A 30 year old lady pregnant for the second time was following up with me. She had a traumatic experience in her first labour as she had an instrumental delivery followed by heavy bleeding and a deep episiotomy which took more than a month to heal.

She was apprehensive about the painful experience of labor and post-delivery discomfort. Pain relief methods in labor were discussed with her and she did not want any medical intervention like epidural analgesia.

She was offered the option of laboring under water. Since this form of delivery is not usual in India she was initially apprehensive about it. She was explained about the benefits of water birth which included faster labour, lesser pain, improved relaxation, decreased anxiety and lesser need of episiotomy.

Since she fulfilled all the selection criteria for water birth she was encouraged to go for the same.

She came to the hospital with spontaneous rupture of membranes at term and was having regular contractions. She entered the pool once in active labor and delivered within an hour without the need of an episiotomy comfortably. She was grateful for her wonderful experience.

About Dr Astha Dayal

Dr Astha Dayal is a renowned Gynaecologist working as a Senior Consultant in CK Birla Hospital for Women, Gurgaon, specializing in medical and surgical management of women’s health. She has a special interest in managing high-risk pregnancy. She is a highly progressive and well-read and has published extensively in national and international indexed journals.

She has worked previously in Medanta Medcity, Artemis, MAMC, over the past 20 years of her illustrious career and has many publications in national and international medical journals to her name

Dr. Astha has completed her MD/MBBS from Maulana Azad Medical College, New Delhi with multiple distinctions. She won the CL Jhaveri Award for best presentation in All India Congress of Obstetrics and Gynecology and was awarded the Best Thesis in Gynecology and Obstetrics.

Dr Astha is also an active member of the Royal College of Obstetricians and Gynaecologists (RCOG), London (UK). She is also associated with the World Association of Laparoscopic Surgeons (WALS).

She has had a number of firsts to her name the latest of them is the first successful water birth delivery in Gurugram.

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Advise to young gynecologists

I meet a number of bright gynecologists and these are my top 5 advice to them

1. As gynecologists, we meet women in their most vulnerable situations and it’s important to be empathetic to them.
2. You will find yourself in high pressure situations early up in your career and you should keep your cool while in stressful situations
3. Your job as a gynecologist gives you an opportunity to just not cure a patients immediate illness but to provide them with holistic advise on how they can lead a more healthy and happy life
4. While it is important to keep yourself up to date with new advances, it is equally important to document and research your own experiences to create evidences that help other medical practitioners.
5. Have fun

The post <strong>Case Summary – Successful water birth delivery in Gurugram.</strong> appeared first on .

Benefits to the baby

1. Breast milk may be regarded as the baby’s first vaccine. It protects the infant from diseases and builds immunity.
2. Up to one third of respiratory infections and almost half of all diarrhea episodes could be avoided in low- and middle-income countries through breast-feeding.
3. It cuts the risk of sudden infant deaths by more than one-third In the high-income countries
4. Children breast fed for a longer duration has been found to have higher intelligence

Benefits to Mother

1. It could prevent about 20,000 extra deaths from breast cancer each year.
2. It also reduces the risk of ovarian cancer.
3. It helps losing pregnancy pounds much faster.

How to Breastfeed successfully?

Although breastfeeding is though to be natural and easy, but its mostly not! Most women face issues during breastfeeding.

You should know when to ask for help or consult your doctor for the same.

Position

1. Make sure that both the baby and you’re comfortable.
2. You should have your back well supported and then get your baby in position.
3. Extend your forearm and hand to support the baby’s neck, spine, and bottom
4. The baby’s nose should be opposite your nipple and his head and body should be in a straight line so that he can swallow easily. Also his neck, shoulders and back should be well supported.

Latching

• The baby should be latched on smoothly; his lower lip should be as far away from the base of your nipple as possible.
• His head should be tilted back slightly, and the area around the nipple should also enter the mouth.

Common problems faced by breastfeeding moms:

Pain

The most common reasons for pain during breastfeeding are

Thrush –

Thrush there could be fungal infection in the milk ducts of the breast, causing pain, more towards the end of feeding. You might find spots of cottage cheese or milk curds in the baby’s mouth and on your nipples. 

Milk letdown 

Milk letdown i.e. the discomfort due to the milk filling up the breast. Proper supportive bras, relaxation techniques, and occasional painkillers usually relieve it.

