GULUiNDEPENDEN + HOSPITAL

The Birth Clinic

 PREGNANCY CARE  ULTRASOUND BABY SCAN

 GYNAECOLOGY CARE  CERVICAL SUTURE

 COMPLEMENTARY THERAPIES  DELIVERY ENSUITE

SPECIALISED CARE THROUGH PREGNANCY AND CHILD BIRTH

THE BIRTH CLINIC BROCHURE 2010/11

SERVICES AT HAND

The BIrth Clinic GIH

Customer Service Desk Tel: +256 4714 32279 Fax: +256 4713 32262

Email: thebirthclinicgih@yahoo.co.uk

Welcome to The Birth Clinic

The Birth Clinic at GIH offers a specialised women’s pregnancy care, childbirth and gynaecology clinic, the clinics specialise in complete care as well as services for women wishing to benefit from our wide range of scan services including 3D and 4D ultrasound baby scans. Our highly-qualified team of complementary therapists and a counsellor provide wider holistic care which can be very important in reproductive healthcare. Our Services The Birth Clinic at GIH offers a comprehensive set of services for pregnant women in Gulu Independent Hospital Airfield Road Gulu. These are broadly categorised below: Pregnancy Care Ultrasound Baby Scans Gynaecology Care Cervical Suture Complementary Therapies Pregnancy care

Pregnancy Care

In most cases all pregnancy care begins with the first consultation, which is usually held at between 8-12 weeks of pregnancy and lasts about 1 hour. The obstetrician will discuss your needs and how the care is organised. We will usually do an ultrasound scan to confirm that your dates are correct. You will be given a report and some pictures of the scan. You will be given advice and a book about nutrition and exercise. You will be given a ‘gestation calculator’ disc which allows you to plan the dates of your continuing pregnancy at a glance. You can discuss travel plans in the light of this. You will have the opportunity to ask questions, and we will discuss antenatal classes with you.

Routine antenatal scans

These include an early pregnancy viability scan at 7-11 weeks, a nuchal translucency scan at 11-14 weeks, an anomaly scan at 21-23 weeks and a wellbeing/growth scan at 36 weeks. During your scans you will be given three photographs and a report of the scan.

The BIrth Clinic GIH

Routine antenatal appointments with the obstetrician

You will have 11 routine appointments with the obstetrician , at 12, 22, 26, 30, 33, 35, 37, 38, 39, 40 and 40+ weeks. At each visit, your blood pressure will be measured and you will have a urine test and tummy assessment. We do not routinely weigh women but you can be weighed if you wish. If you are seeing the obstetrician you can choose to have an ultrasound scan at any appointment. Any concerns that are not an emergency can be discussed at this time. Each of these appointments lasts about 20-30 minutes.

Antenatal booking appointment with the midwife

At 26 weeks, you will be invited to attend a booking consultation with our midwife . This appointment usually lasts 1 hour. She will go through your medical history with you. Details of your pregnancy will be recorded in an obstetric book that The Birth Clinic will keep until you are close to delivery. This information will be transferred to the hospital’s computer records system. You will also be encouraged to attend antenatal classes locally. These will complement the classes later at The Birth Clinic.

The BIrth Clinic GIH

If you want us to do any other blood tests, please discuss this with us as there are many tests available.

Voucher for a complementary therapy We have a range of therapists who are available to offer a range of treatments. When you book, you will be given a voucher for one session of any of our complementary therapies, with the compliments of The Birth Clinic, which you can use at any stage of your pregnancy. Contact our support team to book an appointment.

Antenatal couples class We arrange an antenatal class for first-time mothers and their partners at about 36 weeks of pregnancy. Our classes are always on a Saturday morning to early afternoon. The classes are kept to small groups to ensure they are welcoming and friendly. The obstetrician along with midwife facilitates the class, preparing couples for the practicalities of giving birth and what to expect in the early days after the birth.

Routine antenatal blood tests The Birth Clinic routinely carries out the following tests for all mothers-to-be:

Haemoglobin To check the level of iron in your blood and whether you need to take an iron supplement.

