The skin around the vaginal opening has not stretched enough.
The Process
The pelvic area will be numbed with a local anesthesia
A small cut is made from the bottom of the vagina slightly out to one side at the peak of a contraction
An injection may not be given when sometimes the stretching of the tissues numbs the area so
Stitching after an episiotomy may be difficult and painful as the different layers of the skin and the muscles have to be sewn together. Ask for more anesthesia if needed
The stitches are soluble and need not be removed
Effects
Some discomfort and soreness is normal after an episiotomy.
Sometimes an infection can develop which makes the pain severe
The wound takes up to 14 days to heal
In case the soreness doesn’t go by this time, consult your doctor.
There is less pain with a tear
How to avoid episiotomy or tear
Learn how to relax your pelvic muscles: Lie on your back, with your knees bent and your feet flat on the floor. Now tighten the muscles squeezing as if stopping urine. Imagine you are pulling something into your vagina, pulling it in slightly then pausing then pulling again until you can go no further. Hold for a moment then let go gradually. Repeat ten times.
Keep upright during delivery: Some hospitals perform episiotomies more than the others. Speak to your doctor about the trends in your hospital.
Episiotomy Risks
Episiotomy may result in a few different complications, including:
Infection
Large tears from the incision that may extend through the anus
Bleeding and perineal hematoma, a collection of blood in the perineal tissues
Painful intercourse
Perineal pain
Episotomy is a normal performed by doctors. Do not worry if you have undergone the same .The incision resolves within a few days and you will observe healing soon after it.
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The baby’s due date has crossed by more than a week and he either shows signs of being distressed or the placenta starts to fail.
You have a medical condition like hypertension that puts either you or your baby to risk
What is done?
Induction is always planned in advance and you will be admitted in the hospital a day before. Labour is induced by either of the following ways
Pessary: A pessary is inserted into the vagina. The pessary contains a hormone that softens the cervix. Normally you may go into labour in an hour or so but if it’s your first delivery, it may not be that effective. This is usually done in the evening or very early morning
Breaking the waters: The doctor makes a small hole in the bag of water surrounding the baby, if the labour hasn’t started within eight to twelve hours. Most women don’t feel any pain and contractions usually start soon afterwards.
Hormone: A hormone is given at a controlled rate given which makes the womb contract through a drip attached to your arm. Ask for the drip to be inserted in that arm which you use the least.
How labor is induced
Contractions start after the induction tablet (pessary) or gel applied inside the vagina.
Induction of labor usually takes some time, especially when the cervix (the neck of the uterus) needs to be softened with pessaries or gels.
If you have been given vaginal tablet or gel, doctors usually allow you to wait after you have been given the same. However, you must immediately contact a doctor if :
Contractions begin
If you do not feel any contractions after 6 hours of induction
If you’ve had no contractions after 6 hours, you may be offered another tablet or gel.
Side effects of induction of labor
According to the National Institute for Health and Care Excellence (NICE) some of the side effects of induced labor are:
Among these induced births, when labor was started using drugs:
Less than two-thirds of these women gave birth without further intervention
Around 15% had to undergo instrumental (assisted) births (such as forceps or ventouse)
22% reported to have emergency caesarean sections
Induced labor is more painful than the normal labor starting on its own. Induced labor mostly results in an assisted delivery. However, there are certain situations when induced labor becomes essential. Consult your doctor if you have any apprehensions regarding the induced labor.
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In this month there is maximum growth for the baby, hence maximum weight gain for the mother. The mother can expect to gain about 500gm per week
Changes In The Mother
Skin pigmentation might become darker but will fade post delivery.
The breasts may start producing colostrum, a yellowish cloudy substance that nourishes the baby in the initial days. Don’t try to squeeze it and just wipe it away.
There might be increase in the vaginal discharge
One might experience bleeding gums
Increased chances of having aches and pains and back problems.
The nipples may become darker
The breasts may have increased in size dramatically
The top of the womb is level with the navel
The faint fluttering inside the abdomen indicates the movements of the baby.
Features of the Baby
Length : 25 cm (10 inch)
Weight: 340gms
Hair appears on the baby’s head.
