Taking In
Itu adalah masa ketergantungan. Berlangsung 1-2 hari postpartum. Ibu lebih fokus pada dirinya sendiri. Ibu berulang kali mengatakan proses pengiriman. Ibu merasa tidak nyaman dalam bentuk bagal, nyeri pada jahitan, kurang tidur dan kelelahan. Karena lelah dengan sesuatu yang baru, secara psikologis ibu menjadi mudah marah dan menangis. Kehadiran suami dan keluarga yang sangat diperluan dalam fase ini.
Taking Hold
Berlangsung pada hari ke 3 sampai hari ke-10. Pada fase ini timbul rasa ketidakmamuan ketakutan dan rasa tanggung jawab dalam merawat bayi. Ibu sensitif dan mudah marah.
Letting go
Merupakan periode di mana seorang ibu tidak bisa menerima tanggung jawab untuk peran barunya. Berlangsung 10 hari setelah postpartum. Ibuku memiliki ketergantungan bayi bisa menerima padanya.
2010-10-25
how to improve the quality of care
> Drink a quart of milk per day
> Leaf shoots katuk and salted vegetables make more milk out
> Additionally, important factors soul, mothers spend more tranquil life of the mother's milk which is in grief
> Performing breast care
> With drugs, according to doctor's instructions
> Leaf shoots katuk and salted vegetables make more milk out
> Additionally, important factors soul, mothers spend more tranquil life of the mother's milk which is in grief
> Performing breast care
> With drugs, according to doctor's instructions
2010-10-17
Stages Of Growth and Development
Fetus
Ninth gestational week to birth.
Neonate
Birth to four weeks.
Infant
Four weeks to one year.
Toddler
One to three years.
Preschool
Three to six years.
School Age
Six to twelve years.
Adolesence
12-18 years
Ninth gestational week to birth.
Neonate
Birth to four weeks.
Infant
Four weeks to one year.
Toddler
One to three years.
Preschool
Three to six years.
School Age
Six to twelve years.
Adolesence
12-18 years
Waterbirth
Alternative birthing in the water
Waterbirth is a birth process that is done in warm water. At the time in the womb, the baby is in the amniotic fluid. By birth in the same environment, will be more comfortable for babies, as well as lowering stress levels mama.
What are the benefits?
• Water is soothing, comforting, and increases energy.
• buoyancy mama lose weight, making it possible to move more freely. It will also produce a more efficient contraction. Blood flow will flow more smoothly.
• Water can reduce the causes of stress hormones, and make mama body produce endorphins, pain reducer.
Do not do waterbirth if ....
• Mama suffering from herpes. Herpes is easily transmitted through water.
• Babies in the breech position. consult your doctor.
• Mom diagnosed with severe bleeding and infections of pregnancy.
• baby twins, in this case consult a physician.
Does warm water is not harmful to pregnancy?
Depending on the temperature. If the water is too hot, dehydration can be risky for the mother and her baby, also can raise body temperature and heart rate baby mama. So, make sure the water temperature is stable at temperatures 36 degrees C and the amount is sufficient. Should provide adequate drinking water and a cold cloth to wipe the face and neck mama, mama to prevent dehydration.
How long a baby can survive in water?
In the United States, usually the baby out of the water in the first 10 seconds after birth. Appropriate measures to do is lift the baby without hurry and put him to sleep in mommy's arms.
Water Birth
Water birth is a method of giving birth, the which involves immersion in warm water. Proponents believe That this method is safe and Provides many benefits for both mother and infant, Including pain relief and a less traumatic birth experience for the baby. However, critics argue That the procedure introduces unnecessary risks to the infant Such as infection and water inhalation.
Newborn with umbilical cord still attached after a water birth
Benefits
For the baby
Childbirth cans be a strenuous experience for the baby. Properly heated water [4] helps to ease the transition from the birth canal to the outside world Because the warm liquid resembles the familiar intra-uterine environment, and softens light, colors and noises.
