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- Planning Your Delivery
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Content Map Terms
Pregnancy & Parenting Categories
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Planning Your Pregnancy
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Fertility
- Ovulation and Fertility Pregnancy Planning
- Ovulation and Transport of Egg
- Find Your Ovulation Day
- Infertility: Problems With Ovulation
- Ovulation
- Superovulation
- Interactive Tool: When are you most fertile?
- Infertility
- Infertility: Emotional and Social Support
- Pregnancy after Age 35
- Infertility: Ethical and Legal Concerns
- Infertility: Factors That Affect Treatment Success
- Infertility: Setting Limits on Testing
- Infertility: Problems With the Man's Reproductive System
- Infertility: Problems With Fallopian Tubes
- Infertility: Problems With the Uterus and Cervix
- Cancer Treatment and Infertility
- Fertility Problems: Should I Be Tested?
- Infertility Tests
- Fertility Drugs
- Infertility
- Fertility Problems: Should I Have a Tubal Procedure or In Vitro Fertilization?
- Insemination for Infertility
- Intracytoplasmic Sperm Injection for Infertility
- Infertility Treatment for Women With PCOS
- In Vitro Fertilization for Infertility
- Infertility: Setting Limits on Treatment
- Infertility: Questions to Ask About Medicine or Hormone Treatment
- Infertility: Questions to Ask About Assisted Reproductive Technology
- Infertility: Should I Have Treatment?
- Insemination Procedures for Infertility
- Gamete and Zygote Intrafallopian Transfer for Infertility
- Varicocele Repair for Infertility
- Fallopian Tube Procedures for Infertility
- Follicle-Stimulating Hormone
- Luteinizing Hormone
- Progesterone
- Sperm Penetration Tests
- Basal Body Temperature (BBT) Charting
- Your Health When Planning to Become Pregnant
- Ending a Pregnancy
- Adoption
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Fertility
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Pregnancy
- Healthcare Providers During Pregnancy
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Your Health During Pregnancy
- Foodborne Illness During Pregnancy
- Pregnancy and Seat Belt Use
- Pregnancy: Chemicals, Cosmetics, and Radiation
- Travel during Pregnancy
- Lupus and Pregnancy
- Multiple Sclerosis and Pregnancy
- Cancer During Pregnancy
- HIV and Pregnancy
- Pregnancy and Chronic High Blood Pressure
- Schizophrenia and Pregnancy
- Depression During Pregnancy
- Pregnancy and Epilepsy
- Obesity and Pregnancy
- Pregnancy
- Dental Care During Pregnancy
- Immunizations and Pregnancy
- Quick Tips: Healthy Pregnancy Habits
- Massage Therapy during Pregnancy
- Sex During Pregnancy
- Leg Cramps During Pregnancy
- Medicines During Pregnancy
- Swelling During Pregnancy
- Electronic Fetal Heart Monitoring
- Depression: Should I Take Antidepressants While I'm Pregnant?
- Pregnancy: Dealing With Morning Sickness
- Back Pain During Pregnancy
- Abnormal Pap Test While Pregnant
- Acetaminophen Use During Pregnancy
- Acupressure for Morning Sickness
- Automated Ambulatory Blood Pressure Monitoring
- Braxton Hicks Contractions
- Caffeine During Pregnancy
- Exercise During Pregnancy
- Fatigue During Pregnancy
- Fever During Pregnancy
- Pregnancy: Carpal Tunnel Syndrome
- Pregnancy: Changes in Bowel Habits
- Pregnancy: Healthy Weight Gain
- Pregnancy: Hemorrhoids and Constipation
- Pregnancy: Pelvic and Hip Pain
- Pregnancy: Ways to Find Your Due Date
- Estrogens
- Symptoms of Pregnancy
- Sexually Transmitted Infections During Pregnancy
- Ginger for Morning Sickness
- Heartburn During Pregnancy
- Nausea or Vomiting During Pregnancy
- Urinary Problems During Pregnancy
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Body Changes During Pregnancy
- Pregnancy: Varicose Veins
- Pregnancy: Hand Changes
- Sleep Problems During Pregnancy
- Managing Emotional Changes During Pregnancy
- Breast Changes During Pregnancy
- Pregnancy: Hair Changes
- Pregnancy: Belly, Pelvic and Back Pain
- Pregnancy: Stretch Marks, Itching, and Skin Changes
