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Doppler Scan in Pregnancy- A Complete Guide
Doppler sonography is a technique that uses reflected sound waves to measure movements such as blood flow and heartbeat. Doppler ultrasound scans can be used to determine the speed and direction of the blood flow. This information can be helpful in determining if the foetal growth is normal and whether the tissues are supplied with enough blood and nutrients. Doppler scans are performed with the same apparatus as a regular ultrasound scan and are normally used during the third trimester on women who have high-risk pregnancies.
What is a Doppler Scan?
A Doppler scan is similar to a regular ultrasound scan and works using high-frequency sound waves called ultrasound, which isn't audible to our ears. The ultrasound generated by the equipment bounces off bones and tissues like an echo and is recorded with a microphone. All of this is done with a small hand-held probe called a transducer. A gel which helps in the process is applied over the belly, and the transducer is pressed gently against the skin to scan. Denser substances like bones give off a better echo than the softer tissue that the body is made up of, and by comparing the echo, an image of the baby is generated in a computer and displayed in real-time.
What sets a Doppler scan apart is that unlike a regular ultrasound scan, it can detect the flow of blood in blood vessels, estimate the speed of the blood flow, determine its direction, detect blood clots, etc. Most ultrasound equipment these days have an inbuilt Doppler feature and both the scans can be done together.
Is it Safe to Have a Doppler Scan?
Yes, like with all other ultrasound scans, Doppler is safe when done by trained professionals. The sonographer, who is the person carrying out the scans, follows a set of established guidelines that ensure that you and your baby are safe during the procedure. Since the scans work by using a focused beam of sound waves, the equipment can generate a small amount of heat as a consequence. Therefore, every ultrasound scan machine features a thermal index display that gives a rough estimation of how much heat is being generated.
The machines normally have a low thermal index and come with different output settings for different stages of pregnancy. Most of the ultrasound scans don’t exceed 30 minutes, and a typical Doppler scan lasts only a few minutes. This poses no risk to the baby or the mother. In decades of using ultrasound scans during pregnancies, there has been no evidence that suggests that these scans are harmful.
Why is a Doppler Scan Done During Pregnancy?
Generally, women need two basic ultrasound scans during their pregnancy. The first one is during the first trimester to look for the number of babies, check for the baby’s heartbeat, to determine the baby’s growth, and predict a due date. The second scan is done in the second trimester to check for physical abnormalities and confirm that the baby is developing normally.
If the doctor finds any anomaly during these scans, a Doppler scan is done for further investigation. Dopplers are often used to check the placental blood flow, the foetal umbilical blood flow, and blood flow in the heart and brain to ensure everything is normal. If any restriction to the flow is detected, the doctors can determine if it is caused by a restricted blood vessel, sickle cell anaemia or RH sensitisation.
Restricted blood flow in the foetus can cause lower birth weight, impaired development, reduced size, etc. A special type of Doppler ultrasound called a Transcranial Doppler is used to evaluate the risk of stroke in babies with sickle cell anaemia. Doppler scans are also recommended in conditions such as:
Carrying twins or more
The mother has a low or high body mass index (BMI)
Medical conditions such as diabetes and high blood pressure
The baby is affected by rhesus antibodies
The baby’s growth rate is low
Previous miscarriage or a small baby
The mother smokes
When Your Doctor Will Ask For a Doppler Test
Doctors ask for a Doppler test when complications or abnormalities are detected in earlier scans that demand extra care for the pregnant woman during the course of pregnancy. Some of the other common conditions when doctors ask for Doppler scans are:
Multiple Pregnancies
When the mother is carrying multiples, the pregnancy is considered a high risk one and is monitored regularly with Doppler scans. This is because such pregnancies have chances for several complications to arise. Some of them include - TTTS (Twin to Twin Transfusion Syndrome), IUGR (Intra Uterine Growth Retardation), umbilical cord entanglement, etc. These complications can be detected early with a Doppler scan.
Placental Problems
The placenta supplies the foetus with blood, nutrients and oxygen from the mother’s body. Healthy blood flow in the placenta is essential for normal development of the baby. During the second trimester’s anomaly detection scan, if problems such as slower foetal development are seen, a Doppler scan is used to detect any irregularities in the placental blood flow. A Doppler scan is also used if placenta previa (low lying placenta) is detected. The scan can show the placental position, which can change toward the end of the pregnancy.
