Signs, Symptoms and How to Get HelpBringing a new baby into the world is often portrayed as a joyous time, but for many new mothers, it can also bring unexpected emotional challenges. Postpartum depression and anxiety are common but serious conditions that can affect a mother's mental health. Understanding the signs, symptoms and available help is crucial for new mothers and their families.Understanding Postpartum DepressionWhat is Postpartum Depression?Postpartum depression (PPD) is a severe type of depression that develops following childbirth. Unlike the "baby blues," which are fleeting sensations of melancholy and exhaustion, PPD is more powerful and persistent. It can limit a mother's capacity to care for herself and her child.Signs and SymptomsSymptoms of Postpartum DepressionPersistent Sadness: Feeling hopeless, sad or empty for most of the day.Loss of Interest: Lack of interest in activities you once enjoyed, including spending time with your baby.Fatigue: Extreme tiredness that doesn’t improve with rest.Sleep Issues: Difficulty sleeping, even when the baby is asleep or sleeping too much.Appetite Changes: Appetite fluctuations might result in significant weight loss or increase.Difficulty Bonding: Struggling to connect with your baby.Feelings of Worthlessness: Intense feelings of guilt, shame or inadequacy.Thoughts of Harm: Intrusive thoughts about harming yourself or your baby.Understanding Postpartum AnxietyWhat is Postpartum Anxiety?Postpartum anxiety (PPA) involves excessive worrying, fear and anxiety after childbirth. It can manifest as constant worry about the baby's health, overwhelming feelings of dread and an inability to relax.Symptoms of Postpartum AnxietyExcessive Worry: Constant worry that something bad will happen to the baby.Restlessness: Inability to sit still or relax.Physical Symptoms: Experiencing panic attacks, nausea or heart palpitations.Irritability: Becoming easily frustrated or angry.Hypervigilance: Being overly alert and unable to switch off.Risk FactorsSeveral factors can increase the risk of developing postpartum depression and anxiety:History of Mental Health Issues: Previous depression or anxiety.Lack of Support: Limited emotional or practical support from family and friends.Stressful Life Events: Significant life changes, such as relocation or financial issues.Complications in Birth: Difficult pregnancy or childbirth experience.Hormonal Changes: Drastic changes in hormone levels after birth.How to Get HelpSeek Professional HelpIf you suspect you have postpartum depression or anxiety, it's essential to seek professional help. Contact your healthcare provider, who can conduct a thorough assessment and recommend treatment options. These may include:Therapy: Cognitive behavioral therapy (CBT) and other forms of counseling can help manage symptoms.Medication: Antidepressants and anxiety medicines may be administered.Support Groups: Joining a group for new mothers experiencing similar challenges can provide emotional support.Selfcare StrategiesIn addition to professional help, selfcare strategies can also aid in recovery:Rest and Sleep: Prioritize sleep and rest whenever possible.Healthy Diet: Maintain a balanced diet to promote general health.Exercise: Gentle exercise, such as walking, can boost mood and energy levels.Connect with Others: Contact friends, relatives or support groups for emotional assistance.Final ThoughtsPostpartum depression and anxiety are serious conditions that require attention and care. Recognizing the symptoms and seeking assistance is the first step toward recovery. Remember, you are not alone and help is available. With the right support and treatment, it is possible to overcome these challenges and enjoy your time with your new baby. If you or someone you know is struggling, reach out to a healthcare provider today.

