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The Birthplace Blog

Filtering by Category: Birthing

Fetal Kick Counts - Why is it critical?

The Birthplace

You are probably worried about what’s going on with your baby because there’s no way to tell unless you see your doctor. But by the time you are in your third trimester, there is an easy technique that you can use at home - Fetal Kick Counts.

Feeling your baby’s kicks and jabs and wriggles is one of the most exciting things in your pregnancy! It is almost as if it’s your baby’s way of constantly reminding you to be excited and surprised about what’s going on in your tummy!

Kick counts are important because it gives you an insight into your baby’s pattern and helps you understand if something is off. Keeping your doctor informed of your babies movements may help her address any problems if the baby is in distress. Usually earlier than 28 weeks, your baby doesn’t have a pattern, so any movement is good. Once you hit your third trimester, your baby’s kicks become stronger and more predictable - that’s when you can start on your kick counts.

Here is what you need to look out for:

When - Sometime in the morning when the baby’s kicks are less frequent because you are more active and then sometime in the evening when you are relaxing is when the kicks can be more frequent and noticeable. Its better felt when you are hungry and when you have just eaten.

How - Make a note of the time and count upto 10 kicks and record the time again. This includes any kicks, wriggles, swishes or flutters. 10 kicks in 10 hours - Cardiff count of 10!

Note - 3 kicks in 1 hour, post major meals is very reassuring.

What if you don’t feel 10 movements - Eat a snack or drink a juice and lie down then count for next 1 hour. If you still do not feel at least 3 movements then, contact your doctor. This may not necessarily mean something is wrong but it’s always a good idea to get it checked.

Remember - As you move closer to your due date, regular checking of fetal movements becomes more important. If you notice a sudden decrease in the movements, contact your doctor.

Even if your pregnancy is not a high-risk one, it is important that you count your baby’s movements regularly. In fact, it could save your baby’s life! Counting kicks is an important way to help prevent stillbirth because monitoring can help identify any problem.

Dr. Pratibha Narayan is a Senior Obstetrician and Gynecologist at the Birthplace. In addition to her passion for obstetrics and preventive women's health, she an expert with many years of experience in VBAC. She excels and specializes in managing and treating routine and high-risk pregnancies, and recurrent pregnancy losses. She is also an expert in Cosmetic and aesthetic gynaecology.  To know more or to meet Dr. Pratibha, please call 040-45208108.

Dr. Pratibha Narayan is a Senior Obstetrician and Gynecologist at the Birthplace. In addition to her passion for obstetrics and preventive women's health, she an expert with many years of experience in VBAC. She excels and specializes in managing and treating routine and high-risk pregnancies, and recurrent pregnancy losses. She is also an expert in Cosmetic and aesthetic gynaecology.

To know more or to meet Dr. Pratibha, please call 040-45208108.

Would You Like To Schedule An Appointment?

Planning Pregnancy after 35..?

The Birthplace


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Have you crossed 35 and are planning to conceive?

Yes! Then you are in good company. Many women are delaying pregnancy well into their 30s and beyond and are delivering healthy babies. The risks of pregnancy after 35 tend to get exaggerated but taking special care can help give you and your baby the best start.

Here are some challenges that you may face if you are planning to conceive post 35.

  • Getting pregnant might take a longer time. You are born with a limited number of eggs at birth. By puberty, you lose half of your eggs and by the time you reach your mid-to-late 30s, your eggs decrease in quantity and quality. Also at an older age, the eggs aren’t fertilized as easily as it would when you were younger. If you are in your late 30’s and haven’t been able to conceive for six months, consider consulting your obstetrician for advice.

  • Multiple pregnancy is very likely to occur. Hormonal changes with older age could cause the release of multiple eggs at the same time and hence increasing the chances of having twins. Pregnancy through assisted reproductive technologies may also result in conceiving twins.