- Pregnancy: Changes in Feet and Ankles
- Pregnancy: Vaginal Discharge and Leaking Fluid
- Interactive Tool: From Embryo to Baby in 9 Months
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Your First Trimester
- Check-ups and Tests In the First Trimester
- Embryo and Fetal Development In the First Trimester
- Mothers' Physical Changes in the First Trimester
- Normal Pregnancy: First Trimester
- Week 8 of Pregnancy: What's Going On Inside
- Fetal development at 8 weeks of pregnancy
- Week 12 of Pregnancy: What's Going On Inside
- Fetal development at 12 weeks of pregnancy
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Your Second Trimester
- Mothers' Physical Changes During the Second Trimester
- Check-ups and Tests in the Second Trimester
- Normal Pregnancy: Second Trimester
- Week 16 of Pregnancy: What's Going On Inside /
- Fetal development at 16 weeks of pregnancy
- Week 20 of Pregnancy: What's Going On Inside
- Fetal development at 20 weeks of pregnancy
- Week 24 of Pregnancy: What's Going On Inside /
- Fetal development at 24 weeks of pregnancy
- Pregnancy: Kick Counts
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Your Third Trimester
- Check-ups and Tests in the Third Trimester
- Fetal Development in the Third Trimester
- Mothers' Physical Changes in the Third Trimester
- Prenatal Classes in the Third Trimester
- Writing Your Birth Plan or Wishes
- Normal Pregnancy: Third Trimester
- Week 28 of Pregnancy: What's Going On Inside
- Fetal development at 28 weeks of pregnancy
- Week 32 of Pregnancy: What's Going On Inside
- Fetal development at 32 weeks of pregnancy
- Week 36 of Pregnancy: What's Going On Inside
- Fetal development at 36 weeks of pregnancy
- Week 40 of Pregnancy: What's Going On Inside
- Fetal development at 40 weeks of pregnancy
- Pregnancy: Dropping (Lightening)
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Risks and Complications During Pregnancy
- Pregnancy-Related Problems
- Gestational Diabetes
- HELLP Syndrome
- Gestational Diabetes: Dealing With Low Blood Sugar
- Insulin Injection Areas for Gestational Diabetes
- Gestational Diabetes: Giving Yourself Insulin Shots
- Gestational Diabetes: Counting Carbs
- Gestational Diabetes: Checking Your Blood Sugar
- Pre-Eclampsia: Expectant Management
- Pregnancy: Hot Tub and Sauna Use
- Pregnancy After Weight-Loss (Bariatric) Surgery
- External Cephalic Version (Version) for Breech Position
- Bedrest for Preterm Labour
- Multiple Pregnancy: Preterm Birth
- Multiple Pregnancy: Should I Consider a Multifetal Pregnancy Reduction?
- Multiple Pregnancy: Twins or More
- Twin Pregnancy Types
- High-risk Pregnancy
- Rh Sensitization during Pregnancy
- Post-Term Pregnancy
- Abnormal Vaginal Bleeding
- Intrauterine Fetal Blood Transfusion for Rh Disease
- Miscarriage
- Abruptio Placenta
- Anemia During Pregnancy
- Antiphospholipid Syndrome and Pregnancy /
- Asthma During Pregnancy
- Bedrest in Pregnancy
- Pre-Eclampsia: Checkups and Monitoring
- Functional Ovarian Cysts /
- High Blood Pressure During Pregnancy
- Laparoscopic Ovarian Drilling for PCOS
- Low Amniotic Fluid
- Low-Lying Placenta Versus Placenta Previa
- Miscarriage: Should I Have Treatment to Complete a Miscarriage?
- Molar Pregnancy
- Passing Tissue During Pregnancy
- Placenta Previa
- Polyhydramnios
- Pre-Eclampsia
- Eclampsia (Seizures) and Pre-Eclampsia
- Special Health Concerns During Pregnancy
- Ectopic Pregnancy
- Subchorionic Hemorrhage
- Endometriosis
- Toxoplasmosis During Pregnancy
- Vaginal Bleeding During Pregnancy
- Healthy Eating and Physical Activity
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Emotional Health and Support During Pregnancy
- Getting Help for Perinatal Depression
- Coping with Losing a Baby
- Depression and Anxiety During Pregnancy
- Domestic Abuse While You Are Pregnant
- How Support Teams Can Help During Pregnancy
- Partner Support during Pregnancy
- Pregnancy: Relationship Changes
- Stress While You Are Pregnant
- Tips for Pregnant Parents
- Alcohol and Other Drug Use During Pregnancy
- Interactive Tool: What Is Your Due Date?
