Antenatal Class South Africa Notes

Welcome to
@TheBabyAcademyIrl
We are live !!
We are live !!
• If you’re having an issue hearing or seeing
me, grab another device if you have
one...it’s usually the quickest solution!
We are live !!
• If you’re having an issue hearing or seeing
me, grab another device if you have
one...it’s usually the quickest solution!
• If you’re still having an issue, just email

reception@babyacademy.co.za
and we have someone on hand to get
you sorted.
After the class...
You will receive an email that will give you:
After the class...
• A recording of this class (which you can watch
back for 6 months)
After the class...
back for 6 months)
• A copy of the slides

After the class...
back for 6 months)
• A link to our resource page, where you will find a

host of valuable and practical videos and
documents
After the class...
back for 6 months)
• A link to our resource page, where you will find a

host of valuable and practical videos and
documents
• Any websites I mention throughout the day will be

included in the resources (so no need for you to
open these or write them down)
Questions…
I am here to support
you and answer
questions you may
have.
Questions…
I am here to support
you and answer
questions you may
have.
There are over 40

topics to cover
today, which are
split into 4 sections.
I will open the live
chat after each
section.
We ’re here to support you all
The term partner is meant to include whatever that
means for you personally.
👫👱👱👭👬🙋
Breaks…
We will take a break for a cup of tea or coffee at about 11am ☕
and for lunch at about 1pm 🥳
and for a leg stretch in the afternoon 🕺
Please don’t close the class at the breaks.
A little bit about me and
how I plan to support you today
How about you Guys?
What is your name?
Where are you all from?
When is baby due?!
How many babies are you having?!!
Today’s Game Plan
Labour Birth and potential Your ﬁrst 100 days Baby First Aid:
complications as parents Choking & CPR
We also run a free online 2-hour Baby Care workshop.

You will receive a sign up link in the email you receive after this class.
Before we kick off…
We understand
that some of our
Baby Academy
babies may be
planning to come
into this world via
C-Section.
We understand
that some of our
Baby Academy
babies may be
planning to come
into this world via
C-Section. For some, signs of
labour may begin
prior to your
scheduled C-Section
date, therefore the
following
information around
labour will equip
you with tools
Before we kick off… In this instance we
would urge you to
We understand contact your
that some of our Midwife or
Baby Academy Maternity Hospital
babies may be for advice
planning to come regarding the next
into this world via steps.
C-Section. For some, signs of
labour may begin
prior to your
scheduled C-Section
date, therefore the
following
information around
labour will equip
you with tools
Before we kick off… In this instance we
would urge you to
We understand contact your
that some of our Midwife or
Baby Academy Maternity Hospital
babies may be for advice
planning to come regarding the next
into this world via steps. Given the nature of labour,
C-Section. For some, signs of and ensuring all parents
labour may begin have a good understanding
prior to your of the physiology and
scheduled C-Section practicalities of how it
date, therefore the works, it will typically take
following longer to explain, whereas
information around C-section takes a little less
labour will equip time to explain, as by
you with tools nature it is a little bit more
straightforward.
Labour
Body preparing for labour
• Baby’s head becomes
engaged: This simply means
that your baby's head has
moved down into the pelvis
and is now in the correct
position for birth.
Body preparing for labour
• Baby’s head become • Your womb is a giant muscle which
engaged: This simply means will from time to time contract.. Once
that your baby's head has these contractions are NOT painful…
moved down into the pelvis you are safe in the knowledge that
and is now in the correct they are harmless, painless
position for birth. tightening's… also known as
Braxton hicks.
A show
• A ‘show’ which is also known as a mucous plug
sits in the cervix for the duration of your pregnancy
A show
• Its function is to protect your baby from the

outside world while you’re expecting
A show

• It is a light pink or light brown jelly like substance and

can vary in size
A show

• It is a light pink or light brown jelly like substance and

can vary in size
• If you are more than 37 weeks pregnant and your
baby has been moving around as normal there is
no need to come to hospital just yet
Water breaking
• Can happen at any time
Water breaking
• More likely to happen while you are having contractions

Water breaking
• Colour: clear, light pink, light straw like, cloudy-white

Water breaking
• Gush -vs- a Trickle

Water breaking
• Gush -vs- a Trickle
Always go to hospital
Waters breaking
Placenta
Umbilical
Cord
Bag of
water
Amniotic
fluid Broken
water
Water breaking
• Remember:
C
O
A
T
Water breaking
• Remember:
C- Colour of water
O- Odour of water
A- Activity of baby
T- Time water broke
Water breaking
• Remember:
C- Colour of water
O- Odour of water
A- Activity of baby
T- Time water broke
• Your midwife or nurse will ask you these questions when

you arrive
Water breaking
• Remember:
C- Colour of water
O- Odour of water
A- Activity of baby
T- Time water broke
• Your midwife or nurse will ask you these questions when

you arrive
Note on Meconium and Prematurity: Go to hospital ASAP
Stages of labour
Stages of labour
Stages of labour
Early labour: 0-4cm
• These contractions are IRREGULAR
Early labour: 0-4cm
• And will GET INCREASINGLY STRONGER over the course of

the day (or days)
Early labour: 0-4cm

the day (or days)
• A change in position, massage, walking, eating or drinking
CAN RELIEVE THESE CONTRACTIONS
Early labour: 0-4cm

