Author: Fernandez Hospital

Better Birthing Experience: A Thought-Provoking Finish | Day 2

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On Day 2 of the Better Birthing Experience Conference, delegates and faculty delved deep into thought-provoking panel discussions on reducing unnecessary interventions. Talks and discussions ranged from how to offer VBACs, delayed cord clamping, breech births, and perinatal mental health education. The conference encapsulated a rich tapestry of contemporary childbirth practices and, most importantly, how birth professionals need to listen to women’s voices. Moreover, the significance of culturally appropriate childbirth education took centre stage, affirming the holistic approach towards fostering optimal birthing experiences.

In this blog, we put the spotlight on the diverse talks and panel discussions that marked Day 2 of the Better Birthing Experience conference.

If you haven’t already seen our Day 1 blog recap of the conference, be sure to check it out.

 

The Fourteenth Dr Lourdes C. Fernandez Oration

Ms Karuna Vakati, an IAS officer, currently serving as the Secretary at the Department of Education in the Government of Telangana, delivered the 14th Dr Lourdes C. Fernandez Oration on Telangana’s remarkable journey into midwifery. In her oration, Karuna traced the origins of this transformative initiative, highlighting how it all began with Fernandez. She eloquently described Telangana’s Midwifery Journey as a testament to progressive healthcare practices. She emphasised the crucial role of Fernandez, UNICEF, and the Government of Telangana in laying the foundation for improved maternal and newborn health in the region.

Can we reduce unnecessary medical interventions?

The panel discussion was led by senior consultant Dr Nuzhat Aziz, who heads Fernandez’s Obstetric Emergency Department, and had a stellar panel, comprising Dr Malathi Ponnuru, Consultant Obstetrician and Gynaecologist, Andhra Pradesh Medical Council; Sheetal Samson, Professional Midwife, and National Midwifery Educator,  Dr Vijaya Krishnan, Certified Professional Midwife (CPM), co-founder-The Sanctum, Natural Birth Centre and Dr Jogitha Unni, Obstetrician and Gynaecologist, Fernandez Hospital. Each panellist discussed the challenges and opportunities when it comes to reducing medical interventions in their settings.

Vaginal Birth After Caesarean (VBAC)

Dr Vijaya Krishnan’s talk on VBACs focused on how it is crucial for women who have previously undergone a caesarean section. VBACs allow women to have a vaginal birth for their subsequent pregnancies, reducing the need for surgical interventions and the potential complications associated with multiple caesarean deliveries. Throughout the programme, participants were guided through comprehensive counselling sessions, receiving in-depth information about the risks and benefits associated with VBAC. They were educated about the factors influencing successful VBAC, including uterine rupture, maternal age, and the interpregnancy interval. By addressing their concerns and providing factual details, participants felt empowered and informed about the birthing options, leading to reduced anxiety and increased confidence in the ability to achieve a successful VBAC.

Term Breech Births 

The session was followed by a talk on Breech Births by Kate Stringer. Kate is a Consultant Midwife at the Surrey and Sussex NHS Trust. She has extensive experience in education, training, clinical practice, midwifery-led care, and public health initiatives in the UK and India. In her talk, she focused on identifying the characteristics based on the current evidence concerning fetal positions, the mechanisms of breech birth and characteristics of breech labours. This is to increase care providers’ knowledge in the management of women in labour with a breech-presenting fetus.

Delayed Cord Clamping

Dr Nuzhat Aziz, who heads Fernandez’s Obstetric Emergency Department, delivered an insightful talk on delayed cord clamping during the conference. She emphasised why delay in clamping the umbilical cord has been linked to notable advantages for premature babies. With a blend of expertise and passion, she illuminated the significance of this practice in childbirth. She elucidated the scientific rationale behind delayed cord clamping and its role in promoting a smoother transition for newborns. Her compelling presentation inspired attendees and underscored this practice’s importance in facilitating a healthier start for infants.

Physiological Third Stage

Ms Sheetal Samson, Professional Midwife and National Midwifery Educator at Fernandez Hospital, explained how, in a physiological third stage of labour, you wait for the placenta to arrive on its own. It is the duty of the midwife to wait to cut the umbilical cord after the baby is born so that oxygenated blood may flow from the placenta to the child.

Postpartum Mental Health

The postpartum period, encompassing pregnancy, can be emotionally challenging for many parents. Dr Shubangi Dere offered valuable guidance on recognising and addressing issues like prenatal and postpartum depression and anxiety, empowering health providers to prioritise the mental well-being of pregnant mothers.

Culturally Appropriate Childbirth Education

Why does family matter in childbirth education? This essential question forms the core of Anupama Kumar Vijayanand’s talk. She is a certified childbirth educator, doula, and the founder of Vriksham Pregnancy Care. She emphasised the pivotal role of family in the birthing process and highlighted the significance of childbirth education for fathers and in-laws. Moreover, she delved into the evolving beliefs surrounding childbirth, acknowledging the dynamic shift in perceptions and practices over the years. Understanding these changing perspectives is fundamental in tailoring childbirth education to meet the diverse cultural needs and preferences of today’s families.