Haemoglobin Electrophoresis

To check that you do not carry a tendency to thalassaemia or sickle cell disease.

Glucose To check your blood sugar level, to make sure your diet is maintaining a normal balance.

Syphilis Although syphilis is virtually non-existent, this is a standard test for all pregnant women in the UK because syphilis can be acquired at birth.

Rubella To make sure you are immune to German measles.

Hepatitis B To make sure you are not a carrier.

Blood group If you have a Rhesus negative blood group, we will check to see if your partner is also Rhesus negative to determine if you will need Anti D injections at 28 and 34 weeks to protect your baby being affected by Rhesus sensitisation.

We provide refreshments and sandwiches and you will have the opportunity to ask questions at the end of the session.

the obstetrician and Consultant delivery fee The Consultant Package includes a ‘delivery fee’ for the obstetrician . You can expect the obstetrician to attend to your care during labour, delivery and postnatal until you are discharged from hospital. If one or other doctor has any planned absence for more than one day, you will be informed of this early in your pregnancy.

The BIrth Clinic GIH

24-hour telephone and mobile support

During the antenatal period you can contact the obstetrician via The Birth Clinic customer services which is open from Monday to Saturday. You will also be given a mobile phone number, which can be used out of hours.

6-week postnatal follow-up

Once your baby has been delivered and you have been discharged by The Hospital, you will need about six weeks to recover from the birth. The rate of recovery varies greatly and there are a lot of factors that can affect this – for example, the type of delivery you have, if it is your first or subsequent delivery, and if there were any complications after giving birth. You will be seen by the obstetrician in the sixth week after delivery to confirm that you have made a full recovery. Women who have had a Caesarean section often have to wait the full six weeks before they can resume normal activities such as driving and exercise

The BIrth Clinic GIH

Special Packages

Caesarean section only

The Birth Clinic has tailored a special package for women who have booked into other hospital and discover, late into their pregnancy, that complications have arisen and that they will need a Caesarean section for medical reasons. This is called a ‘medical elective Caesarean section’. If this happens to you, you may prefer to transfer to a private facility for the delivery. The advantages of this are that you will have a private consultant who can discuss a date that is suitable for you, a private room to give you extra comfort during your recovery, and one-to-one care with a midwife after the birth. You will need to meet the obstetrician or consultant at least one consultation and an ultrasound scan and, once it is agreed that this is the best option of care for you, our support team will make arrangements for your admission to hospital. Six weeks after the birth, the obstetrician will see you for a postnatal check-up, to make sure you are fully recovered. If you have medical insurance, you may be able to claim on your insurance to cover the cost of the ‘Caesarean section only’ package. Or you can choose the package as a non-insured patient.

Antenatal care (scans and consultations)

The obstetrician provides this service for women who require antenatal care but do not expect to deliver at GIH. You may want this service, for example, if you are booked in OTHER hospital but are not happy with the number of appointments you receive with a consultant or if you want to ask for a second opinion on some aspect of your care. We are also happy to look after expectant mothers who live abroad. The Birth Clinic Employed experienced maternity nanny with several years’ experience of working with families and newborns. And whose philosophy is to promote and encourage breastfeeding and to support all parents, regardless of their infant feeding choice.

Breastfeeding Consultations

At a breastfeeding consultation you will get one-to-one advice tailored to meet your needs, whether you choose to breastfeed exclusively or choose to explore a combination of breast and bottle-feeding. During your 1-hour consultation we will cover any concerns about: • low milk supply • mastitis (inflammation of the breast) • breast pain or tenderness • oversupply • poor weight gain • explosive stools • frequent or prolonged feeding • gastric reflux • colicky behaviour

The BIrth Clinic GIH

Midwife/Infant Feeding Advisor/ Lactation Consultant

Practice Midwife at The Birth Clinic. is also an Infant Feeding Advisor and holds appropriate qualification There is no doubt that breastfeeding, with its many important physical and psychological advantages is best for both a mother and her baby and is the ideal way to initiate good parent-child relationships. It is not always problem free however, and parents need a lot of support and reassurance at this time. The arrival of a new baby is in itself a life-changing event and can be daunting. Unbiased, accurate advice can help to smooth the way. Research has shown that women who have access to good care from the appropriate health care professional enjoy a more positive birth experience and increased success with breastfeeding. Our midwife believes in respecting and facilitating women’s choice and provides information, help, and support to all mothers in the feeding and nurturing of their babies, whatever that choice might be.

