Birthing options | Dr Anu Mahadik | Obstetrician Sydney

Delivery
options

Birthing options: vaginal birth | Sydney Obstetrician Dr Anu Mahadik

Normal vaginal birth

Normal vaginal birth is the series of coordinated events which the woman undergoes leading to the birth of a healthy child.

How do I know I am in labour?

There are many different symptoms which may indicate the start of labour. You may have:

  • Period like cramps
  • Your tummy may have regular painful tightening’s
  • You may lose mucus plug mixed with some blood from your vagina. This is called show.
  • You may start leaking watery liquid from your vagina. This may be fluid from the bag of water around the baby. If this happens, you should contact the hospital as you will be asked to come in for a check-up of your baby’s wellbeing. If it is confirmed that you are leaking water from around the baby, then you will be offered an induction of labour within 24 hours depending on your preference.

What are the stages of labour?

Labour is divided into three stages. The first stage of labour involves opening of the cervix from a closed cervix to 10 cm dilatation. At this stage, the baby’s head would have descended in the lower vagina and the woman is ready to push. The second stage of labour includes maternal pushing efforts to deliver the baby. Delivery of the baby marks the end of the second stage. The third stage includes delivery of the afterbirths, that is the placenta and the membranes.
Usually, first labour is longer than subsequent labours. The first stage of labour has a slower latent phase and a quicker active phase. The latent phase can last for few hours to a couple of days. During this time, you are encouraged to stay at home, maintain hydration, remain mobile, practice relaxation techniques, distract yourself by watching television, listening to music. You can hop in the shower to relieve the irregular cramps that you are experiencing.
Active first stage of labour lasts for 8-10 hours in the first labour and 6-8 hours in subsequent labours. This is associated with regular painful tightening’s.

What are the options for pain relief that I can use in labour?

There are various different pain relief options that you can use during labour.

  • You have the option of using nitrous gas which you can use during your labour. It does not have any aftereffects on either you or your baby. It takes the edge of the pains and you have to use it continuously during the labour.
  • Morphine injection is an effective injection. It significantly reduces the pain but does not take it away completely. If it is given too close to the birth of the baby, it can cause transient respiratory depression in the newborn. It can also cause some side effects in the mother including altered perception, nausea and respiratory depression.
  • Epidural is an injection that goes in the lower back. It numbs the pain and takes it away completely. This is given by an anaesthetist and is associated with some very rare but serious complications. It may sometimes lower the blood pressure and affect baby’s heartbeat pattern. Your baby’s heartbeat will be continuously monitored if you have an epidural.
  • Use of forceps or vacuum may be occasionally needed to safely deliver your baby in an event of concern with your baby’s heartbeat pattern in second stage of labour/long second stage/prolonged pushing is not advised for your health problems.
  • You still have to push; this is just an assistance your pushing efforts
  • The vacuum uses a soft plastic suction cup which is placed on the baby’s head, whereas the forceps are metal spoons which fit around the baby’s head.
  • They can sometimes cause minor bruising to the baby’s scalp. Very rarely they can cause bleeding under the baby’s scalp or damage to the skull bone.
Birthing options Sydney Obstetrician Dr Anu Mahadik

Birthing options: c-section | Sydney Obstetrician Dr Anu Mahadik

Caesarean section

A Caesarean birth is one where a baby is born through a cut in the mother’s belly. This requires an anaesthetic which could either be a spinal anaesthetic ( given through a needle in the back to numb the belly and legs, “awake anaesthetic” where you remain awake and your support person can be present with you in the operating theatre for the birth of your baby.

When is a caesarean birth required?

Caesarean birth could be planned or elective which means it is known during your pregnancy that you will need birth via caesarean section, and this is usually performed after 39 weeks. This may be because you have had a previous caesarean birth, your baby is not lying head down, the placenta is lying low inside the uterus, twin pregnancy (if first twin is not coming headfirst). Apart from these, there are many other reasons why you may need a planned caesarean delivery.

Emergency Caesarean section is done during labour, either because the progress of labour is inadequate, or the labour has obstructed, or the baby is getting distressed and not coping with the stress of labour.

What are the complications of a caesarean section?

Caesarean Section is generally a safe and a commonly performed operation. However, there are certain uncommon complications that could occur during or after a caesarean section. These include:

  • Bleeding
  • Infection
  • Damage to organs like the bowel/bladder that like close to the uterus
  • Blood clots
  • Reaction to anaesthetic
  • Risks in future pregnancies (repeat caesarean section, morbidly adherent placenta)

What should I expect after a caesarean section?

  • You will not be mobile for 8-10 hours after the operation
  • You will need regular pain medications for a few days
  • You will have a drip in your arm and be given fluids through it
  • You will have a tube/catheter going into your bladder to avoid retention of urine. This is usually removed the following day
  • You will be in the hospital for the next 2-3 days
  • The recovery takes 4-6 weeks and you will need support at home during this time. You will not be able to lift heavyweight, climb too many flights of stairs or drive your car during this time.

Antenatal care Sydney obstetrician

Frequently asked questions about pregnancy care

Across all trimesters of your pregnancy you should:

  • Avoid foods that may contain listeria bacteria as this can cause fetal death (unpasteurised milk, soft cheeses, cold processed meats, pre-cut fruit and salads, pâté, raw seafood and smoked seafood)
  • Wash raw vegetables and thoroughly cook all foods from animals to avoid listeria
  • Avoid eating uncooked or undercooked meat to avoid toxoplasmosis
  • Avoid cleaning cat litter boxes
  • Quit smoking, alcohol and other drugs
  • Avoid exposure to secondhand smoke
  • Reduce your caffeine intake
  • Discuss all over-the-counter drugs you take or are prescribed with your doctor or pharmacist
  • Eat a healthy balanced diet with plenty of water
  • Regular low intensity exercise at least 3 times a week

Sydney Obstetrician Norwest and St George Private Hospitals

Consulting at Norwest and St George Private Hospitals

My consulting rooms are at Burbank Place, Norwest which is near Norwest Private Hospital. If you are preparing for your antenatal care and looking for the best and most suitable solution, you can count on my practice to help you. If you live northwest of Sydney CBD, or near the M2 or M7, you may find my practice in Norwest suitable for your antenatal care consultations.

If you live in the Sydney CBD, or south of Sydney, you may be best served by coming to my rooms in Kogarah, at St George Private Hospital Medical Suites.

I come from a family of doctors and it has always been my intuitive first choice to become an Obstetrician and Gynaecologist. I basically grew up in it, with my father being one of the co-founders of a series of IVF clinics in India. Care for mothers and the babies they are expecting has always been my first nature and I am grateful for being able to serve my patients in their journey.
So if you are in that phase where you are not sure how to choose a private obstetrician in Sydney, let’s have a chat so we can plan your antenatal care together.

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