Pregnancy: Multiple Births, Twins, Triplets, and More
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Cesarean delivery is a surgery to deliver a baby through a surgical cut (incision) on the abdomen and uterus.
Cesarean delivery is a surgery to deliver a baby through a surgical cut (incision) on the abdomen and uterus.
Cesarean delivery is a surgery to deliver a baby through a surgical cut (incision) on the abdomen and uterus. It is generally a safe procedure for the mother and baby. There may, however, be a few risks to the health of the mother and baby. These risks are described below.
Risks to the baby:
Breathing problems: The baby may develop abnormally fast breathing called transient tachypnea of the newborn. Breathing problems generally occur because, in cesarean delivery, the delivery occurs without the start of labor. Thus, there is insufficient clearance of fluid from the lungs of the baby. Breathing problems usually improve within the first two days of delivery.
Injuries: Rarely, there may be injuries to the newborn from the instruments used during the surgery.
Effect of anesthesia: The use of regional anesthesia has reduced the chances of anesthesia side effects on the newborn. Some regional anesthesia may also reach the baby. Its sedating effect on the baby, however, is considerably less than that of general anesthesia.
Risks to the mother:
Excessive bleeding that may require a blood transfusion
Infections such as endometritis (an infection of the womb lining)
Injury to the bladder
Bowel injury
Reactions to anesthesia or the medicines
Deep vein thrombosis (formation of blood clots, especially in the deep veins of the legs or pelvic region)
Potential risk in future pregnancies such as problems with the placenta or the need for a future cesarean delivery. Many women, however, may have a vaginal delivery or vaginal birth after a cesarean delivery (VBAC).
What is a cesarean delivery?
Cesarean delivery is a surgery to deliver a baby through a surgical cut (incision) on the abdomen and uterus. Modern-day cesarean deliveries are generally safe. They may, however, have a higher risk of complications than a vaginal delivery. Having a cesarean delivery does not mean that future deliveries will necessarily be through cesarean delivery. Many women have delivered through vaginal birth after cesarean delivery or vaginal birth after cesarean delivery. However, there may be an increased risk in future pregnancies such as problems with the placenta or the need for future cesarean delivery. There may also be a risk of tearing of the womb or uterine rupture in future pregnancies, especially when a vaginal birth is attempted. The hospital stay and recovery are also shorter in vaginal deliveries compared with those in cesarean deliveries.
Nonetheless, cesarean deliveries are crucial to delivering a baby in situations that may pose a threat to the mother’s or baby’s health. The surgery is done by an obstetrician. Present-day cesarean deliveries are safer because of the advancements such as the preferred use of regional anesthesia instead of general anesthesia and horizontal instead of a vertical incision on the uterus.
SLIDESHOW
Conception: The Amazing Journey from Egg to Embryo See Slideshow
When is a cesarean delivery needed?
A cesarean delivery may be done as an emergency surgery or a scheduled or elective surgery.
Emergency cesarean delivery may be done when
There is placental abruption (a condition in which the placenta separates too soon from the wall of the uterus).
There is slowing or non-progression of the labor that does not improve with medications.
There is fetal distress (the baby’s heart rate becomes abnormal because of reduced oxygen supply to the baby).
There is compression or pinching of the umbilical cord that may affect the baby’s oxygen supply.
There is umbilical cord prolapse (a condition in which the umbilical enters the birth canal before the baby).
The baby’s head or body is very large to fit through the birth canal.
Planned cesarean delivery may be done when
The baby’s position in the uterus is breech (the feet or bottom first) or transverse (sideways).
Some birth defects are present such as severe hydrocephalus (a condition in which excess fluid builds up in the brain).
There are some problems with the placenta such as placenta previa (the placenta rests too low in the uterus and covers the cervix).
The mother has some infections that may make a vaginal delivery risky for herself or the baby such as human immunodeficiency virus (HIV) or an active case of genital herpes.
There are multiple pregnancies (some cases).
The mother previously had a uterine surgery or cesarean delivery (many women, however, have delivered through vaginal birth after cesarean delivery or vaginal birth after cesarean delivery).
