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.

Pregnancy After 35: Things You Need to Know

Age matters in pregnancy. The older you are, the more challenges you may face. Many women over 35 have normal pregnancies and normal deliveries, but statistics show that more problems arise when you’re an older mother.

Older mothers are usually offered more tests during pregnancy, including amniocentesis and chorionic villus sampling. Age makes a difference in the delivery room too. Cesarean delivery rates go up in the over-35 set for a variety of reasons.

Getting Pregnant After 35 Is Not Impossible

Age ain’t nothing but a number. But whenever the topic of conceiving after 35 comes up, having a healthy pregnancy, it can matter. It can’t be that difficult.  No expert claims it’s impossible. It’s just more likely you may have trouble conceiving. But rest assured, most healthy women who get pregnant after age 35 and even into their 40s have healthy babies.

Your Partner’s Age Matters More if You’re Older Than 35

If your partner is five years older than you, and you’re over 35, your odds for conception are lower. In that same study cited above, the one that looked at conception rates on a woman’s most fertile days, women ages 35 to 39 with similarly aged partners had a conception rate of 29 percent. But, if their male partner was five years older, their success rate dropped to 18 percent.

Again, these rates don’t take into consideration miscarriage rates, and miscarriage and birth defect rates do increase with male and female age. Male age does matter.

If You Don’t Get Pregnant Within Six Months

If you have not conceived after 6 months, contact your health care provider to discuss the possibility of fertility testing. You may decide to consult a fertility specialist at this time.

It’s better to get fertility testing done after just six months of trying if you’re 35 or older. If there is a fertility problem found, you will be more likely to have success in treating it sooner than later. If there are no obvious fertility problems, your doctor may suggest you continue trying to conceive naturally for another few months and come back if you still don’t succeed. Consider a supplement containing myo-inositol to help improve egg quality.

Healthy Living Can Help Boost Your Odds of Conception

Though tempting, don’t assume your age is the only reason you’re not conceiving quickly. When you’re over 35, you already have your age possibly working against you. It just makes good sense to be sure the factors you can control are working for you.

Eating healthier, dropping fertility-busting habits, and maintaining a healthy weight may not only help you conceive faster than someone who doesn’t live a healthy lifestyle but can also boost your odds for fertility treatment success if you do need treatments.

Don’t forget about mind-body therapies as well. While research hasn’t yet found a strong link between mind-body therapies like yoga and fertility, there’s a possibility these stress-reducing activities may help.

This applies to men and women, by the way. It takes two to make a baby. And yes, diet and lifestyle habits can impact male and female fertility.

How Can I Increase My Chances of Having a Healthy Baby?

  • Preconception checkups and counseling. You and your health care provider can review your medical history, current medications and overall lifestyle. This gives you the opportunity to address any concerns about trying to conceive after age 35.
  • Get early and regular prenatal care. The first 8 weeks of your pregnancy are very important to your baby’s development. Early and regular prenatal care can increase your chances of having a safe pregnancy and a healthy baby. Prenatal care includes screenings, regular exams, pregnancy and childbirth education, and counseling and support.
  • Take prenatal vitamins. All women of childbearing age should take a daily prenatal vitamin containing at least 400 micrograms of folic acid. Getting enough folic acid every day before and during the first 3 months of pregnancy can help prevent defects involving a baby’s brain and spinal cord. Taking folic acid adds an important level of protection for older women, who have a higher risk of having a baby with birth defects. Some prenatal vitamins have 800-1,000 mcg of folic acid. This is still safe in pregnancy. As a matter of fact, some women need more than 400 mcg for protection against birth defects. Do not take more than 1,000 mcg (1 milligram) of folic acid without asking your doctor. Women with a history of a child with neural tube defects need 4000 mcg.
  • Physically, mentally and emotionally healthy. Alcohol, smoking, and caffeine can negatively affect fertility. Being overweight or underweight can also affect fertility by interfering with hormone function. Manage to have a healthy lifestyle before and during pregnancy.

How Can I Lower My Risk for Pregnancy Problems?

  • Keep up with other doctor appointments. Managing your condition before you get pregnant will keep both you and your baby healthy.
  • Maintain a healthy, well-balanced diet. Eating a variety of foods will help you get all the nutrients you need.
  • Gain the recommended amount of weight. Talk with your doctor about how much weight you should gain.
  • Exercise regularly. Regular exercise will help you stay at a healthy pregnancy weight, keep your strength up, and ease stress. Just be sure you review your exercise program with your doctor.

Finally, older mothers are more likely than younger mothers to have conceived with the help of assisted reproductive technology because fertility rates fall as women age. These pregnancies are more likely to require close monitoring and cesarean delivery than naturally conceived babies.