the day (or days)
• A change in position, massage, walking, eating or drinking
CAN RELIEVE THESE CONTRACTIONS
• The contractions are INCONSISTANT, they are short or may
last a few minutes
Cervical Effacement and Dilatation during labour
Uterus
Cervix
Vagina
Cervix is not effaced or
dilated
Uterus
Cervix
1cm
Vagina
Cervix is not effaced or Cervix is fully effaced and
dilated dilated to 1cm
Uterus
Cervix
1cm
Vagina
5cm
Cervix is dilated
to 5cm
Uterus
Cervix
1cm
Vagina
5cm 10cm
Cervix is dilated Cervix is fully dilated

to 5cm to 10cm
Early labour: 0-4cm (at home)
What’s happening physically?
• Cervix is beginning to
efface (thin out) and open
• Contractions are irregular
• Hormones involved:
Prostaglandin/Oxytocin
Adrenaline/Endorphins
What’s happening physically? Possible feelings:
• Cervix is beginning to • Backache
• Show
• Contractions are irregular • Ruptured membranes
• Hormones involved: • Excited, Impatient,
Prostaglandin/Oxytocin Talkative
Adrenaline/Endorphins • Contractions are mild
What’s happening physically? Possible feelings: What can you do?
• Cervix is beginning to • Backache • Stay at home
• Show • Eat light foods and drink
• Contractions are irregular plenty of water
• Ruptured membranes
• Breath deeply
• Hormones involved: • Excited, Impatient,
Prostaglandin/Oxytocin Talkative • Distraction, Walking, Ball,
Adrenaline/Endorphins • Contractions are mild Paracetamol, Bath
• GO TO SLEEP if during the night
• If you are having a high-risk
pregnancy... please check if
your health care provider would
like you to attend the hospital
when you are in early labour
Monitoring in Labour
Early Labour:
Early Labour:
• You should continue to be aware of your baby’s normal pattern of
movements while at home in early labour
Early Labour:
• You should continue to be aware of your baby’s normal pattern of
movements while at home in early labour
• If you feel that baby is not moving around as per their normal pattern
of movement… despite you sipping fluids and eating snacks.. Please
link in with your healthcare provider for advice.
Heat therapy
• Shower or warm compress
Heat therapy
• Warmth encourages relaxation
Heat therapy
Relaxation increases oxytocin

Heat therapy
Oxytocin increases contractions

Heat therapy
Oxytocin increases contractions
• Plain water at 37 Degrees Celsius

(no bubbles, Epson salts, etc.)
Established Labour: 4-10cm
• These contractions, WILL NOT STOP OR SLOW DOWN,
regardless of or your activity
• They will have a very PREDICTABLE PATTERN e.g. 1:5:1
• They will become INCREASINGLY CLOSER TOGETHER as the

labour progresses

labour progresses
• They will last LONGER than early contractions lasting at least 60
seconds

labour progresses
seconds
• They will be STRONGER than early contractions

labour progresses
seconds
• They will be STRONGER than early contractions
• They will be ‘wave like’ BUILD UP, HAVE A PEAK, THEN REDUCE
Time to go to hospital
Admission procedure
• Checking in and what to expect
Admission procedure
• The admission emergency room and what to expect

Admission procedure
• If not yet in active labour > Home or Early Labour Ward

Admission procedure
• If in active labour > Labour Ward

Admission procedure
• If in active labour > Labour Ward
• Monitoring in labour
Active First Stage: 4-10cm
What’s happening physically? :
• Cervix is now fully

effaced (thinned out) and
between 4 and 10 cm
dilated
• Contractions lasting 60
seconds and are from 3-5
mins apart or 3-4
contractions in 10 mins
What’s happening physically? : Possible feelings :
• Cervix is now fully • Stronger contractions +/-

effaced (thinned out) and back or leg pain.
between 4 and 10 cm • Talkative excitement turns to
dilated seriousness & concentration
• Contractions lasting 60 • Face flushes
seconds and are from 3-5
mins apart or 3-4 • Can be preoccupied or
contractions in 10 mins restless
• Wants companionship
What’s happening physically? : Possible feelings : What can you do? :
• Cervix is now fully • Stronger contractions +/- • Heat therapy, walk around,
effaced (thinned out) and back or leg pain. change positions, deep
between 4 and 10 cm Breathing
• Talkative excitement turns to
dilated seriousness & concentration • Concentrate on one
• Contractions lasting 60 contraction at a time, when
• Face flushes
seconds and are from 3-5 contraction is over.. Let it go,
mins apart or 3-4 • Can be preoccupied or You will never see it again
contractions in 10 mins restless and you will be one
• Wants companionship contraction closer to the birth
of your baby
• Remember to urinate
frequently and drink fluids
What’s happening physically? : Possible feelings : What can you do? :
• Cervix is now fully • Stronger contractions +/- • Heat therapy, walk around,
effaced (thinned out) and back or leg pain. change positions, deep
between 4 and 10 cm Breathing
• Talkative excitement turns to
dilated seriousness & concentration • Concentrate on one
• Contractions lasting 60 contraction at a time, when
• Face flushes
seconds and are from 3-5 contraction is over.. Let it go,
mins apart or 3-4 • Can be preoccupied or You will never see it again
contractions in 10 mins restless and you will be one
• Wants companionship contraction closer to the birth
of your baby
• Remember to urinate
frequently and drink fluids
A video on Breathing in Labour included in the resource page
you’ll get after this class
Active First Stage:
Active First Stage:
• Low-risk: Intermittent FH check every 15mins for 1 minute during 1st stage
and every 5mins for 1 minute during 2nd stage.
Active First Stage:
• High-risk: Continuous fetal-heartrate-monitoring (Pre-term, Meconium,