  • The risk of pregnancy loss is higher. As you get older, perhaps due to pre-existing medical conditions or fetal chromosomal abnormalities, you are at a higher risk of having a miscarriage or a stillbirth. Research suggests that this may be due to a combination of a decrease in the quality of your eggs and an increase in the risk of chronic medical conditions such as high blood pressure and diabetes. During your last weeks of pregnancy, your obstetrician might suggest regular monitoring to ensure the well - being of the mother and the child.

  • The risk of chromosome abnormalities is higher. Babies born to mothers above the age of 35 are at a higher risk of certain chromosome problems, such as Down syndrome.

  • You’re more likely to develop gestational diabetes. Gestational diabetes occurs only during pregnancy and is more common for women conceiving at an older age. Diabetes during pregnancy can cause the baby to grow larger than the average - increasing the risk of injuries during delivery. It is needed to control blood sugar levels through diet and physical activity to decrease the risk of preterm delivery, high blood sugar, and complications to your infant post birth.

  • You’re also likely to develop high blood pressure during pregnancy. High blood pressure that develops during pregnancy is most commonly seen in older women. You will need to visit your obstetrician more frequently to monitor your blood pressure and your baby’s development. If needed, you might have to deliver before your due date to avoid complications.

Dr. Samatha Kumar, is a senior gynecologist at the Birthplace with more than 11 years of experience, specializing in infertility, multiple births, and high-risk pregnancies.  To know more or to meet Dr. Samatha, please call 040-45208108. You can also write to her at  contactus@thebirthplace.com  or visit www.thebirthplace.com

Dr. Samatha Kumar, is a senior gynecologist at the Birthplace with more than 11 years of experience, specializing in infertility, multiple births, and high-risk pregnancies.

To know more or to meet Dr. Samatha, please call 040-45208108. You can also write to her at contactus@thebirthplace.com or visit www.thebirthplace.com

  • You’re more likely to have a premature birth. Premature birth often comes with complicated medical problems, especially for the babies born the earliest. They may also have very low birth weight.

  • You might need a C-section. Women conceiving at an older age are at a higher risk of pregnancy-related complications that might lead to a Cesarean. One such example of a complication is Placenta Previa, a condition in which the placenta blocks the cervix not allowing a natural birth.

There are certainly a list of challenges that older women may face while conceiving or during their pregnancy. But few of these conditions can be avoided if you can take very good care of yourself. Remember! Your baby is healthy if you are!

Here are a few basics you need to pay attention to -

  • Consult your Obstetrician before you start planning for a baby.  It is always good to speak to your obstetrician about your overall health and lifestyle before you plan. Your obstetrician may advice few lifestyle changes, if necessary, to improve your chances of a healthy pregnancy. In case you have trouble conceiving or otherwise, do not hesitate to discuss your concerns about fertility or pregnancy.

  • Seek regular prenatal care. Regular prenatal visits are a must and they help your obstetrician to monitor your health and your baby’s health. Mention any signs or symptoms that concern you. Talking to your obstetrician is likely to put your mind at ease.

Looking for one-on-one counselling?
  • Eat a healthy diet. During pregnancy, your body will need more of folic acids, calcium, iron, vitamin D and other essential nutrients. Maintain a healthy diet to enrich your body with these nutrients. Starting a daily prenatal vitamin, ideally a few months before conception can help fill any gaps.

  • Gain weight wisely. Gaining the right amount of weight is necessary to support your baby’s health. It also makes it easier to shed the extra weight after delivery. Work with your obstetrician to determine what’s right for you.

  • Stay active. Regular physical activity can help you prepare for labor and childbirth by increasing your stamina and muscle strength. It can also help boost your energy level and improve your overall health. Consult your obstetrician before you start or continue an exercise regime.

  • Avoid risky substances. Smoking and alcohol consumption must be avoided right from the time you start planning to conceive.


Ease Your Body. Erase Your Worries.

The Birthplace


A developing bump, pregnancy glow, good hair days are welcoming changes which pregnancy brings, along with a sense of happiness. They also bring with it a multitude of not- so welcoming changes to your body. Evidence shows that physiotherapy, in principle, is helpful in tackling these unpleasant changes and provide relief from certain pregnancy related conditions like pelvic pain, urinary incontinence, lower back pain etc.

