Laura Ikeji Kanu gives birth to a healthy baby boy

Fashionista Laura Ikeji and her husband, Ogbonna Kanu safely welcomed there Ryan.

Such a cutie. Congratulations dear.

Serena Williams glows in her thigh-high slit dress

Pregnancy really suits Serena Williams. The tennis champion now has a certain glow about her since she announced her pregnancy and her dress sense has also changed with her new state. The mum-to-be stepped out on Tuesday for the Burberry DK88 Bag dressed in a navy blue lace gown.

Second Pregnancy Planning

Maybe you’ve got a bouncing baby who’s ready to take his first steps or a toddler who’s just waved bye-bye to diapers or even a bigger kid who’s ready to go to “real” school. No matter what age your firstborn is, you may be feeling nostalgic for those early infancy days and thinking dreamy thoughts about baby number two. So how can you determine if you’re ready to handle a second pregnancy — and a second child? While only you and your partner can truly decide what’s best for your family, there are a handful of factors to consider when figuring out if you’re ready to start planning your second pregnancy.

YOUR HEALTH DURING YOUR SECOND PREGNANCY

Just as you wanted to be as healthy as possible before making baby number one, you’ll want to be as fit as possible before tackling your second pregnancy. While experts say it takes at least a year to fully recover from pregnancy (what with the vitamin depletion, strain on your reproductive system, and weight fluctuations), there’s no rule that says you need to wait a full year before trying again. If you’ve gotten back to your prepregnancy weight, you’re eating well, and you’re feeling energetic enough to plow through a second pregnancy (well, as energetic as you can feel while taking care of a little tyke!) there’s no reason not to go for baby number two as soon as you’d like. Here are some pros and cons to consider if you’re thinking about back-to-back pregnancies:

Health Pros for Back-to-Back Pregnancies

If you’re concerned about your age and fertility, the sooner you start your second pregnancy, the younger (and probably more fertile) you’ll be.Your first baby will likely keep you moving (good physical activity!) throughout your second pregnancy.You probably won’t have time to agonize over every pregnancy symptom since you’ll be busy round-the-clock.

Health Cons for Back-to-Back Pregnancies

During your second pregnancy, you won’t be able to rest (or sleep) as much as you’d like since you’ll have your firstborn clamoring for your nearly constant attention.Unlike your first pregnancy, you’ll be required to do some heavy lifting.

Another factor to consider: how you want tospace your children. Chances are if your little one's clamoring for a younger sib, you'll get bitten by the baby bug all over again. So once your (rubber) ducks are in order, get ready for the baby-making to begin again!

Anxiety During Pregnancy: What’s Normal and What’s Not?

Whether you’re a first-time parent or are adding to your family, struggled to get pregnant or got lucky without trying, nine months of pregnancy can raise all sorts of concerns. You may wonder: Why is the baby kicking so much…or so little? How will I bear the labor pains I've heard so much about? How can I be a good mother if I've got no clue what it’s like to care for an infant? These are all normal worries, since joining the first-time mama’s club means you’ll have plenty of questions only experience can answer. The reality is, nearly every woman — under that baby belly and “pregnancy glow” — is a bit anxious, worried or hesitant about some aspect of pregnancy, childbirth or parenting. But when should anxiety be a cause for concern? And how can it be treated during pregnancy? The answers are information that every expecting woman should hear.
WHAT’S A NORMAL AMOUNT OF ANXIETY?
Anxiety is not only part of being pregnant; it’s part of being human! Everyone worries about their lives, and pregnancy can often amplify those worries. Some women are mostly worried about whether their babies are healthy (previous pregnancy losses or fertility problems can make this an especially overriding worry). Others might worry about whether they’ll be good parents, how their relationships with their partners will change, how siblings will react to a new baby, or the financial aspects of having a child (and even if you worry about all these things, that’s normal too).
But there’s a difference between normal worrying and all-consuming anxiety during pregnancy, also known as antenatal anxiety. It’s time to talk to a healthcare provider if you’re unable to concentrate on your day-to-day life; have trouble functioning at work or home; experience a frequent sense of panic, fear or restlessness; have obsessive thoughts; or don’t enjoy things that used to make you happy. Other signs of a more serious anxiety disorder can be physical, including heart palpitations and muscle tension. This level of anxiety isn’t normal or healthy — but treatment can help.

WHO’S MOST AT RISK?
Just about anyone can develop anxiety during pregnancy. In fact, a poll by the Anxiety and Depression Association of America found that 52 percent of pregnant women report increased anxiety or depression. That said, there are a few criteria that put you at higher risk for a severe anxiety disorder ad that mean you should pay extra-close attention to how you’re feeling when you’re expecting:

A previous diagnosis of an anxiety disorder
Anxiety during a past pregnancy
Previous pregnancy loss or fertility struggles
Pregnancy with complications or bed rest (though practitioners rarely prescribe strict bed rest anymore, in part for this reason)
Stress at home or work
All of these factors can contribute to a heightened risk of anxiety during pregnancy.

WHY SEEK HELP?
Many women are under the mistaken impression that the best way to deal with anxiety is to just put up with it. But if your anxiety is severe and all-consuming, there are a few reasons it’s best to seek help. Although you might tell yourself “I’ll just feel better once the baby is here,” research has actually shown that women who have untreated anxiety during pregnancy are more likely to have severe episodes ofpostpartum depression after baby is born. So although anxiety and depression don’t necessarily occur together, they are closely related — and by learning ways to control your anxiety before your new little one arrives, you’ll increase the odds that you’ll be able to enjoy those joyful first few months. And here’s one more reason to explore treatments: Long-term, severe anxiety during pregnancy can affect your baby’s development. Studies have shown that anxiety or depression during pregnancy can increase the odds of preterm birth and low birth weight, and even make it more likely a child will, down the road, have emotional or behavioral challenges.

ANXIETY MEDICATIONS DURING PREGNANCY
Most drugs that treat anxiety fall into the same class of pharmaceuticals as antidepressants, which means some can be tricky to prescribe during pregnancy. While studies have shown no long-term effects of exposing babies to these drugs, many clinicians admit that could be because there are so few studies on expecting women. The American College of Obstetrics and Gynecology cautions that prescribing these types of medications during pregnancy should always include a careful risk-benefit analysis.

If medications are necessary to ensure your well-being and/or your baby’s, your practitioner and a qualified therapist can work with you to decide which one offers the most benefits for the fewest risks (and how low a dose you can take and still get those benefits). If you’ve been on a medication for panic attacks, anxiety or depression pre-pregnancy, a change or adjustment of dose might be necessary, too.

