've been through labor before, deliveries average around eight hours.

First Stage: The Early Phase
The first part of the first stage of labor is called the early, or latent, phase. It begins with the onset of regular contractions that cause the cervix to start slowly effacing and dilating. It's often hard to tell exactly when these regular contractions begin because they may be hard to distinguish from the irregular, inefficient Braxton Hicks contractions that usually precede them. But once your contractions are coming at regular intervals and your cervix begins to dilate, you are officially in labor. Your contractions will then gradually become stronger and more frequent, and last longer. While the experience of labor can vary widely, a typical one might start out with contractions coming every ten minutes, lasting 30 seconds each, and gradually increasing to every five minutes, lasting 40 to 60 seconds each. Some women will have much more frequent contractions during this phase, though the contractions will still tend to be mild and last less than a minute. You may also notice increasing mucous discharge from the vagina, which may be tinged with blood — the so-called "bloody show." This is perfectly normal; however, if you see more than a tinge of blood, be sure to call your midwife or doctor. (Also call your midwife or doctor if you break your bag of waters, even if you're not having any contractions yet.) The early phase ends when your cervix is approximately 3 to 5 centimeters dilated and your progress starts to accelerate.

How long it lasts: This phase can take from 12 to 14 hours or longer, although it's often considerably shorter for second and subsequent babies.

What it feels like and how to get through it: Your contractions will usually become more regular, intense, and painful than the earlier Braxton Hicks contractions you may have been feeling. Sometimes the contractions in the latent phase can be quite painful, though they may be dilating your cervix much more slowly than you'd like! If you're typical, though, your contractions in this early phase won't require the same attention that they will later in labor. You'll probably find that you can still talk through your contractions and putter around the house. You may feel like taking a walk or a warm bath or watching a video.

Don't become a slave to your stopwatch during early labor — it can be stressful and exhausting to record every contraction over the many long hours, and it isn't necessary. Instead you may want to time them periodically to get a sense of what's going on. In most cases, your contractions will let you know (in no uncertain terms) when it's time to take them more seriously! Meanwhile, it's important to do your best to stay rested, since you may have a long day (or night) ahead of you. Some women even doze off between contractions. (If you can actually sleep through them, it's another sign you're not in true labor yet!) Also, be sure to drink plenty of fluids so that you stay well hydrated. And don't forget to urinate frequently (even if you don't feel the urge), since an empty bladder leaves more room for the baby to descend.

First Stage: The Active Phase
The active phase of labor is when things really get going in preparation for delivery. Your contractions will become more frequent, longer, and stronger, and your cervix will begin dilating faster. As a general rule, once you've had regular, painful contractions (each lasting about 60 seconds) every five minutes for an hour, it's time to call your midwife or doctor. (Some providers may prefer to receive an early warning during your latent phase; when to call is something you will have discussed with them in advance.) In most cases, the frequency of your contractions eventually increases to every two to three minutes. However, some women may never have contractions more often than every five minutes. The latter part of the active phase is often referred to as the "transition" period and is dealt with separately in the next section.

How long it lasts: This phase can last up to six or more hours, although it can be a lot shorter, especially if you've previously had a vaginal delivery.

What it feels like and how to get through it: Now the real work of labor has begun. In contrast to the previous phase, you'll no longer be able to talk through your contractions. Breathing exercises, relaxation techniques, and a good labor coach can be a huge help during this stage. Massage and lots of gentle encouragement can be a big help, too.

By now, you may have arrived at the hospital or birth center. If you have no medical or obstetric complications, you should be able to move around the room. You may find that it feels good to walk but will probably want to stop and lean against someone (or something) during each contraction. If you're feeling exhausted, sitting in a rocking chair or lying in bed on your left side will work fine as well. This might be a good time to take a warm shower or bath if you have access to a tub. Warm water can really help ease the pain of labor, and women sometimes progress quite rapidly with the relaxation that water provides.

If you're having great difficulty coping or have little interest in natural childbirth, this is when you might opt for some pain medication. With systemic pain relief, usually delivered by IV or injection, you'll still feel the contractions but to a lesser extent. Since the medication might make you feel drowsy or dizzy, you won't be allowed to walk around after receiving it. Generally, regional anesthesia (such as an epidural and/or spinal) will provide you with much more complete pain relief, although you might continue to feel some pressure if your baby is low in your pelvis.

First Stage: The Transition Period
The last part of the active phase is called the transition period because it marks the transition to the second stage of labor. Contractions are usually very strong during transition, coming about every two and a half to three minutes and lasting a minute or even a little longer. Your cervix continues to dilate from 8 to a full 10 centimeters.

How long it takes: Transition can last anywhere from a few minutes up to a few hours. It is much more likely to be rapid if you've already had a vaginal delivery.

