Regardless of the volumes we read, there are always some unanswered questions we have. In this section we will answer questions randomly related to conception, pregnancy and related.
Can I drink caffeine?
The Food and Drug Administration advises that pregnant women eliminate or limit consumption of caffeine-containing beverages such as coffee, tea, and colas.
Is
it safe to continue to exercise and work during pregnancy?
· Exercising during pregnancy can help minimize minor discomfort associated with pregnancy, improve your posture, enhance circulation, assist with control of relaxation and/or expulsion during delivery, and provide a feeling of general well-being. A well-conditioned body will perform better and more reliably during the stress of advanced pregnancy, labor, and delivery. Preconditioning will contribute to a quicker recovery of body contour following delivery.
· Exercise regularly, rather than occasionally. Your exercise program should be planned around your prepregnancy fitness level. This is NOT a good time to begin a new, difficult exercise or sport, such as running a marathon for the first time. If you were active before pregnancy, you can continue to be within reason. If, for example, you play tennis, you can still play unless you have special problems of feel very tired. A good "rule of thumb" is to limit exertion to about 2/3 of what you could do before pregnancy. Women who were not exercising prior to pregnancy are advised to begin an exercise program.
· Stop any exercise right away if you develop signs of dizziness, bleeding, faintness, abdominal or back pain, overly rapid heart rate or shortness of breath. If symptoms continue call our office.
· Most of the time, a healthy woman with no complications in her pregnancy can continue working until the end of her pregnancy. Some women may need to make some changes. If you are experiencing problems that you feel may be due to your job, please discuss them with your health care provider at your office appointments. Your family should be able to help you at home as fatigue increases towards the end of your pregnancy.
What can I use for headaches during pregnancy?
· Headaches are fairly common during pregnancy. Usually headaches are NOT a sign of a serious problem. How often they occur and how bad they are may vary. It is important to discuss with your health care provider what medications you can use for your headache. You should contact your health care provider if your headache does not go away, returns frequently, is severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea.
You may use Paracetemol ONLY two regular tablets of one extra-strength tablet for headaches.
What can I do to prevent or reduce heartburn?
Are
herbs and extra vitamins safe during pregnancy?
· No, your prenatal vitamins should be the only supplement used during pregnancy unless your health care provider specifically instructs you to use an additional product
What
can I do to decrease nausea and vomiting during pregnancy?
· Eat smaller, more frequent meals. Try 6 small meals with snacks in between.
What
is postpartum depression?
Is
it normal to swell during pregnancy?
A certain amount of swelling (edema) is normal during pregnancy. If occurs most often in the legs and primarily in the third trimester and may be worse with pregnancy during the summer months. Elevating your legs during the day (feet above the level of your head), and resting during the day and sleeping on your left side may help reduce swelling.
· Decrease prolonged standing or sitting, with brief periods of walking from time to time.
· Do not wear constrictive clothing or stockings or socks that have a tight band of elastic around the legs.
· Let your health care provider know if you have swelling in your hands (your rings are too tight), or face.
· Do not take diuretics "water pills" for swelling unless they have been prescribed for you by your health care provider.
Generally, little weight is gained during the first trimester (3 or 4 lbs.). The most weight (about 12 to 14 lbs.) is gained during the second trimester. In the third trimester, a woman should expect to gain about 8 to 10 lbs.
Can I drink caffeine?
The Food and Drug Administration advises that pregnant women eliminate or limit consumption of caffeine-containing beverages such as coffee, tea, and colas.
What
can I do to relieve constipation?
· Drink
at least 8 glasses of water each day, including 1-2 glasses of fruit juice,
such a prune juice.
· Include bulk foods, foods high in fiber, such as bran, bran cereals,
and raw fruits and vegetables.
· Exercise daily-walking is a good form of exercise. Exercise and good
physical fitness helps to maintain healthy bowel patterns.
· For occasional constipation, you may use a stool softener laxative, mild nonprescription laxative, or enema. Do not use laxatives or enemas regularly as this can cause dependency. Avoid harsh laxatives and cathartics, such as Epson salts or Ex-Lax. The best laxatives are bulk-formers, such as bran, psyllium, polycarbophil and methylcellulose (found in Metamucil and Citrucel).
· For occasional constipation, you may use a stool softener laxative, mild nonprescription laxative, or enema. Do not use laxatives or enemas regularly as this can cause dependency. Avoid harsh laxatives and cathartics, such as Epson salts or Ex-Lax. The best laxatives are bulk-formers, such as bran, psyllium, polycarbophil and methylcellulose (found in Metamucil and Citrucel).
What
can I take if I have cold or allergy symptoms?
· Increase
fluids (especially water) per day.
· Get extra rest.
· Use a cool mist vaporizer/humidifier at night to moisten the air you breathe to keep nasal/bronchial secretions thin and flowing.
· Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will decrease the mucus in the back of throat and help relieve a sore throat.
· Saline nose drops (NOT Afrin or Neo-Synephrine) upon rising in the morning and at bedtime to moisten secretions.
· Plain Paracetemol two tablets every four hours as needed for aches (a maximum of six tablets in 24 hours.) It is preferable to not use during the first trimester and not at all for one week prior to your triple test.
· Coughing can be relieved by mixing one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or cause vomiting, call your health care provider. You may try Robitussin, an over-the-counter cough medication, after the first trimester.
· Get extra rest.
· Use a cool mist vaporizer/humidifier at night to moisten the air you breathe to keep nasal/bronchial secretions thin and flowing.
· Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will decrease the mucus in the back of throat and help relieve a sore throat.
· Saline nose drops (NOT Afrin or Neo-Synephrine) upon rising in the morning and at bedtime to moisten secretions.
· Plain Paracetemol two tablets every four hours as needed for aches (a maximum of six tablets in 24 hours.) It is preferable to not use during the first trimester and not at all for one week prior to your triple test.
· Coughing can be relieved by mixing one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or cause vomiting, call your health care provider. You may try Robitussin, an over-the-counter cough medication, after the first trimester.
Is
it normal for my gums to swell and/or bleed during pregnancy?
· The extra
hormones in your body during pregnancy may cause your gums to swell and bleed.
Floss and brush regularly, using a soft toothbrush. Having a dental checkup
early in pregnancy is a good idea to be sure your mouth is healthy.
· Exercising during pregnancy can help minimize minor discomfort associated with pregnancy, improve your posture, enhance circulation, assist with control of relaxation and/or expulsion during delivery, and provide a feeling of general well-being. A well-conditioned body will perform better and more reliably during the stress of advanced pregnancy, labor, and delivery. Preconditioning will contribute to a quicker recovery of body contour following delivery.
