Unit 2 Pregnancy and Labour Task 1 Signs and symptoms A pattern of signs often alerts a woman that she may be pregnant. A different pattern of signs occurs when labour begins at the end of the pregnancy. a) Work in pairs to complete the list of signs using the words below. bloating contractions discharge fatigue mood morning mucus need nipple period pelvis rupture strength temperature trembling 1. You will miss a menstrual ………………………….. 2. False, ´Braxton Hicks´ ……………………. occur. 3. ……………………… and sleepiness occur. 4. Contractions become more rhythmic and increase in …………….. . 5. Some women feel abdominal ………………. . 6. ………………… swings and stress are often reported. 7. You notice an increase in pink and white ……………… . 8. You may experience ………………… sickness. 9. Your basal body ……………………. will be elevated. 10. There may be a ´show´, which is the release of a ………………. plug from the cervix. 11. You may feel the …………………. to urinate frequently. 12. The baby´s head engages – that is, it lowers into the ………………. . 13. It is common for the area around the …………… to darken. 14. Shivering or ………………. without a reason is common. 15. Your waters break, which is the ……………….. of the amniotic sac. b) Decide if each sign indicates pregnancy or labour. Task 2 Listening Listen to Emma, a midwife, getting advice from another midwife and from a doctor. a) Answer these questions: 1. Why is Emma worried about Mrs Dent´s baby? 2. What does Nina advise Emma to do? 3. How often does the doctor advise her to monitor? 4. What measurement does he suggest taking? 5. What three things does the doctor suggest to raise the baby´s heart rate? b) Try to remember the missing words. Then listen again and check. 1. I think we ought to ……………. the doctor. 2. It´s always a good idea to ……………… help if you´re concerned. 3. You´d better ………………… continuously from now on. 4. I´d ………… Mrs Dent some oxygen too – that won´t do any harm. 5. And try ……….. her to lie on her left side too. 6. If it´s a little slow, but over 100, you may want to ………………. about amnioinfusion. c) Complete the conversation with the words below: ´d may should better shouldn´t try Nurse: Any problems, Maria? Maria: I had a bit of bleeding after my aerobics class. I thought maybe I´d ……………… stop exercising. Nurse: Well, it´s a good idea to exercise, but you ……….. do aerobics if it causes bleeding. You ………….. try swimming or something gentle like that. Maria: I know. I …….. buy myself a swimming costume. Another thing is, I can´t get comfortable at night. Nurse: ……………….. putting a pillow underneath you – that should help. Maria: OK – I´ll try that. I´m also a bit worried about these stretch marks on my tummy. Nurse: I ………….. rub cream or oil into it – that´s very good for stretch marks. d) Speaking Discuss what you could do to help these problems in pregnancy. backache constipation insomnia swollen ankles Task 3 Study the texts below and highlight key terms. A) Childbirth The expected date of delivery (EDD) or the due date is the date on which a woman is expected to give birth to the child she is pregnant with. It is calculated by adding 280 days or 40 weeks to the first day of the last menstrual period (LMP). Childbirth is also referred to by doctors as parturition. Delivery is the process of helping the child to be born. A spontaneous vaginal delivery (SVD) is a normal delivery. If there are complications, the baby may be delivered by caesarean section. A full-term pregnancy is 40 weeks, divided into three trimesters. A baby who is born before this is premature, and one born after 40 weeks is postmature. A baby who is born dead, for example because the umbilical cord around its neck, is stillborn. A pregnancy may end before term spontaneously, with a miscarriage (spontaneous abortion), or be deliberately terminated with an induced abortion (termination of pregnancy). (Note: the verb induce means to cause something to happen) B) Labour The process by which the foetus and placenta are pushed out of the uterus is called labour. It is divided into four stages. Some of the words combined with labour are: premature - prolonged - spontaneous - induced - false C) Presentation and lie Foetal lie is the position of the foetus in the uterus. The normal lie is longitudinal, and the abnormal lie is transverse. Foetal presentation refers to ´the part of the foetus which occupies the centre of the pelvic canal and which the examining finger feels on vaginal examination. The normal presentation is with the head (vertex presentation). Breech presentation means the buttocks are presenting (breech is an old word for buttocks).Abnormal delivery may require delivery with forceps. Task 4 A) Complete the sentences. 