Listening to Women’s Voices

The panel discussion was led by Dr Evita Fernandez, the Managing Trustee of Fernandez Hospital Educational and Research Foundation (FHERF). The panel comprised four women with varied birthing experiences – some were traumatic, and the others very blissful.  All the women agreed that birth trauma significantly altered their mental health, but they wanted to share their experiences so others could learn from it.

Master Class on Breech Births

Day 3 of the Better Birthing Experience conference was the Master Class on Breech Births by Kate Stringer. The class had over 150 participants from across India and helped participants gain a thorough understanding of how to facilitate breech deliveries.

Better Birthing Experience: A Pioneering Conference for Childbirth Practitioners

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Pregnancy, labour, and childbirth are life-changing experiences for a woman and her family. For couples, this is also a time filled with uncertainties, questions, and apprehensions. How do birth professionals make birthing a positive experience for women? How can they remove apprehensions and ensure women are empowered to give birth with confidence?

To answer these questions and equip birth professionals with the latest knowledge about normal undisturbed births, Fernandez Hospital Educational and Research Foundation, in partnership with the United Nations Population Fund (UNFPA), organised the Better Birthing Experience Conference in Hyderabad recently. The conference provided invaluable guidance and support for healthcare providers. The faculty covered a wide variety of topics, from optimal birthing positions and perinatal mental health education to the importance of undisturbed birth and culturally appropriate childbirth education.

In this blog, we will highlight the topics and workshops covered on Day 1 of the conference held on 4 November 2023.

The conference had close to 400 delegates from around 19 states in India and a few other international ones, too. With a mix of professionals, including childbirth educators, obstetricians, midwives, physiotherapists, nurses, doulas, and policymakers, the Better Birthing Experience conference was truly the first of its kind.

Dr Evita Fernandez

Dr Evita Fernandez, the Managing Trustee of the Fernandez Hospital Educational and Research Foundation (FHERF) kickstarted the conference with a powerful introduction on why women all over the world deserve better and positive experiences and, as birth professionals, we owe it to them.

The Beauty of Undisturbed Births

“Undisturbed births are endangered today”, Priyanka Idicula beautifully described what undisturbed births are and how, as healthcare providers, we need to protect the environment in which women birth! Priyanka emphasised the importance of allowing the birthing process to unfold naturally with minimal interventions. Attendees and delegates learned how a calm and supportive environment, combined with respectful care, can enhance the birthing experience, and promote better outcomes for both mother and baby.

After that talk, Priyanka followed it up with a workshop on Birthing Positions. Attendees learned about the advantages of various birthing positions, which can significantly impact the ease and comfort of labour and delivery. Knowledge about these positions empowers parents to make informed choices about their birthing experience.

Priyanka demonstrates the different birthing positions that a woman can choose while birthing

Gentle Birthing

Dr Gowri Motha, world-renowned obstetrician and pioneer of the Gentle Birthing Method, discussed and advocated for a more serene and compassionate birthing experience. She encouraged birth professionals to learn gentle handling of mothers, positive communication, and comfort measures, helping to create a calm and reassuring atmosphere during labour and delivery.

Hydrotherapy and Water Births

Hydrotherapy and water births are gaining popularity as they offer pain relief, relaxation, and buoyancy during labour. Better Birthing Experience Conferences provided insights into the benefits and techniques of water birth in the workshop “Hydrotherapy and Water Births” by Ms Indie Kaur and Dr Usha Ukande. The knowledge gave healthcare providers a chance to learn and explore how water birth and hydrotherapy work during labour.

Optimal Fetal Positions

The Optimal Fetal Positions workshop was a comprehensive session focused on educating participants about the importance of fetal positioning during pregnancy and labour. Led by Dr Latha Balasundaram, Head, Dept of  Physiotherapy, Fernandez Hospital and Ms Sheetal Samson, National Midwifery Educator at NMTI Fernandez, the workshop delved into various techniques and exercises that can help optimise the positioning of the fetus for a smoother birthing process. Attendees gained valuable insights into the impact of maternal positioning on the progression of labour, as well as learned practical strategies to enhance maternal comfort and facilitate an optimal birth experience.

Delegates learn optimal fetal positions facilitated by Dr Latha Balasundaram

Perinatal Mental Health Education

The perinatal period, encompassing pregnancy and the postpartum period, can be emotionally challenging for many parents. The conference had a detailed workshop on “A framework for prenatal mental health education and screening for obstetricians” by Dr Sai Krishna and Dr Shubangi Dere. The session offered valuable guidance on identifying and addressing issues like prenatal and postpartum depression and anxiety, empowering health providers to prioritise their mental well-being.