Before we get to these conditions, lets understand why exercising is important and how does it affect you and your baby.

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WHY SHOULD YOU EXERCISE DURING PREGNANCY?

Exercising during pregnancy has a positive influence, both, on the mother and the baby. It can also help during the postpartum rehabilitation period. It can  ensure a comfortable nine months of pregnancy compared to not exercising at all. It is important to consult your obstetrician before starting any exercise regime.

Benefits for mom-to-be:

  • Reduction in risk of developing gestational diabetes and pregnancy-induced hypertension

  • Fewer obstetric intervention (forceps, vacuum extraction)

  • Reduction in the ‘active stage’ of labor

  • Quicker return to pre-pregnancy weight

  • Reduction in bone density loss during lactation state

  • Decreased incidence of ‘incontinence’ during pregnancy and postpartum

  • Reduction in common pregnancy complaints (leg cramps, back pain, hemorrhoids etc.)

Benefits for the baby: 

  • Infants have less body fat at birth

  • Infants are less cranky which in turn has reduction in the incidence of infant colic

  • Greater neurodevelopmental scores in oral language and motor areas (tested at age 5)

Dr. Snigdha Reddy is a certified Physiotherapist with over 7 years of clinical experience . She has worked as a Consultant in various hospitals in Hyderabad & has been associated with the Birthplace for the last 4 years. She is the co-owner/founder of Physio Pro.  To know more or to consult Dr. Snigdha, please call 040-45208108. You can also write to her at  contactus@thebirthplace.com

Dr. Snigdha Reddy is a certified Physiotherapist with over 7 years of clinical experience . She has worked as a Consultant in various hospitals in Hyderabad & has been associated with the Birthplace for the last 4 years. She is the co-owner/founder of Physio Pro.

To know more or to consult Dr. Snigdha, please call 040-45208108. You can also write to her at contactus@thebirthplace.com

PREGNANCY-RELATED CONDITIONS

Most women during pregnancy experience one or more of these conditions at different stages of gestation, at different levels of severity. Physiotherapy can help you deal with all these conditions for a smooth labor and easy recovery. Here are few pregnancy-related conditions that you may experience during your 9 months. 

Lower Backache:

As your belly gets bigger throughout your pregnancy, the hormonal changes that cause the otherwise stable joints to ease up; because of which, the lower back and pelvis loosen up, preparing the body for a vaginal delivery. In turn, your lower back curves more than usual to accommodate the load – resulting in strained muscles, soreness, stiffness, and pain in the lower back.

Urinary Incontinence:

Do you accidentally leak urine when you exercise, laugh, cough or sneeze? Do you experience a need to get to the toilet in a hurry?

Urinary incontinence is defined as a complaint of any involuntary loss of urine. This is due to the weakening of the pelvic floor muscles, which play a major role in bladder control, with the progression of pregnancy. As the pelvic floor muscles and the pelvis stretch and widen to accommodate the growing baby and its increasing weight, particularly in the final trimester, the muscles become weak and make it difficult to control the bladder.

Coccydynia:

Does it pain between your buttocks when you sit on a chair for long hours?

Coccydynia is commonly known as the Tailbone (Coccyx or bony area located deep between the buttocks above the anus) pain.  It is caused due to inflammation of the tailbone manifested by pain and tenderness. Your tailbone is right behind your uterus and as the baby develops and gets larger, it's bones push against yours, causing discomfort. The other cause is the pregnancy hormones. They make the ligaments (support and connect bones) in your body relax anticipating a vaginal delivery during which the bones could shift causing discomfort and pain. 

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Carpel Tunnel Syndrome:

Do you have tingling sensation and numbness in your hands?

The carpal tunnel is a bony canal formed by wrist bones on three sides and a ligament that runs across the wrist on the other. Fluid retention and swelling which is common during pregnancy can increase pressure in the narrow space compressing the median nerve that runs through it. This pressure on the nerve causes a tingling sensation, numbness, pain or a dull ache in the fingers, hand or wrist, worsening at night.

