Dr Nikolova, do women still prefer giving birth via C. Section?

This tendency became popular in 2004 and continued until 2010. Since 2011 women prefer to give birth naturally. My advise is not to stagger neither to one nor to the other end.

What would you advise the women, who would like to give birth without any medication?

They should let the doctor take care of them. If he decides to undertake  any kind of treatment with medication, they just need to know, that it is only because he has to do so. Some women even refure to have a venflon, but it is just an additional way to react in case of an emergency. Others, refuse to take Oxitocin, which causes the uterus to contract and accelerate the detachment of the placenta.

But does not the placenta detach by itself?

The bloodloss is greater. Some patients believe that when they start nursing the baby, this will cause the necessary contractions. But very often these contractions are very weak. And sometimes the uterus does not contract itself at all and then it is mandatory to use medication.

I have heard that French women prefer to have vaginoplasty procedure right after giving birth? Is it necessary?

We do have patients, who six weeks after giving birth constantly feel that something is about to fall out. This is a clear sign that they should start immediate gymnastics in order to tighten their pelvic floor. And they should continue doing it on a regular basis to avoid any vaginal abnormalities. Of course these exercises work fine for some women, not really for others. It really depends on muscle structure and construction.

What do you do when exercised do not help?

Laser vaginoplasty, the tip of the iceberg all around the world. After that we apply collagen for labio remodelling and vaginal rehydration therapy. The newest method is a special restylane, that hydrtaes and remodels at the same time.

How do we know if we have vaginal prolapse after giving birth?

You just have to knee over a mirror and if the vagina is open, so then you have got a problem. Infections are more often, intimate satisfaction is lowered and most couples start practicing anal sex. This way they injure the anal ring, causing even more troubles.

You also said that gaining weight is also a big problem for all pregnant women.

Gaining weight provoces higher blood pressure. This leads to blood vessel narrowing, the baby gets less oxygen and nutrition and in the end the newborns are smaller and leighter. In addition to that in 30% of the cases high blood pressure during pregnancy remains after that, too. This is why the therapy has to continue after the delivery, too. 

What else are you careful about during pregnancy?

Whether the patient has any chronical immunological  disease, because during pregnancy it has the tendency to flare up doubly. These patients go through even stricter examninations, we check and control their Rh antibodies, constantly monitor the development of the fetus and we are cautious for any premature birth signs. We also treat very cautiously patients with kidney problems, because usually such patients give birth prematurely. Our approach to IVF patients is also very delicate in order to prevent any unwanted uterus contractions.

There is still the view that small clinics do not have the necessary equipment to deal with premature babies.

There are not big or small hospitals, there are those that work well and those that do not. Our neonatal intensive care unit does not exist from yesterday and so far non of our premature cases has been transfered to a government hospital.

A number of pregnant women over 35 years old refuse the amniocentesis, to determine whether the fetus is suffering from Down’s syndrome and trust the computerized blood tests.

They should not really, because 30% of the results from these tests (PAPA test) are incorrect. To those patients, who are afraid of amniocentesis, we offer an absolutely innovative test, not only in our country, but in the world, called “Prenatest”. We take a blood sample and send it to Germany. The result is out in 2-3 weeks. The test is extremely reliable. 

What should a pregnant woman eat?

During the first three months the system is readjusting to work for two. So she can eat whatever she wants to. From then on, she has to eat several times a day, quality meals but smaller portions. For example, half an avocado, a small salad, up to 10 strawberries without sugar, a slice of bread with low fat cheese or a piece of salmon. The portions should be up to 150-200gr. Coffee is allowed, except for women who are hospitalized for some reason.

How do we ease the morning sickness during the first few months?

If the woman cannot eat anything for a few days and the vomiting is more than 4 times a day, we hospitalize her and administer infusions. Some patients develop a hypoglycemic syndrome in their early pregnancy. They experience dizziness, tinnitus, and stomach aches or even lose consciousness. In this case, they should always have something sweet with themselves – a biscuit or a chocolate bar, but nothing more.