This gray cloud does have a silver lining, however. Mothers over 35 have accumulated more life experience and are often more financially secure than younger women, both of which come in handy when you’re raising a child.

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.

Importance and Benefits of Folic Acid before and during Pregnancy

Taking a folic acid supplement is one of the most important things a woman can do during the early stages of her pregnancy because it can help prevent birth defects of your baby’s brain and spinal cord.

Folic Acid is a pregnancy superhero!

What is folic acid?

Folic acid is the synthetic form of folate, a type of B-vitamin also sometimes referred to as B9.  Red blood cells carry oxygen to all the parts of your body. If your body does not make enough red blood cells, you can develop anemia. Anemia happens when your blood cannot carry enough oxygen to your body, which makes you pale, tired, or weak. Also, if you do not get enough folic acid, you could develop a type of anemia called folate-deficiency anemia

For pregnant women, Folate plays an important role in the production of red blood cells and plays a crucial role in the healthy development of the neural tube, brain and spinal cord of the fetus.

The best food sources of folic acid are from vitamins and fortified foods, such as bread, pasta and cereals. Folate is found naturally in foods such as leafy green vegetables, oranges, and beans.

How much folic acid do pregnant women need?

The general recommended dose for a normal, low-risk pregnancy is 400 micrograms (MCGs) a day for pregnant women. However, some women may want or need to take more.  It’s a water-soluble vitamin, so there’s usually no harm in taking extra.

All women need 400 micrograms of folic acid every day. Women who can get pregnant should get 400 to 800 micrograms of folic acid from a vitamin or from food that has added folic acid, such as breakfast cereal. This is in addition to the folate you get naturally from food.

Here’s how much folic acid is recommended each day in terms of pregnancy:

  • While you’re trying to conceive: 400 mcg
  • For the first three months of pregnancy: 400 mcg
  • For months four to nine of pregnancy: 600 mcg
  • While breastfeeding: 500 mcg

Reasons, why some women may need to take higher doses of folic acid, include:

  • If either parent has a medical history of neural tube defects
  • If the mother already has a child with a neural tube defect
  • If the mother is on certain medications, such as anticonvulsants
  • If the mother has diabetes
  • If the mother has impaired gastrointestinal absorption, such as with Celiac disease

When Should I Start Taking Folic Acid?

Ideally, a woman should be taking folic acid about a month prior to conception and at least through the first trimester of pregnancy. Birth defects occur within the first 3-4 weeks of pregnancy. So it’s important to have folate in your system during those early stages when your baby’s brain and spinal cord are developing.

All women who can get pregnant need to take 400 to 800 micrograms of folic acid every. You need to take folic acid every day because it is a water-soluble B-vitamin. Water soluble means that it does not stay in the body for a long time. Your body metabolizes (uses) folic acid quickly, so your body needs folic acid each day to work properly.

If you do not get enough folic acid before and during pregnancy, your baby is at higher risk for neural tube defects. Neural tube defects are serious birth defects that affect the spine, spinal cord, or brain and may cause death.

These include:

  • Spina bifida. This condition happens when an unborn baby’s spinal column does not fully close during development in the womb, leaving the spinal cord exposed. As a result, the nerves that control the legs and other organs do not work. Children with spina bifida often have lifelong disabilities. They may also need many surgeries.
  • Anencephaly. This means that most or all of the brain and skull does not develop in the womb. Almost all babies with this condition die before or soon after birth.

Babies with anencephaly usually do not live long, and those with spina bifida may be permanently disabled. These are scary problems, to say the least. But the good news is that getting enough folic acid may protect your baby from neural tube defects by at least 50%. If you’ve already had a baby with a neural tube defect, getting enough folic acid may reduce your risk of having another child with a neural tube defect by as much as 70%. If you have had a previous child with a neural tube defect, it is recommended that you increase your daily amount of folic acid to 4000 mcg (same as 4 mg) each day. Check with your doctor about how much you should take.

When taken before and during pregnancy, folic acid may also protect your baby against:

  • Cleft lip and palate
  • Premature birth
  • Low birth weight                                   
  • Miscarriage                                          
  • Poor growth in the womb


What Happens to Your Body After Giving Birth

Many things are happening in your body right after you have a baby. During pregnancy, your body changed a lot. It worked hard to keep your baby safe and healthy. Now that your baby is here, your body is changing again. Some of these changes are physical, like your breasts getting full of milk. Others are emotional, like feeling extra stress.

Things that happen to your body after birth:

Afterbirth pains:

Afterbirth pains are belly cramps you feel as your uterus (womb) shrinks back to its regular size after pregnancy. The cramps should go away in a few days. Right after you give birth, your uterus is round and hard and weighs about 2½ pounds. By about 6 weeks after birth, it weighs only 2 ounces.