Diastasis Recti:

Noticed any obvious gap in your stomach muscle near the belly button area?

It is the separation of your outer most abdominal muscles  which creates a gap that allows your belly to pooch out. This may not be a painful condition but affects the physical appearance of your belly.  You may still look pregnant even after you delivered your baby.  Training your core abdomen muscles can help treat this condition. 

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Pelvic Girdle Pain:

Does it pain while moving your legs apart, especially when sitting, lying down or getting out of the car? Is turning over in bed painful?

Your pelvic girdle is the bony arched structure in your hip area that supports your legs - including the symphysis pubis joint, hip joint, coccyx, sacrum, and sacroiliac joint. Pain can occur during pregnancy when there is a mechanical problem within these joints. 

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Pelvic pain is likely to be caused by a combination of factors, including:

  • the joints in your pelvis moving unevenly

  • changes to the way your muscles work to support your pelvic girdle joints

  • one pelvic joint not working properly and causing knock-on pain in the other joints of your pelvis

All the above conditions can be alleviated. Meet a certified physiotherapist today  at the Birthplace to cope with these pregnancy conditions.


Passive Smoking is Equally Injurious when you are Expecting!!!

The Birthplace


Are you planning to have a baby?  Are you pregnant? If the answer to either of these questions is "Yes".  Then there is another important question for you, do you or your partner smoke?

Smoking is an addiction not many find easy to let go, but if you ’re planning to or already having a baby, here are a few things you must be aware of. 

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What does smoking do to your body?

Cigarette contains more than 4,000 chemicals, including cyanide, lead and other carcinogens. The smoke enters your bloodstream which is the only source of nutrition for the baby.

Usually, the first nicotine dose also makes a large difference by significantly tightening the blood vessels and it also hinders oxygen flow to the baby. If the baby doesn’t get sufficient oxygen it could lead to altered brainstem development, altered lung structure, and cerebral palsy, stunned growth, premature birth, or low weight during birth or stillbirth.    

What if you are not the one smoking?

Even if you are not smoking, being exposed to smoke during pregnancy has a detrimental effect on the prenatal health of the baby. It could lead to the following –

  • Delivery before full term is complete

  • Low weight at birth

  • Undermined psychological and physiological development

  • Asthma or allergic rhinitis

  • Unexpected Miscarriage

  • Sudden Infant Death Syndrome

Passive smoke, also known as Second Hand Smoke, that  gets transferred from husbands, friends or other family members can also affect the growth of the baby. The baby’s source of breathing is what you breathe in and if you inhale carcinogens and other harmful chemicals, it finds a way to get into your baby’s lungs too!

What are the other means of transferring smoke?

Toxins have a very sly way of creeping into your breathing or living space. This is usually referred to as Third Hand Smoke, which is residue left behind on furniture, rugs, paint on the walls etc. The surroundings could smell of smoke even if no one is currently smoking, there is a good chance that there is tobacco residue still there. Upon inhaling, these toxins are absorbed into your blood and shared with your baby.

Can effects of smoking be passed down genetically?

Yes! They can! If your grandmother smoked while your mother was pregnant with you, there is a high chance of you being affected by Asthma and other genetic disorders. Genetic history of smoking also alters your genetic make-up and increases your chances of acquiring and transferring diseases to your unborn child.

How can you ensure a smoke-free prenatal zone?

  • Encourage your partner to quit

  • Wear a mask to cover your nose

  • Practice breathing exercises and Prenatal Yoga

  • Avoid places where smoking is prevalent

  • Visit open area places, preferably the ones with a lot greenery!

Looking for one-on-one counselling?

How can we help you in getting the best prenatal growth for the baby?

We at the Birthplace have an excellent team of Obstetricians and Gynaecologists who can guide you and your partner on improving the prenatal health of your baby. We also have a specialist team of Nutritionists, Yoga and Lamaze  Instructors who can work with you to ensure your baby eats and breathes well!

