If you don’t know your fundus from your Braxton Hicks, you’re not alone. With the strange physical changes of pregnancy and birth come a host of scary-sounding medical terms too. Fear not – just read on and you’ll soon go to the top of the (antenatal) class!
This is difficult enough to pronounce, let alone understand! Otherwise known as SFH, this is the measurement from the top of your pubic bone to the top of your uterus (otherwise known as your fundus). Your midwife will start checking this from around the midway stage and it should roughly correspond with the number of weeks pregnant you are, so if you’re 28 weeks, it should roughly measure 28cm.
“It can range a little either way and your midwife will take other factors into account, such as your build and weight,” says Gail Johnson, education and professional development advisor at the Royal College of Midwives. “What’s really important is consistent growth at each appointment.”
As your bump grows, you’ll probably feel it with your fingers to try to identify whether that lump you can see if an elbow or a foot. Your midwife will do the same at your later antenatal appointments – she uses her fingers to ‘palpate’ (feel) your bump to work out what position the baby is in.
Towards the end of your pregnancy, you’ll find you can’t fit in quite as much lunch as you used to and even breathing deeply might be a bit of an effort! This is because the top of your uterus is now high up and it’s squishing your stomach and lungs.
But as your baby’s arrival date nears, his head will usually drop down into your pelvis in preparation to come out. This is known as the baby becoming engaged. In your medical notes, it is written in fifths, with 5/5 being not engaged at all and 2/5 meaning it is engaged.
“Many women suddenly find they can breathe more easily and feel a heaviness in the pelvis,” says Gail. “A midwife can tell you if your baby is engaged. The baby’s head is quite bony and can be felt externally – when it’s engaged, less of the head can be felt above your pelvis. Your bump may look lower too. Not all babies engage prior to labour, though – some drop down during it, particularly if this is a second or third baby.”
This rather old-fashioned sounding word refers to the first movements of your baby that can be felt by you. The word ‘quick’ used to mean ‘alive’ – before scans existed, the movements of the baby felt by the mother were good signs that baby was well. First-time mums usually feel this fluttering, tapping or bubbling sensation around 18 to 20 weeks (or even later), but second-time mums may feel it as early as 15 weeks.
This odd term probably makes you feel like a banana! It actually refers to the process of your cervix getting ready for labour. If you go past your due date, your midwife will check how ‘ripe’ your cervix is as a sign of whether labour is imminent.
“Your cervix is usually long and thick,” says Gail. “But as labour approaches it thins and softens. We give it what’s called a Bishop Score – a score of eight or more means that your cervix is ripe and ready for labour. It also increases the likelihood of success if you have to be induced.”
A sign that you’ll meet your baby soon! This is the passing of the mucus plug that seals the cervix during pregnancy. It’s a brownish or pink-tinged discharge, so it’s also known as a ‘bloody show’. If you’ve ‘had a show’, labour could start within hours, but in some cases, not until several days later.
Sadly not something ‘medicinal’ to take away the pain of labour. This is another name for the amniotic fluid that protects your baby in the womb. You’ll probably know it as the waters. Your midwife will be keeping an eye on the liquor to ensure there is enough of it and that it is not a funny colour. Waters should be a pale, straw colour. Anything different could be a sign of an infection or that there is meconium (your baby’s first poo) in there.
When your midwife asks if she can examine you to find out ‘how many cm dilated your cervix is’ she isn’t heading down there with a tape measure! A gentle vaginal examination using two fingers will give her an estimation of how far open your cervix is. She’s done this a lot, hence knowing an estimate of ‘how far’ dilated you are.
Contractions and Braxton Hicks
To allow your baby into the world, your cervix must widen (dilate) to 10cm and this is achieved through contractions. This is when the uterine muscles tighten and relax, to help the baby move out of your body. Another term you may have heard is Braxton Hicks – these are ‘practice’ contractions and can start around mid-pregnancy.
So how will you know when you’re in labour for real? “As a general rule, Braxton Hicks contractions are irregular and painless,” says Gail. “Real contractions feel like period pain in your lower abdomen or back, last longer, will come at regular intervals (this could be every hour, rather than every few minutes, at the beginning) and increase in intensity and frequency.”
If you think you might be in labour, start timing the contractions so you can let your midwife know over the phone. It’s best to stay at home for as long as possible – if you arrive at hospital just one or two centimetres dilated, you may be sent home again. Most midwives would like you to be having contractions of about 45-60 seconds in length, around five minutes apart, with this pattern having gone on for about an hour.