Language Matters

Does language matter in a labour room?  What role does respect play in maternity care? How does respectful maternity care (RMC) look in reality? The workshop on  RMC by the Fernandez team had all the participants thinking about how they treat mothers. During the workshop, the attendees were divided into diverse groups, fostering collaborative discussions, and sharing learning experiences. The team of Fernandez doctors guided each group through a series of engaging sessions aimed at promoting awareness and understanding of the crucial role of language in fostering respectful maternal care. Participants actively delved into the nuances of communication, emphasising the significance of using compassionate and empowering language when interacting with expectant mothers and addressing their healthcare needs. Through various role-play exercises and case studies, attendees developed a heightened sensitivity to the impact of language on maternal well-being, enabling them to cultivate a more empathetic and supportive environment within healthcare settings.

The Power of Hypnobirthing

The workshop on Hypnobirthing facilitated by Dr Pooja Shenoy had practical demonstrations in which participants gained a comprehensive understanding of how hypnobirthing can alleviate fear and anxiety during childbirth, promoting a more relaxed and positive birthing experience. The workshop emphasised the importance of mindfulness, breathing exercises, and deep relaxation techniques in empowering expectant mothers to harness their innate ability to manage pain and facilitate a smoother labour process.

Overall, day one at the Better Birthing Experience Conference had a treasure trove of information and practical workshops to deepen the understanding of health professionals.

The Sound of New Beginnings: Understanding Newborn Hearing Screening

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The birth of a newborn is a transformative moment, inundating our lives with an abundance of wonder, hope, and love. It marks the beginning of a remarkable journey that is awe-inspiring and responsible. Among these responsibilities, none are as crucial as safeguarding the health and development of your child. This journey into parenthood is not just about cuddles and cooing; it is a profound commitment to nurture, protect, and ensure the well-being of your little one.

One of the most vital aspects of this journey is the newborn hearing screening, a procedure that might not initially stand out but is integral to your baby’s early development. In this blog, we embark on an exploration of the intricacies surrounding this essential examination. We will uncover what this hearing test entails, why it is a fundamental component of your baby’s health, and how it plays a pivotal role in the foundation of your child’s overall well-being.

What is Hearing Screening?

Newborn hearing screening is an objective test designed to assess your baby’s hearing soon after birth. It helps determine if your baby’s hearing is within the normal range or if further evaluation is necessary. Normal hearing is essential for a baby’s speech and language development.

Why is newborn Hearing Screening important?

Hearing loss is one of the most common birth disorders in newborns. Statistics show that approximately four to six babies out of every 1,000 born may have congenital or other forms of hearing loss.1 Screening and early diagnosis of hearing problems are crucial to promptly identifying auditory issues in infants.

Further, this early intervention can profoundly impact a child’s communication and language development. Unidentified hearing loss can lead to difficulties in behaviour, academic achievement, and language development without it.

When is the Hearing Screening test conducted?

Hearing screening for a newborn should ideally be performed after 12 hours of birth. If, for any reason, the screening is missed during the hospital stay, it must be conducted before your baby reaches one month of age or within six weeks. After this period, the calibration of the screening equipment may no longer be accurate.

How is Hearing screening done?

Two main methods to assess a newborn’s hearing are Otoacoustic Emissions (OAE) and Automated Auditory Brainstem Response (AABR). In AABR, electrodes are placed on specific areas of the baby’s head, and a soft ear tip is gently inserted into the baby’s ear. This ear tip emits a clicking sound, and the equipment records the baby’s hearing response, determining whether it is a pass or a refer. The process is quick, typically taking 15 to 20 minutes, and not painful for the baby. It is often conducted while the baby is asleep.

What if your newborn does not pass the hearing test?

If your newborn does not achieve a successful result in the hearing test, it is essential to understand that this does not automatically indicate a hearing impairment. Various factors, including the presence of ear fluid, ambient noise levels, or even your baby’s crying, can affect the screening outcomes. Nevertheless, a non-passing result should serve as a trigger for scheduling a follow-up diagnostic assessment before your baby reaches three months of age.

How is hearing loss treated in babies?

If your baby is diagnosed with hearing loss, various interventions are available, including hearing aids, cochlear implants, and other treatments. It is crucial to engage with your paediatrician if you notice that your child does not react to loud noises or seems unresponsive to sounds.

Newborn hearing screening is not just a medical test but a cornerstone in ensuring your baby’s bright and healthy future. Identifying and addressing potential hearing issues early on gives every child the best chance to embrace the world of sound, speech, and language. It is the gift of hearing, a gift that lasts a lifetime.