Interested in what we have to offer? Reach out to us!


Multiple Pregnancy: Expecting Twins...or Triplets?!

The Birthplace


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Having twins, triplets or even quadruplets can be exciting, but it may also bring worries and concerns for you, your partner and family members. If you are expecting more than one baby, it is important that you are well prepared for the changes that will take place both during your pregnancy and after the babies’ birth.

Here is everything you need to know to be prepared!

What is a multiple pregnancy?

A ‘multiple pregnancy’ is the term used when you are expecting two or more babies at the same time. It occurs in about one in 80 pregnancies. Fertility treatment increases the chances of multiple pregnancy.

What are the different kinds of multiple pregnancy?

At your early ultrasound scan which confirms whether you are carrying twins or triplets, it is important to find out the ‘chorionicity’ of your pregnancy. This is to help identify whether your babies share a placenta and it is important because babies who share a placenta have a higher risk of complications.

Twins can be:

  • Dichorionic-Diamniotic (DCDA) – if two eggs are fertilized or if one egg splits soon after fertilization, each baby has its own placenta with its own outer membrane called a ‘chorion’ and its own amniotic sac

  • Monochorionic Diamniotic (MCDA) – if the fertilized egg splits a little later, the babies share a placenta and chorion but they each have their own amniotic sac; these babies are always identical

  • Monochorionic Monoamniotic (MCMA) – much less commonly, the fertilized egg splits later still and the babies share the placenta and chorion and are inside the same amniotic sac; these babies are always identical; this is rare and carries additional risks.

Similarly, triplets can be Tri-chorionic (each baby has a separate placenta and chorion), Di-chorionic (two of the three babies share a placenta and chorion and the third baby is separate), or Mono-chorionic (all three babies share a placenta and chorion).

What does a multiple pregnancy mean for my babies and me?

For you:  Minor problems that many pregnant women experience, such as morning sickness, heartburn, swollen ankles, varicose veins, backache, and tiredness, are more common in multiple pregnancies. They get better naturally after the babies are born. Any problems that arise in any pregnancy are more common with twins and include:

Dr. Samatha Kumar, is a senior gynecologist at the Birthplace with more than 11 years of experience, specializing in infertility, multiple births, and high-risk pregnancies.  To know more or to meet Dr. Samatha, please call 040-45208108. You can also write to her at  contactus@thebirthplace.com  or visit www.thebirthplace.com

Dr. Samatha Kumar, is a senior gynecologist at the Birthplace with more than 11 years of experience, specializing in infertility, multiple births, and high-risk pregnancies.

To know more or to meet Dr. Samatha, please call 040-45208108. You can also write to her at contactus@thebirthplace.com or visit www.thebirthplace.com

  • anemia – this is usually caused by a shortage of iron because developing babies use up a lot of iron

  • pre-eclampsia – a condition that causes high blood pressure and protein in your urine

  • a higher chance of bleeding more heavily than normal after the birth

  • a higher chance of needing a caesarean section or assisted vaginal delivery to deliver your babies

For your babies: You are more likely to have premature babies if you are expecting twins or triplets. Babies born earlier than 37 weeks of pregnancy have an increased risk of problems, particularly with breathing, feeding, and infection. The earlier your babies are born, the more likely this is to be the case. They may need to be looked after in a neonatal unit.

Also, having twins increases the chance of the placenta not working as well as it should. This can affect the babies’ growth and wellbeing. Twins sharing a placenta (monochorionic pregnancies) also share the blood supply. In around 15 in 100 monochorionic twin pregnancies, the blood flow may be unbalanced. This is called twin-to-twin transfusion syndrome (TTTS). One baby, the ‘donor’, receives too little blood and has a low blood pressure while the other baby, the ‘recipient’, receives too much blood and has a high blood pressure. You will be monitored with frequent scans for signs of TTTS. It can be mild and may not require any treatment, or it can be serious, in which case you will be offered treatment in a hospital with specialist expertise.

How will my pregnancy be managed?

