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Obstetrics

Specialty > Subspecialty > Obstetrics

Obstetrics is a branch of gynaecology that deals with taking care of pregnant women, unborn babies, labour, delivery, and the immediate period after childbirth. An obstetrician makes sure that the baby and mother receive the best prenatal care and the delivery occurs without any complications.  

At Aayush Hospital, we provide a comprehensive range of gynaecology and obstetrician services. Right from the pregnancy test to delivery and post-natal care, you can rest assured to receive the best diagnosis and treatment at each step of your pregnancy.  

Our team of highly renowned gynaecologists, obstetricians, and nurses provide 360-degree solution to your pregnancy needs.  

In addition, we are backed by state-of-the-art infrastructure, modern laboratories, and latest equipment that help our team of doctors to provide exceptional medical outcomes. 

Procedures

 

Prenatal care refers to specialized medical care that you require during pregnancy. This care is important as it ensures that you have a healthy pregnancy and a full-term baby. 

How Often Should You Go for Prenatal Care Checkups? 

You should go for prenatal care checkups as suggested by your gynaecologist. In general, you should follow a schedule like below: 

  • Weeks 4 to 28 of pregnancy: Visit once a month. 

  • Weeks 28 to 36 of pregnancy: Visit twice a month. 

  • Weeks 36 to 41 of pregnancy: Visit every week. 

In case you have certain complications during pregnancy, your doctor may expect you to visit more often. During each of your visits, make sure that your partner or someone from your family accompanies you to discuss complications and precautions (if required). 

What Happens at Prenatal Care Checkups? 

Your first prenatal care checkup will mostly be the longest as your doctor will ask several questions about your health. At your first prenatal care checkup, your gynaecologist will: 

  • Conduct a physical examination to check your weight, height, and how much weight should you gain during pregnancy. 

  • Check your blood, urine, and blood pressure to see if you do not have any medical condition that may affect your child. 

  • Conduct a pelvic exam and pap smear to make sure you are healthy to have the child. 

  • Vaccinate you (if required). 

  • Conduct an ultrasound to confirm your pregnancy. 

  • Discuss your due date with you. 

  • Prescribe prenatal vitamins including folic acid for overall growth and development of the baby. 

  • Discuss your future prenatal tests with you. 

What Happens at Later Prenatal Care Checkups? 

As mentioned, later prenatal care checkups are usually shorter since your gynaecologist has an understanding of you and your baby. During the later checkups, your gynaec will: 

  • Check your weight and blood pressure. 

  • Check the baby’s heartbeat. 

  • Measure your abdomen to check your baby’s growth. 

  • Conduct certain prenatal tests to check your baby. 

  • Enquire about the baby’s movement in the womb. 

  • Conduct a pelvic exam to check if your body is preparing for the due date. 

  • Vaccinate you at 27-36 weeks of pregnancy.

 

Antenatal tests ensure that you and your baby are healthy throughout the pregnancy. These tests help in: 

  • Diagnosing medical problems in babies. 

  • Identifying genetic conditions in your baby and deciding the further treatment. 

  • Checking how your baby is growing and developing. 

It is important for you to not miss any of these tests as they help your gynaecologist in determining the health of your baby. 

  • Screening Tests 

Some antenatal tests include screening tests which estimate the chances of you and your baby having a medical condition. 

  • Diagnostic Tests 

Some antenatal tests are diagnostic tests to confirm if your baby has a medical condition. These tests are generally conducted after screening tests. 

Which Antenatal Tests are Included during Pregnancy? 

A typical antenatal testing will include the following tests: 

  • Full blood count. 

  • Vitamin D test. 

  • Urine test and culture. 

  • Blood group + antibodies. 

  • Nuchal translucency test. 

  • Combined first-trimester screen. 

  • Non-invasive prenatal testing. 

  • Chorionic villus sampling. 

  • Amniocentesis. 

  • Gestational diabetes screening. 

  • Morphology scan.

 

Although it is hard to know exactly what will happen when you give birth, most people have a plan in mind for how they hope their delivery goes. When it comes to delivery, it is always better to know your options and discuss the same with your obstetrician. 

Which Type of Delivery is the Best? 

Generally vaginal delivery is the safest unless you have a medical condition that requires a C-section. 

What is a Vaginal Delivery? 

