Midwife webchat clinic with PB's Nikki Khan, Monday 30th January, 12-1pm

Prima Baby's resident midwife, Nikki Khan will be hosting a webchat here on Monday 30th January, between 12-1pm.



An expert midwife for the past decade, Nikki will advise on all areas of pregnancy, childbirth, and newborn babies.



For more information about Nikki Khan cut and paste the following link into your browser bar: http://tinyurl.com/3gnfmx2



Don't worry if you can't make the time and date, post your question now and Nikki will answer as many queries on the day as possible.

Posts

  • Hi Nikki,



    I had a complicated birth with my son 2 years ago, and this is a large factor in whether we decide to conceive again. I wondered whether an assisted delivery first time round means I'm unlikely to be able to have a homebirth, whether I will need another assisted delivery and whether I'll need to be under consultant care. I also wondered whether I can choose the hospital in which to give birth if the second-nearest is around 30 miles away. My son was unnecessarily induced 2 weeks early and was eventually delivered 3 days later by forceps, for which I had an episiotomy. I realise nothing is certain, but I don't want to find out the likelihood of these things if and when I'm pregnant. Thank you.
  • Hi I am currently 36+5 with third boy. 1st born was 10lb 3oz and 9 days early, normal vaginal birth, except epidural didnt work poss due to high BMI,apart from the contractions not lasting long at the pushing stage he was born normally, I think I tore but not badly. 2nd boy I had GDM with and he was induced a week early with a very quick delivery, again vaginal but with just gas and air, he only weighed 7lbs 7oz I guess with the control of the GDM he didn't get big. This time round my last scan at 36+1 estimated the weight at 10lbs with just under 4 weeks to go. I saw consultant yesterday and they are happy not to induce me but to examine me at 39 wks to see if cervix is favourable or if I am "fed up"(her words), if cervis is favourable then they will consider doing a sweep and/or inducing. My question is how accurate are the scan estimates with regards to the weight, I have heard mixed stories about how they estimate it and it comes out lower than expected and vice versa. Both my partner and myself are tall and the femur, head and abdominal measurements are right off the end of the scale.



    Also I have seen an anesthetic (excuse spelling) and he has put on my notes that if i want an epidural that he should be contacted as soon as I go on to the labour ward. I have read about the risk etc re epidurals I am in two minds about having one with larger babies I am guessing it is harder to push them out so if an epidural slows down the contractions and you also can't feel them will it make my labour longer and harder to push baby out or since its my third will it be quicker? Any advice you can give me will be much appreciated. My first labour was back labour, painful and the second even more painful cos I was induced I would like a more pain controlled labour this time round!!
  • Hi

    I am currently 40 + 5 with my second child. My first birth was very straight forward, (sweep at 40+6, was already 5cm dilated having had no pain, waters broken and 5hrs later with just gas and air my little girl was born. No complications).

    For some unknown reason I am absolutely terrified of giving birth second time round, despite everything going so smoothly last time.

    I am going to see my midwife tmw and have been offered a sweep again, I am wondering how likely it is that I will already be dialated and that my labour will be similar to last time. I know that there are no guarantees but feel like I need some kind of reassurance.

    Are 2nd labours generally

    Easier/harder

    Longer/shorter

    Bigger/smaller baby

    More/less painful



    Thanks.
  • Hello everyone



    My name is Nikki Khan and I am Prima Baby's Expert Midwife and am here from 12pm to help alleviate any concerns you may have about pregnancy and childbirth .



    So am awaiting your questions and looking forward to chatting with you!





    Nikki
  • Hi Nikki,



    I am 32 weeks tomorrow and have had some complications throughout pregancy, am on 40ml of Clexane each day due to APLS and Factor V Lieden. At my last consultant appointment on Friday I had protein in my pee and my blood pressure was 130 over 80 so they are now watching me for pre-eclempsia. What is the likely hood that I have this or will develop this? Also, what would be the course of action to deal with it? It is worrying me as I also have been found to have Group B strep and am frightened about labour.



    I hope you can help



    Thanks



    Natasha
  • Hi Nikki



    I am currently 17+6, i have a fetal heatr monitor at home and have been using it every now and then.

    I always pick up my baby's heartbeat about 5 cm above my bikini line and I just wondered if this is ok as it seems quite low?



    I have a bump now so wouldn't the baby be higher as the uterus is just under your belly button?



    my midwife picked it up allot higher a couple of weeks ago just under my belly button so i was wondering if perhaps its just different equipment?



    thank you! xxxxx
  • Hi EmCB

    To have a homebirth you often have to fulfil certain criteria. Having a forceps delivery first time round does not mean you cannot have a homebirth the next time as long as there were not any complications during the first pregnancy, labour or afterwards, such as your placenta got stuck or you lost a lot of blood. You would have to talk it over with your consultant and midwife at booking and they will help talk you through your options before you make a decision. They will also need to make sure the present pregnancy would continue going to plan of course! You can choose which hospital to deliver in, although the nearest one is often recommended for obvious reasons, especially as second labours are often quicker. However if you feel strongly about which hospital you want to deliver at , discuss this carefully with your GP as to what options are available.

    Remember every birth is different and hopefully the next time round will be easier for you...

    Good luck

    Nikki
  • hi Nikki,



    when i had my daughter 19 months she was a emerg c section to due to being breach, this time around my consultant assumed i'd have another csection, i've read they information given to me by the hospital and still cant make my mind up, if i went for a planned section approx how far in advance do they carry it out also do they take into account that my daughter was born at 38 weeks?
  • Hi Nikki,



    There are two questions I would like to ask you.



