Dr. Amaya Carreras; Obstetrician & Gynecologist at German Medical Center FZ-LLC talks about the important aspects related to your pregnancy's due date.
11 February 2018| Last updated on 11 February 2018
One of the biggest concerns of a pregnant woman (especially when the due date it’s getting close) is: how will the delivery be? Will it be painful? Will I have a normal delivery or will a cesarean section be necessary? And how will I know if I am really in labor?
In fact, it is important to consider the issue of childbirth from the first visits with our obstetrician, since in many countries and also in the UAE, we find as common practice elective caesarean sections as the only delivery option offered by some professionals.
If this is what we need or even what we decide (after being properly informed about it), will we be then in the right place? On the contrary, if we want to have the possibility of a normal vaginal delivery, we must have it in mind when choosing our reference OB/GYN.
Both a vaginal birth and a cesarean section are valid choices, but it should be the best option for each person and her particular case that determines which of them to choose. Recovery from a vaginal delivery is usually faster and the risks are lower.
In contrast, cesarean section involves the surgical risks in addition to those associated with childbirth, and from two caesarean sections, it is not advised to attempt a vaginal delivery (therefore, a third pregnancy will end up being necessarily an elective cesarean section).
Anyhow, we must not forget that doctors are still trying to clarify with enough scientific evidence if it is more "healthy" for women’s pelvic floor to deliver by cesarean section instead of having a vaginal delivery.
The truth is that on this matter, the controversy is served; there are opinions on both sides: recommending a cesarean, and others saying there are no significant differences between both options. Let's hope we can get to know more about this subject in the future.
I think the summary of this first part would be, from my humble point of view, that whenever it is possible and also the mother and baby are well, it would be a better recommendation to try and opt for a vaginal delivery; on the other hand, whenever it is seen to be necessary, go for a cesarean section if there is any risk or difficulty anticipated, and not take unnecessary risks trying to have a vaginal delivery, when what is really important is the mum’s and baby’s health and wellbeing.
And when the day comes, how do I know when to go to the hospital?
The most important warning signs to consider are:
1. Regular contractions every 3-5 min (as a general rule, for more than an hour)
We could have heard (or even lived!) all kinds of stories regarding childbirth, and evidently every woman and every pregnancy are different, but especially if we are first-timers, we must wait patiently at home for the contractions to be regularized and maintained over time.
If they are irregular but if occur every 2-5mins for more than an hour or so, and of increasing pain and intensity, it will also be advisable to approach the emergency department.
2. Vaginal bleeding, if heavier than a period
During dilation of the cervix and with uterine contractions, mild bleeding is quite commonly observed, which can actually be a good sign. However, bleeding similar or heavier than a period, especially if it goes along with pain, would be a reason for urgent consultation at the hospital.
3. Absence of fetal movements
During the lasts weeks of the pregnancy, babies move more softly and it may seem, at times, that they are indeed barely moving. If this happens to you, before getting concerned, the first thing you should do would be to eat something sweet and, if possible, lie down in a quiet place, where you can spend a few minutes (10-15min) recognizing the movements of the baby.
Although they may be soft and delicate, as long as they exist it’s enough to know the baby is fine. If on the other hand, after this time and these measures you continue without noticing any kind of movement, it is advised to approach promptly and calmly to be checked by our obstetrician or at the reference hospital that we may have, to assess the well-being of the unborn child.
4. Exit of amniotic fluid
Last but not least, the famous topic of rupture of the membranes or breaking the waters. In fact, for most women their waters are not broken until they are admitted in labour, but it is important to be on the watch in case it happens.
Contrary to how it usually appears on the movies, the most frequent symptom is to notice a small vaginal leakage of fluid, which can be unclear if it is amniotic fluid or simply a small leak of urine (ups!). If the membranes have indeed ruptured, these little flows will most likely repeat themselves in a short time and even more evidently with movements.
On the other hand, if the problem is some drops of urine, the leak does not usually repeat again. Anyway, in case we doubt, better to be on the safe side and reach the doctor.
If you finally decide to go and be checked at the hospital, for any reason, don’t trouble if they end up telling you that this is not the time yet! It is always better to be safe than sorry. Therefore, it is preferable to go home and after a false alarm than to have waited when it was actually necessary to go.
And those (doctors and nurse) that are waiting to help you, they are also the first ones to encourage you to be checked as many times as needed. Pregnant women are always a priority and it is a pleasure to be able to accompany you in these decisive moments in which we will welcome a new little person into this world.