Breastfeeding Consultations

During the last weeks of your pregnancy, the midwife offers one to one Breastfeeding Preparation Sessions at The Birth Clinic. This greatly assists in enabling mothers to form a strong basis of knowledge in preparing for the early days. After your baby is born, the midwife is available for home visits in any part of Uganda and beyond for advise and consultations should a feeding problem or concern occur. For example:

Baby problems: • Slow weight gain/ Failure to thrive • Prematurity • Twins • Jaundice • Crying/colic • Problems latching on

Mum’s problems: • Low milk supply • Sore/cracked nipples • Mastitis • Blocked ducts • Painful breasts • Breastfeeding following Caesarean Section • Returning to work • Exhaustion • Lack of confidence

The BIrth Clinic GIH

Ultrasound Baby Scans

We perform ultrasound scans ranging from single and early pregnancy scan to 3D and 4D scans. All scans are performed either by specialist obstetrician with side specialisation in (Foetal Medicine specialist), or by one of our three highly experienced sonographers - We perform the following scans: • First Trimester Scans (Up to 12 weeks) Early Pregnancy Viability Scan or Dating Scan Nuchal Translucency Scan • Second Trimester Scans (13 weeks to 26 weeks) Reassurance Scan Sexing Scan Anomaly Scan Cervical Scan • Third Trimester Scans (27 weeks to 40 weeks) Wellbeing Scan or Foetal Growth Scan including Doppler 3D Scan 4D Scan

Early Pregnancy Viability Scan 7 weeks - 11 weeks

This scan is available for anyone who feels a bit worried or just wants to make sure that all is well with the early pregnancy. It is particularly important to have this scan if you have had vaginal bleeding or suspect an ectopic pregnancy. It is also advised for women over 35, and strongly recommended for women over 40.

Viability scans are easily performed at 7-11 weeks of pregnancy. We usually scan ‘transabdominally’, which means through the tummy. If you are having the scan because of a concern about a possible ectopic pregnancy, this scan can be done at 6-7 weeks trans-vaginally. At this stage we are unlikely to see a heart beating but we will be able to confirm that the sac is in the uterus. The scan at 7-11 weeks can show how many embryos there are, confirm the presence of a heartbeat, and indicate the size of the sac or the embryo, which confirms the number of weeks of pregnancy. It can also show if there is any internal bleeding which may be significant and which may need to be carefully monitored.

This scan is also called a Dating Scan, as it can be used to establish the gestational age of the pregnancy. Time needed for scan: 5-10 minutes Preparation: Please try to come to the appointment with a full bladder as this will improve the visibility of the scan done through the tummy. Pictures: We will give you a picture of the little baby for you to keep.

The BIrth Clinic GIH

Nuchal Translucency Scan 11 weeks - 14 weeks

This is the first stage at which the foetus can be seen in greater detail. This scan confirms that there is a heartbeat, and the number of foetuses. The baby’s head, trunk, arms, legs, hands and feet can be seen and we will also look at the placenta, amniotic fluid and umbilical cord. The doctor or sonographer will then measure the ‘nuchal fold’ or ‘nuchal translucency’ and the baby’s nose bone. The nuchal translucency is the skin at the back of the baby’s neck. In some babies with problems such as Down’s syndrome, and also in some normal babies, this can be enlarged by fluid. The nose bone can be small or absent in Down’s syndrome babies. The doctor will take a blood sample from your arm and perform blood test for two particular hormones. The result of this test, which will be available from the lab within two hours, will give you more specific information about your level of risk. From this information we can calculate the risk of your baby having foetal abnormalities such as Down's syndrome. This will be expressed as a probability of abnormality of one in "something". 1/300 or better is considered a good result. You can either wait for the result in our comfortable lounge, or you can give us a convenient phone number and we will call you with the result later in the day. This is called the combined test for Down's Syndrome. Time needed for the scan: 20-30 minutes.

