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GlossaryAAA
Early Pregnancy
• Informed Consent
• My Rights & Responsibilities
• High-Risk Pregnancy
• Nutrition
• The Birth Plan
• Finalization of Birth Plan
Mid-term Pregnancy
• Anatomy and Physiology in Pregnancy
• How to Cope with Nausea, Heartburn and Gas
• How to Cope with Digestive Discomforts
Late Pregnancy
• The First Stage of Labour
• Pre-Term Labour
• Second and Third Stage of Labour
• Back Labour, Coping Methods and Positions
• Patterned Breathing For Labour and Delivery
• Relaxation and Massage Techniques
• Pushing in Labour
• Positions For Pushing
• The Epidural - Information and Risks
• Monitoring Devices
• Methods of Induction
• Immediate Postpartum
• Labour Kits
• The Basics of Breast-Feeding
• How Much Time and Effort Does It Take?
• What a Newborn Looks Like
• Capabilities of a Newborn
• The Postpartum Period
• What a Baby's Day is Comprised Of
• Early Discharge
• How to Choose a Caregiver for Your Baby
• Frequently Asked Questions
Anatomy and Physiology in Pregnancy

A pregnancy is composed of two parts, a woman and a fetus. The female carries the fetus in her pelvic
area in her uterus. The pelvis is comprised of bones: the hip bones, the sacrum, and the coccyx or
tailbone. The bones join together in the front at the pubic symphysis and in the back where the hip bones
join the spine and where the coccyx attaches to the sacrum.
The bones are joined with cartilage and ligaments, which soften and relax under the influence of
hormones during pregnancy.13 This softening causes greater movement and allows room to
accommodate the baby during delivery, thus enabling even a small woman to deliver a large baby. The
better nourishment a woman's diet provides, the more the cartilage will soften, allowing for a greater
chance of vaginal delivery.4
The uterus is an inverted pear-shaped muscular pouch with inner walls covered by a thick vascular lining
that the fertilized egg can burrow into and begin to grow. With the progression of pregnancy, the uterus
grows up and out from the pelvis. The uterus is made up of spiral muscle bundles. In early pregnancy, the
muscle bundles begin to unfold into an open latticework formation at the top of the uterus.6,7 By the end of
pregnancy, the muscles have extended into an almost vertical position. Since the uterus is a muscular
organ, it contracts as well as expands. Inhibiting hormones are released in order to suppress the uterus'
contracting during pregnancy. These hormones also work on the bowels and slow their contractions. This
slowing of the bowels allows them to begin absorbing all of the nutrients that are put in. This may also be
partly responsible for the nausea and vomiting that occurs in pregnancy.10,14,15

As the pregnancy develops the uterus begins to have practice contractions known as "Braxton-
Hicks".7,9,13 These are usually felt at the end of a pregnancy, although some women can feel them earlier.
They can be disconcerting, however they are usually not initiating labour. The uterus does not contract
equally; the upper part of the uterus is the fundus and is thin and contractible, while the lower segment,
which includes the cervix, is thicker and capable of distention.7,13 During labour, the top part of the uterus
contracts and pulls on the lower part, which in turn draws it up onto itself. The uterus is kept closed by the
cervix, which is filled with thickened mucous. During pregnancy, the cervix is long, thick and closed. Not
unlike a turtleneck sweater turned upside-down, the cervix during labour is pulled and stretched until it is
moved up and out of the way so that the baby can pass through.

Inside the uterus we find the fetus; contained in the amniotic sac, and nurturing the fetus is the placenta.
The placenta is usually about 13-18 cm. (5-7 in.) in diameter, 3 cm. (1¼ in.) thick and weighs about 500
grams (1 lb.). It is a reddish/purple in colour and looks like a piece of liver.6 Extending out from the
placenta at one end, and attached to the fetus at the other, is the umbilical cord. This thick flexible cord is
the baby's lifeline, providing a passageway for blood to flow through the placenta for as long as the
mother's heart is beating.

The placenta serves many purposes: it is a means of nutrition and waste disposal for the fetus and it
produces hormones that are needed to support the pregnancy.7 Nutrients pass in one direction and waste
products pass out the other. The placenta can not completely protect the fetus from some things such as
drugs or alcohol,8 therefore good nutrition and the avoidance of harmful substances needs to become a
habit in order to ensure fetal well-being.

The placenta begins producing hormones – mainly HCG – to suppress menstruation as soon as
implantation takes place, and it continues to produce them throughout the pregnancy.12 The placenta
stimulates the release of the hormones that

• allow the ligaments and cartilage to soften and stretch

• suppress or initiate contractions
• cause mood swings
• promote milk development4
The placenta is usually located on the wall or top of the uterus,1 above the cervix. The location of the
placenta can determine the method of delivery. Babies must be born in a specific order to ensure
maternal and fetal survival. All babies must be delivered out of the uterus first, before the cord, and before
the placenta can be delivered. Where the placenta is joined to the uterine lining, millions of tiny blood
vessels are formed and will leave an open bleed site for both mother and baby if the placenta is pulled
away prematurely before labour. During the last stage of labour, contractions also work to squeeze shut
the tiny blood vessels while pushing the placenta off the uterine wall.6,7

Surrounding the fetus is the amniotic sac and amniotic fluid. The sac is comprised of two membranes: the
chorion and the amnion. The amniotic sac allows the fetus to move around freely in the uterus and
cushions the fetus from impacts. The amniotic sac also regulates the baby's temperature.9 The fetus
drinks the fluid, which helps it practice swallowing and also promotes health due to the antibacterial
properties found in amniotic fluid.8 The fetus also urinates into it, however there are no contaminants in
the baby's urine. This drinking may be what causes the hiccups in utero that many women feel.11

The rupturing of the bag of waters is often associated with the onset of labour, however this is not always
the case. It is possible to have your water break with a slow, high leak and this can sometimes go
undetected. If you suspect that your water has ruptured, it is important to let your caregiver know.

Amniotic fluid is generally clear with no odour; if you notice that the fluid is brown, greenish or bloody, you
should notify your caregiver immediately. The colouring could indicate the presence of meconium, or fetal
stool, in the amniotic fluid, which may mean that the fetus has undergone some degree of stress. This can
become a problem if the fetus inhales or swallows the meconium.

While the fetus is developing, the woman's body is also undergoing many changes in her shape, including
her breasts. The hormones in the placenta cause the breasts to become fuller and tender, the nipples
darken and the veins become more prominent as blood flow increases.6 These changes are necessary to
produce the milk needed to feed the baby. The body also begins to store a supply of fat essential for milk
production. These stores are usually located on the upper arm, back and thighs.