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If you’re pregnant, you may wonder about how you want to deliver your baby, and how you might end up delivering your baby – either vaginally or via Cesarean section.

The body is designed for vaginal birth, and most babies are born vaginally, where the baby is delivered from the uterus, inside the pelvis, through the vagina to the outside world. But, babies can also be born surgically, through an incision in the abdomen, which is called a Cesarean delivery or C-section. Sometimes a C-section is needed to protect the health of the baby or mother or both, and other times, patients simply prefer a C-section delivery.

Jade Elliott spoke with Dr. Helen Feltovich, a maternal fetal medicine physician, an OB/Gyn who cares for patients with high-risk pregnancies, with Intermountain Healthcare, about the differences between C-sections and vaginal deliveries.

Advantages of a vaginal delivery

Delivering vaginally usually means you’ll recover faster from childbirth and your hospital stay will be shorter.

Common reasons a scheduled C-section may be recommended:

• Baby is in breech (feet-first or bottom-first) or transverse (sideways) position, rather than cephalic (head-down) position.
• Placenta previa—placenta is covering all or part of the opening to the birth canal.
•  Maternal infection the baby can catch if delivered vaginally, such as HIV, or active genital herpes.
• Multiple gestation (being pregnant with more than one baby).
• A vertical incision on the uterus from a previous C-section or uterine surgery .
• More than two previous C-sections.
•  Baby’s head can’t fit through the maternal pelvis.
•  Baby has a large birth defect that could rupture during vaginal delivery.

Common reasons for unplanned C-sections

• Sometimes complications during labor or delivery necessitate a C-section birth.
• Labor stops or isn’t progressing, or baby can’t fit through the pelvis.
•  Placental abruption (placenta pulls away from uterine wall too soon, cutting off baby’s oxygen).
• Umbilical cord becomes pinched or drops into the birth canal ahead of baby, which can lower baby’s oxygen supply.
• Changes in baby’s heart rate that suggest baby may not be getting enough oxygen

How birth in an operating room is different from birth in a hospital room

While a C-section is a surgery, it is primarily a birth, and this is the focus. Patients are almost always awake and typically have their partner right by them. Mom and partner can see and touch the baby, just like in a vaginal delivery.

As soon as your medical care team is sure your baby is stable, you can hold your baby. Skin to skin contact as soon as possible is encouraged to promote bonding, whether the baby is born via vaginal or Cesarean delivery.

Intermountain is working to reduce unnecessary C-sections

A C-section delivery is major abdominal surgery and like any surgery comes with some risks. If it’s elective, your doctor or midwife can help you evaluate if the benefits of having a C-section outweigh the risks. If there are medical indications, your provider will explain these to you. Once you have a C-section, you have a choice about whether or not to have a C-section in the future, or try for a VBAC (vaginal birth after Cesarean). After you have had two C-sections, it’s not recommended to try a vaginal delivery.

With any surgery, there are risks for possible complications such as infection, injury to bladder or bowel, blood clots and in rare cases, brain damage or death. However, many of these risks apply to pregnancy or delivery in general and they are very, very low. Risks for the baby include a possible increased chance of breathing problems, and extreme sleepiness can occur in the unusual case that general anesthesia is needed.

The C-section rate in the U.S. is a public health issue because of the small increased risk of complication, and increased time of hospitalization. Average stay is two days for a vaginal delivery and 3-4 days for a C-section.

Intermountain was an early adopter of national recommendations to reduce the rate of C-section in American women, and has one of the lowest C-section rates in the country. That said, sometimes patients need to have a C-section for their safety or that of their baby, Intermountain is committed to adhering to evidence-based recommendations for C-section delivery while simultaneously honoring patients’ wishes for how their babies will be delivered.