 

Newborn hearing screening might seem like a routine medical procedure, but it holds a profound significance. It is an early opportunity to assess and address potential hearing issues in your baby, ensuring they have access to the world of sound and communication right from the start. By diving into the details of this screening, we hope to illuminate its importance and empower you with the knowledge and understanding you need to make informed decisions about your child’s health and development.

 

[1]Roush, Jackson, et al. “Hearing Screening in North Carolina’s NICU and Well-Baby Nurseries: Impact of JCIH 2019 and COVID-19.” Journal of Early Hearing Detection and Intervention 7.1 (2022): 11-23.

Safeguarding Our Children: The Significance of Polio Vaccinations

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Polio, short for poliomyelitis, is a highly contagious and potentially crippling disease caused by the poliovirus. It primarily affects children under the age of five and can lead to paralysis or even death within hours of infection. The virus is transmitted by ingesting contaminated food or water that contains the faecal material of an infected person. In this blog, we aim to shed light on the importance of polio vaccinations in protecting our children from this devastating illness and promoting a polio-free world.

So, the first question that comes to mind is how the transmission of polio occurs. Polio is caused by the poliovirus, which attacks the nervous system and can lead to paralysis. This virus is transmitted through contact with infected faeces. Once inside the body, the virus multiplies in the intestine and is excreted in faeces, potentially spreading the infection to others.

Who is at risk of Polio?

Children under five years of age are most vulnerable to polio. However, adults who have not been immunised and healthcare personnel working with polio cases can also be at risk. Approximately one in every 200 people infected with polio will experience irreversible paralysis, usually affecting the legs1. In severe cases, it can even impact the respiratory muscles and the spinal cord.

Can we prevent Polio?

There is no specific cure for paralytic polio, which is why prevention is of paramount importance. The most effective method for preventing polio is through vaccination.

Two types of vaccines are available for this purpose: the oral polio vaccine (OPV) and the injectable polio vaccine (IPV). It is essential to recognise that while significant progress has been made in curbing polio through relentless vaccination efforts, the threat of its resurgence still lingers.

However, the persistent and dedicated work of vaccination campaigns has led to a gradual decline in polio cases.

 

A graphical presentation of India’s success over the years:2

Should a child receive OPV during campaigns and routine immunisations?

Absolutely! It is highly recommended that children receive the oral polio vaccine (OPV) during both vaccination campaigns and routine immunisation schedules. OPV has a well-established track record of safety and effectiveness in preventing polio. To ensure comprehensive protection against this crippling disease, it is crucial to guarantee that every child receives the vaccine. It is important to note that multiple doses of OPV are necessary to establish strong immunity against polio, making it even more imperative to include OPV in both routine and campaign-based immunisation efforts. By doing so, we take a significant step towards safeguarding the health and well-being of our children and contributing to the global mission of eradicating polio.

Is it important to receive both OPV and IPV?

Both OPV and IPV are recommended for a child. OPV induces intestinal local immunity, which not only protects the vaccinated individual but also prevents the transmission of the virus. IPV, on the other hand, is increasingly being used in efforts to phase out OPV while continuing the fight against polio.

A collective responsibility

Polio, once a devastating global health threat, has now been reduced to a few remaining pockets due to the tireless efforts of vaccination campaigns. It is crucial to understand that the threat of polio is not entirely eradicated, and the disease can make a comeback if vaccination efforts wane. The importance of polio vaccinations lies in their role in protecting children from a life-altering and potentially fatal illness. By ensuring that children receive their recommended doses of the vaccine, we not only shield them from the debilitating effects of polio but also contribute to the global mission of eradicating the disease altogether. The significance of polio vaccinations extends beyond individual health; it is a collective responsibility to create a safer and healthier world for future generations.

At Fernandez, we are dedicated to creating a polio-free world. We strongly encourage parents and caregivers to ensure that children under the age of five receive the necessary polio vaccinations. It is only through collective action and vaccination that we can achieve complete polio eradication. Together, we can safeguard our children and work towards a healthier, polio-free future.

If you have any questions or concerns, please do not hesitate to reach out to your neonatologists. Call 1800 419 1397 for appointments.

1Lahariya, Chandrakant. “A brief history of vaccines & vaccination in India.” The Indian journal of medical research 139.4 (2014): 491.

2https://iimcnews6.wordpress.com/2015/03/27/polio-eradication-indias-success-2/

Empowering Expectant Moms: Navigating BMI with the Body Positive Clinic

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Pregnancy is a transformative journey filled with joy and anticipation. However, for pregnant women with a high Body Mass Index (BMI), this journey can come with increased health risks. Recognising this, Fernandez’s Body Positive Clinic was established with a mission to provide specialised care and support to pregnant women with a BMI of 40 and above.

The Body Positive Clinic began in June 2023, aiming to offer focused antenatal care, intrapartum monitoring, and postpartum follow-up. In just four months, the clinic has been supporting 38 mothers with dedicated care. Operating every Friday from 9 AM to noon, the clinic takes eight appointments each week.