Teeth are developing
Vernix, the substance that protects the baby’s skin in the womb forms
The baby’s arms and legs are well developed
The baby can grip firmly with his hands
His legs are in proportion to the rest of the body
The baby is very active and the mother must have noticed it as the rise of bubbles.
The baby may even react to noises around the womb.
Suggestions
If the mother is feeling well, it is a good idea to take a short holiday now
Wear low heeled shoes
Avoid straining your back and keep your posture straight.
Start thinking about essential clothes and equipments for the baby like a pram, cot etc.
Take adequate coaching on how to protect your back and the correct postures for standing, bending, lifting and working at a low level. It is equally important to get up the correct way after lying down
Question Of The Day
Is a long journey advisable?
Though this is the ideal time to travel, but a long car journey is not that advisable as the back may be strained. It is advisable to take a break every 2 hours or so and walk around a little bit, it helps in increasing the blood circulation and eases any discomfort. It is also advisable to wear comfortable clothes and shoes.
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Infertility can be defined as failure to achieve clinical pregnancy after 12 months of regular unprotected sexual intercourse. Infertility is usually regarded in couples less than 30 years of age. Infertility is never a male or a female problem, but it is a concern faced by the couple together. According to statistics- 40 percent of issues in male body results in infertility, female body issues result in 40 percent of infertility, both (male and female) results in 10 percent, whereas issues in both has contributes 10 percent of total infertility, 10 percent infertility has no reasons or is still unexplained.
A single test does not confirm infertility; doctors usually conduct multiple tests before confirming infertility.
Q.What is the cost of infertility?
To confirm infertility basic tests are not expensive. A tube test usually costs 1200-1500 INR, Semen Analysis ranges from 200-5000 INR, laparoscopy and hysterectomy costs around 30,000- 70,000 INR.
In spite of the associated costs no insurance company covers the cost of infertility. It is not only the financial cost which a couple pays but infertility takes a toll on the emotional health of the couple.
Q.What is the solution of infertility in Ayurveda?
Ayurveda aims to treat the root cause if the infertility. It has been observed that Ayurveda is able to treat the cause of infertilily and around 50-60 percent couples have a non- pathological reason (like obesity) for fertility were able to conceive after the ayurveda treatment. In pathological conditions like tubal blockage ayurveda has reported 20 percent of the success rate.
Q.What is the role of diet in conception?
If a couple is planning pregnancy should take into account the below mentioned points w.r.t diet:
Say no to crash diet, if you are fat
Lose weight in a healthy way
Female partner must consume iron rich foods
Eat fresh fruits and vegetables
Take diet rich in macro and micronutrients
Q.How to deal with depression due to infertility?
It is important to stay positive if you are suffering from the same. One must not lose hope so early and must consider few points like:
Talk to your gynecologist
Stay tuned with your doctor
Seek a help from counselor
Go for prescribed tests regularly
Relax and try mediation
Q.What are the challenges of IVF treatment?
IVF is latest medical technology, which is helping millions of infertile couples to conceive baby. This technique involves the artificial or laboratory fusion of male sperm and female ova and then the embryo is fertilized in the female uterus. However, the success rate of IVF cannot be guaranteed. Some complications of IVF are – Understanding about the IVF, access of IVF is a challenge as it is not available everywhere, it poses financial burden to the couple and in the end the success rate of IVF cannot be guaranteed.
Q.What is the adoption procedure?
The couple must register online to initiate the adoption process. Then following that the adoption committee will do a home survey or family background test to ensure the child goes in safe hands. Post that 3 referrals are given to the parent and then usually 20 days are given to complete the formalities to take the child home. In the presence of a doctor and a legal adoption expert the child is handed over to the family.
Planning Pregnancy
Q.Before planning pregnancy, how one should choose the gynecologist?
It is advisable to choose a doctor with good credentials, having a rich experience and expertise in the field. Choose a doctor nearby your home; the doctor should be associated with hospitals having good facilities, so when you visit the hospital the doctor should be able to treat with all the necessary equipment.
Q.What are few concerns which are to be considered before planning pregnancy?
When the couple starts thinking of planning pregnancy, it is vital that the health of the couple should be measured. Family history should be asked for any serious genetic problems. If the couple is suffering from any serious infections like HIV, STD then proper planning and treatment should be employed. Potential mother should be vaccinated against rubella infection. Regular exercise and healthy diet is advisable.