Vaginal birth after a C-Section for a previous pregnancy

A vaginal birth after Cesarean (VBAC) delivery is possible for anyone who has had only one or two C-section deliveries. There is a small but serious risk of the uterus rupturing during a VBAC delivery because the uterus has a scar from the previous surgery. Talk with your provider about your specific medical history to see if you’re a candidate for a VBAC delivery. Factors involved in the decision include the reason for your previous C-section; the type of uterine incision (if it was low on the belly and done side-to-side, it’s more likely you can try VBAC); when your last delivery occurred (less or more than 18 months ago), and other factors.

Do’s and don’ts for recovery after a C-section

Do:

• Take time to sit and bond with your baby.
• Rest when you’re tired.
• Walk every day to maintain strength, and prevent blood clots and constipation.
• Hold a pillow over your incision when you need to cough or laugh to be more comfortable.
•  Shower normally (or take a bath after two weeks).
• Eat healthily
• Drink plenty of water and fluids.
• Take a fiber supplement daily to avoid constipation.

Don’t:

• Lift anything heavier than your baby.
• Use tampons or douche for at least six weeks.
•  Take baths for about two weeks, until your incision is healed.
•  Participate in rigorous activity or core muscle exercises until recommended by your doctor.
•  Have sex until your body feels ready (at least two weeks).
• Be afraid to ask for help from friends or family.
• Soak in public pools or hot tubs for at least six weeks.
•  Crash diet

C-Section incision care:

• Keep the incision area dry and clean.
• Use warm, soapy water to gently wash your incision daily (usually when you shower).
• Pat the area dry, after cleaning.
•  If your doctor used tape strips on your incision, let them fall off on their own. This usually takes about a week.

When to call your doctor:

• Depression, sadness, hopelessness, or having troubling thoughts.
• Signs of an infection including pain, pus, swelling, redness, swollen lymph nodes
•  Fever of more than 100.4 degrees Fahrenheit.
•  Difficulty breathing.
•  Vaginal discharge that smells bad.
• Severe pain in your belly.
• Bright red vaginal bleeding that soaks through more than one pad in two hours or less.
• Vaginal bleeding that gets worse or is still bright red more than four days after birth.
•  Signs of a blood clot, including pain in your thigh, groin, back of knee, or calf.
• Incision comes open.
• Nausea or vomiting.
• Vaginal blood clots larger than a golf ball.
• Trouble passing urine or stool.

For more information about Cesarean sections visit intermountainhealthcare.org

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

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New USDA dietary guidelines are out – and for the first time include the needs of infants and toddlers.

Dietary guidelines are updated every five years to help people know what they should eat and drink to meet nutrient needs, promote health, and prevent disease.

Jade Elliott spoke with Alyssa Scordo, RDN, Intermountain Healthcare, to discuss the new guidelines and how parents should handle sugars and potentially allergenic foods.

This is the first time the guidelines have been differentiated for life stages, from birth to older adulthood, including pregnancy and lactation, said Alyssa Scordo, a registered dietitian nutritionist for Intermountain Healthcare.

“It’s never too early or too late to implement healthy eating – that’s what these new guidelines tell us,” Scordo said. “Introducing infants and toddlers to healthy foods can make a difference in their health and wellbeing throughout their lives.”

Research shows an individual’s eating habits have the greatest impact on their health. Nationally, more than half of all adults have one or more preventable chronic diseases, many of which are related to poor diets and not enough physical activity. Childhood obesity continues to rise, with about one-fifth of children clinically obese nationwide.

Here’s what the new “Make Every Bite Count” dietary guidelines say for infants and toddlers:

Birth to 6 months: Exclusively feed infants human milk and continue through at least the first year of life. If human milk is not possible, feed infants iron-fortified formula during the first year of life. Provide supplemental Vitamin D soon after birth.

At 6 months: Introduce nutrient-dense complementary foods, and a variety of foods from all food groups. Include foods rich in iron and zinc, particularly for infants fed human milk.

