It was reported in the news this week that pregnant women who ask for a caesarean delivery should be allowed to have one. You can read the full story on the BBC website.
A vaginal birth is generally safer than a caesarean birth. However, a caesarean section may be needed to save the life of a mum or baby. In these cases, caesarean birth is without question the safest option.
But there are also times when the decision is not so obvious and it will be up to you and your doctor to weigh up the risks and benefits of having a caesarean to decide what's best for you. Although a caesarean is a common procedure, it involves major surgery in your abdominal and pelvic area, and all operations carry risks.
Disadvantages of a caesarean:
- Pain. The main disadvantage is pain after the caesarean. This may last for a few weeks or more after the operation. You will be given medication to help cope with the pain but it will affect your daily activities.
- Infection. Before the operation, you will be offered a single dose of antibiotics, but about 8% of women still go on to get an infection.
- Blood clot. Any surgery carries a risk of developing a blood clot. This can be serious, or even life-threatening, depending on where the clot develops. You will be given blood-thinning drugs and support stockings to improve the blood flow in your legs after the caesarean. You'll also be encouraged to get up and move around as soon as possible afterwards. This helps your circulation and reduce your risk of developing a clot.
- Adhesions. These are bands of scar tissue which form as you heal and can make organs in your abdomen stick to each other or to the inside of your abdominal wall. About half of women who have had a caesarean get adhesions, and this can increase with more caesareans. Adhesions can be painful because they limit the movement of your internal organs.
- Infertility. Occasionally, adhesions can lead to problems with fertility, as they can press on or block fallopian tubes. Sometimes women experience unexplained infertility after a caesarean.
- Anaesthetic. Most caesareans are done with an epidural or spinal, which numbs you from the abdominal area down. An epidural or spinal is safer for you and your baby than a general anaesthetic. However, having any anaesthetic involves a small risk. With epidurals and spinals a few women can have; a severe headache (affects about 1% of women); nerve damage. This rarely happens and, if it does, it usually only lasts for a few days or weeks although very rarely it’s permanent.
- Injury to the bladder, to the tubes connecting the kidneys to the bladder (ureters) or to the bowel.
- Very occasionally, if there are major complications, to protect a woman's health, doctors may have to perform an operation to remove the uterus (hysterectomy).
- A blood transfusion. If you've had a serious complication during the caesarean, you may need a blood transfusion. Some of the rarer complications of a caesarean can be life-threatening. However, the risk of a caesarean proving fatal is extremely small, only one in 12,000.
- Breathing difficulties for the baby. About 35 in every 1,000 babies have breathing problems after a caesarean compared with five in 1,000 babies born vaginally. Breathing problems are more common for premature babies born by caesarean or babies born by a caesarean before labour started.
- About 2% of babies get a nick or cut from the doctor's scalpel.
- Although early postnatal depression is more common in women who've had a caesarean than women who've had a vaginal birth, by two months, the rates are about the same.
- Women who've had a caesarean are less likely to start breastfeeding than women who've had a vaginal birth. However, once you've started, your chances of success are the same as for a woman who's given birth vaginally.
- It can affect future pregnancies. Once you've had one caesarean, you're much more likely to have another caesarean in future pregnancies. Having had a caesarean slightly increases your risk of having a low-lying-placenta (placenta praevia) in future pregnancies. There is a very small risk of the scar on your uterus opening up again in future pregnancies or births. This is called a uterine rupture but is rare and affects 0.5-1% of women in future pregnancies.
Advantage of a caesarean:
- If it’s planned, you will know when your baby will be born.
- Although you'll have a very sore tummy, you won't have some of the discomforts that can result from a vaginal birth, such as pain and bruising and tears and stitches around your vagina.
- Caesarean birth may help protect against the slight risk of urine leaks and in later years, vaginal prolapse. However, other factors such as the number of births, having big babies, having assisted deliveries and obesity also contribute to these conditions. Pregnancy itself is also a risk factor for these conditions as it can weaken your pelvic floor, so you still need to do your pelvic floor exercises!
If you have any questions about either a caesarean or a vaginal birth, don't be afraid to ask your midwife and talk through all of the options with her.
Best wishes - Amber
Is there anything I should do to prepare for labour?
I often get asked what mums should do to prepare for labour so thought it would be useful to share my advice with you all.
Being well informed can really help. Gather as much information as you can. Read books, join an antenatal, hypnosis or exercise class and talk to your health professionals. Many women fear the unknown about labour which can cause anxiety, tension and uses up valuable energy which can make labour more painful and exhausting. If you know what to expect, you can have some idea about what you would like for yourself.
Consider writing a birth plan. For some women it is important to have written personal a birth plan. It can be helpful if you bring your written wishes with you, especially if you have a midwife in labour you’ve not met before. Usually at a glance at a plan, as midwives, we can see what is important to you - it can be difficult to explain what is particularly important to you in between contractions! Many women keep a copy of their plan in their maternity hand held notes. Keeping an open mind is a good idea, as sometimes you might either choose to do things differently or need to if problems occur, but it’s good to have an idea of what you would like / would like to avoid in advance.
Keep a list of important phone numbers in your handbag or near the phone. Include your hospital or midwife, your birth partner or birth companion, and your own hospital reference number available for when you contact the midwife/hospital.