OTHER ANXIETY TREATMENTS DURING PREGNANCY
While medication is one solution to anxiety disorders, it certainly isn’t the only one. In fact, therapy sessions with a psychologist, psychiatrist or counselor is always the first and best way to help pinpoint what’s causing your anxiety and develop a plan to help you ease your worries or learn relaxation techniques. The following anxiety-alleviating strategies can help, too:

Catch more zzzs. Some research has found that lack of sleep could exacerbate anxiety, so aim for seven to eight hours a night whenever possible. Having trouble snoozing? Try these sleep-busting strategies. If problems persist, talk to your doctor about sleep aids: Many, including Unisom, Tylenol PM, Sominex and Nytol, are generally considered OK for occasional use during pregnancy.
Eat whole, fresh foods. A growing amount of research has shown that what you eat can have a big effect on your mental health. Eating a well-balanced diet — nutrient-dense, whole and unprocessed foods (including fruits, vegetables, fish, nuts, dairy and whole grains) — instead of processed and fast foods helps is thought to support healthy bacteria in the gut, which in turn may help lessen anxiety.
Stay active. Something as quick and easy as a 10-minute walk can decreases levels of tension. Research has found that people who get regular exercise are 25 percent less likely to develop anxiety or depression.
Arm yourself with knowledge.Learning the ins and outs of pregnancy and parenting can go a long way in helping you feel prepared. So read up and consider taking a childbirth class.
Build a support system. Spend time with friends who are expecting as well as with experienced parents and consider joining an online communityto connect with others who are coping with the same feelings as you.
Schedule time in your day to relax.Scientists have found that regular meditation and acupuncture have benefits for people with anxiety. Or try yoga, listen to music or get a massage from a professional or even just your partner.
Lastly, try to learn to remind yourself that you really will know what to do when your bundle of joy arrives. Even if you've never held a baby, instinct is on your side — and what your baby will really need more than anything is simply your love.

Eczema During Pregnancy

Eczema, or dermatitis (aka rash), is a common, chronic skin condition. In mild cases, skin is dry, hot, and itchy; severe cases can cause the skin to become raw and even bleed. The (only) good news: Eczema is not contagious.

WHAT CAUSES ECZEMA DURING PREGNANCY?
The most common variety, atopic eczema, is hereditary and probably triggered by exposure to environmental allergens that are harmless to others (aren’t you the lucky one?). Chances are if you’ve got atopic eczema, you (or someone in your family) probably suffer from asthma, allergies, and/or food allergies as well. Other types of eczema (such as contact dermatitis) are caused by irritants such as chemicals, detergents, yeast, and metals (your rings — if they still fit — might start bugging you).
If you have eczema, it’s likely your raging pregnancy hormones are making the situation better…or worse. No one’s sure exactly why some women experience flare-ups during pregnancy, while other lucky ladies go into remission.

WHAT YOU CAN DO
Talk to your doctor. Certain topical steroids are considered safe during pregnancy but must be used in small quantities under strict medical supervision. Antihistamines may help you cope with itchiness; coal tar has also been used for years for its soothing effect on inflamed skin and comes in numerous preparations, many of which are available over the counter. But check with your practitioner before you use any of these products (and alert your partner: While effective and free of side effects, coal tar smells pretty bad and stains everything it touches).
Stay away from known triggers. Limit contact with potential irritants including wool, pet dander, juices from meats and fruits, plants, and jewelry. And avoid personal-care products that contain alcohol.
Avoid fragranced products. These may aggravate your already sensitive skin and your heightened sense of smell.
Don’t soak. Try to avoid spending too much time in the water (showers, baths, swimming pools), and don’t wash your hands too often (but definitely wash them as needed — pregnancy and germs don’t mix!).
Moisturize early and often. This helps lock in your skin’s own moisture and prevents dryness and cracking.
Stay cool. Try not to get too hot or sweaty —two of the most common eczema triggers. Easier said than done when you’re already one hot mama? That means wearing loose, cotton clothes and avoiding synthetic fabrics, wool, or any material that feels rough to the touch. (Your partner's oversize T-shirt is a great choice for your sensitive skin and your growing belly!) Avoid overheating by favoring that layered look — and peeling off layers as you start to warm up.
Take smart care of your clothing. Use only fragrance-free, neutral pH detergents, and double-rinse your laundry to help prevent flare-ups. Another tip: Wash new clothes before wearing to remove excess dyes and fabric finishers, and cut out any tags or labels that rub against the skin.
Beware of sudden changes in temperature and humidity. A sudden temperature spike can make you sweaty, while a drop in humidity can dry out your skin and lead to a flare-up. In other words, no steam rooms, saunas, or Bikram yoga – all of which are off-limits for expectant moms anyway.
Use a cold compress – and not your fingernails – to curb the itch. Scratching makes the condition worse and can puncture the skin, allowing bacteria to enter and cause an infection (which is especially dangerous during pregnancy). While you’re at it, keep nails short and rounded to decrease the likelihood that when you do inevitably scratch, you won’t puncture the skin. If you tend to scratch in your sleep, try wearing a pair of cotton gloves to bed.
Stay calm. Stress is a common eczema trigger, so try to avoid situations that make you tense. When you feel anxiety creeping in, focus on how incredible your baby will be or how delicious he or she will smell.
One more thing: Research suggests that breastfeeding may prevent eczema from developing in a child, another good reason to nurse your baby if you can.

WHAT SOLUTIONS ARE OFF-LIMITS
Cyclosporine has long been used on severe cases of eczema that don’t respond to other treatment, but current research indicates that it may be associated with an increased rate of premature birth. The bottom line: It’s a no-no now. Some topical and systemic antibiotics may also not be safe for use during pregnancy, so check with your practitioner first.

Protopic and Elidel are a new type of topical prescription medication known as TIMs, or topical immunomodulators, which reduce inflammation. The good news is that since they don’t contain steroids, TIMS don’t cause thinning of the skin (which leads to sores and bleeding). The bad news: They’re still off-limits during pregnancy because they can suppress the immune system. No luck with the oral forms of TIMS either — they cross the placenta and show up in breast milk.

Helping your elderst child ready for a new sibling

With another baby on the way, you’re probably thrilled, excited…and a little (okay, more than a little) nervous. And for good reason — morphing your family of three into a family of four (or more) definitely has its challenges. Sure, you’ve got the baby-care thing down (you can diaper, feed, and soothe in your sleep…and have, many times) and now that you’re no longer a newbie, you’re not worried about “breaking” the baby. But handling two at a time? Fairly dispensing love? Finding time to do it all? That’s a whole different story.