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Medically Reviewed on 10/29/2020
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Top What Are the Side Effects of Cesarean Delivery? Related Articles
Childbirth Delivery Methods and Types
There are various childbirth delivery methods and types such as the Lamaze method, the Bradley method, water birth, and assisted births. Options for where a woman can deliver her baby include home birth, a birthing center, and a hospital. The method and type of labor and delivery options should be discussed with a woman's doctor.
Are C-Sections Really That Bad?
In most births, the baby exits the uterus through the birth canal after a period of labor. C-sections are more complex than vaginal births because they are a form of surgery.
Are Childbirth Classes Really Necessary?
Childbirth is one of the most important and life-changing phases in a couple’s life, particularly in a woman’s life. To learn about the challenges of childbirth and ways to deal with them, there are childbirth classes. Make sure you always register for a class conducted by certified personnel.
C-Section (Cesarean Birth)
C-section (cesarean birth) is surgery to deliver a baby. C-section options, what to expect before, during, and after the delivery of your baby are important considerations for birth. Reasons for a C-section delivery include multiple births, health problems, problems with the pelvis, placenta, or umbilical cord. Vaginal birth after a C-section (VBAC) is also an important issue to discuss with your doctor if you have had prior C-section deliveries.
Pregnancy Symptoms
What are the early signs and symptoms of pregnancy? Can you know before your missed period? Read about nausea and vomiting (morning sickness), bloating, tender breasts, and more. Explore first trimester symptoms of pregnancy and learn what week pregnancy symptoms start.
How Common Are Complications During Childbirth?
Labor or childbirth is a physiologic process during which the fetus, membranes, umbilical cord and placenta are expelled from the uterus. The most common complications during childbirth include preeclampsia, eclampsia, gestational diabetes, preterm labor, infections and uterine atony.
How Do You Do CPR On a Newborn?
Neonatal resuscitation (CPR) provides oxygen, stimulates breathing and gets the heart to start pumping normally. Most premature babies and babies with certain congenital conditions require extensive resuscitation.
Is Natural Birth Better Than Epidural?
You might feel pressured to have a natural birth or an epidural, but the fact is that one isn’t necessarily better than the other.
Pregnancy (Week by Week, Trimesters)
Signs and symptoms of pregnancy vary by stage (trimester). The earliest pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue, and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Eating a healthy diet, getting a moderate amount of exercise, also are recommended for a healthy pregnancy. Information about the week by week growth of your baby in the womb are provided.
Stages of Pregnancy: Week by Week
See pictures on the various stages of pregnancy. See and learn what changes a woman's body goes through and view fetal images of how her baby grows during the 1st, 2nd and 3rd trimesters.
What Are the Steps in Neonatal Resuscitation?
Neonatal resuscitation is a series of emergency procedures performed by a doctor to support newborn babies who are not breathing, are gasping or have a weak heartbeat at birth. These skills allow a doctor to save the lives of newborn babies.
What Is More Painful C-section or Natural Birth?
Ultimately, a natural birth may be more painful than a cesarean section. However, the pain after your cesarean section combined with the heightened risks to you and your baby may outweigh the initial pain of childbirth.
Why Do Doctors Shave You Before Delivery of Your Baby?
Pregnancy labor shave of the perineum before delivery is usually a topic for debate. Doctors may shave you before delivery for hygiene reasons or to reduce the risk of infection due to a surgical incision or C-section incision.
Why Is an Epidural So Bad?
An epidural is a form of regional anesthesia that blocks pain in a particular region of the body. Most epidural side effects are rare and may include soreness, nausea, shivering, drop in blood pressure, ear ringing, difficulty urinating, backache and soreness.
Why Would A Newborn Need A Ventilator?
Some babies may have trouble breathing. Respiratory distress or failure may be the result of underdeveloped lungs or a congenital condition. The mechanical ventilator provides oxygen until the baby can breathe unassisted.
16 Early Signs of Pregnancy: Could You Be Pregnant?
Reviewed By: Melissa Conrad Stöppler, MD
Reviewed on 3/31/2022
Introduction to Pregnancy Symptoms
A missed menstrual period is often the first recognizable sign of a possible pregnancy, but there are other signs and symptoms of early pregnancy as well
A missed menstrual period is often the first recognizable sign of a possible pregnancy, but there are other signs and symptoms of early pregnancy as well. Some subtle signs appear in the first week, and more may be apparent in the weeks before your first missed period.
