Using Epidural Anesthesia During Labor: Benefits and Risks

Using Epidural Anesthesia During Labor: Benefits and Risks

Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body and it’s the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief. The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to a total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. More than 50% of women giving birth at hospitals use epidural anesthesia.

Types of epidurals?

Regular Epidural

After the catheter is in place, a combination of a narcotic and anesthesia is administered either by a pump or by periodic injections into the epidural space. A narcotic such as fentanyl or morphine is given to replace some of the higher doses of anesthetic.

Combined Spinal-Epidural (CSE) or “Walking Epidural”

An initial dose of narcotic, anesthetic, or a combination of the two is injected beneath the outermost membrane covering the spinal cord, and inward of the epidural space. This is the intrathecal area. The anesthesiologist will pull the needle back into the epidural space, thread a catheter through the needle, then withdraw the needle and leave the catheter in place. This allows more freedom to move while in the bed and a greater ability to change positions with assistance. With the catheter in place, you can request an epidural at any time if the initial intrathecal injection is inadequate. 

With the use of these drugs, muscle strength, balance, and reaction are reduced. CSE should provide pain relief for 4-8 hours.

Benefits  of Epidurals During Delivery

  • Potential for a painless delivery. 
  • Allows you to rest if your labor is prolonged.
  • By reducing the discomfort of childbirth, some women have a more positive birth experience.
  • Required in cesarean delivery. will allow you to stay awake and also provide effective pain relief during recovery. 

Risks of Epidurals During Delivery

  • Low blood pressure: About 14 percent of women who get an epidural block experience a drop in blood pressure. Although it’s usually not harmful. Your blood pressure will be closely monitored. If necessary, fluids and medication can be passed through a drip to keep your blood pressure normal.
  • Loss of bladder control: After having an epidural, you may not be able to feel when your bladder is full because the epidural affects the surrounding nerves. You may have a catheter inserted to empty your bladder for you. You should regain bladder control once the epidural wears off.
  • Nausea and vomiting: Opioid pain relievers can sometimes make you feel sick to your stomach, a ringing of the ears, backache, and soreness when the needle is inserted
  • Fever: Women who get an epidural sometimes run a fever. About 23 percent of women who get an epidural run a fever, compared to about 7 percent of women who don’t get an epidural. The exact reason for the spike in temperature is unknown.
  • Permanent nerve damage: In rare cases, an epidural can lead to permanent loss of feeling or movement in, for example, one or both legs.

Other complications

Other very rare complications of an epidural include:

  • fits (convulsions)
  • severe breathing difficulties
  • Death
  • Seizure

When can an epidural NOT be used?

  • You’re Taking Certain Medications
  • You’re Bleeding Heavily
  • Have low platelet counts
  • Are hemorrhaging or in shock
  • Have an infection on or in your back
  • Have a blood infection
  • If you are not at least 4 cm dilated
  • Epidural space cannot be located by the physician
  • If labor is moving too fast and there is not enough time to administer the drug
  • Your Blood Work Isn’t Just Right
  • Labor Restrictions

Before deciding to have an epidural, you should discuss the procedure with your anesthetist about the advantages and disadvantages of each technique. Medication provides the greatest pain relief, but it can cause side effects. Make the decision based on your personal preferences and ability to tolerate pain.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.healthline.com/health/pregnancy/natural-birth-vs-epidural

https://www.healthline.com/health/pregnancy/pain-risks-epidurals

Stages of Pregnancy

Stages of Pregnancy

Stages of Pregnancy

Within 24 hours after fertilization, the egg that will become your baby rapidly divides into many cells. By the eighth week of pregnancy, the embryo develops into a fetus. Pregnancy is counted as 40 weeks, starting from the first day of the mother’s last menstrual period. These weeks are divided into three trimesters. Your estimated date of birth is only to give you a guide. Babies come when they are ready and you need to be patient.  

Pregnancy is divided into three trimesters:

  • First trimester – conception to 12 weeks
  • Second trimester – 12 to 24 weeks
  • Third trimester – 24 to 40 weeks.

The moment of conception is when the woman’s ovum (egg) is fertilized by the man’s sperm to complete the genetic make-up of a human fetus. At this moment (conception), the sex and genetic make-up of the fetus begin. About three days later, the fertilized egg cell divides rapidly and then passes through the Fallopian tube into the uterus, where it attaches to the uterine wall. The attachment site provides nourishment to the rapidly developing fetus and becomes the placenta.

When does pregnancy start?

Medical professionals measure pregnancy week 1 from the first day of a woman’s last menstrual period. This is called the gestational age, or menstrual age. It’s about two weeks ahead of when conception actually occurs. Although a woman is not actually pregnant at this point, counting week 1 from the last menstrual period can help determine a woman’s estimated pregnancy due date. Your healthcare provider will ask you about this date and will use it to figure out how far along you are in your pregnancy.