What’s keeping you up at night this time around (besides the need to pee)? You’re definitely wondering how and when to break the news to your toddler or preschooler (and how you’ll answer follow-up questions like, “How did the baby get in your belly?” and “How is the baby going to come out?”), as well as how to prep your eldest child for the first weeks with a new baby sibling. And what’s the best way to introduce the cute, attention-grabbing competition to baby number one — and just how you’ll nip sibling rivalry in the bud. Will twice as many kids mean twice as much work (or half the sleep)? Can you learn the logistics of a double stroller — not to mention two car seats, two hungry tummies that need feeding, and (if your little one’s still really little) two dirty bottoms that need changing? When will you have time to tackle that mammoth mound of laundry? Also, you (like every soon-to-be mother of two before you) are almost certainly questioning whether you’ll ever be able to love your new baby as much as you love your firstborn. (Short answer: Yes.) And how will your new little one fare without the round-the-clock attention you were able to shower on your older little one? (Short answer: Just fine.)
Maybe you’re not even thinking that far in advance. Maybe, for now, you’re just stressing about how you’ll find the strength to care for your older child while you’re expecting and dealing with those pesky symptoms — from the energy-draining, backache-straining ones to the morning sickness that keeps you hugging the toilet (how, exactly, are you supposed to explain that to a two-year old?).

Not to worry. Moms, in case you haven’t gotten the memo, can do anything. It’ll take some time to hit your stride, to fall into the rhythm and routines that make everything (mostly) work — but it won’t take nearly as long as it did in your first round. Before you know it, you’ll turn from a capable, confident mom of one to a skilled and self-assured mother of two, tending to your dynamic (and demanding) new duo with relative ease. Promise.

In the meantime, when guilt or doubt (or the queasies) strike, call on the troops — ask second-time moms you know (or talk to the members in the WTE groups) about how they coped with these very normal feelings (and how they managed pregnancy and being a mom at the same time). No one gets it like a mom, after all.

Dry Skin during Pregnancy

A dry, flaky, and sometimes itchy tissue that now covers your body — especially your face (did somebody say leather?) — has taken over where your skin used to be. If you’re feeling a bit reptilian these days, that’s normal. Here’s why and what you can do to feel a bit more like yourself, fast.

WHAT CAUSES DRY SKIN DURING PREGNANCY
Hormonal changes rob skin of oil and elasticity in some women, which leads to that dreaded dryness.

WHAT YOU CAN DO ABOUT IT
Wash up. Cleaning your face regularly gets rid of dead skin cells that can contribute to a feeling of dryness. Try a “non-soap” cleanser like Cetaphil or Aquanil — which are less likely to irritate and dry out your skin — and avoid deodorant soaps, which contain ingredients that soak up moisture. Use it no more than once a day (at night if you’re removing makeup); otherwise rinse your face with water. Lightly pat your skin dry with a soft towel.
Don’t steam. Although it may seem to make sense, don’t steam your skin — it removes your skin’s natural oils, making it dry and itchy. That also means you should limit showers or baths to ten to 15 minutes in lukewarm (not hot) water.
Add bath oils to your tub. Just be careful with the slippery surface you’ve created. (Remember, you’re a klutz with a giant belly right now.)
Seal it in. Apply moisturizer right after you clean your skin (including after you wash your hands) to seal in the water before it has a chance to escape, especially in cold or windy weather. Reapply frequently throughout the day and again before turning in at night (how about a bedtime moisture massage from your man?). Unscented products are best, since most dry skin is also sensitive skin – especially when you’re expecting. Try petroleum jelly or A&D ointment on problem areas (elbows, knees, heels) to heal very dry skin.
Try arnica oil. Dry skin can also lead to stretch marks during pregnancy (sorry!) — you can't prevent them, but you can help minimize their appearance by moisturizing your belly (and your hips, thighs, and butt) as it expands. Lots of women swear by arnica oil, which you can get in any health food store.
Mask it. Treat skin to a hydrating facial mask once a week to give your skin an extra boost of moisture.
Protect yourself. Wear a sunscreen with an SPF of at least 15 every day to protect your extra-sensitive skin.
Eat well. When it comes to your skin, you definitely are what you eat — so be sure to include good fats in your diet (mono and polyunsaturated), which are found in foods such as olive and canola oils, nuts, and avocados.
Stay hydrated. Drink plenty of water (soda and coffee don’t count) throughout the day to keep skin moist.
Use a humidifier. Turn it on at night to boost the moisture content in your bedroom. (Hidden bonus: The white noise might help you sleep if you’ve been tossing and turning.)
WHAT SOLUTIONS ARE OFF-LIMITS
Stay away from chemical-based treatments (e.g. peels), which can potentially be absorbed through the skin. If you’re not sure if a treatment is safe, ask your practitioner first.

Itchy Belly during Pregnancy

Suddenly feel like you've got an itch you just can’t seem to scratch? If you've got an itchy belly during pregnancy, you’re not alone: Skin irritation is a common problem for many mamas that tends to start around week 23 of pregnancy, when you’re really starting to show, and only seems to get more pronounced as time passes (and your belly continues to grow).
WHAT CAUSES AN ITCHY BELLY
When skin expands (and the skin on your abdomen is expanding big-time) it becomes increasingly moisture-deprived — and dry skin tends to feel itcWHAT YOU NEED TO KNOW
Call your practitioner if you:
Are experiencing an itch on other parts of your body not related to dry or sensitive skin
Are positively itching everywhere
Have an itchy rash on your belly (especially in the third trimester), which could be PUPP — an annoying but very treatable pregnancy symptom
WHAT YOU CAN DO
Don't scratch. Tempting as it may be, grating away at your skin only causes more irritation.
Moisturize. A light, gentle, fragrance-free moisturizer can temporarily curb the itching; apply it frequently and liberally.
Dab on anti-itch cream. The pink calamine lotion your mom put on your chicken pox works in particularly tough cases.
Smooth on vitamin E oil. It’s very healing — great for sore nipples after pregnancy, too.
Soak it up. A gentle oatmeal bath with warm water can work wonders for dry skin — just make sure the water’s not too hot (it can dry out your skin even more).
Use a humidifier in your bedroom. It may help keep your skin from drying out – but proceed with caution, as it can also spread germs and trigger allergies if used improperly. Follow the manufacturer's directions about keeping the machine spic and span, and don't run it round the clock.hy and uncomfortable. (Your butt might have a serious case of the itchies, too, if it's expanding along with your belly.)

Back pain during Pregnancy

If pregnancy is becoming a pain in your back, you’re not alone — backaches are one of the most common symptoms among the expecting set.
And, unfortunately, backache often starts early on in your pregnancy — sometime around week 18 — and persists (or worsens) until you give birth (when it’s replaced by postpartum back pain).