Mastitis

Mastitis meaning inflammation of the breast. It feels red, hard, sore, hot or swollen and you may also notice a lump, caused by milk in the breast tissue. There may be flu-like symptoms, such as chills, headaches, exhaustion and low-grade fever. You need to contact your doctor urgently if you are having these symptoms.

Breast engorgement 

Breast engorgement : The sudden increase of milk in the breast a few days after delivery can cause the breast becoming hot, swollen and engorged. It is generally relieved with feeding. While this can be painful in the early days, the discomfort should pass once your baby starts feeding. In case the baby has trouble latching on with engorged breasts, expressing some milk by hand or using a breast pump would help. Also, hot fomentation by putting warm damp towels on your breasts before feeding and cold towels or cabbage leaves after feeds helps reduce the engorgement

Sore nipples

Sore nipples – This can be avoided by latching the right way, i.e. the baby should not just nibble at the nipples, a part of the breast should also be in his mouth. A hot wet cloth can soothe sore nipples. Keep nipples moisturized after feeding by nipple creams/lanolin/breast milk itself and avoid washing them with soap.

Not enough milk

Most mothers have the natural capacity to produce milk sufficient for the baby. Despite this most mothers complain of not having enough milk. You must remember that the stimulus for milk production is by the suckling of the baby and emptying of the breast. If the baby were given top feeds, the breast milk would automatically reduce.

To increase the milk supply,

Put the baby to breast more often, during the day and night, if the baby doesn’t latch that often, pump the breast to stimulate milk production.

1. Have a nutritious diet
2. Have enough fluids, don’t dehydrate yourself
3. Have enough rest

Also, remember, every child has a different feeding pattern. Some baby’s may need to be fed every 40 minutes and some not even up to 3 hours.

As long as the baby is active and is gaining weight appropriately, you are doing a good job!

Returning to work

Companies use many solutions to give feeding mothers time and a private and clean place at work for feeding/expressing milk at work.

A variety of permanent, flexible, and even mobile space options provide support, privacy, hygiene and amenities even when space is limited.

Schedules may be managed in creative ways so that women can have enough time to express milk.

Expressing breast milk

• A good time to start expressing is when your milk supply is well established which is usually at around the six to eight weeks after delivery. Expressing after the first feed of the day is helpful.
• You can either express by hand or by manual or electric breast pumps or a combination of both compliments each other and makes it similar to your baby feeding.

Breast milk can be stored at room temperature for up to six hours or in the fridge for up to two days.

It is important to know that breastfeeding is not easy and doesn’t come naturally to most mothers. A nursing mother needs plenty of support and encouragement.

Don’t hesitate in seeking help from a nurse, doctor, family member, or friend, to get over possible bumps in the road.

The post <strong>The Incredible Benefits of Breastfeeding for Babies and Mothers</strong> appeared first on .

सभी महिलाओं में से 75 प्रतिशत से अधिक महिलाएं पर्सनल हाईजीन के बारे में नहीं जानती हैं। अपने निजी अंगों को साफ रखना बहुत महत्वपूर्ण है। प्राइवेट पार्ट को को सूखा रखें, सिंथेटिक अंडरगार्मेंट्स या ऐसे कपड़ों से बचें जिससे वहां पसीना आ सकता है।
खासकर मासिक धर्म के दौरान स्वच्छता बनाए रखने के लिए हर 4 घंटे में पैड बदलने का ध्यान रखें। वॉशरूम का उपयोग करते समय, हमेशा आगे से पीछे की ओर सफाई करें, भले ही जेट स्प्रे का उपयोग कर रहे हों।

साफ-सफाई रखें

खासकर मासिक धर्म के दौरान स्वच्छता बनाए रखने के लिए हर 4 घंटे में पैड बदलने का ध्यान रखें। वॉशरूम का उपयोग करते समय, हमेशा आगे से पीछे की ओर सफाई करें, भले ही जेट स्प्रे का उपयोग कर रहे हों।

अधिक जानकारी के लिए यँहा पढ़े !

https://navbharattimes.indiatimes.com/lifestyle/family/gynaecologist-aastha-dayal-explain-how-to-improve-sexual-reproductive-health/articleshow/98267434.cms

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What is Folic Acid?

Folic acid is a nutrient that is needed in order to produce healthy red and white blood cells, especially during pregnancy. Folic acid is a type of vitamin B present in leafy vegetables, fruits, beans and grains. It is crucial for the healthy development of the baby’s brain and spinal cord.

