There are lots of things to remember and since getting your questions answered is the whole point of taking a maternity ward tour, planning them out beforehand is definitely a good idea. Here are a few to get you started. Perhaps print the list and take it with you on your visit!

• When we arrive, do we need to check in at the front desk, or can I go straight to the Labour and delivery?
• Do we need to call the hospital before we arrive so they can get our files ready and alert the doctor?
• Do we check into the ER or go straight to Labour and Delivery after hours?
• What are the policies on cameras and video cameras?
• Are cell phones allowed?
• Will baby be able to room with me the whole time?
• Can the father stay the night?
• What are my chances for getting a private room? Will my insurance cover it? Can this be pre booked?
• What security measures are in place for the maternity ward? Are there security armbands?
• What are the visiting hours, and what are the special Granny visiting hours?
• What sort of breastfeeding support is offered? How does it work?
• Is there an available lactation specialist in the hospital if needed?
• Where and when are my other children allowed to be with me?
• Is there any extra paperwork involved to get my partner’s name on the birth certificate? (If you aren’t married)
• Can I pre-register a couple of weeks before delivery?
• How many people are allowed in the delivery room?
• Can the expectant father or birth partner accompany the baby at all times while it’s being bathed, etc.?
• If you’re at a teaching hospital, what procedures are done by the attending vs. the residents?
• What is the hospital’s policy for having food or drinks during labor?
• What is the checkout procedure?

This is a great opportunity to go and ask all your questions and put your mind at ease. Be sure to check with your hospital to see when they offer tours.

All the best!

What is a urinary tract infection?

As the name suggests, it’s an infection of the urinary tract – occurring anywhere along its length – which aggravates and inflames the lining of the urinary tract, causing pain and discomfort. Medicine distinguishes between cystitis (lower urinary tract infection) and pyelonephritis (upper urinary tract infection). Urinary tract infections are not uncommon in pregnant women, with pyelonephritis – the most common UTI complication – occurring in approximately 2% of all pregnancies, writes Dr Emilie Katherine Johnson* in Medscape.

What is the urinary tract?

Explains the AUA, the urinary tract makes and stores urine. The entire urinary tract comprises the kidneys, the bladder and interconnecting tubes – the ureters, which connect the kidneys to the bladder, and the urethra, the ‘outlet’, running from the bladder to an orifice just above the vagina. In physiology, the distinction is made between the lower urinary tract – comprising the urethra and bladder – and the upper urinary tract, comprising the kidneys and ureters.

What are the symptoms of urinary tract infection?

Symptoms depend on the severity of infection and include:

• A tender belly
• A sensation of the bladder being full, and feeling the need to urinate frequently, but only a trickle of urine upon trying to empty it
• A burning sensation when urinating
• Cloudy or foul-smelling urine
• Pain under your ribs and towards the back (i.e. in the kidneys)
• Pain during sex
• Nausea
• Fever or chills
• Vomiting.

Your doctor will take a urine sample and test it for bacteria

What causes urinary tract infections?

Under normal conditions, urine is sterile. The chief cause of urinary tract infections is E.coli bacteria. Found in the bowels and on our skin, E.coli can make its way into the urethra, travel up to the bladder and on to the kidneys. Structural abnormalities predispose some people to such infections – one of the more common being a condition called vesicoureteric reflux (VUR). In VUR, the manner in which the ureters are joined to the bladder facilitates the flow of urine back towards the kidneys, increasing the risk of bacteria invading the urinary tract. Since our urethras are shorter than those in men, women are at a greater risk of urinary tract infections; the bacteria having a shorter distance to travel to reach the bladder. Other factors predisposing women to urinary tract infections include using a diaphragm or spermicide, diabetes or obstruction of the bladder, for example during pregnancy.

Urinary tract infection and pregnancy

The causes of urinary tract infections in pregnancy are no different – E.coli invading the urinary tract is the chief culprit. An enlarged uterus can increase the chance of bacterial infection, however – as it presses against the urinary passages, partially blocking them, the bladder can be prevented from emptying completely. Constipation – another common complaint of pregnancy – can also be a contributing factor.