· Exercise regularly, rather than occasionally. Your exercise program should be planned around your prepregnancy fitness level. This is NOT a good time to begin a new, difficult exercise or sport, such as running a marathon for the first time. If you were active before pregnancy, you can continue to be within reason. If, for example, you play tennis, you can still play unless you have special problems of feel very tired. A good "rule of thumb" is to limit exertion to about 2/3 of what you could do before pregnancy. Women who were not exercising prior to pregnancy are advised to begin an exercise program.
· Stop any exercise right away if you develop signs of dizziness, bleeding, faintness, abdominal or back pain, overly rapid heart rate or shortness of breath. If symptoms continue call our office.
· Most of the time, a healthy woman with no complications in her pregnancy can continue working until the end of her pregnancy. Some women may need to make some changes. If you are experiencing problems that you feel may be due to your job, please discuss them with your health care provider at your office appointments. Your family should be able to help you at home as fatigue increases towards the end of your pregnancy.
What can I use for headaches during pregnancy?
· Headaches are fairly common during pregnancy. Usually headaches are NOT a sign of a serious problem. How often they occur and how bad they are may vary. It is important to discuss with your health care provider what medications you can use for your headache. You should contact your health care provider if your headache does not go away, returns frequently, is severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea.
You may use Paracetemol ONLY two regular tablets of one extra-strength tablet for headaches.
What can I do to prevent or reduce heartburn?
Heartburn is a burning feeling in the center of the chest and upper
abdomen and seems to rise into your throat due to indigestion. It is frequently accompanied by
an unpleasant taste in the mouth and burping. It is caused by a backflow of
acid from the stomach into the esophagus. The muscles that close off the upper
stomach become lax, allowing stomach acids to enter the esophagus and irritate
its lining. This may be worsened by pregnancy because pregnancy hormone levels
increase stomach acid production and decreases the emptying time of the stomach
contents. In addition, your growing uterus presses up on your stomach.
· Eat small frequent meals, 5 or 6 per day instead of 2 or 3 large meals. Avoid drinking large amounts of fluids with meals.
· Avoid foods that cause gas and spicy or greasy foods.
· Do not eat or drink before bedtime.
· Wait 2 hours after eating before exercising.
· No alcohol or smoking.
· Avoid very hot or very cold fluids.
· Antacids may be helpful, (in moderation due to salt content) such as Maalox, Tums, or Gaviscon. Liquid forms are often more effective than tablet forms. If heartburn is frequent and only briefly relieved by antacids, speak with your health care provider.
· Eat small frequent meals, 5 or 6 per day instead of 2 or 3 large meals. Avoid drinking large amounts of fluids with meals.
· Avoid foods that cause gas and spicy or greasy foods.
· Do not eat or drink before bedtime.
· Wait 2 hours after eating before exercising.
· No alcohol or smoking.
· Avoid very hot or very cold fluids.
· Antacids may be helpful, (in moderation due to salt content) such as Maalox, Tums, or Gaviscon. Liquid forms are often more effective than tablet forms. If heartburn is frequent and only briefly relieved by antacids, speak with your health care provider.
· No, your prenatal vitamins should be the only supplement used during pregnancy unless your health care provider specifically instructs you to use an additional product
Is
it safe to continue to have sexual intercourse during pregnancy?
· Some couples
worry about having intercourse during pregnancy. They may be afraid that it
will cause a miscarriage. For a healthy woman with a normal pregnancy, intercourse
is safe into the last weeks of pregnancy. You and your partner may want to experiment
with different positions that may be more comfortable for you. If you are having
problems in your pregnancy, your health care provider may advise you to limit
or avoid intercourse as necessary.
· Eat smaller, more frequent meals. Try 6 small meals with snacks in between.
· These foods may NOT be well tolerated: greasy or fried foods (they
take longer to leave the stomach and therefore may cause nausea and/or heartburn),
very sweet foods, spicy hot foods, and foods with strong odors.
· Drink fluids between meals, not with meals.
· Drink chilled or cold beverages, for instance, decaffeinated soda. Don't drink diet soda, you need the calories at this point.
· Eat slowly and rest after meals. It is best to rest while sitting in an upright position for about one hour after eating.
· Dry toast, soda crackers, or dry pre-sweetened cereals (dry starches) may help relieve nausea.
· Keep track of when you feel nauseated, and what causes it.
· If continued vomiting occurs, do not eat of drink anything until the vomiting has stopped. As you feel better, try small amounts of clear liquids such as broth, Jello, apple, grape or cranberry juice, and/or popsicles.
· Tart or salty foods such as lemons or pickles may decrease nausea.
· Avoid mixing hot and cold foods at a meal, as it may stimulate nausea.
· Avoid eating in a room that is stuffy, too warm, or has cooking smells that may disagree with you.
· Avoid the sight/smell of foods that bother you. Eat meals out or have others bring prepared food to you.
· Wear loose fitting clothing.
· Ask your health care provider about medicine to help control the nausea.
· Drink fluids between meals, not with meals.
· Drink chilled or cold beverages, for instance, decaffeinated soda. Don't drink diet soda, you need the calories at this point.
· Eat slowly and rest after meals. It is best to rest while sitting in an upright position for about one hour after eating.
· Dry toast, soda crackers, or dry pre-sweetened cereals (dry starches) may help relieve nausea.
· Keep track of when you feel nauseated, and what causes it.
· If continued vomiting occurs, do not eat of drink anything until the vomiting has stopped. As you feel better, try small amounts of clear liquids such as broth, Jello, apple, grape or cranberry juice, and/or popsicles.
· Tart or salty foods such as lemons or pickles may decrease nausea.
· Avoid mixing hot and cold foods at a meal, as it may stimulate nausea.
· Avoid eating in a room that is stuffy, too warm, or has cooking smells that may disagree with you.
· Avoid the sight/smell of foods that bother you. Eat meals out or have others bring prepared food to you.
· Wear loose fitting clothing.
· Ask your health care provider about medicine to help control the nausea.
· Postpartum
depression is a mood disorder with postpartum onset.
· Occurrence: Postpartum depression develops in approximately 10% of all postpartum women. The greatest risk occurs at approximately 4 weeks after delivery.
· Contributing factors: Risks for postpartum depression include primiparity (first pregnancy), history of postpartum depression, lack of social support, and lack of stable relationships.