A Guide for Expectant MothersPreconception Checkups: The First StepBefore you embark on the journey of pregnancy, it's crucial to ensure your body is ready. Scheduling a preconception checkup with your healthcare provider is the first step. During this session, your doctor will go over your medical history, current health status and any medications you may be taking. This checkup is an opportunity to identify and manage any health issues that could affect your pregnancy.Key Tests and ScreeningsYour preconception checkup may include:Blood tests can determine anemia, blood type, and immunity to infections such as rubella and chickenpox.Screening for sexually transmitted infections (STIs).Assessing your vaccination status and updating any necessary vaccines.A discussion on managing chronic conditions such as diabetes or hypertension.Nutrition Tips for Expectant MothersNutrition is extremely important in preparing your body for pregnancy. A well balanced diet contains critical nutrients that promote fetal and mother health.Key NutrientsFolic Acid: Critical for preventing neural tube abnormalities. Aim for at least 400 micrograms per day from fortified meals or supplements.Iron: Promotes increased blood volume and avoids anemia. Include iron-rich foods like lean meats, spinach and legumes.Calcium: Essential for fetal bone development. Consume dairy products, leafy greens and fortified plant based milks.Omega-3 Fatty Acids: Is essential for brain and eye development. Include fatty fish, such as salmon, walnuts and flaxseeds.HydrationMaintain hydration by drinking lots of water throughout the day. Proper hydration improves overall health and helps alleviate typical pregnancy symptoms such as constipation and exhaustion.Exercise Recommendations for Expectant MothersRegular exercise activity can help boost your overall health, lift your spirits, and prepare your body for the demands of pregnancy and labor. Exercise can also lower the risk of gestational diabetes, preeclampsia and excess weight gain.Safe ExercisesWalking: A easy and effective technique to stay active without overworking your body.Swimming: Provides a full body workout while being gentle on the joints.Prenatal Yoga: Enhances flexibility, reduces stress and promotes relaxation.Strength Training: Helps build muscle endurance. Use light weights and avoid heavy lifting.Exercise TipsConsult Your Doctor: Before beginning any fitness plan, speak with your doctor, especially if you have any pre-existing health concerns. Listen to Your Body: Avoid high-impact or contact sports. Stop exercising if you have any pain, dizziness or shortness of breath.Stay Hydrated: Drink water before, during and after exercise to stay hydrated.Final ThoughtsPreparing for pregnancy involves a holistic approach that includes medical checkups, proper nutrition and regular exercise. By following these steps, you can increase your chances of having a healthy pregnancy and an easy transition into parenthood. Remember that every woman's body is unique, so speak with healthcare professionals to create a strategy that meets your specific needs.Begin this lovely journey with confidence and care, knowing that you're doing everything you can to give your future kid the greatest possible start.

The Importance of Prenatal and Postnatal Vitamins for Mothers and BabiesPregnancy and the postpartum period are critical times for both mother and baby, requiring extra nutritional support to ensure healthy development and recovery. Prenatal and postnatal vitamins play a vital role in meeting these nutritional needs, supporting both the mother’s wellbeing and the baby’s growth. This blog explores the importance of these vitamins, what they contain and how they benefit mothers and babies.Prenatal Vitamins: Supporting a Healthy PregnancyWhy Prenatal Vitamins are Essential?Prenatal vitamins are specially formulated supplements designed to provide the extra nutrients needed during pregnancy. They help bridge nutritional gaps in a mother's diet, ensuring both her health and the healthy development of the baby.Key Nutrients in Prenatal VitaminsFolic Acid: Crucial for preventing neural tube defects in the developing fetus. It's recommended that women start taking folic acid before conception and continue through pregnancy.Iron: Supports the increased blood volume in the mother and helps deliver oxygen to the baby. It also prevents anemia, which can cause fatigue and other complications.Calcium and Vitamin D: Essential for the development of the baby's bones and teeth. They also support the mother's bone health.DHA (Docosahexaenoic Acid): An omega-3 fatty acid important for the development of the baby's brain and eyes.Iodine: Vital for thyroid function, which regulates metabolism and supports fetal brain development.Benefits for the MotherPrenatal vitamins not only support the baby's growth but also help the mother maintain her health. They can reduce the risk of pregnancy complications like preeclampsia, support immune function and help manage pregnancy related fatigue and nausea.Postnatal Vitamins: Nourishing Recovery and LactationThe Role of Postnatal VitaminsAfter childbirth, a mother's nutritional needs continue to be elevated, especially if she is breastfeeding. Postnatal vitamins help replenish nutrients lost during pregnancy and delivery and support lactation.Essential Nutrients in Postnatal VitaminsCalcium: Critical for bone health, especially if breastfeeding, as calcium can be depleted from the mother's body to provide for the baby.Vitamin D: Supports the immune system and bone health for both mother and baby. Breastfed babies rely on their mother's vitamin D stores.Iron: Helps replenish iron stores that may have been depleted during childbirth and supports energy levels.B Vitamins: Including B6 and B12, these support energy production and can help combat postpartum depression and fatigue.Omega-3 Fatty Acids: Important for the development of the baby's brain and eyes and they can support the mother's mental health.Benefits for the BabyPostnatal vitamins are especially important for breastfeeding moms since they have a direct impact on the quality of breast milk. Adequate nutritional intake ensures that the infant gets enough vitamins and minerals to grow and thrive.Choosing the Right VitaminsWhen choosing prenatal and postnatal vitamins, it is important to consult with a healthcare provider. They can recommend a supplement that meets your specific needs based on your diet, health status and any existing medical conditions.ConclusionPrenatal and postnatal vitamins are critical for the health of both mother and baby, since they provide important nutrients for growth, development and recuperation. Understanding the importance of these vitamins and adding them into your healthcare regimen will help you have a healthy pregnancy and postpartum time. Remember that, while vitamins are vital, they should be combined with a well balanced diet rich in whole foods to provide a comprehensive approach to mother and newborn health.