WHAT CAUSES BACKACHE DURING PREGNANCY
As your belly gets bigger throughout your pregnancy, a hormone called relaxin causes the otherwise stable joints in your pelvis to loosen up in order to allow easier passage of your baby during delivery. Add to that the weight of your growing uterus, and your balance gets thrown as your center of gravity shifts forward. In turn, your lower back curves more than usual to accommodate the load – resulting in strained muscles and, you guessed it, soreness, stiffness and pain.
WHAT YOU NEED TO KNOW
If you’re feeling sharp, shooting pain that starts in your back or buttocks and radiates down your legs, you may be experiencing sciatica. The good news about any kind of back pain during pregnancy is that it's as curable as it is common. There are many ways to relieve it – so if one solution doesn’t work, another probably will.
WHAT YOU CAN DO ABOUT PREGNANCY BACK PAIN
Watch your posture when you’re sitting. Lounging around in a chair all day actually puts more strain on your spine than anything else. At home and at work, make sure the chairs you use most provide good support, preferably with a straight back, arms, and a firm cushion. Use a footrest to elevate your feet slightly, and don’t cross your legs. That can cause your pelvis to tilt forward, exacerbating those strained back muscles.
Take breaks. Walk or stand and stretch at least once an hour. Sitting too long can make your back hurt even more. Try not to stand too long, either. If you work on your feet, try to place one foot on a low stool to take some pressure off your lower back.
Avoid lifting heavy loads. If you must, do it slowly. Stabilize yourself by assuming a wide stance; bend at the knees, not at the waist; and lift with your arms and legs, not your back.
Watch your weight. Keep your weight gain where it should be (extra weight is extra hard on any back).
Wear the right shoes. Extremely high heels are out — as are completely flat ones. Experts recommend a 2-inch heel to keep your body in proper alignment. You might also consider orthotics, special shoe inserts designed for muscle support.
Get a firm mattress. If yours isn’t, place a board underneath for the duration of your pregnancy. A body pillow (at least 5 feet long) can also help you find stress-minimizing sleeping positions.
Consider a crisscross support sling. Designed specifically for a pregnant figure, it will help take the burden of your belly’s weight off your lower back.
No reaching for the stars. Or the cookies on the top shelf, for that matter. Use a low, stable, step stool to get items from high places and you’ll avoid additional strain. (Better still, leave the cookies where they are.)
Think happy thoughts. A calm mind leads to a looser back. You can also try some prenatal yoga, which will relax both your mind and your back.
Strengthen your stomach. Do pelvic tilts to strengthen your abs, which in turn support your back. Or sit on an exercise ball and rock bath and forth.
Go hot and cold. Soothe sore muscles by applying cold compresses, then warm compresses in 15-minute intervals.
Take a warm bath. Or turn the showerhead to pulsating for a free back massage.
Get a massage. Talking about massages, go get one (after the first trimester and with a masseuse who knows you’re pregnant and is trained in the art of prenatal massage).
Talk to your doctor. If your back pain is significant, ask your practitioner about physical therapists, alternative medicine specialists (such as acupuncturists), or chiropractors who might be able to help.

Bladder control during Pregnancy

WHAT CAUSES POOR BLADDER CONTROL DURING PREGNANCY?
Your need to pee has probably turned into urinary incontinence, or the leaking of urine that is very common during pregnancy (especially when you sneeze, cough, laugh, or strain).

WHAT YOU NEED TO KNOW ABOUT YOUR BLADDER DURING PREGNANCY:
You can't be happy with your bladder — involuntary peeing during pregnancy can be annoying, messy, and occasionally embarrassing, but it's normal and (mostly) temporary. Always make sure that you are, in fact, leaking urine. A quick smell test should confirm it; urine smells of ammonia. If the liquid is clear and odorless, there's a slim chance you might be leaking amniotic fluid. Call your practitioner immediately. If you're sure it's urine, mention your urinary incontinence issues to your practitioner at your next visit and see what he or she recommends.
WHAT TO DO ABOUT PROBLEMS PEEING DURING PREGNANCY:
Do your Kegels! Try to work up to three sets of 30 Kegel exercises a day.
Keep your weight gain moderate, since extra pounds put extra pressure on your bladder during pregnancy.
Train your bladder to behave. Urinate every 30 minutes — before you have the urge, in other words — and then try to extend the time between pees each day.
Try to avoid constipation during pregnancy, so that your full bowels don't put added pressure on your bladder.
Keep drinking at least eight glasses of fluids every day. (Cutting back on water to control the peeing only makes you vulnerable to dehydration and urinary tract infections.)
Avoid coffee, citrus, tomatoes, soft drinks, and alcohol — all of which can irritate your bladder and make it harder to control those leaks.
Pads can help absorb leaking urine (no tampons, please — they don't block the flow of urine and they're off-limits during pregnancy anyway).
As a last line of defense, do Kegels or cross your legs when you feel the need to cough or sneeze, or when you're about to laugh or lift something heavy.

Pregnant Keishaa Knight Pulliam says she doesn't want a natural birth

Former child-actress, Keshia Knight-Pulliam says she doesn't was a natural birth. The 37 year old said this candidly on the last episode of her weekly podcast called 'Kandidly Keshia' . She said;

“I am very clear: I want all the drugs. I have good insurance. I want every drug you could give me. I want to be smiling. I do not want to feel a human come through my vagina. I have no judgment for women who want to do (a natural birth) — more power to you — but I’m clear on who I am and that isn’t who I am. I am a punk for pain.”Keshia is expecting her first child with estranged husband Ed Hartwell, who filed for divorce and demanded a paternity test the same week Keshia announced she was pregnant

10 Reasons Baby’s Not Sleeping (and How to Cope)

Sleep: No one in your home is likely getting much of it, especially during the first few months. And even once your baby is sleeping through the night, she can develop sleep problems. That’s why knowing the most common reasons babies don’t sleep can help. If you can recognize the issue and have tools to cope, you can defuse potentially tough situations more easily so that, with any luck, everyone gets a better night’s rest. Read on for a few of the most common reasons your baby might not be sleeping at each stage during the first year and then get solutions to help your restless little one rest.

SLEEP PROBLEMS: 0 TO 1 MONTHS OLD
At the newborn stage, babies are still adjusting to a regular sleeping pattern. Newborns generally sleep about 16 hours a day, waking up frequently for feedings both day and night. A 1-month-old should get about 14 to 18 hours of sleep a day in more regular patterns (eight to nine hours at night and another seven to nine hours over the course of several naps). There is still a lot for her (and maybe you!) to learn about how to get enough rest. Here are a couple of challenges you can take steps to solve: 
Resisting Sleeping on Her Back
What it looks like: Your baby fusses or won’t settle when laid on her back to sleep. Babies actually feel more secure sleeping on their tummies, but it’s linked to a much higher incidence of sudden infant death syndrome (SIDS). So experts recommend always laying your baby on her back to sleep.   

