Can the way you sleep prevent stillbirth?

Can the way you sleep prevent stillbirth?

Yes it can!

A new research by ” MiNESS study” has been published today in BJOG: An International Journal of Obstetrics and Gynaecology suggesting that the risk of stillbirth is doubled if pregnant women sleep on their backs in the last three months of pregnancy. This study is the biggest of its kind, and confirms the findings from smaller studies in New Zealand and Australia.

In 2015, there were 2.6 million stillbirths globally, with more than 7178 deaths a day. The majority of these deaths occured in developing countries. 98% occurred in low- and middle-income countries. About half of all stillbirths occur in the intrapartum period, representing the greatest time of risk.

Death of an unborn child is a devastating situation for both parents as well as the doctor involved. There are certain known factors like diabetes, hypertension, placental abruption and others we know that could be in the list of possible causes. But what about those cases where there were no warning signs, no complications and yet the baby stops moving all of a sudden! That is one nightmare each Obstetrician dreads- what could be the cause, did I miss something, what could possibly have gone wrong? And there is no answer at times. Even more horrifying for the to- be parents who have been planning out the name of the baby.

As they say about the drowning man catching straws, this bunch of straws we have through this study is a refreshing change.  It estimates that if all pregnant women went to sleep on their side in the third trimester, there would be a 3.7% decrease in stillbirth – equivalent saving around 130 babies’ lives a year, which is a whole lot !

So what exactly is the logic of a simple sleeping position you may all ask? Well, the logic is that during the last 3 months of pregnancy when you lie supine/ on your back, the weight of the enlarged uterus along with the growing baby exerts pressure on one of your major vessel called the Inferior Vena Cava. Usually, when this compression effect takes place, the Inferior Vena Cava opens up branching vessels which take care of your blood supply during this period. It is when these branches fail to open up, that your blood supply gets seriously curtailed affecting the blood supply to uterus and restricting the oxygen flow to the fetus.

That is why, when you sleep on your sides, can be either your right side or left side, these complications can be prevented. This is a very simple thing that can be incorporated in daily life and prevent unforeseen stillbirths.

How can you check on yourself while you are sleeping? Difficult? Not to worry. Just take care of these simple tips that might help you keep it in check-

  • Put pillows behind your back to encourage you to side- sleeping
  • Go to sleep in any preferred side of yours
  • If you wake up on your back at night, don’t worry. Just roll back on your sides.
  • Even if you are taking a small nap during day, make sure of your side- sleeping position as much as you can.
  • There are Maternity Sleeping pillows available- that may be helpful for those who find it really difficult to sleep on sides.
  • Inform your family members about it- so that they can turn you back on your sides once they notice you on your back.
  • And yes, its not like you cant lie on your back at all ! You can, just not for long periods. Try to keep it as minimum as possible. And as your pregnancy advances, you yourself will find lying on the sides better than on your back since lying straight also hinders with your respiration owing to your cute little baby growing inside you.


So take care of this small thing and continue your beautiful journey to the Motherhood !



The want of a Boy!

The want of a Boy!

Hello folks!

Been a long time since I posted. Had been busy with hospital and realized I have been neglecting the blog.. So hereforth I have decided to quite regular on in here too 🙂

The days in hospital have been gruelsome seeing the deliveries and other problems and just as I am writing I am thinking of this particular patient who disturbs my thoughts, so I might as well share about her to you all.

So, here is this lady who comes in pregnant for the second time, the first being a C- section 2 yrs ago because of her failing to progress in labour and fetal distress. There are set ups where they still do give trials for a previous C section but not in ours according to the guidlines recommended. Previous C section holds risks for the uterus to rupture during those trials of labour patient might get into due to those intense contractions acting upon your previous stitch on uterus. So its basically not safe to try for normal delivery after you have had a C Section just some years back. So, coming to this lady; her first child was a caring little girl who hovered around her mom all the time, and we give her a date for admission to post her for an Elective LSCS as she was already 37 wks and 5 days . They were one of those who strictly believed in astrology, dates , time, etc. They wanted the baby out after 2 1/2 wks because of their astrology which would have been pretty late and we had to convince them of the risks involved . They agreed for the next day as we suggested after a long talk  but still the astrology part remained and now they wanted the baby out early morning 8:00- 8:30 am and wanted us to note the exact time in seconds when the baby comes out.

So we agree to their request and the surgery is planned and everything goes as planned, and we deliver a beautiful baby girl at 8:25 am by C- Section. The baby cries and we hand her over to the paediatrician who takes the baby into his care, wraps her into a clean cloth and brings her to the mother to show this cute little gift of God. The mother acknowledges and we proceed to the rest of the procedure. And then our Senior doctor washes off to congratulate the mother after surgery and finds her sobbing !! On confronting she cries inconsolably , saying she wanted a boy and that the astrologer had said she will be getting a boy this time.

She neglected the baby for a few hours after the operation and gloominess prevailed her face. It was disheartening! Subsequently she did take the baby in her hands, but not with the happiness you expect out of a mom.