Oxytocin, Epidural or signs of fetal-distress or in some cases VBAC.
Active First Stage:

• Vital Signs
Active First Stage:

• Vital Signs
• Vaginal examinations
Any questions on labour?
Time for a Coffee
Birth and potential
complications
Positions for labour
Lying on your
back
Lying on your Sitting

back
Lying on your Sitting Knee-chest

back position
Positions for labour continued….
Lying on your
side
Lying on your Squatting

side
Lying on your Squatting Kneeling with

side support
Always remember……
U
Upright
U F
Upright Forward
U F O
Upright Forward Open
U F O
Note: Ask your Midwife to guide you with this if needing continuous fetal
heart rate monitoring
U F O
Note: Ask your Midwife to guide you with this if needing continuous fetal
heart rate monitoring
A video on Positions in Labour is included in the resource page you’ll get after
this class
Pain Relief Options
Natural
Warmth, Breathing,
Massage, Positions,
Relaxation, Visualisation
Pain Relief Options
Natural Complimentary
Warmth, Breathing, Accupressure,
Massage, Positions, Aromatherapy
Relaxation, Visualisation
Pain Relief Options
Natural Complimentary Pharmacological

Warmth, Breathing, Accupressure, Pethidine,
Massage, Positions, Aromatherapy Nitrous Oxide.
Relaxation, Visualisation Epidural
Pethidine Injection
• A synthetic opioid pain medication
Pethidine Injection
• Suitable anytime up to 4-5cm dilated

Pethidine Injection
• Lasts for 2-4 hours

Pethidine Injection

• Can cause nausea so given with anti
nausea medication
Pethidine Injection

nausea medication
• Passes through placenta
Pethidine Injection

nausea medication
• Passes through placenta
• Normal fetal heart rate monitoring and no more than 4-5cm
dilated prior to pethidine
Nitrous Oxide: 50% Nitrous Oxide & 50% 02
• An inhaled gas also called laughing gas,
gas and air or Entonox
• Suitable from 4cm or in active labour


• Fast acting, quick to wear off

• Can be used alongside heat therapy

• Short term side effects are laughing
and dizziness

and dizziness
• Does NOT pass through placenta

and dizziness
• Does NOT pass through placenta
• Can stay mobile
Epidural
• A regional anesthetic to the area of discomfort brought about by
contractions
Epidural
contractions
• Suitable from 3-4cm dilated

Epidural
contractions
• Does NOT pass through to placenta

Epidural
contractions
• Will need to stay in bed

Epidural
contractions
• Will need urinary catheter, IV (a drip) and continuous fetal monitoring

Epidural
contractions
• Will need urinary catheter, IV (a drip) and continuous fetal monitoring
• Lasts for 6 hours following birth

Risks and benefits of an epidural:
Risks
• Might not always work the way that you
were hoping
Risks
were hoping
• May not relieve pressure and backache
Risks
were hoping
• 1% risk of spinal headache (which is
treatable but can last up to 2 weeks)
Risks
were hoping
• Can cause a drop in blood pressure (so
BP monitored 30 minutely)
Risks
were hoping
• Can result in initial drop in fetal heart
rate... usually resolves quickly but in rare
cases can result in C-Section
Risks
were hoping
• Extremely rare risk of nerve damage or
paralysis 1 in 100,000
Risks Benefits
• Might not always work the way that you • Most effective pharmacological pain
were hoping relief for labour
Risks Benefits
• Might not always work the way that you • Most effective pharmacological pain
were hoping relief for labour
• There are times when you may
benefit from therapeutic rest... your
midwife or OBGYN will guide you if
• Can cause a drop in blood pressure (so necessary
Second Stage: Delivery of baby
• Dilation and effacement are
complete
• Contractions are 45-90 seconds long

and 4-5 minutes apart
• Each contraction pushes baby

further down into birth canal
• Baby will move under pubic bone,

head will crown and baby will be
born, 1st head, then body
• Dilation and effacement are • Contractions will slow down and
complete change in character
• Contractions are 45-90 seconds long • Sometimes a little nausea or

and 4-5 minutes apart vomiting may be present on
transition to the second stage
• Each contraction pushes baby
• An urge to push
further down into birth canal
• Baby will move under pubic bone, • Pressure to the rectum and pelvic
floor
born, 1st head, then body
• Stretching of perineum which
may cause a stinging sensation
as baby’s head emerges
• Dilation and effacement are • Contractions will slow down and • ‘Go with’ your pushing urge,
complete change in character don’t be afraid of the strength
and intensity needed to bring
• Contractions are 45-90 seconds long • Sometimes a little nausea or your baby into your arms
and 4-5 minutes apart vomiting may be present on
transition to the second stage • Take deep cleansing breaths
• Each contraction pushes baby both before and after
• An urge to push
further down into birth canal contractions
• Baby will move under pubic bone, • Pressure to the rectum and pelvic • Listen to your midwife or doctor
floor as baby's head is crowning to a
born, 1st head, then body ensure safe controlled delivery of
• Stretching of perineum which baby
may cause a stinging sensation
as baby’s head emerges
Third Stage: Delivery of Placenta
• Your uterus will begin to

