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Pregnancy & Childbirth

Childbirth Resources

Choosing Anesthesia

Early in your pregnancy, you should discuss options for pain management and anesthesia with your obstetrician. Anesthesiologists are on call and available for all births, 24 hours a day, seven days a week.

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Many patients who deliver at Virginia Hospital Center choose an epidural block, a type of anesthesia that numbs the nerves to the lower body to decrease or even eliminate the pain of contractions. The process is virtually painless, and the epidural will take effect within 10 minutes. Epidurals can be used for vaginal cesarean deliveries when appropriate. In the case of a cesarean delivery, you may receive a higher dosage of an epidural anesthetic, but you will be able to stay awake and have your support person remain with you during delivery.

For cesarean deliveries, when an epidural anesthesia is not the best choice your physician might decide on general anesthesia, which is administered intravenously. Under general anesthesia, you will remain asleep throughout the procedure. A breathing tube inserted during the procedure will be removed before you awake.

No matter the type of anesthesia, our highly trained physicians, and nurses will provide the safe and superior service you expect from Virginia Hospital Center.


When a Cesarean Section is Necessary

A Cesarean section is performed when vaginal delivery is considered to be unsafe for mother or baby.

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“The first Cesarean section has to be done for the right reasons because 90% of women will have a repeat Cesarean section for subsequent deliveries. With each Cesarean delivery, the risks of complications and long-term problems are much higher compared to vaginal delivery,” explains Dr. Fernandez. If the mother has a vaginal delivery as a first delivery, the likelihood of subsequent vaginal births is 90%.

A Cesarean section is performed when vaginal delivery is considered to be unsafe for mother or baby, including when the baby is in the breech position, when mom has had previous gynecological surgery or when other complications arise during labor.

Considered major abdominal surgery, a Cesarean section requires a longer hospital stay and recovery time of 6 weeks. Moms require more assistance because they must be careful about lifting the baby. Managing stairs and doing errands without help is more difficult. Breastfeeding can be challenging due to pain from a healing incision. Virginia Hospital Center has International Board Certified Lactation Consultants who can help position the baby comfortably to facilitate breastfeeding and avoid pressure on the incision.

Labor is a Natural Process

“Evidence now shows that labor actually progresses more slowly than we had previously thought.

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Many women may just need a little more time to labor in order to deliver vaginally,” says Dr. Moxley, who serves as the Vice Chair of ACOG’s Committee on Patient Safety & Quality Improvement. “Patients appreciate that we’re giving them every chance possible to have a safe vaginal birth.” Moms can walk the halls, use an exercise ball, and just take it easy during the early stages of labor. “By avoiding interventions in the natural labor process until necessary, we optimize the chance of having a vaginal delivery,” adds Dr. Fernandez.

“Our nurses are committed to allowing labor to happen on its own schedule,” says Williams. Nurses constantly monitor the needs of the mother and the condition of the baby, and communicate with the OB/GYN or midwife about their progress. They recognize when moms need to rest, focus on maternal efforts, and spend time reassuring and coaching. “We practice patience here.”


Breastfeeding

Why does the Women & Infant services unit consistently garner high patient satisfaction scores in quarterly Gallup polls? Some say it's the teamwork and compassion of cross-trained nurses who are skilled in labor/delivery, nursery and maternity unit care. Or, perks such as room service, an online nursery and a recent makeover in decor.

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For many, though, one saving grace is the nurturing wisdom of our experienced lactation consultants. Although breastfeeding is a natural process, ironically it doesn't always come naturally. Many women find this initiation into motherhood difficult and fear that they won't produce enough milk to feed their babies.

Our consultants teach new moms how to properly "latch" their babies to avoid soreness and ensure a rhythmic flow of milk. Breastfeeding should begin as early as possible (ideally within an hour of birth), and feedings should be frequent - as many as 8 to 12 times per day.

While many new mothers feel compelled to supplement breastfeeding with formula, we discourage this practice unless bottle-feeding is deemed medically necessary due to problems with low blood sugar, dehydration or excessive weight loss. The use of formula early on can condition babies to breastfeed less and to suck differently, which can cause sore nipples when breastfeeding resumes. To alleviate fears about underfeeding, new parents can track their babies' urination/stooling patterns and weight to ensure healthy growth. Breastfeeding is a "learning process in which practice makes perfect."

