Dra. Leila Catherine Onbargi,

Contrary to what is often believed, a woman may have a vaginal delivery after a previous cesarean section, although they must understand that there exists a small possibility of uterine rupture of the previous scar in labor. Among the patients who wish to try this option, the success rate is between 60% and 80%. The decisive factors include the type of incision performed, the condition of the placenta, the relative measurements of the fetus and the pelvis, and the fetal well being registered on the monitor. All this must be taken into account to decide on the best type of delivery. When vaginal birth is attempted it must be highly monitored, and fetal intolerance to labor may make a repeat cesarean section necessary.

This is a process whereby blood is collected after the birth of the baby from the umbilical cord while the placenta is still attached to theuterus. This blood is filled with stem cells which are cells that can develop into many different kinds of cells and can be harvested for future use in certain metabolic or immunological disorders. Patients can request private blood cord banking for their own use, but they can also donate blood cord to public banks. We provide both services to our patients.

Fortunately, most women have normal deliveries with no incidents or complications, and recover quickly. They are discharged from the hospital soon after delivery, and are able to cope with an almost normal level of activity. However some patients take longer to feel fit. The cause can be a cesarean scar, or an episiotomy that gives discomfort and impedes movement. Pelvic, abdominal, and vaginal muscles are weakened after a delivery, and urinary incontinence and vaginal relaxation can be a problem. We provide guidelines about how to get back in shape during the first weeks after giving birth. We also have a specialized pelvic floor therapist in our office who provides pelvic training and therapy for pelvic support issues.

Involuntary loss of urine is a problem that affects many women after childbirth, and can be a source of much suffering and embarrassment. The incontinence can occur either occasionally or on a daily basis. This condition usually improves spontaneously with time, however the incontinence can persist, and often the patient does not seek medical aid and accepts it as a normal post partum condition. An adequate prenatal preparation of the perineum, coupled with basic pelvic floor exercises after delivery can often prevent this condition. We also have a specialized pelvic floor therapist in our office who provides pelvic training and therapy for urinary incontinence in the post partum period.

For social or cultural reasons many parents request the circumcision of their newborn son. This procedure involves the removal of the foreskin covering the penis. It is performed with local anesthesia and without stitches in the first days or weeks after the birth. We can provide detailed information about circumcision and clarify doubts about the procedure.