Dr Aruna Kalra is an eminent and renowned obstetrician, gynaecologist and robotic as well as laparoscopic surgeon with a vast experience of more than 23 years. She strongly believes in patient-centric care and therefore a strong advocate for minimally invasive and scarless surgeries. She is an expert in Scarless laparoscopic surgeries and is becoming a formidable name in the latest robot-assisted surgical techniques.
Her areas of interest include minimally invasive Gynaecological surgeries, Robotic Surgery, Gynae Oncological surgeries, High-risk pregnancies and vaginal birth after caesarean (VBAC). She has previously offered her expertise in popular institutes including Paras Hospital Artemis Hospital and Apollo Cradle.
10 things all couples must do before becoming pregnant
While some couples prefer to leave pregnancy to chance (“let’s just stop trying not to get pregnant and see what happens”), others find themselves meticulously planning every aspect of their pregnancy.
Whichever of these categories you fall in, there are a few things you must do if you are even thinking of becoming pregnant in the near future. These will not only help increase your chances of conceiving, but also make your pregnancy healthier. They significantly reduce the risk of pregnancy complications and aid in maintaining your baby’s health both before and after birth.
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10 things all couples must do before getting pregnant are:
There is no grey area with regard to smoking. If you are not a smoker, do not start. And if you are a smoker, it is always a good time to stop.
Smoking during pregnancy is a strict no-no. It has been linked to a wide range of pregnancy complications including preterm labour, premature birth, low birth weight amongst others. It also increases the baby’s chances of developing chronic conditions such as obesity later on in life.
It is a lesser known fact that smoking also has extremely adverse effects on both male and female fertility. Couples can significantly increase their chances of becoming pregnant by simply kicking this habit.
Finding a good maternity hospital can be very tough. And this decision is one of the most important ones you will make for your pregnancy.
Do extensive research into their qualifications and experience before making your choice. It is essential that you be comfortable with your doctor. You should be able to call them for any question or concern at any time without hesitation.
Try finding your doctor before your pregnancy itself. Schedule a visit with your doctor as soon you decide to start trying to conceive. They will probably assess your general health; review the medications you are currently on, test for infections and advise you to lose or gain weight as required.
Read: Early signs of pregnancy
Certain vaccines that contain live viruses are not advised for pregnant women. These include rubella and the chicken pox vaccine. However, protecting oneself against these diseases can go a long way in preventing them from causing complications in your pregnancy.
If you have never had measles, mumps, rubella or chickenpox, your doctor might advise you to get these vaccinations before you become pregnant.
During pregnancy, women often report that they can feel the effects of caffeine on their unborn child. Women who consume a lot of caffeinated products might find it tougher transitioning to “decaf” during pregnancy. Common symptoms of caffeine withdrawal include headaches, irritability and constipation. Try reducing your caffeine intake before you conceive to avoid experiencing any of these unpleasant symptoms during your pregnancy.
Unfortunately, raw meat such as sushi and certain cheeses can cause mild to severe infections. Pregnant women are advised to steer clear of unprocessed cheese and any type of raw or undercooked meat. If your favourite dish falls into either category, try weaning yourself off gradually or simply go cold turkey before your pregnancy.
Most of us confuse becoming fit with just losing weight. However, being fit and healthy is more than just losing weight. Start exercising regularly to make your body stronger for the pregnancy. It is also advised to start Kegel exercises to avoid complications such as fallen or prolapsed bladder. Remember to continue exercising throughout your pregnancy unless advised otherwise. If you are concerned about what exercises are or are not safe for your baby, consult your obstetrician.
Folic acid is probably one of the most essential and well-known vitamin supplements associated with pregnancy. Women are advised to start folic acid as early as one month before conception. It is generally consumed for the first three months of pregnancy. Folic acid is known to promote the development of your baby’s brain, skull and spinal cord. It helps prevent neural tube defects such as spina bifida in the baby.
Based on your general health, you should also consider taking iodine, iron, fish oil and vitamin D3 supplements.
For the male partner, the following supplements have been shown to have a positive impact on sperm health.
Do not wait for your baby to come before you go for a dental visit. You will not have the time. During pregnancy, your hormones will go haywire and can sometimes cause unpleasant dental issues. It is a good idea to get your teeth cleaned and healthy before you start your pregnancy.