Your baby is born normally through your vagina in a vaginal delivery. It is the most preferred way as it carries low risk. A vaginal delivery usually occurs between 37 to 42 weeks of pregnancy and involves 3 stages, viz., labour, birth, and delivery of the placenta. It provides the following benefits: 

  • Faster recovery. 

  • The safest way to deliver the baby. 

  • Lower rate of infection. 

  • Easier lactation. 

  • Healthy babies. 

What is Assisted Vaginal Delivery? 

An assisted vaginal delivery refers to a delivery method during which your obstetrician will use a forceps or vacuum device to get your baby out of the vagina. This is done when: 

  • You have been in labour for a long time. 

  • Your labour is not starting. 

  • You are too fatigued to continue pushing. 

  • Your baby is showing signs of distress. 

What is a Caesarean Section? 

During a C-section, your obstetrician delivers your baby with the help of surgery. The surgery may be planned or unplanned in case of a medical condition. A planned c-section will be recommended if you have: 

  • Had a previous C-section. 

  • Twins. 

  • Placenta previa. 

  • Breech baby. 

  • Uterine fibroid or other obstruction. 

  • Baby with foetal macrosomia. 

An unplanned C-section may be needed, if you have the: 

  1. Foetal distress. 

  1. Umbilical cord prolapse. 

  1. Placental abruption. 

  1. Excessive bleeding. 

  1. Uncontrolled labour. 

What Are the Risks of C-sections? 

Since C-section is a surgical method, it carries some risks, including: 

  • Infection. 

  • Need for a blood transfusion. 

  • Blood clot. 

  • Bowel or bladder injury. 

  • Longer recovery and hospital stay. 

  • Abdominal adhesions. 

What is Vaginal Birth After Caesarean (VBAC)? 

If you have had a baby with caesarean before, you may be able to have your next baby from vaginal delivery. Since, a previous C-section causes a scar on your uterus, a naturally induced labour may rupture the scar and cause injury. This is one of the main reasons why a vaginal delivery is avoided after c-section. 

You can, however, deliver a baby naturally after c-section if you meet the criteria, which includes: 

  • Your obstetrician made a low transverse incision during your first c-section. 

  • You do not have any uterine scar or abnormality. 

  • You have had a vaginal delivery previously. 

  • You have not had a previous uterine rupture.

 

Postpartum or postnatal is a time after childbirth. It refers to a timeframe of the first 6-8 weeks after delivery until your body returns to its pre-pregnancy stage.  

Your body goes through several changes during pregnancy and even during the postpartum phase. For instance, you will have tremendous hormonal changes or vaginal bleeding which will also be exhausting. Hence, pay close attention to how you feel and your body feels during this period and let your obstetrician know about the same.  

Taking care of yourself during this phase is important for both you and the baby. 

Postpartum Recovery Timeline

Similar to pregnancy, recovery from pregnancy is also unique for everyone. The general changes that you may notice in the few hours and days after childbirth are: 

  • Your uterus will shrink back to its original size which may cause cramps and even bleeding. 

  • You will notice hormonal changes including hot flashes, mood swings, and headaches. 

  • Your breasts will enlarge in size and prepare you for breastfeeding. 

  • You will also have pain in the vagina due to childbirth. 

  • If you had a C-section, you may feel soreness at the incision site. 

  • You will also have fatigue from childbirth. 

What Are the Stages of Postpartum? 

Postpartum is classified into 3 phases: 

  • Acute Phase: this refers to a phase between the first 6 to 12 hours. During this phase, you may experience certain conditions including eclampsia, and haemorrhage. Your doctor will monitor your blood pressure and heartbeat during this time. 

  • Subacute Phase: this refers to a phase starting from 24 hours after birth and lasts for up to 6 weeks. Your body will change tremendously during this time but you may not experience any medical emergency. 

  • Delayed Phase: This phase lasts from 6 weeks to 6 months. Changes during this phase will be gradual and your body will try to return to pre-pregnancy state. 

How Do I Take Care of Myself During Postpartum? 

Postpartum care is important for both you and your baby. Make sure that you rest and give yourself time to heal. Visit your obstetrician for frequent checkups so that you mitigate any medical emergency. 

Apart from this, have: 

  • Proper nutrition and stay hydrated. 

  • Take care of your vaginal area and discuss the same with your obs about how you can help in healing it. 

  • Restrict your physical activity. 

  • Take mental health support if required. 