For the mother
Pain management
Full immersion in water promotes physiological responses in the mother That reduce pain Including a redistribution of blood volume, the which stimulates the release of oxytocin and vasopressin (Katz 1990), the latter Also the which increases oxytocin blood levels (Odent 1998). No evidence was found That this benefit was associated with poorer outcomes for babies or longer labours. "It has Also been found That in waterbirths the buoyancy of the mother and the baby, allow for a gravitational pull. This pull not only opens up the mother's pelvis Also but allows the baby to descend more Easily
Intact perineum / decreased episiotomy
Water birth is believed to aid stretching of the perineum and Decrease the risk of skin tears. Support from the water slows crowning of the infant's head and offers perineal support, the which decreases the risk of tearing and reduces the use of episiotomy, a surgical procedure cans the which cause a number of complications. Indeed, there is a zero episiotomy rate in the waterbirth literature (Harper 2000). Moreover, "perineal trauma is reported to be Generally less severe, with more intact perineums for multips, but in Some literature about the Same frequency of tears for primips in or out of the water," (Harper 2000; Also see Burn 1993 and Garland 1997).
Risks and concerns
Infection
Due to the rigorous protocols for cleaning birthing tubs Between labors (especially in Hospitals), there is little (if any) risk of transferring bacteria from infant to mother or mother to infant. In a 1999 study of bacterial Cultures carried out at the Oregon Health Sciences University Hospital, there were the resource persons Cultured no instances of bacteria from the birth pool Itself. While Pseudomonas bacteria (common in tap water) were the resource persons present, even those Infants That tested positive for the bacteria needed no treatment for infections.
Slowed labor
Due to the documented relaxing effects of water, laboring in water is Sometimes associated with a Decrease in the intensity of contractions, and is thus thought to slow labor. While home birth experts (eg Harper, RN) argue That this must be evaluated on a case-by-case basis, Some Hospitals have adopted a "5 centimeter" rule, allowing women to enter the tub only once the cervix has already expanded to 5 centimeters (Harper 2000).
Maternal blood loss
For care providers, Who Are inexperienced in delivery in water, it May be Difficult to assess the amount of maternal blood loss. While well-developed methods of determining the maternal blood loss in water do exist, many providers prefer to deliver the placenta "on land" for this reason (eg the University of Michigan hospital.)
On the other hand, Some doctors and midwives see waterbirths That Actually have been known to reduce the amount of blood loss. The Water Surrounding the mother Actually lowers the mother's blood pressure and heart rate. Mothers still lose significant amount of blood through the passing of the placenta [13].
Waterbirth is a birth process that is done in warm water. At the time in the womb, the baby is in the amniotic fluid. By birth in the same environment, will be more comfortable for babies, as well as lowering stress levels mama.
What are the benefits?
• Water is soothing, comforting, and increases energy.
• buoyancy mama lose weight, making it possible to move more freely. It will also produce a more efficient contraction. Blood flow will flow more smoothly.
• Water can reduce the causes of stress hormones, and make mama body produce endorphins, pain reducer.
Do not do waterbirth if ....
• Mama suffering from herpes. Herpes is easily transmitted through water.
• Babies in the breech position. consult your doctor.
• Mom diagnosed with severe bleeding and infections of pregnancy.
• baby twins, in this case consult a physician.
Does warm water is not harmful to pregnancy?
Depending on the temperature. If the water is too hot, dehydration can be risky for the mother and her baby, also can raise body temperature and heart rate baby mama. So, make sure the water temperature is stable at temperatures 36 degrees C and the amount is sufficient. Should provide adequate drinking water and a cold cloth to wipe the face and neck mama, mama to prevent dehydration.
How long a baby can survive in water?
In the United States, usually the baby out of the water in the first 10 seconds after birth. Appropriate measures to do is lift the baby without hurry and put him to sleep in mommy's arms.
Water Birth
Water birth is a method of giving birth, the which involves immersion in warm water. Proponents believe That this method is safe and Provides many benefits for both mother and infant, Including pain relief and a less traumatic birth experience for the baby. However, critics argue That the procedure introduces unnecessary risks to the infant Such as infection and water inhalation.
Newborn with umbilical cord still attached after a water birth
Benefits
For the baby
Childbirth cans be a strenuous experience for the baby. Properly heated water [4] helps to ease the transition from the birth canal to the outside world Because the warm liquid resembles the familiar intra-uterine environment, and softens light, colors and noises.