Health Conditions of the Mother
The mother’s health has a profound effect on the growth of the foetus. Doctors use Doppler scans to determine the blood flow rate in the umbilical arteries and the placenta. There are conditions under which blood flow in the arteries can get restricted, such as the contraction of arteries due to smoking, certain medications, and other lifestyle-related causes. The contracted arteries offer high resistance to the flow of blood, resulting in improper oxygen and nutrient supply to the foetus. Conditions such as high blood pressure and diabetes can also have a significant effect on this.
Health Conditions of the Foetus
When the growth rate of the foetus in previous ultrasound scans is not satisfactory, doctors use a Doppler foetus scan for further analysis.
How a Doppler Scan is Different From Other Pregnancy Scans
A typical ultrasound scan bounces high-frequency sound off the tissues of the body to give a thin two-dimensional image that does not show any movement. A Doppler ultrasound scan, on the other hand, relies on the Doppler Effect. The phenomenon is a continuous change in the frequency of the bounced sound wave when it hits something that moves, like the blood flow in the arteries. It can measure the difference between blood that is moving away from the probe and blood that is moving towards the probe, as well as its speed. A Doppler can also detect the heartbeat of the foetus, which other scans cannot.
Which Areas Are Checked During a Doppler Ultrasound?
Dopplers are generally used to determine blood flow. When anomalies are detected in previous scans, the doctor generally scans the blood flow in the critical parts of the mother and the foetus’ body.
Uterine Artery Doppler Scan
Uterine arteries are the blood vessels that carry blood to the mother’s uterus (womb). During pregnancy, these arteries become stretchy and expand in size to richly supply the uterus with blood. This physical change allows more amount of blood flow with low resistance through the arteries, so the foetus can be supplied with ample nourishment. If the mother suffers from conditions such as Pre-eclampsia, the blood flow to the artery is restricted. A Doppler scan can be used to detect this condition early on.
Umbilical Artery Doppler Scan
In conditions where a pregnant woman is carrying twins, a baby appears to be growing slowly, or if the baby is affected by the rhesus antibodies, the doctor would recommend an umbilical artery scan. Umbilical arteries carry blood from the placenta to the baby through the umbilical cord. A Doppler scan of this artery reveals the amount of blood flow in it and how much nutrients and oxygen the baby is receiving. If any issues are discovered at this point, further Doppler tests might be done to reveal the cause and also check the blood flow in the baby’s brain and its aorta (a major artery in the body).
Middle Cerebral Artery(MCA) Doppler Scan
This scan shows the amount of blood flow in the middle cerebral artery, which supplies blood to the baby’s brain. The scan is performed only if the baby is suspected to be anaemic, the baby is affected with slapped cheek syndrome, or if the baby is affected by rhesus antibodies.
Ductus Venosus Scan
This is a rather uncommon Doppler scan. It is done in the first trimester, along with other tests to look for a chromosomal abnormality in the foetus. It is also done to scan the umbilical vein, which carries blood to the baby’s heart.
Types of Doppler Scan in the Pregnancy Phase
There are different types of Doppler scans that can determine various characteristics, such as the direction of the blood, the velocity of the blood, and the location. Depending on what needs to be assessed, three types of Doppler scans are used:
Continuous Wave Doppler
This system utilises a continuous transmission and reception of ultrasound waves to accurately measure high velocities of blood flow. It does not show the direction or the location of the flow, but only the speed. It is compact and commonly used.
Duplex Doppler
A duplex Doppler can generate an image of the blood vessel and the surrounding organs, while at the same time, measuring the speed and direction of the blood flow.
Colour Doppler
A colour Doppler is similar to a duplex Doppler but gives a better visualisation of the scanned area. A computer overlaps colour images depicting the blood flow onto the image of the blood vessel and its surrounding tissues. The different colour schemes show the speed and direction of the blood flow. A variation of this instrument called a Power Doppler can be used to look at blood flow in solid organs.
How to Prepare For a Doppler Scan
There are no special instructions to be followed before undergoing a Doppler scan. Women who smoke must avoid smoking or using any nicotine-based products two or more hours before the procedure. As nicotine causes blood vessels to constrict, it could give a false diagnosis, which could be mistaken as a pathological constriction. Other general instructions include wearing loose-fitting clothes to the clinic and staying well hydrated.
How a Doppler Test in Pregnancy is Done
A Doppler pregnancy test is done in the same way that a normal ultrasound scan is done. The pregnant woman will be asked to lie down on the examination platform, and her skirt/pants will be lowered to expose the baby bump. The sonographer then applies a water-based gel on the tummy. The function of the gel is to facilitate a secure contact of the transducer with the skin so that no air bubbles get trapped in between and interfere with the sound waves as the transducer is moved about. The image of the scan is displayed on a computer screen in real-time and saved for further analysis. The scan should be over within a few minutes and is painless.