How to treat urinary tract infections

Generally, urinary tract infections clear spontaneously after a few days. A severe urinary tract infection, though, can cause complications like blood poisoning or kidney failure. A course of antibiotics should, however, clear the infection in three to five days.

It’s better for pregnant women to be safe than sorry, so if you suspect you have a urinary tract infection, see your doctor as soon as possible. S/he will take a urine sample and test it to see what bacteria are present. Appropriate medication – safe for you and your baby – will be prescribed. Remember, as long as it’s treated early by your doctor, there’s little cause for alarm.

Preventing urinary tract infections in pregnant women

If you struggle with recurrent urinary tract infections, try these tips:

• After urinating, wipe from front to back to prevent spreading E.coli bacteria towards the opening of the urethra
• Wash your hands before and after going to the toilet
• When washing the entrance to the urethra, do not rub – rather wipe gently with a clean, fresh cloth or antiseptic wipe. Avoid over-washing this area since this can remove the body’s natural protection barriers (for example, mucus).
• When bathing, don’t use bubble baths or other bath additives – they can irritate the skin
• Avoid fragranced soaps – nothing beats baby soap!
• Wear loose clothing and cotton underwear – pack away those pantyhose and skinny jeans!
• Don’t sit cross-legged
• Up your Vitamin C intake
• Drink plenty of water
• Eliminate coffee, spicy foods, chocolate and cola drinks
• When taking medication, always follow your doctor’s instructions.

*Dr Emilie Katherine Johnson is a Resident Physician at the Department of Urology at the University of Michigan Medical School.

Latex or acrylic paints aren’t made using solvents, and for this reason, they are generally considered safe if the area is ventilated thoroughly. Oil-based paints, on the other hand, contain harsh solvents and require chemicals for clean-up. They are not recommended for use by women who are expecting.

Latex (or acrylic) paint

This is the most common type of paint. It doesn’t contain solvents, can be cleaned up with soap and water, and is generally considered safe to use and be around while you’re pregnant as long as the area is well ventilated.

Oil-based paint

Oil-based paint contains solvents and requires turpentine or mineral spirits for clean-up. Some studies over the years have shown that exposure to solvents may increase the risk of having a miscarriage so using oil-based paint or being around the fumes during pregnancy is generally not recommended.

Lead paint

Lead based paint was commonly used prior to the 1970’s. Pregnant women should avoid removing old paint because of the risk of lead exposure. Exposure to lead paint increases the likelihood of lead poisoning and mental retardation. Scraping or sanding any kind of old paint, or being in a place while scraping or sanding is taking place, should be avoided.

While there are a variety of changes that occur during pregnancy, some of the most significant are skin changes. To name but a few, some pregnant women have to deal with acne, melasma, dry skin, stretch marks and PUPP.

During the first trimester of pregnancy, the increase in hormone levels tend to be the highest, thus resulting in more acne during this phase. At least breakouts tend to disappear after giving birth! It is important for pregnant women to avoid cleansers which are formulated for acne. These often contain Salicylic Acid and other ingredients which are not recommended during pregnancy. One should rather aim merely to keep skin clean and follow a healthy diet.

The second condition, melasma, is a common concern and it is characterized by dark spots on the forehead, nose, upper cheeks and lips. It is also known as the mask of pregnancy. The precise cause is unknown, but it is believed that excess hormones during pregnancy may stimulate pigment-producing cells, which produce more melanin. Fortunately, it is typically just a cosmetic concern and not a health issue. The sun causes melasma to worsen, so it is important to use an SPF 15 or higher daily. Pregnant women should avoid products with “lightening” ingredients, especially those containing Hydroquinone and Vitamin A. Fortunately, melasma often gets better after giving birth and one can also try chemical peels, Lactic Acid products or laser treatments to help clear up the marks after breast feeding.