Q.Who is a pregnancy coach?
It is a new concept in India. A pregnancy coach trains the couple and advices certain exercises, suggests eating habits, and trains the couple about lifestyle changes to become fit as a parent.
Q.How trustworthy are pregnancy apps?
Most of the information on apps which are not authenticated and could be misleading. However, it is suggestive that the government sites can be referred for necessary information. Buy good books like –What to expect when you are expecting. Do not follow any app blindly; always rely on doctor or good websites.
Q.What is the optimum nutrition while planning pregnancy?
It is important to prepare body for the pregnancy. The body will undergo lot of changes post and during pregnancy; a healthy nutrition prepares the body for the same. Say No to alcohol and smoking and even to passive smoking. Consume macro and micro nutrients in right proportions. In general, the diet should contain right amounts of carbohydrates, fats, proteins, minerals and vitamins
Q.Role of mind and body in planning pregnancy?
A synchronized mind and body is necessary for planning pregnancy. Emotional health is important as it increases your chances of having a baby. One must employ healthy lifestyle, eat a balanced food, should have adequate rest for about 7-8 hours and exercise enough. Meditation and yoga help a lot, try to create a work life balance. Try breath focus exercises to reduce anxiety.
Miscarriage
Q.What is miscarriage?
Miscarriage is natural termination of pregnancy up to 20 weeks of conception. The reason could be either a defect in mother or the fetus. If fetus has some congenital abnormality or the mother has some hormonal defect example- progesterone deficiency, poor placenation example in fibroids, have some immunological defect example the mother becomes allergic to own fetus or trauma to cervix or uterus can cause miscarriage.
Q.Dealing with miscarriage?
Seek help form a psychologist to combat depression post miscarriage. During counseling sessions psychologist will help you recover faster. Being positive and telling yourself that your body might require some more time to get ready and have baby. Give your time some time to heal and get your tests done properly before planning the other one.
Q.What are effects of miscarriage on women?
As such the body does not undergo much changes after miscarriage. Timely detection and rest helps to recover faster. However, a resting for a longer period of time is not advised as it is not much required. If too much of blood loss happens to mother blood transfusion might be required.
Q.What are the symptoms of miscarriage?
Some symptoms are-
Bleeding
Ultrasound showing no pregnancy growth
Brownish discharge
Disappearance of vomiting and nausea in first trimester
The symptoms can be painless or pain free.
Q.Miscarriage and genetics?
Miscarriage could be related to genetics. The best way to avoid is one must avoid marrying in the same family or close relatives, as it increases the chances of miscarriage. However, role of family is important in dealing with miscarriage a supportive partner helps in dealing with depression.
Q.Nutrition after miscarriage?
Along with rest it is important to take right diet. A diet rich in proteins is beneficial. Consume right amounts of carbohydrates , fats and proteins, vitamins and minerals. Include fruits vegetables, ghee and butter in right amounts. Take olive oil and fish oil to supplement the body with omega3.
Q.What are the parameters of legal abortion?
One can go for abortion if it is a contraception failure, congenital abnormality or it the life of the mother or child is in danger. Consult your gynecologist and plan ina right way.
Q.How to prevent miscarriage?
Miscarriage can be avoided. Today is a complex world which poses many problems. Taking care of your mental health is pivotal in preventing miscarriage. Do not take mental stress, take adequate rest and sleep atleast for 7-8 hours during pregnancy.
Q.When to plan baby after miscarriage?
It is advisable to wait for atleast 3 months before planning the other child; it helps the body to prepare again for the pregnancy. If miscarriage happened due to a specific cause then ask your doctor and treat the cause. Relax during this time and keep a positive outlook.
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With just three months of pregnancy left, the seventh month marks the beginning of the last trimester. The baby is very active during this period and moves around quite a lot. Babies born in this month and are called premature babies and while they need special care, they can surely survive.
During these final months, the mother gains about 4 kgs, approximately 40 percent of the total pregnancy weight gain.
Changes in the mother
Red stretch marks may start appearing on the stomach area
False contractions (known as Braxton Hicks) are sometimes felt around this time and though they are not very painful they can be misleading.