Some women have pains for a few days after birth. After-birth pains can feel like labour pains or mild to moderate period pain. This pain comes from your uterus contracting towards its pre-pregnancy size. They are more common in women who have had other babies than in women who have just had their first baby.

You may also experience Shivering or getting the shakes. This can happen right after delivery and it can also happen during the transition stage of labour.

What you can do about this is ask your provider about over-the-counter-medicine you can take for pain. Over-the-counter medicine is the medicine you can buy without a prescription from your provider.

Perineum soreness:

The perineum is the area between your vagina and rectum. It stretches and may tear during labor and vaginal birth. It’s often sore after giving birth, and it may get even sore if you have an episiotomy. This is a cut made at the opening of the vagina to help let your baby out.

What you can do:

  • Do Kegel exercises. These exercises strengthen the muscles in the pelvic area. To do Kegel exercises, squeeze the muscles that you use to stop yourself from passing urine (peeing). Hold the muscles tight for 10 seconds and then release. Try to do this at least 10 times in a row, three times a day.
  • Put a Swelling on ice. Put a cold pack on your perineum. Use ice wrapped in a towel. Or you can buy cold packs that you freeze in your freezer.
  • Sit on a pillow or a donut-shaped cushion.
  • Soak your Bottom. Just fill the tub with a few inches of tepid water and hang out there for about 20 minutes, three to four times a day. It decreases swelling, cleans the area so there’s less risk of infection and generally soothes discomfort,
  • Wipe from front to back after going to the bathroom. This can help prevent infection as your episiotomy heals.
  • Witch Hazel up. Another way to find sweet relief from uncomfortable hemorrhoids? Witch hazel, an herbal remedy with tannins and oils that can help reduce inflammation.

Vaginal discharge:

After your baby is born, your body gets rid of the blood and tissue that was inside your uterus. In the week or so after birth, you’ll bleed from your vagina. The blood is called ‘lochia’. It is bright red and heavy and might have clots. This is normal, but if you pass a clot bigger than a 50 cent piece or notice a bad smell, tell your midwife. You can expect to see lochia for 4 to 6 weeks. Over time, the flow gets less and lighter in color. You may have discharge for a few weeks or even for a month or more.

Breast engorgement:

This is when your breasts swell and are painfully overfull of milk. It usually happens a few days after giving birth. Your breasts may feel tender and sore. The discomfort usually goes away once you start breastfeeding regularly. If you’re not breastfeeding, it may last until your breasts stop making milk, usually within a few days.

Breast engorgement usually occurs when a mother makes more milk than her baby uses. Your breasts may become firm and swollen, which can make it hard for your baby to breastfeed. When your baby suddenly starts breastfeeding less than usual.

Nipple pain:

If you’re breastfeeding, you may have nipple pain during the first few days, especially if your nipples crack. During pregnancy, nipple pain is generally caused by hormones. Although nipple pain in the early days (usually peaking at 3-7 days postpartum) is common, it is not necessarily normal. A common problem leading to sore nipples is an ineffective latch.

Urinary problems can happen after giving birth:

In the first few days after giving birth, you may feel pain or burning when you urinate (pee). Or you may try to urinate but find that you can’t. Sometimes you may not be able to stop urinating. This is called incontinence. It usually goes away as your pelvic muscles become stronger again.

Urine may leak out of the bladder when there is additional pressure exerted, for example, when a pregnant woman coughs or sneezes. After pregnancy, incontinence problems may continue, because childbirth weakens the pelvic floor muscles, which can cause an overactive bladder.

Emotional changes:

You might find that you go up and down a lot, from being happy to feeling very down. That’s normal.

Your baby didn’t come with a set of instructions. You may feel overwhelmed trying to take care of her. Taking care of a baby is a lot to think about.

Many women feel teary, irritable or more emotionally sensitive than usual a few days after giving birth. These feelings are known as the baby blues, and they’re normal, too. It’s a physically and emotionally challenging time. Most women feel better a few days after birth with support and understanding from those around them. If you don’t feel better after 2 weeks, please seek help.

You might find a lot of people want to come to see you, and especially to see your baby. That’s great, but it can be tiring for you both. It’s up to you how many visitors you have, and when. If you’re feeling exhausted, you can always avoid visitors for a while so that you can rest.

“Birth is not only about making babies. Birth is about making mothers — strong, competent, capable mothers who trust themselves and know their inner strength.”

—Barbara Katz Rothman



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.