Another common pregnancy problem entails dry, itchy skin. This is caused by the skin expanding beyond its normal capacity or by hormonal changes which deprive the skin of oils and elasticity. One should use non-soap cleansers on the face and body to avoid stripping the skin of any more moisture. Remember, proper moisturising is a must!

If a woman experiences excessive itching late during her pregnancy, possibly accompanied by nausea, vomiting, loss of appetite, fatigue and possibly jaundice, she should contact a doctor. It could be a sign of cholestasis, which is related to the function of the liver.

Pruritic urticarial papules and plagues (PUPP) is an outbreak of pale red bumps on the skin. PUPP occurs in about one in every 150 pregnancies. These bumps could be itchy, may burn or even sting. Luckily, this too usually clears up after pregnancy. Treatment for PUPP may consist of oral antihistamines, topical antihistamines, some steroids and other medications such as moisturizers and antibiotics.

Stretch marks are another very common skin problem during pregnancy. These are either the result of skin not “bouncing back” to its original state after rapid growth, or it could be caused by glucocorticoids. Glucocorticoids are hormones which break down the skin supporting materials in the dermis. Pregnancy causes glucocorticoids to circulate in higher concentrations, and thus, pregnant women experience more stretch marks. Genetics play a major role in determining the severity. It is generally recommended to only treat stretch marks after pregnancy as many treatments penetrate the skin and could lead to birth defects. After breast feeding, vitamin A creams, anti-stretch creams and laser treatments are great options to try out.

According to Karina Els, Skin Therapist and Managing Director of Revive Skin Lounge, one of the most important things is to use sunscreen. “I cannot stress the importance of sunscreen enough!” she says. “Sunscreen must be at the top of the list.”

Also, a gentle, non-abrasive exfoliator can be used once or twice a week to aid the sloughing off of dead skin cells and to assist with skin product absorption.

This article is courtesy of Revive skin lounge. For more information visit them at www.reviveskin.co.za.

Expecting a baby is thrilling. There are so many moments to look forward to: the birth, the first smile, first tooth, first steps… But, as wonderful as pregnancy may be, there is certainly a serious side to it.

In the past, the expectant mother would go through her pregnancy unaided and, to a large degree, unchecked. This “wait and see” approach obviously had its drawbacks, with things often going awry during the 9-month wait or during the birth itself.

Fortunately, huge medical advancements have been made since then, and pregnant women have never before had access to better prenatal care than they do right now.

As a result of this progress, there has been an increase in prenatal diagnostic testing. One of these tests is a procedure known as amniocentesis. You’ve probably heard about this test already, but – if you’re anything like us – you probably still have an impressive list of questions.

To put you in the picture, we’ve answered the 10 most common questions about amniocentesis.

1. What is amniocentesis?

Amniocentesis is a specialized diagnostic procedure done during pregnancy whereby amniotic fluid is removed from the uterus and then tested for specific abnormalities that the baby may have. The procedure is also sometimes done to determine whether or not the foetus’s lungs are developed enough for birth. It also identifies the baby’s gender.

The procedure has an accuracy level of around 99.4% and is considered to be one of the most reliable prenatal tests available.

2. What are the problems that an amniocentesis can detect?

The procedure can identify hundreds of defects, problems and genetic disorders, including:

-          Down’s syndrome

-          Sickle cell disease

-          Cystic fibrosis

-          Muscular dystrophy

-          Edwards’ syndrome

-          Spina bifida

-          Rhesus incompatibility

-          Infection

3. Who should have an amniocentesis?

Specialists advise that you have an amniocentesis if:

-          You’re 35 or older

-          You’ve had abnormal results from other prenatal screening tests

-          Previous babies had chromosomal abnormalities or other defects

-          You have a family history of genetic disorders

-          You or the baby’s father is a carrier of any genetic disorders

-          Infection is suspected in mom or baby

-          It’s necessary to identify severity of amnesia should the foetus have Rh disease

-          Your doctor advises decreasing the volume of amniotic fluid

-          It’s necessary to determine whether the baby’s lungs are mature enough for birth

4. What are the risks?

Because amniocentesis is an invasive procedure, there are risks, although these are low.