contract.
• The placenta will detach

from the uterine wall
• The placenta will then be

delivered by the midwife or
doctor
• Your uterus will begin to • Mild contractions or

contract. cramping
• The placenta will detach • A sudden gush of dark blood

from the uterine wall may occur
• The placenta will then be

delivered by the midwife or
doctor
• Your uterus will begin to • Mild contractions or • Encourage baby to feed at the
contract. cramping breast, this will stimulate the
production of oxytocin which
• The placenta will detach • A sudden gush of dark blood causes the uterus to contract
from the uterine wall may occur and birth the placenta, it will
also help to keep the uterus
• The placenta will then be firm thus preventing
delivered by the midwife or haemorrhage
doctor
• It is common practice in South
Africa to actively manage the
third stage. This involves giving
an injection of oxytocin to
minimise risk of haemorrhage
After the Birth: Baby
• Skin to Skin and First Feed
👶
👶
• Vitamin K and Eye ointment
👶
• Oxygen/Suctioning/resuscitation discussion
👶
• Name tags
👶
• Name tags
• Weigh baby and Measurements
👶
• Name tags
• Weigh baby and Measurements
• Initial exam of baby
After the Birth: Mom
• Suturing/Care of sutures
🤱
🤱
• Shower/ A light snack and a drink
🤱
• Lochia
🤱
• Lochia
• Transfer to postnatal ward

🤱
• Lochia
• Transfer to postnatal ward
• Postnatal care
Birth Partners: How can you help?
• Physical support
• Emotional support
• Information support
• Birth Preference List or Birth Plan

• Birth Preference List or Birth Plan
Let’s open the live chat and get some more great ideas!
(We have another Q&A session in a little while,
so please keep all questions until then)
Special Circumstances
• Instrumental Delivery
• Episiotomy
• Caesarean Section
• Induction of labour
Instrumental Delivery
Why?
1) Suspected or confirmed fetal distress
2) Delay during 2nd stage

Why?
1) Suspected or confirmed fetal distress
2) Delay during 2nd stage
How?
• Performed by obstetrician or advanced midwife
• Cervix 10cm and baby in birth canal
• Baby’s position will influence instrument choice
• Pediatrician ideally present for delivery
Vacuum Extraction Delivery ( Ventouse )
Why?
Episiotomy
• Suspected or confirmed fetal distress
• Sometimes with instrumental delivery

Why?
Episiotomy
• Suspected or confirmed fetal distress
• Sometimes with instrumental delivery
How?
• Mothers consent and adequate pain relief should always be given
• Incision made to perineum
• Sutured by midwife or doctor using dissolvable sutures
Perineal massage antenatally may reduce the likelihood of an

episiotomy... However, perineal massage in the second stage will
generally not reduce the likelihood of an episiotomy
Episiotomy
Head of
Vagina baby
Possible
episiotomy
Anus
angles
Planned C-Section:
Planned C-Section:
• Attend hospital at given date/time and fasting from 10pm the night before
Planned C-Section:
• Admitted to maternity ward/bed
Planned C-Section:
• Hospital gown given
Planned C-Section:
• Vital signs monitored
Planned C-Section:
• Bloods will have been taken in the antenatal clinic
Planned C-Section:
• Midwife or Nurse will check your baby/babies position, FHR etc.
Planned C-Section:
• Transfer to Operating Theatre for C-Section (usually in a bed)
Planned C-Section:
• Partner will join you for C-Section
Planned C-Section:
• You will need: Spinal Anaesthesia, IV fluids, Urinary catheter
Planned C-Section:
• Generally: Obstetricians x2, Midwife x1, Paediatrician x1, Operating
Theatre sister x2, Anaesthetist x1
Planned C-Section:
• Skin to skin/ first feed within first hour
Planned C-Section:
• Skin to skin/ first feed within first hour
• Stay in hospital for a minimum of 72 hours
Unplanned C-Section:
Why?
• Suspected or confirmed fetal distress, undiagnosed breech or Moms wellbeing
• Delay during the 1st stage

Why?
• Suspected or confirmed fetal distress, undiagnosed breech or Moms wellbeing
• Delay during the 1st stage
How?
• Performed by obstetrician
• Incision made to lower abdomen
• Cervix either <10cm or if 10cm baby not in birth canal
• Pediatrician always present for delivery
Induction of Labour:
Induction of Labour:
Why?
• Post-dates, Gestational diabetes are the most common reasons
• High blood pressure
How?
• You will be admitted to hospital
• Prostaglandin pessary and oxytocin drip
• Designed to mimic normal labour
• Can use all pain relief options discussed in this course
How can I try to avoid going overdue
• Raspberry leaf tea
• 10 Medjool dates a day
• Stretch and Sweep
• Sexual intercourse (prostaglandins in male semen and oxytocin produced with orgasm)
• Acupressure
• Acupressure
• Reflexology
• Acupressure
• Reflexology
• Acupuncture
• Acupressure
• Reflexology
• Acupuncture
• Keep Calm…..and enjoy the wait!!!!
Stress won’t allow your body to produce much needed labour

hormones
Decision Making
B:
R:
A:
I:
N:
Decision Making
B: What are the Benefits of........?
R:
A
I:
N:
Decision Making
R: Are there any potential Risks?
A:
I:
N:
Decision Making
A: Is there an Alternative?
I:
N:
Decision Making
I: What does my Intuition tell me?
N:
Decision Making
I: What does my Intuition tell me?
N: What would happen if we did Nothing and re-assessed in 1-2hrs time?
Labour Ward
(see your resource page for 360 video)
Any questions on birth and
potential complications?
Time for some lunch
Your first 100
days as parents
Before we kick on....
The World Health Organisation (WHO) recommends exclusive
breastfeeding for your baby's first 6-months. We understand that this may
not be possible for everyone due to medical reasons and personal choice.
We will cover both breastfeeding and formula feeding in this

section.
Given the nature of breastfeeding, and ensuring all parents have a good
understanding of the physiology and practicalities of how it works, it will
typically take just over an hour to explain, where as formula feeding
takes a little less time to explain, as by nature it is a little bit more
straightforward.
The Benefits of Breastfeeding
For Baby:
For Baby:
• Better mouth and teeth formation
For Baby:
• Less likely to suffer with allergies such as Asthma and Eczema

