Facts about labour

Want to know about caesareans or epidurals? Our family GP informs you about your delivery choices

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An elective caesarean is usually done at 39 weeks

When is the best time for an elective caesarean?

Generally elective caesareans are now done at 39 weeks of pregnancy as this has been found to be the safest for your baby. Babies delivered by elective caesarean before 39 weeks are more likely to have breathing problems.

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Epidural Rules

Headlines over NHS plans to cut down on epidurals during childbirth may have worried you. Targets were drawn up a year and a half ago but it seems some hospitals are now trying harder to stick to them – and coming under fire for doing so. But before you panic, remember you can’t legally be denied an epidural. Before the birth, consider every possibility with your birth partner, get information about pain relief and what you can do to help labour, then see how it goes. Start with distraction, TENS, breathing, water, and, as your labour progresses, move on to pain relief step by step if needed. If you have an epidural, don’t feel guilty. It does increase the likelihood of an instrumental delivery, but the relaxation that follows it can actually speed up dilation.

Reasons for an assisted delivery or c-section:

  • Placenta praevia. A rare condition where the placenta covers the opening of the uterus.
  • Breech presentation. When your baby is ‘upside down’ because she’s been unable to turn.
  • Multiple babies. With twins, a vaginal birth may be attempted, but triplets are generally delivered by caesarean.
  • Foetal distress. When the baby is in trouble (generally detected through his heartbeat).
  • Previous traumatic delivery. Following a severe tear, a caesarean may be discussed.

Q. I have a lump of skin outside my vagina. At my postnatal check, my GP said it was a prolapse – what can I do about it?

A. A prolapse isn’t uncommon following pregnancy and vaginal delivery, both of which stretch the pelvic floor muscles and vaginal skin. The looser muscles and skin can then drop slightly and cause a lump outside the vagina – that’s the prolapse.

As you’ve only given birth fairly recently, you should find it improves. Doing pelvic floor exercises will help, and your GP may recommend seeing a physiotherapist who specialises in pelvic floor exercises, to ensure you’re doing them effectively. If it doesn’t go away, speak to your GP about it again.

Can your periods affect whether you need an assisted delivery?

There are many reasons why a mum might need an assisted delivery (using forceps or a suction cup, known as a ventouse) or a caesarean. But did you know a possible influence is the age you started your periods? Researchers at Cambridge University spoke to 3,739 mums and found that those who started their periods aged 12 or younger needed help more often than those who were 15 or older when they first had a period. Why? The experts say starting your periods earlier gives you exposure to female hormones for longer, which may have an effect on womb function. If you started your periods early and are expecting, talk to your midwife about what an assisted delivery involves although, remember, you might not necessarily need one.

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