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Labour and Birth
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Planning Your Delivery
- Childbirth Classes
- Childbirth: Labouring in Water and Water Delivery /
- Childbirth: Perineal Massage Before Labour
- Choosing Where to Give Birth Hospital or Home
- Doulas and Support During Childbirth
- Making a Birth Plan
- Packing for Birth at a Hospital
- Pregnancy: Deciding Where to Deliver
- Vaginal Birth After Caesarean (VBAC)
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Stages of Labour
- Labour and Delivery
- Cervical Cerclage to Prevent Preterm Delivery
- First Stage of Labour - Early Phase
- First Stage of Labour Active Phase
- First Stage of Labour Transition Phase
- Information on Fourth Stage of Labour
- Information on Second Stage of Labour
- Information on Third Stage of Labour
- Preterm Labour and Short Cervix
- Preterm Labour
- Preterm Labour: Testing for Fetal Fibronectin
- Preterm Prelabour Rupture of Membranes (pPROM)
- Telling Pre-Labour and True Labour Part
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During Labour
- Breathing Techniques for Childbirth
- Caesarean Section
- Cervical Effacement and Dilatation
- Cervical Insufficiency
- Childbirth: Epidurals
- Childbirth: Opioid Pain Medicines
- Childbirth: Pudendal and Paracervical Blocks
- Childbirth: Strep Infections During Delivery
- Comfort Positions Labour and Birth
- Epidural Anesthesia
- Epidural and Spinal Anesthesia
- Episiotomy and Perineal Tears
- Epistiotomy Vacuum and Forceps During Labour and Birth
- Fetal Monitoring During Labour HY
- Labour Induction and Augmentation
- Local Anesthesia for Childbirth
- Pain Relief Options Labour and Birth
- Postpartum Bleeding
- Postpartum: First 6 Weeks After Childbirth
- Postural Management for Breech Position
- Practicing Breathing Techniques for Labour
- Spinal Block for Childbirth
- Stillbirth
- VBAC: Labour Induction
- VBAC: Participation During Birth
- VBAC: Uterine Scar Rupture
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After Labour and Care for New Moms
- Alcohol and Smoking After Pregnancy
- Baby Blues
- Depression: Managing Postpartum Depression
- Fitness: Staying Active When You Have Young Children
- Sex After Childbirth
- Support Teams for New Parents
- Taking Care of Yourself When Your Baby Is Fussy
- Your Body After Pregnancy
- After Childbirth: Coping and Adjusting
- After Childbirth: Pelvic Bone Problems
- After Childbirth: Urination and Bowel Problems
- Childbirth Afterpains
- Help with Urination After Giving Birth
- Managing Bowel Movements After Pregnancy
- Mom and Baby Staying Together
- New Moms and Abuse
- Postpartum Depression
- Problems After Delivery of Your Baby
- Vaginal Care After Giving Birth
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Planning Your Delivery
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Parenting Babies (0-12 months)
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Baby Care
- Pregnancy: Should I Bank My Baby's Umbilical Cord Blood?
- Umbilical Cord Blood Donation and Private Banking
- Preparing Siblings for Meeting your New Baby
- Can Cloth Diapers Work for Your Familiy
- Bonding With Your Baby
- Infant Crying
- Crying: Tired or Overstimulated
- Baby's Daily Needs: What to Expect
- Ways to Comfort a Crying Baby
- Coping Strategies to Avoid Harming a Baby
- Coping When Your Baby Cries A Lot
- Tips for Soothing Babies
- Immunizations for Premature Infants
- Important Paperwork for Newborns
- NICU: Communicating With the Staff
- Premature Infant: Safe Travel With Your Baby
- Tips for Diapering a Newborn Baby
- Ways to Comfort a Baby in the Hospital
- Premature (Preterm) Infant
- Bonding With Your Newborn
- Bathing and Skin Care For Newborn Babies
- What to Expect When You Have an Extremely Premature Infant
- Birthmarks
- Biting
- Caring for More Than One Baby
- Caring for a Baby's Nails
- Circumcision
- Circumcision: Should I Keep My Son's Penis Natural?
- Cleaning Your Young Child's Natural (Uncircumcised) Penis
- Cleft Lip
- Cleft Palate
- Club Foot
- Common Types of Birthmarks
- Diaper Rash
- Infant Massage
- Oral Care For Your Baby
- Positional Plagiocephaly
- Quick Tips: Getting Baby to Sleep
- Screening for Hearing Problems
- Separation Protests: Helping Your Child
- Thumb-Sucking Versus Pacifier Use
- Using Soothers and Stopping When it is Time
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Breastfeeding
- A Video on Breastfeeding Positions
- A Video on Breastfeeding and Skin-to-Skin Contact
- A Video on Hand Expressing Breastmilk
- Breast Engorgement
- Breast Surgery and Breastfeeding
- Breastfeeding After Breast Surgery
- Breastfeeding After a C-Section
- Breastfeeding During Pregnancy
- Breastfeeding Multiple Infants
- Breastfeeding Positions
- Breastfeeding With Inverted Nipples
- Breastfeeding Your Newborn and an Older Child
- Breastfeeding a Sick Baby
- Breastfeeding and Your Milk Supply
- Breastfeeding at Work
- Breastfeeding
- Breastfeeding: Baby's Poor Weight Gain
- Breastfeeding: Planning Ahead