When Should You Consult Your Doctor? 

Although postpartum symptoms are common, some symptoms may indicate a medical emergency, these include: 

  • Heavy vaginal bleeding. 

  • Passing large blood clots in urine. 

  • Fever. 

  • Increase in pain. 

  • Foul smelling vagina. 

  • Pain in your legs and swelling. 

  • Bloody discharge or pus from your c-section. 

  • Dizziness or change in your vision 

  • Severe headache. 

  • Shortness of breath. 

  • Chest pain.

 

During pregnancy, your obstetrician will check the health of your baby including its heart rate and function. The monitoring will be done in 2 ways: 

  • External monitoring: 

This includes a special tool called a fetoscope that sends sound waves to your uterus and generates images on the computer. 

  • Internal monitoring: 

This includes a small electrode that is put on your baby’s head when it is inside the uterus. 

Why is Foetal Monitoring Important? 

Foetal monitoring especially heartbeat monitoring is important to check the heartbeat of your unborn baby. By monitoring this, your doctor may check if the heart rate is too high or too low or changing too much. Irregularities in the heartbeat can mean that your baby is not getting enough oxygen. It may call for an emergency delivery. 

What Happens During Foetal Monitoring? 

During the foetal monitoring, your doctor will: 

  • Put a gel on your belly. 

  • Put a device called an ultrasound probe on your belly and move it. This device will send the foetal heartbeat to the recorder which will be displayed on the screen. 

  • Put another device called a tocodynamometer which will record the pattern of your contraction. 

When is Foetal Monitoring Done? 

Foetal monitoring will be done during: 

  • Your prenatal visits. 

  • high-risk pregnancy. 

  • Birth of your baby. 

 

Labour induction refers to a procedure wherein your obstetrician starts labour instead of labour starting on its own. This is done to speed up the process of childbirth in situations when the health of your baby is at risk when you have passed your due date. 

How is Labour Induced? 

Your obstetrician will thoroughly examine you and your cervix before deciding on a way to proceed with labour induction. The ways include: 

  • Medication to soften and dilate your cervix and prepare it for birth. 

  • Rupturing amniotic sac to break your water. 

  • Medication to speed up contractions. 

  • Cervical ripening balloon. 

Why is Labour Induction Done? 

Labour induction is mainly done to protect your baby’s health. You may also require it, if: 

  • You are two or more weeks past your due date. 

  • Your amniotic sac has broken but you are not having contractions. 

  • You have certain health conditions including gestational diabetes, preeclampsia, or high blood pressure. 

  • Your foetus has stopped growing. 

  • You do not have adequate amniotic fluid. 

  • Your placenta has separated from your uterine wall. 

  • You have an infection in your uterus. 

How Long Does a Labour Induction Last? 

The labour induction will depend on your condition. For the majority of people, however, it lasts for 24 hours until their cervix reaches about 6 cm. 

What Are the Risks of Labour Induction? 

Although important, labour induction may also have certain risks. It involves: 

  • Infection. 

  • Uterine rupture. 

  • Increased risk of c-section. 

 

Vacuum extraction refers to a procedure of assisted delivery during which you’re a vacuum extractor is applied to suction your baby out of the vagina while you push. This is done when your labour is stalled in the second stage. 

Why Do You Need a Vacuum Extraction? 

You may need vacuum extraction if: 

  • Your labour is prolonged or stalled in the second stage. 

  • The baby’s heartbeat is non-reassuring. 

  • You are unable to push anymore due to exhaustion or other medical conditions. 

What is a non-reassuring Heartbeat? 

An abnormal heartbeat of the baby is called non-reassuring. This is a sign that your baby is not getting enough oxygen during labour.  

What Happens During Vacuum Extraction? 

Before the procedure, your obstetrician will discuss the benefits and risks associated with vacuum extraction. Once you confirm, vacuum extraction will be started. During this procedure, your obstetrician will: 

  • Carefully place the cup of the vacuum at the right spot on your baby’s head. 

  • Apply traction with a mechanical pump during your contraction. 

  • Ask you to push the baby with both hands. 

  • Remove the baby from the uterus. 

What Happens After Vacuum Extraction? 

Once your baby has been delivered, a team of doctors will check you and your baby for any signs of wounding. Your baby will be monitored for several hours.  

Complete recovery will take up to 6 weeks. 