Start introducing allergenic foods, such as peanuts, egg, cow milk products, tree nuts, wheat, shellfish, fish and soy. Introducing peanut-containing foods, for example, reduces the risk that an infant will develop an allergy to peanuts. For infants at high risk of peanut allergy, introduce peanut-containing foods between 4-6 months of age.

Hold off on giving babies foods and drinks with added sugar, and limit foods high in sodium.

At 12 months: Toddlers should consume between 700-1,000 calories per day through age 23 months, in a variety of food groups:

• Vegetables (2/3 cup to 1 cup)
•  Fruits (1/2 cup to 1 cup)
• Grains (3 ounces, half of which are whole grains)
•  Dairy (1 2/3 cup to 2 cups)
•  Protein (2 ounces)
•  Oils (1/2 tablespoon)

It’s also important to avoid added sugar and limit foods high in sodium. Juice should be 100 percent fruit juice, and limited to 4 ounces per day.

Here are a few simple changes to help toddlers eat healthier:

• Replace sugary cereals with cereals containing minimal added sugar.
•  Replace fried vegetables with roasted vegetables.
•  Replace sugary fruit products with fruit canned in 100 percent juice.
•  Replace high-sodium meats, like hotdogs, with lean ground meats.
•  Choose unsweetened beverages over sugary drinks.

“Everyone, even young children, can benefit from making changes to what they consume to help build a healthy diet,” Scordo said. “Giving children healthy foods early on will help them make better food choices as an adult, and hopefully, help them to live happier, healthier lives.”

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

For more information: intermountainhealthcare.org.

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Many babies develop birthmarks in the first few weeks of life. Many of those birthmarks are harmless and will disappear with age. But some will need special treatment to prevent issues as the child grows.

Jade Elliott spoke with Dr. Kate Puttgen, Intermountain Healthcare, about birthmarks on this episode of the Baby Your Baby Podcast.

Some infants develop a hemangioma, a non-cancerous tumor made of excess blood vessels. Hemangiomas can be superficial with a red color, or deep beneath the skin with a bluish color, or a mix of superficial and deep with both red and blue coloring, said Dr. Kate Puttgen, a pediatric dermatologist with Intermountain Healthcare. They grow rapidly in the first three to five months of life.

“It’s critical for hemangiomas to be detected early,” Dr. Puttgen said. “Most babies do fine with diagnosis and watchful waiting, but it’s important to work with a pediatrician who can refer the child to a specialist when necessary to ensure the hemangioma is not more dangerous.”

Hemangiomas occur in up to 10 percent of Caucasian infants, and are more common in babies of low-birth weight and who are born prematurely. They also are up to three times more common in girls than in boys.

Hemangiomas can develop anywhere on the body, and go through a period of growth and stabilization, and then decrease in size. Many will eventually disappear, but some can leave behind significant scarring or cause functional problems, such as with vision or feeding, depending on their size and location, Dr. Puttgen said.

Most hemangiomas present by about 2 weeks of age, and will at least double in size in the first two months of life. Eighty percent of the time, the maximum size will be reached by the time the baby is 3 months old, and by age 5 months, the vast majority have essentially finished growing. Deep hemangiomas and larger hemangiomas usually have a longer growth phase.

But in rare cases, a hemangioma can grow for longer periods of time or, if on the head or neck, can create distortion to the face, and result in disfiguring scar tissue or eye damage if left untreated, Dr. Puttgen said.

“The bottom line is, the majority of birthmarks in babies will not adversely affect their growth and development,” she said. “For other more complicated hemangiomas, we have excellent treatments, and can prevent the need for surgery or laser treatment before the child starts school if we start medicine as soon as possible in most cases.”

Beta blockers, commonly used for decades in babies with heart issues, are an effective treatment for hemangiomas, without significant side effects for most babies. The beta blockers shrink hemangiomas, and come in oral or topical versions. They are most effective when used in the baby’s first four months of life, though children as old as 5 years have benefited.