Current research shows that miscarriage occurs in less than 1% of women.

Other risks include:

-          Cramping

-          Vaginal bleeding

-          Preterm labour

-          Needle injury to baby

-          Leaking of amniotic fluid

-          Infection

-          Infection transmission

5. How is amniocentesis performed?

The procedure is performed on an outpatient basis, lying still on your back with a full bladder.

Generally, a local anaesthetic isn’t necessary, but may given.

These are the steps your doctor will follow:

-          Baby’s position will be detected with ultrasound

-          Antiseptic is applied to clean your abdomen

-          A thin, hollow needle is inserted into the uterus via the abdominal wall

-          A sample of amniotic fluid is extracted into a syringe

-          The needle is withdrawn

-          The baby’s heart rate is monitored for a while after the procedure

6. At what stage of pregnancy is the procedure done?

Genetic amniocentesis is usually carried out after week 15 of pregnancy (the second trimester), by which stage sufficient amniotic fluid will surround the baby.

The procedure is also done when early delivery is best for the mother. This test to assess the development of the baby’s lungs is known as maturity amniocentesis.

7. Does it hurt?

Amniocentesis causes discomfort more than it does pain.

You could possibly experience:

-          A stinging sensation

-          Mild cramping of the uterus

-          Vaginal bleeding

8. How long will I have to wait for the results?

Generally, results will be available 2-3 weeks following the procedure. This delay is due to the sample going through karyotyping, a process which involves growing the baby’s cells to the point where diagnosis is possible.

9. What happens if the outcome is worrying?

Should your baby present with an untreatable condition, you’ll need to decide whether to continue or terminate the pregnancy. This is extremely heart-wrenching, so you will need the love and support of friends and family during this time, as well as a session with your genetic counsellor.

10. Is there anything else I should know about amniocentesis?

-          Make sure you have a full bladder before the procedure

-          Get a friend to drive you home afterwards, then rest

-          Call your doctor in the case of fever, heavy bleeding, discharge or severe cramps

• Being clingy: It’s normal for a child to get quite clingy and irritable in the last month of your pregnancy. Explain the situation and what’s about to happen, even if you have to do it a couple of times. Perhaps use a book to illustrate, but don’t overdo it. Rather use this time to spend some quality time with your toddler and focus on her.
• New playmate: Don’t make promises of a new playmate, as toddlers are often disappointed in the fact that all this new, selfish family member does is sleep and cry.
• Stick to the routine: Try to keep the siblings’ lives as unchanged as possible by fitting your baby’s routine in with theirs as far as possible. Make a list of all the activities you share with your toddler – bath time, trips to the park, cuddle time, routine etc. and keep these going. It’s important that she doesn’t feel as if her whole life came to a stand still and that she doesn’t matter.
• Test run: Arrange a trip to the hospital to show your her where you’ll be having the baby and remind her of the arrangements a week before the time – such as “you will be staying with daddy and granny”. When the big moment arrives, don’t slip away to avoid conflict, tell her what’s going on. Tip: Give her a wrapped gift box with loads of interesting goodies to make the going away a bit easier.
• New baby and sibling gifts: When your toddler is visiting you in the hospital keep in mind that she is visiting you and not the baby, so make some special time but keep the visit short and sweet. Arrange for the exchange of small gifts from baby to toddler and the other way around, beforehand.
• One on one time: See to it that your toddler is on an outing when you and baby get home. Get baby and yourself settled in so that you can be there for her when she arrives.
• Her time to shine: Let your toddler show the visitors her new baby brother or sister.
• Feeding time tricks: Plan a drink or a snack in advance for her to enjoy while you are feeding your baby so she doesn’t feel left out. Another idea is to keep some special activities like a puzzle, play-dough or a DVD exclusive to feeding times.
• Discipline: Stick to the old rules and discipline your toddler like you would always do – don’t feel guilty.
• Baby mode: Your toddler might want to go back into old habits like nappies, bottles or dummies. Explain that she has already done all of these and create distractions. Be patient.
• She’s special: Work at it to make her feel that the baby likes her.
• Don’t pair off: When asking dad to help out by taking your toddler for an outing, be careful not to make pairs such as mom and baby, dad and toddler. Your toddler will start to resent this. Swap often and keep the balance.

