Vaginal Birth After C-Section (VBAC)

Vaginal Birth After Cesarean (VBAC) - Fernandez Hospital

She believed she could. So, she did.

Many women believe that the only way to have their child after undergoing a Caesarean section is another Caesarean section. This is not true in all cases. Studies show that about 60 to 80% of women who attempted a trial labour after Caesarean section (TOLAC) had successful normal deliveries. VBAC or Vaginal Birth after Caesarean is a formidable mode of birthing for women with uncomplicated pregnancies.

What is VBAC?

VBAC is a term used for having a normal vaginal birth after having undergone a Caesarean section previously. It is an achievable task and depends on several factors.

Most women fear for the safety of themselves and their babies. VBAC is a safe means of birthing in the absence of underlying complications. All you need is an optimal environment with the right guidance and support.

Undergoing a C-section can be a pretty traumatizing experience for some women as it paralyzes them into a singular position and their choices and wishes aren’t well respected.

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Birthing, Naturally: Going Mother Nature’s Way

Natural Birthing - Fernandez Hospital

 

“The whole point of natural birth is the knowledge that the woman is the birth power source.

She may need help, but in essence, she always had, currently has and will always have that power.”

                                                                                                                      – Heather McCue

India’s caesarean section rates are on a rise. There are 6.6 million children born via C-section annually and the numbers have increased from 8.5% in 2005-06 to 17.2% in 2015-16. 80% of women in India have uncomplicated pregnancies and would have normal births if supported to do so, 20% with medical complications would require obstetric interventions. There is growing evidence highlighting that children born via C-section have a greater risk of asthma, allergies, autism and collagen disorders. Medical interventions, while extremely important in complicated high-risk pregnancies, should be totally avoided in case of uncomplicated pregnancies. Childbirth is a normal physiological event. Having a professional midwife has been well researched to increase the chances of achieving a normal birth, reducing unnecessary interventions and enhancing a positive birth experience. more “Birthing, Naturally: Going Mother Nature’s Way”

What are the common complication during pregnancy?

Pregnancy is a natural process, which ideally requires a minimal or non-invasive procedure. However, there are few complications that may occur during pregnancy which require immediate medical attention to ease the process. The complications may affect either the mother’s or the baby’s health and sometimes both. Most of the complications can be avoided or treated with the right supervision and treatment.

Loss of pregnancy within the first 20 weeks is termed as a miscarriage. A miscarriage happens when there are chromosomal abnormalities in the fertilised egg which keep the embryo from developing further.

The first symptom to identify a miscarriage is excessive vaginal bleeding. However, it is common to spot blood during early pregnancy. It is best to consult the doctor at the earliest to detect a miscarriage.

 

Preeclampsia

This is a serious complication which can occur during the first 20 weeks of pregnancy, causing high blood pressure. Women with preeclampsia are advised to deliver the baby at the earliest. If it is too early to deliver the baby, the mother and baby will be under medical surveillance until the due date.

This condition can also lead to some serious problems and affect other organs.

An ideal time for delivery is once the mother reaches 37 weeks of pregnancy. If the baby is delivered before 37 weeks, it is a preterm birth and the baby is considered a premature baby. A preterm birth can sometimes be fatal to the baby.

 

Gestational diabetes

This condition occurs when the pregnant woman cannot process her sugar intake. This fairly common condition is serious enough to cause complications during pregnancy. Therefore, it is important for the mother to maintain a healthy diet and exercise plan in order to deliver a healthy baby.

A poorly-maintained diet will lead to sugar imbalance in the blood. This problem can be cured by modifying the diet accordingly. In few cases, insulin will be prescribed by the Doctor to help keep sugar levels in control.

Ectopic pregnancy

An ectopic pregnancy is when the fertilised egg attaches itself to places other than the uterus. 1 out of 50 pregnancies is an ectopic pregnancy. It occurs in the fallopian tubes, which aren’t designed for holding a growing embryo. The growing embryo creates a rupture in the fallopian tubes and causes internal bleeding. One can identify an ectopic pregnancy through symptoms like vaginal bleeding, sharp pain in the intestines, weakness and some others.