Pictures: We will give you a few pictures of your baby for you to keep. After you have had the results of this combined test, you can make an informed choice about whether to have a CVS (chorionic villous sample) at 12 weeks, or an amniocentesis at 16 weeks. These tests give definitive information about whether there are any abnormalities. A scan is not usually necessary at this stage of pregnancy, but you might have one if you have had bleeding or have been unwell. The baby’s head, abdomen, and leg length will be measured, the placenta can be located and the amniotic fluid and umbilical cord assessed. The measurements will be plotted on a graph which you will be given. Time needed for the scan: About 15 minutes.

The BIrth Clinic GIH

Sexing Scan 17 weeks onward

A scan at this stage can determine the sex of your baby. We also measure the baby and assess his or her wellbeing. Our sexing scans are highly reliable but may be more difficult if the woman is very overweight, or if the baby is in an unfavourable position. We will not tell you the sex of the baby if we are not sure about it, but it is very unusual for us not to be able to do so. Time needed for the scan: About 15-20 minutes.

Anomaly Scan 21 weeks - 23 weeks

At the beginning measurements will be made of the baby's head, brain, abdomen and legs. These will be plotted on a chart. We then continue a very thorough scan to check your baby's heart, brain, spine, bowel and limbs, to detect any abnormalities. This can never completely guarantee that the baby will be normal, but it gives very strong reassurance. We also check the placenta, amniotic fluid and the umbilical cord. If you wish, you can find out the sex of your baby from this scan. Time needed for the scan: About 30 minutes.

Cervical Scan

If you are at risk of premature birth, it may be useful to have a scan, using a probe in the vagina, to assess the length of the uterine cervix. This can be done at any stage from 16 weeks but is most useful if done sequentially at 17 and 21 weeks of pregnancy. A cervical scan is usually done after an abdominal scan.

Wellbeing or Foetal Growth Scan including Doppler 23-40 weeks

This is also called a ‘foetal growth scan’ or a ’wellbeing scan’. During this scan we measure the baby's head, abdomen and limbs, and estimate the baby’s weight. This gives a guide to how big your baby will be at birth. We also look at how the baby is moving, the amount of amniotic fluid, and where the placenta is. We will also assess the Doppler blood flow in the umbilical cord blood vessels. It is possible to tell the sex of your baby from this scan, but this becomes more difficult as you approach the end of your pregnancy. Time needed for the scan: About 30 minutes.

The BIrth Clinic GIH

3D Scan 26-32 weeks

A 3D ultrasound scan is a special scan that shows the baby in three dimensions. This forms part of a 4D Scan. 3D scans are not usually needed for medical reasons. If the baby has a rare malformation, a 3D scan could provide extra information for medical purposes, but this is rare. Parents may want the scan if they are curious to see their baby's face. If you have a 3D scan, we always do a wellbeing scan first, before trying to view the face or other parts of the body. It may take some time to get a good view of the baby, so the scan could take 30-60 minutes. If the baby is not in a favourable position you may be asked to go for a walk and return later. The best time to do a 3D scan is at 26-32 weeks of pregnancy when there is a greater volume of amniotic fluid but when the baby has not yet become too big. It is more difficult to see the face if the baby has its arms or legs in front of the face. If the scan is to be prolonged, you may be asked to take a break and move around to see if the baby will also move. The cost of the 3D scan includes a scan report and 3D scan pictures. Note that 3D pictures are a part of 4D Scan. Time needed for the scan: About 30-60 minutes.

