Do-it-yourself Pedicure

Let's gather the essentials first. You'll need:
-non-acetone nail polish -remover and cotton balls
-nail file
-buffing block
-sugar scrub to exfoliate
-orangewood stick
-cuticle oil
-moisturizer
-nail polish (base coat, color, and top coat) (optional)

Step 1: Soak your feet
Don't cheat yourself out of
the foot soak just because
you're doing your pedi at
home. This step does more
than clean your feet and
make you feel amazing. It
also softens dead skin cells
in preparation for
exfoliation.
As you let a tub fill with
warm water, remove all traces of old polish. Add to
the water a teaspoon of tea tree oil (to banish stinky
bacteria), a capful of witch hazel (to cleanse and
tone), a half cup of Epsom salts (to rejuvenate), and
three drops of peppermint or rosemary oil (to heal
and freshen). Soak your feet for five to 10 minutes.

Step 2: Scrub off dead skin
To slough off rough spots,
look for exfoliants with
medium-size grains, like
sugar or salt crystals (sugar
is less irritating), and moisturizing agents such as
jojoba or almond oil. Massage each foot for a minute or two with a quarter-size blob of scrub. Start at your heel and work your way out to your toes, ankles, and calves using tiny circular motions. Rinse off with warm water.

Step 3: Buff away bumps
Now it's time to smooth down nasty calluses. Wet a
pumice stone or lava rock, and coat it with a little body
wash.
Using a back-and-forth motion, lightly scrape your heels, the bottoms of your feet, and your toes. The key is to be gentle—you want to abrade only the very top layer of skin, not rub your flesh raw. And don't even think about attacking calluses with a razor blade!

Step 4: Trim and file Using
a strong steel clipper made
specifically for toenails, trim your nails straight across, then smooth the edges with a nail file (a glass file is best). Giving them a slightly
rounded shape helps prevent painful ingrown nails.

Step 5: Moisturize and
massage. Drench your soles
with a moisturizing product
made especially for your
feet. Preferably those that have shea butter to add and lock in moisture; arnica to
reduce inflammation; and
Laponite powder, which zaps
odour.
Using a circular motion, massage a quarter-size dollop of cream all over your feet and lower legs. Then, with the knuckle of your index finger, press down gently into the arch of one foot and knead; repeat on the other foot. The mini massage will relax your feet while boosting circulation, which reduces swelling.

Step 6: Polish (if you want). First, swipe your nails with a non- acetone polish remover
(acetone will damage your
nails) to get rid of any cream
residue left over from your
foot massage. Insert foam
toe separators or roll up a
paper towel and weave it
through your toes. Next,
apply a clear basecoat—the
formula should contain protein, vitamin E, and/or
calcium, all of which will help strengthen brittle nails
and prime them to hold on to polish longer.

Source: Women's Health Magazine

Morning Sickness: Getting Relief

Here are some things you can do to get relief?

If you have a mild case of nausea and vomiting, some relatively simple measures may be enough to help. (If not, there are safe and effective medications you can take.) Many of the following suggestions are not supported by hard evidence, but obstetricians and midwives commonly recommend them, and they have worked for many women.

*Eat small, frequent meals and snacks throughout the day so your stomach is never empty. Some women find that carbohydrates are most appealing when they feel nauseated, but one small study found that high-protein foods were more likely to ease symptoms. Whatever you eat, eat it slowly.
*Avoid lying down after eating (especially on your left side), as this can slow digestion.
*Keep simple snacks, such as crackers, by your bed. When you first wake up, nibble a few crackers and then rest for 20 to 30 minutes before getting up. Snacking on crackers may also help you feel better if you wake up nauseated in the middle of the night.