This condition can be cured if a doctor is immediately consulted upon experiencing a sharp pain or spotting blood.

As the famous saying goes, “prevention is better than cure”. It is important for a pregnant woman to be in a positive and healthy environment.

At Stork Home, we believe that every woman is capable of giving birth naturally and is treated with utmost care and warmth. We always encourage the mother to follow the required diet, therefore, avoiding any kind of complication. However, during any complication, our specialist team of doctors, midwives and support staff are on their toes to provide the required care and treatment to the mother and the baby.

Is heavy bleeding normal during menstruation?

Heavy bleeding during menstruation is a fairly common problem. It is also one of the most ignored problems, often waived off as something normal. An abnormal menstruation, with heavy bleeding, big clots, and cramps, needs immediate medical attention. Visit your doctor immediately in such a case. 

Women with heavy bleeding during menstruation experience severe cramps which make day-to-day functioning difficult. Effective medical treatment can cure the issue.

  • Abnormal vaginal bleeding
  • Need to change the pad/tampon every hour
  • Big blood clots
  • Need to change over soaked pad/tampon in the middle of the night
  • Periods lasting more than 7 days
  • Women with heavy menstrual bleeding also experience fatigue, shortness of breath and anaemia.

Hormone imbalance: A thin line builds up inside the uterus. It sheds during periods. Estrogen, makes the lining thicker, whereas Progesterone makes it thinner. It is important that these hormones are balanced. If estrogen levels are high, the lining gets thicker and leads to heavy bleeding when it is shed.
Fibroids and Polyps:  Fibroids and polyps are non-harmful growths within the uterus. These cause heavy bleeding during periods. In many cases, fibroids influence the blood flow.
Cancer:  Women in their postmenopausal phase, or those who have had an abnormal Pap test in the past, are potential victims of uterine and cervical cancers. These cancers cause excessive and prolonged bleeding.
Bleeding disorders:  Mostly, these disorders are inherited. They cause blood clots and heavy menstrual bleeding.
Medical conditions:  Women with liver disease, kidney disease and thyroid issues are more likely to develop heavy bleeding.
Pregnancy complications:  A miscarriage causes heavy periods. Ectopic pregnancy also causes heavy bleeding. During this pregnancy, the fertilized eggs get attached outside the uterus. 
Intrauterine device:  This birth control device is a common cause for heavy bleeding. Many women use IUDs for birth control. This can lead to heavy menstrual bleeding.

At Stork Home, we have the finest gynecologists. They provide holistic care and treatment for a range of women’s medical conditions. We provide specific treatment for heavy menstrual bleeding. Our experts take various factors into consideration. They discuss the medical history and menstrual cycle period. The treatment is continued after taking into account the woman’s tolerance levels. She is given absolute freedom to make the right, informed choice for herself.

Heavy menstrual bleeding is treated with surgery on an Outpatient basis and the patient is likely to be discharged the same day.

Ankle Swelling During Pregnancy

When you’re pregnant, your belly is not the only thing that swells. You may notice mild swelling throughout the body, particularly in the ankles and feet. As the body produces around fifty percent more blood and fluids to fulfil the needs of the growing baby, swelling is a normal part of a pregnancy. However, the amount of swelling you experience may vary and by the end of the day become more and reduce after a night’s sleep. Swelling could be more in women with multiples pregnancies or having excessive amniotic fluid.

Causes of Swelling

Also known as Edema, ankles and feet swelling during pregnancy is a common thing that goes away after childbirth. There are various factors responsible for the swelling. Along with the extra body fluid, the growing uterus, hormonal changes etc. are also responsible for ankles, feet and leg swelling. The uterus which constantly grows during pregnancy puts pressure on the pelvic veins and the large vein impairing the return of blood to the heart and results in swelling.

Though mild ankles and feet swelling is normal and goes away with the completion of pregnancy, but a sudden increase in swelling may indicate that the blood pressure is higher than normal. This could be a sign of preeclampsia. And a sudden swelling in one leg could be a symptom of a blood clot i.e., deep vein thrombosis. So, if you notice any one of these, it’s important to consult your doctor. However for mild swelling, you can adopt some ways to reduce it.