How early can I know I’m pregnant?

From the moment of conception, the hormone human chorionic gonadotrophin (hCG) will be present in your blood. This hormone is created by the cells that form the placenta (food source for the growing fetus). It’s also the hormone detected in a pregnancy test. While you may get a positive POAS test at 3 weeks, it’s a good idea to wait a week or two and test again to confirm. A blood test also can detect hCG and is more sensitive than a urine test. Pregnancy can detect pregnancy as early as 6 days after ovulation, you could be able to confirm your pregnancy at/around 3 weeks.

Stages of Fetal Development

During the first trimester, your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. 

The developing baby is tinier than a grain of rice. The rapidly dividing cells are in the process of forming the various body systems, including the digestive system. The evolving neural tube will eventually become the central nervous system (brain and spinal cord).

First trimester (week 1–week 12)

  • 1 and 2: Getting ready
  • 3: Fertilization
  • 4: Implantation
  • 5: Hormone levels increase
  • 6: The neural tube closes
  • 7: Baby’s head develops
  • 8: Baby’s nose forms
  • 9: Baby’s toes appear
  • 10: Baby’s elbows bend
  • 11: Baby’s genitals develop
  • 12: Baby’s fingernails form

Second trimester (week 13–week 27)

Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.

You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move. Fetal development takes on new meaning in the second trimester. Highlights might include finding out your baby’s sex and feeling your baby move.

  • 13: Urine forms
  • 14: Baby’s sex becomes apparent
  • 15: Baby’s scalp pattern develops
  • 16: Baby’s eyes move
  • 17: Baby’s toenails develop
  • 18: Baby begins to hear
  • 19: Baby develops a protective coating
  • 20: The halfway point
  • 21: Baby can suck his or her thumb
  • 22: Baby’s hair becomes visible
  • 23: Fingerprints and footprints form
  • 24: Baby’s skin is wrinkled
  • 25: Baby responds to your voice
  • 26: Baby’s lungs develop
  • 27: At 27 weeks, or 25 weeks after conception, your baby’s nervous system is continuing to mature. Your baby is also gaining fat, which will help his or her skin look smoother.

Third trimester (week 28–week 40)

Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Your baby will open his or her eyes, gain more weight, and prepare for delivery.

  • 28: Baby’s eyes partially open
  • 29: Baby kicks and stretches
  • 30: Baby’s hair grows
  • 31: Baby’s rapid weight gain begins
  • 32: Baby practices breathing
  • 33: Baby detects light
  • 34: Baby’s fingernails grow
  • 35: Baby’s skin is smooth
  • 36: Baby takes up most of the amniotic sac
  • 37: Baby might turn head down
  • 38: Baby’s toenails grow
  • 39: Baby’s chest is prominent
  • 40: Your due date arrives

As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited as the final countdown has begun.

Don’t be alarmed if your due date comes and goes with no signs of labor starting. Your due date is simply a calculated estimate of when your pregnancy will be 40 weeks. It does not estimate when your baby will arrive. It’s normal to give birth before or after your due date.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Preferences:

https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/stages-pregnancy

https://my.clevelandclinic.org/health/articles/7247-fetal-development-stages-of-growth

Most Dangerous Birth Complications

What is dangerous birth complications?

Childbirth is the process of giving birth to a baby. It includes labor and delivery. The labor and birth process is usually straightforward, but sometimes complications arise that may need immediate attention. Complications can occur during any part of the labor process. It may cause a risk to the mother, baby, or both. It is very important for women to receive health care before and during pregnancy to decrease the risk of pregnancy complications.

A childbirth complication refers to any abnormal obstetrical condition or adverse event occurring during pregnancy, labor, or delivery that can greatly impact a mother or baby. Obstetric complications are ultimate what cause all birth injuries. Some of these complications are relatively benign while others can be dangerous and even life-threatening.

The list below identifies the most dangerous childbirth complications:

  • Fetal distress is a sign that your baby is not well. An irregular heartbeat in the baby happens when the baby isn’t receiving enough oxygen through the placenta. If it’s not treated, fetal distress can lead to the baby breathing in amniotic fluid containing meconium (poo).
  • Shoulder dystocia typically defined as a delivery in which additional maneuvers are required to deliver the fetus, includes changing the mother’s position and manually turning the baby’s shoulders. Shoulder dystocia occurs when the fetal anterior shoulder impacts against the maternal symphysis following delivery of the vertex. An episiotomy, or surgical widening of the vagina, may be needed to make room for the shoulders.
  • Umbilical Cord Prolapse in a normal childbirth, the baby goes through the birth canal first and is followed by the umbilical cord and placenta. Prolapse occurs when the vital umbilical cord drops down into the cervical opening first and ends up in front of the baby as it enters the birth canal. The umbilical cord prolapse must be dealt with immediately so the fetus doesn’t put pressure on the cord, cutting off oxygen.
  • Fetal Macrosomia is the scientific term for a baby that is too big for safe vaginal delivery. Any baby in excess of 9 lbs. at full term is considered macrosomic. Undiagnosed fetal macrosomia is a potentially dangerous complication. Vaginal delivery is not safe for macrosomic babies because they are too big and are very likely to get stuck in the birth canal. It is associated with increased risks of cesarean section and trauma to the birth canal and the fetus.
  • Uterine rupture is rare. It can occur during late pregnancy or active labor. It is spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity. Prior cesarean delivery, induction of labor, size of the baby, and maternal age of 35 years or more are some factors. The mother may be at risk of excessive bleeding.
  • Failure to progress or Prolonged labor happens when labor slows and delays delivery of the baby. The cervix may not thin and open as it should. This makes it hard for the baby to move down the birth canal. Fetal Descent Stations (Birth Presentation) The progress of the baby can be progressively measured. Some of the reasons include slow cervical dilations, a small birth canal or pelvis, delivery of multiple babies or emotional factors.
  • Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies. A cesarean delivery is usually necessary.

Can complications be fatal?

Childbirth complications can be life-threatening if there is a lack of proper health care. Appropriate health care can prevent or resolve most of these problems. It is vital to follow the doctor’s advice and instructions regarding pregnancy and delivery and to attend all prenatal visits during pregnancy.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Reference:

https://www.medicalnewstoday.com/articles/307462

https://www.webmd.com/baby/features/childbirth-complications#1

https://www.birthinjuryhelpcenter.org/pregnancy-dangerous-complications.html

Giving birth during COVID-19: What to expect

Many pregnant women are worried about planning the birth of their baby during the pandemic. If your stress level is rising and you’re becoming overwhelmed with questions, that’s totally understandable. Giving birth is stressful enough. Adding a pandemic to the mix has only increased anxiety among today’s moms-to-be. While it’s true that aspects of labor and delivery may look different than they did prior to COVID-19. To ensure the health and safety of mom and baby remains the goal.

Here are some concerns you may want to address

What health and safety protocols have been implemented to reduce COVID-19 exposure risk?

As COVID-19 spreads through the air and women who are in labor breathe heavily during contractions, everyone in the room with you needs to wear a mask for your safety. Getting the vaccine protects the baby that’s why pregnant women are recommended to get the COVID-19 vaccine. The good news is not only does doing the vaccine protect you, it protects your baby, who will receive antibodies from you. The obstetricians, midwives, physician anesthesiologists, nurses, and other health care providers who care for women in labor have been vaccinated and follow other precautions to ensure safety, such as wearing personal protective equipment (PPE). recommends 

How many support persons can I have by my side in the hospital?

Currently, most hospitals will allow only one or two support people in the room with the laboring mom. If you test positive for COVID-19, safety protocols mean you will not be able to bring anyone in the room with you. After delivery, most new moms leave the hospital sooner, they spend less time in the hospital than they might have before the pandemic. one day (vs. two days) after vaginal birth and two or three days (vs. three or four) after cesarean delivery. The elements of the protocol include providing patient education prior to delivery, promoting breastfeeding and mother-baby bonding, and getting women up and moving as quickly and safely as possible. Rest assured that some things haven’t changed during the pandemic. Health care providers such as physician anesthesiologists will be by your side during your time of need.

Are there any extra precautions I should be taking at home before my baby arrives?

The final weeks before your delivery are an important time to continue social distancing. This means limiting contact with people outside your immediate family. This will lower your risk of getting COVID-19 just before you have your baby.  Hospitals have implemented several additional health and safety measures to make it as safe as possible for you to have your baby during the COVID-19 pandemic. 

Despite the challenges, we need smart ways to promote maternal and infant health during the pandemic.

Choosing where you’ll welcome your baby into the world is an important decision. Plan ahead if you can. Pack any special snacks, drinks, books, toiletries, and anything else you might want during your stay. It’s where you’ll make your first memories together. No matter the circumstances, having a baby is a joyful occasion. Changes in labor and delivery protocols during COVID-19 ensure it’s a safe experience.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.healthpartners.com/blog/giving-birth-during-covid-19/

https://uvahealth.com/services/covid19/birth-coronavirus-faqs

https://www.newswise.com/coronavirus/six-facts-women-need-to-know-about-giving-birth-during-the-covid-19-pandemic/?article_id=750200

Treatment for Pregnant COVID-19 Patients

Treatment for Pregnant COVID-19 Patients

Pregnancy can be a time of joyous anticipation and excitement for women and their families. But the coronavirus pandemic raises concerns. If you haven’t had a COVID-19 vaccine, take steps to reduce the risk of infection. Pregnant women who have known or suspected COVID-19 infection need to be evaluated quickly to determine the severity of their symptoms and if they have risk factors that put them at risk for severe disease. Treatment for Pregnant COVID-19 Patients varies the severity of their symptoms.