By the way, getting up slowly in the morning—sitting on the bed for a few minutes rather than jumping right up—may also be helpful.
*Try to avoid foods and smells that trigger your nausea. If that seems like almost everything, it's okay to eat the few things that do appeal to you for this part of your pregnancy, even if they don't add up to a perfectly balanced diet.
*Try to eat food cold or at room temperature, because food tends to have a stronger aroma when it's hot.
*Avoid fatty foods, which take longer to digest. Also steer clear of spicy, acidic, and fried foods, which can irritate your digestive system. It might help to stick to bland foods.
*Brush your teeth and rinse out your mouth after eating.
*Try drinking fluids mostly between meals. You might find cold, carbonated beverages easiest to keep down. (Some women also find sour drinks, such as lemonade, easier to handle.)
*Don't drink so much at one time that your stomach feels full, as that will make you less hungry for food. A good strategy is to sip fluids throughout the day. Try using a straw if sipping isn't going well.
*Aim to drink about a quart and a half each day. If you've been vomiting a lot, try a sports drink that contains glucose, salt, and potassium to replace lost electrolytes.
*Watch for non-food triggers, too. A warm or stuffy room, the smell of heavy perfume, a car ride, or even certain visual stimuli, like flickering lights, might trigger your nausea. So might changing positions too quickly. Avoidance of triggers can become an important part of your treatment.
*Get fresh air. A walk or an open window might ease your nausea.
*Nausea can become worse if you're tired, so give yourself time to relax and take naps when you can. Watching a movie (preferably not one about food!) or visiting with a friend can help relieve stress and take your mind off your discomfort.
*Try taking your prenatal vitamins with food or just before bed. You might also want to ask your healthcare provider whether you can switch to a prenatal vitamin with a low dose of iron or no iron for the first trimester, since this mineral can be hard on your digestive system. If the prenatal vitamin still makes you nauseated, ask if you can stop taking it until your nausea gets better.
Try ginger, an alternative remedy thought to settle the stomach and help quell queasiness. See if you can find ginger ale made with real ginger. (Most supermarket ginger ales aren't.) Grate some fresh ginger into hot water to make ginger tea, or see if ginger candies or crystallized ginger helps.
Research shows that taking powdered ginger root in capsules may provide some relief. Unfortunately, there's no way to be sure how much of the active ingredient you're getting in these ginger supplements, so talk to your provider before taking them. (As with many other things that are helpful in small amounts, the effects of megadoses are unknown.)

Some women find similar relief from sipping peppermint tea or from sucking peppermint candies, especially after eating.
*Experiment with aromatherapy. Some women find scents such as lemon, mint, or orange useful. You can use a diffuser to dispense an essential oil, or you can carry a drop or two of an essential oil on a hanky to smell when you start to feel queasy. (Essential oils are very strong, so use only one or two drops.)

¤What about anti-nausea medications?

If you've been unable to find relief from your nausea, talk with your provider about medication. There's no need to continue to suffer, and waiting too long to take appropriate medication may make your condition more difficult to treat.
By the way, while it won't help you now, if you plan to get pregnant again, make sure to be taking a multivitamin at the time of conception and in early pregnancy. It may help prevent severe morning sickness, though no one knows why.

¤What if I just can't keep anything down?

If your nausea and vomiting are so severe that you can't keep anything down, including water, juice, food, prenatal vitamins, or medications, you probably have a condition called hyperemesis gravidarum. If your situation is that severe, your doctor will most likely want to check you into the hospital and treat you with intravenous (IV) fluids and medications.

In any case, count it all joy when you are faced with diverse symptoms. Fix your eyes on the joy in the making. The joy of The Lord is your strength!

Ref: Baby Center

Morning Sickness : Causes

"Morning sickness" is a misnomer. (In fact, the technical medical term is "nausea and vomiting of pregnancy.") For some pregnant women, the symptoms are worse in the morning and ease up over the course of the day, but they can strike at any time and, for most women, last all day long. The intensity of symptoms can vary from woman to woman, too.
Overall, this condition affects about three quarters of pregnant women during the first trimester. About half of pregnant women suffer from both nausea and vomiting, one quarter have nausea alone, and one quarter luck out altogether. The nausea usually starts around 6 weeks of pregnancy, but it can begin as early as 4 weeks. It tends to get worse over the next month or so.

About half of the women who get nausea during pregnancy feel complete relief by about 14 weeks. For most of the rest, it takes another month or so for the queasiness to ease up, though it may return later and come and go throughout pregnancy. A small percentage of women have symptoms that persist continually (or nearly so) until delivery.

Of course, just because morning sickness is common—and likely to last "only" a few months—doesn't mean it's not a challenge. Even a mild case of nausea can wear you down, and bouts of round-the-clock nausea and vomiting can leave you exhausted and miserable. Talk with your caregiver about your symptoms and the possibilities for relief.

What causes nausea and vomiting during pregnancy?