  • Take regular breaks

Make sure not to stand or sit for a long period. Taking a short walk will help in better blood circulation. And when you sit, keep your feet on a stool, rotate your feet at the ankles and stretch your legs from time to time.

  • Sleep on your side

Sleeping on the left side is helpful in reducing ankle swelling during pregnancy. When you sleep on your left side, it takes the pressure off the large vein that returns the blood from the lower half of the body to the heart.

  • Do physical activity

Mild physical activity is necessary during pregnancy to keep oneself active and healthy. If you can’t indulge in exercising, taking a walk daily is very helpful.

  • Wear comfortable shoes

When you go out of the house, wear comfortable shoes and at home, wear a pair of soft slippers and make sure that they are not slippery.

  • Wear compression stockings

You may be recommended by your doctor to wear stockings or supportive tights during

the daytime.

  • Drink plenty of water and eat well

Drinking plenty of water has a positive effect on reducing overall swelling. Make sure to avoid junk foods and include healthy options in your diet.

 

Treating Headaches During Pregnancy

Pregnancy is a phase during which you get ready to welcome your little bundle of joy. It is also a time when women undergo physical changes and experience some discomforts. Headache during pregnancy is quite common, especially in the first trimester. Though most frequent in the first and third trimester, pregnancy headache may occur at any time during the gestation period.

Other factors responsible for headaches during pregnancy –

  • Dehydration
  • Inadequate sleep
  • Stress
  • Low blood sugar level
  • Women who used to have a high intake of caffeine but stopped the intake due to pregnancy
  • Preeclampsia
  • Stopped smoking during pregnancy

How to get relief from headache during pregnancy?

You can get relief from mild headaches during pregnancy without taking medicines by a adopting the following.

  • Cool compress

In order to get quick relief from mild headaches, lie down and put a cool compress on your head.

  • Do physical activity

Though remaining active during pregnancy may seem difficult but including physical activity in your routine such as walking or aerobics can be helpful in preventing headaches. However, make sure to consult with your doctor before doing aerobics or any kind of other exercise.

  • Manage stress

Managing stress can help you in getting relief from mild pregnancy headaches.

  • Practice relaxation methods

Relaxation techniques such as deep breathing, visualization, yoga and massage can make you feel better.

  • Eat regularly

When you eat scheduled meals regularly and maintain a healthy diet, you can prevent pregnancy headaches. Make sure to remain adequately hydrated by drinking a plenty of fluids.

  • Have a sleep schedule

Lack of sleep can result in pregnancy headaches. Make sure to have the required sleep and follow a regular sleep schedule.

  • Peppermint oil

The anti-inflammatory and relaxant nature of peppermint oil can ease the mind and relieve the discomfort. A few drops on your pillow can do the trick and help you sleep comfortably.

  • Avoiding triggers

Certain odours, foods and postures may cause headache. Try to avoid the headache triggers during pregnancy.

Headache during pregnancy is common, but if it doesn’t go away or you experience more than normal, make sure to consult with your doctor. Severe headaches can be signs of pregnancy complications such as high blood pressure and damage to other organs. Fortunately, there are some effective treatments for pregnancy headaches that help you in getting relief.

Getting Rid of Pregnancy Stretch Marks

Pregnancy is one of the most beautiful phases of a woman’s life. Along with your little bundle of joy, you may also get stretch marks. They are quite common, especially in the third trimester. And though not harmful or painful, some women feel distressed with the appearance of their skin.

Stretch marks tend to occur when your body gains weight or loses excess weight suddenly. With the baby developing inside the womb, the skin stretches beyond its capacity. Due to this and the hormonal changes stretch marks occur. You may have stretch marks in the areas prone to fat accumulation such as abdomen, tummy, hips, arms, thighs and breasts. They often start as reddish or purple in colour and after delivery, they gradually fade and become white or greyish.

Medical treatment and home remedies can make stretch marks fade away but you cannot get rid of them completely. With passing time, they turn into fine lines gradually almost close to your skin tone. You can even try exercises that work on the muscles of the areas having stretch marks. Exercises help regenerate the tissues, tighten the loosened skin and diminish the stretch marks. A combination of balanced diet and exercises can make a visible difference.