Avoiding the Coronavirus During Pregnancy

Avoiding infection with the coronavirus is a top priority for pregnant women. You should do everything you can to protect yourself from getting COVID-19. Pregnant women can experience changes to their immune systems that can make them more vulnerable to respiratory viruses. 

Pregnant women should be vaccinated against influenza (the flu) because if they get the flu they can get very sick, and having a high fever raises the risk of harm to your baby.

If you think you have been exposed to an infected person, and you are having COVID-19 symptoms such as fever, cough, HA, sore throat, the new loss of taste or smell, fatigue, myalgias, GI symptoms (diarrhea, nausea, vomiting), rhinorrhea, chills, difficulty breathing and/or SOB, should be tested for infection with the SARS-CoV-2. You must call your doctor and follow his or her advice. Adhere to precautions carefully. Stay at least 6 feet from others, wear a mask, and avoid large gatherings and indoor socializing outside of your household. 

Outpatient Treatment of Pregnant COVID-19 Patients

For COVID-19 in pregnancy, we can provide treatment. Several medications currently in use are also being used for our pregnant women, and early studies have shown they can provide some benefit.

Patients who are stable and not in an increased risk situation can continue to be monitored at home. Video conferencing communication is preferred to phone calls. A minimum, daily temperature with values over 38.3°C warranting further evaluation. If the patient can acquire medical devices such as a thermometer, a doppler monitor for fetal heart rate recording, she can be instructed to monitor fetal activity to reassure herself about fetal well-being. Report the findings to the OB provider during telemedicine visits. Monitoring can be completed every 2-3 days depending on the severity of COVID-19 infection. Telemedicine visits can be done more frequently for at-risk patients. Many rural and urban health institutions have already established at-home self-testing

If the patient has comorbidities known to increase the risk of severe COVID-19 infection, she is considered to be a moderate risk and should be evaluated as soon as possible in an ambulatory setting where she can test the pulse rate. Social environments where there are limited resources for remote at-home care and monitoring, no internet access, who live alone or are undomiciled, and who have limited or no transportation, may increase a pregnant woman’s risk for severe COVID-19 symptoms. Patients at risk for obstetrical complications, poor outcomes, stillbirth, and premature labor may need to be evaluated in person. 

Above all, focus on taking care of yourself and your baby. Contact your health care provider to discuss any concerns. If you’re having trouble managing stress or anxiety, talk to your health care provider or a mental health counselor about coping strategies.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://blog.thesullivangroup.com/treatment-for-pregnant-covid-19-patients-not-requiring-hospitalization

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-and-covid-19-what-pregnant-women-need-to-know https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/pregnancy-and-covid-19/art-20482639

Fetal Heart Rate Monitoring During Labor

What is Fetal Heart Rate Monitoring?

Fetal heart rate monitoring is a procedure used to evaluate the well-being of the fetus by assessing the rate and rhythm and the presence or absence of accelerations (increases) or decelerations (decreases) of the fetal heartbeat. It also checks how much the fetal heart rate changes around the baseline. The average fetal heart rate is between 110 and 160 beats per minute and can vary five to 25 beats per minute. The fetal heart rate may change as the fetus responds to conditions in the uterus. An abnormal fetal heart rate or pattern may mean that the fetus is not getting enough oxygen or there are other problems. An abnormal pattern also may mean that an emergency cesarean delivery is needed. 

How is fetal monitoring performed? 

Using a handheld Doppler (a type of ultrasound) to listen and measure the response of the fetus’s heart rate to contractions of the uterus. This is often used during prenatal visits to count the fetal heart rate or in a pregnancy less than 24 weeks. Electronic fetal monitoring is used in late pregnancy to evaluate the fetus or to check fetal well-being during labor. It provides an ongoing record that can be read. The procedure for monitoring the fetal heart rate is painless, but internal monitoring can be uncomfortable. There are very few risks associated with this procedure, so it’s routinely done on all women in labor and delivery. 

  • The gel is applied to the mother’s abdomen to act as a medium for the ultrasound transducer.
  • The ultrasound transducer is attached to the abdomen with straps and transmits the fetal heartbeat to a recorder. The fetal heart rate is displayed on a screen and printed onto special paper.
  • During contractions, an external tocodynamometer (a monitoring device that is placed over the top of the uterus with a belt) can record the patterns of contractions.
  • Sometimes, internal fetal monitoring is necessary for a more accurate reading of the fetal heart rate. Your bag of waters (amniotic fluid) must be broken and your cervix must be partially dilated to use internal monitoring. Internal fetal monitoring involves inserting an electrode through the dilated cervix and attaching the electrode to the scalp of the fetus, called a fetal scalp electrode.