What to Expect in Each Stage of PregnancyPregnancy is a transforming experience that involves both physical and emotional changes. Understanding what to expect in each trimester can help you navigate this exciting time with confidence. This guide breaks down the key changes you may experience during each stage of pregnancy.First Trimester: Weeks 1-12Physical ChangesDuring the first trimester, your body undergoes rapid changes as it begins to support the growing fetus. Common physical symptoms include:Nausea and Vomiting: This is commonly known as morning sickness and it can occur at any time of day.Fatigue: Hormonal changes can leave you feeling unusually tired.Breast Tenderness: Hormones may cause your breasts to become sore and swollen.Frequent Urination: Increased blood flow to the kidneys can result in more frequent trips to the restroom.Emotional ChangesThe first trimester can be an emotional rollercoaster due to fluctuating hormone levels and the excitement or anxiety of impending motherhood. It's normal to feel a mix of joy, worry and mood swings during this time.Second Trimester: Weeks 13-26Physical ChangesThe second trimester is often referred to as the "golden period" because many women experience relief from early pregnancy symptoms. However, new physical changes may occur, including:Visible Baby Bump: Your abdomen will begin to expand as the baby grows.Increased Appetite: With nausea subsiding, you may feel hungrier than before.Movement: By around 18-20 weeks, you may start feeling the baby's movements, known as quickening.Skin Changes: Hormones can cause skin pigmentation changes, such as the darkening of the areolas and the appearance of a linea nigra (a dark line running down the abdomen).Emotional ChangesAs your pregnancy progresses, you may feel more connected to your baby and experience a surge of positive emotions. However, it's also common to feel stressed or anxious about the future and impending responsibilities.Third Trimester: Weeks 27-40Physical ChangesThe third trimester can be physically demanding as your body prepares for childbirth. Common symptoms include:Braxton Hicks Contractions: These "practice" contractions help your body prepare for labor but are usually irregular and less intense than true labor contractions.Swelling: Increased blood volume and pressure on veins can lead to edema in the feet, ankles and hands.Back Pain: Extra weight and changes in posture can cause backaches.Difficulty Sleeping: Physical discomfort and frequent urination can make sleep challenging.Emotional ChangesThe anticipation of childbirth can bring a mix of excitement and anxiety. It's natural to feel a range of emotions as you prepare for labor and the arrival of your baby. Many women also experience nesting instincts, feeling a strong urge to prepare their home for the new arrival.Final ThoughtsEach trimester of pregnancy brings unique physical and emotional changes. Understanding what to expect might help you deal with these changes and make the most of this unique time. Remember that each pregnancy is unique, so consult your doctors for tailored guidance and support.Embrace this journey with an open heart and mind, knowing that these changes are all part of the incredible process of bringing new life into the world.