For Baby:
• Mom’s immunities will pass to baby via breast milk

For Baby:
• Unlikely to suffer with stomach upsets and constipation

For Baby:
• Unlikely to suffer with stomach upsets and constipation
• Higher IQ due to good brain development in early life

Wow!
For Mom:
For Mom:
• Reduces chance of breast and ovarian cancer
For Mom:
• Faster return to pre pregnancy figure

For Mom:
• Faster return to pre pregnancy figure
• Allows time for bonding and of course….it’s free!

Breastfeeding
• Food and Diet: Great news!! You can eat and drink what you like when you’re
breastfeeding
Breastfeeding
breastfeeding
• Caffeine: No more than 1-2 cups of tea or coffee a day

Breastfeeding
breastfeeding

• Extra Calories: We need an extra 300-500 calories a day to fulfil the energy
requirements needed to make enough healthy breast milk for baby
Breastfeeding
breastfeeding

• Extra Calories: We need an extra 300-500 calories a day to fulfil the energy
requirements needed to make enough healthy breast milk for baby
• First 1,000 days: A really cool recipe book (included in the resource page
you’ll get after this class) to help steer you towards the right foods to eat… and why!
Breast Changes
• Breast Growth
Breast Changes
• Breast Growth
• Pigment changes
Breast Changes
• Breast Growth
• Pigment changes
• Leaking of colostrum
Breast Changes
• Breast Growth
• Pigment changes
Ribs
• Leaking of colostrum
Areola Muscle
• Hormones involved: Nipple layer
with
² Oxytocin-Responsible for the milk flow multiple Fat
² Prolactin-Responsible for the milk supply openings layer
Milk duct
Milk-producing
gland
Breastmilk
• Colostrum: Days 1-3
Breastmilk
• Transitional Milk: Days 4-14

Breastmilk
• Mature Milk: Days 14+

Breastmilk
• Mature Milk: Days 14+
• Awareness of milk composition changes

during a feed
How do I know my baby is hungry?
Early Cues or Rooting:
Stirring Mouth opening Turning head,

seeking, routing
Mid Cues or hands to mouth:
Stretching Increasing physical Hand to mouth

movement
Late Cues or Crying :
Crying Agitated body Colour turning red

movements

movements
Calm crying baby before feeding:

movements
Calm crying baby before feeding:
✰ Skin-to-skin on chest
✰ Talking
✰ Stroking
Positions for feeding
Cradle hold
Laid back feeding
Cradle hold
Laid back feeding
Cradle hold
Cross Cradle Hold

Twins
Side lying
Twins
Side lying
Twins
Football or Rugby hold

Attachment: The key to successful breastfeeding
Always remember...
• C:
• H:
• I:
• N:
• S:
Always remember...
• C: Close and chin leading
• H: Head free
• I: In line
• N: Nose to nipple
• S: Sustainable for both
Why is a good latch so important?
Deep latch -v- Shallow latch
Top Tips for Successful Breastfeeding
• Keep Calm… and breastfeed!! This will ensure sufficient oxytocin
can be produced to allow for good milk ‘flow’
• First feed within first hour if possible while prolactin levels are
very high
very high
• Feed baby on demand / but no longer than 3-4 hours apart until
baby returns to birth weight
very high
• Watch for feeding cues

very high
• Watch for feeding cues

• Skin to skin ++
Top Tips Continued...
• Importance of efficient feeds
• Always offer 2nd side

• Tummy size
• Tummy size
• Maternity Bras
• Tummy size
• Maternity Bras
• Barrier Creams / Ointments

Guidelines for
Moms
This is on page 28 of the
booklet called Breastfeeding:
A good start in life
Support Network
Support Network
• Midwives in hospitals
Support Network
• Lactation Consultants (if necessary)
Support Network
• Hospital Breastfeeding Support Group
Support Network
• Community Breastfeeding Support Groups
Support Network
• kellymom.com is a reputable ‘go-to’ or reference website
Support Network
• “Breastfeeding Friend” App: Link in the resource page, which you’ll get
after this class
Support Network
• “Breastfeeding Friend” App: Link in the resource page, which you’ll get
after this class
• Expectant Mothers Guide will have info around BF support groups
• Momconnect programme
Loads of valuable video content from

our Midwives @TheBabyAcademySA
Supplementation – E BM and Formula
• Sometimes medically indicated…e.g. Jaundice, low blood sugar levels
• EBM is always first option. Formula is offered when EBM is unavailable.