4D Scan 26-32 weeks

A 4D scan is a 3D scan with the added dimension of time – as in a film or video – so the baby can be seen to be moving. 4D scans are not usually needed for medical reasons. If the baby has a rare malformation, a 3D or 4D scan could provide extra information for medical purposes, but this is rare. Parents may want the scan if they are curious to see their baby's face. If you have a 3D or 4D scan, we always do a wellbeing scan first, before trying to view the face or other parts of the body in 4D. It may take some time to get a good view of the baby, so the scan could take 30-60 minutes. If the baby is not in a favourable position you may be asked to go for a walk and return later. The best time to do a 4D scan is at 26-32 weeks of pregnancy when there is a greater volume of amniotic fluid but when the baby has not yet become too big. It is more difficult to see the face if the baby has its arms or legs in front of the face. The baby can be seen to be moving. Sometimes it is possible to record your baby yawning or stretching. If the scan is to be prolonged, you may be asked to take a break and move around to see if the baby will also move. The cost of the 3D/4D scan includes a scan report, 3D scan pictures and a DVD with a 20-30 minute recording of the scan. Time needed for the scan: About 30-60 minutes.

The BIrth Clinic GIH

Gynaecology Care The Birth Clinics offers comprehensive care meeting the needs of women from late teenage years through menopause and beyond.

Screening Our services include routine well woman checks – cervical smear screening, ovarian screening, pelvic and breast examinations in addition to advice on contraception, hormone replacement therapy and sexual health checks.

Common gynaecological problems We are able to offer care for the full range of gynaecological problems including problematic periods (too many, too few, too painful), pelvic pain, fibroids, endometriosis, ovarian cysts, polycystic ovarian syndrome and troublesome vaginal discharge.

Fertility We perform fertility health checks including an assessment of hormone status, ovulation confirmation, fallopian tube patency and semen analysis. We perform laparoscopic tubal surgery if scarring or distortion of the fallopian tubes is likely to be preventing pregnancy.

Specialist services our doctors has a particular interest in disorders of the pelvic floor resulting in prolapses, urinary and faecal incontinence. He is trained in minimal access (keyhole) surgery and will use these techniques whenever possible in managing gynaecological problems requiring surgery..

Gynaecology Ultrasound Scans

Our state-of-the-art scanning equipment provides the latest in ultrasound technology. You may attend for a gynaecology ultrasound on its own or in conjunction with a consultation and examination. The majority of gynaecology scans are performed using a vaginal probe (a small device inserted gently into the vagina) to obtain the clearest views of the pelvis. The most comprehensive scan is a full pelvic ultrasound scan. Most specifically we offer endometrium thickness scan and follicle tracking scan. In some circumstances pelvic scans may be performed through the tummy wall.

Full Pelvic Ultrasound Scan This is performed for women with a variety of gynaecological complaints including infertility. In principal this is a transvaginal scan performed by one of our experienced sonographers This is done with an empty bladder. The uterus, cervix and both ovaries are visualised and measured.. Any cysts or abnormalities are noted. Normal fallopian tubes cannot be seen on scan. Any pathology is clearly documented. The position of an intra uterine device in the uterus can be seen.

Endometrial Thickness Scan This is undertaken for women following an IVF programme. It may need to be done more than once. It gives guidance about the timing of IVF.

Follicle Tracking Scan This is done to help women in monitoring their ovulation for fertility purposes. There will usually be three scans in one cycle.

The BIrth Clinic GIH

Cervical Suture Also called Cervical Cerclage

Our Doctor has a special interest and expertise in the treatment of women who have had recurrent miscarriages in the middle part of pregnancy. If this applies to you, the Doctor will carry out a full analysis to find out whether weakness of the cervix (cervical incompetence) is playing a role. Other causes of mid-trimester pregnancy loss and pre-term birth also have to be considered – for example, twins and higher order multiple pregnancy, abnormal shape of the womb, recurrent bleeding, infections, excessive amniotic fluid with foetal abnormality or monochorionic twins. A history of cervical cone biopsy and cervical amputation is also important as it can help decide the type of treatment needed. What is Cervical Suture? Cervical Suture – also called Cervical Cerclage – can help prevent a miscarriage in certain cases where cervical weakness is playing a role. A cervical suture is a nylon tape stitch placed around the upper part on the cervix to lengthen and strengthen it. There are three types of cervical suture: McDonald Suture, Shirodkar Suture and Transabdominal Suture. A McDonald Suture is done by most doctors. It is the easiest suture to insert with the least risk. However, it is placed low down on the cervix and is probably the least effective in a difficult case. There is limited evidence about how effective this type of suture is.