What Are the Risks of Vacuum Extraction? 

Vacuum extraction may pose certain risks during childbirth. This includes: 

  • Vaginal tears. 

  • Postpartum bleeding. 

  • Difficulty urinating. 

  • Bruising. 

  • Intracranial haemorrhage. 

 

Forceps delivery is a type of assisted vaginal delivery which is used when your labour is not progressing. Forceps are like metal salad tongs that are placed inside your birth canal to guide your baby out. 

Why Choose Forceps Delivery Over Vaccum? 

Forceps delivery and vacuum extraction are both types of assisted deliveries. Out of both forceps delivery is less common as it requires an expert. While vacuum extraction requires your baby to have head-first, forceps delivery can rotate your baby during delivery. Moreover, it also has an overall higher success rate than vacuum extraction. 

What Happens During Forceps Delivery? 

While forceps may take you back to your kitchen, delivery with forceps is not what you think. The surgical forceps are ergonomically designed, curved at both ends to cradle the shape of your baby’s head and curved along their length to accommodate the shape of your pelvis. 

During the procedure, you will lie on your back with your legs spread apart. You will continue pushing with your contractions. Your obstetrician will use the time between your contractions to place the forceps with one blade at a time on either side of your baby’s head or feet. With your next contraction, the surgeon will apply little traction to take your baby out.  

What Happens After a Forceps Delivery? 

Once your baby has been delivered, a team of doctors will check you and your baby for any signs of wounding. Your baby will be monitored for several hours.  

Complete recovery will take up to 6 weeks. 

What Are the Risks Associated with a Forceps Delivery? 

A forceps delivery may cause: 

  • Vaginal tears. 

  • Tears on the muscular wall of the rectum. 

  • Difficulty urinating. 

  • Pelvic organ prolapses. 

 

Caesarean section or c-section is a surgical procedure to deliver your baby. This procedure is recommended when vaginal delivery is not safe or not possible or if your baby is at risk. 

When Do You Need a C-section? 

You may need a C-section if you have: 

  • Cephalopelvic disproportion. 

  • Previous C-section. 

  • Twins. 

  • Placenta previa. 

  • Transverse lie. 

  • Breech presentation. 

  • Other health conditions. 

What Happens During a C-section? 

During the procedure, your obstetrician will: 

  • Give you an anaesthesia mainly epidural. 

  • Clean your abdomen with an antiseptic and place an oxygen mask over your mouth and nose to increase oxygen to your baby. 

  • Place a sterile curtain between your head and the lower body. 

  • Make an incision through your skin and into the wall of the abdomen. 

  • Make a transverse or vertical incision depending on your case. 

  • Make a 3-4 inch incision into the wall of your uterus. 

  • Remove your baby through the incisions. 

  • Cut the umbilical cord and placenta. 

  • Close the incision. 

What Happens After a C-section? 

After the c-section, you will be moved to a recovery area. Your abdomen will be sore for a few days or weeks and you may be required to stay in the hospital for 2-3 days. 

What Are the Risks Associated with a C-section? 

C-section may cause: 

  • Infection. 

  • Haemorrhage. 

  • Blood clot. 

  • Foetal injury. 

  • Abnormalities of the placenta. 

 

Episiotomy refers to a surgical procedure during which your obstetrician makes a small cut between the bottom of your vaginal opening and anus for childbirth. This makes the opening of the vagina wider and allows your baby to come out easily. 

Why Do You Need an Episiotomy? 

You may need an episiotomy, if: 

  • Your baby is in distress and needs to be delivered quickly. 

  • You are exhausted and dehydrated from prolonged labour. 

  • Your baby is in breech position or stuck in your pelvis. 

  • Your baby is large. 

  • You have been pushing for too long and cannot control pushing anymore. 

What Happens During an Episiotomy? 

During the procedure, your obstetrician will: 

  • Give you an anaesthesia preferably epidural. 

  • Once your baby’s head is at the vaginal opening, your surgeon will use episiotomy scissors to make an incision. 

  • Deliver your baby followed by the placenta. 

  • Close the incision. 

What Are the Risks Associated with Episiotomy? 

Episiotomy is safe. It may, however, cause: 

  • Bleeding. 

  • Infection. 

  • Painful sex. 

  • Injury to anal sphincter. 

  • Scarring. 

  • Prolonged recovery time. 