For the mother
Pain management
Full immersion in water promotes physiological responses in the mother That reduce pain Including a redistribution of blood volume, the which stimulates the release of oxytocin and vasopressin (Katz 1990), the latter Also the which increases oxytocin blood levels (Odent 1998). No evidence was found That this benefit was associated with poorer outcomes for babies or longer labours. "It has Also been found That in waterbirths the buoyancy of the mother and the baby, allow for a gravitational pull. This pull not only opens up the mother's pelvis Also but allows the baby to descend more Easily
Intact perineum / decreased episiotomy
Water birth is believed to aid stretching of the perineum and Decrease the risk of skin tears. Support from the water slows crowning of the infant's head and offers perineal support, the which decreases the risk of tearing and reduces the use of episiotomy, a surgical procedure cans the which cause a number of complications. Indeed, there is a zero episiotomy rate in the waterbirth literature (Harper 2000). Moreover, "perineal trauma is reported to be Generally less severe, with more intact perineums for multips, but in Some literature about the Same frequency of tears for primips in or out of the water," (Harper 2000; Also see Burn 1993 and Garland 1997).
Risks and concerns
Infection
Due to the rigorous protocols for cleaning birthing tubs Between labors (especially in Hospitals), there is little (if any) risk of transferring bacteria from infant to mother or mother to infant. In a 1999 study of bacterial Cultures carried out at the Oregon Health Sciences University Hospital, there were the resource persons Cultured no instances of bacteria from the birth pool Itself. While Pseudomonas bacteria (common in tap water) were the resource persons present, even those Infants That tested positive for the bacteria needed no treatment for infections.
Slowed labor
Due to the documented relaxing effects of water, laboring in water is Sometimes associated with a Decrease in the intensity of contractions, and is thus thought to slow labor. While home birth experts (eg Harper, RN) argue That this must be evaluated on a case-by-case basis, Some Hospitals have adopted a "5 centimeter" rule, allowing women to enter the tub only once the cervix has already expanded to 5 centimeters (Harper 2000).
Maternal blood loss
For care providers, Who Are inexperienced in delivery in water, it May be Difficult to assess the amount of maternal blood loss. While well-developed methods of determining the maternal blood loss in water do exist, many providers prefer to deliver the placenta "on land" for this reason (eg the University of Michigan hospital.)
On the other hand, Some doctors and midwives see waterbirths That Actually have been known to reduce the amount of blood loss. The Water Surrounding the mother Actually lowers the mother's blood pressure and heart rate. Mothers still lose significant amount of blood through the passing of the placenta [13].
Hyperemesis Gravidarum
Persistent, severe vomiting which is an extreme form of “morning sickness”.
Symptoms
Frequent vomiting which may occur at any time of day or night
Loss of weight
Little or no preceding nausea
Duration
Vomiting in pregnancy usually starts after the 4th week of pregnancy and has cleared by the 14th – 16th week.
Causes
The exact cause is not known, but vomiting may due to the changes in the levels of hormones or the effects of the growth of the uterus. Fears and worries may then aggrevate the tendency to vomit.
Complication
The patient may become very short of body fluids, minerals and vitamins.
Symptoms
Frequent vomiting which may occur at any time of day or night
Loss of weight
Little or no preceding nausea
Duration
Vomiting in pregnancy usually starts after the 4th week of pregnancy and has cleared by the 14th – 16th week.
Causes
The exact cause is not known, but vomiting may due to the changes in the levels of hormones or the effects of the growth of the uterus. Fears and worries may then aggrevate the tendency to vomit.
Complication
The patient may become very short of body fluids, minerals and vitamins.
GENERAL OBSTETRIC’s DEFINITION
Gravida
Any pregnancy, regardless of duration: also, the number of pregnancies, including the one in progress, if applicable.
Nulligravida
A woman who has never been pregnant.
Primigravida
A woman who is pregnant for the first time.
Multigravida
A woman who has been pregnant before. Regardless of the duration of the pregnancy.
Para
A woman who has given birth to one or more children who reached the age of viability (20 weeks gestation). Regardless of the number of fetuses delivered and regardless of whether those children are now living.
Multipara
A woman who has given birth to two or more children (past the point of viability), regardless of whether the children were alive. The term is also used informally to describe a woman before a birth of her second child.
Nullipara
A woman who has not given birth to a child who reached the point of viability.
Abortion
Termination of pregnancy before viability (20 weeks gestation), either spontaneously of induced.
Gestational age
Prenatal age of the developing fetus calculated from the first day of the woman LNMP.
Fertilization age
Prenatal age of the developing fetus calculated from the date of cpnception: approximately 2 weeks shorter than the gestational age.
