New Beginnings

Having a baby is a natural event and a joyous and important milestone in your life. At Aga Khan University Hospital (AKUH), we try to make this experience as happy as it should be and as safe as it can possibly be for your baby and you.

After registration at the clinic, your first contact will be with an AKUH nurse. Nurses at the AKUH are highly qualified and well trained in Obstetrics and Gynaecology. They will assist you during your difficult moments and provide personalized and high quality of nursing care. This is during pregnancy and while you are having your baby.

Please do share your concerns and needs with our nurses. They are keen to help you and explain things to you and you should make use of their expertise and assistance. Keeping your fears to yourself will only make things worse - please talk about them to your nurse or doctor and you will feel much better!

PRE-NATAL CARE

At AKUH, we help and advise mothers to take good care of herself and her baby during pregnancy. Please register at our Antenatal Clinics as early as possible in your pregnancy.

On your periodic visits, you will be assessed by different methods. These include interviews and questions, physical examinations and laboratory tests as well as ultrasound. You will be advised on any special care that is necessary for you. Your baby's growth and development will be regularly checked during the pregnancy period.

ANTENATAL CLASSES

The Antenatal classes are a certificate course consisting of four sessions of two hours each. The sessions are held every Saturday from 10:30 AM to 12:30 PM Please make enquiries about these classes at the counter when you come to the consulting clinic 4 and register yourself at your convenient dates. Skilled and experienced nurses conduct these classes in order to educate our patients on pregnancy and labor.

Pregnancy is a new and exciting experience for every woman; it is only natural that mother will have questions and concerns about pregnancy and childbirth. We urge all mothers to be, especially if they are pregnant for the first time to attend the antenatal classes.

You will be taught how best to take care of yourself during pregnancy, how to watch out for a few danger signs and given plenty of helpful hints. We will also educate you on the benefits of a healthy diet, and demonstrate exercises, which will prevent backache and help you during labour and during postnatal period, etc.

• Session I includes information about the first three months of pregnancy.
• Session II includes information about the middle three months of pregnancy.
• Session III includes information about the last three months of pregnancy.
• Session IV includes information about Normal delivery as well as care before and after the delivery.

Educational films are shown in all classes. Preparations and techniques for breast-feeding are also explained and a useful booklet is available at a small charge, which covers both breast-feeding and exercise.

We encourage fathers-to-be also attend these classes so that they can be more supportive and helpful to their wives during pregnancy and labour.

YOUR DOCTOR

You may have chosen or been assigned to one of our specialist doctors, who will co-ordinate your care. Since our doctors have many responsibilities, you will appreciate that your own doctor cannot always be present at the clinic or during labour. In case your doctor is delayed else where, or is away on leave, another competent doctor, who knows about your case, will take care of you. Our consultant doctors rotate their duties so that there is always a consultant available at all times of the day and on all days of the year including public holidays.

AKUH is a teaching hospital and thus maintains the highest standards of care. During the course of your visits to the hospital you will become faimiliar with the many doctors in the department. These include residents (postgraduate doctors specializing in Obstetrics), interns and senior medical officers as well as students both female and male.

HOW TO CONTACT YOUR DOCTOR

There may be occasions when you want to seek advice from the hospital staff between scheduled clinic appointments.

Just duty on the extension:

• 486-4642/4647/4641 (Monday through Friday 9:00 AM to 5:00 PM) or 486-4391 (5:00 PM through 9:00 AM the following day or during weekends i.e Saturday and Sunday as well as on holidays).
• During week days and working hours (Monday through Friday from 9:00 AM to 5:00 PM), your duty will be transferred to the secretary of the Department of Obstetrics and Gynaecology. Please indicate whether it is an emergency or not.
• In case of an emergency, he/she will immediately locate your doctor or his/her representative
• If it is not an emergency and your doctor is not immediately available, please leave a message for him or her with the secretary, and your duty will be returned as soon as possible.
• If any emergency arises during evening hours (from 5:00 PM through 9:00 AM, the following day) and during weekends (Saturday and Sunday) as well as on holidays, ask the telephone operator for the RMO on-duty in Obstetrics and Gynaecology.
• If you cannot telephone or get through to the right person, you should come to the Emergency Room immediately.

YOUR SPECIAL WISHES

We will try to accommodate your special wishes as much as possible. If you have any special requests because of previous experiences, religious beliefs or family customs, please feel free to discuss them with us. On certain occasions, if we fail to oblige you, please understand that we have a large number of patients to consider and we must do what is best for the majority.