Pregnant Women

The Journey so far

Pregnant women with morbid obesity face heightened risks of maternal and perinatal complications. Fernandez’s Body Positive Clinic has developed a specialised algorithmic care approach that has been proven to improve outcomes for these mothers. Through a team of skilled healthcare providers, the clinic offers personalised care that addresses the unique challenges associated with a high BMI during pregnancy.

Understanding BMI and Its Importance

BMI, or Body Mass Index, is a crucial metric that assesses an individual’s body fat based on height and weight. For pregnant women, maintaining a healthy BMI is vital because an elevated BMI can lead to various complications during pregnancy. A BMI at or above 30 is considered obese and 40 is severely obese. This index plays a pivotal role in determining the risk factors and care needed during pregnancy.

How High BMI Affects Pregnancy

High BMI during pregnancy is associated with a range of complications, including diabetes, hypertensive disorders, preterm births, increased rates of caesarean births, anaesthesia-related challenges, macrosomic babies, foetal anomalies, intrauterine foetal demise, postpartum haemorrhage, and surgical site infections. Fernandez’s Body Positive Clinic understands these risks and works diligently to mitigate them through specialised care.

Clinic’s Operation

Fernandez’s Body Positive Clinic operates as a specialty clinic, featuring a team of doctors from various medical fields, such as:

  • Obstetrics
  • Foetal medicine
  • Nutrition
  • Dietetics, and
  • Physiotherapy

The clinic operates weekly, offering a fixed number of appointments to ensure individualised care, attention, and long-term follow-up throughout pregnancy, labour, and post-birth. The dedicated team focuses on antenatal care, foetal surveillance, physical activity, and dietary modifications essential for healthy pregnancy outcomes.

Post-Birth Follow-Up

Body Positive Clinic goes the extra mile by following up with mothers not only throughout pregnancy but also during the postpartum period. This commitment extends to at least 12 months post-birth, ensuring that mothers receive continued support and care beyond delivery.

Fernandez’s Body Positive Clinic has emerged as a beacon of hope and support for pregnant women with high BMIs. By recognising the importance of BMI and tailoring specialised care to address its challenges, this clinic is transforming the pregnancy journey for expectant mothers, offering them the best chance for a healthy and positive experience.

CLINIC SCHEDULE

  • Every Friday
  • 9:00 AM – 12:00 NOON
  • 1st Floor, Fernandez Clinic, Hyderguda (Unit 4)

FOR APPOINTMENTS

 

Understanding Preeclampsia: Signs and Symptoms

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Preeclampsia is a pregnancy-related disorder characterized by high blood pressure and damage to organs, typically the liver and kidneys. It usually occurs after the 20th week of gestation and can pose risks to both the mother and the unborn baby. While the exact cause of preeclampsia remains unknown, several factors such as genetics, immune system dysfunction, and inadequate blood flow to the placenta are thought to contribute to its development.

Signs and Symptoms

Recognizing the signs and symptoms of preeclampsia is crucial for early detection and management.

Common symptoms include:

  • Persistent high blood pressure
  • Swelling in the hands and face
  • Sudden weight gain
  • Headaches
  • Changes in vision
  • Abdominal pain

Additionally, protein in the urine, often detected during routine prenatal check-ups, is an important diagnostic marker of preeclampsia. It’s vital for pregnant women to communicate any unusual symptoms to their healthcare providers promptly.

While preeclampsia can affect any pregnant woman, certain risk factors increase the likelihood of developing this condition. These include a history of preeclampsia in previous pregnancies, high blood pressure, obesity, multiple pregnancies (twins, triplets, etc.), and certain underlying health conditions like diabetes or kidney disease. Although prevention is challenging, regular prenatal care, a healthy lifestyle, maintaining a balanced diet, staying physically active, and adhering to the prescribed prenatal vitamin regimen can help reduce the risk and severity of preeclampsia.

Preeclampsia is a potentially serious pregnancy complication that requires careful attention and management. Early detection and appropriate prenatal care are essential to ensure the well-being of both mother and baby.

By understanding the signs, risk factors, and preventive measures, expectant mothers can work closely with their healthcare providers to navigate preeclampsia and achieve a healthy pregnancy outcome.

For more information, please consult our team of Obstetricians. To book an appointment, call 1800 419 1397.

Immunization: 5 Reasons Why It Is Not A Matter Of Choice

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Immunization, also known as vaccination, is one of the most effective and important methods to protect against infectious diseases. Immunization works by stimulating the body’s immune system to produce antibodies that can fight off specific infections. These antibodies provide long-lasting protection against diseases, often for a lifetime, and can help prevent the spread of contagious illnesses.

Here are five key points to understand why immunization can’t be a matter of choice.