The average length of a human gestation is 280 days or 40 weeks. The gestation period is usually counted from the first day of woman’s last menstrual period. It’s good and healthier for babies not to be born before they’re due. If the labour starts before 37 weeks of pregnancy, then it is usually called as premature labour. In this case, the baby is not fully grown and is not entirely ready to come into the outside world.In premature labour, the mother is unable to carry her baby for the full 9-month term. There are a number of reasons behind the preterm labour, including traumas, accidents and unpredictable diseases. Although the reasons are not clear, here are the common and best advisable ways to avoid premature labour.Learn what you can do to prevent early labour!  See your health care provider early and regularly during your pregnancy. Prenatal care is designed over the years to minimise the risk and complications of pregnancy. A good health care provider can ensure and plan your pregnancy. Attend all prenatal appointments with your doctor and have all the screening tests to check your health and your baby’s health. Understand the common problems of the pregnancy and check the root causes in case of complications. Understanding the root causes will help you and your doctor plan better labour for you.  Stay away from smoke, drink, or illegal usage of drugs. Protect your baby’s health and well being by staying away from smoke, drink or usage of drugs. Indirect exposure or passive exposure will also cause tremendous issues. Get help to quit for your or your family members around you, if needed. Always remember tobacco and alcohol will cause harm to your pregnancy! Stay or get to a healthy weight during pregnancy. Overweight and underweight women have a higher chance of giving premature birth. Work with your doctor and understand the weight demands during pregnancy. Try to achieve a healthy weight based on what your doctor suggests. Don’t get discouraged; even a small change in your weight may lower the chance of giving birth to a preterm baby. Always keep your weight on check.  Track your chronic diseases and take care of them  Inform your health care provider in case of any chronic disease such as diabetes, blood pressure or gastritis. They have to be kept well controlled before, during and after pregnancy. However, if any of the chronic conditions worsen during pregnancy, the chances for premature labour are higher. Thus, tracking and taking care of such chronic diseases is highly important.  Practice a healthy diet and regular yoga Taking care of your body and mind during pregnancy plays a vital role in the health of the baby. Eat a variety of foods and drink lots of water to maintain the balance of vitamins, proteins and minerals in your body. Do regular exercise or yoga to boost your metabolism and contain the stress levels.  Preterm pregnancies cant always be prevented. But following a healthy routine will definitely lower the chances of premature births. Studies suggest that women who get routine prenatal care are more likely to have a healthier pregnancy and baby.    *Information shared here is for general purpose. Please take doctors’ advice before taking any decision.

No matter how happy you are about your pregnancy, stress during the pregnancy phase is unavoidable. Most of the time, it is because of the hormones that play around. But there are a lot of other factors that account to stress. Managing stress during pregnancy is an efficient way to enjoy your pregnancy period.  Knowing the changes and accepting them happening to your body will help you best during this phase. However, know more efficient ways to reduce stress during pregnancy.  Here are the 5 easy ways to reduce stress during pregnancy.  Eat well and sleep well must be a routine  Nothing can replace the best benefits of proper food and sound sleep. Ensure that you follow a balanced diet with all the necessary supplements that your body needs and take enough rest. A night of proper sleep will make your day brighter and keep you comparatively in a cheerful mood. Rest when you are tired. Do not overdo during pregnancy. A perfect routine for food and sleep will ease up your hormones.  Surround yourself with positive energy. Talk to your friends and family. Pregnancy can put you through a lot of thoughts. It will make you think about the least possible negativity. Well, these are the instincts of the mother to safeguard her child. So it is no wonder that you get all such thoughts. However, do not put them all to yourself. Talk them out with your best buddies and family. Let them know your concerns and allow them to soothe you down.  Exercise must be your normal  We are not talking about heavy workouts and impulsive training. It is all about simple meditation and gentle exercise. Mild exercise during pregnancy will lower cortisol levels; the stress hormone is partly responsible for your stress. Thus, regular exercise will help you stay fit and help you check your stress levels during pregnancy.  You can choose simple exercises like walking, swimming, low paced stationary bike etc. Learn more about safe cardio exercises that you can consider during pregnancy here.  Take time out for yourself You might feel upset over small things. It is normal to be so during pregnancy. Do not feel wrong about such instances. Instead, when you feel low or feeling upset over something, take some time out for yourself to calm you down. Pick your favourite activity that you love to do and spend enough time with it. Try it for yourself! Taking a break can do significant wonders for your mental health, especially during pregnancy! Do not skip your doctor appointments  Visiting your doctor regularly for prenatal appointments will make you feel at ease. Knowing your condition and baby’s condition will help you better understand the situation. At times, a simple talk with your doctor can help you calm down. Regular appointments will also help you check for the complications of pregnancy. An excellent way to check your mental health and ease you as well!  Remember, it is perfectly alright to worry about your unborn baby. Whether the baby is healthy or growing out well inside. But, do not let these thoughts overcome the joy of your pregnancy. Follow the above-mentioned suggestions to reduce your stress during pregnancy and enjoy the blissful moments of your life!!  *Information shared here is for general purpose. Please take doctors’ advice before taking any decision. 