- Breastfeeding: Tobacco, Alcohol, and Drugs
- Breastfeeding: Waking Your Baby
- Breastfeeding: When Baby Doesn't Want to Stop
- Common Breastfeeding Concerns
- Common Breastfeeding Positions
- Coping With Thrush When You’re Breastfeeding
- Experiencing Let-Down Reflex
- FAQs About Breastfeeding
- Get Started on Expressing Breastmilk
- Getting Comfortable Breastfeeding in Public
- Hospital Policies and Breastfeeding
- Latching Your Baby - Video
- Learning Basics of Breastfeeding
- Learning to Latch
- Mastitis While Breastfeeding
- Medications and Herbal Products for Breastfeeding Moms
- Medicine Use While Breastfeeding
- Milk Oversupply
- Nipple Shields for Breastfeeding Problems
- Oxytocin
- Plugged Milk Ducts When You're Breastfeeding
- Poor Let-Down While Breastfeeding
- Preventing Mastitis
- Pumping Breast Milk
- Quick Tips: Successful Breastfeeding
- Signs That Your Baby Is Getting Enough Breast Milk
- Sleep, Rest, and Breastfeeding
- Storing Breast Milk
- Storing and Using Breastmilk
- Under or Over Production of Milk During Breastfeeding
- Vitamin D Supplements for Breastfeeding Babies
- What you need to Know About Supplementing Baby Formula
- Your Milk Supply
- Breastfeeding: Weaning a Baby
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Feeding Your Baby
- Alternative Feeding Methods for Newborns
- Baby Feeding Cues - Video
- Bottle-Feeding: When Baby Doesn't Want to Stop
- Burping a Baby
- Choosing Baby Bottles and Nipples
- Cleft Palate: Feeding Your Baby
- Combining Breastfeeding and Formula-Feeding
- Cup-Feeding Baby With Breast Milk or Formula
- Feeding Schedule for Babies
- Feeding Your Child Using Division of Responsibility
- Feeding Your Infant
- Feeding Your Premature Infant
- Getting Started and Feeding Cues
- How Often and How Long to Feed
- Introducing Solid Foods to Your Baby
- Learn More Before You Supplement Formula
- Safe Drinking Water - Your Baby's First Year
- Safe Water for Mixing Infant Formula
- Signs of a Good Feed
- Spitting Up
- Weaning
- Bottle-Feeding: Weaning a Baby
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Baby Health
- Newborn Rashes and Skin Conditions
- Early Disease Screening of Newborns
- Group B Streptococcal Infections in Newborns
- Drug Withdrawal in Newborns
- Umbilical Cord Care
- Jaundice in Newborns (Hyperbilirubinemia)
- Abdominal Gas and Colic
- Basic Dental Care From Birth to 16 Years
- Bowel Movements in Babies
- Cataracts in Children
- Chronic Lung Disease in Infants
- Colic Diary
- Colic
- Colic: Harmful Treatments
- Comforting a Child Who Has a Respiratory Illness
- Common Health Concerns for Babies First Year
- Cough Symptoms in Children
- Cradle Cap
- Croup
- Croup: Managing a Croup Attack
- Crying Child That Is Not Acting Normally
- Dehydration: Drinking Enough Fluids
- Dental Care From Birth to 6 Months
- Developmental Dysplasia of the Hip
- Developmental Problems: Testing
- Failure to Thrive
- Gastroesophageal Reflux in Babies and Children
- Health and Safety, Birth to 2 Years
- Healthy Hearing and Vision For Babies
- Immunization, Your Baby's First Year
- Orchiopexy for Undescended Testicle
- Reducing Biting in Children Ages 8 to 14 Months
- Reducing Biting in Teething Babies
- Teething Products
- Teething: Common Concerns
- Treating Asthma in Babies and Younger Children
- Tongue-tie and tethered oral tissues
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Baby Growth and Development
- Helping Your Newborn Learn
- Physical Growth in Newborns
- Cognitive Growth in Newborns
- Language Development in Newborns
- Sensory and Motor Growth in Newborns
- Babies' social and emotional development
- Children's Growth Chart
- Cognitive Development 9-12 mos
- Cognitive Development First 6-9 Mos
- Emotional and Social Growth in Newborns
- Growth and Development Milestones
- Growth and Development, Newborn
- Importance of Tummy Time for Babies' Development
- Speech and Language Milestones, Birth to 1 Year
- Stimulate Your Baby's Learning
- Tooth Development in Children
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Baby Safety
- Child Car Seats
- Quick Tips: Babyproofing Your Home
- Baby's Sleep Position and Sudden Infant Death Syndrome
- Baby Proofing Your Home First Year
- Choking Rescue for Babies
- Safer Sleep for My Baby
- Crib Safety
- Safe Chairs for Baby's First Year
- Safety at Home for Baby's First Year
- Shaken Baby Syndrome
- Sudden Infant Death Syndrome (SIDS)
- Sun Safety Babies for their First Year
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Baby Care
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Parenting Toddlers (12-36 months)
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Caring for Your Toddler
- Acetaminophen Use in Young Children
- Breath-Holding Spells
- Breath-Holding Spells: Keeping a Record
- Brushing and Flossing a Child's Teeth
- Care for Toddlers' Colds and Coughs
- Crying, Age 3 and Younger
- Dental Care and Teething in Toddlers
- Egocentric and Magical Thinking
- Hearing Health for Toddlers
- Ibuprofen Use in Young Children
- Managing Your Toddler's Frustrating Behaviours