No one knows for sure what causes nausea during pregnancy, but it's probably some combination of the many physical changes taking place in your body. Some possible causes include:

*Human chorionic gonadotropin (hCG). This hormone rises rapidly during early pregnancy. No one knows how hCG contributes to nausea, but it's a prime suspect because the timing is right: Nausea tends to peak around the same time as levels of hCG. What's more, conditions in which women have higher levels of hCG, such as carrying multiples, are associated with higher rates of nausea and vomiting.
*Estrogen. This hormone, which also rises rapidly in early pregnancy, is another suspect. (It's possible that other hormones play a role as well.)
*An enhanced sense of smell and sensitivity to odors. It's not uncommon for a newly pregnant woman to feel overwhelmed by the smell of a bologna sandwich from four cubicles away, for example. Certain aromas instantly trigger the gag reflex. (Some researchers think this may be a result of higher levels of estrogen, but no one knows for sure.)
*A sensitive stomach. Some women's gastrointestinal tracts are simply more sensitive to the changes of early pregnancy. Also, some research suggests that women with a stomach bacterium called Helicobacter pylori are more likely to have nausea and vomiting. Not all studies confirm this link, though.
*Stress. Some researchers have proposed that certain women are psychologically predisposed to having nausea and vomiting during pregnancy as an abnormal response to stress. However, there's no conclusive evidence to support this theory. (Of course, if you're constantly nauseated or vomiting a lot, you certainly may begin to feel more stressed!)

¤ Are some pregnant women more likely than others to feel nauseated?

You're more likely to have nausea or vomiting during your pregnancy if any of the following apply:
*You're pregnant with twins or higher multiples.This may be from the higher levels of hCG, estrogen, or other hormones in your system. You're also more likely to have a more severe case than average. On the other hand, it's not a definite thing—some women carrying twins have little or no nausea.
*You had nausea and vomiting in a previous pregnancy.
*You have a history of nausea or vomiting as a side effect of taking birth control pills. This is probably related to your body's response to estrogen.
*You have a history of motion sickness.
*You have a genetic predisposition to nausea during pregnancy. If your mother or sisters had severe morning sickness, there's a higher chance you will, too.
*You have a history of migraine headaches.
*You're carrying a girl. One study found that women with severe nausea and vomiting in the first trimester were 50 percent more likely to be carrying a girl.

¤Will my nausea affect my baby?

The mild to moderate nausea and occasional vomiting commonly associated with morning sickness won't threaten your baby's well-being. If you don't gain any weight in the first trimester, it's generally not a problem as long as you're able to stay hydrated and can keep some food down. In most cases, your appetite will return soon enough and you'll start gaining weight.

If nausea keeps you from eating a balanced diet, make sure you're getting the nutrients you need by taking a prenatal vitamin.

Severe and prolonged vomiting, however, has been linked to a greater risk of preterm birth, low birth weight, and newborns who are small for their gestational age. However, a large study of women who were hospitalized with severe vomiting found that those who were able to gain at least 15.4 pounds during their pregnancy had no worse outcomes than other women.

In any case, count it all joy when you are faced with diverse symptoms. Fix your eyes on the joy in the making. The joy of The Lord is your strength!

Credits: Baby Center

********I'll be back with the concluding part

Breast Engorgement

Breast engorgement is the painful overfilling of the breasts with milk. This is usually caused by an imbalance between milk supply and infant demand. This condition is a common reason that mothers stop breast-feeding sooner than they had planned but it shouldn't because it's a phase that will definitely pass.

Engorgement can happen:

-When milk first "comes in" to your breasts, during the first few days after birth.
-When you normally have a regular breast-feeding routine but cannot nurse or pump as much as usual.
-If you and your baby suddenly stop breast-feeding.
-When your baby's breast-feeding suddenly drops, either when your baby is starting or increasing solid foods or when the baby is ill with a poor appetite.

As you get close to your due date, your breasts make colostrum. Colostrum is a yellowish liquid that contains important nutrients and antibodies that a baby needs right after birth. About 2 to 5 days after your baby is born, your breasts start making milk for your baby. When your milk comes in, your breasts will most likely feel warm and heavy. Some women feel only slight swelling. Others feel uncomfortably swollen.

If don't breast-feed after your baby is born, you will have several days of mild to moderate breast engorgement. This gradually goes away when the breasts are not stimulated to make more milk.

Overfilled breasts can easily become very swollen and painful, leading to severe engorgement. Common causes of severe engorgement are:

-Waiting too long to begin breast-feeding your newborn.
-Not feeding often enough.
-Small feedings that do not empty the breast well. Babies who are fed formula or water are less likely to breast-feed well.