Home remedies such as oil treatment, honey aloe vera, egg white, cocoa butter or shea butter etc., can help your skin feel better. Remaining adequately hydrated is vital as it helps in restoring the elasticity of your skin and keeping it supple.

Do not feel embarrassed or worry if you have stretch marks during pregnancy. Get the help of your doctor, apply creams and take proper care of your skin, and the stretch marks will reduce as time passes.

 

Galactorrhoea — Symptoms and Causes

The secretion of milk from the breast (lactation) not due to childbirth or nursing is known as galactorrhoea. The milk may be secreted spontaneously or expressed and the volume of milk may be large or small.

This inappropriate lactation occurs usually in women, even in those who never had a child or after menopause (that is when periods stop around age 50). This condition can occur in infants (babies under 1 year) and as well as in men and is not a disease by itself but could be a sign of underlying problems.

Causes of Galactorrhoea

Galactorrhoea is often caused by an increase in the level of Prolactin, the hormone that stimulates milk production. Other factors may include:

  • Disorders of the pituitary gland (pituitary and hypothalamus are glands in the brain that secrete hormones).
  • Excessive stimulation of the breasts
  • Birth control pills
  • Side effects of medication such as antidepressants, high blood pressure drugs, certain sedatives etc.
  • Herbal supplements such as fenugreek seeds and fennel
  • Chronic kidney disease
  • Spinal cord surgery, injury or tumours
  • Hypothyroidism (underactive thyroid)
  • Nerve damage to the chest wall due to burns or surgery
  • Use of marijuana or cocaine

However, in some cases, the cause of galactorrhoea is not known.

Symptoms of Galactorrhoea

One or both breasts may be affected with galactorrhoea. The symptoms may include:

  • Persistent milky discharge from the nipple
  • Nipple discharge involving multiple milk ducts
  • Headache
  • Problem with vision
  • Irregular or absent menstrual period

When to See A Doctor

If you are not expecting or breastfeeding and experiencing continuous milky discharge from your nipple or experiencing the above-mentioned symptoms, it is important that you visit a doctor. Experiencing non-milky nipple discharge such as clear, yellow or bloody discharge, requires immediate medical attention as it could be a sign of an underlying medical condition.

To find this, your doctor may do some of these tests:

  • A physical exam to check for breast lumps or any other suspicious factors.
  • A blood test to check the prolactin level in your body.
  • Analysis of the discharged fluid to check if fat droplets are present.
  • A pregnancy test to exclude that pregnancy could be the possible cause of the milk secretion.
  • If any lump or suspicious appearance or lesion is found in your breast during the physical exam, mammography, ultrasound scan of the breasts or both will be performed to obtain the images of the lump.
  • MRI (Magnetic Resonance Imaging) of the brain to check for tumour or any other abnormality with the pituitary gland.

Based on the results, your doctor will provide you with the necessary treatment.

Galactorrhoea in Infants and Men

Galactorrhoea in newborn babies occurs sometimes when the high estrogen level pass through the placenta into the baby’s blood. Due to this, enlargement in the breast tissue of the baby may occur which is associated with the milky discharge. In case of men, deficiency of testosterone hormone is associated with galactorrhoea due to which the breasts may enlarge or become tender.

Trimesterwise Pregnancy Meal Planning — Third Trimester

The Third Trimester is the final stage of pregnancy during which your baby grows at a faster rate. All organs, brain, eyes, ears, lungs, bones etc. develop more rapidly and for this, the nutritional needs of your baby also increase. You have to concentrate on eating a healthy and balanced diet. A wholesome diet will help meet the extra nutritional needs of your baby.

In this last stage of pregnancy, heartburn and indigestion may occur but these issues don’t last long in most pregnant women. If you do happen to be affected, you can opt for small but frequent meals. Normally, during the last trimester, a woman needs around 350 calories more. So, now, you should include foods that contain the following:

Calcium: Is needed for bone development of the baby.

You can include the following foods in your diet.