Read: How to prepare your body for Pregnancy: A complete how-to-guide
High stress levels can severely lower your chances of becoming pregnant. This can invariably result in greater stress. Get out of this vicious cycle and start taking care of your psychological health. Try doing some breathing exercises, yoga, meditation etc. to manage stress. Some couples also find short vacations and getaways extremely effective. Also remember to talk openly to your partner as well as your doctor.
Diet plays a key role in improving one’s fertility. Both partners must be conscious about what they are consuming. You and your partner can increase the chances of conception by following a healthy balanced diet. Be sure to include plenty of whole grains, unsaturated fats and vegetable proteins. Your obstetrician will also guide you with your diet based on your nutritional deficiencies.
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What are the 4 most popular birthing techniques?
Throughout the ages, childbirth has been considered to be one of the most beautiful and life-changing experiences. Many expectant mothers, however, especially first-time mothers dread the infamous labour pains that come along with “the miracle of birth”.
With leaping advances in technology and medical care, women have a number of alternatives to choose from while deciding how to deliver their baby. These birthing techniques adopt different ways to manage labour pain and make childbirth easier for the mother as well as the baby. Here we will explore these birthing alternatives in greater detail, exploring the various pros and cons associated with each.
Benefits of vaginal delivery
Going into labour and opting for a vaginal delivery generally means spending several hours in the labour room, straining to bring your baby into this world. It is a physically gruelling process which involves a lot of hard work and pain.
However, many women opt for vaginal delivery in-spite of the labour pains because of its benefits in the long run. Vaginal delivery usually means significantly shorter hospital stays and recovery times. The mother also avoids life-long scarring that comes with surgical birthing techniques.
Women opting for vaginal deliveries also avoid the risks associated with major surgery such as bleeding, infection, post-op pain and complications due to anaesthesia. As the you would be more aware during vaginal birth (as compared to post surgery), you can start breastfeeding sooner.
Studies also indicate that vaginal birth is beneficial for the baby as it helps in squeezing out fluid from the baby’s lungs as he/she travels through the birth canal. The baby is also exposed to healthy bacteria in the birth canal which in turn boosts his/her immunity.
Risks of vaginal delivery
Even though vaginal delivery is often thought to be the “best” birthing technique, it does involve a number of risks that every expectant mother should be aware of. Today, medical authorities around the world are mandating that every birthing alternative should be discussed with the to-be parents in detail, enabling them to make informed decisions.
Natural vaginal delivery is associated with risks such as tearing, excessive bleeding (haemorrhaging), injury to pelvic floor muscles amongst others. In some cases, the doctor can make a small incision in the perineum (the area between the vagina and anus) to aid the delivery. This procedure is called an episiotomy. Vaginal delivery can also result in injuries to the baby, if the baby is too large or the labour too intensive and long.
Also, read: Normal delivery – tips & preparation
Benefits of caesarean section
Caesarean section is a surgical birthing technique in which the doctor delivers the baby through incisions in the abdomen and uterus. Opting for caesarean delivery often allows the parents to schedule the procedure. In some cases, it can be an emergency procedure or the only suitable birthing technique available. This is especially true for high risk pregnancies, pregnancies with complications such as gestational hypertension, preeclampsia etc.
Caesarean section is the safest option for mothers if there are any concerns about her health or her baby’s. This surgical birthing method reduces the risk of painful labour, vaginal injuries, heavy bleeding, loss of bladder control, pelvic organ prolapse etc. It also offers the doctor better control of the delivery.
Risks of caesarean section
Like all surgical procedures, caesarean section involves the risks of bleeding, infection, blood clots, surgical injury and complications from anaesthesia. Caesarean section is usually not recommended for first time mothers who want to have more children, as this procedure can cause complications in subsequent pregnancies. These complications include placenta previa, preterm birth etc.
The recovery time for patients who underwent caesarean section is also longer. They are usually kept under observation in the hospital for a few days, post which they can continue recovering at home.
Read: Caesarean section delivery – What to expect
Benefits of assisted vaginal delivery
When vaginal delivery is aided by forceps or a vacuum device to pull the baby out, it is called an assisted vaginal delivery. In some cases, such as when the mother becomes too tired to push, forceps or vacuum is used to help her deliver the baby. In case of a forceps assisted delivery, the forceps are inserted into the vagina to gently hold the baby’s head which is then pulled out of the birth canal while the mother is pushing. A vacuum assisted delivery is similar with the exception of a suction cup being used instead of forceps.