Age of viability
A fetus that has reached the stages (usually 20 weeks) where it is capable of living outside the uterus.
Any pregnancy, regardless of duration: also, the number of pregnancies, including the one in progress, if applicable.
Nulligravida
A woman who has never been pregnant.
Primigravida
A woman who is pregnant for the first time.
Multigravida
A woman who has been pregnant before. Regardless of the duration of the pregnancy.
Para
A woman who has given birth to one or more children who reached the age of viability (20 weeks gestation). Regardless of the number of fetuses delivered and regardless of whether those children are now living.
Multipara
A woman who has given birth to two or more children (past the point of viability), regardless of whether the children were alive. The term is also used informally to describe a woman before a birth of her second child.
Nullipara
A woman who has not given birth to a child who reached the point of viability.
Abortion
Termination of pregnancy before viability (20 weeks gestation), either spontaneously of induced.
Gestational age
Prenatal age of the developing fetus calculated from the first day of the woman LNMP.
Fertilization age
Prenatal age of the developing fetus calculated from the date of cpnception: approximately 2 weeks shorter than the gestational age.
Age of viability
A fetus that has reached the stages (usually 20 weeks) where it is capable of living outside the uterus.
Fetal Heart Rate
Signs and symptoms
1.Decreased movement felt by the mother
2.Meconium in the amniotic fluid
3.Cardiotocography signs
a.increased or decreased fetal heart rate (tachycardia and bradycardia),
especially during and after a contraction
b.decreased variability in the fetal heart rate
4.Biochemical signs, assessed by collecting a small sample of baby's blood from a
scalp prick through the open cervix in labour
a.fetal acidosis
b.elevated fetal blood lactate levels indicating the baby has a lactic acidosis.
Abnormal Fetal Heart Rate :
a.A normal fetal heart rate may slow during a contraction but usually recovers to
normal as soon as the uterus relaxes.
b.A very slow fetal heart rate in the absence of contractions or persisting after
contractions is suggestive of fetal distress.
c.A rapid fetal heart rate may be a response to maternal fever, drugs causing rapid
maternal heart rate (e.g. tocolytic drugs), hypertension or amnionitis. In the
absence of a rapid maternal heart rate, a rapid fetal heart rate should be
considered a sign of fetal distress.
Some of these signs are more reliable predictors of actual distress than others. For example, cardiocartography can give high false positive rates, even when interpreted by highly experienced medical personnel. Acidosis is a highly reliable predictor, but is not always available. A highly effective method of assessment of distress would be to use fetal heart rate as a first indicator of distress, to be confirmed with a more reliable method of diagnosis before radical treatment is performed.
Causes
There are many causes of fetal distress:
a.Breathing problems
b.Abnormal position and presentation of the fetus
c.Multiple births
d.Shoulder dystocia
e.Umbilical cord prolapse
f.Nuchal cord
g.Placental abruption
h.Premature closure of the fetal ductus arteriosus
Risk Factors
Women with a history of:
a.Stillbirth
b.Intrauterine growth retardation (IUGR)
c.Oligohydramnios or polyhydramnios
d.Multiple pregnancies
e.Rhesus sensitization
f.Hypertension
g.Diabetes and other chronic diseases
h.Decreased fetal movements
i.Posterm pregnancy.
There is some evidence that maternal age over 35 years is an independent risk factor for uteroplacental insufficiency and fetal distress.
Complication
a.Asfiction
b.Fetal death
In many situations fetal distress will lead the obstetrician to recommend steps to urgently deliver the baby. This can be done by induction, or in more urgent cases, a caesarean section may be performed.
General Management
a.Prop up the woman or place her on her left side.
b.Stop oxytocin if it is being administered.
Something must be done by the midwife if there are any indications like the text below :
a.If a maternal cause is identified (e.g. maternal fever, drugs), initiate
appropriate management.
b.If a maternal cause is not identified and the fetal heart rate remains abnormal
throughout at least three contractions, perform a vaginal examination to check
for explanatory signs of distress:
c.If there is bleeding with intermittent or constant pain, suspect abruptio
placentae;
d.If there are signs of infection (fever, foul-smelling vaginal discharge) give
antibiotics as for amnionitis;
e.If the cord is below the presenting part or in the vagina, manage as prolapsed
cord.
f.If fetal heart rate abnormalities persist or there are additional signs of
distress (thick meconium-stained fluid), plan delivery:
g.If the cervix is fully dilated and the fetal head is not more than 1/5 above the
symphysis pubis or the leading bony edge of the head is at 0 station, deliver by
vacuum extraction or forceps;
h.If the cervix is not fully dilated or the fetal head is more than 1/5 above the
symphysis pubis or the leading bony edge of the head is above 0 station, deliver
by caesarean section.