  • Low fat Milk
  • Cheese
  • Low fat Yoghurt/ Curd
  • Green Leafy Vegetables
  • Ragi
  • Horsegram
  • Okra
  • Fortified Orange Juice
  • Fortified Soya Milk
  • Unsalted Almonds
  • Sesame Seeds
  • Tofu

Iron:

As the volume of blood increases during pregnancy, the demand of iron also increases. Moreover, the developing baby starts storing iron for further development. Some important iron-rich foods which you can include in your third trimester meal chart are:

  • Leafy Green Vegetables
  • Grains like pearl millet(bajra), finger millet(ragi) etc
  • Legumes like Bengal gram, moth beans, horse gram etc
  • Poultry and egg

Vitamin A:

Vitamin A is essential as the mother’s intake is a determinant of vitamin A status of the baby. Even after delivery, baby depends on breast milk for vitamin A so adequate intake is necessary.

  • Dairy Products
  • Eggs
  • Yellow to dark orange coloured vegetables and fruits

Selenium:

One of the minerals necessary during the third trimester, Selenium acts as an antioxidant to fight against free radicals. This mineral may be helpful in making the lungs of the baby healthy. Some of the healthy food sources of selenium are:

  • Seafood
  • Meat
  • Poultry and egg
  • Certain Cereals and millets

Some Important Things to Remember During the Third Trimester

  • Keep yourself hydrated by drinking plenty of water.
  • Eat snacks that are healthy and try to avoid foods like cakes, biscuits and chocolates in which sugar content is higher.
  • Have lots of vegetables and fruits.
  • Choose dairy products that are low in fat.
  • Have different types of starchy foods like whole grain cereals, millets, potatoes, bread, rice, pasta etc.
  • Choose protein-rich foods such as beans, nuts, lentils, eggs, fish, soya, poultry etc.

Trimesterwise Pregnancy Meal Planning — 2nd Trimester

A pregnant woman’s body goes through different phases. It is very necessary that she eats a healthy diet as the developing baby receives all the nutrients from her. A healthy diet during the gestation period refers to a perfect balance of protein, carbohydrate and fat to the body. A balanced diet should contain adequate calories and provide your baby with essential nutrients.

As the baby starts developing, the nutritional requirements also vary. So, it becomes necessary that the pregnant woman takes proper care of her diet and heeds the nutritional needs of the different phases of pregnancy. In order to keep your level of energy high and ensure your body gets the essential nutrients you can have three meals a day along with snacks. Moreover, a pregnant woman should drink lots of water throughout the day.

During the second trimester, the external body structures and all the major organs of the baby start forming. During this phase, you should ensure your diet includes foods that contain vitamins, minerals, proteins, calcium, magnesium and Omega 3 fatty acid.

Breakfast: Eating a healthy breakfast provides you enough energy to remain active throughout the day. And it becomes more necessary to have a healthy breakfast when you are pregnant. During the second trimester, you should have a balanced meal which may include:

  • Eggs
  • Whole grains like whole wheat toast, whole wheat flakes, daliya, oats
  • Fruits
  • Skimmed milk

Lunch: During pregnancy, having a proper lunch is also very important. You can include the following:

  • Whole grains and millets like brown rice, whole wheat breads, quinoa, fox tail millet, bajra, jowar
  • Fortified cereals
  • Lean meats like chicken and fish
  • Yoghurt/ curd/ paneer
  • All Vegetables
  • Beans/ Legumes like Chickpeas, kidney beans, black beans, black eyed beans, peas, soya bean etc
  • Lentils/ Pulses/Dals

Dinner: Having a healthy dinner is also necessary to keep yourself and your baby healthy. Include food such as:

  • Brown rice
  • Vegetables
  • Grilled chicken or fish
  • Grains
  • Beans
  • Lentils
  • Fortified breads
  • Whole wheat Pasta, rotis

Snacks: You can have one or two snacks between meals. You can include the following as healthy snacks:

  • Fruits
  • Low fat milk and dairy products
  • Ready to eat cereals
  • Porridges from Grains like ragi malt, oats
  • Soya milk
  • Soups
  • Vegetable juices
  • Fruits salad
  • Nuts, Seeds and dried fruits