Folic acid is a B vitamin that comes from the Latin word folium, meaning leaf. Folic acid was first discovered by Lucy Wills.

The name ‘folate’ was used for the substance until it was discovered that it could not be synthesized by animals and had to come from our diet. ‘Folate’ means leaf, because it was first found in green vegetables such as lettuce and spinach.

The proper intake of folic acid has been shown to reduce the risks of neural tube defects (NTDs) in infants – such as spina bifida – during early development in the womb.

What Are Neural Tube Defects?

Neural tube defects refer to a group of birth defects in which the neural tube (a structure that forms the spine and brain) does not close all the way.

Neural tube defects can occur when the fetus is developing, usually during the first 28 days following conception. The most common types of neural tube defects are spina bifida and anencephaly.

What are the Risks Associated With Not Getting Enough Folate in Pregnancy?

One of the risks associated with not getting enough folate during pregnancy is a neural tube defect. It is important to not just get your folate through diet but also from supplements.

Other Risk factor, A lack of folate in pregnancy can lead to major complications in terms of neurological development, heart disease, and reproductive difficulties.

Folate supplements are essential for pregnant women to reduce the risk of birth defects. As long as you make sure you’re taking in enough, this vitamin can reduce the risk of major birth defects by 30%.

Benefits of Consuming More Folic Acid in Pregnancy

Folic acid is important for pregnant women and their developing babies. It can help prevent serious birth defects of the baby’s brain and spine.

Pregnant women should take more folic acid to protect their babies from serious birth defects. The Centers for Disease Control and Prevention recommends 600 micrograms of folic acid a day during pregnancy, especially in the first few weeks.

Folic acid benefits are also significant for both mothers and fathers.

Reduce the risk of birth defects

Reducing the risk of neural tube defects

Reduced risks of cardiovascular disease, stroke and heart attack.

Helps in babies mental development and prevents autism spectrum disorder.

How Much Folic Acid Should You Take in Pregnancy?

It is highly recommended that pregnant women take 400 micrograms of folic acid daily, most notably in the first few weeks. This should be continued until pregnancy is complete.

Folic acid (400 micrograms) is an essential nutrient which can help prevent birth defects like spina bifida during pregnancy. It is important to start taking it before you are even pregnant, and continue throughout your entire pregnancy.

The state of the fetus’ neural tube depends on folic acid intake during the first weeks of pregnancy– between 3 to 7 days after conception– when the neural tube will close up permanently.

It is recommended for pregnant women to take 400 micrograms of folic acid daily, as this can help lower their risk of having a baby with neural tube defects such as spina bifida.

It is important to have a well-balanced diet that includes all the essential nutrients like Vitamin A, C, E, calcium magnesium, potassium to make sure that you are getting enough folic acid in your daily routine.

Good sources of folic acid, you should take

Some good food sources of folic acid include:

• Leafy greens like spinach and kale
• Certain whole grains like oatmeal and barley
• Avocado
• Beans, lentils, and other legumes (Beans: ½ cup cooked beans = 193 mcg RDI)
• Dairy products such as milk, cheese, yogurt (yogurt -1 cup plain yogurt = 400 mcg RDI)
• Oats: 1 cup (6½ ounces) dry oats = 884 mcg RDI

How Dr. Astha Dayal helps in Pregnancy care?

Dr. Astha Dayal is a gynecologist and an obstetrician in gurgaon who is known for her clinical skills and her understanding of the many facets of pregnancy care.

She has been in practice for over 19 years and she has gained expertise in women’s health, family medicine, reproductive health, gynecology, obstetrics, prenatal care, diabetic care and more. Dr. Astha Dayal aims to provide holistic services to the women who visit her clinic so that they can have a healthy pregnancy that would result in a beautiful baby.

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A prepregnancy care checkup is a way to make sure you are healthy enough for pregnancy and there are no complications with your health.

This article will guide you through what a prepregnancy care checkup entails and how it can be beneficial for your future pregnancy.

It will also give you information about what to expect during the prepregnancy care checkup, who benefits from a prepregnancy care checkup, how frequently they’re recommended, and why this type of health assessment is beneficial for any individual who is trying to conceive.

What happens during a pre-pregnancy care checkup?

During the prepregnancy care checkup, we at our center, will discuss everything that you need to know before starting a pregnancy. Prepregnancy care can also be called preconception care or family planning.

You will get advice on how to take better care of yourself before and during pregnancy, what lifestyle changes are good for you and your baby, as well as important things like travel safety. It is also a great time for planning your birth experience.