Health Benefits and Risks of Eating Pickles During Pregnancy

Pickle is one of the most craved foods during pregnancy and pregnant women are notorious for having weird cravings for foods like pickles and ice cream. While pickles aren’t the healthiest food you could eat during pregnancy, indulging in a pickle or two every once in a while isn’t likely to cause harm. Pickles have very less nutritional value. One ounce of pickle contains no amount of protein, fat or cholesterol and less than one gram of carbohydrates. This is less than 0.1 percent of the amount of carbohydrates you should ideally have on a daily basis while you are pregnant. Pickle juice does contain high amounts of vitamin C and sodium. It also contains very small amounts of potassium

Is Consuming Pickles in Pregnancy Safe?

Consuming pickles in limited measures when pregnant may not be harmful. But it is not advisable to make pickles a part of your everyday diet while pregnant. Overindulgence in pickles during pregnancy can lead to certain health issues. Moderation should be the guiding factor whenever you are tempted to reach for that jar of pickles.

Moreover, during pregnancy, it is crucial to pay special attention to your dietary intake for your health along with that of your growing fetus. Pickles don’t include much nutritional value. So, their consumption is best kept to the minimum. Further, you may also like to avoid consuming very spicy pickles.

Benefits you eating pickles in moderation:

Helps Maintain Proper Balance Of Electrolytes In Your Body: Potassium and sodium are the two main electrolytes in your body. These are minerals that help in conducting electrical transmissions in your body. When you are pregnant, your body starts retaining more amount of fluid. During these months, your baby’s needs from your body also increase. This causes an increase in your body’s need for an electrolyte.

Calories, Macronutrients, and Boosts Digestion: Pickles are thought to improve digestion and even the immune function to some extent. Pickles may contain healthy bacteria which prevents it from getting spoiled. So eating pickles can aid in multiplying the good bacteria in your digestive system which can help in combating a lot of digestive issues. Eating pickles isn’t likely to cause you to exceed your daily recommended calories during pregnancy and gain too much weight. Dill pickles are low in both calories and fat.

Vitamins and Minerals: Having fresh pickles of various vegetables and fruits may provide important vitamins like vitamin A, C, K and minerals like calcium, iron, and potassium which can lower your risk of falling prey to diseases during pregnancy by strengthening your immune system. Each pickle has about 25.4 micrograms of, or 32 percent of the daily value for, this essential vitamin. Dill pickles provide trace amounts of other essential micronutrients as well, such as calcium, potassium, manganese and vitamin A.

Risk To Your Unborn Baby And You From Excess Sodium Content In Pickles:

Sodium Considerations: The main problem caused by eating dill pickles during pregnancy comes from their high sodium content. This can negate any benefits that eating pickles may have during pregnancy. The high quantity of sodium can actually be very dangerous for both your unborn baby and you if taken regularly over a period of time. Each pickle has 595 milligrams of sodium, which is about one-third of your daily sodium need during pregnancy. Getting too much sodium can increase your risk for high blood pressure, and during pregnancy, it can make you more likely to suffer from swelling. Drinking plenty of water can help minimize this effect. Another option is to eat a low-sodium version of dill pickles instead because these pickles have only about 12 milligrams of sodium each.

Potential for Heartburn: Refrain from eating very spicy pickles as it can trigger dysentery and digestive problems like heartburn and acidity. Pregnant women sometimes have problems with heartburn because pregnancy causes your body to produce more of the hormone progesterone. This hormone relaxes the valve that helps keep stomach acid and partially digested food from backing up into the esophagus.

Food Safety Considerations: Eating pickle during pregnancy which is homemade may have traces of listeria bacteria that can be potentially dangerous for the pregnancy. While store-bought dill pickles are generally safe during pregnancy, you may want to stay away from homemade refrigerator pickles during pregnancy. The listeria bacteria can survive the process used to make this type of pickle and this type of food poisoning is particularly dangerous for pregnant women. It can cause premature delivery, stillbirth, health problems for the baby or miscarriage.

Having a little pickle is alright, as long as you are not overdoing it and it is not turning into a regular habit. Speak to your doctor when pregnant before consuming pickles and discuss how much and how frequently you can have pickles if you really crave for it, as well as your concerns regarding safety and likely allergic reactions.


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.

Prenatal Care

Prenatal care is the health care you get while you are pregnant. It includes your checkups and prenatal testing. Prenatal care can help keep you and your baby healthy. It lets your health care provider spot health problems early. Early treatment can cure many problems and prevent others.

Why is prenatal care important?

Prenatal care is an important part of staying healthy during pregnancy.  

Your doctor, nurse, or midwife will monitor your future baby’s development and do routine testing to help find and prevent possible problems. These regular checkups are also a great time to learn how to ease any discomfort you may be having, and ask any other questions about your pregnancy and the birth of your future baby and also will give you a schedule for your prenatal visits.

When do I need to start having prenatal care appointments?

You can start getting prenatal care as soon as you know you’re pregnant.

It’s actually best to see a doctor BEFORE you get pregnant, this is sometimes called pre-pregnancy care or preconception planning. But if that’s not possible, just begin prenatal visits as soon as you can.