What it feels like and how to get through it: This is the most intense phase of labor, with contractions coming hard and fast, and with symptoms that may include shaking, shivering, and nausea. Some women who have been coping well up to this point begin to "lose it" during transition. They might reject those around them but clearly have trouble being left alone. Some women who have previously expressed the desire for a drug-free birth may now begin to lose faith in their ability to make it through. This is the time when you'll need lots of encouragement. If you've made it this far without medication, you can usually be coached through transition, one contraction at a time, with constant reminders that you're doing a great job and the end is near.

By the culmination of the first stage of labor, when the cervix reaches full dilation, the baby has usually descended somewhat into the pelvic area. This is when you might begin to feel rectal pressure, as if you have to move your bowels. Some women begin to bear down spontaneously and may even start making some deep grunting sounds. There is often a lot more bloody discharge. You may also feel nauseated or even vomit as you make the transition to second stage.

If you've had an epidural, you'll feel varying amounts of pressure, depending on the type and amount of medication you're getting. If you'd like to become a more active participant in the second stage of labor, you can ask to have the dose reduced at the end of the first stage of labor.

Second Stage
Once your cervix is fully dilated, the work of the second stage begins: the descent and ultimate birth of your baby.

How long it lasts: This stage can last anywhere from minutes to hours. The average duration of the second stage is close to an hour for a first-timer (or longer if you have an epidural) and 20 minutes if you've previously had a vaginal delivery.

What it feels like and how to get through it: Your contractions may be a little further apart in the second stage than during transition, giving you the chance for a much needed and well-deserved rest between them. As the uterus contracts, it exerts pressure on your baby, moving him down the birth canal. Some women feel an involuntary urge to push early in the second stage, while others don't have this sensation until the baby is lower down. Depending on your wishes, your particular situation, and the practice patterns of your doctor or midwife, you may be coached to push with each contraction in an effort to speed up the baby's descent. Or you might take it more slowly, and let the uterus do the work by itself until you spontaneously feel the urge to push. If you have an epidural, you'll need explicit coaching to help you to push effectively.

Although it can be hard and exhausting, many women find the work of the second stage to be deeply satisfying. While some find the intense sensation of pressure while pushing to be very uncomfortable and even scary, many laboring mothers find that working with the contractions and being an active participant is exciting and helps to dull the pain of the contractions.

It's important to pay attention to the signals your body is giving you during second stage. Try different positions for pushing until you find one that feels right and is effective for you. Squatting or sitting works well for some women, but not all. If you have back labor (where the baby is positioned face up) you might find that pushing on all fours is more comfortable and effective. If you're exhausted, pushing while lying on your left side often works quite well and can allow you to rest between contractions. It is not unusual to use a variety of different positions during the second stage.

The descent of your baby can be rapid or, as is often the case if this is your first, more gradual. With each contraction, the force of your uterus — combined with the force of your abdominal muscles if you're actively pushing — exerts pressure on your baby as he continues to move down through the birth canal. When a contraction is over and your uterus is relaxed, your baby's head will recede slightly. It's like a two steps forward, one step backward type of progression.

After a time, your perineum will begin to bulge with each push, and before long, your baby's scalp will become visible. You can ask for a mirror to get that first glimpse of your baby, or you may simply want to reach down and touch the top of your baby's head. It's a very exciting moment as you realize that, yes, I am going to have a baby! And soon!

The urge to push becomes even more compelling than before. With each contraction, more and more of your baby's head becomes visible. The pressure of his head on your perineum feels very intense, and you may have an unpleasant burning sensation as your tissue begins to stretch. (This feeling is sometimes called "the ring of fire.") At some point, you may be asked to push more gently (or not to push at all) so the head can gradually stretch out your vagina and perineum — a slow, controlled birth is essential to prevent your skin from tearing. By now, the urge to push can become so overwhelming that, to counter the urge, you'll be coached to blow or pant.

The baby's head continues to advance with each push until it "crowns" — this is the term used to describe the time when the widest part of your baby's head is finally visible. The excitement in the room is palpable as your baby's face begins to appear: the forehead, nose, mouth, and, finally, the chin. It's a moment of unparalleled beauty.

After the head delivers, you'll be coached to pant while your midwife or doctor suctions the baby's mouth and nose, and feels around the neck for the umbilical cord. (No need to worry — if the cord is around your baby's neck, it's either slipped over his head or, if need be, doubly clamped and cut.) His head then turns to the side as his shoulders rotate inside the pelvis to get into position for their exit. With the next contraction, you'll be coached to push as his shoulders deliver, one at a time, followed by the body. Your baby needs to be kept warm and will be dried off with a towel. You can ask ahead of time that (if all is well) your baby be lifted onto your bare abdomen as soon as he is born so you can touch, kiss, and simply marvel at him. The skin-to-skin contact will keep your baby nice and toasty.