Keep in mind that not all women have all symptoms or experience them in the same way. Some of the most common first trimester pregnancy symptoms are discussed in the following slides. Read on to learn more early pregnancy signs.
Missed Period
The first sign many women recognize as an early sign of pregnancy is a missed menstrual period.
The first sign many women recognize as an early sign of pregnancy is a missed menstrual period (amenorrhea). Some women may experience lighter-than-normal periods, and they may also have spotting that can occur 1 to 2 weeks following conception.
A missed menstrual period can be caused by other conditions aside from pregnancy, so it is not always a definitive sign.
Breast Swelling, Tenderness, and Pain
You may notice tenderness or swelling in your breasts in the first or second week after you conceive.
Breast enlargement, tenderness, or pain similar to premenstrual symptoms can occur early in pregnancy. Early pregnancy breast changes may include breasts that feel full or heavy, and the area around the nipple (areola) may darken. A dark line called the linea nigra that runs from the middle of the abdomen to the pubic area may appear. You may notice tenderness or swelling in your breasts in the first or second week after you conceive.
When Does Morning Sickness Start?
A woman experiences nausea and vomiting due to morning sickness.
"Morning sickness" is nausea and vomiting that typically come in the morning in early pregnancy. When does morning sickness start? This usually happens between weeks two and eight of pregnancy. It's somewhat a misnomer because morning sickness symptoms like nausea and vomiting can actually happen at any time. It's thought that changes in levels of estrogen may play a role in developing nausea.
Another early pregnancy sign may be food cravings or aversions. Women may have an unusual urge to eat a particular food, even one she previously did not like, or she may be completely repulsed by a food she used to love. This is common, and usually the food aversions fade at the end of the first trimester.
Fatigue and Tiredness
The extra progesterone in a woman's body during pregnancy may cause her to feel fatigued and tired, and her need for naps increases.
The extra progesterone in a woman's body during pregnancy may cause her to feel fatigued and tired, and her need for naps increases. By the second trimester, energy levels usually rise again.
Is Bloating an Early Sign of Pregnancy?
The rise in progesterone during pregnancy can also cause abdominal bloating, fullness, and gas.
The rise in progesterone during pregnancy can also cause abdominal bloating, fullness, and gas. The weight gain in the first trimester is usually minimal, but swelling and fluid retention may make you feel as if you have gained more than the typical one pound per month.
Frequent Urination
The urge to urinate more frequently starts about six weeks into pregnancy.
Frequent urination starts about six weeks into pregnancy, thanks to the hormone human chorionic gonadotrophin (hCG). The hormone causes increased blood flow to the pelvic area and can stimulate the urge to urinate. Later in pregnancy, the urge to urinate may be increased by the growing baby in the enlarging uterus putting pressure on the bladder.
Basal Body Temperature in Pregnancy
The basal body temperature usually rises around ovulation and lasts until the next menstrual period.
Many women hoping to become pregnant will chart their basal body temperature (the lowest body temperature in a 24-hour period, usually first thing in the morning after waking). The basal body temperature usually rises around ovulation and lasts until the next menstrual period. During early pregnancy, basal body temperature may remain high past the time when a woman would normally have her next period.
Pregnancy Mask (Melasma)
During the first trimester, the skin on your forehead, bridge of your nose, upper lip, or cheekbones may darken.
During the first trimester, one of the early signs of pregnancy is melasma. This is when the skin on your forehead, bridge of your nose, upper lip, or cheekbones may darken. This is often referred to as the "mask of pregnancy," and the medical term is melasma or chloasma. It is more common in darker skinned women and those with a family history of melasma.
Early Pregnancy Mood Swings
Rapid changes in hormone levels during pregnancy may be responsible for mood swings and feelings of stress.
Rapid changes in hormone levels during pregnancy may be responsible for mood swings and feelings of stress. When do pregnancy mood swings start? Newly pregnant women may feel emotional, anxious, or depressed, and have crying spells. Mood swings may be worst in the first trimester, easing up somewhat in the second, and coming back as the pregnancy nears the end in the third trimester.
Pregnancy Headaches
Headaches are common in early pregnancy.
