Tag Archive | "pregnancy"

The importance of birth planning

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The importance of birth planning

Posted on 26 June 2014 by Kristrun

babyleaningonarmsAfter years of working with families to prepare for birth, we have long ago learned that the term ‘birth plan’ is probably not a good description, and by that I mean to hand out a piece of paper that states BIRTH PLAN at the top.  This indicates that there is “a” plan, and that the parents expect things to go a certain way.  This can sometimes be hard, because if there is a change in the beginning, for example if you need to be induced, sometimes the whole “plan” is then changed or not valid anymore.  Similarly, sometimes these plans are quite unrealistic and come from someone else that perhaps had different reasons for choosing what they did.

Without ditching the term “birth plan”  we go around this in a slightly different way when we assist parents in their preparation. We suggest that you view the birth similar to an adventure trip that has certain planned checkpoints beforehand, but the whole journey is unknown.  It is much better to be well prepared for it, with the right people/hospital to support you, and some parts of it need to be planned.

In the period leading up to the birth, the term ‘birth planning’ will be used many times and you will likely be asked at the hospital if you have a birth plan.  Your birth plan will always be restricted to certain hospital guidelines, but there is usually some flexibility in both public and private settings.  To ensure a realistic and tailor-made birth plan that suits your needs, we therefore suggest two types of planning/preparation: short and long term.  The long term planning involves choosing the right hospital and doctor, with direct answers about what practices and rules there may be for women who are in labour.  Statistics and details are needed when this is done.  The short term planning involves more detailed information about your own choices during the labour and birth and may include information about your care and preferences regardless what type of labour / journey you embark on.

Attending antenatal courses and/or private consultation about typical scenarios during childbirth, and what interventions are available, is normally the first step in your birth planning. This is the part where you figure out what will be important to you on the day when you go into labour. It´s also about working out if you as a couple are hoping for the same type of experience, as labour is not the right time to figure these things out.

Birth planning becomes even more important when you are seeking care in a private doctor and hospital environment. Educate yourself so you know what you prefer, rather than have the “system” make these decisions on your behalf. Are there any financial gains underlying your care? Be in charge.

In the public system in Hong Kong, you will not have many choices. The long term birth planning will be you educating yourself on what types of choices you think will be important for you and your partner and how to make the most of it. First step will be your antenatal education. From there you make your choices within a reasonable birth plan which you present and make clear to your caregivers at the hospital.

The short term birth planning is when you create the final document and submit to your caregiver. It is very important to create a birth plan that is in line with what is available in each hospital, and a plan that meets your needs even in the event of different birth circumstances than were originally planned.  This is important both to make sure you get the best birth possible, but also to ensure your emotional health and to avoid any feelings of failure after the birth. We advise against ‘copy-paste birth plans’ from the internet where individual needs are not taken into account.  Creating a birth plan is a very personal and important part of your birth preparation.

Birth planning is a big part of the support we offer. Through our classes, consultation and routine checkups we have created a detailed educational program that goes perfectly well with the public and private systems in Hong Kong. For the best results, join our ‘Best of Both’ for public hospital births and ‘Private package’ for giving birth in a private hospital in Hong Kong. Equip yourself with the tools you need to navigate the system in which you are giving birth.

The Annerley midwives

Book a private birth planning session with a midwife > let us know how we can help