· Signs and symptoms: Symptoms of postpartum depression are the same as those of any major depression: sadness, frequent crying, insomnia, appetite change, difficulty concentrating, worthless feelings, inadequate feelings, lack of concern about personal appearance, persistent anxiety, and irritability toward others.
· Treatment may require counseling, anticipatory guidance, support from others and antidepressant therapy.
· Occurrence: Postpartum depression develops in approximately 10% of all postpartum women. The greatest risk occurs at approximately 4 weeks after delivery.
· Contributing factors: Risks for postpartum depression include primiparity (first pregnancy), history of postpartum depression, lack of social support, and lack of stable relationships.
· Signs and symptoms: Symptoms of postpartum depression are the same as those of any major depression: sadness, frequent crying, insomnia, appetite change, difficulty concentrating, worthless feelings, inadequate feelings, lack of concern about personal appearance, persistent anxiety, and irritability toward others.
· Treatment may require counseling, anticipatory guidance, support from others and antidepressant therapy.
· Approximately
50% of new mothers may experience some degree of baby "blues" (postpartum
blues) a few days after delivery. Most common time is 3 to 10 days after delivery
(but can occur anytime in the first year) and usually last anywhere from 48
hours to 2 weeks. This is the result of many factors, some of which are emotional
letdown following delivery, physical discomfort of the immediate postpartum
period, fatigue, and anxiety.
· Postpartum blues are treated with anticipatory guidance and counseling.
· Postpartum blues are treated with anticipatory guidance and counseling.
· The most
severe form of postpartum mental disorder is postpartum psychosis. It is a relatively
uncommon disorder.
· Women with postpartum psychosis may lose touch with reality. They have stretches of lucidity alternating with psychosis. Also frequently noted are symptoms of confusion and disorientation. The woman who is psychotic usually will have difficulty in caring for her infant, and may have delusions leading t thoughts of self-harm or harm of the infant.
· The peak onset of psychotic symptoms is 10 to 14 days after childbirth, but the risk remains high for months after delivery.
· Treatment may include hospitalization, medication, counseling and support from others.
· Women with postpartum psychosis may lose touch with reality. They have stretches of lucidity alternating with psychosis. Also frequently noted are symptoms of confusion and disorientation. The woman who is psychotic usually will have difficulty in caring for her infant, and may have delusions leading t thoughts of self-harm or harm of the infant.
· The peak onset of psychotic symptoms is 10 to 14 days after childbirth, but the risk remains high for months after delivery.
· Treatment may include hospitalization, medication, counseling and support from others.
· It is
important for a woman to report feelings of sadness following delivery to her
health care provider.
A certain amount of swelling (edema) is normal during pregnancy. If occurs most often in the legs and primarily in the third trimester and may be worse with pregnancy during the summer months. Elevating your legs during the day (feet above the level of your head), and resting during the day and sleeping on your left side may help reduce swelling.
· Decrease prolonged standing or sitting, with brief periods of walking from time to time.
· Do not wear constrictive clothing or stockings or socks that have a tight band of elastic around the legs.
· Let your health care provider know if you have swelling in your hands (your rings are too tight), or face.
· Do not take diuretics "water pills" for swelling unless they have been prescribed for you by your health care provider.
What should I weigh?
Being overweight, underweight, or a desired weight at the beginning of your pregnancy affects your recommended weight gain. Ideally you want to aim for a BMI (body mass index) between 20 and 25. Your BMI is determined by taking your weight (kg) and dividing it by your height (m2) to get your BMI number. Calculate your BMI using your weight before you were pregnant.
Being overweight, underweight, or a desired weight at the beginning of your pregnancy affects your recommended weight gain. Ideally you want to aim for a BMI (body mass index) between 20 and 25. Your BMI is determined by taking your weight (kg) and dividing it by your height (m2) to get your BMI number. Calculate your BMI using your weight before you were pregnant.
| BMI (Kg/m2) Before Pregnancy |
Recommended Weight Gain During Pregnancy |
| Low (BMI <19.8) | 12.5-18 kg (28-40 lb) |
| Normal (BMI 19.8-26) | 11.5-16 kg (25-35 lb) |
| High (BMI 26-29) | 7-11.5 kg (15-25 lb) |
| Obese (BMI >29) | no more than 6 kg (no more than 15 lb) |
Generally, little weight is gained during the first trimester (3 or 4 lbs.). The most weight (about 12 to 14 lbs.) is gained during the second trimester. In the third trimester, a woman should expect to gain about 8 to 10 lbs.
Is my prenatal vitamin enough?
The idea of taking one pill that will take care of all those extra nutrient needs to support all the activity in your womb sounds too good to be true. However, most nutritionists will tell you that if you are not able to get all of those extra nutrients out of your diet alone, then a prenatal vitamin is just the ticket. It can also be very helpful if you are having a tough time keeping food down because of nausea. However, don't let the prenatal vitamins substitute healthy eating and the daily goal of getting all the recommended calcium, folate, vitamin B, iron, etc. The prenatal vitamin should be used in addition to healthy eating, not as a substitute.
The idea of taking one pill that will take care of all those extra nutrient needs to support all the activity in your womb sounds too good to be true. However, most nutritionists will tell you that if you are not able to get all of those extra nutrients out of your diet alone, then a prenatal vitamin is just the ticket. It can also be very helpful if you are having a tough time keeping food down because of nausea. However, don't let the prenatal vitamins substitute healthy eating and the daily goal of getting all the recommended calcium, folate, vitamin B, iron, etc. The prenatal vitamin should be used in addition to healthy eating, not as a substitute.
Can I drink herbal tea?
Even though herbal teas are advertised as natural, safe, and healthy, they are not regulated as drugs are and they are not necessarily safe. Growing evidence suggests some herbs may be harmful to pregnant women. They are best avoided, though if you do choose to drink herbal teas, stick to those with ingredients found in an ordinary diet, such as cinnamon, orange, lemon, and apple
Even though herbal teas are advertised as natural, safe, and healthy, they are not regulated as drugs are and they are not necessarily safe. Growing evidence suggests some herbs may be harmful to pregnant women. They are best avoided, though if you do choose to drink herbal teas, stick to those with ingredients found in an ordinary diet, such as cinnamon, orange, lemon, and apple
Am I getting enough folic acid?
If yours is a planned pregnancy, hopefully you have been taking a daily multivitamin containing at least 400 micrograms (mcg) of folic acid or an over-the-counter prenatal vitamin, which has 800 mcg. Now that you are pregnant, you'll need at least 600 mcg daily, although many doctors recommend 800 mcg. Most doctors will recommend taking a supplement, as well as, eating plenty of folate-rich foods such as leafy green vegetables, chicken or beef liver, lentils or cereal, etc.