The doctor can answer any questions that you have about family planning (birth control) or STIs (sexually transmitted infections).

A pre-pregnancy care visit is your first meeting with a doctor. This will be a time for you to discuss your plans for pregnancy and for them to provide any advice.

During this visit, we will ask about:

– Your menstrual history and reproductive health;

– Pregnancy history;

– Allergies, medications, and illnesses that you or other family members have had recently.

– Diet and exercise habits;

– Sexual history (if applicable);

– What contraception you are using (if applicable)

How can I try to be healthier before pregnancy?

In this section, we will talk about the importance of healthy habits before pregnancy.

One of the best ways to try to be healthier before pregnancy is by getting enough sleep. In today’s world, it is a challenge to get enough sleep because of

• how much work we have?
• how online content is addictive?
• and how much stress we have?

Keeping some sort of fitness & healthy routine in place will also help you be healthier before pregnancy, such as

• Eating a healthy diet
• Taking a prenatal vitamin
• Doing regular exercise
• Maintaining a healthy weight
• Stopping unhealthy habits, like (tobacco, alcohol, marijuana, illegal drugs, and prescription drugs taken for a nonmedical reason)
• Keeping your environment safe & healthy
• Trying to maintain happy environment

We all want to be healthy before pregnancy, and luckily there are some ways we can do this. Getting enough sleep, eating a variety of healthy foods and exercising regularly are a few ways to make sure you are at your best before pregnancy.

The post Pregnancy Care & Your Well-Being: A Guide to Preparing for a Healthy Pregnancy appeared first on .

We have come a long way from the traditional belief that women should avoid doctor visits till the first 2-3 months of pregnancy.

The benefits of the preconception visit are many-

The gynecologist can check you for any pre-existing medical problems eg Diabetes, epilepsy, thalassemia, any genetic conditions.You should also inform your physician or specialist treating your medical condition that you are planning pregnancy, so that they can ensure it’s safe for you to get pregnant, and stop or change your medicines if needed.

Some medications are not safe in pregnancy. Your gynecologist checks what all medicines you are on and may need to modify or stop them if you are planning pregnancy. 

You can be advised to start  folic acid tablets. Every woman should start 400micrograms of folic acid to avoid neural tube defects(problems in the spinal cord) of the baby. 

You are advised to have a blood test to check for rubella, thyroid, thalassemia, hepatitis B, syphilis, and HIV

We also advise you about a healthy diet. Include foods rich in iron, calcium and folic acid; also, some oily fish.

Have strict food hygiene. In particular, wash your hands after handling raw meat, or handling cats and kittens, and before you prepare food.

Making Healthy Choices

It is important to enter a pregnancy in your most healthy state.This is essential to avoid complications in the mother or the baby.

Ideally, prenatal vitamins are started 3 months prior to conception

• Folic Acid – helps prevent neural tube defects (defects of the brain and spinal cord)
• Calcium – promotes strong bones and teeth for both you and baby
• Iron – aids in the development of blood and muscle cells for mom and baby
• Combined, these vitamins reduce the risk of low birth weight babies
• Omega-3 Fatty Acids – help with brain development
• Vitamin D – important later in pregnancy

Diet

• Have an Antioxidant rich diet to improve your fertility.Vitamins A, C,E have antioxidant properties, and they are found in all colorful fruits and vegetables.
• These include all green leafy vegetables, berries and citrus fruits, beans and nuts.Consume whole grains instead of refined flour.
• Avoid refined, processed food with all-purpose flour (maida) and sugar.

Alcohol

• You need to avoid it if planning pregnancy.As long as the habit is discontinued immediately, there should be no harm to your growing baby.

Caffeine

• Limit caffeine intake to 1 cup of coffee or 1-2 cups of tea or avoid it if you take dark chocolate. The aim is to keep caffeine intake not more than 200mg of daily. 

Exercise

• YES! Contrary to the popular belief that exercise can harm a pregnancy, it actually helps improve your fertility and helps you get pregnant.
• Discuss an exercise program with your practitioner depending on your weight/BMI and fitness levels 
• Those who exercise regularly before pregnancy are typically encouraged to continue their routine.

Smoking

• NO!  Quitting before 3 months of getting pregnant reduces harm to your baby.
• Passive smoking should also be avoided.
• Husbands should also quit smoking as it may affect the sperm quality.
• Infact, quitting smoking will improve fertility and chances of getting pregnant for both males and females.
• Smoking can cause preterm birth, low birth weight, miscarriage, wheezing or breathing issues in the baby in first few months of life.