The mother might experience acidity, indigestion, heartburn and cramps.
The mother starts feeling large and may bump into things. She may also become forgetful or dream about labour, childbirth and the baby. This may be caused by disturbed sleep or due to the baby’s movements.
One can notice an increased weight around the thighs, buttocks and the stomach.
The top of the womb is halfway between the stomach and the navel.
The veins on the breast may become more noticeable around this time.
Features of the Baby
Length 14.5 inch
Weight 1 kg
The face and body is covered with vernix, which acts as a waterproofing agent.
The seal over the eyes is gone.
The hearing is well developed
The skin is red and wrinkled
A seven month old infant feels pain and responds exactly like a full term baby
Fat starts to accumulate under the skin
Taste buds are more pronounced than they will be at birth
Lungs have still not reached the stage of maturity
Around this time if the baby twists and turns the shape of the foot can be seen on the mother’s stomach
If the father is keen on feeling the baby movements, he can feel the baby move over the mother’s abdomen with his hand
The baby’s heartbeat can be heard with an ordinary fetal stethoscope.
Suggestions
If you are a working woman, try to put your feet up as and when possible
Make sure you get enough rest during the day and sleep early at nights.
Let the employer know in writing when you intend to take a break and when you will return to work post delivery.
Make a visit to the antenatal clinic every two weeks from now onwards.
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The eighth month is an exciting time indeed, as the baby is fully formed by now. Around this month, due to the increased weight, the expectant mother start feeling rather tired. It is important to calm down and get all the rest you can get. It is also a good idea to join antenatal classes.
Towards the end of this month, the mother’s weight gain may slow down, though the baby is growing rapidly.
Changes in the Mother
The frequency to pass urine increases. It is very common to leak a little urine when one coughs or sneezes.
She may face breathlessness
The sleep may be disturbed and that may make the mother irritable.
There might be a change in the shape of the navel. For some it pops out while in others it flattens.
There might be discomfort in the pelvic area as the joints are expanding in preparation for birth.
The dark line running down the stomach may become more prominent.
The base of the ribcage may be sore as the womb presses upwards.
The mother may feel more of Braxton-Hicks Contractions that can feel like strong bands tightening across your uterus, making the uterus feel hard.
You may also start experiencing stronger baby kicks
You may experience night awakening as you may experience REM sleep – a sleep state in which you dream more and awaken more easily. Also, your enlarging uterus makes it difficult to sleep.
Features of the Baby
Length 16 inch
Weight 1.6 kg
The baby looks almost as it will at birth and only needs to gain more weight and fat.
The head is proportionate to the body now
As there is less space in the womb, the normally turns into a head down position in preparation for birth.
The baby can differentiate between light and dark
Suggestions
If you leak urine while coughing, sneezing etc, you will need to strengthen your pelvis. Pelvic floor exercises are very useful and you can ask your doctor or midwife to help you practice it regularly
Start attending antenatal classes if you haven’t as yet.
Put your feet up for an hour or two during the course of the day
If you are having sleeping difficulties, take the help of breathing and relaxation techniques.
Get a blood test done to check for anemia or negative blood group problems.
Buy basic essentials for the baby, which may include
A carry cot
A blanket
Bedding
Car seat
Bath tub
Towels
Nappies
Bottle feeding equipments
Vests
Cardigans
Jumpsuits
Night suits
Socks
Hat
Don’t over think or stress too much and try to be as relaxed as possible. Catch up on sleep as and when possible as this would become a scarce commodity once the baby comes home.
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The end of the third month signifies the closure of the first trimester and is considered the right time to announce the pregnancy as the early signs of discomfort in the mother tend to cease.
Physical Changes
Morning sickness, nausea and vomiting starts to ease.
There is a decline in the frequency of urination.
There can be signs of constipation because of slow bowel movements during pregnancy.
Hormonal changes may lead to mood swings.
The volume of blood circulation in the body increases, leading to increased burden on the lungs, kidneys and heart of the mother.
Increased heaviness and tenderness in the breasts.
While there will not be much change in the shape of the mother’s body, the top of the womb can be felt just above the pubic bone.