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Testimonial from Regina

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Testimonial from Regina

Posted on 18 September 2013 by Kristrun

I just wanted to let you know how supportive the staff at Annerley have been during my pregnancy & now in caring for my daughter. When I moved to Hong Kong, I was 12 weeks pregnant. It was a bit daunting to be pregnant in a foreign country where I wasn’t familiar with the medical system and had limited social support. From the start, through Belly to Belly Workshops and antenatal classes, the staff at Annerley provided me with opportunities to learn about the maternity system in Hong Kong, gave me the tools hlep me to advocate for myself within the system, and provided me with all the information I needed for a healthy pregnancy and delivery. In working with Sofie during Belly to Belly workshops, one to one meetings, and the positioning class, I had a very fast labor and was able to have the non medicalized, drug-free birth I wanted. Given my history as brain tumor survivor, it would have been easy for the highly medicalized physicians in Hong Kong to convince me that I needed a scheduled c-section. However, the staff at Annerley taught me what questions to ask the physicians, how to express my wishes, and how I would know if and when medical interventions would be necessary. It was very useful when Sofie taught me about the importance of posture during pregnancy to help with the baby’s position. I was thrilled with my labor and birth, being able to labor in the different positions Sofie taught and even deliver standing up.
The midwife visits after returning home from the hospital with my daughter helped my husband and me feel more comfortable caring for our daughter and more confident in our parenting. The night we arrived home, my daughter was having some difficulty eating and it was very comforting to know that Rowena would be visiting the next morning to help sort us out. During those early weeks, having Rowena and Conchita visit helped us get through difficult days and nights. Breastfeeding was difficult for me due to my medical history and without the support of Annerley and the visiting midwives, I would not have been able to breastfeed at all. With proper planning before my daughter’s birth and support afterwards, I was able to provide breast milk to my daughter for 10 weeks. While that might seem like a short time for many mothers, for me, it was a major accomplishment. During those 10 weeks, when things got difficult & I wasn’t sure I could continue, support from Conchita helped very much. Her family centered and strengths based approach helped me to think through what the goal was for me, my baby and my family and what was going to make for a happy mom and happy baby, without any pressure to continue breastfeeding. Since giving birth, I have come to clinic, had home visits, and one to one meetings with Conchita. I appreciate that I can ask any parenting, childcare or medical question, no matter how big or small. And unlike visits with pediatricians, Conchita focuses on our entire family’s wellness and happiness, not just our baby’s. It is very comforting to know that Conchita and the staff at Annerley are available through all the stages of my daughters development. I am looking forward to discussing the next milestone with Conchita, starting solids. Conchita has been able to provide the medical support and emotional support that all new parents need.
My helper took Conchita’s course, “Caring for 0-12 month old babies” in the spring. My helper has over 20 years raising Western children but my husband and I felt strongly that she take a course from the same professionals who were teaching our antenatal and childcare classes. When my helper came home from the course each day, she was energized and shared with me the different things that she learned. It was fantastic that Conchita taught her new things and sent her home with “homework assignments”. It encouraged her to have conversations with me about what she was learning. Some of the highlights for both of us included baby proofing the house, how to encourage language development, and starting solids. It was wonderful that Conchita could make this information exciting to such a seasoned child care provider. Additionally, Conchita stressed to helpers in the class the importance of communication with employers. This ended up being a helpful reinforcement for both my helper and myself when after the baby arrived we realized we needed to communicate differently than we had before. I would highly recommend the course to all helpers who will be working with infants regardless of how much experience they have.
The services at Annerley fill the gap many of us feel without local family and give new parents the opportunity to get support on childcare and parenting, which is something the medical system does not routinely provide.
Thank you for all that you do,

Regina Karchner September 2013

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Prenatal Charges & OB-GYN Fees in Hong Kong 2013

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Prenatal Charges & OB-GYN Fees in Hong Kong 2013

Posted on 21 August 2013 by hulda

Pre-natal Charges & OB-GYN Fees in Hong Kong 2013Published in Geobaby – 3 May 2013

Having a baby in Hong Kong? Our list of OB-GYNs and their charges will be a good start for you as you embark on your journey to mommyhood.

For your convenience and quick reference, we’ve compiled a list of doctors who deliver in Hong Kong, and their basic fees. In the table below, you will find the hospitals the doctors deliver in, and the fees for the consultation, ultrasounds, and the price of natural vs. c-section deliveries.

There were some data that we were unsuccessful in obtaining, so if you’ve just had a baby please share your doctor’s fees with us. All of these doctors can be found in our directory, but if your doctor isn’t listed here, drop us a line at editor@geobaby.com.

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Antenatal care in Hong Kong

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Antenatal care in Hong Kong

Posted on 14 August 2013 by hulda

By Oláfia Aradottir – Published on Geobaby.com – 25 July, 2013

In Hong Kong, as in much of the rest of the westernised world, when you learn you are pregnant, you take it for granted that you will follow a programme of antenatal visits. After the initial excitement it can feel that the checkups are a bit tedious and over-fussy, especially when all that the healthcare practitioner seems to do is check your weight, urine and blood pressure, but it is exactly these checks that provide the first indicators of a problem.