You will be under the care of a specialist healthcare team and will be advised to have your babies in a consultant-led maternity unit that has a neonatal unit. Your team will usually include an Obstetrician who specializes in multiple pregnancies, Fetal medicine expert, Nutritionist, Lactation consultant and an excellent Neonatal Team.

  • Having a multiple pregnancy means that you will need more visits to the antenatal clinic at your hospital.

  • You will be offered extra ultrasound scans to monitor your babies’ growth more closely. It could be as frequent as every 2 weeks from 16 weeks of pregnancy.

  • You may be advised to take iron tablets and folic acid each day throughout your pregnancy. Also, if there are risk factors for pre-eclampsia, you may be advised to take low-dose aspirin from 12 weeks of pregnancy onwards to reduce the risk.

  • Ultrasound / clinical assessments of the cervix may be done at regular intervals for measuring the length since a short cervical length is found to be associated with a higher chance of premature delivery. In case of a short cervix length, a cervical cerclage is done to suture the cervical opening.

Looking for one-on-one counselling?

How will I deliver my babies?

Delivery depends on many factors including fetal positions, gestational age, the health of the mother and babies. If both the babies are in a head down positions and there are no other complications a vaginal delivery is possible.

Caesarean delivery is for babies that are in abnormal positions, who are discordant in growth, or in higher order multiples, like triplets and more. In latter case, the babies are usually delivered by cesarean section unless you are in very premature labor or you give birth to the first baby very quickly.

Vaginal delivery may take place in the operating room because of a greater risk of complications which may require a Caesarean Section. 

Your own preference is also important and you should be given enough time to consider all of the relevant information before deciding what suits you best.

Will I be able to sufficiently breastfeed my babies?

Breast milk is best for new-born babies and your body should produce enough milk for your babies. If you encounter difficulties, our lactation expert will offer you the advice and support you need.

How will I cope with two babies at once?

Twins often come early and you will have a bigger bump than if you were having just one baby. You might consider stopping work early, possibly at around 28 weeks. When the babies are born, it will be a very busy time for any household but it is made much easier if you are supported and accept help when it is offered.

What is the Multi-Fetal Pregnancy Reduction?

In recent years, a procedure called multi-fetal pregnancy reduction has been used for very high numbers of fetuses, especially four or more. This procedure involves injecting one or more fetuses with medications, causing fetal death. The objective of multi-fetal reduction is that by reducing the number of fetuses in the pregnancy, the remaining fetuses may have a better chance for health and survival.


Vaginal Birth After C-Section Delivery (VBAC) – Is it an option for me?

The Birthplace

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Sunita was excited to learn she was expecting again. She and her husband had a three year old little boy and they felt that their family wasn't complete yet. Her excitement was tempered by one concern, though. Several hours into labor with their son, he had started to show signs of fetal distress. Her doctor made the decision to do an emergency C-section and almost before she'd known what was going on she'd been wheeled into an operating room. Now, years later, Sunita wondered whether there was any chance she'd be able to have a vaginal delivery this time or if the only option was a repeat C-section.

Sometimes pregnancy can feel like a dizzying whirl of decision-making. Will you breastfeed or use formula? Should you do genetic screening? What about circumcision? Things get even more complicated if you've previously given birth via C-section and are expecting again. Suddenly, there's an additional important decision to consider: attempt a VBAC or not?

VBAC, or Vaginal Birth After Cesarean, is when you have a normal delivery after having a previous C-section. While a number of factors affect whether you're a good candidate for VBAC, in many cases it is a safe alternative to having a planned C-section and one that should be given serious consideration.