How to solve it: If your baby just won’t settle down on her back, talk to your pediatrician, who may want to check for any possible physical explanations. But much more likely, your baby just doesn’t feel as secure on her back. If that’s the case, there are a few tricks you can try to encourage back-sleeping, including swaddling your baby and rocking her to sleep. Just skip the sleep positioner, and stick with a consistent routine.Eventually, your baby will get used to sleeping on her back.

Mixing Up Day and Night
What it looks like: Your baby sleeps all day, but then stays up all night long (not such a party for you!). When your baby was in your womb, your activity during the day rocked her to sleep, leaving her awake all night as you were trying to rest. 

How to solve it: Your baby’s nocturnal ways will correct themselves as she adjusts to life on the outside, but there area few things you can do to help speed along the process of helping baby to separate day and night, including limiting daytime naps and making clear distinctions between day and night (like keeping baby’s room dark when she naps and avoiding turning on the TV during nighttime feedings).



SLEEP PROBLEMS: 2 TO 3 MONTHS OLD
Your baby should sleep and wake in normal patterns now, with a few naps during the day and then a longer period of sleep at night, interrupted by the occasional feeding. A 2-month-old should get a total of 14 to 16 hours a day (eight to 10 at night and four to eight over a few naps), while a 3-month-old should get about nine to 10 hours at night and a few naps a day of one and a half to two hours each.
Sleep Regression
What it looks like: At 3 months old, your formerly sleepy baby may be ready for anything but bedtime — even though you're ready to drop. Welcome to sleep regression — a perfectly normal blip on the sleep radar that many babies experience at this time, then often again at 8 to 10 and 12 months (though it can happen at any time). Why? With all this fascinating new stuff to play with and see and people to encounter, it seems life is just too much fun these days to waste time sleeping.

How to solve it: Stick with (or start) your baby bedtime routine — the bath, the story and the cuddles. Also be sure your baby is getting enough sleep during the day to make up for lost sleep at night (it’s even harder for an overtired baby to settle down at night). Keep in mind, too, that sleep regression is temporary. Once your baby acclimates to her new developmental abilities, sleeping patterns should return to baseline.

Frequent Late Night Feedings
What it looks like: Most 2- to 3-month-old babies, particularly breastfed ones, still need to fill their tummies once or twice during the night. Three or four middle-of-the-night chow-downs, on the other hand, are typically too much of a good thing by this point — and for most babies, not necessary. 

What to do about it: You can work ongradually reducing the number of late-night feedings your baby gets by increasing the size of bedtime feedings, making sure baby's getting enough to eat all day long, and slowly stretching the time between night-time feedings.

Teething Pain
What it looks like: If your baby is showing signs of teething during the day — such as drooling, biting, feeding fussiness and irritability — teething pain may also be waking her up at night. Keep in mind that teething-related sleep issues can begin almost any time during the first year: Some babies grow their first tooth as early as 2 to 3 months, while others are toothless until their first birthday.

How to solve it: While you shouldn’t ignore your baby, try to avoid picking her up. Instead, offer a teething ring, some gentle words and pats, or maybe a lullaby. She might settle down on her own (though you might have to leave the room for that to happen). If tender gums seem to pain her night after night, ask your pediatrician about offering some baby acetaminophen at bedtime.

SLEEP PROBLEMS: 4 TO 5 MONTHS OLD
By 4 months, your baby should be sleeping about 15 hours a day, broken up into two or three daytime naps totaling three to four hours, and then another 10 to 11 hours at night. As your baby gets closer to 6 months old, she should be sleeping nine to 11 hours at night with two longer naps during the day, usually one in the morning and one in the afternoon.

Changing Naps and Sleep Patterns
What it looks like: As babies get older, they nap less. If your baby seems happy with her changing schedule and sleeps well at night, embrace this milestone and carry on. But if your little one is napping less but fussing more, or having trouble going to bed at night, she may be overtired and in need of some nap-time encouragement.

How to solve it: Try an abbreviated bedtime routine before each nap (some quiet music, a massage, or some storytelling) and be patient — it may simply take her longer to settle into a routine, but she’ll get there.

SLEEP PROBLEMS: 6 MONTHS AND UP
Not Falling Asleep on Her Own
What it looks like: Almost everyone, adults and babies alike, wakes up a couple times during the night. A lifetime of good sleep habits depends on learning how to fall back asleep alone — and that’s a skill babies need to learn. If your little one is still waking you up for midnight feedings and snuggles at 6 months old, you may want to consider sleep training.

How to solve it: If you’re open to sleep training (not everyone is, and that’s okay, too), be prepared that it’s going to be as hard — if not harder — on you than it is on your baby. How you tackle sleep training, also called cry it out or CIO, is up to you.

The basic idea: At the end of your bedtime routine, say goodnight and mean it — even when you hear protests and tears as you exit the room. It’s okay to go back and assure your little one that everything’s okay, but have a plan in place as to how often you’ll walk back into her room (and how long you’ll stay there). Don’t have a plan yet? There are many sleep training strategies, so decide what you think might work best for you and give it a fair shot.

Frequent Late Night Feedings
What it looks like: By the time your baby is 6 months old, she doesn’t need mid-night feedings anymore. So if she’s not sleeping without nursing and rocking first, or she still gets up multiple times throughout the night and won’t go back to sleep without the same send-off, she’s wise to the fact that crying often results in being picked up, rocked and fed — pretty good motivation to keep right on wailing. Many babies have to learn how to soothe themselves back to sleep.

What to do about it: If you’re comfortable trying sleep training, it can be a good option for babies who wake up frequently to feed throughout the night.

Waking Early
What it looks like: Your baby is waking up— and staying awake— at the crack of dawn.

What to do about it: If your baby is at least 6 months old, there are a few tactics you can try to get her to sleep in later, like adjusting her nap schedule, experimenting with different bedtimes and making her room more light- and sound-proof.

SLEEP PROBLEMS AT ANY AGE
Disruptions in Sleep Routines
What it looks like: It doesn't take much to turn a baby's sleep routine on its head. A cold or an ear infection can wreak havoc on sleeping patterns, as can emotional challenges such as Mom returning to work or getting used to a new babysitter. Traveling is another surefire sleep-schedule killer, and major milestones — like mastering crawling or learning to walk — can also temporarily interfere with sleep.

How to solve it: Although babies with changing sleeping routines can be a little fussier, during these times, you've got to cut your baby some slack in the snoozing department (and ease up on enforcing routines). Do what you can to comfort your little one through these little disruptions to her schedule. Then try to get back into your regular groove as soon as you can — following the same comforting pre-bed routine in the same order as usual (a bath, then feeding, then a story and so on).

Breakfast during Pregnancy

Sure, you’ve heard it before: Breakfast is the most important meal of the day (though that probably hasn’t stopped you from dashing out the door with just a stomach full of coffee). But now that you’re eating for another, this meal is even more essential — and may be in need of a makeover. It’s your first opportunity to pack in the nutrients you need to keep going through the day and get your growing baby off to a great start. Make it a good morning with these yummy recipes, some of which you can make ahead of time so you can sneak in some extra z’s (a must when you’re dealing with pregnancy fatigue).

