Posts Tagged ‘C-section’

Medical reasons you may need a c-section

Friday, August 11th, 2017

A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. If your pregnancy is healthy and you don’t have any medical complications, it’s best to have your baby through vaginal birth. However, sometimes your health care provider may suggest that you have a c-section for medical reasons. In these cases, a c-section can help to keep you and your baby safe.

You and your provider may schedule a c-section because of known pregnancy complications, such as:

There are also situations that come up during labor and childbirth that may require you to have an unplanned (emergency) c-section. Here are some possible reasons you may need to have an unplanned c-section:

  • Your baby is too big to pass safely through the vagina.
  • Your baby is in a breech position (his bottom or feet are facing down) or a transverse position (his shoulder is facing down). The best position for your baby at birth is head down.
  • Labor is too slow or stops.
  • Your baby’s umbilical cord slips into the vagina where it could be squeezed or flattened during vaginal birth. This is called umbilical cord prolapse.
  • Your baby has problems during labor, like a slow heart rate. This is also called fetal distress.
  • Your baby has a certain type of birth defect.

Remember, if you’re scheduling your c-section for medical reasons,make sure to talk to your provider about waiting until at least 39 weeks of pregnancy, if possible. This gives your baby the time she needs to grow and develop before birth.

If your pregnancy is healthy and you don’t have any medical reasons to have a c-section, it’s best to have your baby through vaginal birth. But for some women and their babies, a c-section is safer than a vaginal birth. If you have questions or concerns about whether a c-section may be right for you, talk to your health care provider.

Have questions? Send them AskUs@marchofdimes.org.

Can you turn a breech baby?

Friday, December 4th, 2015

DoctorPregnant_zps3ac96800You may have heard recently about a technique that can be used to “flip” a breech baby. This procedure is called external cephalic version (ECV) and is done by your prenatal care provider.

When is a baby breech?

As your due date approaches, your baby usually moves into a head down position. During a vaginal delivery, this means that the baby’s head comes out first. But in about 3-4% of full-term births, the baby doesn’t move into a head-down position. This is called a “breech presentation.” A breech baby can be positioned so that the baby’s bottom, feet, or both are facing down.

What is ECV?

Since it is best for your baby to be in a head down position for a vaginal delivery, if the baby is breech, a C-section may be medically indicated. To improve your chances of giving birth vaginally, your provider may decide to perform an external cephalic version. According to the American Congress of Obstetricians and Gynecologists (ACOG) “external cephalic version (ECV) is an attempt to turn the baby so that he or she is head down.”

Your health care provider may attempt an ECV when you are between 36-38 weeks of pregnancy. He or she will apply firm pressure on the outside of your belly to try to get the baby to roll into a head-down position. Two people may be needed to do this and ultrasound may be used to help guide the turning.

When is ECV not safe?

An ECV will not be attempted if:

  • You are pregnant with more than one baby
  • There are concerns about the health of the baby
  • You have certain uterine or cervical problems
  • The placenta is in the wrong place or has detached from the wall of the uterus (placental abruption)

Can complications occur with ECV?

ECV typically takes place in the hospital in case complications arise.  The baby’s heart rate will be monitored both before and after the procedure.  Some problems that may occur with an ECV include:

ACOG states that over 50% of all ECV attempts are successful. However sometimes the baby moves back into a breech position. While ECV can be tried again, it gets more difficult as the baby gets bigger.

If your baby is in a breech position, talk to your health care provider. You can discuss if you are a candidate for ECV as well as what delivery options may be best for you.

Have questions? Email us at AskUs@marchofdimes.org.

World Thrombosis Day

Tuesday, October 13th, 2015

pregnant woman blood pressureA blood clot (also called a thrombosis) is a mass or clump of blood that forms when blood changes from a liquid to a solid. The body normally makes blood clots to stop the bleeding after a scrape or cut. But sometimes blood clots can partly or completely block the flow of blood in a blood vessel, like a vein or artery. This can cause damage to body organs and even death. Blood clots affect 900,000 people each year and as many as 100,000 people die each year due to blood clots.