A Shirodkar Suture is placed in a higher position on the cervix. It requires greater expertise to carry it out, and there is a greater risk of bleeding. However, once it is in place it is likely to be more effective and there is less risk of infection compared with a McDonald suture. Some doctors use this type of suture when a previous McDonald Suture has failed. Dr Gibb has extensive experience of doing a Shirodkar Suture in women who are at particular risk of miscarriage. A Transabdominal Suture is used for women who have had their cervix removed by extensive cone biopsy or amputation due to early-stage cancer. These women (some of whom may have had a suture inserted vaginally) may then have had a miscarriage in mid-pregnancy or a premature birth. A Transabdominal Suture is inserted by making an incision (cut) through the abdomen, above the pubic area. This type of suture can be inserted at 11-12 weeks of pregnancy, after an early scan has confirmed that the pregnancy is normal. After this operation, most women can then resume their normal life until a planned Caesarean section at 37 weeks. If serious pregnancy complications arise before the baby is viable (at 24 weeks), the suture can be removed through the vagina (rather than having a second abdominal operation). At Caesarean section for a healthy baby, the suture is left in place.

The BIrth Clinic GIH

Complementary therapies Complementary therapists are on hand to support you through your pregnancy and beyond. Our therapy services include: • Psychotherapy and Autogenic Therapy Autogenic training (AT) during pregnancy is a relaxation therapy based on six simple mental exercises for natural self-regulation of mind and body. • Osteopathy Osteopathic treatment can help to ease some of the physical discomforts that women may experience during pregnancy. It is also available to newborns and children. • Acupuncture Acupuncture for pregnancy and childbirth is a safe and effective way of treating many discomforts of pregnancy. • Other therapies Reflexology, Shiatsu Massage, Pregnancy Massage and Beauty Therapy and

Acupuncture Acupuncture has been used in the Far East to restore, promote and maintain good health for over 2,500 years. It is a gentle yet effective way of treating many so 'minor' pregnancy ailments including: • Morning sickness / Nausea / Heartburn • Insomnia / Anxiety / Vaginal itching / Urinary tract infection Acupuncture as a pre birth treatment A series of treatments in the final weeks of pregnancy to prepare women for childbirth and help build energy reserves to prepare for the post-natal period. It also helps to get the baby into the optimal foetal position which can reduce the pain and the duration of labour. As well as helping with labour it is also used for the following: • Reducing the need for medical induction / Breech and posterior presentation • Constipation / Leg cramps • Difficulty sleeping / Pain Acupuncture and IVF It is not uncommon for pregnancy to take a little longer to achieve and some couples will need assisted reproductive treatment. This will be largely based on acupuncture being given at specific times of the IVF/IUI cycle Acupuncture can help with the following: • Improved ovarian response and reduce FSH levels where high • Improved sperm quality / Increased pelvic blood flow • Relieving side effects of drugs / Relieving stress • Relaxing the uterus if given at the time of transfer

The BIrth Clinic GIH

Nutrition Coaching

Our Midwife have got experience in Nutritional Therapist who believes that nutrition has to be really 'do-able' in everyday life. The Birth Clinic doesn't believe in something that doesn't work or isn't practical and is dedicated to making nutrition approachable and fun

Nutrition and your life The Nutrition Coach concept is unique - we combine nutritional therapy with life coaching principles. – This means we are enabling you within your existing lifestyle to incorporate change, rather than trying to force you to make changes that you will never keep up – It is born out the practical knowledge that although we may have a sincere wish to change our eating habits or lifestyle – without on going help this is nearly impossible. With the support and help of a nutritionist (Nutritional Therapist) we help you identify your goals and gently lead you by the hand until you get there. Our aim is to give you the tools to transform your life and your health forever: • Balance • Do-ability • Empowerment