Having felt your bump, your midwife may well announce that your baby is ‘cephalic’ or ‘vertex’. Sounds strange, but both just mean the baby’s ‘head down’ and in the ideal position for labour – good news!
External cephalic version (EVC)
If, at about 37 weeks, your baby is resolutely staying with his feet or bottom down by your cervix (neck of your uterus), in a position known as breech, then a procedure called an ECV might be recommended.
This involves a doctor slowly trying to turn your baby around by manipulating your bump with his hands. “You may be given a medication to help your uterus relax,” says Gail. “If there’s plenty of room in the uterus, the baby will shoot around, but if space is tight, it may not work.”
If your baby cannot be turned and does not do so naturally, your doctor will likely recommend a c-section delivery.
Back to back
If your midwife has a feel of your bump and then mutters something about it being ‘back to back’, this doesn’t mean that your bump is the wrong way round. It simply means that your baby is lying with her back turned round facing your back, rather than the more common position of her back being against your bump. On your notes, this will be written as OP – occiput posterior.
It’s nothing to worry about but can make the birth last longer because he cannot tuck his chin into his chest to help the passage through the pelvis. Some mums find it gives them more pain in the back during labour too.
Stretch and sweep
Some time between 40 and 42 weeks, if you are not showing any signs of labour, you will be asked if you would like to try a ‘stretch and sweep’ or membrane sweep.
“Your midwife will sweep two fingers around your cervix to separate the membranes inside the cervix,” says Gail. “This causes the release of hormones called prostaglandins, which can stimulate labour. It can be a little uncomfortable, but shouldn’t be painful. It may be repeated a few days later if it doesn’t work.”
If you’re heading towards 42 weeks’ pregnant and your baby has decided that he’s quite happy where he is, despite a stretch and sweep, your midwife will suggest an induction. This means that labour will be started artificially.
If this fails, you will go into hospital around 42 weeks to be induced. This usually starts with a prostaglandin pessary or gel being inserted into your vagina and may graduate to a hormone drip.
A deep state of relaxation using special breathing techniques learned in classes, which help you deal with the pain and fear of birth. Your midwife will likely ask if you are using hypnobirthing in labour, so she knows to try and assist you with it.
An injection of anaesthetic into the lower back, given by an anaesthetist, providing total pain relief for 90 per cent of women.
Gas and air
Mixture of oxygen and nitrous oxide (also known as laughing gas), which you breathe in with a contraction. Doesn’t remove the pain but helps you detach from it.
An injection of mild painkiller into your thigh or buttock, which can relax you during labour but doesn’t remove all the pain.
No live orchestra for this one – it just means that the doctors may need to use special equipment to help the delivery. These include ventouse, a suction cap, and forceps, special metal tongs which both help ‘pull’ the baby out. The type used will depend on the position of the baby’s head.
A caesarean section can also be referred to as an instrumental birth.
After the birth
The strange language doesn’t stop once you’ve given birth. From your milk supply to your healing ‘down there’, there’s more to come. Remember if you hear something you’re not sure about, your midwife and then health visitor are there to answer any questions. But watch out for these being mentioned in the first few hours and days after you give birth:
You may have found a page in your notes referring to an Apgar scale. This is a set of simple checks of your baby one minute after he’s born and then five minutes later – it rates his appearance (skin colour), pulse, grimace (responsiveness), activity (muscle tone) and respiration (breathing) with a number between zero and two for each category.
The numbers are added up for an Apgar score to see if the baby might need some medical help. Most babies score between seven and 10 – and the majority of babies need no help at all after birth.
The blood loss that initially is like a heavy period and then lessens but can continue on and off for up to six weeks. You will get this whether you have had a vaginal or caesarean delivery. Stock up on maternity pads in preparation.
Stitches sometimes needed following a vaginal birth, always with a caesarean section.
The first milk you produce for your baby, which is very concentrated as he will only need tiny amounts to start.
Milk coming in
Breasts become ‘engorged’ and tender as the supply of your milk is increased and becomes more watery – particularly on the third or fourth day following the birth.
Let down reflex
A tingling in the breasts following the release of oxytocin, a hormone that stimulates the muscles of the breast to squeeze out the milk.
Hormone changes around day three, often causes mum to feel tearful.