Other Risks
There are no risks from the ultrasound on the foetus or the mother in a Doppler scan. On the contrary, opting to not get an ultrasound scan throughout the pregnancy can be risky. Research has shown that Doppler scans lower the risk in high-risk pregnancies.
Please note that vaginal probe Doppler scans are usually not recommended during the early weeks of pregnancy.
Can You Use a Hand-Held Doppler Device at Home
Small hand-held Doppler ultrasound pregnancy heartbeat scanners can be purchased to listen to the baby’s heartbeat. The device won’t usually work until the woman is 13 weeks into the pregnancy, as the womb is still in the pelvis. It is possible to detect the heartbeat after 13 weeks.
However, doctors and midwives recommend against it, as the average untrained person won’t be able to tell the difference between a baby’s heartbeat and their own placental blood flow. Even though the technology is safe to use, it can be falsely reassuring and even misleading which can cause unnecessary stress and anxiety among pregnant women.
On the other hand, electronic fetal monitoring done by a doctor or a midwife using a Cardiotocograph has some real benefits to it. A Cardiotocograph or CTG is a small Doppler that monitors the baby’s heart rate for normal heartbeats and irregularities. A healthy baby’s heart rate varies all the time and changes as it moves around. Women with healthy pregnancies don’t need to have a CTG to monitor the baby. As long as it can be felt moving regularly during the day, the baby is fine.
CTG used during labour is a highly useful tool for when continuous monitoring of the baby is needed. The baby’s heart rate, along with the woman’s contractions, is measured to see a positive relationship between the two. If the CTG shows that the baby’s heart rate is decreasing with increasing contractions, the doctor administers a drug to lessen the contraction’s strength. If that doesn’t work, the woman would need an emergency caesarean.
Taking a Doppler Test can be extremely useful and help in detecting anomalies that cannot be detected with a normal ultrasound. If your doctor recommends you to take a Doppler test, rest assured that it is for the health and safety of you and your baby. Read more
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Vaginal Birth after Caesarean Delivery
When a woman who has had a Caesarean delivery in the past conceives again or is planning to conceive, the first question that pops up in her mind is, whether she will be able to deliver her baby vaginally this time. Here we attempt to clarify all the doubts and related facts to make you aware and updated on VBAC.
What is VBAC?
The term VBAC stands for Vaginal Birth After Caesarean. It means delivering your next baby vaginally after having a baby through a caesarian delivery.
If the mother and the doctor are convinced that the conditions are suited for a VBAC birth, then the mother will have to go through "trial of labour after Caesarean" or TOLAC. To describe TOLAC further, it means that the mother is planning to go into labour with an intention to deliver the baby vaginally. TOLAC does not guarantee a vaginal birth. In case there are any complications or the labour does not progress as planned, the mother may still have to go for a C-section delivery. As per most of the studies, 40 to 60% mothers who go through TOLAC, ultimately get their C-section delivery done.
Another important question is, whether the trial of labour after Caesarean is safe. Having a VBAC birth is quite safe for most women, but depends on several other factors including why the woman had a Caesarean delivery in the previous case and how many Caesarean deliveries she has already had. The doctor can give specific advice depending on every individual case, and help a mother decide whether she should go for TOLAC and VBAC or not.
Are There Any Chances of Normal Delivery After the C-section?
Women can have a normal delivery after C-section. If you were required to have a C-section delivery with your first child, it does not necessarily mean that you will need it again. Studies indicate that around 60-80% of the women who have previously had a C-section can give birth vaginally if they try.
A VBAC is more likely to be successful in the following cases:
If your previous C-section was not done due to difficult labour, delayed or stuck labour
You are not experiencing the same medical condition (such as pre-eclampsia) as the last delivery which led to the C-section
You have already had a VBAC before
You go into labour on your own
If your age is less than 35
If you are not obese
If your foetus is not very large or is less than 4 kgs
If your pregnancy is less than 40 weeks
Your previous pregnancy happened more than 1.5 years earlier
Your baby is in the head down position
Am I fit for Vaginal Birth after Caesarean?