Choosing how and what to feed your baby is a personal decision that deserves careful and thorough consideration of the facts, your opinions, and options. Feeding your baby breast milk or bottled formula are both healthy and responsible decisions, each with advantages and disadvantages. How and what to feed your baby is a decision that should "fit" you, your baby, and your family.

Breastfeeding is the natural nutritional source for infants less than one year of age. Most healthcare professionals recommend breastfeeding for your baby's first year (including the American Academy of Pediatricians and the National Association of Pediatric Nurse Associates & Practitioners). Breast milk is the best source of nutrition for the first six months of life. It contains appropriate amounts of carbohydrate, protein, and fat, and provides digestive enzymes, minerals, vitamins, and hormones that infants require. Breast milk also contains antibodies from the mother that can help the baby resist infections. Experts agree that breastfeeding your baby for any length of time, regardless of how short, is of benefit to you and your baby.


Postpartum Depression

Many women experience some feelings of inadequacy and sadness after the birth of a baby. These feelings tend to last about 3-4 days and often go away as quickly as they come. However, in about 30% of new mothers, these symptoms get worse and are indicative of Postpartum Depression (PPD). They can last 2 weeks or more.

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Symptoms include:

  • Difficulty sleeping
  • Loss of appetite
  • Little interest in things you used to find pleasurable
  • Nervousness and excessive worry
  • Thinking your baby would be better off without you
  • Crying over the slightest issues
  • Separating yourself from family and friends
  • Difficulty concentrating
  • Unexplained anger
  • Thoughts of hurting yourself
  • You stop caring for your baby
  • Thoughts of hurting your baby

Postpartum Depression is a real and very treatable disease. If you are experiencing symptoms of PPD, Virginia Hospital Center wants to help. Get in touch with your Obstetrician immediately so they can refer you to a mental health professional. They will provide reassurance, guidance and, if necessary, a referral for professional counseling.

  • How common are anxiety and depression after giving birth?
  • How is this different from the "baby blues?"
  • What causes perinatal mood and anxiety disorders?
  • How are they treated?

One Mom’s Story

“This is not traditional depression. What these moms feel is isolation, anxiety and loss of confidence.”
Mary Crowther, MBBS, OB/GYN

Mandy had wanted to have a baby for so long and, yet, she felt unhappy throughout her first pregnancy. After her first child was born, “everything really went downhill,” she recalls. “Breastfeeding was a struggle. I was not able to sleep at all and I felt completely overwhelmed. I wasn’t enjoying my baby.”
Two weeks after delivery, Mandy went to see her OB/GYN who recommended she get help at home to get more rest and also see a therapist. Once her son started sleeping longer, things were a little better, but Mandy still felt anxious and depressed.
“I was scared to give my baby a bath by myself for fear that I would drop him,” she says. “The anxiety was paralyzing.”
Mandy started attending the Postpartum Support Group. It helped her to hear other women’s stories and to see “it wasn’t just me,” she says.
After one particularly difficult weekend, her therapist said it was time to consider taking a low dose anti-depressant, a treatment Mandy had resisted initially. This time, she agreed.
“Within weeks, my crying was much less intense and I didn’t feel as sad. My anxiety was still there, but more manageable,” she says. It took about nine months after her baby was born for Mandy to feel completely like herself again.
The decision to have another baby was one that she and her husband considered carefully. Her experience with her second son has been “100% different. My anxiety is much lower and every moment with him has been a joy,” Mandy says.
She still attends the Postpartum Support Group, but for different reasons. “This time, I realize when I have a bad day it won’t last forever. I want to share my experiences and what I learned to help other new moms,” Mandy says.

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It’s Never Too Early to Start Planning for a Healthy Baby


“The earliest a pregnant mom typically sees her doctor is around six weeks. By that time, the baby’s organs have already started developing. You need to take care of yourself way before you get pregnant.” — Dr. Williams.

The road to having a healthy baby starts long before pregnancy. And, while pregnancy typically lasts 40 weeks, planning for pregnancy can take that long, too...

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Pregnancy-related Musculoskeletal Disorders

If you suffer from any of the following diagnosis, Physical Therapy for Pelvic Floor Rehabilitation may be an option for you:

  • Constipation
  • Diastasis Recti
  • Dyspareunia
  • Levator Ani Syndrome
  • Painful Episiotomy
  • Pelvic Organ Prolapse
  • Pubic Symphasis
  • Sacro-iliac Joint Dysfunction
  • Urinary/Fecal Incontinence
  • Vulvodynia

Please consult with your physician and contact Outpatient Rehabilitation Department at 703.558.6507 with any questions.

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