Congratulations! You did it, and your baby is finally here! It's a special moment, and you may feel a wide range of intense emotions: euphoria, awe, pride, disbelief, excitement (to name but a few), and, of course, relief. Exhausted as you may be, you're also likely to feel a huge burst of energy, and any thoughts of sleep will vanish for the time being.

Third Stage
The third stage of labor begins immediately after the birth of your baby and ends with the delivery of the placenta. Shortly after your baby is born, your uterus begins to contract again. The first few contractions usually separate the placenta from the uterine wall. When your midwife or doctor sees signs of separation, she may ask you to gently push to help expel the placenta. (This is usually one short push and is not at all difficult or painful.) After you deliver the placenta, your uterus should contract and get very firm. You'll be able to feel the top of it in your abdomen, around the level of your navel. Your midwife or doctor, and later your nurse, will periodically check to see that it remains firm. A well-contracted uterus is necessary to prevent continued bleeding from the place where the placenta was attached. Nursing your baby triggers your body to release oxytocin and helps to keep the uterus well contracted. If you're not nursing or are bleeding excessively, you may be given medication to help your uterus contract, either intravenously or by injection.

How long it lasts: Mild contractions generally resume within about three to five minutes after the arrival of your baby. The third stage of labor can take only a few minutes or last up to 30 minutes or so. On average, you can expect it to take about five to ten minutes.

What it feels like and how to get through it: The contractions in the third stage are relatively mild. By now your focus has shifted to your baby, and you may well be oblivious to what else is going on around you. If this is your first baby, you may feel only a few contractions after you've delivered the placenta. (If you've had a baby before, you may continue to feel contractions intermittently for the next day or two.) These so-called afterbirth pains can feel surprisingly uncomfortable, like strong menstrual cramps. If they bother you a lot, ask for pain medication. You may also find that you get a case of the chills or feel very shaky. This is perfectly normal and won't last long. Ask for a warm blanket, since that can be very soothing.

And then what? Your midwife or doctor will examine the placenta to make sure it's intact. Then she'll check you thoroughly to see if you have any tears that need to be stitched. If you have lacerations or had an episiotomy, you may be given an injection of a local anesthetic before being sutured. You may want to hold your newborn while you're getting stitches — it can be a great distraction. Or, if you feel too shaky, ask your partner to sit by your side and hold your new arrival.

If you had an epidural during labor, the anesthesiologist or nurse anesthetist will come by and remove the catheter from your back. (This takes just a second and doesn't hurt.) Unless your baby is in need of special care, be sure to insist on some quiet time together. The eye drops, vitamin K, and footprints can wait a short while — you and your partner will want to share this special time with each other as you get acquainted with your new baby and revel in the miracle of his birth.

from www.babycenter.com

Wednesday, June 01, 2005

Bersyukur

Entah selama ini aku kurang bersyukur apa orang laen yang nasibnya jelek ya.. hehe..

Selama ini aku suka mengeluh tentang betapa boringnya kerjaanku, betapa kecil gaji yang aku dapet, betapa enaknya orang laen yang bisa jalan2 ke luar negri, betapa enaknya orang laen yang bisa sekolah lagi.. s2 ato bahkan s3.. betapa senengnya orang laen yang dapet kerjaan yang dia sukai....

Ternyata, setelah melihat2 sekelilingku dan mendengar sendiri dari bosku yang tiap hari interview orang buat gantiin aku selama aku cuti 3 bulan.. makes me relief..

ternyata ga semua orang bisa sekolah sampe s1 ya.. ada yang kudu kerja dulu ngumpulin duwit buat biaya s1 nya.. ada yang emang otaknya ga mampu buat nerusin s1.. dan sekolah sampe s1 itu suatu kemewahan buat mereka.. padahal sekolahnya cuman di sekolah yang boten2.. bener2 ga bersyukur ya aku ini, bisa sekolah dengan aman & nyaman & ga susah both masuk & keluarnya, di sekolah yang bagus, yang beken banget, yang kadang denger namanya aja bisa bikin orang ngeper.. kikikik....

ternyata ada, bahkan banyak orang yang kerjaannya sama denganku tapi pendapatannya cuman 1/2 bahkan 1/3 dari yang aku dapet.. bahkan setelah mereka kerja bertahun2.. kok bisa ya? entahlah..

ternyata ada orang yang belum pernah keluar kota buat jalan2, apalagi ke luar negri buat jalan2, buat kerja aja ga pernah.. bener2 ga bersyukur ya diriku, pernah dikasih jalan2 gratis ke luar negri, nginep di hotel bintang 5, biar deket juga sampe ga perlu visa?!

perlu belajar buat mensyukuri hidup nih..