  1. Immunization saves lives: Vaccines have been successful in preventing serious diseases such as polio, measles, and tuberculosis, which have historically caused significant morbidity and mortality. By vaccinating people against these diseases, we can save millions of lives each year.
  2. It is safe: Vaccines are thoroughly tested and approved for use by regulatory bodies globally. The vaccines used in immunization programs are highly safe and effective, and the risks of serious side effects are very low.
  3. Immunization protects the community: When enough people are vaccinated against a disease, it creates herd immunity, which helps protect those who cannot receive vaccinations for medical reasons or who are too young to receive them. This also helps to reduce the spread of disease in the community, making outbreaks less likely to occur.
  4. It is cost-effective: The cost of vaccination is far lower than the cost of treating someone who contracts a vaccine-preventable disease. Immunization not only saves money on treatment but also reduces the number of hospitalizations, doctor visits, and missed workdays due to illness.
  5. Protection for Travel: Immunization is essential for travel, especially to certain countries where diseases such as yellow fever, typhoid, and hepatitis are prevalent. Many countries require proof of immunization against certain diseases before allowing entry.

In conclusion, immunization is essential for preventing the spread of deadly diseases, protecting communities, and saving lives. It is a safe and cost-effective way to keep individuals healthy and prevent the spread of diseases. Vaccination is a crucial public health measure, and it is important for everyone to be aware of its benefits and get vaccinated on time.

Birth from the Lens of A Midwife

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The 10 Most Essential Aspects of Midwifery

One extremely powerful moment in a woman’s life is the birth of her baby. To nurture and grow a new life in the womb and eventually birth a human is an enriching process. It transforms the woman’s mind, body, and soul. It also leaves an imprint on all who witness the surging flow of events as they support the mother-to-be through those nine months.

Who is a Midwife? 

The word “Midwife” means being “with a woman.” At the very core of the Midwifery Philosophy lies this valuable tenet – to be with a pregnant woman at every step. Through centuries, the profession of Midwifery has changed in many ways, yet the concept of being “with women” has remained constant. Every mother around the globe longs for care and a helping hand during the birth of her baby. This fact guides the pathways of care that midwives engage in.

Midwifery in Today’s Day and Age

Professional Midwives are clinically trained, duly qualified and equipped with competencies to support pregnancy, birth, and post-birth care. Midwives practice the art and science of supporting the normal physiology of pregnancy and childbirth. They do so with evidence-based, safe and women-centred care.

Apart from being specialists in facilitating normal births, Midwives also manage many common obstetric complications that may arise. They work in collaboration with Obstetricians to provide holistic care to women.

Midwives listen to women’s voices and choices and trust their innate ability to give birth with confidence. They provide high-quality care for pregnant women and help them make the best decisions for themselves and their families. Midwifery care has ten most crucial characteristics:

  • The Midwifery Model of Care is sustainable, low-cost, high-quality and evidence-based.
  • It facilitates a natural, gentle start to the birth process by boosting love hormones and natural pain-relief hormones, thus keeping fear and anxiety at bay.
  • Midwives provide informational support to mothers so that they can understand their bodies and their babies and get in tune with their natural instincts.
  • Midwives make the mother feel emotionally, spiritually, and physically empowered by giving them the right knowledge at the right time, thus encouraging them to go through the journey in the most natural way possible.
  • Their continuity of care model encompasses supporting physiological and psychological needs and promoting mobilisation throughout labour and birth, thus using gravity to aid the baby’s journey through the birth canal.
  • They facilitate the mother and the baby to have a beautiful lasting bond by encouraging skin-to-skin contact and delayed cord clamping right after birth.
  • Midwives diligently support the golden hour after birth, encouraging early breastfeeding initiation.
  • Midwifery care reduces the use of medical interventions during labour and birth.
  • Women under midwifery care are more likely to have a vaginal birth and experience higher satisfaction with their birth experience.
  • Mothers are less likely to have a cesarean section or require medications for pain relief. Evidence also supports that midwife-led care lowers the risk of pre-term and stillbirths.

Over the years, research has revealed that every woman can benefit from a Midwife. Midwives trained to global standards are highly skilled and have the expertise to handle 87% of essential care required for women and newborns.

A humane approach throughout, ongoing informational support for the mother, the couple, and the family, essential clinical observations, and decision-making motivating mobilisation and use of alternative pain-relief measures keeps the wheel of a trust-based relationship moving. That is how Midwives ensure a blissful, fulfilling and satisfying birth experience.

To learn more about our Midwifery services, visit www.fernandezhospital.com/bogulkunta/services/midwifery

Prenatal Infections in Pregnancy

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Women are vulnerable to certain infections during pregnancy. If the infections are left untreated, they may become severe and develop further complications. They might affect you and your baby adversely. However, these can be prevented by taking a few preventive measures and making certain healthy choices.

What are Prenatal Infections?