Some more things to keep in mind about pregnancy and breakfast:

If you’re a latte lover, you’ll have to cut back on those morning cups of joe (too much caffeine during pregnancy is a no go). Aim to drink no more than two cups of coffee a day — or a total of 200 mg of caffeine — and instead rely on your breakfast foods to give you an energy boost. Combine low-fat protein (like lean meats, beans, or eggs) with a complex carb (like whole grains and fresh fruits) to get an extra kick.
Speaking of eggs, be sure to avoid the runny variety (like sunny side up or poached), since they pose a salmonella-poisoning risk. Mixing up a batch of pancakes instead? Resist the urge to lick the batter off the spoon if it contains raw eggs.
A glass of OJ is still a great way to start your day, but you should be sure that it’s pasteurized (aka has been refrigerated continuously). The same goes for dairy products, whether it’s your morning glass of milk or a dash of cheddar in your breakfast burrito.
In fact, it’s probably best to avoid all soft cheeses for the next nine months — it’s usually made with unpasteurized milk, which can contain listeria. So yes, that spinach and feta omelet is off the menu for now.
One other major morning meal snag — morning sickness. If you can’t stomach breakfast during pregnancy, try eating small portions throughout the day to keep your tummy just full enough to quell queasiness. Always opt for bland complex carbs that will sit well in your stomach, like dried apricots, whole-grain crackers, and dry whole-wheat toast. Just eat whatever healthy foods you can get down (even if that means a grilled cheese sandwich for breakfast). And most important of all: Stay hydrated!

Forceps during delivery

Forceps — a device that resembles a long pair of metal spoons or salad tongs — are used to help the baby make his or her descent down the birth canal to be born if he or she's having trouble.

WHEN FORCEPS ARE USED

Forceps are used much less often these days than vacuum extraction, but your doctor may decide to use forceps:

• To help your baby out if your uterus is not contracting well enough to push the baby down
• If your baby needs to be delivered in a hurry because of fetal distress
• If your baby is in an unfavorable position during the pushing stage (the forceps can be used to rotate the baby's head so he or she can be born more easily)
• If your baby gets stuck in the birth canal
• To protect the baby's head if he or she is premature or in a breech position
• When a mother can't push well or at all (as from exhaustion or if the mother has a heart condition or very high blood pressure and pushing would be detrimental to her health)

HOW FORCEPS ARE USED

Forceps are inserted one at a time, locked into position around the baby's head, and then used gently to pull the baby out of the birth canal. There may be some bruising or swelling on the baby's scalp from the forceps, but it will usually go away within a few days after birth. In fact, studies show that when forceps are used correctly by an experienced practitioner, the risks to the baby and to the mother are low.

Before the forceps are applied to the baby's head, you'll be numbed with a local anesthetic (unless you already have an epidural in place). You'll also likely receive an episiotomy to enlarge the vaginal opening to allow for the placement of the forceps. If your practitioner attempts delivery with forceps, but the attempt is unsuccessful, you'll likely undergo a C-section.

This Is the Number One Smell Pregnant Women Can't Stand

Pregnancy can feel like a cruel joke when you just can't stand one more uncomfortable symptom. And now, according to a new survey, you've got reason to worry baby's gonna come for your little daily pleasures, too!
I kid. Well, mostly. That's because Emma’s Diary, a UK pregnancy website, canvassed expecting women about the smells they can’t stand, and number one on the list is actually delicious. 

It's garlic! Which sort of makes sense, given it is a pretty strong odor. But garlic bread, garlic fries, aioli...I digress.

Although, when you think of garlic frying in olive oil in the context of the other odors rounding out the top 10 list, they do make a pretty strong point:

• Cigarette smoke (ok, that makes sense)
• Perfume and air freshener (understandable, even if you’re not pregnant…)
• Fish (ditto)
• Chicken (classic: we’re supposed to get more protein than ever now…but apparently we can’t stand eating two main sources of it)
• Tea and coffee (well, that sucks since we’re also knocked off our feet with fatigue)
• Fried food (wait, who did these people interview?)
• Bacon (seriously, WHO DID THESE PEOPLE INTERVIEW??)

This survey confirms what pregnant women everywhere already know: HIDE.

When you’re expecting, pregnancy hormones make it so your sense of smell and taste are funky. And that means any strong odors simply ratchet up your nausea and vomiting instinct. Which makes visiting many public places gag-inducing. It’s plain cruel!

I guess during pregnancy we've just gotta pick restaurants carefully and use the thought of that sweet newborn to get us through the day...

Oh, and those first bites of garlic and bacon, of course.

7 Labor Fears vs. Realities

What type of labor story is a better tell? One embellished with horror ("My water broke in the middle of the supermarket." "The hospital sent me back home three times because I wasn't really in labor yet, and then I practically gave birth on the freeway." "I was in back labor for 53 hours") — or one that's peaceful, calm and hitch-free? Though there are probably at least as many positive birth experiences as there are challenging ones, the truth is that an easy and uneventful labor and delivery makes for a much less compelling anecdote. Which means that the good birth stories don't get circulated as much as the bad ones do. Keep that in mind as you consider the following: Generations of women before you have labored, delivered and lived to tell (and embellish) about it. Soon you will too! 

Nevertheless, the best way to nip the fear of childbirth in the bud is to become as educated as you can. So read on to learn more about new moms’ most common labor fears — and the realities to hopefully help ease your worries:

WHAT IF I DON’T MAKE IT TO THE HOSPITAL ON TIME?

While you’ll always see viral videos of dramatic back-of-the-car or side-of-the-road emergency births, they are the exception, for sure. The average labor for first-time mamas lasts around 20 hours — and about eight hours for second-timers. So unless you live a few states away from your hospital, there’s a pretty good chance you’ll arrive in plenty of time. Instead of biting your fingernails about the impending commute, remember this: Call your midwife or OB as soon as you experience the signs of labor she indicates — usually when you experience contractions that don’t go away when you lie down or change positions (they’ll continue regularly every five minutes) for two hours, or if your water breaks. She’ll give you the lowdown on if and when you should head to the hospital. If you follow that rule, the odds are overwhelmingly in your favor of arriving at the hospital in time.

ACK! I DON’T WANT TO POOP WHILE PUSHING!

Here’s the thing: You, dear mama, are the only one in the delivery room with this worry. Most seasoned labor and delivery nurses are able to quickly get rid of any poop-by-way-of-pushing evidence before you know it even happened. It’s their job. They’re used it.  And, well, to be honest poop happens the majority of the time. The reason: When baby’s head is ready to exit, you have to rely on many muscles to get him out — including the muscles in your rectum. Since stool tends to be in the rectum at any given time of day, some will likely come out when you’re pushing. 