Breast Engorgement-Symptoms
Severe engorgement can make it difficult for your baby to latch on to the breast properly and feed well. This can make the problem worse. As a result:

Your baby may not receive enough milk.
Your breasts may not empty completely.
Your nipples may become sore and cracked. This is caused by your baby's attempts to latch on to your overfull breasts. If you then breast-feed less because your nipples are sore, the engorgement will increase.
Without treatment, severe engorgement can lead to blocked milk ducts and breast infection, which is called mastitis.

¤Easing the pain of engorgement
*Soak a cloth in warm water and put it on your breasts. Or take a warm shower. This techniques, when used just before breastfeeding or expressing milk, will encourage milk flow.
*Warmth may not help in cases of severe engorgement. In this case, you may want to use cool compresses in between or just after feeding.
*Express milk or pump just enough for comfort's sake.
*Feed on demand not following routine feeding.
*Try feeding your baby in more than one position. Begin by sitting up, then lying down. This changes the segments of the breast that are drained most optimally at each feeding.
*Gently massage your breasts from under the arm and down the nipple. This will help reduce soreness and ease milk flow.
*Wear a supportive bra (not too tight though).
*I read about the use of cold cabbage leaves. Keep the cabbage leaves in a refrigerator and place next to the breasts in your bra. (I never got to try it but I have heard many people's testimony of the cabbage therapy).
*You may use a mild and safe pain relieving medicine (with your doctor's approval).

Fortunately, engorgement lasts only a few days while lactation is getting established. However, it can occur any time, when feedings are skipped and the breasts are not emptied frequently or when weaning your baby.

References:
WebMD
AAP

Vaginal Birth After Cesarean (VBAC)

If you have had a cesarean delivery (also called a C-section) before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC.

Most women, whether they deliver vaginally or by C-section , don't have serious problems from childbirth.

If you and your doctor agree to try a VBAC, you will have what is called a "trial of labor after cesarean," or TOLAC. This means that you plan to go into labor with the goal to deliver vaginally. But as in any labor, it is hard to know if a VBAC will work. You still may need a C-section. As many as 4 out of 10 women who have a trial of labor need to have a C-section.

»Is a trial of labour safe?
Having a vaginal birth after having a C-section can be a safe choice for most women. Whether it is right for you depends on several things, including why you had a C-section before and how many C-sections you've had. You and your doctor can talk about your risk for having problems during a trial of labor.

A woman who chooses VBAC is closely monitored. As with any labor, if the mother or baby shows signs of distress, an emergency cesarean section is done.

»What are the benefits of a TOLAC?
The benefits of a VBAC compared to a C-section include:

*Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy. The more scars you have on your uterus, the greater the chance of problems with a later pregnancy.
*Less pain after delivery.
*Fewer days in the hospital and a shorter recovery at home.
*A lower risk of infection.
*A more active role for you and your birthing partner in the birth of your child.

»What are the risks of TOLAC?
The most serious risk of a trial of labor is that a C-section scar could come open during labor. This is very rare. But when it does happen, it can be very serious for both the mother and the baby. The risk that a scar will tear open is very low during VBAC when you have just one low cesarean scar and your labor is not started with medicine. This risk is why VBAC is often only offered by hospitals that can do a rapid emergency C-section.

If you have a trial of labor and need to have a C-section, your risk of infection is slightly higher than if you just had a C-section.

»What Criteria Must I Meet To Be Considered For VBAC?
*No more than 2 low transverse cesarean deliveries.
*No additional uterine scars, anomalies or previous ruptures.
*Your health care provider should be prepared to monitor labor and perform or refer for a cesarean if necessary.
*Your birth location should have personnel available on weekends and evenings in case a cesarean is necessary.

»What Other Criteria Would Make Me A Good Candidate For A VBAC?
*If the original reason for a cesarean delivery is not repeated with this pregnancy
*You have no major medical problems
*The baby is a normal size
*The baby is head-down

Source:
-WebMD
-American Pregnancy Association

Cesarean Section

A cesarean section is the delivery of a baby through a cut (incision) in the mother's belly and uterus. It is often called a C-section. In most cases, a woman can be awake during the birth and be with her newborn soon afterward.

If you are pregnant, chances are good that you will be able to deliver your baby through the birth canal (vaginal birth). But there are cases when a C-section is needed for the safety of the mother or baby. So even if you plan on a vaginal birth, it's a good idea to learn about C-section, in case the unexpected happens.

When is a C-section needed?
A C-section may be planned or unplanned. In most cases, doctors do cesarean sections because of problems that arise during labor. Reasons you might need an unplanned C-section include:

*Labor is slow and hard or stops completely.
*The baby shows signs of distress, such as a very fast or slow heart rate.
*A problem with the placenta or umbilical cord puts the baby at risk.
*The baby is too big to be delivered vaginally.