There are two methods for fetal heart rate monitoring

  • External fetal heart rate monitoring uses a device to listen to or record the fetal heartbeat through the mother’s abdomen. One type of monitor is a hand-held electronic Doppler ultrasound device. This method is often used during prenatal visits to count the fetal heart rate. A Doppler device may also be used to check the fetal heart rate at regular intervals during labor. Continuous electronic fetal heart monitoring may be used during labor and birth. An ultrasound transducer placed on the mother’s abdomen conducts the sounds of the fetal heart to a computer. The rate and pattern of the fetal heart are displayed on the computer screen and printed onto the special graph paper.
  • Internal fetal heart rate monitoring uses an electronic transducer connected directly to the fetal scalp.  A wire called an electrode is used. It is placed on the part of the fetus closest to the cervix, usually the scalp. This type of electrode is sometimes called a spiral or scalp electrode. Internal monitoring provides a more accurate and consistent transmission of the fetal heart rate than external monitoring because factors such as movement do not affect it. Uterine contractions also may be monitored with a special tube called an intrauterine pressure catheter that is inserted through the vagina into your uterus. Internal monitoring can be used only after the membranes of the amniotic sac have ruptured (after “your water breaks” or is broken). Internal monitoring may be used when external monitoring of the fetal heart rate is inadequate, or closer surveillance is needed. After internal fetal heart rate monitoring, the electrode site on the newborn baby will be examined for infection, bruising, or a laceration. The site may be cleansed with an antiseptic.

Risk:

Fetal monitoring is widely used. There are no known risks to using the fetoscope, Doppler, or external monitoring. There may be a slight risk of infection with internal monitoring. The scalp electrode may also cause a mark or small cut on the baby’s head, but this usually heals quickly. An abnormal fetal heart rate pattern does not always mean the fetus is in danger. Electronic fetal monitoring is widely used in the United States. However, studies have found that the use of electronic fetal monitoring is associated with a greater chance for vacuum and forceps use with vaginal deliveries, and for cesarean delivery.

Benefits:

Fetal monitoring may help with a possible recognition of problems in the fetus. Other testing or delivery may be necessary.

Why is fetal heart rate monitoring done during labor and delivery?

Fetal heart rate monitoring may help detect changes in the normal heart rate pattern during labor. If certain changes are detected, steps can be taken to help treat the underlying problem. Fetal heart rate monitoring also can help prevent treatments that are not needed. A normal fetal heart rate can reassure both you and your obstetrician-gynecologist (ob-gyn) or other health care professional that it is safe to continue labor if no other problems are present.

What happens if the fetal heart rate pattern is abnormal?

Abnormal fetal heart rate patterns do not always mean there is a problem. Other tests may be done to get a better idea of what is going on with your fetus.

If there is an abnormal fetal heart rate pattern, your ob-gyn or other health care professional will first try to find the cause. Steps can be taken to help the fetus get more oxygen, such as having you change position. If these procedures do not work, or if further test results suggest your fetus has a problem, your ob-gyn or other health care professional may decide to deliver right away. In this case, the delivery is more likely to be by cesarean birth or with forceps or vacuum-assisted 

There is no special type of care required after external fetal heart rate monitoring. You may resume your normal diet and activity unless your health care provider advises you differently.

Your health care provider may give you additional or alternate instructions after the procedure, depending on your particular situation.

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Postpartum Hair Loss

Postpartum hair loss is a normal and temporary, however, not all women experience postpartum hair loss, but it is quite common. Fortunately, this is a totally temporary situation. Typically, it’ll take three to four months for the hair growth phase to cycle through.

During pregnancy, your hormones change dramatically. Hormones are the biggest reason for your pregnancy hair changes and postpartum hair loss.

So after your baby arrives and your hormone levels drop, your hair makes up for the lost time by falling out in much bigger clumps than it normally does. The total volume of your hair loss probably isn’t more than you would have lost over the last nine months, it just seems like it because it’s happening all at once.

Postpartum hair loss can set in any day after your baby arrives, and it sometimes continues as long as a year. It usually peaks around the 4-month mark, so if your baby is a few months old and you’re still losing clumps of hair, that doesn’t mean it’s time to panic!

Causes

While breastfeeding is often blamed for hair loss, there is no evidence to show that breastfeeding causes or increases hair loss in the postpartum period. Unfortunately, this is a symptom that almost all moms will experience. While this condition can become extreme (called Postpartum Alopecia) some hair loss is normal and a natural part of postpartum. Most moms will experience this symptom somewhere around three months postpartum. It can last a few weeks or a few months, depending on how long your hair cycles last. Often moms forget that they are still considered postpartum by this point and don’t think to relate childbirth to this symptom.