1. A baby that is born a week before the EDD is ………………… . 2. A ……………….. of pregnancy may be necessary for medical reasons. 3. The first three months of pregnancy are known as the first ……………….. . 4. Foetal distress in the first stage of ……………… is an indication for caesarean ………………….. . 5. It was a breech ………………….. and delivery was by forceps. 6. A …………………. is another term for a spontaneous abortion. 7. The ……………………… was wound tightly around the baby´s neck and it was unfortunately ………………….. . B) Complete the table. Verb Noun abort deliver induction miscarry present termination (Glendinning, E. H. & Howard, R. Professional English in Use. CUP, 2007.) Task 5 Listening A) Listen to five short conversations between the midwife and Hannah, a first-time mother. Decide whether each one takes place 1 pre-birth 2 during birth 3 after birth a) _________ b) _________ c) _________ d) _________ e) _________ B) Listen again and complete the sentences . a) Give a ……………….. push – that´s the way! b) My ………………. broke last night, and I started getting strong ………………. early this morning. c) Well, you´re seven centimetres ……………. now, so I don´t think we´ll need to induce you. d) Now, on your ……………… you said that you´d like …………………. as pain relief, yes? e) Yes, but if I can´t bear the pain, I´d like an ………………. . f) That´s normal when ……………….. are used. g) I´ve had ……………….. before, so they thought I should have a scan. h) The baby´s ……………………. is perfect, with the head down. Task 6 Stages of labour Reading: Match the descriptions with the three stages of labour. A) Expulsion of the foetus. It begins when the cervix is fully dilated and is complete when the baby is completely born. ____ B) Separation and expulsion of placenta and membranes. It lasts from the birth of the baby until the placenta and membranes have been expelled. ____ C) Dilatation of the cervix. It begins with rhythmic contractions and is complete when the cervix is completely dilated. ____ Speaking: What is the role of the midwife in each of these stages? Task 7 Diagnosis of onset of labour The primary signal that labour is occurring is progressive dilatation of the cervix in response to uterine contractions. There are three clinical signs, which are all related in some degree to this phenomenon. A) Show This is the passage of the plug of ……………… which normally helps to seal the cervix during ……………… against the ingress of infection. However, because cervical ripening occurs from about 36 weeks onwards in primigravidae, the passage of a ´show´ often precedes active labour ……………. many hours, and sometimes days. B) Regular …………. contractions The onset of regular contractions is an important indicator that cervical dilatation is taking …………….. . The cervix needs to open about 10cm for a baby to pass through. This is called ‘…………………. dilated’. Contractions at the start of labour help to soften the cervix so that it gradually opens. Sometimes the process of softening can take many hours before you are in what midwives call ‘established labour’. Established labour is when your cervix has dilated to more than 3cm. C) Spontaneous rupture of membranes (SRM) In about 10% of pregnancies, SRM is the first sign that labour is starting. Contractions and progressive cervical dilatation will follow within 24 hours in 80% of cases. In the remaining 20%, there is a small risk of amniotic fluid …………………. . In most cases, if membranes are intact at the onset of labour, they will rupture …………….. as labour progresses. Some obstetric units have a policy of routine ………………. rupture at 4 cm dilatation. (Elder, M. G. Reproduction, Obstetrics and Gynaecology. Oxford, 1988.) Task 8 Grammar – Gerund vs. infinitive Complete the gaps with either –ing or infinitive forms of the verbs in brackets. 1. Pregnant women should avoid ………… (eat) undercooked meat or eggs. 2. She stopped ………….. (drink) alcohol two months ago. 3. I took folic acid before ………….. (get) pregnant. 4. I have come ………………. (have) an ultrasound scan. 5. Do you mind ……………….. (wait) a few more minutes? 6. A scan may be needed ……………… (confirm) the position of the placenta. 7. The nurse recommended ………………. (try) the bathtub. 8. I forgot ………….. (take) the medication this morning. 9. Try ……………… (eat) cranberries to prevent UTIs. 10. I tried really hard…………….. (push) but I had no more strength.