Meconeum
a.Meconium staining of amniotic fluid is seen frequently as the fetus matures and
by itself is not an indicator of fetal distress. A slight degree of meconium
without fetal heart rate abnormalities is a warning of the need for vigilance.
b.Thick meconium suggests passage of meconium in reduced amniotic fluid and may
indicate the need for expedited delivery and meconium management of the neonatal
upper airway at birth to prevent meconium aspiration (page S-143).
c.In breech presentation, meconium is passed in labour because of compression of
the fetal abdomen during delivery. This is not a sign of distress unless it
occurs in early labour.
1.Decreased movement felt by the mother
2.Meconium in the amniotic fluid
3.Cardiotocography signs
a.increased or decreased fetal heart rate (tachycardia and bradycardia),
especially during and after a contraction
b.decreased variability in the fetal heart rate
4.Biochemical signs, assessed by collecting a small sample of baby's blood from a
scalp prick through the open cervix in labour
a.fetal acidosis
b.elevated fetal blood lactate levels indicating the baby has a lactic acidosis.
Abnormal Fetal Heart Rate :
a.A normal fetal heart rate may slow during a contraction but usually recovers to
normal as soon as the uterus relaxes.
b.A very slow fetal heart rate in the absence of contractions or persisting after
contractions is suggestive of fetal distress.
c.A rapid fetal heart rate may be a response to maternal fever, drugs causing rapid
maternal heart rate (e.g. tocolytic drugs), hypertension or amnionitis. In the
absence of a rapid maternal heart rate, a rapid fetal heart rate should be
considered a sign of fetal distress.
Some of these signs are more reliable predictors of actual distress than others. For example, cardiocartography can give high false positive rates, even when interpreted by highly experienced medical personnel. Acidosis is a highly reliable predictor, but is not always available. A highly effective method of assessment of distress would be to use fetal heart rate as a first indicator of distress, to be confirmed with a more reliable method of diagnosis before radical treatment is performed.
Causes
There are many causes of fetal distress:
a.Breathing problems
b.Abnormal position and presentation of the fetus
c.Multiple births
d.Shoulder dystocia
e.Umbilical cord prolapse
f.Nuchal cord
g.Placental abruption
h.Premature closure of the fetal ductus arteriosus
Risk Factors
Women with a history of:
a.Stillbirth
b.Intrauterine growth retardation (IUGR)
c.Oligohydramnios or polyhydramnios
d.Multiple pregnancies
e.Rhesus sensitization
f.Hypertension
g.Diabetes and other chronic diseases
h.Decreased fetal movements
i.Posterm pregnancy.
There is some evidence that maternal age over 35 years is an independent risk factor for uteroplacental insufficiency and fetal distress.
Complication
a.Asfiction
b.Fetal death
In many situations fetal distress will lead the obstetrician to recommend steps to urgently deliver the baby. This can be done by induction, or in more urgent cases, a caesarean section may be performed.
General Management
a.Prop up the woman or place her on her left side.
b.Stop oxytocin if it is being administered.
Something must be done by the midwife if there are any indications like the text below :
a.If a maternal cause is identified (e.g. maternal fever, drugs), initiate
appropriate management.
b.If a maternal cause is not identified and the fetal heart rate remains abnormal
throughout at least three contractions, perform a vaginal examination to check
for explanatory signs of distress:
c.If there is bleeding with intermittent or constant pain, suspect abruptio
placentae;
d.If there are signs of infection (fever, foul-smelling vaginal discharge) give
antibiotics as for amnionitis;
e.If the cord is below the presenting part or in the vagina, manage as prolapsed
cord.
f.If fetal heart rate abnormalities persist or there are additional signs of
distress (thick meconium-stained fluid), plan delivery:
g.If the cervix is fully dilated and the fetal head is not more than 1/5 above the
symphysis pubis or the leading bony edge of the head is at 0 station, deliver by
vacuum extraction or forceps;
h.If the cervix is not fully dilated or the fetal head is more than 1/5 above the
symphysis pubis or the leading bony edge of the head is above 0 station, deliver
by caesarean section.