Risk factors for blood clots

Certain conditions make you more likely to have a blood clot. These include:

  • Being pregnant. Your blood clots more easily during pregnancy to help your body get ready to lessen blood loss during labor and birth. Also, blood flow in your legs gets slower late in pregnancy. This is because the blood vessels around your pelvis and other places are more compressed (narrow) and your growing uterus (womb) puts pressure on your pelvis.
  • Having certain health conditions, like a thrombophilia, high blood pressure, diabetes or being overweight or obese.  A family history of blood clotting problems also increases your chances of blood clots. If you have a family history or a personal history of a thrombophilia, make sure you tell your health care provider.
  • Taking certain medicines, like birth control pills or estrogen hormones. These medicines can increase the risk of clotting. If you’ve had problems with blood clots or thrombophilias or have a family history of these conditions, birth control pills may not be safe for you to use. Talk to your health care provider about other birth control options.
  • Smoking. Smoking damages the lining of blood vessels, which can cause blood clots to form.
  • Having surgery, like a cesarean section. The American College of Obstetricians and Gynecologists (ACOG) recommends that doctors help prevent blood clots in women during a c-section. This may include using devices that put pressure on your legs to help keep your blood flowing during the c-section, like compression socks.
  • Being dehydrated. This means you don’t have enough water in your body. Dehydration causes blood vessels to narrow and your blood to thicken, which makes you more likely to have blood clots.
  • Not moving around much. This may be because you’re on bed rest during pregnancy or recovering from surgery. Being still for long periods of time can lead to poor blood flow, which makes you more likely to have blood clots. Even sitting for long periods of time, like when travelling by car or plane, can increase your chances of having a blood clot.
  • Having a baby. You’re more likely to have a blood clot in the first 6 weeks after birth than women who haven’t given birth recently.

Know the signs

Make sure you recognize the symptoms of a blood clot. These include:

  • Swelling, usually in one leg (or arm)
  • Leg pain or tenderness often described as a cramp or Charley horse
  • Reddish or bluish skin discoloration
  • Leg (or arm) warm to touch

If you have any signs or symptoms, contact your health care provider right away. Blood clots can be treated with special medications.

Have questions? Text or email us at Askus@marchofdimes.org.

Severe bleeding during pregnancy can be placenta previa

Monday, July 27th, 2015

contemplative pregnant woman During my mom’s pregnancy with me, she was diagnosed with placenta previa, a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits on the top of the vagina. If you have placenta previa, when your labor starts, your cervix begins to thin out and dilate (open up), and the blood vessels connecting the placenta to your uterus may tear. This can cause severe bleeding.

My mom remembers the day I was born, like it was yesterday. She remembers my Aunt running down the hall to get towels for her while she stood in the bathroom bleeding during her third trimester. She was rushed to the hospital and had an emergency Cesarean section (C-section) performed. My mom says she can still remember what the pressure felt like on her lower abdomen during the procedure.

We don’t know what causes placenta previa, which happens in about 1 in 200 pregnancies. If you have placenta previa early in pregnancy, it usually isn’t a problem. However, it can cause serious bleeding and other complications later in pregnancy.

Diagnosis and symptoms

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. If you have spotting or bleeding during pregnancy, it’s important you call your provider right away. But, not all women with placenta previa have vaginal bleeding. In fact, about one-third of women with placenta previa don’t have this symptom. An ultrasound can usually pinpoint the placenta’s location to determine if you have placenta previa.

Is there treatment?

Treatment depends on how far along you are in your pregnancy, the seriousness of your bleeding and the health of you and your baby. The goal is to keep you pregnant as long as possible, but at any stage of pregnancy, a C-section may be necessary if you have dangerously heavy bleeding or if you and your baby are having problems.

How can I reduce my risk?

We don’t know how to prevent placenta previa, but you may be able to reduce your risk by not smoking or doing illicit drugs such as cocaine. If you have a healthy pregnancy, and there isn’t a medical reason for you to have a C-section, it’s best to let labor begin on its own. The more C-sections you have, the greater your risk of placenta previa.

As soon as my mom held me in her arms, she said she forgot all about the scary hours beforehand. She was so grateful that she had gone to the hospital when she did.

Remember, if you have spotting or bleeding at any point in your pregnancy, call your provider right away or go to the emergency room.

