True Birth

Recently, Dr. Abdelhak was interviewed by Elisabeth Sherman for Input Magazine www.inputmag.com about an article relating to the use and addiction of internet chat groups in pregnancy and this got us thinking about the overall use of the internet in pregnancy. What role does the internet play in pregnancy? How useful is it? And, how much should a woman and her family rely on the internet and its information when making decisions about their health and pregnancy?

Btw, you can check out that great article here.

The internet can be overwhelming. We quickly went from a dearth of information in pregnancy to an over abundance (a TMI, if you will) in just under a decade. Anyone can post a blog or a vlog and print has a semblance of authority, making it hard to decern what is correct and what is hogwash. Listen in as these two pregnancy experts weigh in on what the internet has to offer for pregnancy and how to utilize this information effectively.

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Traveling in pregnancy is generally considered to be safe for most women. It is typically recommended to check in with your medical provider before booking your trip and before going away on your trip. The biggest risk the travel itself typically poses is being away from your primary medical provider and not the travel itself, via air, train, ship or car.

There also is the the potentially increased risk of exposure to infectious diseases such as Zika, malaria and SARS-CoV-2 and each of these should be considered with your provider based on your gestational age and destination.

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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When there is a loop of umbilical cord around the baby's neck in the womb it called a nuchal cord. This is actually a common ad normal finding during labor and delivery.

Medically speaking the term nuchal cord is define as: an umbilical cord that passes 360 degrees around the fetal neck. They are classified as single or multiple and tight and loose. Single is more common than multiple and loose is more common than tight.

The incidence of nuchal cords is roughly about 25 percent at term and is associated with increased fetal movement and longer umbilical cords.

Listen in as Dr. Abdelhak and Kristin talk about their experience with umbilical cords around the neck with over 10,000 births between them.

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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Sweeping the membranes is a great tool that is often used at the end of the 9th month to help stimulate contractions or labor.

It is typically performed during an office visit when and the cervix needs to be partially dilated in order for it to be effective. The OB will typically insert one finger on a vaginal exam beyond the internal cervical os and then rate the finger circumferentially along the lower uterine portion of the uterus/cervix to pull the uterus away from the fetal membranes. This helps to simulate the body into labor and is more effective as a woman approaches her due date and beyond.

Stripping or sweeping the membranes before labor has begun is associated with better outcomes in birth such as lower c-sections and shorter durations of pregnancy (i.e. less chance of going overdue). This is a great tool that many OBs will use to help to stimulate labor and assist a woman

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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Shoulder dystocia is when the shoulders fail to delivery easier after the fetal head. If the shoulders do not deliver easily with a few simple maneuvers it is considered an obstetric emergency. Shoulder dystocia is not always easy to anticipate and prevent, and often occurs in the absence of risk factors.

The incidence of shoulder dystocia is 0.2 to 3 percent of births and the calm trained demeanor of an expert birth professional is paramount to navigating these situations with confidence.

In this episode, Dr. Abdelhak walks us through how to approach this labor room situation.

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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Dr. Abdelhak answered some weekly questions about pregnancy.

If you have any comments or questions you would like us to answer please connect with us!

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

Subscribe to the podcast on Apple Podcasts, Spotify, Google Podcasts, & Stitcher and leave a review!

Long gone is the thought of once a cesarean always a cesarean. Women who have had a cesarean delivery in the past have the option of undergoing a trial of labor after cesarean (TOLAC) delivery or planned repeat cesarean delivery (PRCD) in their next pregnancy. Ideally, a planned TOLAC leads vaginal birth after cesarean (VBAC) but may end in an unplanned cesarean delivery.

How to decide if you are a good candidate for a TOLAC, VBAC or PRCD can be a hard choice for women to make. In this episode, we aim to give women some confidence in their choice regarding how they give birth after a cesarean. It is important to take into account personal preferences, as well as medical and pregnancy history

Other factors that influence a women's decision include the chance that a woman will end up with a VBAC based on various factors as well as a woman's chance of uterine rupture.

If you have any comments or questions about VBAC please connect with us!

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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How much weight gain in pregnancy is normal? The answer is it's individual and unique for each woman. Excessive weight gain can pose problems in pregnancy and is not typically recommended but in general there are several factors that contribute to what is normal and what is an acceptable amount.

There have been several guidelines outlining the appropriate levels of weight gain in pregnancy and they can vary.

Generally physiologically weight gain is as follows

• Fetus – 7 to 8 lb (3.2 to 3.6 kg)
• Fat stores – 6 to 8 lb (2.7 to 3.6 kg)
• Increased blood volume – 3 to 4 lb (1.4 to 1.8 kg)
• Increased extravascular fluid volume – 2 to 3 lb (0.9 to 1.4 kg)
• Amniotic fluid – 2 lb (0.9 kg)
• Breast enlargement – 1 to 3 lb (0.45 to 1.4 kg)
• Uterine hypertrophy – 2 lb (0.9 kg)
• Placenta – 1.5 lb (0.7 kg)

Weight loss can also happen and can even be considered normal in the beginning of pregnancy. In this episode, pregnancy (gestational) weight gain is meant to be a personal and individual discussion with a woman an her provider.

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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Assisted vaginal delivery (also known as operative vaginal delivery) is when the doctor or midwife assists the woman to delivery using forceps, a vacuum, or other devices to extract the baby from the vagina during the second stage (pushing stage) of labor. There are several factors that go into the decision of when to use an instrument to aid a woman in the delivery of her baby. These factors both maternal and fetal are discussed in this episode. In general, this type of assistance is given in lieu of a cesarean birth.

The prevalence of assisted vaginal delivery with forceps or vacuums is around 3-4.5%. Forceps are utilized much less commonly and account for approximately 0.5 percent of vaginal births, and vacuum deliveries accounted for 2.6-4 percent of vaginal births.

Forceps can be used to delivery the head and or rotate the head to an optimal position for delivery. Different type of forceps can be utilized: outlet forceps, low forceps and mid forceps.

Vacuum deliveries do not have a separate classification system and the rotation of the baby's head is not performed with vacuum deliveries.

We have included a video link here with some explanations of birth forceps and vacuum.

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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Cervical insufficiency (previously termed cervical incompetence) is defined as recurrent and painless cervical dilation leading to pregnancy loss typically in the second trimester.

While we addressed the primary cause of unexplained second trimester loss in a previous podcast episode, this is a common explainable reason for pregnancy loss in the second trimester. Cervical weakness or insufficiency may be a result of trauma to the cervix, prior cervical or uterine surgery (eg, LEEP, dilation and curettage, hysteroscopy) or a congenital (birth) abnormality.

Cerclage is a wonderful treatment (both preventative and therapeutic) for cervical insufficiency. In this episode, we review the different types of cerclage and when in a pregnancy they can be placed. A preventative cerclage or a history-indicated cerclage is usually performed at 12 to 14 weeks. Whereas a rescue cerclage and an emergency cerclage are performed later in the second trimester.

The two most common transvaginal techniques for cerclage were described by Shirodkar and McDonald techniques. You can see the video which explains them in more detail.

Dr. Abdelhak explains his rationale for each type of cerclage and when as well as briefly discusses the abdominal cerclage.

We'd love to hear from you. Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS Social Facebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

Subscribe to the podcast on Apple Podcasts, Spotify, Google Podcasts, & Stitcher and leave a review!