Pelvic Pain Pelvic pain is pain in the lower part of the abdomen and pelvis. It can stem from multiple causes. Pelvic pain arises from the conditions associated with reproductive, urinary or digestive systems, or from muscles and ligaments in the pelvis. Pelvic pain can be due to irritation of nerves in the pelvis. Chronic pelvic pain is constant or intermittent pelvic pain for six months or more. Pelvic pain may spread to lower back, buttocks or thighs. Pelvic pain can also be situational, such as while using the bathroom or have sex. Causes More than one condition can lead to Pelvic pain. Common causes of acute pelvic pain Ovarian cyst– it is fluid-filled bubble arising from an ovary and causes pelvic pain when it ruptures or becomes twisted Acute pelvic inflammatory disease– a bacterial infection of the reproductive organs, which often follows a chlamydia or gonorrhoea infection and needs immediate treatment with Antibiotics. Ectopic Pregnancy (or other pregnancy-related conditions) Miscarriage or intrauterine fetal death Menstrual cramps (dysmenorrhea) Mittelschmerz (ovulation pain) Appendicitis – a painful swelling of the appendix which usually causes pain on the lower right-hand side of your abdomen Peritonitis– inflammation of the peritoneum; it causes sudden abdominal pain that gradually becomes more severe and requires emergency treatment Urinary tract infection – it will cause pain or a burning sensation while urination Kidney stones Constipation or bowel spasm – this could be due to changes in diet, medication, irritable bowel syndrome or, in rare cases, a bowel obstruction Less common causes include: Pelvic abscess –it is collection of pus in between pelvic organs requiring urgent treatment Endometriosis – a condition where bits of endometrium is found outside the uterus, such as on the ovaries, leading to painful periods Uterine fibroids Long-term pelvic pain If pelvic pain persist for 6 months or more that is either intermittent or continuous, it’s known as chronic pelvic pain. The most common causes of chronic pelvic pain are: Endometriosis Chronic pelvic inflammatory disease – a bacterial infection of female reproductive organs which often follows a chlamydia or gonorrhoea infection and needs immediate treatment with antibiotics Irritable bowel syndrome – a common condition of the digestive system that can cause cramps, bloating, diarrhoea and constipation Conditions involving the muscles, joints, and ligaments in the pelvis, lower back, or hips. Less common causes of chronic pelvic pain are: Recurrent ovarian cysts  Recurrent urinary tract infection Lower back pain Prolapse of the uterus– where the uterus slips down along with other organs from its normal position and usually causes a “dragging” pain Adenomyosis – endometriosis that affects the muscle of the uterus, causing painful, heavy periods Fibroids – tumours(non-cancerous) of the uterus, fibroids can be painful if they twist, but uncomplicated fibroids aren’t usually painful Chronic interstitial cystitis – chronic inflammation of the bladder Inflammatory bowel disease (IBD) –It includes ulcerative colitis and Crohn’s disease, which affect the gut Hernia  Trapped or damaged nerves in the pelvic area  Uterine cancer Cervical cancer Vulvodynia Symptoms Worsening of menstrual cramps Menstrual pain Vaginal bleeding, spotting or discharge Painful or difficult urination Constipation or diarrhoea Bloating or gas Blood seen with a bowel movement Blood in urine Pain during intercourse Fever or chills Pain in the hip area Pain in the groin area Diagnosis To begin with, your doctor will do a complete examination to look for problems with your reproductive system. The doctor will need complete information about past and present health and symptoms. You might need to undergo some tests, such as: Blood and urine tests for signs of infection. A pregnancy test. Tests for sexually transmitted infections (STIs)– vaginal culture Emotional issues can be a big part in chronic pain. Inform your doctor about any depression or stress that is adding to your problem. Your Doctor will need to know about any past or current sexual or physical abuse. It can be tough to talk about these things, but all this information is needed to provide right treatment. If initial tests don’t suggest anything significant, then you might have to go for other tests that show pictures of the organs in your belly. These may include: Abdominal and pelvic X-rays. Diagnostic laparoscopy Hysteroscopy (procedure to examine the uterus). Stool guaiac test- tests microscopic blood in stool sample Lower endoscopy such as colonoscopy or sigmoidoscopy Ultrasound  CT scan of the abdomen and pelvis Finding the cause of pelvic pain can take long time. You should keep record about the type of pain you have, timings and any precipitating factors. Treatment Once your condition is diagnosed- you will be treated for that problem. Some common treatments include: Birth control pills or hormone treatment for problems related to your periods. Surgery for removal of a growth, cyst, or tumor. Medical management- such as an antibiotic for infection or medicine for irritable bowel syndrome. If you are not diagnosed foe the condition causing pelvic pain-you can be offered treatment to help you manage the pain. Best results are seen from a combination of treatments such as: Pain relievers called NSAIDs, like ibuprofen or naproxen. Tricyclic antidepressant medicine or anticonvulsants, which can help with pain and with depression. Cognitive-behavioural therapy or biofeedback, to help you change the way you think about or react to pain. Counselling, to give you emotional support and reduce stress. Physical therapy to help you relax your muscles, improve your posture, and be more active. Pain relievers that are injected (local anaesthetic) into specific areas to help with pain. You may need to try many treatments before you find the ones that help you the most. If the things you’re using aren’t working well, ask your doctor what else you can try. Taking an active role in your treatment may help you feel more hopeful.