IF YOU NEED ADVICE IN A HURRY

If, during your pregnancy, you need advice or guidance in a hurry, it is usually best if you come to the Labour Room. Bring your Antenatal Card with you. If this is not possible, please duty the Labour Room (486-4391), identify yourself and ask for a member of the medical staff, who will respond to your needs.

WHEN THE TIME COMES! HAVING YOUR BABY

If you need any advice regarding labor, please telephone the Labour Room (486-4391). Please give:

• Your name
• Medical Record Number (which is on your white plastic registration card)
• Name of your obstetrician/doctor.

If you cannot telephone or if there is an emergency, please come to the Labour Room at the Hospital and bring your Antenatal Card with you.  

IN THE LABOUR ROOM

Dur ing labour, a nurse will be assigned to take care of you. The doctors will check you carefully and you will be helped as was shown to you in your antenatal classes. Most labours are a natural process, but if special care is needed for any reason, then all facilities are available at AKUH.

If your delivery is absolutely normal, you will be delivered by the doctor on-duty. The consultant on-duty will of course be called if there are any problems and your own doctor cannot be present. Your own doctor will see you at the earliest opportunity.

AFTER THE BABY IS BORN

You will rest and regain strength, start nursing and learn to take care of your child. This is a time for happiness and joy. These days a new mother does not need to be in hospital for very long.

A healthy newborn should usually be located near the mother. This natural relationship is called bonding or attachment and has many benefits. The baby has a better chance to become attached to the mother, to develop good breast-feeding habits, which helps to avoid most infections. At the same time, you need help in caring for your baby, and to let your have rest after childbirth, the nurse on duty will respond to your needs. Flexibility is possible, please do discuss freely with the nurse your baby's care and progress.

Once the baby is delivered it is admitted under the care of a Paediatrician and will be seen daily by a doctor. In special cases when requested, the Paediatrician will be present at the time of delivery for receiving the baby. If the baby has to be taken away for tests or special treatment, the nursery staff will keep you informed.

A specially designed exercise programme will be demonstrated to you. This will enable you to quickly regain you body strength and full function.

VISITING HOURS

• Ward A2 (Private Room):
  Daily 11:30 AM to 12:30 PM and 4:00 PM to 8:00 PM
• Ward B2 (Semi Private/General Wards Beds):
  M onday through Saturday 4:00 PM to 7:00 PM
• Sunday and holidays 10:00 AM-11:30 AM & 4:00 PM-7:00 PM

BREAST-FEEDING IS BEST

Experts recommend that breast-feeding is best for both the mother and the baby. You will be encouraged to put the baby on the breast (suckle) soon after delivery and regularly afterwards. Do not be disappointed if the milk does not flow immediately. For the first two or three days after birth, a watery yellowish fluid is discharged from the nipple. This has tremendous benefit for the baby and also provides nourishment. The baby does not require any water or bottle milk if regular suckling is present. If, however, you have strong views against breast-feeding, please discuss them with your consultant during your antenatal visits.

Best for Babies:

• Breast milk is the ideal food for babies, because:
• It contains all the nutrients that babies need for the first 4 to 6 months.
• It is easily digested and the baby's body is able to use the iron in breast milk better than from other sources .
• Breast milk contains substances that may help protect babies against illness.
• Some studies have shown that babies who were nursed on the breast had less colic and diarrhoea, fewer colds and ear infections.
• Breast milk also seems to protect babies from food allergies as they get older.
• The American Academy of Paediatrics has stated that breast milk is the best food for infants throughout the first year of life.

Best for Mothers:
Breast feeding gives the new mother a chance to show her special love and provides her with much emotional satisfaction.

It is convenient. When a baby is hungry at night, the mother can just offer the baby her breast and go to sleep again.

Breast-feeding helps the uterus get back to its normal size. When a mother breast-feeds, her uterus contracts. This makes the uterus smaller and firmer.

For mothers who are concerned about weight gained during pregnancy, breast-feeding helps them shed added pounds the natural way. The fat that pregnant women tend to put on acts as a caloric reserve to be used up while nursing.

Mothers say that breast-feeding creates a special closeness in the family and fits in with the more natural lifestyle that many young families seek.

Birth Certificate:
After the birth of the baby, a computer generated application form bearing the birth information will be provided to you. You will be required to verify the information, sign the form and submit it to the Medical Records Department along with a photocopy of the National Identity Card of   both the parents atleast a day prior to discharge, so that you could pick up the Birth Certificate on your way home.

As the Original Birth Certificate is required to be submitted to KMC, a facility is available to have a copy of the birth Certificate for your record purposes against a processing fee.