Reasons you may need a c-section

Friday, April 10th, 2015

There are times when your health care provider may recommend a cesarean section (also called c-section). If there are problems with your pregnancy or during labor, you may need to have a c-section to keep you and your baby safe.

In this video of Dr. Siobhan Dolan discusses some of the medical reasons why a c-section may be necessary and what you can expect.

C-sections, scheduling births and why healthy babies are worth the wait

Friday, April 4th, 2014

We’ve written a lot of posts about labor and, that if your pregnancy is healthy, it’s best to wait for labor to begin on its own. We’re glad that more moms know that having a healthy baby is worth the wait. But sometimes, it doesn’t hurt to have a reminder – not just for moms-to-be, but for everyone.

Both of my babies were late, especially my son. (He’s a true mama’s boy and I sometimes get the feeling that he would climb back in if he could!) I remember all of the frustration and discomfort I felt as I reached and went past my due date. But as uncomfortable as those last weeks were, it was a small sacrifice to make for my baby’s health.

If there are no medical reasons for either you or your baby to have a c-section or schedule your baby’s birth, then it’s best to wait for labor to begin on its own. And unless you have a medical reason for having a c-section, it’s best to have your baby through vaginal birth.

A c-section is major surgery that takes longer to recover from than a vaginal birth. And you’re more likely to have complications from a c-section than from a vaginal birth. A c-section can cause problems for your baby, too. Babies born by c-section may have more breathing and other medical problems than babies born by vaginal birth.

All this is to say that if your pregnancy is healthy and you’re thinking about scheduling your baby’s birth, consider the risks. And even though those last weeks can be very uncomfortable, your baby’s health is worth the wait.

When your baby is overdue

Monday, September 30th, 2013

bellyThe average healthy pregnancy is around 40 weeks. Some babies come earlier and others run later. A pregnancy that lasts longer than 42 weeks is called a post-term pregnancy.

Dr. Siobhan Dolan discusses overdue pregnancies in the book Healthy Mom Healthy Baby. Here is an excerpt from the book.

“Although many post-term babies are healthy, some risks do start to increase after 41 to 42 weeks. An overdue pregnancy takes a toll on the placenta, amniotic fluid, and umbilical cord. As the baby grows larger, the chances of stillbirth and delivery injuries go up, and there is a greater likelihood that the baby will experience meconium aspiration (inhaling stool from the amniotic fluid into the lungs) or a condition called dysmaturity syndrome (in which the baby is no longer getting enough nourishment because the placenta is aging and becoming calcified).

“When a baby is overdue, the provider may do some tests to check on the baby’s health. They include:
– Ultrasound exam
– Kick count, which is a count of how many times your baby moves or kicks you during a certain period of time
– Nonstress test, in which a fetal monitor measures your baby’s heart rate for a certain amount of time
– Biophysical profile, which uses a fetal monitor and an ultrasound to score a baby on each of five factors (nonstress test, body movements, breathing movements, muscle tone, and the amount of amniotic fluid)
– Contraction stress test, which compares your baby’s heart rate at rest with the heart rate during contractions induced by a shot of oxytocin or nipple stimulation

“If these tests suggest that your baby is in good condition, you can continue to wait for labor to begin naturally. If they raise concerns, your provider may wish to induce labor or perform a c-section. Providers rarely allow a pregnancy to go beyond 42 weeks.”

Study shows we can reduce unnecessary early deliveries

Tuesday, April 9th, 2013

A study published today in Obstetrics & Gynecology shows that hospital-based quality improvement programs across many states can be remarkably effective at reducing early elective deliveries of babies.

The rate of elective early term deliveries (i.e., inductions of labor and Cesarean sections without a medical reason) in a group of 25 participating hospitals fell significantly from 27.8 percent to 4.8 percent during the one-year project period, an 83 percent decline.

The March of Dimes, which partly funded the study, calls the findings good news, because babies delivered before full-term are at increased risk of serious health problems and death in their first year of life.

“This quality improvement program demonstrates that we can create a change in medical culture to prevent unneeded early deliveries and give many more babies a healthy start in life,” says Bryan T. Oshiro, MD, of Loma Linda University School of Medicine and lead author of the study.