There was one more patient, a Muslim, I had come across a few months back, who had 2 girls and she delivered a girl 3 rd time too. This one did not look at the child for about 2 days until we had to force her to breastfeed the child for child’s health. Where she was so adamant about not holding the child, her family was pretty open minded and were consoling her. It was nice to see a family who loved girls. They went on to say her about the blessings a girl brings in house and how they; no matter what always remain a priced treasure for parents who takes care of them in their old age. A Muslim father gets rewarded with Paradise for raising up 2 or more girls with all good morals and behaviour, and this was what the family explained to her.   It was beautiful.

Why does a boy child seem so important still in some families. The women go on getting pregnant and affecting their health in want of a single boy. It’s a child afterall..! And what should matter is that you are lucky to have one, there are families undergoing repeated IVF treatments to be blessed with even one child atleast. Its when you don’t have , you realize the worth! This is something we come across quite often in hospitals , but all I wanted to convey was that be happy you are blessed to have a child when many don’t. Thank God for this happiness and He will make your children the source of your peace and happiness.

Stay blessed.

Smoking – Risking Two Lives

Smoking – Risking Two Lives

When it comes to drug or substance abuse among pregnant women, SMOKING is the most common one pointed out. This condition of smoking during the pregnancy period is very common in the west but it has been noticed that the incidence of smoking in pregnancy is increasing at a very rapid pace in India too.

Woman who smokes during the pregnancy have higher rate of miscarriage. Placental malfunction is the most common form of problems that occurs among the women who smoke as placenta plays an essential part during pregnancy and help in oxygen and nutrition flow. Placental Abruption which causes premature separation of placenta from the uterus. Placental Insufficiency may lead to cause improper supply of blood, oxygen and nutrition to the developing fetus (baby). Under-weight born babies can also be the result of smoking. Cot death is a syndrome which causes an unexplained sudden death of the newborn is very common among the women who smoke during the pregnancy.

Passive Smoking is also something which is worth mentioning in this discussion. Even though a woman is not smoking but if the environment surrounding her contains the the nicotine and carbon monoxide smoke which usually comes from cigarette, can cause almost the same effect on pregnancy.

Due to the above mentioned risks of smoking during pregnancy, its is our duty to persuade women to refrain from smoking. It can really be difficult for anyone to overcome this addiction, but it can never be difficult for a MOTHER.


Menstrual cramps – All about it!

Menstrual cramps – All about it!

Bringing on board one of the most common problem faced by all the ladies at one point of time or another.

    • So, is it really that common ?
    • Is there a need to know if the pain is usual or to be alarmed about ?
    • And what can you do resort to for the relief of pain ?

So here, let’s tackle all of them one by one.

Menstrual pains occur is about 70% teenagers and 30-50% menstruating women.
They can be of 2 types :

      • One that is begins a few hours before or just after onset of menstrual periods and last for 48-72 hrs
      • Second type where pain begins several days before menstrual flow and persists until a few days after stopping of bleeding – this is the type you need to be alarmed about.

This could be due to causes like :

      • Pelvic inflammatory disease
      • Fibroids
      • Polyps
      • Cervical stenosis
      • Congenital malformation of uterus
      • IUCD ( intrauterine contraceptive device)
      • Endometriosis
      • Adenomyosis

Why the pain?

Basically, in a normal cycle, the uterus lining thickens in preparation for pregnancy incase it occurs.
If you get pregnant, this lining remains and supports pregnancy.
If not, after your ovulation time when the ovum or eggs are not fertilized, this uterus lining sheds off and releases a substance called prostaglandin which makes your uterus contract.
This contraction inturn constrict the blood supply to tissues in uterus and thereby uterus squeezes out the dead uterus lining of uterus with each contraction.
This is what you experience as painful cramps during your periods.

When to seek help?

      • painful periods > 3months causing absenteeism from school/work/ hindrance in daily work
      • cramping pain with nausea
      • pain without periods
      • fever, headache, diarrhea

Home treatments-

      • heating pad on abdomen or back
      • massaging abdomen
      • warm bath
      • light nutritious meals
      • reduce intake of salt, alcohol, caffeine
      • Vit E 200mg 1-0-1  ( starting 2 days prior and 3 days during periods)


      • Analgesics- paracetamol 500mg 1-1-1
      • Antispasmodics- hyoscine( buscopan)1-1-1
      • Drotaverine (drotin) 1-1-1
      • NSAIDs- mefenamic acid 250-500mg 1-1-1-1 provides relief in 80-90%
      • Indomethacin  25mg 3-6 times a day- relief 70% cases
      • Ketoprofen 50mg 1-1-1 successful 90% cases

In case you want contraception along with relief of your menstrual cramps,
several options are available on advice of your doctor depending on what might suit you best :

      • Like oral contraceptive pills ( regularizes periods+ contraception+ reduces bleeding)
      • Progesterone containing IUCD (Mirena/Progestasert- relieves pain + contraception)

If not relieved with medical options, evaluation is needed to find the pathology causing it.

Surgical options-

      • Diagnostic hysteroscopy
      • Diagnostic laparoscopy and treatment of causative factors
      • Hysterectomy in elder women- as last resort
      • Transcutaneous electrical nerve stimulation- effective in 45% cases

So, hopefully this helps you to tackle your menstrual cramps better now.

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