- Positive Parenting
- Preparing Your Toddler for Health Care Visits
- Preventing Breath-Holding Spells in Children
- Promoting Positive Behaviour in Your Toddler
- Breastfeeding Your Toddler
- Childproofing your Home
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Toddler Growth and Development
- Cognitive Development, Ages 12 to 24 Months
- Emotional and Social Development, Ages 1 to 12 Months
- Emotional and Social Development, Ages 12 to 24 Months
- Growth and Development, Ages 1 to 12 Months
- Growth and Development, Ages 12 to 24 Months
- Growth and Development, Ages 2 to 5 Years
- Language Development 12-18 Months
- Language Development 18-24 Months
- Language Development 24-30 Months
- Milestones for 2-Year-Olds
- Milestones for 3-Year-Olds
- Physical Development, Ages 1 to 12 Months
- Physical Development, Ages 12 to 24 Months
- Sensory and Motor Development, Ages 1 to 12 Months
- Sensory and Motor Development, Ages 12 to 24 Months
- Speech and Language Development: Helping Your 1- to 2-Year-Old
- Speech and Language Milestones, Ages 1 to 3 Years
- Toddler Play Activities
- Toddlers Language Development 30-36 Months
- Toddlers Physical Development 18-24 Months
- Toddlers Physical Development 24-30 Months
- Toddlers Physical Development 30-36 Months
- Toddlers Social and Emotional Development 12-18 Months
- Toddlers Social and Emotional Development 18-24 months
- Toddlers Social and Emotional Development 30-36 Months
- Toddlers social and Emotional Development 24-30 months
- Toilet Training
- Toilet Training: Knowing When Your Child Is Ready
- Understanding your Toddlers Development
- Toddler Sleep
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Caring for Your Toddler
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Parenting Preschoolers (3-5 years)
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Caring for Your Preschooler
- Motivational Therapy for Bedwetting
- Daytime Accidental Wetting
- Dental Care: 3 Years to 6 Years
- Health and Safety, Ages 2 to 5 Years
- Preschoolers: Building Self-Control
- Preschoolers: Building Social Skills
- Preschoolers: Building a Sense of Security
- Preschoolers: Encouraging Independence
- Preschoolers: Helping Your Child Explore
- Preventing Tooth Decay in Young Children
- Temper Tantrums
- Temper Tantrums: Keeping a Record
- Thumb-Sucking: Helping Your Child Stop
- Your Child and the Dentist
- Moisture Alarms for Bedwetting
- Nightmares and Other Sleep Problems in Children
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Preschooler Growth and Development
- Emotional Development, Ages 2 to 5 Years
- Encouraging Language Development in Your Preschooler
- How Reading Helps Language Development
- How to Teach Your Child by Example
- Milestones for 4-Year-Olds
- Milestones for 5-Year-Olds
- Speech Problems: Normal Disfluency
- Speech and Language Delays: Common Misconceptions 49
- Speech and Language Development
- Speech and Language Development: Red Flags
- Speech and Language Milestones, Ages 3 to 5 Years
- Stuttering
- Thumb-Sucking
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Caring for Your Preschooler
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Parenting School-Age Children (6-11 years)
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Caring for Your School-Age Child
- Bedwetting
- Building Kids Resilience
- Childhood Fears and Exposure to Violence
- Conversations that Teach Children Resilience
- Establishing Limits With Your School-Age Child
- Help Your School-Age Child Develop Social Skills
- Helping Your School-Age Child Learn About the Body
- Quick Tips: Using Backpacks Safely
- Sample School Plan
- Self-Esteem, Ages 6 to 10
- Back to School
- School-Age Children Growth and Development 6-11
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Caring for Your School-Age Child
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Parenting Teens (12-18 years)
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Teen Growth and Development
- Adolescent Sensory and Motor Development
- Cognitive Development, Ages 15 to 18 Years
- Emotional and Social Development, Ages 11 to 14 Years
- Emotional and Social Development, Ages 15 to 18 Years
- Growth and Development, Ages 11 to 14 Years
- Growth and Development, Ages 15 to 18 Years
- Menarche
- Menstruation: Not Having a Period by Age 15
- Milestones for Ages 11 to 14
- Milestones for Ages 15 to 18
- Physical Development, Ages 11 to 14 Years /
- Physical Development, Ages 15 to 18 Years
- Puberty Issues
- Teenage Sleep Patterns
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Caring for Your Teen
- Conversations that Teach Resilience
- Help Your Working Teen Balance Responsibilities and Set Priorities
- Helping Adolescents Develop More Mature Ways of Thinking
- Helping Your Child Transition Into Middle School or Junior High
- Helping Your Teen Become a Safe Driver
- How to Get Back on Track After Conflict with Teenagers
- How to Start a Conversation with Teens About Alcohol
- Medical Checkups for Adolescents
- Talking to Your Adolescent or Teen About Problems