Assisted vaginal delivery is usually done if there are any concerns about the baby’s heart rate, if the mother is too tired, the baby is not moving forward in the birth canal and if the mother has any medical condition which limits her ability to push safely.
The main benefit of assisted vaginal delivery is that it helps avoid the need for a caesarean section and the risks involved in the same.
Risks of assisted vaginal delivery
Risks associated with assisted vaginal delivery are very similar to those of normal vaginal delivery. These include injury to the vaginal tissues, perineum and anus. It can also cause injury to the pelvic floor muscles. For the baby, there is an extremely small risk of injury due to improper use of forceps and suction.
Benefits of water birthing
This birthing technique has been around for centuries however, the past few years has seen an exponential rise in the popularity of water birthing. Simply put, it is the process of giving birth inside temperature-controlled water. Some women choose to give birth to their baby while immersed in water, while some women may choose to step out of the birthing pool before giving birth to the baby.
There are numerous benefits of water birthing. Reduction of labour pains is one of the most well-known benefits of water birthing. Many women also say that they felt calmer and more in control while they were immersed in water. They also had a greater sense of privacy. The warm water helps in making the perineum more elastic and relaxed, reducing the risk of injury or tear during birth.
Water birthing is also thought to be less stressful for the baby as he/she enters an environment similar to the womb (amniotic sac).
Risks of water birthing
Like every medical procedure, water birthing has a few risks as well. In case of emergencies such as a baby in distress or increased labour pains, it can become difficult to get the mother out of the birthing pool. Another disadvantage of water birthing is that fetal monitoring is not possible. Water birthing also limits the usage of pain management techniques such as epidurals. Due to such reasons, water birthing is recommended only for healthy non-complicated pregnancies.
There is also a risk of infection if the baby passes stool during delivery. However, these are extremely rare cases.
Today, there are a number of birthing options available to women. Many factors such as personal opinion, maternal and fetal health, pregnancy complications etc have to be considered while deciding which birthing technique to opt for. Remember to have this discussion with your maternity doctor early on in the pregnancy so you can start preparing mentally and physically for childbirth.
Also, read: Water Birth: The Most Natural Form of Normal Birth
Ques 1: Can I have normal delivery after caesarean?
Ans: Yes, these deliveries are termed as VBACs (Vaginal delivery after caesarean section). You can consult an obstetrician who specialises in VBACs to find your suitability for this procedure.
Ques 2: Can my baby be injured during normal vaginal delivery?
Ans: There are a few risks for the baby during normal vaginal delivery. This process is quite painful and long for many women. They can get tired mid labour, causing the baby to get stuck in the birthing canal, the baby can also get hypoxia if he/she gets stuck in their umbilical cord etc. While choosing a maternity hospital, make sure the team is experienced in handling pregnancy emergencies. In such cases, the doctor usually aids the delivery with forceps or vacuum suction cups.
Ques 3: Can caesarean section make it tougher for me to get pregnant again?
Ans: Caesarean sections are known to make future pregnancies difficult, hence it is not recommended for first-time mothers or for women desiring to have more children.
Read: Normal Vaginal Delivery – What Should ‘Mothers-to-Be’ Expect
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Why should you consider physiotherapy during pregnancy?
Ask a pregnant woman how she is feeling and you will hear either absolute happiness or absolute discomfort. During the route of pregnancy, there seems to be no in-between. While pregnancy is a beautiful phase, it comes with its own share of distress, for instance – back pain. Approximately 50-80% of women are affected by lower back pain pregnancy. However, there is a very simple solution to this worry – physiotherapy during pregnancy.
Physiotherapy in pregnancy is an effective practice to reduce painful symptoms such as lower back pain, pelvic pain and involuntary urination.
In this article, Dr Aruna Kalra, a renowned obstetrician & gynaecologist at the CK Birla Hospital explains the various benefits of physiotherapy for pregnant women.
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Physiotherapy, also known as physical therapy, is an evidence-based technique that involves the science of movement to promote healing and holistic fitness. It includes a wide array of exercises and massages.
While any person, irrespective of age and gender, can benefit from this technique, physiotherapy during pregnancy has well-defined advantages.