THE BIG, FAT EPIDURAL NEEDLE SCARES ME  

Truth is, you’ll already be numb by the time the epidural needle (which is about 4 inches long) comes near you. That’s because first the anesthesiologist numbs the area where the epidural needle will go with lidocaine, a local anesthetic. You’ll feel a burning sensation when the lidocaine is injected, but soon it fades and in goes the epidural needle. Once it’s inserted, you’ll feel a little pressure, but that’s it. Compared to contractions, this is a piece of cake! 

I DON’T WANT AN EPISIOTOMY

An episiotomy is a procedure where the tissue between the vagina and the anus (called the perineum) is cut in order allow more room for baby. While it used to be common practice, these days most obstetricians allow the vaginal tissue to tear naturally, on its own. Even the American College of Obstetricians and Gynecologists recommends against routine episiotomies, and midwives rarely use the procedure at all. 

I DON’T WANT MY VAGINA TO TEAR

Wait. Did you just read “tear on its own” and add another fear to your list? Try not to worry. While as many as half of all women will have at least one small vaginal tear after childbirth, the most common type is a first-degree laceration — which generally only involves the lining of the vagina, doesn't bleed and may not even require any repair. Being a first-timer andgaining excessive weight during pregnancy ups your chances of tears — though women who’ve already pushed out a baby or two tend not to tear (the vagina, it seems, has a good memory when it comes to stretching). If you’re still worried, try a bit of perineal massage in the couple of weeks leading up to your due date to gently stretch your perineum (the area between your vagina and rectum) and minimize your chances of vaginal tears or an episiotomy during childbirth.

THE PAIN WILL BE TOO MUCH!

We’re not going to lie to you: Childbirth is not pain-free. However, fearing the pain will intensify any pain you feel. It can cause your heart to beat faster, it can make you breathe faster, you become anxious, your blood pressure goes up, and your muscles become tense. All of these reactions can up the pain factor. The best way to nip your labor pain-fears in bud is to become as educated about the birthing process as you can. Continue reading about it, go to a childbirth education class, watch a video or two and ask moms who’ve been there. Always keep in mind two things. First: This is pain with a positive purpose — that is, to thin and open your cervix and bring your baby into the world. And this pain ends. Second: The pain of childbirth is a pain you don't have to endure if you choose not to. Pain medication (like an epidural) is just a request away should you want it. 

I’M TERRIFIED I’LL WIND UP HAVING A C-SECTION

Any surgery can be a scary, so it’s understandable to be nervous about the possibility.  But you need to put the possibility in perspective: While it may seem like everyone and her sister is having a cesarean, the numbers are actually on the decline. After a 12-year stretch whenC-sections rose steadily, the cesarean rate in the U.S. has finally leveled off to about one third of all births. There are, of course, some women — like those withpreeclampsia — who are at a higher risk for having a cesarean. Talk to your doctor about when and whys she’s performed them in the past and express your concerns. For instance, does your physician know how to deliver a breech baby, or is a cesarean a must in that case? How does your doctor feel about delivering large babies vaginally? If you’ve had a C-section in the past, does your physician support a vaginal delivery after C-section, or VBAC, this go round? Finally, research has shown that women who have continuous labor support with someone like a doula present are 26 percent less likely to have a cesarean. In fact no matter what kind of labor you end up experiencing, you'll be much more comfortable with company — whether that’s a doula, your partner, your mother or a friend. A little support can go a long way in easing your fears.

10 Signs that labor is near

It’s the event you've been happily anticipating (and fearfully dreading) for months: Your baby’s birth! Many an expectant mama has wondered — and worried — about signs of labor. When will it happen? How will it feel? How long will it take? And, commonly: How will I knowit’s time? It’s hard to predict the answers to those first three questions, since every birth is different. But for number four, we can help. There are some clear labor signs to watch for. Pay attention and they’ll tell you: Baby’s on the way!

PRE-LABOR: ONE TO FOUR WEEKS BEFORE LABOR

1. Your baby “drops” 

A few weeks before labor begins, your baby will start to descend into your pelvis (for first-time moms; in future births, this “lightening” doesn't usually happen until you’re truly in labor). Your baby is getting into position to make his exit: head down and low. Yes, you might feel you’re waddling even more than you have been up until this point — and you may be back to taking very frequent bathroom breaks like you did way back in your first trimester, because baby’s head is pushing down on your bladder too. But the good news is you have a little more breathing room, since baby is moving away from your lungs.

2. Your cervix dilates

Your cervix, too, is starting to prepare for birth: It starts to dilate (open) and to efface (thin out) in the days or weeks before you deliver. At your weekly check-ups, your provider may measure and track dilation and effacement via an internal exam. But everyone progresses differently, so don’t be discouraged if you’re dilating slowly (or not at all yet).

3. You feel more cramps and increased back pain

Especially if this is not your first pregnancy, you may feel some crampiness and pain in your groin and lower back as labor nears. Your muscles and joints are stretching and shifting in preparation for birth.

4. Your joints feel looser

Throughout your pregnancy, the hormone relaxin has made all of your ligaments soften and loosen (it’s also responsible for your bouts of clumsiness this past trimester). Before you go into labor, you may notice your joints all over your body feel a bit looser. Relax — it’s just nature’s way of opening up your pelvis for your little passenger to make his or her way into the world.

5. You have diarrhea

Just as the muscles in your uterus are relaxing in preparation for birth, so are other muscles in your body — including those in our rectum. That can lead to loose bowel movements. Though annoying, this is normal; stay hydrated and remember it’s a good sign!

6. You stop gaining weight (or lose pounds)

Weight gain tends to level off at the very end of pregnancy. Some moms-to-be even lose a couple of pounds! This is normal and won’t affect your baby’s birthweight. He’s still gaining, but you’re losing due to lower levels of amniotic fluid, more potty breaks (see #1 and #8 on this list), and even increased activity (see #7).

7. You feel extra-tired...or you have an urge to nest

Wait a minute, is this the third trimester or the first? Between the active bladder and the exhaustion, sometimes you can feel like you’ve traveled backwards in time. That super-size belly, along with the smooshed bladder, can make it hard (even impossible) to get a good night’s sleepduring the last days and weeks of pregnancy. Pile on those pillows and take naps during the day if you possibly can! That is, unless you’re feeling the opposite of fatigued: Some moms get a burst of energy as birth-day nears, and can’t resist the compelling urge to clean and organize everything in sight. That’s okay, as long as you don’t overdo it!