• Brands of Formula
• Expressing
• Expressing
• Storage of breastmilk
Formula
• Have you read instructions?
Formula
• Hand washing
Formula
• Hand washing
• Making a bottle
Formula
• Hand washing
• Making a bottle
• FF Booklet
Formula
• Hand washing
• Making a bottle
• FF Booklet
• Role of Public Health Nurse…hungry babies
/ colic / reflux/ constipation etc.
Burping Baby
Vitamin D
Sterilising
Before you go home....Mom
Review by Prescription Plan for follow

Postnatal
doctor if up appointments
Midwives Check if needed
Caesarean if needed
Before you go home....Baby
Paediatric Hearing
Hip Check
Exam Check
Leaving the hospital...
• Mom: Best to wear maternity clothes that fit you when you were 24-
28 weeks pregnant
28 weeks pregnant
• Baby: Dress baby in one layer more than you, a hat and 2-4
layers of cellular blankets
28 weeks pregnant
• Car Seat: Have a few trial runs with this so you are very confident on
the day
28 weeks pregnant
• Car Seat: Have a few trial runs with this so you are very confident on
the day
Return of fertility
• Did you know that you can ovulate as soon as two weeks after having
your baby
Return of fertility
your baby
• How soon can I resume sexual intercourse?
Return of fertility
your baby
• How soon can I have another baby?
Return of fertility
your baby
• Only you can answer these questions (being mindful that perineal
sutures do take 6 weeks to fully heal)
Return of fertility
your baby
• Only you can answer these questions (being mindful that perineal
sutures do take 6 weeks to fully heal)
• GP will be happy to discuss contraception methods as part of 6 week
check up
Pap Smear
• Women are encouraged to have a pap smear performed yearly
Pap Smear
• Your GP or Midwife will offer this service

Pap Smear
• Your GP or Midwife will offer this service
• If due a smear test please arrange for 6+ months after baby is born
Emotional Wellbeing after having a new baby
• Life can be busy with a new baby
• When there is a lot to get done, we can begin to think that self-care is
indulgent, this is not the case
• Taking care of your own wellbeing (both emotional and physical)
gives you all you need to take care of your new baby
• Taking care of yourself is as important as taking care of your new baby
• Your mental wellbeing and happiness can also affect those around you
too
too
• If you are feeling good, they will benefit too!
too
• If you are feeling good, they will benefit too!
Some time this week, write down some important self-care activities that you will
make time for after your baby is born
Baby Blues Versus Postnatal Depression
Baby Blues (0-2 weeks):
• Weepiness/crying for no apparent

reason

reason
• Feeling “I’m not like myself” or, “this
isn’t me”

reason
isn’t me”
• Impatience

reason
isn’t me”
• Impatience
• Irritability

reason
isn’t me”
• Impatience
• Irritability
• Restlessness

reason
isn’t me”
• Impatience
• Irritability
• Restlessness
• Anxiety
Baby Blues (0-2 weeks): Postnatal Depression (2 weeks -1 year):

reason
isn’t me”
• Impatience
• Irritability
• Restlessness
• Anxiety
• Weepiness/crying for no apparent • Difficulty sleeping, insomnia, exhaustion

reason
isn’t me”
• Impatience
• Irritability
• Restlessness
• Anxiety

reason • Lack of energy
isn’t me”
• Impatience
• Irritability
• Restlessness
• Anxiety

• Feeling “I’m not like myself” or, “this • Low sex drive
isn’t me”
• Impatience
• Irritability
• Restlessness
• Anxiety

isn’t me” • Changes in appetite, weight loss or gain
• Impatience
• Irritability
• Restlessness
• Anxiety

• Impatience • Weepiness, excessive worry, agitation,
• Irritability anxiety
• Restlessness
• Anxiety

• Restlessness • Feelings of inadequacy, hopelessness,
• Anxiety despair

• Anxiety despair
• Guilt, sadness, fear of being alone
• Irritability

• Anxiety despair
• Irritability
• Difficulty concentrating, panic, anger

• Anxiety despair
• Irritability
• Difficulty concentrating, panic, anger
• Scary thoughts about baby, over-concern
for baby’s health
Pregnancy related mental health concerns
• 1 in 5 women will experience perinatal mental health symptoms.
• If you experience symptoms as per previous slide for >10 days in a row it is
important to talk with someone you trust about how you are feeling.
• Mental health symptoms can be treated in a number of ways, some examples

are: breathing techniques, relaxation exercises, self care promotion, counselling,
medication.

medication.
• Together with your mental health support person you will decide what is the most
suitable option for you.

medication.
• Together with your mental health support person you will decide what is the most
suitable option for you.
• Your Midwife, GP, Maternity Hospital or Designated Healthcare Provider will have
the resources to support your needs.
Tips for your transition to parenthood
• Tackle things, one day at a time
• Try to get your recommended 7-8hrs sleep every 24hrs (you might need
to play catch up at the weekend)
• Mind Your Body with plenty of water and good nutrition
• Move Your Body, gentle exercise and nice walks
• Don’t be shy about asking for help and support
• Make time to socialise (albeit a virtual baby group or an exercise class
in the park)
in the park)
• Talk when you need to... a problem shared is a problem halved
in the park)
• Talk when you need to... a problem shared is a problem halved
• Every day is a learning day, always be open to learning new
approaches that might suit you, your baby and your family's needs
Any questions on your first
100 days as parents and
Infant Feeding?
Time for a leg stretch
Follow us on Instagram for practical videos and
to join the conversation @TheBabyAcademySA
Also, tag The Baby Academy on your Instagram Post or Story to be in a chance to
win a R1,000 voucher to use at any BabysR'us store or on their website
Follow us on Instagram for practical videos and
to join the conversation @TheBabyAcademySA
Baby First Aid
(This is our final and shortest section)
First of all, how do I know my baby is thriving?
• Feeding well
• Feeding well
• Sleeping well
• Feeding well
• Sleeping well
• Settling well between feeds