As soon as you think you’re pregnant, schedule your first prenatal appointment. Set aside ample time for the visit. You and your health care provider have plenty to discuss! You might want to include your partner in the appointment as well.

How often should I see my doctor during pregnancy?

Your doctor will give you a schedule of all the doctor’s visits you should have while pregnant. Most experts suggest you see your doctor:

  • About once each month for weeks 4 through 28
  • Twice a month for weeks 28 through 36
  • Every week from the 37th week until delivery

If you are over 35 years old or your pregnancy is high risk because of health problems like diabetes or high blood pressure, your doctor or midwife will probably want to see you more often. You can also expect to see your healthcare provider more often as your due date gets closer.

What happens during a prenatal visit?

Your health care provider will ask many questions, including details about:

  • Your menstrual cycle and gynecological history
  • Past pregnancies
  • Your personal and family medical history
  • Medication use, including prescription and over-the-counter medications or supplements
  • Your lifestyle, including your use of tobacco, alcohol, and caffeine

Due date

Few women actually give birth on their due dates. Still, establishing your due date or estimated date of delivery is important. An accurate due date allows your health care provider to monitor your baby’s growth and the progress of your pregnancy, as well as schedule certain tests or procedures at the most appropriate time.

Physical exam

Your health care provider will check your weight and height and use this information to calculate your BMI. He or she will use your BMI to determine the recommended weight gain you need for a healthy pregnancy. Will measure your blood pressure, heart rate, and breathing rate and do a complete physical exam. He or she will check for any undiagnosed medical conditions. Will also examine your vagina and the opening to your uterus (cervix). Changes in the cervix and in the size of your uterus can help confirm the stage of your pregnancy. You might need a Pap test to screen for cervical cancer as well, depending on how long it’s been since your last screening.

Lab tests

  • Check your blood type
  • Measure your hemoglobin
  • Check immunity to certain infections
  • Detect exposure to other infections
  • Screening tests for fetal abnormalities

Lifestyle issues

Your health care provider will discuss the importance of proper nutrition and prenatal vitamins. Your first prenatal visit is a good time to discuss exercise, sex during pregnancy and other lifestyle issues. You might also discuss your work environment and the use of medications during pregnancy.

Other first trimester visits

Subsequent prenatal visits, often scheduled about every four weeks during the first trimester, will probably be shorter than the first. Your health care provider will check your weight and blood pressure, and you’ll discuss any concerns.

Near the end of the first trimester, by about nine to 12 weeks of pregnancy,  you might be able to hear your baby’s heartbeat with a small device that bounces sound waves off your baby’s heart (Fetal Doppler). You may check online for Fetal Dopplers

Remember, your health care provider is there to support you throughout your pregnancy. Your prenatal appointments are an ideal time to discuss any questions or concerns, including things that might be uncomfortable or embarrassing.

Also, find out how to reach your health care provider between appointments. Knowing help is available when you need it can offer precious peace of mind.


Your First Postpartum Period: What to Expect

There are many things to love about pregnancy. Another is that you’ll have at least nine months of freedom from your period. But after you deliver, you’re probably curious about what will happen with your menstrual cycle. After its months-long hiatus, your postpartum period might return with a vengeance—or a whisper—and stay that way for years.

When your period returns often depend on whether or not you breastfeed. And just like your life after baby, you might find your periods after pregnancy is somewhat different.

When will my period return?

There are several factors that affect the return of your menstrual cycle, but most women will experience their first period between six to eight weeks after childbirth if you are not breastfeeding Approximately 80% of non-nursing mothers will have their period by the time they are 10 weeks postpartum. Those who practice exclusive breastfeeding might not have a period the entire time they breastfeed. “Exclusive breastfeeding” means that your baby is receiving only your breast milk. But for others, it might return after a couple of months, whether they’re breastfeeding or not.

If this is not your first pregnancy, keep in mind that every pregnancy is different. Even if your period returned exactly six weeks after the birth of your first child, this does not mean your menstrual cycle will return at the same point with your second pregnancy.

If your period does return quickly after giving birth and you had a vaginal delivery, your doctor might recommend that you avoid using tampons during your first menstruation post-baby. This is because your body is still healing, and tampons could potentially cause trauma. Ask your doctor if you can return to using tampons at your six-week postpartum checkup.

Breastfeeding and Your Menstrual Cycle

Typically, women who are breastfeeding don’t get their periods as quickly because of the body’s hormones. Prolactin, the hormone needed to produce breast milk, can suppress reproductive hormones. As a result, you don’t ovulate or release an egg for fertilization. Without this process, you most likely won’t menstruate.