- Teen Relationship Abuse
- Teen Substance Use: Making a Contract With Your Teen
- Teenage Substance Use: Choosing a Treatment Program
- Teenage Tobacco Use
- Teens With Diabetes: Issues for Parents
- Tips for Parents of Teens
- Your Teen's Sexual Orientation and Gender Identity
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Teen Growth and Development
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Keeping Your Child Safe
- Quick Tips: Helping Your Child Stay Safe and Healthy
- Poison Prevention for Toddlers
- Playground Safety for Toddlers
- Safety Outdoors in the Cold for Toddlers
- Bathroom Safety For Toddlers
- Your Toddler: Safe Ways to Explore
- Child Safety: Preventing Burns
- Child Safety: Preventing Drowning
- Water Safety for Toddlers
- Child Safety: Preventing Child Abduction
- Child Safety: Fires
- Protecting Your Child From Infections
- Child Safety: Pets
- Child Safety: Preventing Falls
- Child Safety: Streets and Motor Vehicles
- Child Safety: Washing Toys to Prevent Germs
- Preventing Choking in Small Children
- Preventing Children's Injuries From Sports and Other Activities
- Child Safety: Air Pollution
- Child Safety: Bathing
- Child Safety: Bicycles and Tricycles
- Child Safety: Drowning Prevention in Pools and Hot Tubs
- Child Safety: Guns and Firearms
- Child Safety: Strollers and Shopping Carts
- Head Injuries in Children: Problems to Watch For
- Head Injury, Age 3 and Younger
- Object Stuck in a Child's Airway
- Preventing Choking
- Playground Safety
- Bullying
- Quick Tips: Safely Giving Over-the-Counter Medicines to Children
- Preventing Poisoning in Young Children
- Bullying: How to Help Your Child Who Bullies
- Staying Healthy Around Animals
- Bullying: Building a Child's Self-Esteem
- Thinking About Child Safety
- Bullying: Signs a Child Is Bullied
- Rule of Nines for Babies and Young Children
- Abuse: Signs of Abuse-Related Injuries
- Media and Your Child: Making Choices
- Child Abuse: Emotional Abuse by Parents
- Protecting Your Toddler From Potential Abuse
- Sexual Abuse: Signs and Symptoms
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Relationships and Emotional Health
- Helping Your Child Build Inner Strength
- Helping Your Child Build a Healthy Body Image
- Symptoms of Depression in Children
- Active Listening
- Aggression in Youth
- Appreciating Your Child's Personality
- Family Life Cycle
- Family Meetings
- Recognizing and Developing Your Children's Special Talents
- Sibling Rivalry: Reducing Conflict and Jealousy
- Violent Behaviour in Children and Teens
- Growth and Development: Helping Your Child Build Self-Esteem
- Effective Parenting: Discipline
- Corporal Punishment
- Talking With Your Child About Sex
- Helping Kids Handle Peer Pressure
- Substance Use Problems: How to Help Your Teen
- Helping Your Child Avoid Tobacco, Drugs, and Alcohol
- Stress in Children and Teenagers
- Stress Management: Helping Your Child With Stress
- Family Therapy for Depression in Children
- Comparing Symptoms of Normal Moodiness With Depression in Children
- Conditions With Symptoms Similar to Depression in Children and Teens
- Warning Signs of Suicide in Children and Teens
- Taking Care of Yourself When You Have a Child With Physical, Emotional, or Behavioural Problems
- Taking Care of Yourself When Your Child Is Sick
- Grief: Helping Children With Grief
- Grief: Helping Children Understand
- Grief: Helping Teens With Grief
- ADHD: Taking Care of Yourself When Your Child Has ADHD
- Baby's Best Chance
- Toddler's First Steps
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Birth Control
- Birth Control Hormones: The Pill
- Birth Control Hormones: The Shot
- Birth Control Hormones: The Mini-Pill
- Birth Control Hormones: The Patch
- Birth Control Hormones: The Ring
- Breastfeeding as Birth Control
- Birth Control: How to Use a Diaphragm
- Birth Control
- Birth Control: Myths About Sex and Pregnancy
- What to Do About Missed or Skipped Birth Control Pills
- Birth Control Pills: Missed or Skipped Periods
- How Birth Control Methods Prevent Pregnancy
- How to Take Birth Control Pills
- Birth Control: How to Use the Patch
- Birth Control: How to Use the Ring
- Hormonal Birth Control: Risk of Blood Clots
- Effectiveness Rate of Birth Control Methods
- Birth Control
- Diaphragm for Birth Control
- Spermicide for Birth Control
- Contraceptive Sponge for Birth Control
- Cervical Cap for Birth Control
- Birth Control: Pros and Cons of Hormonal Methods
- Intrauterine Device (IUD) for Birth Control
- Hormonal Methods of Birth Control
- Barrier Methods of Birth Control
- Tubal Implants for Permanent Birth Control
- Birth Control Patch
- How Pregnancy (Conception) Occurs
- Getting Pregnant After Stopping Birth Control
- Male Condoms
- Emergency Contraception
British Columbia Specific Information
If you are thinking about your options for your next birth after a caesarean, Perinatal Services BC has an online tool called My Next Birth to provide information about repeat C-sections and what the different choices may mean for you, your family, and your health.