What you need to know about pelvic organ prolapse? What is pelvic organ prolapse?  Uterus (womb), bladder & rectum (back passage) are the organs present within a woman’s pelvis. They are normally held in their place by ligaments and muscles called pelvic floor. If these support structures are weakened there will be bulge of organs from their natural position into the vagina. When this happens it is known as pelvic organ prolapse. Is it common to have prolapse?  It is very common especially in older women. As many women don’t go to doctor or talk about it, it might be difficult to know exactly the proportion of women who can have this problem. It is estimated that at least 50% of women over 50 years of age will have symptoms with pelvic organ prolapse. Why does pelvic organ prolapse happen?  Being Pregnant and giving birth are most common reasons for weakening of pelvic floor. More births the woman had, more difficult births, more bigger babies, more likely is the chance of you having the prolapse. After menopause it is common. Being overweight, constipation, persistent cough, and prolonged heavy lifting can also increase the chance of having the prolapse. Sometimes there is hereditary tendencies too. What symptoms will be there if I have a prolapse?  Sometimes there might not be any problem at all and we will know only when examination is done. Most of the times, it is the sensation of lump coming down is the symptom. Backache, heaviness or dragging discomfort in the vagina can be there.If bladder is also prolapsed – You may experience need to pass urine frequently, incomplete emptying, frequent urine infections. If bowel is also prolapsed – You can have constipation or incomplete bowel emptying. Some women might have to push the lump back to be able to empty bladder or bowel. Sex might be uncomfortable and lack of sensation during intercourse can be distressing. Will I need tests?  Prolapse is usually diagnosed by performing a vaginal examination. Your doctor will insert a speculum (a metal or plastic instrument used to separate the walls of Vagina) to assess the prolapse and to determine exactly which organs are prolapsing. Urine test will be done to check for infection. If you have leakage of urine special tests like Urodynamics will also be done. What are the treatment options?  If mild prolapse and no symptoms, you might choose to take wait and see option, however losing weight if you are overweight, reducing cough, avoiding constipation, avoiding heavy lifting can help to reduce worsening of the problem. Kegels or pelvic floor exercises will help to strengthen the pelvic floor muscles.If you are unable to do these exercises you will be referred to a physiotherapist to guide you doing the right way. Vaginal hormone might be recommended. Other options include pessaries or surgery. Pessary – Is a good way of supporting the prolapse. If you don’t wish the surgery or if surgery is too risky for you due to any medical condition you will be given this option. Pessary is made of plastic or silicone. There are many varieties and sizes of pessaries available. Your doctor will advise the right one for you. Most commonly used pessaries are ring pessaries. Fitting the right size pessaries can sometimes take more than one attempt. They have to be changed frequently. You have to report to your doctor if you experience any irritation or bleeding. Surgery – Choosing surgery will depend on severity of your symptoms, effect on quality of life and if other options are not helpful. There will be some risks with any operation especially if you are overweight or have any medical problems. The usual surgery that is done is removal of uterus and pelvic floor repair. Lifting up the uterus or vagina to a bone of your spine or a ligament within your pelvis are also available especially if prolapse is recurrent. Closing off the vagina will be considered only if many surgeries are unsuccessful or you are in very poor medical health. How successful is the surgery? In 75% of women surgery is successful. However in 25% of women, prolapse can come back and might require further surgery at a later date.