If yours is a planned pregnancy, hopefully you have been taking a daily multivitamin containing at least 400 micrograms (mcg) of folic acid or an over-the-counter prenatal vitamin, which has 800 mcg. Now that you are pregnant, you'll need at least 600 mcg daily, although many doctors recommend 800 mcg. Most doctors will recommend taking a supplement, as well as, eating plenty of folate-rich foods such as leafy green vegetables, chicken or beef liver, lentils or cereal, etc.
Is a glass of wine OK?
When you drink alcohol your baby is drinking it too. Therefore,
you should avoid all forms of alcohol when you are pregnant. This
includes beer, wine and hard liquor. When a pregnant woman drinks
alcohol, it quickly reaches the baby through the blood stream. Drinking
alcohol during pregnancy may result in Fetal Alcohol Syndrome, lower
birth weight, physical deformities, mental retardation, and motor
development complications. There is no data to support a safe level of
alcohol consumption during pregnancy. Therefore, medical experts
recommend avoiding alcohol completely during your pregnancy.
What are good snack ideas?
It's break time at work. The lure of the high-fat donuts and sweet rolls at work is almost impossible to resist. However, with a little planning, a more healthful choice can be made that will still satisfy your taste buds. A great thing to do is pack your coffee break "treat" while you are making your lunch in the morning or the night before. Ideas include:
What are good snack ideas?
It's break time at work. The lure of the high-fat donuts and sweet rolls at work is almost impossible to resist. However, with a little planning, a more healthful choice can be made that will still satisfy your taste buds. A great thing to do is pack your coffee break "treat" while you are making your lunch in the morning or the night before. Ideas include:
- muffins
- cinnamon twists
- bagels
- breadsticks
- popcorn
- tasty trail mix
- nuts and bolts
- fresh fruit and dip
- string cheese
- single-serving fruit cups
- yogurt
- bagels with light cream cheese and a little jelly
- baby carrots and dip
- cheese and crackers
- dried fruits, nuts, and seeds
- juice boxes
Do I need a calcium supplement?
It is recommended by most experts that a pregnant woman should get 1,200 mg of calcium daily. A good multivitamin or prenatal vitamin should include at least 150 to 200 mg of calcium and you can also try a calcium supplement. You should still aim for four servings of dairy or other calcium-rich foods a day.
It is recommended by most experts that a pregnant woman should get 1,200 mg of calcium daily. A good multivitamin or prenatal vitamin should include at least 150 to 200 mg of calcium and you can also try a calcium supplement. You should still aim for four servings of dairy or other calcium-rich foods a day.
What exercises are safe to do while I'm pregnant?
Times have changed--women are now encouraged to stay active and fit during pregnancy. There are many safe activities you can enjoy while keeping fit during your pregnancy (unless your doctor has prescribed otherwise).
Times have changed--women are now encouraged to stay active and fit during pregnancy. There are many safe activities you can enjoy while keeping fit during your pregnancy (unless your doctor has prescribed otherwise).
- Swimming is a great activity because it helps strengthen your whole body and is a great cardiovascular exercise. Plus, it's low impact, it helps support your weight, and it keeps you cool. One thing, it's probably not a good idea to dive into a pool, especially later in your pregnancy.
- A brisk walk--doing a mile in 12-15 minutes--is a great workout, even if you're new to exercise. Jogging is also OK in moderation, if you did it before you were pregnant. You'll want to avoid overheating and make sure to drink plenty of fluids. Plus, remember that are more off balance now, so be extra careful not to fall.
- Tennis is OK if you played before you were pregnant. You'll want to keep the pace moderate, playing doubles is a great way to do this. Again, you may have more problems with balance, so be careful, especially with sudden stops.
- Golf and bowling are fine too, but they may not give as much benefit as other activities. Again, watch your balance.
- Mind-body classes like tai chi, yoga and pilates are attracting more pregnant participants as well. These types of classes can do wonders for the management of stress and teach students new methods of relaxation. There are many specialty tapes available on the market and you are sure to find and try many new exercises using these tapes.
- This is also not the time for contact sports where you could fall, injure yourself, or be struck in the abdomen, or badly shake the baby. Therefore, avoid these activities: scuba diving, water skiing, basketball, softball, baseball, horseback riding, and snow skiing.
How can I strengthen my back?
Pregnancy can be harsh on ligaments and joints because of the added weight your body supports. Your back may be one of the major areas where you'll notice the ache. Regular stretching and exercise help offset these effects by improving flexibility, strength, muscle tone, and reducing the incidence of lower back pain.
Pregnancy can be harsh on ligaments and joints because of the added weight your body supports. Your back may be one of the major areas where you'll notice the ache. Regular stretching and exercise help offset these effects by improving flexibility, strength, muscle tone, and reducing the incidence of lower back pain.
How can I prepare for breastfeeding?
When it comes to breastfeeding, preparation is the key. Talk with family and friends who have successfully breastfed. Check out breastfeeding books at your local library. And definitely sign up to take a breastfeeding class at a local hospital, taught by a certified lactation consultant. During this class you will learn breastfeeding basics, tips and techniques, and do's and don'ts. With hands-on instruction you will be exposed to different holding techniques, basic nipple and breast care, how to store breast milk, ways to determine if your infant is getting enough milk, and how and when to use a breast pump. You'll learn what to do if problems should arise, and know when it is necessary to call your doctor or the pediatrician.
When it comes to breastfeeding, preparation is the key. Talk with family and friends who have successfully breastfed. Check out breastfeeding books at your local library. And definitely sign up to take a breastfeeding class at a local hospital, taught by a certified lactation consultant. During this class you will learn breastfeeding basics, tips and techniques, and do's and don'ts. With hands-on instruction you will be exposed to different holding techniques, basic nipple and breast care, how to store breast milk, ways to determine if your infant is getting enough milk, and how and when to use a breast pump. You'll learn what to do if problems should arise, and know when it is necessary to call your doctor or the pediatrician.
Can I continue to use my asthma inhaler during pregnancy?
Yes, it is generally recommended that women who have asthma continue to use their asthma inhalers during pregnancy. Changes that happen to the body as part of the natural course of pregnancy can cause asthma symptoms to worsen. For this reason, it is particularly important for you to discuss your asthma treatment during pregnancy with your health care provider and call the Pregnancy Riskline with questions.