In most cases, the rule of thumb is that it’s perfectly normal to wait up until six months after you’re finished breastfeeding for your menstrual cycle to return. If you haven’t gotten your first period at this time, your doctor may prescribe a medication to jump start menstruation and ovulation.

First Period after Pregnancy

Your first period after pregnancy is likely to be more painful than what you remember. Part of this is due to the hormonal changes in your body from pregnancy and part of it is just due to the fact you haven’t been menstruating for quite some time. Your cycle will likely return to a more normal rhythm within a few months, although you should feel free to contact your healthcare provider if you are concerned. Occasional spotting within the first three to six months after your menstrual cycle returns is normal and does not indicate a problem.

Women who had endometriosis before pregnancy might actually have lighter periods after giving birth. Light periods can also be caused by two rare conditions, Asherman syndrome and Sheehan syndrome. Asherman syndrome leads to scar tissue in the uterus. Sheehan syndrome is caused by damage to your pituitary gland, which may be the result of severe blood loss.

Another problem that women often have after pregnancy is adjusting to the use of tampons.  This is because your body is still healing, and tampons could potentially cause trauma. Ask your doctor if you can return to using tampons at your six-week postpartum checkup.

What postpartum symptoms should I watch out for?

It’s important that you call a doctor if you experience any of the following symptoms:

  • soaking through more than one pad every hour
  • bleeding that’s accompanied by sudden and severe pain
  • a sudden fever                                                                                                           
  • bleeding continuously for more than seven days
  • Blood clots that are bigger than a softball
  • foul-smelling discharge
  • A severe headache                                                    
  • Trouble breathing
  • Pain while urinating                            

A return to your menstrual cycle is just one of the parts of recovery and returning to your pre-pregnancy body. In some, menstruation may be delayed due to the hormone increases associated with breastfeeding.

If anything seems out of the ordinary about your first period after pregnancy, contact your doctor. Excess bleeding or indications of infection are especially concerning for a new parent. Listen to your body and play it safe.


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.

Baby Kicks in the Womb

One of the most exciting moments in your pregnancy is when you feel those first little flutters of your baby kicking. These tiny movements reassure you that your baby is developing and help you feel closer to the little life inside of you.

Though the womb is a tight space in which to exercise, it turns out that those kicks are vital for the baby’s healthy bone and joint development.


Feeling a baby moving and kicking in the womb might be a weird sensation, but it’s simply a sign of healthy development. 


Fetuses begin moving in the womb about as early as 7 weeks, when they slowly bend their necks, according to a review paper published in the journal Ultrasound in Obstetrics & Gynecology. As the babies grow, they gradually add more movements to their repertoires, such as hiccupping, arm and leg movements, stretching, yawning, and thumb sucking. But the mom won’t feel the bigger movements such as kicks and punches until 16 to 18 weeks into her pregnancy when the baby is a bit stronger.

What Does the Baby’s Kicking Feel Like?

Pregnant women describe their baby’s movements as butterflies, nervous twitches, or a tumbling motion. At first, it may be hard to tell whether your baby has moved. Second- and third-time moms are more adept at distinguishing those first baby movements from gas, hunger, and other internal motions.

By your second and third trimesters, the movements should be more distinct, and you’ll be able to feel your baby’s kicks, jabs, and elbows. Babies in the womb are doing more than just kicking. By 15 weeks, the baby is also punching, opening and closing its mouth, moving its head, and sucking its thumb. A few weeks later, the baby will open and close its eyes. But the mother will feel only the major movements: kicking, punching and maybe big hiccups.

How Often Should I Feel My Baby Moving?

Babies tend to move more at certain times of the day as they alternate between alertness and sleep. They are usually most active between 9 p.m. and 1 a.m., right as you’re trying to get to sleep. This surge in activity is due to your changing blood sugar levels. Babies also can respond to sounds or touch, and may even kick your partner in the back if you snuggle too close in bed. Studies show that by the third trimester, the baby moves about 30 times each hour.

Should I Count My Baby’s Kicking? 

If you are counting, it helps to chart your baby’s kicks so that you can keep track of your baby’s normal patterns of movement. To count movements, pick a time when your baby is usually most active (often, this is right after you’ve eaten a meal). Get into a comfortable position either sitting down in a comfortable chair or lying on your side.

Opinion varies as to how to count your baby’s movements, but the American College of Obstetricians and Gynecologists recommends noting the time it takes for your baby to make 10 movements. You should feel at least 10 movements within a two-hour period.

Counting your baby’s kicks (and jabs and rolls!) is important because a change in movement in the third trimester is often the earliest sign of distress in a baby. When moms know what is normal for their baby, then they are more alert to potential red flags. We frequently hear from moms whose babies were saved because they noticed a change in their baby’s movement pattern and alerted their healthcare provider.