Prenatal infections, also known as maternal infections, are caused during pregnancy or childbirth. These are primarily viral or bacterial infections that can be transmitted to the baby from the mother during pregnancy, labour, or shortly after birth. Such conditions increase the risk of preterm birth or health complications in the baby.

Types of prenatal infections

Prenatal infections are divided into two categories:

  • First category: It consists of infections that are acquired during pregnancy. TORCH-O stands for toxoplasmosis, syphilis, rubella, cytomegalovirus and herpes simplex, and other infections like chicken pox and zika virus, etc. These infections have a high possibility of passing onto your baby through the placenta.
  • Second category: These infections can be passed onto the baby through the birth canal. These include group B streptococcus, Hepatitis B virus, and HIV.

Implications of prenatal infection on pregnancy

Prenatal infections can cause various complications, including preterm birth, delayed development of the foetus, physical malformations, and sometimes pregnancy loss.

Infections that occur early in the pregnancy result in worse outcomes. TORCH-O infections are responsible for 2 to 3% of all congenital disorders. If diseases like HIV and Hepatitis B get transmitted to the baby, they might persist for a lifetime.

Treatment

Pregnancy needs to be monitored with the help of a maternal foetal medicine specialist. Early and prompt treatment can reduce the risk of complications. Most mothers can be treated with medication, however, sometimes the infection cannot be treated, and proper rest and hydration are recommended.

Depending on the condition, the baby may require immediate medical attention or care in a Neonatal Intensive Care Unit (NICU). The newborns should also be immunized to prevent transmission of diseases like Hepatitis B.

Tips to prevent prenatal infections.

  • Regularly wash your hands with soap and water. This is especially important after using the washroom, preparing raw meat and vegetables, and playing with children.
  • Cook meat until it is well-cooked.
  • Don’t consume unpasteurized or raw dairy products.
  • Don’t share eating utensils, cups, and food with others.
  • Reduce contact with saliva and urine from babies and young children.
  • Avoid changing cat litter and keep your distance from wild or pet rodents.
  • Practice safe sex and get tested for sexually transmitted infections.
  • Make sure your vaccinations are up to date.
Please get in touch with your consultant to learn more about prenatal infections and their prevention.

Induction of Labour: Important things to know

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For many mothers having a natural birth is a dream. Despite all the pain, they find the experience rewarding and empowering. Mothers with low-risk pregnancies choose natural birth to avoid possible risks and be in charge of their birthing journey. Chances of natural birth increase if a mother gets into labour spontaneously.

However, birthing is not always straightforward. What if a woman needs early delivery either because of medical complications or if her baby is not growing appropriately before spontaneously setting into labour? Does that shut down the chances of having a normal birth? Is a caesarean section the only option for her? The answer is ‘no.’ Induction of labour comes to the rescue in such cases.

Labour Induction

What is the Induction of Labour?

Labour induction is the process of artificially prompting the uterus to contract during pregnancy before labour begins on its own for a vaginal birth. Usually, the labour starts when a woman completes her term, that is, between 37 and 42 weeks of pregnancy.

Reasons for inducing labour

Some of the major reasons for the induction of labour are:

  • The woman is overdue (41 weeks and beyond)
  • Her water breaks without getting contractions
  • If the mother has medical problems like hypertension, gestational diabetes, or other medical complications.
  • The baby is not appropriately grown for that period.

Process of Induction of labour

Assessing the baby’s well-being before starting induction through a cardiotocograph is crucial. Once the process of inducing starts, the mother and baby will be closely monitored, and the labour progress will be periodically assessed. The process takes 24-48 hours, depending on the response. The primary purpose of Induction is to soften and dilate the cervix so that membranes around the baby can be broken.

Methods of Induction

    Either medical or mechanical methods are used to perform induction of labour.

  • Medical method: Medically induced labour is done by either placing pessary in the vagina or gel in the cervix. Oxytocin or Pitocin are given intravenously to induce labour or strengthen the contractions.
  • Mechanical method: In the mechanical process, a Foley catheter is placed in the cervix that causes the cervix to dilate. Then it is inflated with normal saline/ distilled water. Foley bulb induction is a safe way to promote cervical dilation in pregnancy when required.

If the cervix does not dilate sufficiently using one method, other methods may be used. However, the chances of vaginal birth decrease as the number of procedures required for induction increases. A caesarean section is performed if one/ all methods fail (that is, there is no progress of labour) or if any risk factors develop.

Cervical Cancer: Benefits of an Early Diagnosis

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Globally, cervical cancer is the fourth most common type of cancer among women. However, early screening and primary prevention can help decrease the burden on healthcare and mortality rates. The thought of cervical cancer is particularly alarming for women since it is one of the major causes behind all cancer-related deaths among women. According to WHO, “cervical cancer is caused by sexually acquired infection with Human Papillomavirus (HPV). Most people are infected with HPV shortly after the onset of sexual activity”.