Yes, it is generally recommended that women who have asthma continue to use their asthma inhalers during pregnancy. Changes that happen to the body as part of the natural course of pregnancy can cause asthma symptoms to worsen. For this reason, it is particularly important for you to discuss your asthma treatment during pregnancy with your health care provider and call the Pregnancy Riskline with questions.
What about hair dye? Is it safe?
Yes, getting your hair dyed or highlighted is not expected to be harmful during any trimester of pregnancy. The hair dye will not enter your system in large enough amounts to get to the developing baby.
Yes, getting your hair dyed or highlighted is not expected to be harmful during any trimester of pregnancy. The hair dye will not enter your system in large enough amounts to get to the developing baby.
What kind of diet is recommended in pregnancy?
Plenty
of water and roughage in the diet is essential. Fresh fruits and
vegetables are helpful in providing necessary vitamins and minerals.
Small frequent meals are helpful in the first three months to reduce
nausea and bloating. It is advisable to restrict yourself to food
prepared at home.
What extra precautions do I need to take for twins or triplets?
Extra caution needs to be exerted for multiple pregnancies. Haematinics to prevent anemia, watching out for baby growth discrepancy and preventing early delivery is the key. There are increased chances of bleeding in pregnancy, waters breaking early and caesarean section. Multiple sonography examinations are often needed to monitor the growth of the babies
How often should I be seeing my doctor?
Once a month visits are optimal in early pregnancy. Later in pregnancy, however check ups will usually become more frequent. For a high-risk pregnancy, you may need to visit your doctor repeatedly.
Is pain in the lower tummy normal in pregnancy?
Many women throughout pregnancy may experience mild irregular cramping pain. These are almost always due to contractions of the womb or uterus and are usually not suggestive of adverse events. Mild antispasmodics may be prescribed if the discomfort increases.
What are the first changes that happen to a woman when she becomes pregnant, even before she realizes she's pregnant?
Even before she knows she's pregnant, she'll notice breast changes. Her breasts become tender. Her nipples become tender. Her breasts enlarge ever so slightly and increase during the entire pregnancy. Some other changes are generalized gas production, so constipation as well as gas bloating of the belly occur. These are some of the changes that people come into the office complaining of when they don't even know they're pregnant. Other early changes occur in the skin. There are some ever-so-slight pigment changes in the face or all over the body. Some women can get increased oil production and acne as well in early pregnancy.
What's the tip-off for a woman that she's pregnant?
Some of the tip-offs that you're pregnant could include generalized bloating or difficulty in digestion. That's a big one. Many women begin to feel like they have to urinate very often.
You mentioned that one of the first changes is breast swelling. What happens to the breasts during pregnancy?
Some of the changes in the breast that occur include increased growth of the actual cells of the breast. Initially they increase in number. This is very early. Then what happens during the rest of the pregnancy is that the glandular and ductal cells grow in number and actually expand, getting ready to fill with milk, which will happen right after delivery.
What causes morning sickness and what does it actually indicate?
The causes of morning sickness are not always clear. There is some thought that hormone changes — increases in progesterone and estrogen — cause morning sickness. Usually about 70 to 80 percent of women suffer from morning sickness during early pregnancy; some even begin noticing nausea as early as four to eight weeks. Morning sickness occurs not just in the morning but actually all through the day. It usually ends at about 14 to 16 weeks. One thing that triggers morning sickness is an empty stomach. One way to battle that would be to actually keep food in the belly every two to three hours. There have also been reports showing that vitamin B-6 and calcium can help as well.
What does morning sickness indicate?
Morning sickness is a signal that the progesterone hormones are actually increasing normally. When a woman comes into the office and tells me that she has quite a bit of morning sickness, I actually tell her that's a very good thing. That usually shows that the progesterone hormones are increasing normally and her pregnancy is most likely very protected.
What changes occur to the uterus during pregnancy?
The uterus is made of muscle cells. Throughout pregnancy, many changes occur in the uterus. First, these muscle cells start increasing in size and number. They increase in size all the way through to the delivery. During pregnancy, the uterus grows from about the size of my fist and even smaller in some people, to the size of a large orange or grapefruit, then to the size of a cantaloupe, and then, of course, to the size of a small watermelon at the end.
Around nine to 12 weeks the uterus actually goes from being a pelvic organ to being an abdominal organ. We can feel it in the abdominal exam after about 12 weeks or a little bit earlier.
When will I show?
You should show around 12 weeks, or between months 3-4. Gas, bloating, etc., may have you looking pregnant before then. If you've been pregnant before you may "pop out" earlier.
How long will the morning sickness last? I'm so nauseous!
Morning sickness should occur less and less by the second trimester/4 months. Maybe sooner! On rare occasions it will stick around. Rare!
As the mother's belly gets bigger, as her baby grows, how are the abdominal muscles able to stretch?
As the uterus grows and the abdomen distends, the actual muscles of the abdominal wall increase in size. Since it's over a long period of time, the body compensates very nicely.
Women who have had more than one or two pregnancies will sometimes get a separation of the muscles that run up and down the mother's abdomen and the rectal muscles. It usually doesn't happen in first-time pregnancies, but it can.
In general, though, these muscle tissues as well as the facia, which is a strong tissue underneath the skin and fat, are made to stretch very, very slowly and can incorporate the very large uterus.
Some pregnant women have changes in their vision and their hearing. What accounts for these changes?
During early pregnancy, a lot of women actually experience a change in their vision, and have to get their prescriptions changed if they wear glasses. So we usually ask women to go ahead and get their eyes checked. Most of the time their hearing stays in check, but there can be changes. The reasons are again very unclear. It's most likely due to the change in the multitude of hormones. Their vision will sometimes return to normal, but most of the time, vision changes remain that way.
Is there truth to the advice that you shouldn't lie on your back later in pregnancy?
After about 20 weeks of pregnancy, we encourage pregnant women not to lay on their back anymore. At this point, the uterus is quite a bit heavier and it actually lays on the blood vessels that run up your back, the inferior vena cava and the aorta. The vena cava is the big vessel that carries the blood to the heart, and the aorta's the big vessel that carries blood away from the heart. They both become compressed, and some people will lose consciousness when pressure's applied to these vessels. Numbness and tingling can occur in the upper and lower extremities. After about five months, we encourage women to sleep on their sides instead.
When will I feel the baby kick? Can I interact with him?