Weight Gain of the Mother
Around this time the mother expects to gain about 10 percent of the total pregnancy weight gain, which would be approximately 1.2 kg. If the expectant mother faces nausea and morning sickness, the weight gain could be much less.
Length and Weight of the Baby
The baby would have grown to about 2.5 inches now and weigh around 18 gms
Features of the Baby
The external ears are well developed
Tiny fingers and toes have formed
The baby looks much more human
The head is still large in proportion to the body
The limbs are small though fully formed now
He can suck and swallows the fluid that surrounds him
He can pass urine.
Eyelids have developed and are closed over the eyes
Miniature fingernails and toenails are growing.
Pregnancy Tips
Get into the habit of standing straight in this stage as this will prepare your body to carry the excess weight in a stable way in the later stages of pregnancy.
Make your first visit to the antenatal clinic where routine tests are carried out by the doctor and mid wives to check that the pregnancy is progressing normally.
Do inform your doctor in case you are suffering from constipation and include a lot of water and high fiber food in the diet.
Buy a bra that will give adequate support to the breasts.
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The ninth month is synonymous with childbirth and as pregnancy draws to a close, the mother tends to have mixed feelings. While she is eager to deliver, she is equally anxious and apprehensive about labour, child birth and the challenges of becoming a mother. If the baby were born now he would have an excellent chance of survival.
The rate of weight gain slows down and completely stops after week 38. If the total weight gain is approx 10kgs or less, it is relatively easier to return to pre pregnancy weight after delivery. In the final two weeks there might be a slight reduction in weight. This shows that the baby is matured now and you can expect labor within 10 days. The total weight gain during pregnancy ranges from 10 to 12 kgs but it may vary from woman to woman.
Changes in the mother
The growing belly alters the weight distribution, so a correct posture is a must to prevent accidents.
There might be extreme tiredness due to lack of sleep and extra weight of the baby
The bladder is under pressure so the urgency to pass urine becomes even more frequent.
The baby’s head may have dropped in the pelvis by now.
Once the baby’s head drops in the pelvis, heartburn, acidity, indigestion and breathlessness may begin to lessen
You may be feeling high on energy due to the mother’s instinct and would want to clear out space in the cupboards. Please take it easy and don’t tire yourself in the process.
Your skin will feel stretched over the abdomen and may itch a little too.
The baby bulge will be huge and make it difficult to lie down in the bed
Bumping into objects will become a common feature.
There will be a feeling of heaviness in the lower abdomen
A lot of effort will be needed for every single movement that you make.
Your cervix will be softening in preparation for labour
Braxton and Hicks contractions may make you feel you are in labour.
There might be pricking sensation in the legs like pins and needles.
Features of the Baby
Length 20 inch
Weight approx 3 kg
The baby takes up all the space in the womb and kicks and punches rather than shifts.
The head would have dropped into your pelvis, ready for birth
The baby gains about 20gms every day for the remaining four weeks in the womb
Soft nails have grown on the tips of fingers and toes
In a boy, the testicles would have descended.
Hair may have grown up to 5cm
Baby has pinkish skin
Since fat is being stored, the baby becomes more rounded.
Suggestions
Due to the increase in the weight of the baby, the mother can suffer from swollen ankles and varicose veins. You need to put your feet up as much as possible.
Take a tour of the delivery room and maternity ward
Make a weekly visit to the clinic until birth
Stock the pantry and the fridge with food for the time when you are in the hospital and after delivery
Buy nursing or feeding bras. Measure yourself properly and choose from the various types of nursing bra that are available
Pack your suitcase for the hospital
Discuss with your doctor if your partner wants to be with you while you are in labour.
This is the perfect time to do whatever makes you happy and content. Being relaxed and stress free and moving around a little may contribute a lot towards a normal delivery. As the initial few weeks after delivery will revolve around your baby, enjoy these last baby free days.The baby can be expected any time from now so just enjoy these last weeks before the new phase of your life begins.
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The beginning of new life is a magical process gifted by nature. At the time of conception, it is a single cell which will convert into a fetus during the first 8 weeks.
Ovulation
Ovulation occurs around the 14th day of the menstrual cycle when a ripe egg is released by the ovaries, caught by the fallopian tube and drawn inside. The egg can survive up to 24 hours and if not fertilized passes out with the lining of the womb in the next cycle.
