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The Birthplace Blog

Filtering by Tag: Twin Pregnancy

The Birthplace Tales: 9 Months Of Bliss!

The Birthplace

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All about Gunjan’s pregnancy and Dr Pratibha Narayan’s take patient-doctor trust..

Are you expecting?

Congratulations are in order! In the happiness of seeing the two lines on your home pregnancy test, do not forget that with this happiness comes great responsibility. This is not just towards your unborn child, but also towards every single decision that you are going to be taking for the next 9 months, extending all the way into the next 18 years!

So, where do you begin?

Choose A Doctor You Can Trust

Often, your nine months of pregnancy will be spent a great deal with your Ob/Gyn, so taking the right decision there is paramount. While you’d have several checklists on your mind in helping you decide as to who the right doctor would be, let’s understand one aspect that many people miss out on.

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.

Thanks to the extent to which information is available through the internet, everybody can now claim that they are the experts. Unlike a decade back when diagnostic reports could only be decoded and explained by doctors, today, search engines prompt people to arrive at conclusions of their own. That’s not a great sign at all. While it’s good to be well-informed, it’s best to trust the doctors, who have degrees to their credit, with the medical expertise.

The keyword here is: trust. So, the first step in a happy pregnancy is finding yourself a doctor you can trust, so that search engines are useful for online shopping and other stuff. When Gunjan conceived her twins, she had already consulted Dr Pratibha at the Birthplace before. Therefore, she had no doubt in her mind that all she needed was Dr Pratibha’s guidance and assurance.

In fact, Dr Pratibha believes that the level of comfort between the doctor and the patient can determine several things. With a patient as lovely as Gunjan who Dr Pratibha says followed her instructions to the last alphabet, a great relationship is already established. To add to that, when the doctor spends all the time needed to explain every minute detail and concern, the trust evolves naturally. That’s one of the factors that made Gunjan and Yash’s experience at the Birthplace memorable and comfortable.

Dealing With An IVF Pregnancy And Associated Anxiety

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At 33, when Gunjan couldn’t conceive naturally, she had to go through IVF to get pregnant with her twins - Suhaani and Yuvaan. Considering this was a very precious pregnancy that happened after years of prayers and treatments, Dr Pratibha knew that the parents-to-be would be very anxious. Therefore, she exercised all clinical requirements very carefully, as is the norm at the Birthplace, while being warm and considerate.

It was natural that Gunjan and Yash had a lot of questions. Dr Pratibha spent time meticulously clarifying all their doubts ensuring they didn’t have to rely on their phones for reassurance. In fact, father-to-be Yash was the one who was more nervous than his wife Gunjan. He says that Dr Pratibha was the best choice that they had made and also felt that her motherly nature put them at immediate ease.

The Pregnancy: Routine And Normal

Usually, having IVF can bring about complications in a pregnancy, especially when they are multiples. In Gunjan’s case however, everything was normal and the babies were very healthy. Even then, as a precautionary measure, Dr Pratibha ensured that there were a few special tests performed apart from the routine tests instead of leaving things to assumption.

  1.  Nuchal Translucency Test: This test was recommended to Gunjan by Dr Pratibha to pick up on any chromosomal defects that the babies might have had. Usually performed in the first trimester, this test is also an indicator of Down’s Syndrome and even fetal heart defects.

    This test consists of two parts: one, the collection of a blood sample and two: an ultrasound scan that’ll feel like the usual scans, measuring the skin thickness at the nape of the baby’s neck.

  2. Anomaly Scan: While the first test is conducted to identify chromosomal abnormalities, this one is done to look for any structural problems. This test is usually conducted between the 18th-20th week mark and this gives the doctor a clearer understanding of the shape of the baby’s head, the alignment of the spine and the bones, the stomach, the heart and even the position of the placenta.

  3. Serial Growth Scan: This test is recommended to understand how the baby is growing by taking various measurements that include the circumference around and across the head, abdomen and thighs. This scan also helps estimate the weight of the baby to determine the type of delivery and so on.

The Significance Of Antenatal Tests

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Even though the mother-to-be can get overwhelmed by the number of tests, antenatal tests play a big role in rolling in a healthy pregnancy. Dr Pratibha believes that these tests help her determine the bigger picture to ensure that everything is perfectly fine with the mother and the baby. Even for the expecting parents, the results of these antenatal tests can help them remain stress-free, which is one of the most critical factors in a happy pregnancy.

Right from checking if the baby is growing fine to looking for any abnormality that could lead to birth defects, many of these screenings help catch problems early on. Then there are tests to ensure that the mother-to-be has no health conditions that are determined by urine tests, ultrasound tests, blood tests and some vaginal tests like pap smear.

Gunjan had to go through all these tests and perhaps that’s one of the reasons why her pregnancy was smooth without any hassle. In fact, it was her trust with Dr Pratibha that made her comfortable unlike many patients who feel that the doctor is prescribing unnecessary tests.

The Next Chapter: Birth!

After a full-term pregnancy that Gunjan says she enjoyed to the fullest, in the next blog, we’ll find out about how the big day was! From all the emotions to the details of the birth, the next blog will talk about the grand arrival of twins Suhaani and Yuvaan and how Dr Pratibha worked through the challenges. Stay tuned!