• Feeding well
• Sleeping well
• Having wet and dirty nappies

• Feeding well
• Sleeping well
• Having wet and dirty nappies
• Gaining weight (with the exception of the first week where it is normal for
baby to lose up to 10%)
When would I be worried or concerned?
• High temperature >37.8℃
• Not settling as normal

• Not feeding efficiently

• Having <6 wet nappies a day

• A change from baby’s normal bowel habit, e.g. baby appearing

constipated and straining to pass a bowel motion
• A change from baby’s normal bowel habit, e.g. baby appearing

constipated and straining to pass a bowel motion
• Baby not yet back to birth weight after 2 weeks

What to do if concerned
• High temperature >37.8℃: If <2 weeks: Paediatrician/Clinic Sister
If >2 weeks: GP/Emergency room if concerned
• Not settling as normal: Is baby hungry, dirty nappy, too hot, too cold, overtired or unwell?
• Not feeding efficiently: Do you need feeding support, could baby be sleepy as a result of
jaundice… talk to your designated health care provider
• Having < 6 wet nappies a day: How is the feeding going? How is baby’s temperature?
• A change from baby’s normal bowel habit, e.g. baby appearing constipated and straining
to pass a bowel motion: try bicycle legs or tummy massage in clockwise motion, if still
concerned link in with PHN
• A change from baby’s normal bowel habit, e.g. baby appearing constipated and straining
to pass a bowel motion: try bicycle legs or tummy massage in clockwise motion, if still
concerned link in with PHN
• Baby not yet back to birth weight after 2 weeks: Will be recognised by the clinic
sister/GP or paediatrician and a plan will be given
If you are concerned that baby is unresponsive,
not breathing or struggling to breathe:
1. Call for help
2. Practice initial steps of first aid while waiting for medical
assistance to arrive
Initial steps of First Aid
What is first aid?: First aid is the initial assistance given to someone who has
been injured or taken ill before the arrival of qualified medical assistance
Initial steps of First Aid
What is first aid?: First aid is the initial assistance given to someone who has
been injured or taken ill before the arrival of qualified medical assistance
*Ambulance response time can be up to 30 minutes*

Do you know your area and postal codes?
• Save it on your phone
• Leave it on a sticker on your fridge for babysitter, grandparents, etc.
When an Issue Arises…
What do I do first?
When do I call
for help?
What order do I
do things in?
OMG…
I’m confused!
Follow the Golden Rule:
What do I do first?
When do I call
for help?
What order do I
do things in?
OMG…
I’m confused!
Follow the Golden Rule:
What do I do first?
When do I call
for help? Hard to remember?
Look at the first letter of each word…
What order do I
do things in?
Dr ABC
OMG…
I’m confused!
• First of all, assess the situation for dangers to you, your baby, or others.
• If you deem it too dangerous to attend your baby, call 10177.
• If you can move your baby to safety, now is the time to do so.
How do you check your baby for a response?
Tap and talk!
Baby Two outcomes...
Responds
Action: Place in recovery position (we

need to learn this). Ask someone to call
10177 or do so yourself if needed. Then
remain with your baby until qualified
medical assistance arrives.
The Recovery Position
Cradle the infant in your arms
with their head tilted downwards.
How do you check your baby for a response?
Tap and talk!
Baby Two outcomes... No
Responds Response
Action: Place in recovery position (we need to Action: Shout for help. Ask someone to call
learn this). Ask someone to call 101077 or do 10177, if nobody is available use your mobile
so yourself if needed. Then remain with your phone on speaker, do not ever leave the baby.
baby until qualified medical assistance arrives. Check airway (see next slide).
Without a clear airway, brain damage is possible in 4 minutes.
The airway is everything. So, open your baby’s mouth.
Foreign Object
Vomit/Blood See Nothing
(food, LEGO, etc.)
Action: Turn baby’s head to the Action: Try to remove Action: Same as below
side and gently remove If you can’t remove the object,
vomit/blood. Ring 10177 if you observe the baby’s coughing.
feel necessary.
Noisy Coughing Silent Coughing
Action: Let it come Action: Back blows

up naturally (we need to learn this)
Back Blows and Chest Thrusts
Lower your arm onto your thigh so that the infant’s
head is lower than his/her chest.
Using the heel of your hand, deliver five firm blows

between infant’s shoulder blades to try to dislodge
the object.
Turn the infant as per demo and deliver five chest

thrusts to the baby’s breastbone, just below the line
of the nipples.
The aim of clearing the airway was to ensure your baby is breathing.
But what if the baby is not breathing?
Make sure you are correct. Tilt your baby’s head back and put two fingers
under their chin.
Give yourself 10 seconds to…