When doctors know about a problem ahead of time, they may schedule a C-section. »Reasons you might have a planned C-section include:

*The baby is not in a head-down position close to your due date.
*You have a problem such as heart disease that could be made worse by the stress of labor.
*You have an infection that you could pass to the baby during a vaginal birth.
*You are carrying more than one baby (multiple pregnancy).
*You had a C-section before, and you have the same problems this time or your doctor thinks labor might cause your scar to tear (uterine rupture).
In some cases, a woman who had a C-section in the past may be able to deliver her next baby through the birth canal. This is called vaginal birth after cesarean (VBAC). If you have had a previous C-section, ask your doctor if VBAC might be an option this time.

In the past 40 years, the rate of cesarean deliveries has jumped from about 1 out of 20 births to about 1 out of 3 births.1 This trend has caused experts to worry that C-section is being done more often than it is needed. Because of the risks, experts feel that C-section should only be done for medical reasons.

»What are the risks of C-section?
Most mothers and babies do well after C-section. But it is major surgery, so it carries more risk than a normal vaginal delivery. Some possible risks of C-section include:

*Infection of the incision or the uterus.
*Heavy blood loss.
*Blood clots in the mother's legs or lungs.
*Injury to the mother or baby.
*Problems from the anesthesia, such as nausea, vomiting, and severe headache.
*Breathing problems in the baby if it was delivered before its due date.
*If she gets pregnant again, a woman with a C-section scar has a small risk of the scar tearing open during labor (uterine rupture). She also has a slightly higher risk of a problem with the placenta, such as placenta previa.

»How is a C-section done?
Before a C-section, a needle called an IV is put in one of the mother's veins to give fluids and medicine (if needed) during the surgery. She will then get medicine (either epidural or spinal anesthesia) to numb her belly and legs. Fast-acting general anesthesia, which makes the mother sleep during the surgery, is only used in an emergency.

After the anesthesia is working, the doctor makes the incision. Usually it is made low across the belly, just above the pubic hair line. This may be called a "bikini cut." Sometimes the incision is made from the navel down to the pubic area. After lifting the baby out, the doctor removes the placenta and closes the incision with stitches.

Most women go home 3 to 5 days after a C-section, but it may take 4 weeks or longer to fully recover. By contrast, women who deliver vaginally usually go home in a day or two and are back to their normal activities in 1 to 2 weeks.

Before you go home, a nurse will tell you how to care for the incision, what to expect during recovery, and when to call the doctor. In general, if you have a C-section:

*You will need to take it easy while the incision heals. Avoid heavy lifting, intense exercise, and sit-ups. Ask family members or friends for help with housework, cooking, and shopping.
*You will have pain in your lower belly and may need pain medicine for 1 to 2 weeks.
*You can expect some vaginal bleeding for several weeks. (Use sanitary pads, not tampons.)
Call your doctor if you have any problems or signs of infection, such as a fever or red streaks or pus from your incision.

Source: WebMD

Episiotomy

An episiotomy is a surgical cut in the muscular area between the vagina and the anus (the area called the perineum) made just before delivery to enlarge your vaginal opening.

Obstetricians used to do episiotomies routinely to speed delivery and to prevent the vagina from tearing, particularly during a first vaginal delivery, in the belief that the "clean" incision of an episiotomy would heal more easily than a spontaneous tear. Many experts also believed that an episiotomy might help prevent later complications, such as incontinence.

But many studies over the past 20 years have shown that this is not the case. In fact, there is no good evidence that episiotomy offers your vaginal tissue and pelvic floor muscles any real protection, and the procedure may actually cause problems.

»Why might I need an episiotomy?

There are a few situations in which an episiotomy might be helpful.

If your baby is very large and your practitioner needs a little extra room to manipulate him during delivery or to apply forceps, she may opt to do an episiotomy. And if your baby needs to be born as quickly as possible – because his heart rate shows he isn't handling the last minutes of labor well – your practitioner may decide that an episiotomy will help expedite the delivery. In these scenarios, an episiotomy may be essential to ensure your baby is delivered safely.

»How can I make sure I won't have an unnecessary episiotomy?

Talk to your practitioner early on about the procedure.