Topic Overview
What is a vaginal birth after caesarean (VBAC)?
If you have had a caesarean delivery (also called a C-section) before, you may be able to deliver your next baby vaginally. This is called vaginal birth after caesarean, or VBAC.
Most women, whether they deliver vaginally or by C-section, don't have serious problems from childbirth.
If you and your doctor or midwife agree to try a VBAC, you will have what is called a "trial of labour after caesarean," or TOLAC. This means that you plan to go into labour with the goal to deliver vaginally. But as in any labour, it is hard to know if a VBAC will work. You still may need a C-section. About 25 out of 100 women who have a trial of labour need to have a C-section. This means about 75 out of 100 women who have a TOLAC deliver vaginally.footnote 1
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 or midwife can talk about your risk for having problems during a trial of labour.
A woman who chooses VBAC is closely monitored. As with any labour, if the mother or baby shows signs of distress, an emergency caesarean section is done.
What are the benefits of a TOLAC and VBAC?
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 labour is that a C-section scar could come open during labour. 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 caesarean scar and your labour 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 labour and need to have a C-section, your risk of infection is slightly higher than if you just had a C-section.
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Is VBAC Right for You?
Having a vaginal birth after having a C-section can be a safe choice for most women. But it can have risks for both the mother and the baby. Whether VBAC is right for you depends on what risk factors (things that increase your risk) you have that could make it unsafe. You and your doctor or midwife can decide whether VBAC is right for you.
As with a first-time childbirth, even if you are a good candidate for a successful VBAC, there is no guarantee that you will give birth vaginally and without complications.
What Affects VBAC Success
Pregnancy, labour, and delivery are different for every woman and difficult to predict. Even if your first pregnancy required a caesarean, the next one may not. The likelihood of a successful vaginal birth after caesarean (VBAC) is influenced by many things. Usually a combination of things affects how well or poorly a trial of labour goes.
Your chances of a successful VBAC are best when:footnote 2
- Your previous caesarean was not done for stalled labour.
- You do not have the same condition that led to a previous caesarean (such as a breech, or feet-down, fetus).
- You have had a vaginal delivery or a successful VBAC before.
- Your labour starts on its own and your cervix dilates well.
- You are younger than 35.
Your chances of a successful VBAC are lower when:footnote 2
- Your previous caesarean was because of difficult labour, which is called dystocia. This is especially true if you were fully dilated when you had a caesarean section for dystocia.
- You are obese.
- You are older than 35.
- Your fetus is estimated to be very large [bigger than 4000 g (9 lb)].
- You are beyond 40 weeks of pregnancy.
- Your last pregnancy was less than 19 months ago.
- You have pre-eclampsia.
VBAC can be considered for pregnancies with twins.
Risks of VBAC and Caesarean Deliveries
Whether you deliver vaginally or by caesarean section, you are unlikely to have serious complications. Overall, a routine vaginal delivery is less risky than a routine caesarean, which is a major surgery. But a pregnant woman who has a caesarean scar on the uterus has a slight risk of the scar breaking open during labour. This is called uterine rupture.
Although rare, uterine rupture can be life-threatening for both mother and baby. So women with risk factors for uterine rupture should not attempt a vaginal birth after caesarean (VBAC).
Risks of VBAC
The risks of VBAC include:
- Problems during labour that result in a caesarean delivery. This occurs with about 25 out of 100 women who try VBAC. But it doesn't happen with 75 out of 100 women who try VBAC.footnote 1
- Rupture of the scar on the uterus, which is rare but can be deadly to the mother and baby. About 5 out of 1000 women have a uterine rupture during a trial of labour.footnote 1 A vertical incision used in a past C-section, use of certain medicines to start (induce) labour, and many scars on the uterus from past C-sections or other surgeries are some of the things that can increase the chance of a rupture.
- The chance of infection. Women who have a trial of labour and end up having a C-section have a higher risk of infection. This means that the risk of infection is lower after vaginal births and after planned cesareans.footnote 2
Risks of any caesarean
The risks of caesarean delivery include:
- Infections.
- Pain.
- Blood loss that requires a blood transfusion.
- Genital or urinary problems.
- Blood clots.
- Risks from anesthesia.
- A longer recovery time.