Why antenatal care is so important?

Much research has shown how important antenatal care is for improving mother and baby survival rates, and a World Health Organization study published this year shows that even skimping on visits can have scary results, even for low-risk mothers.

Antenatal visits are important because in most cases, the indicators for some of the rare but serious conditions that cause death for mother and/or baby can easily be detected in the early stages, and this means that the condition can be treated or managed safely to reduce risk and prevent the condition escalating and causing further complications.

Who provides your antenatal care depends on where you live. In Europe midwives are generally the prime carer for low-risk pregnancies, even doing most deliveries, whereas in the US, care is more obstetric-led.

Antenatal care in Hong Kong

In Hong Kong’s private hospitals care is obstetrician led, but midwives take care of the women throughout labour with the obstetricians making all major decisions and then delivering the baby. However, in government hospitals, midwives usually deliver the babies having taken care of the mother throughout labour.

This involvement of midwives is important because for a vast majority of women, pregnancy is not a medical condition, but is an important life transition. A famous piece of research (Cochrane) has shown that, compared with women who were cared for under other models of care, women who received midwife-led models of care were less likely to be admitted to hospital during pregnancy, less likely to receive regional analgesics during labour and childbirth, and to have an episiotomy. In addition, women who received midwife-led models of care were also more likely to have spontaneous vaginal birth, to feel in control during labour and childbirth, and to initiate breastfeeding. And if that wasn’t enough: babies born to women who received midwife-led care were less likely to die before 24 weeks of pregnancy and were more likely to have a shorter length of hospital stay.

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Exercise during pregnancy

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Exercise during pregnancy

Posted on 09 August 2013 by Kristrun

Feeling great and staying safe

bekkabumbaIt was not so long ago that pregnant women were encouraged to cut back on exercise, if not stop altogether. We now know, of course, that the right sort of physical activity is only ever a good thing.

Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Pregnancy can drain your energy, so the boost of feel-good hormones which result from exercise can really help your mood. It can improve your posture and decrease some common discomforts such as backache and fatigue. There is evidence that physical activity may prevent gestational diabetes, relieve stress, and build more stamina needed for labor and delivery.

“Maintaining an exercise programme which is right for you can only ever be beneficial, and will also help you prepare for labour, birth and beyond” says Annerley midwife  Sofie Jacobs.

Even if you have been a couch potato up until now, you can still begin an exercise regime whilst carrying your baby. Just take it easy and start slowly – walking is a great way to begin – and always consult your doctor if exercising is something new for you and how to chose the best nurses stethoscope for home usage.

What exercise is safe during pregnancy?

Actually, as it has been made evident on sites like FitnessTrainer.com, most forms of exercise are fine to continue, as long as you are careful and don’t overdo it. Activities with low risk of injury, such as swimming, brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics or dancing can be continued until birth.

Tennis, badminton and other racquet sports are also usually fine, but as you grow larger and your centre of gravity changes, your balance may be affected as you make rapid movements. If you were previously a jogger, then carry on with care. Just listen to your body and don’t push yourself to the point of exhaustion.

If you are an athlete or have been working with a personal trainer before your pregnancy, then it is usually fine for you to carry on as before. One point to note with cardio-vascular exercise is that the “talk-test” is far more important than monitoring your heart-rate, as you may have been used to doing pre-bump. In other words, stop before you reach the point where breathing becomes so laboured that you can no longer hold a conversation easily.

Pre-natal yoga and pilates are wonderful ways to increase flexibility, strength and stamina – just the things you need when preparing for birth! But it is important to make sure your instructor is qualified in this field, as the hormones produced during pregnancy can cause the ligaments which support your joints to loosen and stretch. This helps your baby to enter the world come the Big Day, but can also increase your risk of injury during exercise. The same goes for the extra and varying distribution of weight which can lead to stresses and strains and increase the risk of loss of balance.

