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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Choosing a caesarean delivery

Question: Is it true that you can now have a selected c section? JDC  (UK)

Answer: That is true; up to a point. In the UK, you can have a caesarean section the indication being maternal choice. However it is left to the discretion of your consultant obstetrician. If he/she is unhappy with your decision, he/she can decide to decline your request where you are left with the option of abandoning your quest or asking for another consultant to look after you.

You may find that many obstetricians would decline to perform a caesarean section where there is absolutely no medical indication. This is not a case of specialists flexing their muscles unnecessarily. It remains the case that when a specialist agrees to perform a surgical procedure, he/she takes full responsibility of any consequences of that. That is even in the event of the patient’s own request, in this case, the expectant mother. In the event of things going wrong (as they sometimes do), a defence of ‘it was her choice’ has no legal standing.

Periods ‘up and down’

Question:  My period is going up and down; is this normal? V. (USA)

Answer: I am not sure I understand what you mean by up and down? Is it that they are sometimes heavy and other times light? If that is the case, then it is likely to be within the spectrum of what would be described as normal. I do not know how old you are but many women find that when they get past their mid thirties, periods start changing in their pattern. Periods could become variable both in the amount of loss, timing and duration. Change in menstrual pattern is the commonest problem gynecologists deal with. The reasons are many. This is around the time when many complete their families and get off the pill. It is also the time when fibroids are commonest. Ovulation is also increasingly irregular affecting the regular menstrual cycle. If you are significantly younger than this, it is worthwhile bringing this to the attention of your doctor. Amongst young women, polycystic ovarian syndrome is one of the leading causes of erratic periods.

Chances of conception in the peri-menopause

Question:  I am 44 no periods for 10 months is it possible i will ovulate at any time? Doctor says i am pre menopause. Will ivf be possible without egg donor? S. (UK)

Answer: If you have had no periods for the best part of a year and a blood test shows that you are peri-menopausal, the only realistic way you can get pregnant is via IVF using a donor egg. Standard IVF works by stimulating the woman’s own ovaries to produce eggs which are then fertilised outside and the embryo implanted back into the womb. When the ovaries cease to work through natural menopause, it is not medically possible to stimulate them to produce eggs.

One of the most objective ways now available to check whether your ovarian egg reserve is exhausted is to perform a test called  the Anti-Müllerian Hormone (AMH) test. This test has been available only in the last couple of years. It is still unavailable in many , probably most, NHS hospitals. However, in the UK, it is easily available privately for a fee. It is a very reliable test for ovarian reserve. If you are unsure about the tests that your doctors have done and want to know for sure where you stand, this is the test for you. If this shows that you still have a reserve of eggs, then of course you can still pursue IVF using your own eggs. If, on the other hand, it shows that the eggs reserve is exhausted, you can be sure donor egg is your only option.

Fibroids causing pain in pregnancy

Question:  is there any other alternative to treat fibroids when in pregnancy or just to leave it and continue with painkillers? What’s gonna happen to the baby if you continue taking painkillers such as, Paracetamol and codeine phosphate? V.M. (UK)

Answer: If a fibroid is causing pain during pregnancy, the only safe measure that can be taken is to use pain-killers. The two you mentioned, Paracetamol and Codeine (or a combination of the two) are regarded to be safe when used in normal doses during pregnancy.

There is certainly no option of elective surgery for fibroids during pregnancy.

Pregnancy measuring slightly bigger than dates

Question: I am 20 weeks pregnant and already my stomach measures 22 cm. I know the issue is looked into when it's more or less than 3 cm. What could be the reasons why the stomach length is more or less than expected? What can be done to maintain right length. R.N. (UK)

Answer: Measurements of the fundal height in the first half offundal height the pregnancy are not very useful and very rarely used in monitoring progress of the pregnancy. It is beyond this stage when the height in cm will normally be measured and recorded. Being 20 weeks, I would expect that you have or are due to have a detailed anatomy scan. if this shows normal measurements of the baby (and fluid), then there is no need for concern.

More questions and answers on the next page

Measuring fundal height in pregnancy is quite useful but mainly so in the second half of pregnancy