Look: Is your baby’s chest moving?
Listen: Can you hear your baby breathing?
Feel: Can you feel your baby’s breath or chest moving?
Breathing but unconscious Not breathing
Action: Place in recovery position. Ask Action: CPR

someone to call 10177 or do so yourself if
needed. Then remain with your baby until
qualified medical assistance arrives.
Start with five rescue breaths.
Next, place the tips of two fingers over the lower third of
your baby’s breast bone, just below the line of the
nipples. Give 30 compressions at a speed of 120
compressions a minute.
After 30 chest compressions deliver two rescue breaths.
Repeat the sequence of 30 chest compressions and two

rescue breaths (i.e: the only time you give the five recue
breaths is the first time.
Continue CPR until you see signs of life or until medical

professionals arrive.
Accident prevention
Can we avoid accidents and emergencies?
●Crawl around on your knees and see what mischief you can get up to…
○Sharp objects
○Sharp objects
○Water in toilet
○Sharp objects
○Water in toilet
○Heavy items
○Sharp objects
○Water in toilet
○Heavy items
○Sweets (AKA dishwasher and washing machine tablets
○Sharp objects
○Water in toilet
○Heavy items
○Sweets (AKA dishwasher and washing machine tablets)
○Blind cords
Car Seat Safety
● Straps should be very tight so that you can’t pinch the harness strap between your thumb and forefinger.
Car Seat Safety
● Ensure chest clip slid up to baby’s armpit level.
Car Seat Safety
● New born insert until baby can support their own head.
Car Seat Safety
● Only use what came with the carseat.
Car Seat Safety
● No aftermarket pads, bumpers or inserts.
Car Seat Safety
● Ensure universal anchorage system is correctly fitted.
Car Seat Safety
● Ensure carseat has National Safety Mark.
Car Seat Safety
● Designed for travelling… not designed to be baby’s place of sleep.
Car Seat Safety
● Not recommended to be in car seat for longer than 2 hours at a time.
Car Seat Safety
● Dress your baby normally then cover with blankets over the harness.
Car Seat Safety
● Dress your baby normally then cover with blankets over the harness.
● No snow suits or puffy, fluffy clothing or cuddle bags that are inserted behind the harness. Car seat covers
that go over top of the carseat are okay.
Keeping Baby Safe in a Sling
●T
●I
●C
●K
●S
● T: Tight
●I
●C
●K
●S
● T: Tight
● I : In view at all times
● C:
● K:
● S:
● T: Tight
● C: Close enough to Kiss
● K:
● S:
● T: Tight
● K: Keep chin off the chest
● S:
● T: Tight
● K: Keep chin off the chest
● S: Supported Back
Any questions on Baby First Aid?
Thank you
173 Oxford Road, Rosebank,

Johannesburg, 2196
www.babyacademy.co.za
reception@babyacademy.co.za
Oops...the instructor is on mute
One moment please

Oops...we are having an issue.
Please keep the class open

Oops...we are having an issue.
We have sent you an SMS and email

with an update

Antenatal Class South Africa Notes

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Antenatal Class South Africa Notes

Uploaded by

Copyright:

Available Formats

Welcome to

• If you’re still having an issue, just email

• A copy of the slides

• A copy of the slides

• A link to our resource page, where you will find a

• A copy of the slides

• A link to our resource page, where you will find a

• Any websites I mention throughout the day will be

There are over 40

We also run a free online 2-hour Baby Care workshop.

• Its function is to protect your baby from the

• Its function is to protect your baby from the

• It is a light pink or light brown jelly like substance and

• Its function is to protect your baby from the

• It is a light pink or light brown jelly like substance and

• More likely to happen while you are having contractions

• More likely to happen while you are having contractions

• Colour: clear, light pink, light straw like, cloudy-white

• More likely to happen while you are having contractions

• Colour: clear, light pink, light straw like, cloudy-white

• Gush -vs- a Trickle

• More likely to happen while you are having contractions

• Colour: clear, light pink, light straw like, cloudy-white

• Gush -vs- a Trickle

• Your midwife or nurse will ask you these questions when

• Your midwife or nurse will ask you these questions when

• And will GET INCREASINGLY STRONGER over the course of

• And will GET INCREASINGLY STRONGER over the course of

• And will GET INCREASINGLY STRONGER over the course of

Cervix is dilated Cervix is fully dilated

• Contractions are irregular

Relaxation increases oxytocin

Relaxation increases oxytocin

Oxytocin increases contractions

Relaxation increases oxytocin

Oxytocin increases contractions

• Plain water at 37 Degrees Celsius

• They will become INCREASINGLY CLOSER TOGETHER as the

• They will become INCREASINGLY CLOSER TOGETHER as the

• They will become INCREASINGLY CLOSER TOGETHER as the

• They will become INCREASINGLY CLOSER TOGETHER as the

• The admission emergency room and what to expect

• The admission emergency room and what to expect

• If not yet in active labour > Home or Early Labour Ward

• The admission emergency room and what to expect

• If not yet in active labour > Home or Early Labour Ward

• If in active labour > Labour Ward

• The admission emergency room and what to expect

• If not yet in active labour > Home or Early Labour Ward

• If in active labour > Labour Ward

• Cervix is now fully

• Cervix is now fully • Stronger contractions +/-

• High-risk: Continuous fetal-heartrate-monitoring (Pre-term, Meconium,

• High-risk: Continuous fetal-heartrate-monitoring (Pre-term, Meconium,

• High-risk: Continuous fetal-heartrate-monitoring (Pre-term, Meconium,

Lying on your Sitting

Lying on your Sitting Knee-chest

Lying on your Squatting

Lying on your Squatting Kneeling with

Natural Complimentary Pharmacological

• Suitable anytime up to 4-5cm dilated

• Suitable anytime up to 4-5cm dilated

• Lasts for 2-4 hours