 

Amniocentesis is a prenatal test that is performed during the second or third trimester of the pregnancy. It is done to diagnose certain chromosomal conditions. 

What Does Aminocentesis Detect? 

An amniocentesis can detect: 

  • Down’s syndrome. 

  • Tay-Sachs disease. 

  • Neural tube defect. 

  • Foetal lung development. 

  • Rh disease. 

What Happens During Amniocentesis

During the procedure, your obstetrician will: 

  • Clean a small area on your belly with an antiseptic. 

  • Apply a special gel on your belly. 

  • Move the ultrasound probe over the gel. 

  • Insert a thin, hollow needle through your abdomen and uterus. 

  • Remove a small amount of fluid through the needle. 

  • Monitor foetal heartbeat and movement of the baby. 

What Are the Risks Associated with Aminocentesis? 

Most amniocentesis procedures are safe. It may, however, cause: 

  • Cramping. 

  • Injury. 

  • Infection. 

  • Premature labour. 

  • Bleeding or leaking amniotic fluid.

 

A prenatal ultrasound is a test during pregnancy which checks the health and development of your baby.  

What Can Foetal Ultrasound Detect? 

A foetal ultrasound can help in: 

  • Confirming your pregnancy. 

  • Checking for ectopic pregnancy, molar pregnancy, and miscarriage. 

  • Determining the gestational age of your baby. 

  • Checking your baby’s growth and movement. 

  • Looking for multiple babies. 

  • Examining your pelvic organs. 

  • Checking your baby’s position in the uterus. 

What Are the Types of Foetal Ultrasounds? 

Foetal ultrasounds are of two types: 

  • Transvaginal Ultrasound: 

During this procedure, your obstetrician will place a device inside your vaginal canal to detect foetal heartbeat or determine your pregnancy age.  

  • Abdominal Ultrasound: 

This is a much more common procedure during which your obstetrician will directly place the ultrasound probe on your abdomen.  

What Happens After a Foetal Ultrasound? 

After the foetal ultrasound test, your obstetrician will print some pictures that you can take home with you and discuss the results of the test with you.

 

A non-stress test or foetal non-stress test (NST) refers to a pregnancy screening that measures foetal heart rate and reactions to movement. This is done to ensure that the foetus is healthy and getting enough oxygen. 

 

Why Do You Need an NST? 

You may need an NST, if: 

  • You are past your due date. 

  • You don’t feel your foetus moving as much. 

  • Your foetus measures small for its gestational age. 

  • You are expecting twins. 

  • You are Rh negative. 

What Happens During an NST? 

During the procedure: 

  • You will lie down on a reclined chair. 

  • Your obstetrician will attach two elastic belts to your abdomen. Each belt will have sensors attached to it. One sensor will monitor your contractions and the other will monitor your foetal heart rate. 

  • Your obstetrician will record this information for about 30 minutes. 

  • Your belts will be removed. 

In case your foetus does not move during the process, it may be asleep. Your obstetrician may try waking it up with a small buzzer. Sometimes a sugary drink or snack may wake them up during the test. 

 

A biophysical profile or BPP is a test that is performed after 32 weeks of pregnancy to evaluate the health of your foetus. It is done when you have a high-risk pregnancy or if you have irregular test results. 

Why Do You Need a BPP? 

You may need a BPP, if you have: 

  • Hypertension. 

  • Previous stillbirth. 

  • Twins. 

  • Decrease in the foetus movements. 

  • Possible intrauterine growth restriction. 

  • Diabetes. 

  • Too much or too little amniotic fluid. 

  • Age more than 35 years. 

  • Obesity. 

What Happens During BPP? 

During a BPP, your obstetrician will perform: 

  • Ultrasound Examination: 

During an ultrasound, you’re lying down or reclining on an exam table. Your provider moves a device called a transducer (or probe) over your abdomen to produce sound waves. The transducer converts the sound waves to images that can be viewed on a screen. 

  • Non-stress Test: 

An electronic fetal monitor measures the fetus’s heart rate while you’re reclining or lying down on an exam table. Your provider places a belt with an electronic sensor around your abdomen. There should be two or more accelerations in their heart rate. If there are fewer than two, it may indicate the fetus is asleep. In that case, your provider may use a buzzer or a loud noise to stimulate movement. In some cases, your provider will place a second monitor with a sensor around your abdomen. This monitor measures and records your uterine contractions.