One study, published in 2001 in the journal Human Fetal and Neonatal Movement Patterns, found that boys may move around more in the womb than girls. The average number of leg movements was much higher in the boys compared to the girls at 20, 34 and 37 weeks, that study found. But the study’s sample size was small, only 37 babies, so Nowlan and her colleagues are hesitant to claim there’s a relationship between gender and fetal movement.

What if You Don’t Feel Your Baby Moving

If you haven’t yet reached 25 weeks and don’t feel your baby move, or you’re not sure that what you’re feeling is actually your baby, don’t panic. As your baby grows, you’ll be able to better distinguish his or her movements. You’ll also figure out at what times of the day your baby is most active. Some babies just naturally move less often than others.

A lack of movement also may mean that your baby is asleep. You may feel fewer kicks and jabs after the 32nd week as your baby gets bigger and has less room to move around in the uterus.

If you notice less movement during the day, Study suggests drinking a large glass of juice or a high-sugar drink and lying on your left side in a comfortable and quiet location. There is a good chance the baby will move with a sugar and hydration boost and wait for two hours to see if your baby’s movement becomes noticeable.

If your baby still doesn’t move within that two-hour period, you may contact your health care provider or obstetrician. You may get an ultrasound to make sure the amniotic fluid around the baby is normal and the baby’s muscle tone and reflexes are present. Your doctor may also put you on a heart monitor to carry out the ultimate test for your baby’s well-being.

Timeline of Baby Movement

Here is a guide to your baby’s possible movements.

Week 12: Your baby should start to move, but you probably won’t be able to feel anything, because the baby is still so small.

Week 16: Some pregnant women will start to feel tiny butterfly-like flutters. The feeling might just be gas, or it might be the baby moving.

Week 20: By this point in your baby’s development, you may start to really feel your baby’s first movements, called “quickening.”

Week 24: The baby’s movements are starting to become more established. You might also begin to feel slight twitches as your baby hiccups.

Week 28: Your baby is moving often now. Some of the kicks and jabs may take your breath away.

Week 36: Your uterus is getting crowded as the baby grows, and movements should slow down a bit. However, alert your healthcare provider if you notice significant changes in your baby’s usual activity. You should feel consistent movement throughout the day.



Mood Swings During Pregnancy and How to Cope

Pregnancy is a life-changing event full of physical and emotional changes. Understanding these changes will help you have a positive experience. Mood swings during pregnancy are common. You may be excited about being pregnant, but you can also be stressed or overwhelmed. You may have constant worries that contribute to your mood swings.

Mood swings during pregnancy are caused by a variety of factors, including your rapidly changing hormones, the physical discomforts of pregnancy, and the very normal worries of upcoming life change.

Here’s why you may experience emotional ups and downs during pregnancy and how to cope.

Pregnancy Hormones and Mood Swings

One big reason for pregnancy mood swings is your rapidly changing hormones. Specifically, estrogen and progesterone. Mood changes during pregnancy can also be caused by physical stresses, fatigue, changes in your metabolism. Significant changes in your hormone levels can affect your level of neurotransmitters, which are brain chemicals that regulate mood. Mood swings are mostly experienced during the first trimester between 6 to 10 weeks and then again in the third trimester as your body prepares for birth.

Many women look forward to pregnancy and motherhood at some point in their lifetime. But once you do become pregnant, whether the pregnancy was planned or not, your feelings may be different from what you expected. Women who anticipated feeling fearful may be surprised at ease; those who thought they were ready may suddenly feel unsure.

It’s not just estrogen that’s increasing. The hormone progesterone also rapidly increases during pregnancy, especially during the first three months. While estrogen is usually associated with energy (and too much of it associated with nervous energy), progesterone is associated with relaxation.


Remember to take good care of yourself, as you are the priority at the moment. In a few years, you might look back at these nine months and miss them greatly.


What Triggers Mood Swings  

Hormones trigger mood swings during pregnancy, but it’s not only the hormones. The discomforts of pregnancy can cause emotional distress as well. For example, morning sickness during the first trimester. Fatigue is another common early pregnancy symptom and one that can cause mood swings. No one feels well emotionally when they are tired, and you may feel really tired during those first months of pregnancy.

During the second trimester, hormones are still changing but much less so than during the first three months. Most women feel more energy and don’t have morning sickness anymore. Still, there are potential emotional triggers. For one, during the second trimester, the body shape changes really kick in. Some women can avoid maternity clothing during the first trimester, but by the second, the need for extra room is unavoidable.

During the third trimester, getting comfortable at night can be a problem. Fatigue and difficulty with sleep can lead to mood swings. Fears and worries about the upcoming birth can get intense during the last trimester, along with worries about becoming a mother (or worries about mothering another child).