Fertilization
Sperms can dissolve the outer covering of the egg and penetrate it. The sperm then fuses with the egg and forms a single cell. If an egg hasn’t been released, the sperm can survive in the fallopian tube for 48 hours.
Cell Division
The cell then starts dividing into more and more cells as it travels down the fallopian tube.
Reaching the womb
Around the 4th day after fertilization, a ball of about 100 cells with a hollow fluid filled centre floats in the womb cavity for the next four days.
Implantation
Around week three, the fertilized egg begins to implant itself in the in the lining of the womb.
Conception
Conception is complete when the egg is securely attached to the lining. The outer cells of the embryo burrow into the lining to link with the mother’s blood vessels, which later become the placenta. The inner cells divide into 3 layers, which later develop into different baby parts.
How can the baby’s sex be influenced?
There is a very common misconception that it is the mother who is responsible for the sex of the baby. The baby’s sex is actually determined by the father’s sperm which could be male or female. It is illegal to find out sex of child in India and one may be sentenced for the same. Both male and female child are blessings of nature and must be loved and cared equally.
Having a child is a natures blessing, conception becomes easier and a happy process if you and your partner stay happy and positive. One must visit a doctor before planning pregnancy, as it helps to detect many underlying problems which you may not be able to notice.
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Congratulations – for becoming officially pregnant. Your doctor or your pregnancy kit has revealed that you have landed into the beautiful phase of your life-pregnancy.
However, first two weeks of the first month you cannot be called as pregnant, as the complete conception is still in the process. But, for calculating the start of your pregnancy, week first is considered from the beginning of your last menstrual cycle.
A tiny embryo will start forming if your mates sperm and your egg has fertilized successfully.
After the fertilization, the egg starts to grow, split and multiply. The egg grows and forms the zygote.
Further, zygote travels to the uterus through the fallopian tubes and gets itself placed in the uterus. Zygote once attached to your uterus confirms pregnancy and from now onwards you will not have your monthly menstrual cycle.
Changes in your body
How you feel during the first month of pregnancy can differ from woman to woman. Some women start experiencing changes from the moment the fertilized egg implants in the uterus, but on the other hand not many may not feel any change in their body until well after the first month.
You may experience one or mixed of the following symptoms:
Feeling of nausea and cramping
You may have spotting or light periods
A feeling of tiredness and fatigue
Some women also experience swollen or pain in the breasts
Mood swings-You may feel anxious or happy at times.
However, above mentioned symptoms do not confirm that you are pregnant, consult your doctor if these symptoms have started .Do not start any medications to suppress these symptoms as it may have serious side effects on your baby.
The aforementioned signs and symptoms may also indicate late periods. The specific test which can detect pregnancy which can detect a hormone called human chorionic gonadotropin, known as hCG Pregnancy kit can detect this hormone in your urine or you can undergo a blood test after consulting a doctor. A blood test is more specific and accurate in detecting hCG hormone in your body and can detect pregnancy at its earliest.
What You Need to Know in the First Month of Pregnancy
The first few weeks are crucial for the development of your baby. Cells are continuously dividing and each and every day marks a change in your baby’s growth. As during initial weeks you might not be aware that you pregnant, so once you start planning pregnancy you can start with a multi-vitamins that includes folic acid. Folic acid helps to prevent spina bifida and other neural tube defects. Taking Omega 3 fatty acids can also promote the eye, heart and brain development.
Do’s and Do not’s
If you are planning pregnancy or you are trying to get pregnant or you have entered pregnancy, so you need to cut down the tobacco products, alcohol, or recreational drugs. Say no to toxic fumes. If you are taking any medications consult your doctor about their further intake and usage.
Pregnancy kits are a great way to find out if you are pregnant, but it is important to consult your doctor to confirm the news. This is a good time to share the news with your family and friends. You can start with the antenatal classes to learn more about healthy pregnancy.
The most important thing is to stay happy and relaxed during this phase. Eat healthy and nutritious food to keep yourself and your baby happy and healthy.
Finally, celebrate! Your have entered a new era of your life. Coming next 8 months your body will experience new changes and you will be culminating a new life inside your womb!!
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