Ask how often and under what conditions he would perform an episiotomy, and how he might help you avoid tearing. (Also ask about others in the practice, in case you end up with someone else at your delivery.) Studies show that, as a group, midwives tend to do far fewer episiotomies than obstetricians.

»How is an episiotomy done?

If your practitioner decides to do an episiotomy, she'll give you an injection of a local anesthetic and use surgical scissors to make a small cut in your perineum shortly before the birth of your baby. (Sometimes, if your perineum is already numb and thinned out from the pressure of your baby's head – or if you already have an epidural – she can do the episiotomy without pain medication.)

After you've given birth, you'll get another shot of local anesthesia to be sure you're completely numb before the cut is stitched up.

»What's the recovery like?

If you've had an episiotomy (or a tear), you'll have stitches in a very tender area, and you'll need some time to heal. Your stitches won't have to be removed – they'll dissolve on their own during the weeks after delivery.

Some women feel little pain after the first week, while others have discomfort for a month or more, particularly if they have a third- or fourth-degree laceration.

»In the meantime, you can help promote healing:

*Soothe the wound. Apply an ice pack to the affected area, or place a chilled witch hazel pad between a sanitary napkin and the wound. You can find witch hazel pads in most pharmacies.
*Take the sting out of urination. Use a plastic cup to pour warm water over your vulva as you're urinating, and rinse yourself with a squirt bottle afterward.
*Prevent pain and stretching during bowel movements. Press a clean pad firmly against the wound when you bear down for a bowel movement.
*Sit down carefully. Tighten your buttocks as you lower yourself to a seated position. Sit on a pillow or padded ring rather than a hard surface.
*Use medication as needed. Your health care provider might order prescription medications or recommend an over-the-counter pain reliever or stool softener. Pain-relieving creams or ointments haven't been found to be effective for episiotomy wounds.
*Consider complementary treatments. Some research suggests that lavender might help relieve pain after a tear or episiotomy. If your health care provider approves, add a few drops of lavender essential oil to your bath water or apply the oil directly to the tissue between your vaginal opening and your anus.
While you're healing, expect the discomfort to progressively improve. Contact your health care provider if the pain intensifies, you develop a fever or the wound produces a pus-like discharge. These could be signs of an infection.

»When can I have sex again?

Your perineum should be completely healed by four to six weeks after delivery, so if your caregiver gives the okay and you're up to it, you can try having sex then. If you had a third- or fourth-degree laceration, it's particularly important to wait to have sex until after you've been examined.

You might feel some initial tenderness and tightness. Try taking a warm bath and leaving plenty of time for foreplay. You might prefer to be on top so that you can control the degree of penetration, or you may find that lying on your side is most comfortable.

Relaxing as much as possible and using a good water-soluble lubricant will help make sex more comfortable. This may be especially helpful if you're breastfeeding, because lactation lowers your estrogen levels, which reduces the amount of lubrication your vagina can produce. Many women continue to use a lubricant during sex until they stop nursing.

If you try these measures and find that sex is still uncomfortable or painful, talk to your caregiver about treatment.

Sources:
Mayo Clinic;
BabyCenter

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease, commonly called PID, is an infection of the female reproductive organs. PID is one of the most serious complications of a sexually transmitted disease in women: It can lead to irreversible damage to the uterus, ovaries, fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.

»What Causes Pelvic Inflammatory Disease?

Normally, the cervix prevents bacteria that enter the vagina from spreading to the internal reproductive organs. If the cervix is exposed to a sexually transmitted disease -- such as gonorrhea and/or chlamydia -- the cervix itself becomes infected and less able to prevent the spread of organisms to the internal organs. PID occurs when the disease-causing organisms travel from the cervix to the upper genital tract. Untreated gonorrhea and chlamydia cause about 90% of all cases of PID. Other causes include abortion, childbirth, and pelvic procedures.

»What Are the Symptoms of Pelvic Inflammatory Disease?
The symptoms of PID can vary, but may include the following:
-Dull pain or tenderness in the stomach or lower abdominal area, or pain in the right upper abdomen
-Abnormal vaginal discharge that is yellow or green in color or that has an unusual odor
-Painful urination
-Chills or high fever
-Nausea and vomiting
-Pain during sex

»What Puts a Person at Risk for Pelvic Inflammatory Disease?
There are several things which would put a woman at risk for PID, including:

-Women with sexually transmitted diseases -- especially gonorrhea and chlamydia -- are at greater risk for developing PID.
-Women who have had a prior episode of PID are at higher risk for another episode.
-Sexually active teenagers are more likely to develop PID than are older women.
-Women with many sexual partners are at greater risk for sexually transmitted diseases (STDs) and PID.
Some studies suggest that douching may contribute to PID. Douching may push bacteria into the upper genital tract and may mask the discharge that could alert a woman to seek medical attention.