How to Cope With All These Mood Swings

Although all of the above are normal, you can take measures to lessen your mood swings during this exciting but stressful time:

  • Stay physically healthy. Eat well, exercise and get plenty of rest. If you don’t feel well or are tired, you’re more likely to be anxious or upset.
  • Become informed. For example, attend prenatal and childbirth classes and read books about pregnancy. Knowing what to expect, hearing from professionals and meeting other parents-to-be can help to alleviate stress.
  • Share your thoughts and feelings with your partner, friends or family members.
  • Avoid overextending yourself with home or work commitments.

What should I do to treat my mood swings?

It is important to understand you are not alone. Mood swings are just another aspect of the pregnancy experience. Knowing that what you are experiencing is normal and somewhat expected may help you cope.

When should I seek professional help?

If your mood swings last more than two weeks and do not seem to get better, you may want to ask your health care provider for a referral to a counselor. More than 11 million American women are affected by depression each year. Depression is most prevalent in women during childbearing years but can occur at any age.

Check with your healthcare provider before taking any medication for depression or mood swings, including herbal remedies. Always consult your healthcare provider before taking any drugs, over-the-counter or prescription, during pregnancy.


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.


The Risks of Inducing Labor

Labor induction also is known as inducing labor is the stimulation of uterine contractions during pregnancy before labor begins on its own to achieve a vaginal birth. There are a number of reasons your obstetrician might want to induce labor before your due date or before they naturally start on their own. It may be that you’re overdue with no signs that you’ll be going into labor anytime soon, or that your water (meaning the amniotic sac of fluid your baby floats in and is protected by) has broken. A situation that puts him at risk of infection. (Breaking the amniotic sac in order to induce labor is called amniotomy.)

Sometimes inducing labor is the best thing for a mother or her child. But it’s not always necessary to rush things along. In fact, it can cause problems or even be unsafe.

Generally, inducing labor is safe, but there are risks:

  • Higher risk of a C-section. If induction doesn’t work, your doctor might decide to switch to a C-section instead. If after her water is broken a woman isn’t able to give birth vaginally, it will be necessary to deliver the baby via C-section. This is because once the amniotic sac is gone, the baby is more vulnerable to infection. A cesarean in an induced labor also is more likely if the baby is in a poor position for being born naturally or is in fetal distress.
  • Health problems for your baby. Women who are induced often have babies born a little early between the 37th and 39th weeks. Early babies can have problems with breathing and other things. They might have a higher risk of long-term developmental problems. Being born even a week or two early can cause a baby to be more likely to have more trouble breathing, eating, and maintaining a normal and steady body temperature, which often means he simply isn’t physically developed enough to be ready to leave the womb and will need special care in the NICU until he is.
  • Increased risk of infection. Breaking the amniotic sac can lead to infection if you don’t deliver within a day or two after induction. Some methods of labor induction, such as rupturing your membranes, might increase the risk of infection for both mother and baby. Prolonged membrane rupture increases the risk of an infection.
  • Low heart rate. The medications used to induce labor oxytocin or a prostaglandin might cause abnormal or excessive contractions, which can diminish your baby’s oxygen supply and lower your baby’s heart rate. This can lead to a fetal distress and makes labor longer and more painful for the mother.
  • Bleeding after delivery. Labor induction increases the risk that your uterine muscles won’t properly contract after you give birth (uterine atony), which can lead to serious bleeding after delivery.
  • Risk of Jaundice. Jaundice is an inability of the liver to break down red blood cells. In newborns, it’s caused when the baby’s liver simply isn’t yet mature enough to do this job. The result is an increase in the levels of bilirubin in the baby’s blood, bringing a tell-tale yellow hue to his skin and the whites of his eyes. Jaundice isn’t uncommon and it’s treatable, but it can mean a longer stay in the hospital.

Labor induction isn’t appropriate for everyone. Labor induction might not be an option if:

  • You’ve had a prior C-section with a classical incision or major uterine surgery  
  • The placenta is blocking your cervix (placenta previa)
  • Your baby is lying buttocks first (breech) or sideways (transverse lie)
  • You have an active genital herpes infection
  • The umbilical cord slips into your vagina before delivery (umbilical cord prolapse)

How long it takes for labor to start depends on how ripe your cervix is when your induction starts, the induction techniques used and how your body responds to them. If your cervix needs time to ripen, it might take days before labor begins. If you simply need a little push, you might be holding your baby in your arms in a matter of hours.

After the procedure

In most cases, labor induction leads to a successful vaginal birth. If labor induction fails, you might need to try another induction or have a C-section.

If you have a successful vaginal delivery after induction, there might be no implications for future pregnancies. If the induction leads to a C-section, your health care provider can help you decide whether to attempt a vaginal delivery with a subsequent pregnancy or to schedule a repeat C-section.


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.