EARLY LABOR: THE HOURS BEFORE LABOR STARTS

8. Your vaginal discharge changes color and consistency

In the last days before labor you’ll notice an increased and/or thickened vaginal discharge. You may also notice the loss of your mucous plug — the cork sealing off your uterus from the outside world. It can come out in one large piece (it looks similar to the mucous you have in your nose, but with faint streaks of blood) or lots of little ones (though you may not notice it at all if you’re the flush-and-run type). This thickened, pinkish discharge is also called the bloody show and is a good indication that labor is imminent (though without labor contractions or dilation of three to four centimeters, labor could still be a few days away!).

9. You feel stronger, more frequent contractions

Contractions are an early sign of active labor — except when they aren’t. You can experience Braxton-Hicks contractions for weeks and even months before delivery. You’ll feel their pinch as the muscles in your uterus tighten in preparation for their big moment (pushing that baby out!). How can you tell the difference between real and false labor contractions? Look for these signs of real labor:

• If you’re active, contractions get stronger instead of easing up
• If you change position, contractionsdon’t go away
• The contraction pain starts in your lower back and moves to your lower abdomen, and possibly your legs
• Contractions progress: They get more frequent and more painful, and sometimes fall into a regular pattern

10. Your water breaks

While movies would have you think you’ll learn you’re in labor only when your water breaks (of course in the middle of a romantic dinner date at a busy restaurant), that’s a very unlikely scenario. It’s actually one of the final signs of labor most women notice — and it happens in less than 15% of births. So don’t count on it as your only labor sign!

Still feel like you won’t know when to announce “It’s time!” and get ready to meet your baby? Try not to stress about it. You’ll be seeing your doctor or midwife frequently now, and she’ll help you spot all the important signs.

SHOULD I CALL THE DOCTOR?

Toward the end of your pregnancy, your practitioner will advise you on what to do when your contractions become regular: “Call me when they’re coming about five minutes apart for at least an hour,” for example. Contractions won’t all be exactly spaced, but if they are becoming pretty consistent, it’s time to check in with your doc. If you think you might be in labor but aren't sure, get on the phone; your provider can advise you on what’s going on. Don’t feel embarrassed or worry about calling outside of office hours (your doctor or midwife knew this would happen when she got into the baby-catching business!).

You should always call if:

• You experience any bleeding or bright-red discharge (not brown or pinkish).
• Your water breaks — especially if the fluid looks green or brown; this could be a sign that meconium is present (which is your newborn’s first stool; it can be dangerous if your baby inhales or ingests it during birth).
• You experience vision changes, a headache, or sudden or severe swelling. These can be symptoms ofpreeclampsia, or pregnancy-induced hypertension.

Episiotomy

Some call it the unkindest cut of all — but at least these days it's no longer called a routine one. In fact, midwives and most doctors rarely preform the procedure without good reason. That's likely in large part because the American College of Obstetricians and Gynecologists now recommends that episiotomies — a surgical cut in your perineum (the muscular area between your vagina and your anus) right before delivery to enlarge your baby's exit — not be performed routinely. And the rate has dropped from about 25 percent of all vaginal births in 2004 to just 11.6 percent in 2012.

Historically, episiotomies were performed to prevent spontaneous tearing of the perineum and to reduce the risk of fetal birth trauma (such as when the baby's head would push against the perineum for a long time). But these days studies have shown that there infants fare just fine without an episiotomy — and mothers, too, seem to labor better without it. As opposed to women who have an episiotomy, laboring women who tear spontaneously during delivery:

• Recover in the same (or less) time and with less pain
• Often experience fewer complications including fecal and urinary incontinence, infection and blood loss
• Are less likely to have tears turn into serious third- or fourth-degree tears (those that go close to or through the rectum, sometimes causing fecal incontinence)

• WHEN EPISIOTOMY IS NECESSARY

  While routine episiotomies are no longer recommended, there is still a place for them in certain birth scenarios. You you might need an episiotomy either for your wellbeing or that of your baby:
  • When your baby is very large and needs a roomier exit route
  • When forceps or possibly vacuum extraction needs to be used
  • When your baby's shoulder gets stuck in the birth canal during delivery (shoulder dystocia)
  • When your fetal monitoring of your baby's heart rate during the last minutes of labor shows he or she's in fetal distress and needs to be born right away

  WHAT HAPPENS DURING AN EPISIOTOMY

  If you do need an episiotomy, you'll get an injection of local pain relief before the cut (though you may not need a local if you're already anesthetized from an epidural or if your perineum is thinned out and already numb from the pressure of your baby's head). Your practitioner will then take surgical scissors and make either a median (also called midline) incision (a cut made directly back toward the rectum) or more commonly in this country, a mediolateral incision (which slants away from the rectum). After delivery of your baby and the placenta, the practitioner will stitch up the cut (you'll get a shot of local pain medication if you didn't receive one before or if your epidural has worn off).

  RECOVERY AFTER AN EPISIOTOMY

  Everyone who delivers vaginally can experience some perinal pain after birth, which, unfortunately, is likely to be compounded if the perineum was surgically cut. Like any freshly-repaired wound, the site of an episiotomy will take time to heal, usually seven to 10 days.
  While you're in the hospital, a nurse will check your perenium at least once daily to be certain there's no inflammation or other indication of infection. She'll also instruct you in a postpartum perineal hygiene, which helps prevent infection of not only the repair site but the genital tract as well (germs can get around). For this reason, the same precautions apply for those who delivered completely intact. Your doctor will also tell you when it's safe to resume sex again, usually after your stitches heal.
  Be sure to keep up Kegel exercises as frequently as possible after delivery and through the postpartum period to stimulate circulation to the area, promote healing and improve muscle tone. Don't worry if you can't feel yourself doing them; the area will be numb right after delivery. Feeling will return to the perenium gradually over the next few weeks — and in the meantime, the work's being done even if you can't feel it.

  HOW TO REDUCE YOUR RISK OF AN EPISIOTOMY

  To reduce the possibility that you'll need an episiotomy and to ease delivery without one:
  • Talk to your practitioner early on about your desires not to have an episiotomy; it's very likely she will agree that the procedure should not be performed unless there's a good reason
  • Note it in your birth plan
  • Do Kegel exercises throughout your pregnancy
  • Do perineal massage for six to eight weeks before your due date
  • Place (or having your doula, support person, or nurse place) a warm compress on your perineum during labor to soften the skin in the area, enabling it to better stretch
  • Stand or squat while pushing the baby out
  • Push for only five to seven seconds at a time and bearing down gently (instead of pushing hard for 10 seconds while holding your breath)
  • Ask your practitioner to apply gentle counterpressure to your perineum as the baby's head emerges so that it doesn't push out too quickly and cause an unnecessary tear
  But keep in mind that, very occasionally, episiotomies do turn out to be necessary, and the final decision should be made in the delivery or birthing room when your baby's head is crowning.