In early pregnancy, headaches are common. They may be caused by the surge of hormonal changes that begin soon after conception. Or they may be sinus headaches brought on by nasal congestion, which may also be a symptom of early pregnancy.
Bleeding, Spotting, or Discharge (Leukorrhea)
You may also experience light bleeding following a pelvic exam, Pap test, or after sex.
About 15% to 25% of pregnant women experience light bleeding or spotting in early pregnancy. This symptom can begin as soon as one week after conception. You may also experience light bleeding following a pelvic exam, Pap test, or after sex. This is common and usually not concerning, although if bleeding occurs later in pregnancy it can be serious.
Thin, milky, vaginal discharge is normal throughout pregnancy, and it may occur every day that you are pregnant. This is called "leukorrhea," and it is caused by the extra estrogen your body is now producing. The color of discharge in early pregnancy may be white or clear, and it may have a mild odor or none at all, all of which is normal. This is a necessary side effect of pregnancy, so there is no medical treatment for leukorrhea. However, it may be distressing for some women. Panty liners can help. But avoid tampons, which may cause infections.
Constipation
Many pregnant women become constipated.
Many pregnant women become constipated. Possibly more than 35% of pregnant women develop this discomfort, according to some experts. This may be due to the hormonal changes that pregnancy causes, including an increase in progesterone.
Relief of constipation in early pregnancy may include drinking more fluids, eating more fiber, and getting enough exercise to move things along. But if these safe remedies don't work, with a doctor's guidance you may find other helpful treatments that are safe during pregnancy, such as certain types of laxatives. Do not take any medication while pregnant without your doctor's recommendation.
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Pregnancy: Multiple Births, Twins, Triplets, and More
Reviewed By: Melissa Conrad Stöppler, MD
Reviewed on 11/8/2021
What Are Multiple Births?
The number of multiple births is on the rise thanks to fertility treatments.
When a woman carries more than one infant in her uterus during pregnancy, they are called "multiples." When a mom gives birth to twins, triplets, quadruplets, quintuplets, sextuplets, or even more babies, it is termed a multiple birth. The babies may be genetically identical or genetically different (fraternal). It is becoming more common for women to carry and give birth to many infants at one time due to assisted reproductive technology (ART). Multiple pregnancy also occurs naturally without the help of medical intervention.
What Are Identical Multiple Births?
Identical twins are born genetically identical.
An embryo consists of one single egg fertilized by one sperm. Sometimes, the egg splits in two, resulting in genetically identical twins. If one of these eggs splits again, triplets result. Four or more identical babies may result from eggs that split, but this is much more rare than twins or triplets. However many times an egg splits, the babies will be 100% genetically identical and will be the same gender. Approximately 3 or 4 of every 1,000 live births are identical.
What Are Fraternal Multiple Births?
Fraternal twins are siblings that are not genetically identical.
If a woman releases more than one egg per month, it is possible for multiple eggs to become fertilized at the same time. Each egg has distinct genes and is fertilized by different sperm. This results in multiples that are genetically unique, or fraternal. The babies may be different genders. They may appear as alike or dissimilar as any other genetically unique brothers and sisters. Fraternal multiples are more common than identical ones.
Is It Possible for Multiples to Have Different Dads?
It is possible for multiples to have different dads.
A woman is fertile for a certain amount of days every month. If a woman releases two or more eggs during this fertile period, the eggs may be fertilized at different times. If a woman has more than one sexual partner around the time of ovulation, it is even possible for the eggs to be fertilized by different men. Multiples may be conceived at different times by different fathers in the same pregnancy.
Communication Begins in the Womb
Parents of twin siblings notice their special bond.
Many parents of twins notice the children have unique ways of communicating with each other. They may even have their own secret language. One study of twins in utero found that by the 14th week of gestation, the infants make specific movements towards each other. The movements are intentional and not accidental. Additional studies are needed to see if the same behavior occurs with triplets, quadruplets, and other multiples.
Giving Birth to Multiples
Multiple pregnancy babies are often born via C-section.
Women who are pregnant with two or more babies may give birth via a cesarean section, or C-section. The doctor makes an incision in the lower abdomen and uterine wall to deliver the babies. Women who carry two or more infants at a time may experience more potential complications by trying to give birth vaginally. In cases in which the health of the mother or the infants is at risk, C-section birth may be necessary. Many twins and most triplets and greater numbers of multiples are born via C-section.