“Well-child checkups are a great time to talk to pediatricians about skin concerns, and address issues early on,” Dr. Puttgen said. “If a parent notices a birthmark, they should feel empowered to speak up and consult with their provider to determine whether a specialist is needed, and know that there are safe and effective treatments.”

For more information about birthmarks, go to primarychildrens.org

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

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As the weather warms up, parents and caretakers need to pay extra attention to protect children from accidental heatstroke in cars.

People should never leave a child in a vehicle – even for a minute – to prevent unintended injury or even death.

Jade Elliott spoke with Jessica Strong, community health manager at Intermountain Primary Children’s Hospital, to discuss how to keep your children safe.

“Even if it’s not that warm outside, the insides of cars heat up quickly and can present a serious hazard for children,” said Jessica Strong, community health manager at Intermountain Primary Children’s Hospital. “Everyone must remain vigilant to never leave a child alone in a car for any amount of time to prevent a tragedy.”

About 40 children across the country die each year after being left in a hot vehicle, Strong said.

In Utah, 13 children have died in hot vehicles since 1990, and others have suffered injuries in “close calls.”

Yet 2020 was one of the lowest years for heat stroke deaths in recent memory, at 25 deaths nationwide. In Utah, no hot car deaths were reported.

“My speculation is that with fewer people driving, and more parents working from home, there were fewer opportunities to leave children in cars, resulting in fewer deaths,” Strong said. “My hope, though, is that this decrease is the start of a trend in the right direction, which will continue until the number of deaths reaches zero.”

Strong says accidental heat stroke tragedies can happen to anyone, and often occur when caretakers forget a child is in the car.

Stress, fatigue, and change of routine can push a person’s brain into autopilot, making it easier to forget. Summer time can present more risk of injury due to hot weather and changes in routine, including children out of school and families staying up late for activities.

Intermountain Primary Children’s Hospital is offering these tips to help caretakers remember that a child is inside a vehicle to prevent unintentional injuries:

– Never leave your child alone in a vehicle – even for a few minutes. A child’s body temperature can increase 3-5 times faster than an adult’s. Cracking a window has very little effect on the temperature inside the car.

• Always check your vehicle before leaving it.
• Keep a visual reminder that a child is with you, like a stuffed animal or diaper bag in the seat next to you.
• Place something you’ll need when you arrive at your destination, like your briefcase, backpack, purse or cell phone, in the back seat. That way, when you reach for the item, you’ll likely see the child.
• If you see a child left alone in a car, contact the police or call 911.

For more information, visit primarychildrens.org/safety.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

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It’s nice to open the windows to let fresh spring air circulate the home. But open windows also bring hidden dangers for children, said Jessica Strong, community health manager at Intermountain Primary Children’s Hospital.

“Windows are a fall hazard for kids, and the consequences can be severe,” Strong said. “Window screens are a great way to keep bugs out, but not kids in.”

Jade Elliott spoke with Jessica Strong, community health manager, Intermountain Primary Children’s Hospital, to discuss how to keep your children safe on this episode of the Baby Your Baby Podcast.

Nearly 15,000 children are injured by falling out of windows every year. Often, children were leaning against window screens before they fell.

Window screens are designed to easily pop out in case of a fire or other emergency to help people easily escape. As a result, they give way with moderate pressure.

“The best way to keep children safe from window falls is to keep them away from open windows,” Strong said. “There are a number of precautions that can be taken, but it’s important to remember there is no substitute for adult supervision. Most window falls occur when children are alone.”

Here are some other tips for preventing window falls:

• Keep windows closed and locked.
•  Before opening a window, make sure it is inaccessible to children.
• Keep furniture or anything children can climb on away from windows.
• Teach children only to open windows with permission and help from adults.
•  Consider installing window locks, guards, or other safety equipment to prevent children from opening windows too wide — or at all — without help from an adult.

For more information: primarychildrens.org/safety.

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.