Have a question for our expert? This line is open until Friday, Sept 10th. Gwinnett will then answer a few questions Monday and we’ll post her answers right here and on the forums.
Q: If a woman has had one or more prior C-sections, is there any chance she can have a vaginal birth for subsequent deliveries?
A: Vaginal Birth after Cesarean (VBAC) can be an option, but, it depends on several factors. The main issue depends on the type of incision the mother had on her uterus (not on the outside on the skin itself) from her previous C-Section. There are three types of uterine incisions: the Low Transverse, which is a side to side cut across the lower, thinner part of the uterus; the Low Vertical, made in the lower, thinner part of the uterus and the High Vertical or Classical, which is a vertical cut through the upper section of the uterus. Other factors to consider if the mother can have a VBAC include problems with the location of her placenta (afterbirth), the number of previous C-Sections the mother has had and other medical conditions.
The overall success rate for a vaginal birth after a C-Section is approximately 70%. If the mother has had a previous vaginal delivery, the success rate can be higher.
Remember, VBAC is not without risk. The main threat is that the previous cesarean scar may rupture or tear during a VBAC delivery. The uterus may also rupture, but, this is rare. Also, VBAC is not performed in some hospitals if the hospital cannot perform an emergency cesarean delivery.
Overall, VBAC is best discussed between the mother and her obstetrician and should take place early in the pregnancy. There are physicians who do not allow trials of labor, if this is true with your obstetrician and you are a candidate for VBAC, you should try to locate one as early as possible to discuss a trial of labor.
Q: Can you really tell the sex of the baby by how it sits, cravings, etc.?
A: No. There is no scientific way to tell the sex without an ultrasound or amniocentesis, although I have heard of many myths, including carrying the baby “high or low in the pelvis, increased heartburn, etc.”
Q: How much weight can/should I gain?
A: The average weight gain in pregnancy is 25-35 lbs. Women who are underweight may gain 40 lbs and overweight women may gain 15 lbs or less if eating properly. Pregnancy is a time when many women are very cautious about their diet and because of improved eating habits, may actually lose some weight. The average weight gain is 3-6 lbs in the first trimester, and 1/2 to 1 lb per week in the last two trimesters.
Q: Should I give in to cravings?
A: Some cravings are the result of nutritional deficiencies. For example, women who are anemic (low iron) may crave ice, or starches. Instead of continuing to eat ice, it is recommended that iron supplements be given in addition to prenatal vitamins. In some places in the south, women actually ate ARGO starch, a brand of starch found in grocery stores, or red clay in response to starch cravings. Other cravings include ice cream. This may be due to calcium deficiency. The growing fetus will sometimes use the mother’s calcium and iron, thereby leaving the pregnant mom with a calcium deficiency.
Q: When should I start to feel movement? How much is normal?
A: For first time moms, fetal movement, or quickening, occurs at approximately 20 weeks. For others it is usually 16 weeks. As the fetus grows, movements are easier to feel. Although the fetus moves throughout the day, there are times when a pregnant woman will perceive the baby to be more active. This is usually after meals and at night while the mother is resting. Each mom knows how often her baby normally moves, but, it should move a minimum of ten times a day.
Q: When do I need to call my doctor?
A: There are several times when you may need to call you physician or mid-wife: if the mother experiences a sudden onset of bright red bleeding, with or without pain; if leaking or a gush of fluid occurs; if the mother is experiencing premature contractions, low-back or pelvic pain (less than 36 weeks) and if there is a decrease in fetal movement (you cannot feel your baby moving). These examples are not all inclusive.