Between 16 and 20 weeks you should feel that first noticeable kick. Babies respond to touch by week 26. Ask your doctor to show you the amount of pressure you can use to interact with your unborn child. In examination, he or she may be able to help you feel the head. Some parents have claimed they taught their unborn child to kick on request, by using a verbal cue whenever the baby would kick on its own
In what month does the baby start to see or hear? Can we interact?
Around week 29 the baby can turn its head to find the source of a bright light. Some research has shown reactive "listening" as early as 14 weeks gestational age. The baby should be able to hear the mothers voice at 20 weeks, certainly by 30. You can play music for your baby, talk to your baby and have hubby talk to your baby - long before month 8!
Is spotting normal?
Spotting can be normal in the first trimester. Warning signs to call your doctor: cramps, heavy bleeding, passage of clots or tissue, increase in pain and/or fever, red spotting (instead of brown or pink). Otherwise don't panic, but be sure to mention it on your next visit.
How can I help my labor along?
There are many tips online that can be dangerous if you're not being monitored, such as prolonged nipple stimulation. The best way to help your labor along is to relax during that first stage. Talk a shower, a walk, have an energy packed meal, and breathe. Stay upright so that gravity can help you. I've seen much disagreement on what helps, what is unsafe... You're body will do most of the work on it's own.
What are Braxton Hicks contractions and what is their purpose?
Braxton Hicks contractions are irregular contractions that happen even in very early pregnancy. As early as four to eight weeks, the uterus is noticed to exhibit very low-pressure, irregular contractions — maybe five to 20 a day. Most of the time they're not detected. When most women reach maybe 24 to 28 weeks, they will actually feel these contractions. Again, they're not painful, they're very low in pressure. Women typically notice a tightening that quickly passes. The cause is not well known. We know that they're there and no cervical change occurs with them, so it's not preterm labor. Braxton Hicks contractions actually increase in frequency during late pregnancy. So at around 36 to 40 weeks, most women will notice they're much more frequent, but without any specific pattern and without pain.
How does a woman know she's in labor? What are the early signs?
One of the early signs of labor would be regular contractions. We usually have women time their contractions, and tell them to call us if they're coming more than four to six times an hour and lasting at least 30 to 60 seconds. These are also stronger than Braxton Hicks contractions. They'll sometimes start with some mild cramping, then increase to about four to six times an hour. If you notice that one hour goes by and you have six contractions, and then the next hour goes by and you have 10 contractions, and you're noticing that there is actually a pattern — every 10 minutes or every five minutes — that's when we have you call the doctor just to let them know what's going on.
Some other things that you can look for are mucus changes. You might notice bloody mucus or the mucus plug, which is a large amount of mucus that actually passes out some time between two weeks and a few days before actual labor starts.
Sometimes the water breaks before contractions begin, either as a small trickle of fluid or a large gush. In such situations please contact your doctor immediately.
What is a contraction?
A contraction is the uterus muscles tensing at the same time. The uterine muscles are smooth muscles. They're involuntary muscles, which means that we don't have control of them. The parasympathetic system or the involuntary system of the body actually causes the uterus to contract.
What are the three different stages of labor?
The first stage of labor begins when the initial strong contractions start and continues until the cervix is dilated fully. The second stage of labor begins with the mother pushing and ends with the expulsion of the baby. Stage three begins at the delivery of the baby and ends at expulsion of the placenta.
What changes occur to the cervix during early pregnancy?
Many changes happen to the cervix during pregnancy. Early on, the cells on the outside of the cervix become hypertrophied or more prominent. During the first exam, very early in pregnancy, sometimes you can actually see a blue cervix, due to increased blood vessel changes. Sometimes a little bit of bleeding can occur after normal activity or sex. Usually this is not dangerous, but it's very alarming to a newly pregnant woman. Another change that can happen due to hormonal changes is that the cervical opening can become a little more relaxed.
There are several other changes that happen to the pelvis. The pelvic ligaments relax quite a bit. The pelvic bone structure changes. The hips change in their diameter, and actually the hollow of the sacrum flattens with different positions in pregnancy.
As labor approaches, the pelvic opening actually widens a little bit. The pelvic bones separate ever so slightly, which can cause a lot of discomfort. In late pregnancy, there can be much pressure and pulling and tugging in the pelvic region, which we call round ligament pain, and that's usually in the groin area.
While the cervix is effacing and dilating, what is the uterus doing to expel the baby?
The rhythmic, powerful uterine contractions cause the cervical changes. Cervical change doesn't usually happen without uterine contractions. The contractions are a physical tightening of the entire uterus. All those uterine smooth muscles work together in concert to squeeze the infant out as well as when the mother pushes. Of course the mother has to push to actually get the baby out, but the uterus itself is expelling the baby with the uterine contractions
What factors might lead to a Caesarean-section delivery?
Some of the factors that cause or contribute to a C-section would be slow progression of labor or no progression of labor. There's a certain speed to labor that is normal. We usually try to adhere to that to keep it safe for the mom and the baby. What happens in many cases is that the pelvic bones are just not large enough to allow the passage of a certain size baby. If that's the case, the cervix may open to a certain number, say, to 4 to 5 centimeters, and just stop and stay at that number for two hours.
Usually a first-time mom who is experiencing good, strong labor contractions with no progress for several hours would be a candidate for a C-section. Another case would be if the cervix dilated to 10 centimeters and the mom was pushing for a certain amount of time without the baby appearing, we'd assume that the baby's just not going to be able to come out through the pelvic outlet. We allow a shorter amount of time for somebody without an epidural.
But there are two big reasons that C-sections happen. One big one would be where the fetal heartbeat would drop suddenly and stay down rather than recovering after a contraction. That would be an emergency and we would have to get the baby out.
The other situation would be if the fetal heart tracing just does not look normal regardless of the resuscitation that we're doing — oxygen and position change or putting some fluid back up inside the uterus. If things are just not looking healthy or safe for the baby or the mother, that would necessitate a C-section.
What extra precautions do I need to take for twins or triplets?
Extra caution needs to be exerted for multiple pregnancies. Haematinics to prevent anemia, watching out for baby growth discrepancy and preventing early delivery is the key. There are increased chances of bleeding in pregnancy, waters breaking early and caesarean section. Multiple sonography examinations are often needed to monitor the growth of the babies
How often should I be seeing my doctor?
Once a month visits are optimal in early pregnancy. Later in pregnancy, however check ups will usually become more frequent. For a high-risk pregnancy, you may need to visit your doctor repeatedly.
Is pain in the lower tummy normal in pregnancy?