Exercises to avoid

Common sense would tell us that any activity which has a high risk of falling or injury is not a good idea, so maybe save the skiing or horse-riding until after baby has arrived. Contact sports such as football, volleyball, hockey, basketball etc have the double risk of injury from a fast-moving projectile coupled with a lot of jarring movements and rapid changes of direction both of which can cause abdominal trauma.

Activities often advised against are those which require extensive jumping, hopping, skipping, bouncing, or running as well as certain movements such as deep knee bends and leg raises. However, if you were doing this kind of thing before, it may be perfectly fine for you to carry on as normal so always check with an expert first.

Bouncing whilst stretching is never a good idea, pregnant or not, and exerting yourself in hot, humid conditions is of course discouraged. Better swap the Hong Kong summer hikes up hills for something cooler!

Avoid exercises which involve lying flat on your back for prolonged periods of time. This can cause compression of a large blood vessel called the vena cava and cause dizziness and discomfort.

When you should stop

It’s very important to listen to your body and only do what feels good for you. You may not be able to continue with the same level of exercise which you were used to back when the only “body” you had to consider was your own! Stop exercising and consult your midwife or doctor if you feel anything out of the ordinary, other than breathing a little faster and the familiar feeling of muscles working.

Most pertinent to pregnant women would be any abdominal or pelvic pain/contractions, an absence or decrease in fetal movement, headache, vaginal bleeding or leaking, sudden swelling of any part of your body, difficulty in walking or muscle weakness. As well as, of course, the regular signs to watch out for such as chest pain, shortness of breath, dizziness etc.

When it’s not a good idea

You should always talk with your health care provider if you have a pre-existing condition such as asthma or diabetes. Exercise may also not be advisable if you have a pregnancy-related condition such as a low placenta, recurrent miscarriage, history of early labour or an incompetent cervix.

If you have any questions to ask regarding exercise during pregnancy, or after birth, why not book a private consultation with one of our midwifes. Available in the office, on Skype or over the phone.  

Related article: Brazilian Jiu Jitsu In San Diego.

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Blooming Bellies – A Natural Birth – Event photos and Review

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Blooming Bellies – A Natural Birth – Event photos and Review

Posted on 20 June 2013 by hulda

Thank you all – guests, speakers, sponsors – for helping us create yet another wonderful Blooming Bellies evening on the 18th June.

Annerley_Blooming-Bellies-audience

Thank you to the guests

Thank you for coming to the evening and we hope that you took much information of value away with you. We are passionate about empowering women to make informed decisions about birth and we hope we have achieved that in the evening. Please take advantage of your free $500 voucher for a consultation with our midwives; we’re sure it will be of value.

Thank you to the speakers

Gianna Buonocore – thank you for sharing your own experience of birth and your parenting challenges. Traditional Chinese Medicine and its application for birth and labour is an area that is not so accessible for non-Chinese speakers and it is fascinating to learn more about the medicine of the area we live in.

Annerley-Blooming-Bellies-Arden-Wong-Michell-HuangArden Wong and Michell Huang – we were honored that you shared your preparation and experience of a homebirth in such an honest, humourous and humble way. Thank you for your suggestions:

  • How practising yoga, exercising and using visualisations techniques helped you to prepare for the birth.
  • To acknowledge the inevitable fear and to face it rather than try to stifle it.
  • Prepare using physical tools, such drawings of labour positions, to support you through labour
  • How the role of the father, especially in a hospital environment, is to support his wife’s decisions and help keep her willpower strong, and to challenge the automated suggestions for medical interventions.
  • Do not feel pressured to have family and friends as guests in the first few days after birth, make this a time of peace and quiet for the new family.

Annerley_Blooming-Bellies-Hulda-ThoreyHulda Thorey – It’s a rare occasion when we get to learn how one of Hong Kong’s most experienced midwives went through the birth of her own four children. Hulda’s recommendations include:

  • Before birth you need to know what you want and why you want it so that it is easier to stick to your plan when alternatives are offered to you.
  • Equip yourself for labour with support tools that will work whatever environment.
  • While you may not be able to control the hospital environment, make your home environment as comfortable as possible to support your body in the early stages of labour.
  • If using the private system, be clear that you are the paying customer and that, within reason, your will should be respected.

Hulda also shared a breathtaking video celebrating a natural birth.