Blame it on hormones. During pregnancy, estrogen increases, which typically encourages hair growth and improves texture. But in the postpartum period, estrogen levels drop. Plus, you may have vitamin deficiencies lingering from pregnancy.  All these factors along with the exhaustion that accompanies being a new parent can lead to hair loss.

The other reason is that when you are pregnant your hair goes into a dormant cycle and you lose less hair. This is called the telogen phase. Eventually, your hair will go into the next phase (telogen effluvium) and fall out. Therefore, when you have the baby you start losing all of the hair that you didn’t lose when you were pregnant. The hair loss and regrowth will probably be most apparent in the area above your forehead. If you gained a lot of extra hair when you were pregnant, this can look quite dramatic.

How to Handle Postpartum Shedding

It’s normal for your hair to thin out after pregnancy. If it’s not worrying you, you don’t need to do anything to treat it. And, unfortunately, there is nothing that has been shown to prevent or slow postpartum hair loss. But if your hair loss is bothering you, there are treatments you can try to make your hair appear fuller and healthier.

  • Skip the styling

Heating your hair with a dryer or curling iron may make it look thinner. Try to hold off on fancy styling and let your hair air-dry till the thinning tapers out. Brushing too hard can also cause your hair to fall out in bigger clumps, so be gentle when brushing and don’t brush more than once a day. You can use the extra time to cuddle your baby or catch up on sleep!

  • Consider a haircut

It may sound counterintuitive, says Sheppard, but a short ‘do can disguise thinning hair. If you’re ready for a change, try a bob, lob, or pixie cut, she recommends—with shorter hair, you’ll naturally have more volume because you’ll have removed the weight.

  • Eat right

What you eat can help control hair loss. Aim to get lots of protein, vitamin-rich foods, green leafy vegetables, and eggs and dairy. Taking vitamin D, B-complex vitamins, and omega-3 is recommended to help reduce postpartum hair loss.

  • Switch up your product routine

If your postpartum hair is very different from your pregnancy hair or your pre-pregnancy strands it only makes sense to try different products. Look for options that include the words volumizing or thickening in their name or description. A new shampoo is also a good idea.

  • Take your vitamins

Vitamins shouldn’t be a substitute for a varied diet, especially when you’re a new mom with a baby to take care of. But they may help as a supplement if your diet is not well-balanced. While no specific vitamins have been shown to affect hair loss, they are important for overall health. It is often recommended to continue your prenatal vitamins after your baby is born, especially if you are breastfeeding.

When to Talk to Your Practitioner

Usually, by the time your hair begins to thin, you have already had your postpartum checkup with your doctor or midwife. If your shedding becomes extreme or you are losing large patches of hair, call your practitioner and mention it. Occasionally hair loss is the sign of other postpartum issues, like hypothyroidism. You want to be sure to rule those out. If you are still losing hair around your baby’s first birthday, call your practitioner. Typical hair loss does not usually continue that long into the postpartum period.

 

 

How to Prepare For a Cesarean Section

A Cesarean section, or C-section, is a procedure during which a baby is surgically delivered. This procedure is carried out when a vaginal birth isn’t possible when vaginal birth will put the mother’s or baby’s life at risk, A C-section is a form of surgery during which a doctor cuts through your belly and uterus to enable your baby to be born. In some circumstances, a c-section is scheduled in advance. In others, the surgery is needed due to an unforeseen complication. If you or your baby is in imminent danger, you’ll have an emergency c-section. Otherwise, it’s called an unplanned section.

The Preparation

If you are planning for a scheduled C-section or want to prepare yourself in the event an emergency C-section is necessary, you should be aware of the details of the procedure, get the necessary testing done, and create a hospital plan with your doctor. In most cases, a scheduled C-section will be done under a local anesthetic, so you will be awake during the operation. An epidural is administered in the spine to numb any feeling.

 

Why would I have an emergency c-section?

You may need to have an emergency c-section if problems arise that make continuing labor dangerous to you or your baby. These include the following:

  • Your baby’s heart rate gives your practitioner cause for concern, and she decides that your baby can’t withstand continued labor or induction.
  • The umbilical cord slips through your cervix (a prolapsed cord). If that happens, your baby needs to be delivered immediately because a prolapsed cord can cut off his oxygen supply.
  • Your placenta starts to separate from your uterine wall (placental abruption), which means your baby won’t get enough oxygen unless he’s delivered right away.
  • You’re attempting vaginal birth after cesarean (VBAC) and there’s concern about a uterine rupture at the site of your previous c-section incision.

 Why would I have a scheduled c-section?