Many women throughout pregnancy may experience mild irregular cramping pain. These are almost always due to contractions of the womb or uterus and are usually not suggestive of adverse events. Mild antispasmodics may be prescribed if the discomfort increases.
| What are the first signs of delivery? | |
| Low
back pain occurring periodically and gradually increasing in intensity
could be the first sign of an impending delivery. A blood stained mucoid
discharge and breaking of waters are other signs of impending delivery. What are the warning signs of miscarriage? Lower tummy cramping and low back pain associated with bleeding or discharge. Passage of clots or a fleshy mass could be suggestive of an impending or ongoing miscarriage. Early medical intervention is warranted though it may not always be of benefit once the abortion process has started. Is bleeding normal in pregnancy? Bleeding is not normal in pregnancy and any amount of bleeding should be taken seriously. Early pregnancy bleeding may be suggestive of an abortion while late pregnancy bleeding could indicate low-lying afterbirth, distress to the baby or premature labor. What changes in my body can I expect during pregnancy? In the first few months there may be a sense of warmth due to increased blood flow in the body. Mild breathing discomfort, tingling of breasts and a watery discharge from the passage may be experienced. What changes in my bowel habits may I expect during pregnancy? Besides nausea and vomiting in early pregnancy, an increase in acidity, indigestion and flatulence may occur during pregnancy. This is essentially due to the slow bowel movements due to hormonal action. For the same reason you may experience constipation of varying degrees, which need to be addressed by appropriate medicines. Are secretions from the breast normal in pregnancy? Some women may have milky discharge from the breast during pregnancy. This is not abnormal and needs no treatment. Nursing bras can be used to avoid the discomfort. How soon can I see the baby’s heart beating? Sonography done from inside the passage can detect your baby heartbeats as early as 6 – 7 weeks after the missed period. For regular sonography from the tummy above, the heartbeats can be seen a week later. How should I prepare myself before a pregnancy? Make sure you have nutritious diet and treat yourself of any treatable illness. If you are a diabetic your sugars need to be controlled. If you have any chronic illness or are on medication for any disorder, a medical evaluation would be necessary. It is a good practice if you take a folic acid supplement daily three months prior to conception Is ultrasonography safe in pregnancy? Research over 40 years has proven that ultrasonography in pregnancy is usually safe. Regular ultrasounds do not cause anomalies in the baby. Usually an early ultrasound in the first three months for dating and a mid trimester ultrasound, around 18 - 20 weeks to rule out anomalies is routinely suggested. Besides this, as the necessity arises more sonograms may be required. |
What are the first changes that happen to a woman when she becomes pregnant, even before she realizes she's pregnant?
Even before she knows she's pregnant, she'll notice breast changes. Her breasts become tender. Her nipples become tender. Her breasts enlarge ever so slightly and increase during the entire pregnancy. Some other changes are generalized gas production, so constipation as well as gas bloating of the belly occur. These are some of the changes that people come into the office complaining of when they don't even know they're pregnant. Other early changes occur in the skin. There are some ever-so-slight pigment changes in the face or all over the body. Some women can get increased oil production and acne as well in early pregnancy.
What's the tip-off for a woman that she's pregnant?
Some of the tip-offs that you're pregnant could include generalized bloating or difficulty in digestion. That's a big one. Many women begin to feel like they have to urinate very often.
You mentioned that one of the first changes is breast swelling. What happens to the breasts during pregnancy?
Some of the changes in the breast that occur include increased growth of the actual cells of the breast. Initially they increase in number. This is very early. Then what happens during the rest of the pregnancy is that the glandular and ductal cells grow in number and actually expand, getting ready to fill with milk, which will happen right after delivery.
What causes morning sickness and what does it actually indicate?
The causes of morning sickness are not always clear. There is some thought that hormone changes — increases in progesterone and estrogen — cause morning sickness. Usually about 70 to 80 percent of women suffer from morning sickness during early pregnancy; some even begin noticing nausea as early as four to eight weeks. Morning sickness occurs not just in the morning but actually all through the day. It usually ends at about 14 to 16 weeks. One thing that triggers morning sickness is an empty stomach. One way to battle that would be to actually keep food in the belly every two to three hours. There have also been reports showing that vitamin B-6 and calcium can help as well.
What does morning sickness indicate?
Morning sickness is a signal that the progesterone hormones are actually increasing normally. When a woman comes into the office and tells me that she has quite a bit of morning sickness, I actually tell her that's a very good thing. That usually shows that the progesterone hormones are increasing normally and her pregnancy is most likely very protected.
What changes occur to the uterus during pregnancy?
The uterus is made of muscle cells. Throughout pregnancy, many changes occur in the uterus. First, these muscle cells start increasing in size and number. They increase in size all the way through to the delivery. During pregnancy, the uterus grows from about the size of my fist and even smaller in some people, to the size of a large orange or grapefruit, then to the size of a cantaloupe, and then, of course, to the size of a small watermelon at the end.
Around nine to 12 weeks the uterus actually goes from being a pelvic organ to being an abdominal organ. We can feel it in the abdominal exam after about 12 weeks or a little bit earlier.
When will I show?
You should show around 12 weeks, or between months 3-4. Gas, bloating, etc., may have you looking pregnant before then. If you've been pregnant before you may "pop out" earlier.
How long will the morning sickness last? I'm so nauseous!
Morning sickness should occur less and less by the second trimester/4 months. Maybe sooner! On rare occasions it will stick around. Rare!
As the mother's belly gets bigger, as her baby grows, how are the abdominal muscles able to stretch?
As the uterus grows and the abdomen distends, the actual muscles of the abdominal wall increase in size. Since it's over a long period of time, the body compensates very nicely.
Women who have had more than one or two pregnancies will sometimes get a separation of the muscles that run up and down the mother's abdomen and the rectal muscles. It usually doesn't happen in first-time pregnancies, but it can.
In general, though, these muscle tissues as well as the facia, which is a strong tissue underneath the skin and fat, are made to stretch very, very slowly and can incorporate the very large uterus.
Some pregnant women have changes in their vision and their hearing. What accounts for these changes?
During early pregnancy, a lot of women actually experience a change in their vision, and have to get their prescriptions changed if they wear glasses. So we usually ask women to go ahead and get their eyes checked. Most of the time their hearing stays in check, but there can be changes. The reasons are again very unclear. It's most likely due to the change in the multitude of hormones. Their vision will sometimes return to normal, but most of the time, vision changes remain that way.
Is there truth to the advice that you shouldn't lie on your back later in pregnancy?