 

Thank you to the sponsors and partners

GeoBaby
who helped spread the word. Have you seen their new site?
TIny Footprints
Tiny Footsteps – who donated the amazing door prizes of the Mima Moon Highchair, cushion set & footrest (valued at $4,135) and an Il Tutto Nico Baby Bag (valued at $2,495). Visit their website for more great baby products.
Yoga Privates
Monica Proctor – Yoga Privates

 

Jenny Smith - Gecko Yoga
      Mandarin Spa The Mandarin Spa team – for glorious mini manicures and pedicures, the generous door prizes and the wonderful array of goodies that helped stuff the goody bags. Remember that you are in good hands with the Mandarin Spa team

And congratulations to the winners of the Mima Moon Highchair, the Il Tutto Nico Baby Bag, the 4D-Scanning Experience by Annerley, The Annerley Helper Training course.

If only the odds of winning the Mark6 were the same!

 

View the gallery below from our Blooming Bellies – A Natural Birth event

 

Make sure that you don’t miss the next Blooming Bellies  - sign up to receive our newsletters to learn more about all aspects of pregnancy, birth and childcare.

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Pregnancy after 35 – am I too old?

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Pregnancy after 35 – am I too old?

Posted on 23 April 2013 by Kristrun

pregnancy after 35The simple answer to this is that NO, it is not risky to have a baby after 35 years of age. In fact for a variety of reasons, in today’s society it is becoming more common for women to wait to start a family until they are over 35. It is important to remember that although there are some risks associated with your ‘advanced’ age, there are also benefits for both mother and baby by waiting. There are a number of aspects to consider in answering this question fully, so I will try to give you a summary of the information.

The risks – real or perceived

  • Fertility: The risks associated with having a baby at 35+ are wide-ranging and specific to each individual. In the first instance, there is a higher possibility of couples finding it more difficult to conceive, however in many situations technology is assisting families in this area.
  • Chromasomal Abnormality / Down Syndrome / Twins: There is an increased risk for all mums over 35yrs old, of the possibility of conceiving a baby with a chromosomal abnormality. Despite this, it is important to remember that the majority of babies are fine, and except for the chromosomal abnormalities, research indicates that babies of older mothers are no more at risk of birth defects than babies of younger mothers. The major concern is that of Down Syndrome, or others related to complications with cell division. Individuals have different feelings and beliefs about this subject and there are tests available to either screen or diagnose for these abnormalities. These tests are optional and have far reaching implications, which you should consider prior to having any performed. Added to this there is a higher chance of having a twin pregnancy, which may be considered as either a benefit or complication.
  • Your energy levels: Once pregnant with a healthy baby the adage of “you are only as old as you feel” is definitely true. Age itself does not indicate risk; health, lifestyle, family history and socioeconomic matters also impact on the pregnancy and birth. The majority of mothers complete their pregnancy and birth with no complications, often to the surprise of their caregivers. Data does indicate that the incidence of pre-existing conditions which can impact on birth and pregnancy do increase with age, however these are all able to be well managed throughout the pregnancy.
  • Your health: Throughout the pregnancy there does seem to be a higher possibility of gestational diabetes and high blood pressure, bleeding and low lying placenta. However, these once again are all conditions which are able to be well managed with current knowledge and medications. These are issues which you can impact on by ensuring good health prior to conceiving and seeing a doctor or midwife for preconceptual care.One area to consider is how you and your caregivers’ approach to the pregnancy may affect its course. There does seem to be a higher rate of intervention in mothers who are more mature. It is difficult to establish the reasons behind this, however it is possible that it is related to the caregivers’ anxieties, rather than actual clinical needs. It is important to discuss with your caregivers throughout the pregnancy, any concerns you have and how you would like to approach the birth.

The benefits

  • Maturity! Despite the real, perceived or potential risks, all studies agree that the actual outcome for the baby is every bit as good as that for younger mothers. On the positive side more mature parents are often in a more secure financial situation, have achieved a level of success in their working lives and have been shown to be more psychologically assured, as well as being more aware of a healthy lifestyle.

Previously issued on Yummy Mummy in 2010 – now updated.