The Birthplace Tales: Double Lines and Double Celebrations

The Birthplace

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Gunjan and Yash’s first chapter in having twins and how it all began at the Birthplace...

Blaring TVs are suddenly replaced by cute babbles; toys and mini-sized clothes occupy almost every corner of the house. From their first smiles to their oh-so-adorable sneezes, everything they do warrants being frozen in time. Phone galleries brim with their photos and their giggles just ripple through your heart - having children is one of the most beautiful experiences and motherhood, an absolute blessing.

Suhaani and Yuvaan are now 18 months old - their laughter pierces through the silence of the room, reflecting in the eyes of their parents - Gunjan and Yash. Their lives have got a new meaning ever since these two little ones have made their way into their lives. But, having them wasn’t easy - to hold them for the first time in their arms, both Gunjan and Yash had to cross several hurdles. Yet, here they are now, happier than ever before, their life full of cute cuddles and adorable stories.

With very intense maternal instincts, Gunjan Nolkha knew for sure how much she wanted to experience the bliss of motherhood. So, at 33, when she couldn’t conceive naturally, she was determined to utilise the advancements of medicine to its optimal best. But, what’s all the medicine worth without the touch of an excellent doctor? When Gunjan had shared her desire to consult with a good doctor, one of her friends had referred her to Dr Pratibha Narayan, an experienced senior gynecologist and a high risk pregnancy expert at the Birthplace.

With a heart full of hope and eyes full of dreams, Gunjan and Yash first met Dr Pratibha to discuss their issues and understand what their next steps would be. After a thorough examination as is the standard procedure at the Birthplace, Dr Pratibha’s recommendation for Gunjan was for her to go through a couple of cycles of IUI (Intrauterine Insemination) to check the response and chart further treatment plans.

What Exactly Is An IUI?

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.

There can be several reasons why a woman can’t conceive. It could either be because of the partner’s low sperm count or lower sperm mobility, or because of fertility issues in the woman. This could include several factors like the eggs not getting fertilised, or conditions of the uterus like having a hostile environment, endometriosis or even a scar tissue from a previous treatment or procedure. Sometimes, the causes of infertility remain undermined.

 In Gunjan’s case, Dr Pratibha wanted to initiate the process of IUI, in which sperm is placed in the uterus through a catheter. To begin the procedure, many women are asked to take ovulation inducing medicines and are then monitored to track the maturing of the eggs. As soon as the lady experiences a surge in the LH hormone, indicating that ovulation is around the corner, the procedure of IUI is then performed.

 With the goal of helping her eggs get fertilised, Dr Pratibha administered a couple of rounds of IUI to Gunjan, because this is one of the least invasive treatments for infertility and causes minimal discomfort.

What Happened Next

Even though the success rates of IUI are as much as 20% per cycle, in this case, the eggs have to get fertilised on their own. When that didn’t happen in Gunjan’s case, Dr Pratibha swiftly moved on to the next course of plan.

 The next part of the treatment procedure was to go for IVF or In-Vitro Fertilization. This is one of the most popular forms of assisted reproductive techniques that involves gathering matured eggs from the woman and sperm from the man and helping the sperm fertilise the eggs in a controlled environment inside a lab.

 Once that happens, depending on the patient, a number of these fertilised eggs are transferred to the lady’s uterus, monitoring her developments closely. If one or more of these eggs attach themselves to the lining of the uterus, the procedure is successful and the lady conceives.

Two Lines Of Joy!

Gunjan is a firm believer of will-power. She says that the processes of artificial reproduction are tiring, painful and very uncomfortable, but having the determination to become a mother, alongwith the unwavering support from Yash held her through the arduous journey. That said, she says she cannot thank Dr Pratibha enough. When Dr Pratibha realised that IUI wasn’t going to be of great help, she immediately pulled the plug at the right time and advised the couple to go for IVF, unlike many other doctors who keep dragging the process, causing inexplicable amounts of discomfort to the patient, which leaves them very disheartened.

Would You Like To Schedule An Appointment?

 However, thanks to the timely suggestion by Dr Pratibha, the miracle of modern day medicine brought about two glorious lines on the home pregnancy test, something that Gunjan and Yash had been praying so hard for! But then, they were in for a bit of a surprise.

 Of the several fertilised eggs that had been implanted into Gunjan’s womb, four of them had attached themselves to her uterus! While the joys of being pregnant had been immense, yet, knowing that she had four babies inside of her was, well, slightly unexpected and quite challenging to digest. With inputs from Dr Pratibha and in the interests of the couple, Gunjan went through the process of reduction, all set to welcome a pair of twins in the next nine months.

 Ask how the feeling of having twins was and the one word in which Gunjan would describe it would be - interesting!

Onto Parenthood

Gunjan and Yash had been to several other doctors before consulting with Dr Pratibha, but it was with her that they had finally found the comfort and right medical advice. With the expertise and warmth of Dr Pratibha to guide them through the nine months of pregnancy that Gunjan says she absolutely enjoyed, the next blog will talk about all the things that Gunjan and Yash experienced during this beautiful phase and Dr Pratibha take on the case.

 Keep reading!

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.

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  • 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.


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.

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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.