Bacterial vaginosis is a vaginal infection caused by bacteria. It is the most common cause of abnormal vaginal discharge that happens in reproductive-age women. It can cause a “fishy” odor and vaginal irritation in some women. Others may not have any symptoms. SYMPTOMS Most of the females with bacterial vaginosis will not have any symptoms but when they have, it includes- Burning feeling while micturation Fishy smell mostly after sex Itching Thin white, gray, or green discharge RISK FACTORS It is rarely seen in females who are not sexually active. It most commonly affects- Pregnancy Unprotected Intercourse Have an intrauterine device (IUD) Have multiple sex partners Have a new sex partner Have a female sex partner Use douches Smoking Perfumed bubble baths, vaginal deodorants, and few scented soaps Washing underwear with strong detergent CAUSES BV is due to an imbalance of natural vaginal bacterial flora. Why this happens is not clear. The role of bacteria Bacteria is present allover our bodies, but some are beneficial while others are harmful. These bacteria become infectious when number of harmful bacteria increases. The vagina is house for mostly “good” bacteria and some harmful bacteria. BV occurs when the harmful bacteria outgrows the good bacteria in number. A vagina should contain bacteria called lactobacilli. These bacteria produce lactic acid, making the vagina slightly acidic. This prevents growth of other bacteria. Acidity of vagina decreases if levels of lactobacilli decreases leading to growth of other bacteria’s. However, exact relationship of these harmful bacteria with BV is not known. COMPLICATIONS Bacterial vaginosis doesn’t generally cause complications. Sometimes, having bacterial vaginosis may lead to: During pregnancy– In pregnant women, bacterial vaginosis is linked to loss of pregnancy, early rupture of amniotic membranes, Chorioamnionitis, premature deliveries and low birth weight babies due to preterm labours. After Delivery-Postpartum Endometritis, an irritation or inflammation of uterine lining. Sexually transmitted infections– Bacterial vaginosis makes women more susceptible to sexually transmitted infections, like HIV, herpes simplex virus, chlamydia or gonorrhea. If you have HIV, bacterial vaginosis increases the chances of passing on the virus to your partner. Infection risk after gynecologic surgery- such as hysterectomy or dilation and curettage (D&C). Pelvic inflammatory disease (PID) – Bacterial vaginosis can sometimes cause an infection of the uterus and the fallopian tubes therefore the risk of infertility increases. Studies have shown that success rate of IVF decreases in BV. PREVENTION Minimize vaginal irritation- by using mild or nonscented soaps and tampons or pads. Don’t douche- douching disrupts the vaginal balance and may increase your risk of vaginal infection.  Avoid Sexually transmitted diseases- Use a male latex condom, limit your number of sex partners. Always wipe from front to back instead of back to front after using the bathroom. Wear cotton or cotton-lined underwear. Bacteria thrive in moist environments. Cotton helps wick away moisture. DIAGNOSIS The doctor will: Ask about your medical history- about previous STIs, etc. Do an overall physical exam Do a pelvic exam- for signs of infection, condition of pelvic organs Take a sample of discharge from your vagina to look for  bacteria Test your vaginal pH. A vaginal pH of 4.5 or higher is associated with bacterial vaginosis. TREATMENT Often it remains asymptomatic, but women with signs and symptoms should take treatment to avoid complications. Often antibiotics (metronidazole, clindamycin, tinidazole) are required to treat BV. This could be a tablet or a cream or gel you put into your vagina. Most females need to take treatments for 5 to 7 days. Finish full course of medicines, even if the symptoms go away. Incomplete medications course can lead to recurrence. Since BV can be spread through sex, so it is advisable to avoid sexual contact till treatment is finished. Female sexual partners should see their doctor to find out if they need treatment. IUDs users with BV can opt for other forms of contraception. To treat bacterial vaginosis, following medicaions can be prescribed: Metronidazole- This is given as oral forms mostly. Metronidazole is also be given as a topical gel to insert into the vagina. It is the most commonly used antibiotic. It is preferred over other antibiotics if the woman is breastfeeding or pregnant. Clindamycin -This medicine is available as a cream that you insert into your vagina. Clindamycin creams are known to weaken latex condoms- so take adequate precautions for atleast 3 days after stopping the treatment. Tinidazole-This medication is taken orally. Tinidazole reacts with alcohol, so avoid alcohol during treatment and for at least three days after completing treatment. Secnidazole -This is an antibiotic you take orally in one dose.  Generally it is not necessary to treat an infected woman’s male sexual partner, but it can spread among female sexual partners, so female partners should be tested and treated accordingly. It’s especially important for pregnant women with symptoms to be treated to decrease the risk of premature labour. RECURRENCE Around one-third of women whose symptoms disappear with treatment will have a recurrence within 3 months, and half will have a recurrence within 6 months. If more than three episodes occur within 12 months, the doctor may prescribe a vaginal metronidazole gel to use twice a week for 3 to 6 months. While current research shows there may be some benefit to probiotic therapy, more research is needed on the subject.