Meconeum
a.Meconium staining of amniotic fluid is seen frequently as the fetus matures and
by itself is not an indicator of fetal distress. A slight degree of meconium
without fetal heart rate abnormalities is a warning of the need for vigilance.
b.Thick meconium suggests passage of meconium in reduced amniotic fluid and may
indicate the need for expedited delivery and meconium management of the neonatal
upper airway at birth to prevent meconium aspiration (page S-143).
c.In breech presentation, meconium is passed in labour because of compression of
the fetal abdomen during delivery. This is not a sign of distress unless it
occurs in early labour.
Pregnancy
DANGER SIGN IN PREGNANCY
1.Suddent gush of fluid from vagina
2.Vaginal bleeding
3.Abdominal pain
4.Persistent vomiting
5.Epigastric pain
6.Edema of face and hands
7.Severe, persistent headache
8.Blurred vision or dizziness
9.Chills with fever over 38 degres celcius
10.Painful urination or reduced urine output
The Characteristic of High Risk Pregnancies
1.Relate to the pregnancy itself
2.Occur because the woman has a medical condition or injury that complicates the
pregnancy.
3.Result from the environmental hazards that effect on the mother or her fetus
4.Arise from maternal behaviours or lifestyle that have a negative effect on the
mother or fetus.
1.Suddent gush of fluid from vagina
2.Vaginal bleeding
3.Abdominal pain
4.Persistent vomiting
5.Epigastric pain
6.Edema of face and hands
7.Severe, persistent headache
8.Blurred vision or dizziness
9.Chills with fever over 38 degres celcius
10.Painful urination or reduced urine output
The Characteristic of High Risk Pregnancies
1.Relate to the pregnancy itself
2.Occur because the woman has a medical condition or injury that complicates the
pregnancy.
3.Result from the environmental hazards that effect on the mother or her fetus
4.Arise from maternal behaviours or lifestyle that have a negative effect on the
mother or fetus.
2010-10-16
menstrual
Menstruation is the release of the uterine lining (endometrium) that is accompanied by bleeding and occur repeatedly every month except during pregnancy.
First menstruation (menarche) is common at the age of 11, but also can terjadin at the age of 8 years or 16 years. The first day of perharahan calculated as the beginning of each menstrual cycle (Heri to-1). The cycle ends just before the next menstrual cycle. Mrnstruasi cycle ranges from 21-40 days. Only 10-15% of women who have a 28-day cycle.
The distance between the most oanjang cycles usually occur shortly after menarche and immediately before menopause. At first, the cycle may be irregular. The distance between 2 cycles can last for 2 months or within 1 month may occur 2 cycles. This is normal, after a long cycle will become more regular.
And duration of the menstrual cycle can be known by making notes on a calendar. By using the calendar, you can know your cycle pattern and this will assist you in estimating the cycle that would come. Mark every day 1 with a cross, then count to the next cross. Thus you can find out your cycle. Every month after the 5th day of menstrual cycle, the endometrium begins to grow and thicken in preparation for the possibility of pregnancy.
Source: Kissanti, Annia. 2009. Book Smart Women Health and Beauty. Araska.
First menstruation (menarche) is common at the age of 11, but also can terjadin at the age of 8 years or 16 years. The first day of perharahan calculated as the beginning of each menstrual cycle (Heri to-1). The cycle ends just before the next menstrual cycle. Mrnstruasi cycle ranges from 21-40 days. Only 10-15% of women who have a 28-day cycle.
The distance between the most oanjang cycles usually occur shortly after menarche and immediately before menopause. At first, the cycle may be irregular. The distance between 2 cycles can last for 2 months or within 1 month may occur 2 cycles. This is normal, after a long cycle will become more regular.
And duration of the menstrual cycle can be known by making notes on a calendar. By using the calendar, you can know your cycle pattern and this will assist you in estimating the cycle that would come. Mark every day 1 with a cross, then count to the next cross. Thus you can find out your cycle. Every month after the 5th day of menstrual cycle, the endometrium begins to grow and thicken in preparation for the possibility of pregnancy.
Source: Kissanti, Annia. 2009. Book Smart Women Health and Beauty. Araska.
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