- Injury to the baby during the delivery. The injury usually isn't serious.
- Breathing problems (respiratory distress syndrome) for the baby after birth if the due date has been miscalculated and a caesarean is done before the baby's lungs are fully developed.
Future risks. If you are planning to get pregnant again, it's important to think about scarring. After you have two C-section scars, each added scar in the uterus raises the risk of placenta problems in a later pregnancy. These problems include placenta previa and placenta accreta, which raise the risk of problems for the baby and your risk of needing a hysterectomy to stop bleeding.
For more information about caesarean risks, see the topic Caesarean Section.
Examinations and Tests
Besides the usual prenatal tests, your doctor will take measures to assess whether vaginal delivery is likely to be a safe birthing option for you. (For more information on standard prenatal tests, see the topic Pregnancy.) These extra measures can help you and your doctor make a well-informed decision about your delivery.
Assessments done sometime during the pregnancy to help find out whether a trial of labour is a safe option may include:
- A review of surgery records to verify the type of incision used for a previous caesarean.
- A fetal ultrasound.
- Fetal heart monitoring, which is also used during labour and delivery to watch for fetal distress. Fetal heart monitoring can also help detect a sudden uterine rupture. A rupture is typically followed by a sudden and then ongoing drop in fetal heart rate. The mother might notice bleeding and pain.
What To Expect
Information, preparation, and teamwork are needed for a successful vaginal birth after caesarean (VBAC).
Childbirth and VBAC education
To prepare for labour, consider taking a childbirth education class at your local hospital or clinic. You and your birthing partner can learn:
- What to expect during labour and delivery.
- How to manage the birth using controlled breathing and emotional and physical support.
- What medical pain control options may be available for a vaginal delivery.
Labour
Other than requiring closer monitoring, trial of labour after caesarean, or TOLAC labour, is the same as normal labour. During early labour, a woman can remain as active and mobile as she wants. There are no specific restrictions for TOLAC until active labour begins. During the active period of labour, continuous fetal heart monitoring is done to watch for early signs of fetal distress or uterine rupture. (For more information, see Examinations and Tests.)
If you are attempting a trial of labour and you have not had a previous vaginal birth or your previous caesarean was done early on in labour, your labour will be like a first-time labour.
For more information about labour and delivery, see the topic Labour and Delivery.
Medicines for starting or strengthening a trial of labour
As the end of pregnancy nears, the cervix normally becomes soft and begins to open (dilate) and thin (efface), preparing for labour and delivery. When labour does not naturally start on its own, labour may be started artificially (induced).
Some doctors avoid the use of any medicine to start (induce) a trial of labour, because they are concerned about uterine rupture. Other doctors are comfortable with the careful use of oxytocin to start labour when the cervix is soft and opening (dilating).
If your labour slows or stops progressing, your doctor may use oxytocin to strengthen (augment) contractions.
Pain medicine
As with most vaginal births, most women who choose VBAC can safely use pain medicine during labour.
Pain medicine usually is started when the cervix has opened (dilated) 3 cm (1.2 in.) to 4 cm (1.6 in.). Types of pain medicines used include:
- Local anesthesia, which numbs the small area where the medicine is injected.
- Epidural anesthesia, which partially or fully numbs the entire lower part of the body. Studies have shown that epidural anesthesia does not increase uterine rupture rates during vaginal birth after caesarean (VBAC) trials of labour.footnote 3
- Opioids (narcotics), which partially relieve pain and help you relax.
Recovery
Vaginal birth after caesarean (VBAC) recovery is similar to recovery after any vaginal birth. After a vaginal delivery, the mother and baby can usually go home within 24 to 48 hours. By comparison, recovery from a caesarean section requires 2 to 4 days in the hospital and a period of limited activity as the incision heals.
The overall risk of infection is low for both vaginal and caesarean deliveries. But it is lower after a vaginal birth. Before you leave the hospital, you will receive a list of signs of infection to watch for in the first few weeks after delivery.
For more information, see:
Related Information
References
Citations
- Guise JM, et al. (2010). Vaginal birth after cesarean: New insights. Evidence Report (Publication No. 10-E003). Rockville, MD: Agency for Healthcare Research and Quality.
- American College of Obstetricians and Gynecologists (2017). Vaginal birth after cesarean delivery. ACOG Practice Bulletin No. 184. Obstetrics and Gynecology, 130(5): e217–e233. DOI: 10.1097/AOG.0000000000002398. Accessed May 25, 2018.
- Cunningham FG, et al. (2010). Prior cesarean delivery. In Williams Obstetrics, 23rd ed., pp. 565–576. New York: McGraw-Hill.
Credits
Current as of: November 9, 2022
Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology
Kirtly Jones MD - Obstetrics and Gynecology
Current as of: November 9, 2022
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & Anne C. Poinier MD - Internal Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology & Kirtly Jones MD - Obstetrics and Gynecology
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