In some cases, your doctor will recommend a c-section instead of a vaginal delivery. For example, you may require a planned c-section if:

  • You’ve had a previous cesarean with a “classical” vertical uterine incision (this is relatively rare) or more than one previous c-section. Both of these significantly increase the risk that your uterus will rupture during a vaginal delivery.
  • NOTE: If you’ve had only one previous c-section, with a horizontal uterine incision, you may be a good candidate for vaginal birth after cesarean or VBAC. (Note that the type of scar on your belly may not match the one on your uterus.) Or you may choose to have an elective c-section.
  • You’ve had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal of fibroids), which increases the risk that your uterus will rupture during a vaginal delivery.
  • You’re carrying more than one baby. (You might be able to deliver twins vaginally, or you may need a cesarean, depending on factors like how far along in the pregnancy you are when delivering and the positions of the twins.) The more babies you are carrying the more likely it is you’ll need a c-section.
  • Your baby is expected to be very large (a condition known as macrosomia). Your doctor is particularly likely to recommend a c-section in this case if you’re diabetic or you had a previous baby who suffered serious trauma during vaginal birth.
  • Your baby is in a breech or transverse position. (In some cases, such as a twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby may be delivered vaginally.)
  • You’re near full-term and have placenta previa (when the placenta is so low in the uterus that it covers the cervix).
  • You have an obstruction, such as a large fibroid, that would make vaginal delivery difficult or impossible.
  • The baby has a known malformation or abnormality that would make a vaginal birth risky, such as some cases of open neural tube defects.
  • You’re HIV-positive, and blood tests done near the end of pregnancy show that you have a high viral load.

Should you be worried about a scheduled C-section?

Doctors will only advise a Caesarean section as a way to minimize the risks to you or your baby, which could arise from natural birth. A C-section is usually a more quick and controlled way of your baby being born.

If you are advised to have a scheduled C-section, it is likely because your doctor sees it as the safest way for your little one to be born. However, as with all major surgeries, it does carry some risks. You are more prone to bleeding and you can experience the side effects of an epidural, which your doctor will discuss with you.

If you have already made a birth plan before the decision to have a C-section was made, then it is still a good idea to take it with you to the hospital. Surgery can be a very scary thing but knowledge is power. If you know what is going to happen, you’ll feel much more confident about it.

What to pack for a scheduled C-section

Take note that you’ll be staying in the hospital a little longer after a scheduled C-section — most likely 2-3 days — and baby will be staying with you.

You’ll want to bring comfortable clothing and slippers. Go for items that are easy to maneuver if you are breastfeeding.

Also, remember that you won’t be able to get out of bed for the first 8-12 hours after surgery, while the epidural wears off. So make sure that the clothes you’ll bring are easy to put on and take off, for easier changing when needed.

Don’t worry too much about what to bring though, as you can always ask your partner or family members to bring anything you forget!

 What are the risks of having a c-section?

A c-section is major abdominal surgery, so it’s riskier than a vaginal delivery. Moms who have c-sections are more likely to have an infection, excessive bleeding, blood clots, more postpartum pain, a longer hospital stay, and a significantly longer recovery. Injuries to the bladder or bowel, although very rare, are also more common. It’s also possible that you’ll have a reaction to the medications or to the anesthesia.

Studies have found that babies born by elective c-section before 39 weeks are more likely to have breathing problems than babies who are delivered vaginally or by emergency c-section.

Not all c-sections can – or should – be prevented. In some situations, a c-section is necessary for the well-being of the mother, the baby, or both. Ask your practitioner exactly why he is recommending a c-section. Talk about the possible risks and advantages for you and your baby in your particular situation.

If you’re due to give birth to your little one by a scheduled C-section, don’t panic. Relax and think positive thoughts — you and your baby can do it!

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

https://www.wikihow.com/Prepare-for-a-Cesarean-Section

https://sg.theasianparent.com/how-to-plan-for-a-scheduled-c-section/

Water Birth: Benefits and Risks

Water birth is the process of giving birth in a tub of warm water. Some women choose to labor in the water and get out for delivery. Other women decide to stay in the water for the delivery as well. It is believed that water birth results in a more relaxed, less painful experience for mothers.

During a water birth, you’ll be submerged in water, usually in a stationary or inflatable tub, and you’ll birth your baby in the water. This may be a good option if you want the benefits of hydrotherapy, along with the benefits of delivering in a hospital. The theory behind water birth is that since the baby has already been in the amniotic fluid sac for nine months, birthing in a similar environment is gentler for the baby and less stressful for the mother. Ask your hospital beforehand if they allow women to labor in water.

It can take place in a hospital, a birthing center, or at home. A doctor or midwife helps you through it. Beyond location, more and more women are choosing water births as the way their babies enter the world.

What are the benefits of water births?