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How to get pregnant, and fertility issues

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How to get pregnant, and fertility issues

Posted on 16 February 2013 by hulda

fertility and pregnancy

 

Good things come to those that mate! Most people – this is a statistic – will get pregnant within a year if they have regular unprotected sex, and so long as they are not too old.

In instant-gratification-city Hong Kong, too many people expect results at the press of a button and Hulda Thorey warns that some couples are rushing off to see fertility experts too soon. “Most young couples will conceive within a year,” she says, “but expecting instant results can cause stress which works against you. Stress has an impact on fertility so being relaxed – and having sex – is the key to getting pregnant for most women.”

Read more about fertility in this recent Playtimes article featuring Hulda and Dr Christopher Haines, professor of obstetrics and gynaecology at Chinese University of Hong Kong.

Download the story here, or read the complete magazine here.

 

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Pregnant

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A Breastfeeding at Work: Tips for Working Moms

Posted on 20 April 2012 by hulda

Jennifer Williams returned to her job at a leading financial company after the birth of Gemma and, through thick and thin, has managed to make it to six months breastfeeding at work.

How much maternity leave did you take?

In the end I took 14 weeks maternity leave which I know is good for Hong Kong, but it didn’t seem good for me. It was all too soon and as  Gemma is my first child I wasn’t the most organised in my first weeks  back at work; I missed the network of friends and family who might have forwarned me of how tricky it all would be.

How did you deal with trying to express at work?

I work at an international bank and we are lucky enough to have what they call a nursing room. I imagined a comfortable room with sofas and sterilizers, but in fact is a little cubicle which you reach by walking past a whole row of people.  And it wasn’t that private – One day a workman walked in and got the shock of his life.

But it was very hard, and exhausting. I would do an hour’s work and then go to do some expressing which, with my original single pump, could take as long as an hour. After a while I invested in a double “hands-free” pump which made things so much better, and meant that I could write notes and work while I was expressing. My single biggest tip would be to invest in a double pump at the outset.

Were there any disasters?

Yes – and this is an indication of the level of preparation needed. I was rushing home late one night and left the milk that had been expressed that day in the taxi, and then learned that I was running low with my stock at home.  I was devastated as it meant I had to stay home the next day, and also start Gemma on formula.

Did you make use of the Annerley Working Mother’s Group?

I go when I can; it makes the day so much better.  The group follows on from the Helper & Baby Group so it means that I can slip out and feed Gemma myself. It gives me a much-needed break from expressing it was good to be able to talk to other working mother’s to see how they were coping.

And now?

I did get into the rhythm, and now at six months I am slowly winding down to one breastfeeding session a day. Although “Breast is Best”, I have to say to other mothers that you cannot be hard on yourself. You are doing your best in extremely challenging circumstances.

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Low-lying placenta

Posted on 19 April 2012 by Annerley

My obgyn has told me that I have a low-lying placenta so I may need a c-section. Why is this? Do I have any hope of a natural birth with this condition?

Hulda responds:

With regard to low lying placentas (as with one of the later questions) there are degrees of this.  Often women are told early in the pregnancy that they have a low lying placenta, only to find that as the pregnancy progresses, the lower segment develops and the placenta moves further away from the opening.   So yes you have every hope of a natural birth.

As many as 15% to 20% (one in 5-6) of pregnancies have a low lying placenta. Fortunately, only 5% (one in 20) of these remain low lying at 32 weeks and only one third of those are low lying at term (37 weeks). After 28 weeks, a low lying placenta is known as placenta praevia.

The degrees are often called grades and the most severe is when the placenta sits completely over the cervix.  In terms of having a vaginal birth, this causes problems in that the baby cannot be born through the placenta and the placenta cannot be born before the baby, so in this instance the baby must be born by CS.  There are then lesser grades where the placenta either touches, or sits close to the edge of the cervix.

At approximately 32-36 weeks you should have a repeat ultrasound,  if at this stage the placenta is covering the internal cervical opening then that is an indication for a CS, however as stated earlier, by this stage most are clear and the baby is able to be born vaginally.  Indications that the placenta is still low could be bleeding or the baby failing to move into a position optimal for birth.  If the baby’s head is moving into the pelvis then this is a good sign that the placenta is not causing it any problems.

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