After about 20 weeks of pregnancy, we encourage pregnant women not to lay on their back anymore. At this point, the uterus is quite a bit heavier and it actually lays on the blood vessels that run up your back, the inferior vena cava and the aorta. The vena cava is the big vessel that carries the blood to the heart, and the aorta's the big vessel that carries blood away from the heart. They both become compressed, and some people will lose consciousness when pressure's applied to these vessels. Numbness and tingling can occur in the upper and lower extremities. After about five months, we encourage women to sleep on their sides instead.
When will I feel the baby kick? Can I interact with him?
Between 16 and 20 weeks you should feel that first noticeable kick. Babies respond to touch by week 26. Ask your doctor to show you the amount of pressure you can use to interact with your unborn child. In examination, he or she may be able to help you feel the head. Some parents have claimed they taught their unborn child to kick on request, by using a verbal cue whenever the baby would kick on its own
In what month does the baby start to see or hear? Can we interact?
Around week 29 the baby can turn its head to find the source of a bright light. Some research has shown reactive "listening" as early as 14 weeks gestational age. The baby should be able to hear the mothers voice at 20 weeks, certainly by 30. You can play music for your baby, talk to your baby and have hubby talk to your baby - long before month 8!
Is spotting normal?
Spotting can be normal in the first trimester. Warning signs to call your doctor: cramps, heavy bleeding, passage of clots or tissue, increase in pain and/or fever, red spotting (instead of brown or pink). Otherwise don't panic, but be sure to mention it on your next visit.
How can I help my labor along?
There are many tips online that can be dangerous if you're not being monitored, such as prolonged nipple stimulation. The best way to help your labor along is to relax during that first stage. Talk a shower, a walk, have an energy packed meal, and breathe. Stay upright so that gravity can help you. I've seen much disagreement on what helps, what is unsafe... You're body will do most of the work on it's own.
What are Braxton Hicks contractions and what is their purpose?
Braxton Hicks contractions are irregular contractions that happen even in very early pregnancy. As early as four to eight weeks, the uterus is noticed to exhibit very low-pressure, irregular contractions — maybe five to 20 a day. Most of the time they're not detected. When most women reach maybe 24 to 28 weeks, they will actually feel these contractions. Again, they're not painful, they're very low in pressure. Women typically notice a tightening that quickly passes. The cause is not well known. We know that they're there and no cervical change occurs with them, so it's not preterm labor. Braxton Hicks contractions actually increase in frequency during late pregnancy. So at around 36 to 40 weeks, most women will notice they're much more frequent, but without any specific pattern and without pain.
How does a woman know she's in labor? What are the early signs?
One of the early signs of labor would be regular contractions. We usually have women time their contractions, and tell them to call us if they're coming more than four to six times an hour and lasting at least 30 to 60 seconds. These are also stronger than Braxton Hicks contractions. They'll sometimes start with some mild cramping, then increase to about four to six times an hour. If you notice that one hour goes by and you have six contractions, and then the next hour goes by and you have 10 contractions, and you're noticing that there is actually a pattern — every 10 minutes or every five minutes — that's when we have you call the doctor just to let them know what's going on.
Some other things that you can look for are mucus changes. You might notice bloody mucus or the mucus plug, which is a large amount of mucus that actually passes out some time between two weeks and a few days before actual labor starts.
Sometimes the water breaks before contractions begin, either as a small trickle of fluid or a large gush. In such situations please contact your doctor immediately.
What is a contraction?
A contraction is the uterus muscles tensing at the same time. The uterine muscles are smooth muscles. They're involuntary muscles, which means that we don't have control of them. The parasympathetic system or the involuntary system of the body actually causes the uterus to contract.
What are the three different stages of labor?
The first stage of labor begins when the initial strong contractions start and continues until the cervix is dilated fully. The second stage of labor begins with the mother pushing and ends with the expulsion of the baby. Stage three begins at the delivery of the baby and ends at expulsion of the placenta.
What changes occur to the cervix during early pregnancy?
Many changes happen to the cervix during pregnancy. Early on, the cells on the outside of the cervix become hypertrophied or more prominent. During the first exam, very early in pregnancy, sometimes you can actually see a blue cervix, due to increased blood vessel changes. Sometimes a little bit of bleeding can occur after normal activity or sex. Usually this is not dangerous, but it's very alarming to a newly pregnant woman. Another change that can happen due to hormonal changes is that the cervical opening can become a little more relaxed.
There are several other changes that happen to the pelvis. The pelvic ligaments relax quite a bit. The pelvic bone structure changes. The hips change in their diameter, and actually the hollow of the sacrum flattens with different positions in pregnancy.
As labor approaches, the pelvic opening actually widens a little bit. The pelvic bones separate ever so slightly, which can cause a lot of discomfort. In late pregnancy, there can be much pressure and pulling and tugging in the pelvic region, which we call round ligament pain, and that's usually in the groin area.
While the cervix is effacing and dilating, what is the uterus doing to expel the baby?
The rhythmic, powerful uterine contractions cause the cervical changes. Cervical change doesn't usually happen without uterine contractions. The contractions are a physical tightening of the entire uterus. All those uterine smooth muscles work together in concert to squeeze the infant out as well as when the mother pushes. Of course the mother has to push to actually get the baby out, but the uterus itself is expelling the baby with the uterine contractions
What factors might lead to a Caesarean-section delivery?
Some of the factors that cause or contribute to a C-section would be slow progression of labor or no progression of labor. There's a certain speed to labor that is normal. We usually try to adhere to that to keep it safe for the mom and the baby. What happens in many cases is that the pelvic bones are just not large enough to allow the passage of a certain size baby. If that's the case, the cervix may open to a certain number, say, to 4 to 5 centimeters, and just stop and stay at that number for two hours.
Usually a first-time mom who is experiencing good, strong labor contractions with no progress for several hours would be a candidate for a C-section. Another case would be if the cervix dilated to 10 centimeters and the mom was pushing for a certain amount of time without the baby appearing, we'd assume that the baby's just not going to be able to come out through the pelvic outlet. We allow a shorter amount of time for somebody without an epidural.
But there are two big reasons that C-sections happen. One big one would be where the fetal heartbeat would drop suddenly and stay down rather than recovering after a contraction. That would be an emergency and we would have to get the baby out.
The other situation would be if the fetal heart tracing just does not look normal regardless of the resuscitation that we're doing — oxygen and position change or putting some fluid back up inside the uterus. If things are just not looking healthy or safe for the baby or the mother, that would necessitate a C-section.
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