We can help with a number of pregnancy related conditions but also: • IBS (irritable bowel syndrome) • Hormone problems • Fertility • Weight gain

Osteopathy

Osteopathy during pregnancy Osteopathic treatment can help to ease most of the physical discomforts that women may experience during pregnancy, including: • Nausea • Heartburn • Breathing difficulties • Chest and ribs pains • Low Back and pelvic pains • Sciatica • Water retention • Varicose veins and Haemorrhoids

Preparing for labour with Osteopathy Loosening the pelvis and releasing tensions from the lower back and abdomen will help you relax and experience a more comfortable labour and birth.

Osteopathy for the newborn and children Retained moulding of the cranial or upper neck compression may occur during labour. Some babies cope extremely well with this. Others can display a variety of problems that osteopathy can help resolve with. Following is a non-exhaustive list of the most common symptoms that the babies present to us with: • Feeding/Digesting difficulties • Sleep disturbances • ENT recurrent infections • Colic and Wind • Irritability/Excessive crying

The BIrth Clinic GIH

Pregnancy Massage and Beauty Therapy

This was previously an established luxury service for men and women, providing the ultimate pampering beauty and well-being services. Achieving a balanced life and a healthy body is important to each individual. We have made it easier for you to find that balance whilst diving into heavenly relaxation in the environment of medical excellence which the Birth Clinic provides. Discover Egoist's comprehensive range of treatments, varying from facials and tension relieving massages, to the latest detoxifying, Alpha and beta acid peels, and microdermabrasion treatment. Therapies are available to mothers, fathers or anybody else.

60-minute pregnancy massage Give yourself the special attention a mum-to-be needs. Regular massage during pregnancy helps with the emotional and physical preparation for giving birth, as well as many minor ailments, such as: • Achy hips • Backache • Mussel tension • Fluid retention Massage treatments are suitable from the second trimester.

5-week baby massage courses 90 minute sessions Give your little angel the perfect start – baby massage promotes bonding, reduces stress hormones and helps with: • Improved sleep patterns • Relief of colic and digestive problems, including constipation • Teething discomfort Specialist baby massage instructor, member of the International Association of Infant Massage (IAIM).

Relationship problems Autogenic training (AT) during pregnancy is a relaxation therapy based on six simple mental exercises for natural self-regulation of mind and body. AT has been researched and used for many years in the treatment of primary infertility during pregnancy and childbirth. AT has been noted by leading obstetricians as helping significantly in facilitating, economizing and accelerating the physiological processes of natural delivery. Studies have reported that, of those women who received relaxation therapy, a positive response was observed in a significant number of documented contractions. It was also observed that the women who used relaxation therapy had significantly longer pregnancies and larger babies when compared to those women who were not practicing the relaxation therapy.

Psychotherapy and autogenic therapy are particularly useful to help with the following: Miscarriage and termination trauma • Infertility issues • Reduces nausea, vomiting, indigestion, constipation • Helps insomnia and physical discomfort • Eases irritability, tension and anxiety during birth • Allows the physiology of the body to do its job naturally • Reduces stress, i.e. muscle spasm and tension • Shortened labour • Provides pain relief after the birth • Accelerates healing • Boosts milk production • Reduces postnatal depression

Being pregnant is a time of great joy and anticipation. It is also a time of great change and upheaval, leading to conflicting emotions and physical demands upon the body, as you prepare for this new life to arrive. Reflexology is a wonderful way of helping you through the myriad of changes. “For me, reflexology was time I gave to myself and space - without any demands - to be cared for and by extension care for my baby” T. Shand

The BIrth Clinic GIH

GULUiNDEPENDEN + HOSPITAL

THE BIRTH CLINIC BROCHURE 2010/11 The BIrth Clinic

Airfield Road, Gulu, Uganda, East Africa GIH

A 21st Century Hospital