“Reducing unnecessary early deliveries to less than five percent in these hospitals means that more babies stayed in the womb longer, which is so important for their growth and development,” says Edward R.B. McCabe, MD, medical director of the March of Dimes. “This project saw a decrease in the proportion of babies born at 37 and 38 weeks and a corresponding increase in the 39-41 week range during the one-year period studied. Additional studies, perhaps over a longer period of time, could clarify whether such quality improvement programs can also bring down a hospital’s overall preterm birth rate.”

This was the first project of a collaborative with perinatal quality improvement advocates from state health departments, academic health centers, public and private hospitals, and March of Dimes chapters from the five most populous states in the country: California, Florida, Illinois, New York, and Texas. These five states account for an estimated 38 percent of all births in the United States.

The March of Dimes urges hospitals, health care providers, and patients to follow the American College of Obstetricians and Gynecologists guidelines that if a pregnancy is healthy, to wait for labor to begin on its own. The final weeks of pregnancy are crucial to a baby’s health because many vital organs, including the brain and lungs, are still developing.

“A Multistate Quality Improvement Program to Decrease Elective Deliveries Before 39 Weeks,” by Dr. Oshiro and others, appears in the April 8 online edition of Obstetrics & Gynecology, Vol. 121, No. 5, May 2013.

What is the breech position?

Friday, April 5th, 2013

Dr. Siobhan Dolan discusses the breech position in the new March of Dimes book, healthy mom, healthy baby.

“Babies typically move into a head-down position during the last month or so of pregnancy. But some don’t, meaning that when labor starts, they are positioned to be born feet-first or buttocks-first. This is called the breech position. Having a breech baby is most likely to happen when a woman goes into labor early, has had previous pregnancies, is pregnant with more than one baby, has a condition in which there is too little fluid in the amniotic sac, or has problems or abnormalities with the uterus or placenta. Sometimes it happens for no identifiable reason.

“If your baby is breech, your provider may recommend a procedure called an external cephalic version. In this procedure, a provider places his or her hands on your belly and tries to move the baby into a head-down position from the outside of your body. This can be uncomfortable, and it may not work. Sometimes a “version,” as it is often called, is attempted more than once. Delivering a breech baby vaginally is risky, especially for mothers having their first delivery, so if your baby can’t be moved out of the breech position, your provider will likely recommend a c-section.”

Learn more about healthy mom, healthy baby, read excerpts from the book, even order a copy at this link.

Preeclampsia is not a thing of the past

Monday, January 28th, 2013

downton-abbey1Did you watch Downton Abbey? What a shocker! But did you know that losing a mother and/or baby to eclampsia resulting from preeclampsia still happens today?

Preeclampsia is a condition that happens only during pregnancy (after the 20th week) or right after pregnancy. It’s when a pregnant woman has both high blood pressure and protein in her urine. We don’t know what causes it and we don’t know how to prevent it.

Most women with preeclampsia have healthy babies, but it can cause severe problems for moms. Without treatment, preeclampsia can cause kidney, liver and brain damage. It also may affect how the blood clots and cause serious bleeding problems. In rare cases, preeclampsia can become a life-threatening condition called eclampsia that includes seizures following preeclampsia. Eclampsia sometimes can lead to coma and, in Lady Sybil’s case, death.

It has been nearly 100 years since the time of the story portrayed on Downton Abbey, yet to this day there still is no cure for preeclampsia except immediate delivery of the baby, often via cesarean section. Preeclampsia can turn into full eclampsia fairly quickly and it’s important that medical professionals keep an eye out for signs.

Signs and symptoms of preeclampsia include:
High blood pressure
Protein in the urine
Severe headaches
Vision problems, like blurriness, flashing lights, or being sensitive to light
Pain in the upper right belly area
Nausea or vomiting
Dizziness
Sudden weight gain (2 to 5 pounds in a week)
Swelling in the legs, hands, and face

It’s true that many of these signs and symptoms are normal discomforts of pregnancy. That’s one of the reasons why it’s so important to receive regular prenatal care. If you’re pregnant and have severe headaches, blurred vision or severe upper belly pain, call your health care provider right away.

You can read one woman’s personal story here, and for more information about preeclampsia, go to this link.