»How Is Pelvic Inflammatory Disease Diagnosed?
Your doctor will begin with a detailed history of your general health and sexual activity. He or she will perform a pelvic exam to check the health of your reproductive organs, and look for evidence of gonorrhea and chlamydia infection. Your doctor may find the abnormal cervical discharge and tenderness of the cervix, fallopian tubes and cervix on examination. This discharge will be tested to determine the cause of the infection, including cultures for gonorrhea and chlamydia.

If your doctor suspects PID, he or she may order other tests, including:
-Blood tests to analyze blood for evidence of infection.
-Ultrasound (sonogram) to view the reproductive organs.
Other tests less commonly performed include:

-Endometrial biopsy, a procedure in which a small sample of tissue from the lining of the uterus (endometrium) is removed for evaluation and testing.
-Laparoscopy, a procedure during which a thin, lighted instrument (laparoscope) is inserted through a small cut in the lower abdomen to allow the doctor to examine the internal reproductive organs.

»What Is the Treatment for PID?
If the findings of your exam or tests suggest PID, treatment is started immediately.

-Antibiotics. The initial treatment for mild cases of PID usually consists of one or more antibiotic medications taken by mouth. More significant cases can be treated with a combination of intravenous and oral antibiotics. If treatment is not effective, if you cannot take antibiotics by mouth, or if the infection is severe, you may need to be hospitalized to receive medication intravenously (directly into a vein).
If you are diagnosed with PID, your sexual partner also must be treated even if they do not have any symptoms. Otherwise, the infection will likely recur when you have sex again.

-Surgery. When PID causes an abscess (when the inflamed tissue forms a collection of pus), antibiotics are no longer as effective. Surgery is often needed to remove the abscesses (or the organ with the abscess) to prevent them from rupturing and causing widespread infection throughout the pelvis and abdomen. Depending on the conditions, this may be done with a laparoscope (a thin, lighted instrument) or with a procedure in which the doctor opens the abdomen to view the internal organs (laparotomy). Both techniques are major surgical procedures and are performed under general anesthesia (you are put to sleep).
-If abscesses have formed on the uterus or ovaries, your doctor may recommend hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries).

»What Problems Could Pelvic Inflammatory Disease Cause?
Recurrent episodes of PID can result in scarring of the fallopian tubes, which can lead to infertility, ectopic (tubal) pregnancy, or chronic pelvic pain. Infertility occurs in about one in eight women who have PID.

»Can Pelvic Inflammatory Disease Be Prevented?
PID is completely preventable. The number one cause of PID is untreated STDs (also called STIs, sexually transmitted infections). Steps you can take to prevent PID include:

-Avoid multiple sexual partners.
-Use barrier methods of birth control (condoms and/or a diaphragm) and spermicides for every single act of intercourse -- even if you use birth control pills.
-Avoid IUDs if you have multiple sexual partners.
-Seek treatment immediately if you notice signs of PID or any sexually transmitted disease, including unusual vaginal discharge, pelvic pain, or bleeding between periods.
-Have regular gynecologic check-ups and screenings since many cervical infections can be identified and treated before they spread to the internal reproductive organs.
Credits: WebMD

Uterine Fibroids

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.

Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue. The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

Who Gets Uterine Fibroids?

Uterine fibroids are extremely common. In fact, many women have uterine fibroids at some point in life. Uterine fibroids in most women are usually too small to cause any problems, or even be noticed.

No one knows what causes uterine fibroids, but their growth seems to depend on estrogen, the female hormone. Uterine fibroids don’t develop until after puberty, and usually after age 30. Uterine fibroids tend to shrink or disappear after menopause, when estrogen levels fall.

Black women tend to get uterine fibroids two to three times as often as white women, and also tend to have more symptoms from uterine fibroids.

As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

Other factors may influence development of uterine fibroids:

*Pregnancy: Women who have had children are less likely to get fibroids.
*Early menstruation: Women whose first period was before age 10 are more likely to have uterine fibroids.
*Women taking birth control pills are less likely to develop significant uterine fibroids.
*Family history: Women whose mothers and sisters have uterine fibroids are more likely to have them.