It’s just a matter of time before they will be best friends!

How ideal would it be if we could get back to basics and have most moms experience natural birth the way it was intended to be! With the high caesarean rate, natural births have taken a back seat. The reason for this may, to some extent, be due to fear and a lack of knowledge. Some busy-busy-busy moms also find it more convenient to schedule the birth date in order to get on with life. All that’s needed is a tick in their diary to show that the task as complete and then life goes on as planned. Although we respect every single mom’s choice of birth, we’d like to encourage you to try and go natural. From our side we’ll offer support in the form of solid information to help you decide what birth option will be best suited for you.

So, what exactly is a doula?
Mommy’s little helper

Origin: Doula is a Greek word and means ‘woman caregiver’.

The short and sweet is that a doula is an assistant that provides non-medical support. The support may be during your prenatal period, childbirth or postnatal, depending on your preference and her experience and background. Most importantly, she provides emotional support and an objective viewpoint, something any woman can appreciate!

What does a doula do
What doesn’t she do?

• She offers continuous physical, emotional and informational support during your pregnancy, birth (home, hospital or clinic) and postpartum period.
• She understands the birthing process and general medical interventions and can keep you posted on what’s happening at all times, which usually relieves some tension.
• Provides emotional support throughout your pregnancy, birth and thereafter.
• Gives tips and advice on physical fitness to ensure a more comfortable pregnancy and birth.
• Assists in preparing the birth plan; Acts as the your voice during labour and makes sure that the parents’ wishes are respected at all times.
• Provides massage and other non-pharmacological pain relief measures.
• Suggests different birth positions and assists with the birth.
• Provides support to the partner so that he can in turn encourage you.
• Helps to avoid unnecessary medical intervention where possible.
• Assists with breastfeeding.
• Is present during the birth and afterwards for as long as you might need her.

Questions to ask a doula
Her pedigree

• What is your education for providing labour support?
• Are you certified by a labour support training program?
• How long have you been in practice and how many births have you attended?
• Do you have education and experience in any other type of care such as childbirth education, midwifery care, nursing care, breastfeeding support or postpartum doula support?
• What is your philosophy with regards to birth? How do you view your role at the birth?
• Can you supply us with recent references?
• What services do you provide during labour and birth? What do you bring with you?
• How do you help women cope with labour pain?
• At what stage would you be with me in labour? How long would you stay after the birth?
• Do you offer any postpartum services? Breastfeeding advice and assistance?
• Are you available by phone? In person?
• Where would my husband fit in?
• What is your fee, what does it include and how is it payable? Any hidden costs?
• Are you available at all times and if not, what is the back-up plan? Can I meet the back-up individual?
• Do you know of anything that may cause you to be unavailable?
• Do you have any other clients that are due around the same time as me?
• What is your relationship with midwives, medical caregivers, hospitals etc.? Have you ever worked with my caregiver of choice?
• What do you expect from us?
• If you were looking for a doula to assist at your birth, what would you look for?
• How do you feel about……. (list any concerns).

Interesting facts
Did you know?

A world wide study involving more than 1500 women found that moms that made use of doulas were the ones with the shortest labours (can life get any better?!) More interesting stats with regards to doulas:

• Greater than 50% drop in caesarean births
• 30% reduction in the mother’s need for medication
• 60% reduction in epidural requests
• 40% reduction in forceps delivery

There you have it. It’s important to be informed so that you can make an educated decision when it comes to choosing a winning pregnancy and childbirth team.