What Is Fertility Treatment?
Fertility drugs increase the chance of twin pregnancy and multiple pregnancy.
Fertility treatment increases the chance that a woman may conceive more than one baby at a time. Some fertility drugs increase the number of eggs released by the ovaries. More eggs mean a female has more chances to get pregnant. It also means she is more likely to get pregnant with fraternal multiples.
What Is In Vitro Fertilization?
In vitro fertilization is more popular in recent years.
This is a type of assisted reproductive technology (ART) in which a female is first given fertility drugs. Eggs are then harvested and fertilized with sperm in a laboratory procedure. The resulting embryos are then implanted within the female's uterus. Sometimes, two or more embryos are placed within the uterus to increase the chance of a successful pregnancy. With this procedure, a female may end up carrying more than one embryo if more than one implant successfully.
Do the Age and Race of the Mom Matter?
More twins are born from African-American women than from females of other races.
African-American females have twins more often than women of other races. Asian females are least likely to have twins. A little more than one-third of American females over the age of 30 have babies. Women over the age of 30 are more likely to release two or more eggs during ovulation, so older females are more likely to become pregnant with more than one baby. This is a natural phenomenon that occurs without infertility treatment. Hormonal factors are likely responsible for the effect.
Does the Height of the Mom Matter?
Tall moms have hormones that increase fertility and the chance of multiple births.
Mothers who carry more than one baby at a time are an average of 1 inch taller than moms who carry single babies. Tall women tend to have higher levels of insulin-like growth factor (IGF), a hormone that may be responsible for the effect. This hormone stimulates the ovaries to release many eggs at once.
Milk Increases the Chance of Multiples
Dairy consumption increases the likelihood of multiple pregnancy.
Ovarian Stimulation
One study found that women who consumed milk and dairy products were more likely to have a multiple pregnancy than women who were vegan. Vegan females had twins at one-fifth the rate that vegetarian and omnivorous females did. The effect was especially pronounced in regions where the cattle were treated with growth hormones. Consuming dairy products from cows treated with growth hormone is supposed in the study to increase insulin-like growth factor, a hormone that stimulates the ovaries to release more eggs. However a different study concludes there is no difference in the level of hormones found in milk from treated cows compared to conventional milk.
Other Factors for Multiple Pregnancy
High BMI increases the chance of pregnancy and multiple births.
Multiple pregnancy runs in families. A woman who has a sister or mother who has fraternal twins is approximately twice as likely to have fraternal twins herself. Females who have a higher body mass index (BMI) are also more likely to have fraternal twin pregnancies. BMI is an indicator of body fat. Having a BMI that is higher than ideal is bad for your overall health.
What's the Risk of Preterm Delivery?
It is more common for multiples to be born preterm.
When a mom is pregnant with more than one baby, preterm delivery is very common. Newborns who are delivered under 37 weeks are considered preterm and likely to have low birth weight. Early delivery is a common risk of multiple pregnancy. Infants delivered at 39 or 40 weeks of gestation are considered full-term. Newborns born before 32 weeks of are more likely to suffer from long-term health problems including vision issues, hearing loss, cerebral palsy, and potentially brain damage. During pregnancy, doctors watch for signs of fetal distress and monitor for the possibility of preterm birth.
What Is Preeclampsia?
Preeclampsia rates are higher in females carrying more than one fetus.
Preeclampsia is a condition in which pregnant mothers develop high blood pressure and possibly vision problems, headaches, vomiting, and nausea. Any pregnant mom can develop the condition but it is more common in multiple pregnancy. The condition is treatable with medication. Preeclampsia typically goes away after delivery. Frequent and adequate prenatal care decreases the risk that mom and babies will develop complications due to preeclampsia.
Prenatal Care Is Vital
Females pregnant with multiples need special medical care.
Moms with multiple pregnancy have a higher risk of potential complications, so frequent check-ups are necessary. Fetuses are also at increased risk in multiple pregnancy. The doctor will track fetal growth and development. The physician will monitor mom's weight, blood pressure, blood sugar, and other factors. The doctor will also look for signs of early labor.
cesarean delivery side effects?