Have your bags ready. Only about 5% of babies actually come on their due date, so it is always a good idea to have your bags packed or homebirth items ready to go.
Stock up at home for when your baby has arrived. You may not want to do much more than rest and care for your baby, so do as much planning as you can in advance. Stock up on basics such as toilet paper, sanitary pads and nappies. If you have a freezer, prepare some meals in advance and freeze them.
Hope this helps.
Importance of good dental hygiene for babies and young children
Babies are born with a preference for sweet-tasting foods and a baby’s sole source of nutrition for the first few months of life, breastmilk or infant formula, tastes sweet (with the sweetness coming from the carbohydrate lactose). But once weaning onto solids starts, whether your baby’s teeth have started to appear yet or not, it is important to limit the amount and frequency of sugars in their diet. Controlling sugars intake will help to ensure a baby eats a more balanced diet and does not put on too much weight, and will help reduce the risk of dental caries (decay). You can’t remove sugars from a baby’s diet completely and actually sugars can be a really useful source of energy in babies, especially with their small stomachs and high energy requirements. But it’s all about getting the balance right, introducing them to lots of different tastes, avoiding high-sugar foods and drinks, and giving sugar-containing foods and drinks at the right times.
Foods containing sugars should be eaten at mealtimes and should be avoided between meals to keep the risk of dental caries to a minimum. Milk and water remain the preferred drinks for babies and toddlers, but you can give diluted fruit juice as well occasionally at mealtimes. An advantage of fruit juices with vitamin C is that they help the body to absorb vitally necessary iron, but as they contain naturally occurring sugars they should be used sensibly. Try to introduce your baby to a feeding cup or beaker instead of a feeding bottle as early as possible to avoid prolonged contact of sugars with growing teeth.
Cleaning your baby’s teeth needs to become part of their daily routine as soon as teeth start erupting. Use a pea-sized amount of children’s fluoride toothpaste on a soft toothbrush or cloth, cleaning using small circular movements, front and back, in the morning and last thing before bed. Get your toddler used to going to the dentist too - start them off by coming with you for your check-up so that they can get used to the environment – dentists try hard to make children feel comfortable and will often give out stickers too!
For more information on diet and dental health have a look at the following links:-
Bye for now.
How to get a good night’s sleep during pregnancy
Constant trips to the loo, nagging heartburn, backache, sore hips, or simply a grumpy bed partner, can all make a good night’s sleep difficult to come by when you're pregnant. There are however some things that you can do to help:
- Try to get some fresh air and exercise during the day, like walking, swimming or yoga.
- Have a soak in a warm bath before you go to bed. If in the last three months of pregnancy, add a 2-3 drops of lavender oil to your bath water. Lavender is known for it’s relaxing qualities. This may help you wind down before bedtime.
- Have a w arm milky drink before you go to bed or, if in the last three months of pregnancy, try camomile tea.
- Make sure your bedroom is not too hot - open a window. It helps, though, to have warm feet, so consider using a hot water bottle or bed socks.
- Gather together a number of small pillows and use these to help get comfortable. Try a pillow under your bump, another between your knees and a third in your back.
- An extra layer of padding underneath you can also help with comfort. A folded up quilt or soft blanket on top of your mattress under your bottom sheet can be nice.
- Practise relaxation exercises. When you are ready to sleep, breathe slowly and deeply, and try to clear your mind by visualising a favourite place. Make sure your muscles aren’t tense by working from head to toe making sure all your muscles are relaxed.
- If you can, rest during the day to make up for the sleep you’re losing at night – but beware that you’re not sleeping so much during the day that you are not really tired at night.
- If you are having difficulty getting to sleep, or are waking up very early, consider whether you are really tired. If you have stopped work and are leading a more leisurely life for a while, you may not need so much sleep as before.
- If you wake in the night or very early in the morning and cannot get back to sleep, try to accept the situation. Read a good book, listen to music through headphones, think about your baby, write shopping lists or poetry – and enjoy this private and peaceful time.
Hope this helps!
Amber - HiPP Midwife
Are organic foods better for your baby?
It’s Organic September - time to celebrate everything about organic! I’ve worked with HiPP for over 12 years now and during this time I have read a lot about organic farming and organic food production and in my opinion there are four main reasons why it is better to choose organic:
1. Babies are more vulnerable than adults to the effects of unwanted chemicals found in non-organic foods and will benefit from foods containing no GM ingredients or harmful pesticides.
2. Organic food is food as nature intended, and often tastes better
3. Organic foods are often higher in essential nutrients e.g. vitamin C and antioxidants
4. Organic foods are better for wildlife, animal welfare and the environment.
Some official UK bodies are yet to be convinced on the benefits of organic foods, but there is growing evidence in Europe and internationally that there are nutritional benefits in choosing organic versus non-organic foods.
The following websites give more information on organic foods and I hope once you’ve had a look at these you will agree that organic foods may well be better for all of us, our wildlife and our environment -
What do you think - do you believe organic foods are better for you and/or your baby? Have you changed your mind on this recently? Or do you think organic foods are an unaffordable or unnecessary luxury? We’d love to hear your views.
All the best,