CervicalCancer1

However, if detected early, most cervical cancer cases can be managed well. During the initial stages, there are no signs to tell a woman that she may be at risk. There are many tests used for diagnosing cervical cancer. Some such tests are:

Cervical Smear Test

The PAP smear test is the most common test to detect early cell changes leading to cervical cancer. It involves collecting a sample of cells from the cervix.

By looking at the smear, experts can confirm whether the cervix is normal, healthy, or abnormal. The presence of abnormal cells suggests that cancer may develop in the future.

How is it done?

The smear test is a simple outpatient procedure where the gynaecologist scrapes some of the cells from the cervix (the neck of the uterus) and smears it on a glass slide for examination.

After the test

  • It takes 3-4 days to get the results from the lab. If the smear test is standard (as it is in most cases), it should be repeated after three years.
  • If the test discloses some “abnormalities,” this usually means that some changes have occurred in the cells, which, if left untreated, could develop into cancer after many years. Remember, most women who have had an abnormal smear test are successfully treated.
  • Once treatment starts, it will be necessary to repeat the test after some months. If the subsequent smear tests are regular, then the tests should be done every three years.
  • If the subsequent smear tests are not regular and continue to show some abnormalities, it will be necessary to investigate further.

CervicalCancer2

Colposcopy

A Colposcopy examination is an outpatient procedure, just like a smear test. It is an in-depth examination of the cervix through a special microscope called a colposcope. A colposcope acts like a magnifying glass with light, allowing the doctor to look closely at the cervix.

How is it done?

Colposcopy is usually indicated when the routine cervical screening test, i.e., Pap smear test, has picked up abnormal cells from the cervix.

A solution is applied to the cervix, which will cause the affected areas to turn white. The cervix is then viewed through the colposcope, placed just outside the vagina. If there are any abnormal areas on the cervix, a tiny tissue sample is taken (biopsy) and sent to the lab for further testing.

After the test

Some tissues are taken from the cervix; you may experience mild cramping or light bleeding for a few days, which can be relieved by any anti-inflammatory medication. It is advisable to abstain from sexual intercourse for a few days after a biopsy.

When to get the test done?

  • Women between the ages of 20 – 60 should do the test every three years.
  • Women who have excess / recurrent attacks of vaginal discharge or bleeding after sexual intercourse.
  • It should be done within ten days of the onset of periods.
For more information, please consult our team of Gynaecologists. To book an appointment, call 1800 419 1397.

Type I Diabetes and Pregnancy: Few Important Things to Know

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Type 1

What is Type I Diabetes?

Diabetes is a medical condition in which our body is unable to control the level of sugar in the blood properly. Type I diabetes is severe diabetes mellitus, a condition in which our body requires insulin daily as the lack of insulin increases the sugar level in blood and urine. Basically, this is insulin-dependent diabetes.

Type I Diabetes and Pregnancy

If you are a diabetic and if you have conceived or are trying to conceive, it is necessary to keep your diabetes in control to have a healthy pregnancy. This protects your baby from any adverse effect.

What are the Symptoms?

  • Increased thirst
  • Excessive urination
  • Increased hunger
  • Dry mouth
  • Weight loss
  • Extreme fatigue
  • Blurred vision

What are the Risks?

Women with Type I diabetes can have a healthy pregnancy and baby, but it’s critical to keep an eye on diabetes complications that may worsen during pregnancy.

  • Macrosomia: Also known as foetal obesity, macrosomia is a medical condition in which the baby grows too large, making it difficult for vaginal birthing.
  • Growth restriction: The baby may not grow at the normal rate if the mother has Type 1 diabetes.
  • Growth acceleration: The baby may grow at a faster rate than the normal development.
  • Birth defects: A baby born to a mother with uncontrolled diabetes may suffer from a variety of birth defects.

 

Healthy Plate

Here are some tips to manage your Type I diabetes better!

  • Meal planning: You should plan your meal and maintain proper timings of meals throughout the day. You should eat three meals which should be small and around one to three snacks daily.
  • Include fibre: Have adequate fibre intake in the form of vegetables, fruits, and whole grains.
  • Avoid sweets: Avoid having sweets or items containing sugar, honey, jaggery or any other sweetener.
  • Do physical activity: You should engage yourself in mild physical activities like walking, swimming etc., as advised by the Doctor/ Physiotherapist
  • Check glucose level frequently: Monitor the glucose level frequently as it will help you to know whether your blood sugar level is normal or not. In addition, keep a proper record of the test results.
  • Take insulin: Some women may need extra insulin to keep the glucose level normal. In that case, you must take insulin as recommended by your doctor which is not harmful to your baby.

For more information, please talk to our team of Nutritionists and Dieticians. Call 1800 419 1397.