*Symptoms*
In women who have symptoms, the most common symptoms of uterine fibroids include:

*Heavy menstrual bleeding
*Prolonged menstrual periods — seven days or more of menstrual bleeding
*Pelvic pressure or pain
*Frequent urination
*Difficulty emptying your bladder
*Constipation
*Backache or leg pains

Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and, rarely, fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.

Fibroid location, size and number influence signs and symptoms:

»Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are more likely to cause prolonged, heavy menstrual bleeding and are sometimes a problem for women attempting pregnancy.

»Subserosal fibroids. Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing a pressure sensation, or on your spinal nerves, causing backache.

»Intramural fibroids. Some fibroids grow within the muscular uterine wall (intramural fibroids). If large enough, they can distort the shape of the uterus and cause prolonged, heavy periods, as well as pain and pressure.

»Pedunculated fibroids usually grow outside of the uterus, attached to the uterus by a base or stalk.

When To See a Doctor

See your doctor if you have:

*Pelvic pain that doesn't go away
*Overly heavy or painful periods
*Spotting or bleeding between periods
*Pain consistently with intercourse
*Enlarged uterus and abdomen
*Difficulty emptying your bladder

Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.

* DIAGNOSIS *

Moderate and large-sized uterine fibroids are often felt by a doctor during a manual pelvic examination. Imaging tests are often done to confirm the presence of uterine fibroids.

»Ultrasound
An ultrasound probe is inserted into the vagina or over the pelvis on the abdomen, and high-frequency sound waves reflect off the uterus and pelvic structures. The uterus and any uterine fibroids are displayed on a video screen.

»Magnetic resonance imaging (pelvic MRI)
An MRI scanner uses a high-powered magnet and a computer to create highly detailed images of the uterus and other pelvic structures. Pelvic MRI can confirm the presence of uterine fibroids, if the diagnosis is unclear.

»Uterine biopsy
Occasionally, a doctor may be concerned that a mass in the uterus is cancer, not a uterine fibroid. A small piece of tissue (biopsy) taken from the uterus can usually tell a fibroid from cancer. A uterine biopsy may be done through the vagina, or may require surgery.

»Hysterosalpingogram
Dye is injected into the uterus through the vagina and cervix, and X-ray films show an outline of the uterus and fallopian tubes. Hysterosalpingogram is usually done in women with uterine fibroids who are trying to become pregnant.

»Sonohysterogram
A water solution is injected into the uterus through the vagina and cervix, and an ultrasound is then done. Sonohysterogram may show uterine fibroids or other growths not visible on a traditional ultrasound.

»Hysteroscopy
A tube with a lighted viewer on its tip (endoscope) is advanced into the uterus, and a video screen shows the uterus interior. Hysteroscopy can detect uterine fibroids projecting into the uterus, but cannot see any part of a fibroid in the uterus wall or outside the uterus.

»Treatment of Uterine Fibroids«

Most uterine fibroids don’t need any treatment, because they don’t cause symptoms or problems. Uterine fibroids causing problems may be treated with non-surgical or surgical options.

Credits: Mayo Clinic and WebMD

Exclusive Breastfeeding

Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. Review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond. I practised exclusive breastfeeding for my children and I think you should choose to too.

To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO and UNICEF recommend:

*Initiation of breastfeeding within the first hour of life
*Exclusive breastfeeding – that is the infant only receives breast milk without any additional food or drink, not even water
*Breastfeeding on demand – that is as often as the child wants, day and night
*No use of bottles, teats or pacifiers

Breast milk is the natural first food for babies, it provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.

Breast milk promotes sensory and cognitive development, and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery during illness. These effects can be measured in resource-poor and affluent societies.

Breastfeeding contributes to the health and well-being of mothers; it helps to space children, reduces the risk of ovarian cancer and breast cancer, increases family and national resources, is a secure way of feeding and is safe for the environment.

While breastfeeding is a natural act, it is also a learned behaviour. An extensive body of research has demonstrated that mothers and other caregivers require active support for establishing and sustaining appropriate breastfeeding practices. WHO and UNICEF launched the Baby-friendly Hospital Initiative in 1992, to strengthen maternity practices to support breastfeeding. The foundation for the BFHI are the Ten Steps to Successful Breastfeeding described in Protecting, Promoting and Supporting Breastfeeding: a Joint WHO/UNICEF Statement.

Reference:
(Kramer M et al Promotion of Breastfeeding Intervention Trial (PROBIT): A randomized trial in the Republic of Belarus. Journal of the American Medical Association, 2001, 285(4): 413-420)
WHO, 2015