Our body produces a hormone known as relaxin. While both men and women form relaxin, this hormone is primarily produced in pregnant women. It is responsible for preventing any damage to a woman’s body during childbirth.
The production of relaxin increases significantly during the second trimester. Primarily, this hormone is aimed at the loosening of the birth canal and preparing your body for childbirth. However, besides the birth canal, high levels of relaxin result in the loosening of other ligaments in your body. While on one hand relaxin facilitates the flow of blood, it leads to muscle, joint and body pain, on the other. This side-effect of relaxin is the fundamental cause of your lower back pain pregnancy. The transitory loosening during this period of pregnancy can make your muscles and ligaments weak for a long period of time.
Physiotherapy during pregnancy is a helpful approach in dealing with the pain resulting from an increase in relaxin. This practice can assist in alleviating from muscle pain through the means of specific exercises and massages. The targeted exercises not only help in reducing pain but also maintain the strength of muscles.
As discussed above, antenatal physiotherapy can help in reducing pain and improving the strength of muscles. While a majority of pregnant women complain of the lower back pain, there are other areas that physical therapy can help with.
Some common issues pregnancy physiotherapy can deal with are:
It is important to remember that the source of your pain and discomfort is the increase in levels of relaxin. However, the location of your pain can be unique. The role of physiotherapy in pregnancy is identifying the precise location of the pain and addressing it to minimise ache.
Physiotherapy benefits pregnant women in multiple ways. The role of physiotherapy in pregnancy has both, long and short-term advantages. Some of the top benefits include:
As your pregnancy progress across three trimesters, physiotherapy and exercise during pregnancy also vary.
1. First trimester: The first trimester is the time when you are just getting used to pregnancy and the various changes it brings. Your physical activity, diet and physiotherapy will aim at assisting you in getting used to these changes. Your physiotherapist will begin by educating you and your partner about maternal and fetal changes and what to expect.
Physiotherapy in the first three months focuses on your posture, challenges at home and work and pre-existing musculoskeletal problems (if any).
Your physiotherapist will slowly assist you in correcting your postural at workplace and home. He/she will offer you techniques for safe lifting and mobility and treat any musculoskeletal problems you had been suffering from.
2. Second trimester: By the second trimester, you are well into pregnancy and accommodating the tremendous changes in your hormones and your body. Physiotherapy in the second trimester of pregnancy helps you in keeping up with these shifts.
Your physiotherapist will start exercises after completion of the anomaly scan and with clearance from your primary consultant.
Physiotherapy in the second trimester focuses on stretching techniques to improve the flexibility of the lower limbs and pelvis. You will be instructed to do mobility and strengthening exercises for the spine and the abdomen. The goal of this exercise during pregnancy is to enhance fitness and emphasise on pain management.
3. Third trimester: By the last three months of your pregnancy, your physiotherapist will focus on promoting strength and flexibility. You will be assisted towards labour coping strategies such as relaxation techniques, breathing exercises, positioning to facilitate labour and techniques to use in the pushing stage.
Physiotherapy in the third trimester of pregnancy involves advanced strengthening for the spine and abdomen, pelvic floor exercises, techniques to improve the flexibility of the lower limbs and pelvis and pain management.
Your choices during pregnancy will help in deciding the health of your fetus. Physiotherapy during pregnancy is a preferable choice for expectant women who wish to inculcate exercise and relaxation in their life.
Make sure to visit a verified and qualified physiotherapist and follow their correct instructions to avoid any complications.
For personalised guidance on antenatal care, book an appointment with Dr Aruna Kalra, the best obstetrician in Gurgaon at the CK Birla Hospital.
Is physiotherapy safe during pregnancy?
Yes, physiotherapy is a completely safe and effective method of pain management, exercises and relaxation during pregnancy.
How can physiotherapy help in pregnancy?
Physiotherapy during pregnancy has a large number of benefits. It helps an expectant mother to engage in physical activity, relaxes sore muscles, strengthens muscles, improves flexibility and offers pain management.
Is exercise recommended during pregnancy?
Yes, nearly 30-40 minutes of regular exercise is recommended for pregnant women to have a smooth and safe pregnancy, labour and childbirth.
Who should not exercise during pregnancy?
A pregnant woman who is suffering from severe anaemia, chronic heart or lung conditions, placenta previa or other complications should avoid doing exercise.
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