For many people, C-sections have come to be viewed as virtually routine, despite the fact that they remain invasive and expensive surgeries. While no one can debate the fact that C-sections can be critical, life-saving procedures, the rise in Cesareans in India over the last few decades raises concerns. Until 2010, C-sections represented only about 8.5% of births in India. Since then, the rates have skyrocketed, averaging around 50% for some areas of the country

Dr. Pratibha Narayan is a Senior Obstetrician and Gynecologist at the Birthplace. In addition to her passion for obstetrics and preventive women's health, she an expert with many years of experience in VBAC. She excels and specializes in managing and treating routine and high-risk pregnancies, and recurrent pregnancy losses.  To know more or to meet Dr. Pratibha, please call 040-45208108. You can also write to her at  contactus@thebirthplace.com  or visit www.thebirthplace.com

Dr. Pratibha Narayan is a Senior Obstetrician and Gynecologist at the Birthplace. In addition to her passion for obstetrics and preventive women's health, she an expert with many years of experience in VBAC. She excels and specializes in managing and treating routine and high-risk pregnancies, and recurrent pregnancy losses.

To know more or to meet Dr. Pratibha, please call 040-45208108. You can also write to her at contactus@thebirthplace.com or visit www.thebirthplace.com

This is an unfortunate trend, considering the possible advantages of VBAC compared to a C-section. First, VBAC, like all vaginal deliveries, involves a shorter hospital stay, a shorter recovery, and less pain after delivery. Babies born naturally are also less likely to experience neonatal breathing problems because vaginal birth forces fluid out of the baby's lungs. There may be emotional benefits as well as you and your partner will be more likely to play an active role in the delivery experience than you would during a C-section.

The choice of VBAC versus C-section becomes especially important if you are considering becoming pregnant again in the future. Each time a C-section is performed, it causes scarring to the uterus. As the amount of scarring increases, there is a greater likelihood of problems in subsequent pregnancies, especially with the placenta. Conditions such as placenta previa, placenta accreta, and placenta abruption all become more common with multiple C-sections. Bowel and bladder injuries are also more likely to occur with repeat C-sections. For these reasons, conventional wisdom suggests limiting the total number of C-sections a woman experiences.

Of course, there are also risks associated with having a VBAC. Most serious among these is the possibility of the uterus tearing at the site of a previous C-section incision. Known as uterine rupture, this rare condition can have dire consequences for both mother and baby, especially if the tear goes through all layers of the uterus. Fortunately, uterine rupture is rare, and may happen in only 0.5 percent of VBAC labors; and of the cases where ruptures do occur, less than 5 percent result in serious outcomes for the mother or baby.

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Besides uterine rupture, there is also the possibility that a VBAC attempt will result in an emergency C-section. Typically, a VBAC begins with a trial of labor where the mother is either allowed to begin labor naturally, or is induced to start contractions. The labor proceeds similarly to a typical vaginal delivery, although during a VBAC the doctor monitors both mother and baby closely in case an emergency C-section becomes necessary. While the majority of women who begin a trial of labor will complete a successful VBAC, roughly 20-30 percent will ultimately require a C-section to deliver.

If you are considering a VBAC, it's important to identify an obstetrician with specific experience performing these kinds of deliveries. She will be able to discuss what factors may affect your likelihood of having a successful VBAC, such as the reason for your previous C-section, the type of incision made during your C-section, whether you've previously had a successful vaginal delivery, the time since your last C-section, etc. She should encourage you to ask questions and fully explore all of your options. While not every woman is a good candidate for a VBAC, for most it is a safe option that the right doctor will feel comfortable discussing.

An experienced doctor will also be able to help you select the best place to deliver when considering a VBAC. Each hospital and birthing center is likely to have unique guidelines regarding VBAC attempts, so it's important to find out ahead of time what policies affect your choice to give birth at a specific location. It's also a good idea to confirm the location's ability to provide rapid access to surgery and anesthesia in case an emergency C-section becomes necessary. Locally, the Birthplace is proud to support mothers who choose to attempt vaginal births after having C-sections and has several successful stories to it’s credit.

For Sunita, like most women, a VBAC ended up being a safe alternative to having a C-section. If you've had a previous Cesarean delivery, taking time early on in your pregnancy to discuss with your gynecologist whether a VBAC is right for you, will help put your mind at ease and leave you more time to wrestle with other important pregnancy decisions...like nursery colors and baby names!

Best Wishes from the Birthplace !