Bleeding during pregnancy is relatively common, but it can be a dangerous sign. Visit your doctor even if its spotting or it stops. What causes bleeding early in pregnancy? Having sex- mostly due to pregnancy changes in cervix An infection Smoking Implantation Bleeding- When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow. Usually occur 10-14days after conception. It is harmless. Invasive testing like Amniocentesis and Chorionic villus sampling- done to check genetic abnormalities. Hormone changes. Medical conditions- Bleeding disorders Changes in your cervix. Occasionally bleeding or spotting in the first trimester can be due to a serious problem, like: Miscarriage- loss of pregnancy before 20weeks. Almost all women who miscarry have bleeding or spotting before the miscarriage. Bleeding can be along with pain abdomen. Ectopic pregnancy-fertilized egg implants outside uterine cavity and begins to grow.  Molar pregnancy- it is growth of abnormal tissue in the uterus, instead of a baby. Molar pregnancy is rare. What causes bleeding in the Second and Third Trimesters? Abnormal bleeding in late pregnancy is considered more serious because it can lead to severe complications to mother or baby.  Placenta previa-the placenta is located in lower uterine segment, partially or completely covers the internal OS. Placenta previa is not very common in the late third trimester, occurs in one in 200 pregnancies. It leads to painless bleeding. Placental abruption- In about 1% of pregnancies, the placenta separates its attachment on the uterus before or during labour. Placental abruption is very dangerous for the mother and baby both. It is often associated with severe abdominal pain, severe bleeding from the vagina, tender uterus, and backache. Uterine rupture-In rare cases, a scar from a previous C-section or uterine surgery can tear open during pregnancy. Uterine rupture can be life-threatening, and requires an emergency C-section. It can present with pain and tenderness in the abdomen. Vasa previa- In rare circumstances, baby’s blood vessels in the umbilical cord or placenta lies just above the opening to the birth canal. It can be fatal for the baby because the blood vessels can tear anytime, causing the baby to bleed severely and lose oxygen. It might be associated with abnormal fetal heart rate and excessive bleeding. Premature labor- Vaginal bleeding late in pregnancy can be due to your body getting ready to deliver. Preterm labour is when labour starts before 37th week of pregnancy. Other symptoms of preterm labor include contractions, vaginal discharge, abdominal pressure, and lower backache. Other causes of bleeding in late pregnancy are: Sex Internal examination by your doctor. SHOW- Mucus plug which was inside cervix during pregnancy comes out, as the cervix is getting ready for labour to start. It can happen anytime from few days before contractions start or during labour itself. Injury to the cervix or vagina Polyps- usually painless bleeding  Cancer What should you do if you have bleeding or spotting during pregnancy? Seeking medical attention immediately is must in case of- Heavy bleeding Bleeding with pain or cramping Dizziness and bleeding Pain in your belly or pelvis Passing some tissue with blood Keep a record of amount of bleeding, if it gets heavier or lighter, and number of pads you are using.  Check the color of the blood.  Your provider may want to know. Bleeding can be brown, dark or bright red. Do not use a tampon, douche or have sex during bleeding. Inform your Doctor if you are Rh Negative. Diagnosis To find out the cause of bleeding, you will need to have a detailed vaginal or pelvic examination, an ultrasound scan or hormonal levels through blood tests. Your doctor will inquire about other symptoms, like as abdominal cramp, dizziness and pain. Sometimes it might not be possible to find out what caused the bleeding. How are bleeding and spotting treated? Treatment depends on cause of the bleeding.  Rest is very important part of treatment during bleeding. Take time off from work and take rest for a little while. Don’t have sex, douche or use tampons. If your symptoms are not severe and you are preterm-you’ll be monitored and can be kept in hospital for observation. Severe Symptoms and term gestation can mandate delivery.