Timings: Daily 9:00 AM – 8:00 PM (except Sundays and public holidays)

SCREENING TEST OF NEW-BORNS

This is a unique service provided by the AKUH to your baby. Some babies are born with problems not seen at once. For many of these, screening tests are available   - an example is deficiency of the thyroid hormones, which is extremely essential for the normal brain development of a baby. It is difficult to identify the babies with this problem by just looking at them. But by doing a blood test on a few drops of blood, which are taken from the baby's heel, this problem can be detected very early, i.e. in the first few days of life. This test is done on all babies born at AKUH.

If you receive a letter informing you that the test is abnormal, please do not be alarmed. The test has to be repeated on a larger sample of blood before we can say that the baby has a problem. Do not ignore the letter either. Please do come back for a repeat test, which in most cases is negative.

If the second test is positive, your baby will be given timely treatment.

HOSPITAL COSTS

In order to place a ceiling on delivery costs and in response to requests from numerous families, AKUH has taken the lead in introducing delivery packages in the Private, Semi-private and General Ward beds. After examining the mother to-be, the doctor will determine the eligibility for the package. The mother to-be has the option of selecting the bed category, the package prices are for Normal, Forceps, Breech/Twins and Caesarean deliveries. For more information, please contact the Unit Receptionist at the Obstetrics/Gynaecology clinic.

YOUR MEDICAL BILLS

If you are planning to deliver at Aga Khan Hospitalplease register for delivery. When you register for your delivery at AKUH, you would be requested to pay Rs. 1,000 as registration fees. Make enquiry about where you have to deposit this fees when you come for your visit.This sum will be adjusted in your final bill after you have had your baby. As you are looked after by a team, charges include those of all physicians, e.g. residents, instructors and consultants, who have attended to you and your baby during your stay at the Hospital.

DISCHARGE: GOING HOME

On the day of your discharge, the nurse will explain to you regarding the care of your baby and medications to be continued at home. If you have any concerns, please clarify with the doctor or the nurse. In the meantime your bill will be prepared so that you can settle it before going home. This process takes approximately four hours.

We wish you and your baby a healthy and happy life!

CHILD'S PATTERNS OF GROWTH AND DEVELOPMENT

1st  Month : Hearing is fully developed, but eyes do not focus and may appear to cross. Often yawns, hiccups and sneezes. Hands are lightly curled. Head needs support. Sleeps most of the time when not being fed.

2 nd   Month: Turns head in direction of voices. Different cries for food, discomfort and excitement. May begin to sleep through nights. Settles into a regular routine.

3 rd   Month : Smiles, babbles, learns that crying gets attention. Holds up head and can turn from side to back. Enjoys bright colours. Can hold toy if placed in hand.

4 th Month : Holds up head without support. Coos and smiles. Reaches for toes.  P lay with hands and can grasp toys.

5 th   Month: Birth weight usually doubles. Reaches for objects. Carries e verything to mouth. More selective in taste. Can turn from back to side. Raise hands to show desire to be filled.

6 th   Month : Eyes and hands work together. Sites with some propping. Definite emotions. First tooth may appear, usually the lower one.

7 th -8 th   Months: Sits without support. Transfers toys from hand to hand. A ssociates ideas with words. Probably can start drinking from a cup.

9 th   Months : Crawls. Stands with support. May take first steps. Can say a word or two like "mama, dada", understands many. Probably has 6 to 8 teeth.

ONE YEAR: Understands simple sentences and commands. Walks with support. Speaks a few recognizable words. Throws objects around.

TWO YEARS: Demands constant adult attention. Can kick a ball. Runs well, walks up and down. Forms short sentences. Spoon-feeds himself.

THREE YEARS: Asks frequent questions. Walks upstairs with alternating feet. Listens to and demands stories. Can draw a cross or a circle.

FOUR YEARS: Engages in imitative play. Plays with other children. Uses proper sentences to describe recent experiences. Can give name and age.

FIVE YEARS: Runs on toes, skips on alternate feet. Can tie shoelaces. Co-operates more with friends. May know letters of alphabet and may be able to read simple words.

WEANING FOODS: Weaning foods should be started at the age of 4 months. Initially soft, semi-solid and preferably home-made foods like mashed banana, "suji", etc., may be started. Later on more solid foods like "dalia", "Khichri", etc. Should be introduced one at a tim, 1-2 week apart and at a different time with the aim that the child is able to eat from family foods without spices, between one to two years of age.

Vitamins should be given after consultation with the doctor.

For further information, please contact:

Aga Khan University Hospital, Karachi
P.O Box 3500, Stadium Road, Karachi-74800, Pakistan.
Email: marketing@aku.edu