“If a doula were a drug, it would be unethical not to use it.”
- Suzanne Arms ‘Birthing the Future’

Click here if you want to list your services as a doula on our website

References:
Doula.org
Wombs.org.za

Antenatal classes
Inside Info

When you visualise a childbirth class, you probably see a serene mom sitting crossed-legged on the floor with the hands-on dad right behind her, ready to support her every move while they lovingly smile at each other. Whilst this is what may happen in the movies, real life is somewhat different. The level of structure and approach of these classes differ from clinic to clinic, but they mostly cover the same content:

• Normal delivery and labour
• Breathing exercises
• Caesarean section
• Pain relief
• Breastfeeding
• Post delivery body changes and caring for your baby during the first few weeks

Benefits of antenatal classes
This is why

Attending an antenatal class can be beneficial in many ways. It will:

• Prepare you
  These classes will give the new parents-to-be a healthy expectation on what to expect from birth and the first few weeks at home.
• Inform you
  It will provide you with practical tips and advice on pregnancy, birth and caring for your newborn.
• Connect you
  An antenatal class is a great way of meeting new people; many a lifelong friendship is born this way. It can be extremely comforting comparing notes with these moms once your babies are born.
• Calm you
  Attending an antenatal class will fill you with a sense of peace, knowing that you have done everything possible to prepare yourself for the arrival of the new addition to your family and give you the opportunity to ask the questions that have been haunting you.

When to book
You snooze you lose

Even though you will probably only attend an antenatal class later on in your pregnancy, it is important to book early in advance to avoid disappointment and to ensure your place.

To find classes closest to you we suggest you  contact your  Gynaecologist. They will be the best person to gain this knowledge from.

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• When it comes to seafood, you’ll need to avoid those high in mercury. It’s perfectly safe and even advisable to eat seafood which is full of protein, and fish which provides you with essential omega-3 fatty acids. Some seafood contains high levels of mercury, however, and should be avoided during pregnancy because it could damage your baby’s developing nervous system. The bigger and older the fish is, the higher levels of mercury it has. Avoid swordfish, shark, king mackerel and tilefish. And limit your intake of canned tuna fish.
• According to the US Food and Drug Administration you can safely eat up to 170g albacore (white) tuna fish as part of your weekly total limit of 340g seafood low in mercury. This weekly allowance can include salmon, shrimp, canned light tuna, cod, pollock and catfish.
• Avoid fish caught in rivers, lakes and streams as recreational anglers may hook fish contaminated with bacteria or chemicals. Also remember to cook seafood properly – avoid raw seafood completely.
• Certain types of cheeses should be avoided as they are more prone to allow bacteria growth which can be harmful to your unborn baby. Avoid Roquefort, Brie, Blue Wensleydale, Danish Blue, Pont L’Eveque , Chaumes, Pyramide, Cambozola, Torta del Cesar, Camembert, Chèvre, Taleggio, Vacherin-Fribourgeois, Bergader, Bleu d’Auvergne, , Shropshire Blue, Dolcelatte, Gorgonzola,  Stilton and Chabichou.
• Other foods to avoid during pregnancy are undercooked meats, poultry and eggs. Your metabolism and circulation changes when you are pregnant and your reaction to bacterial food poisoning might be more severe. Be aware of hot dogs and deli meat; rather avoid them completely if you haven’t cooked them yourself. Also avoid refrigerated pates and meat spreads – but canned versions are ok. Also, don’t buy raw poultry that’s been pre-stuffed, and always cook eggs until yolks and whites are firm.
• Avoid unpasteurised foods when pregnant; try sticking to low-fat products such as skim milk, mozzarella and cottage cheese. Unless brie, feta, camembert, blue cheese and Mexican-style cheeses are clearly labelled as being made with pasteurised milk, don’t eat them. Unpasteurised juices – such as cider purchased from roadside stands, at farms or in stores are prone to germs – should also be avoided.
• Be careful with unwashed fruit and vegetables during pregnancy – always wash them thoroughly and cut away damaged portions. Avoid raw sprouts as well as large quantities of liver – which is very high in vitamin A.
• Too much caffeine can cross the placenta and affect your baby’s heart rate. Because of the potential effects on your developing baby, it is recommended limiting the amount of caffeine in your diet to less than 200mg a day during pregnancy.
• Some gynaes recommend that you avoid herbal tea, while others don’t. It’s entirely up to you and what you feel comfortable with, but if you do decide to drink herbal tea remember to stick to small amounts and to those herbs considered safe for pregnant women.
• We all know that alcohol shouldn’t be consumed in large amounts when you are pregnant; beer, wine, and spirits rob developing cells of oxygen – making normal development impossible. But a glass of wine every now and then is not going to hurt you or your baby. However those who drink too much alcohol have a higher risk of miscarriage and stillbirth. Too much alcohol during pregnancy may also result in foetal alcohol syndrome, which can cause facial deformities, heart problems, low birth weight and mental retardation.
• Depending on your family history, your child may be at risk for developing food allergies. Avoiding foods including peanuts and peanut products during pregnancy may reduce allergy risk in susceptible children.