Recreational drugs

• Absolutely not! Drugs like cocaine can have chemicals that can cause grave harm to the pregnancy, so avoid at all costs when planning a pregnancy

Weight

• A woman should enter a pregnancy at a healthy weight. You should calculate your BMI or Body mass index by dividing your weight (in kg) by the square of your height (in metres).
• If your BMI is more than 25( overweight) or obese(BMI>30), you should bring it down before getting pregnant. High BMI can cause problems in pregnancy like high blood pressure.
• You should start a diet and exercise plan to reduce your BMI when planning pregnancy.

Cats

• Keep them. But avoid changing the litter box yourself or use disposable gloves because cat litter can transmit a viral infection called Toxoplasmosis, which could affect the pregnancy adversely.

• Do tell your doctor if you have pets, so that you can be tested for toxoplasma and CMV virus before planning pregnancy.

Hot Tubs & Saunas

• Hot tub use is safe during pregnancy, although we recommend feet only.
• Any prolonged period with a body temperature >102˚F may cause harm to the baby. This is similar for saunas or steam rooms.
• Males should avoid high temperatures for prolonged time as it may affect sperm quality.

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How does COVID-19 affect pregnant women?

Researchers are still learning how COVID-19 affects pregnant women. A report released in June 2020 looked at whether pregnant women might be at increased risk of getting very sick from COVID-19. This report from the Centers for Disease Control and Prevention (CDC) notes that:

• Pregnant women with COVID-19 may be more likely than non-pregnant women with COVID-19 to need care in an intensive care unit (ICU) or need a ventilator (for breathing support).
• Pregnant women who are Black, Hispanic, or Asian may have a higher risk of severe illness or need ICU care more often than other pregnant women. This is likely caused by social and economic inequity, not biological differences.

Although the risk of needing more care in the hospital and having more severe illness may be increased, the overall risk of these outcomes is still low for pregnant women. Also, it’s important to know that the report suggests the risk of death is not higher for pregnant women with COVID-19 than for nonpregnant women with COVID-19. 

What should pregnant women do to avoid the coronavirus?

Pregnant women should take steps to stay healthy, including

• keeping your prenatal care visits 
• limiting contact with other people as much as possible
• staying home as much as possible
• staying at least 6 feet away from other people if you need to go out 
• wearing a mask or cloth face covering in public and any other needed protection while at work 
• washing hands often with soap and water for at least 20 seconds
• cleaning hands with a hand sanitizer that contains at least 60 percent alcohol if you can’t wash them (rub until your hands feel dry)
• avoiding touching your eyes, nose, and mouth 
• having a good stock of essential supplies, including at least 30 days of any medications (so you don’t have to go out as often)

What is corona virus?

Corona viruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

Can the virus that causes COVID-19 be transmitted through the air?

Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air. See the previous answer on “How does COVID-19 spread?”

What is COVID-19?

COVID-19 is an infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019.

Can CoVID-19 be caught from a person who has no symptoms?

The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true in the early stages of the disease. It is therefore possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill.

What are the symptoms of COVID-19?

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don’t feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.

Can I catch COVID-19 from the feces of someone with the disease?

The risk of catching COVID-19 from the feces of an infected person appears to be low. While initial investigations suggest the virus may be present in feces in some cases, spread through this route is not a main feature of the outbreak. The ongoing research on the ways COVID-19 is spread and will continue to share new findings. Because this is a risk, however, it is another reason to clean hands regularly,after using the bathroom and before eating.

How does COVID-19 spread?

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose, or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.

How likely am I to catch COVID-19?

The risk depends on where you are – and more specifically, whether there is a COVID-19 outbreak unfolding there. For most people in most locations, the risk of catching COVID-19 is still low. However, there are now places around the world (cities or areas) where the disease is spreading. For people living in, or visiting, these areas the risk of catching COVID-19 is higher. Governments and health authorities are taking vigorous action every time a new case of COVID-19 is identified. Be sure to comply with any local restrictions on travel, movement, or large gatherings. Cooperating with disease control efforts will reduce your risk of catching or spreading COVID-19. COVID-19 outbreaks can be contained and transmission stopped, as has been shown in China and some other countries. Unfortunately, new outbreaks can emerge rapidly. It’s important to be aware of the situation where you are or intend to go.

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