    First I am nearly 8 weeks pregnant and have been booked for my first scan at the end of Feb but have not hearded from the midwifes in the hospital regarding the blood tests I need to have done. This is my second pregnancy and I remember that with the first I had few blood screening tests done in the begining. Should I contact the hospital and find out?



    Also in about two weeks I have to fly over to portugal and have read about flying not beeing very good in the firts 12 weeks. Is that true?



    Many thanks

    Anna
  • Hi Everyone



    I will answer all your questions posted by 1pm today, so please bear with me if I am a bit delayed getting to yours!



    Many thanks!



    Nikki
  • Hi snoopyUK3

    Congratulations on the pregnancy first of all! I can understand your concerns but as you have delivered a big baby before your Consultant may well think you will be fine to deliver vaginally this time round. It is unlikely you will go past your due date, especially if you have GDM again & they may even favour induction if you do not go into labour, but fingers crossed that you start labour on your own! The fact that the anaesthetist has said he wants to be contacted early could also be a good thing & it may be because your epidural with your first pregnancy did not work and this time he wants to ensure all goes to plan. Epidurals can make the urge to push less but most epidurals still allow the urge to push to be present, although they can tend to slow down the labour. On a positive note, if you have had a baby before, your labour will often be quicker, although some people say that third labours do tend to be slower!

    By the time you are in the late stages of pregnancy, scans are accurate, as long as your baby is small or average size, however when your baby is bigger than average like your little one it is harder to measure him so potentially they can be less accurate in your case!

    Have a chat with your Consultant or Midwife about your concerns and hopefully she can help to reassure you that everything is going to plan!

    Nikki
  • Hi shrewpin

    Good question!

    In general terms, second labours are often quicker so considering your previous birth was quite quick, make sure your ring the hospital at the first twinge! Don't worry you will have time so please don't worry, but make sure you have your partner's contact details at hand, especially when you go for a sweep and your bags packed ready to go!

    Second babies are also normally bigger but the labours are often easier, so hopefully things won't be too traumatic and having a sweep is a good idea as that may be all you need to get the labour going!

    It is natural to be apprehensive about labour even second time around so please talk to your midwife tomorrow and she will hopefully reassure you...

    Good luck!

    Nikki
  • Hi Nikkikayj

    I can imagine how you must feel but you can get quite a few twinges in the first and second trimester that are harmless, as the uterus expands and the ligaments around the uterus are stretched. It could be you are overdoing it a bit and your uterus is a bit irritable, thus telling you that you need to slow down a little!

    If you cannot get hold of your Midwife try contacting your GP for advice and reassurance as I can fully understand that you don't want to wait until 14 February! Sometimes if you have a urine infection, it can give you strange feelings in your tummy and your GP can check this for you.

    First time mums often are not aware of their baby moving between about 18 to 20 weeks pregnant, but it can be later, so please do not be concerned about not feeling many movements.

    If the pain persists or you have any vaginal bleeding you should attend the Accident & Emergency Department so they can review you and put your mind at rest!

    Hopefully the discomfort will pass & good luck with the rest of your pregnancy!

    Nikki
  • Hi Natasha

    I can quite understand why you feel worried, but you are being monitored more closely than most pregnant women because of your blood disorder so if you are having problems this will be picked up and treated early. No-one can say if you are going to develop pre-eclampsia apart from your treating doctors and midwives who are reviewing your blood tests regularly , so have a chat with them about your concerns and I am sure they will be able to put your mind at ease .

    If you are developing pre-eclampsia, you will have regular blood tests and CTG's and may also need to be started on certain medication to control your blood pressure. It may be that you will need to be induced before Term but you can discuss this with your Midwife about the protocols in their hospital.

    With regards to being Group B strep, this simply means that you will be given IV antibiotics once you go into labour to prevent your little one being born with an infection.

    Even with all these little 'hiccups', your obstetric and midwifery team will be there to monitor and reassure you along the way.

    Take care and stay positive!

    Nikki
  • Hi LittleMissImpatient

    As a guideline, your belly button level is 20 weeks gestation & approx. 3cms below would be approximatekly 17 weeks gestation. However your Midwife will be measuring you whilst you are lying down and at a different angle to you when she is looking at your tummy, so don't be concerned about the difference in the location of your baby's heartbeat. Your baby is growing and that is the main point!

    Good luck



    Nikki
  • Hi Isabellasmummy

    Firstly you do not necessarily need to have a caesarean section the second time around and in fact many women have a VBAC - Vaginal birth after caesarean. It may be that your baby is in the breech position again however and if that is true than a caesarean section would be the preferred method of delivery. With regards to when a planned caesarean section is carried out, it is normally around 38 weeks but you may need to discuss this with your consultant as to what his recommendations would be.

    Nikki
  • Hi ani79

    The blood tests are normally done as part of your booking appointment around 11 or 12 weeks and are normally with the first scan o that would probably fit in with your antenatal schedule. It may be that the first time around your booking appointment was a little earlier. Your booking appointment should take place by 10 weeks gestation.



    With regards to flying in the first trimester, it is best avoided due to the increased risk of miscarriage in this period & should be specifically avoided if there is any history of miscarriage or premature birth, excessive morning sickness or any problems such as bleeding in the first trimester, so always check with your GP first.. Second trimester is often the best recommended time to fly.

    Good luck with the rest of your pregnancy!

    Nikki
  • Thank you to everyone for all your questions.

    Am signing off now and wish you all good luck in your pregnancies!



    Check out my website for Intensive Antenatal Classes starting in February 2012.



    www.nikkikhan.co.uk



    Nikki x
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