References:
www.mayoclinic.com
www.webmd.com

In most cases, however, women miscarrying in the first trimester of pregnancy who are otherwise stable (with no fever or excessive bleeding) can choose to have non-surgical treatment. You can wait and see if your miscarriage progresses over days, weeks or even months – to complete itself. In this case you’ll eventually need your gynae to use ultrasound to confirm that all pregnancy tissue has been passed from your uterus. Another option is taking medicines which can cause the uterus to contract and empty – but this takes longer than surgical treatment and can be painful and have bad side-effects. And it’s not always effective, which means you might end up needing surgical treatment after all.

What is a D&C and why is it necessary?

Dilation and curettage refers to the dilation of the cervix and the surgical removal of the contents of the uterus – assisting women in managing a miscarriage that is causing severe bleeding. It is a therapeutic gynaecological procedure, and the first step in a D&C is to dilate the cervix – often done a few hours before the surgery. The woman is usually put under general anaesthesia before the surgery begins, and then a curette – a metal rod with a handle on one end and a sharp loop on the other – is inserted into the uterus through the dilated cervix. The curette is used to gently scrape the lining of the uterus and remove the remaining pregnancy tissue. This tissue is then examined for completeness. The procedure usually takes about 10-20 minutes, and you won’t have to stay in hospital overnight.

What are the advantages of having a D&C?

There are a few advantages of having a D&C that are worth pointing out. First of all, on the emotional side, it helps you get over a miscarriage faster. Most miscarriages occur in your first pregnancy trimester, but your body might only expel the foetus three months later, and waiting for this to happen can be traumatic. A D&C completes and ends the miscarriage without dragging out a painful incident any longer than necessary. On the physical side, because a D&C completes a miscarriage faster, it shortens the amount of time you experience bleeding, cramping and other symptoms of a miscarriage.

What are the risks involved with a D&C?

Although very rare, especially with the increased use of suction over actual scraping, there are some risks involved with having a D&C. They include possible reactions to anaesthetic medicines, infection and puncture of the uterus.

• The risk of sharp curettage is uterine perforation. Although normally no treatment is required for uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own.
• Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.
• Another risk is intrauterine adhesions, or Asherman’s syndrome. One study found that in women who had one or two sharp curettage procedures for miscarriage, 14-16% developed some adhesions. Women who underwent three sharp curettage procedures for miscarriage had a 32% risk of developing adhesions.

How soon can I have sex after a D&C?

The recovery period following a D&C is short, and most women are able to return to work and other normal activities within one or two days. During the recovery period, however, you might experience:

• Mild pelvic cramping
• Small amounts of vaginal bleeding
• A slight vaginal discharge

You might also find that your next period will be early or late, and you should stay away from intercourse, douching and the use of tampons for at least two weeks.

References:
www.pregnancytoday.com
www.wikipedia.org
www.webmd.com