Benefits for Mother:

  • Warm water is soothing, comforting, relaxing.
  • may help shorten the duration of labor.
  • Speed up your labor
  • Laboring in water may also decrease your need for epidurals or other spinal pain relief and more oxygen for the baby.
  • Labor in water may also have a lower cesarean section rate
  • The water seems to reduce stress-related hormones, allowing the mother’s body to produce endorphins which serve as pain-inhibitors.
  • As the laboring woman relaxes physically, she is able to relax mentally with a greater ability to focus on the birth process.
  • Water provides a greater sense of privacy, it can reduce inhibitions, anxiety, and fears.
  • Floating in water helps you move around more easily than in bed.

Benefits for Baby:

  • Provides an environment similar to the amniotic sac.
  • Eases the stress of birth, thus increasing reassurance and sense of security.

What are the risks to the mother and baby?

  • You or your baby could get an infection.
  • chance of umbilical cord damage
  • trouble regulating the baby’s body temperature
  • Your baby could breathe in bath water.
  • Your baby could have seizures or not be able to breathe.
  • respiratory distress for baby

Water birthing may not be recommended if you have any of the following complications or symptoms:

  • maternal blood or skin infection
  • fever of 100.4 F (38°C) or higher
  • excessive vaginal bleeding
  • Difficulty tracking fetal heartbeat, or need for continuous tracing
  • history of shoulder dystocia
  • Sedation
  • carrying multiples

What situations are not ideal for water birth?

  • If your baby is breech: Although water birth has been done with bottom or feet first presentations, you should discuss this risk thoroughly with your healthcare provider.
  • If you are having multiples: Although water births have been successful around the world with twin births, you should discuss this risk thoroughly with your doctor.
  • If preterm labor is expected: If a baby is preterm (two weeks or more prior to due date), water birth is not recommended.
  • If there is severe meconium: Mild to moderate meconium is fairly normal. Since meconium floats to the surface in a tub, your health care provider will watch for it and remove it immediately, or help you out of the tub. Meconium usually washes off the face of the baby and even comes out of the nose and mouth while the baby is still under water. If the water is stained and birth is imminent, the woman can lift her pelvis out of the water to birth the infant.
  • If you have toxemia or preeclampsia: You should thoroughly discuss this risk with your healthcare provider.

Some science suggests that the water may lower chances of severe vaginal tearing. And it may improve blood flow to the uterus. But study results about these points aren’t clear.

You may also reach out to friends or family who has had previous water births to learn more about their experiences. What’s most important is choosing a birthing plan that’s right for you and your baby.

If you’re planning a water birth, it’s also a good idea to come up with a backup plan in case you have complications as your pregnancy progresses, or during labor.

There isn’t enough formal evidence to support the benefits or risks of labor and delivery while submerged in water. Much of what you will read is anecdotal. More research is needed to assess the benefits for both mother and baby.

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Prolonged Labor Management

What is Prolonged Labor?

Prolonged labor is also referred to as “failure to progress.” It occurs when labor goes on for about 18 to 24 hours after regular contractions begin. For twins, a labor that goes on for 16 hours is considered prolonged. New mothers, having their first baby, are expected to be in labor for a longer period of time, so prolonged labor may not be declared until 22 to 24 hours, whereas for the second- or third-time mothers may be considered prolonged after 16 to 18 hours. A prolonged latent phase happens during the first stage of labor. It can be exhausting and emotionally draining, but rarely leads to complications.

What Causes Prolonged Labor?

There are many potential causes of experiencing prolonged labor. During the latent phase, slow effacement of the cervix can cause labor time to increase. A baby that is very large may cause labor to take longer because it cannot move through the birth canal. The birthing canal is too small, or the woman’s pelvis is too small, delivery can take longer or fail to progress.

A breech position with the baby’s feet or bottom positioned to emerge first may also cause prolonged labor. Carrying multiples may also lead to prolonged labor, as might weak uterine contractions, or an incorrect position of the baby. Research has also linked prolonged labor or failure to progress to psychological factors, such as worry, stress, or fear. Additionally, certain pain medications can slow or weaken your contractions.

Treating Prolonged Labor

If labor is taking an unusually long time, a woman’s doctor or nurses will monitor her carefully for the timing of contractions and their strength. They will also monitor the fetal heart rate and the mother’s vital signs. If the prolonged labor continues, contractions seem too weak, or the health of the mother or baby is at risk, there are steps that can be taken to speed delivery.

If the baby is already in the birth canal, the doctor or midwife may use special tools called forceps or a vacuum device to help pull the baby out through the vagina.  If the baby has not progressed that far, the mother may need to take a medication, called Pitocin, to speed up and strengthen contractions. This medicine speeds up contractions and makes them stronger. If after your doctor feels like you are contracting enough and the labor is still stalled, you may need a C-section or if the baby is too big, or the medicine does not speed up delivery, you will also need a C-section. The Cesarean section may be the answer to several of the issues that cause prolonged labor. Nearly a third of C-sections are performed due to failure to progress. A Cesarean birth might be the best choice to avoid further complications.

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.