For most women, a VBAC is safe. However, depending on certain medical conditions it can also pose serious complications for the mother and the baby. Hence, your doctor who is fully aware of your medical history and has all the necessary details related to your previous C-section delivery is the best guide for you. Based on your history and present condition, your doctor can weigh the risk factors and help you take a call on whether to opt for VBAC or not.
One of the concerns for women who have had a Caesarean previously is the risk of “uterine rupture” during VBAC. As per the American College of Obstetricians and Gynecologists (ACOG), for women who have had an earlier Caesarean delivery where a low transverse incision (a horizontal cut into the uterus) was made, the risk of uterine rupture during a natural VBAC is around 0.2 to 1.5%.
Also, in the case of Dystocia, which is a lengthy and difficult labour because of slow cervical dilation or a small pelvis or a big baby, VBAC is not recommended. If you had genital herpes or foetal distress in the previous delivery, then most likely your doctor will schedule a C-section for you. But if you do not have a major medical issue, the baby is normal in size with his/her head down; then you may be a good candidate for VBAC.
Comparing VBAC to Repeat C-section Delivery
Repeat C-section
VBAC
Surgical procedure
Normal delivery
Risks only related to usual surgery
Risks like uterine rupture, hysterectomy, bladder infection, blood clot, etc. (Though such cases are only 1%)
4-5 days of hospitalization
Two days of hospitalisation
Discomfort or ongoing pain due to incision
Temporary pain
Infection may develop during surgery
Risk of infection is double if TOLAC is attempted but is unsuccessful, resulting in a C-section
Risks like bladder injury or bowel injury
Risk like episiotomy, a surgical procedure wherein an incision is made in the perineum to enlarge the opening through which the baby is delivered
Surgery may lead to blood clots in the pelvic area
No such risk
Baby may have respiratory problem
No such risk in vaginal delivery
For mothers who are planning more children, having multiple C-sections is riskier as they may cause scarring which is associated with the risk of placental problems
No such risk
Advantages and Disadvantages of Having VBAC
There are many advantages and disadvantages of VBAC. The advantages are:
Having another surgery means having more incision scars, difficulty and discomfort of surgery which can be avoided in case of VBAC delivery
There is less pain after a VBAC delivery. You'll only experience vaginal pain which is temporary and will disappear with time
Fewer days of hospitalisation as compared to the C-section delivery. This also means lower expenses
The risk of infection related to the surgical process, like excessive bleeding which can cause blood transfusion or hysterectomy, is eliminated. The risk of developing other infections and organ damage is also associated with a surgical procedure
In case you are planning more children, every repeated C-section increases the risk and complications for future pregnancies
The disadvantages of a VBAC are mentioned below:
Uterine rupture is one of the main VBAC complications. You may keep yourself in the pain of labour hoping for a VBAC which may end up in an unplanned C-section. An unscheduled C-section may cause you more trouble and complications like excessive bleeding, uterus infection, hysterectomy, etc.
The baby may suffer neurological disorder or even death in extreme cases after an unsuccessful VBAC
Bruises around your vagina or pelvic floor weakening
Baby prolapsing, a condition in which the womb slips into the vagina
Other Risks of Having Vaginal Birth after Caesarean
20% to 40% women end up having a C-section delivery after attempting for VBAC. There is always some uncertainty associated with VBAC, and you may be among 2-4 women out of 10 who may need an emergency C-section. This may happen when the labour slows down or if the doctor is worried about the well-being of the baby.
In the case of an emergency C-section, the risk and complications are even higher as compared to the planned C-section. With an unplanned C-section, there is always a doubt of surgical complications like the development of blood clots, more bleeding than normal which may need a blood transfusion or even a hysterectomy.
Such risks are more common when VBAC is unsuccessful as opposed to a successful vaginal delivery or a scheduled C-section.
Why is VBAC Done?
Till the 20th century, most people thought that once a woman goes through a Caesarean delivery, she would have to opt for Caesarean delivery for rest of the pregnancies. However, recent studies have debunked this theory and proved that it does not hold true.
VBAC is mostly done and preferred because it is a hassle-free process that eliminates the complications associated with the Caesarean delivery. It is the most natural way of delivering the baby. Also, there are negligible post-delivery troubles in the case of VBAC. Like in a Caesarean delivery, you will need to be in the hospital for more number of days as compared to the normal delivery as the surgery requires more healing hours.
One positive is that postpartum troubles in the case of VBAC are less as compared to a Caesarean delivery. The wound and incision may take longer to heal in the case of a Caesarean delivery and there may be some ongoing troubles and pain that may continue for life. For example, many women complain of back ache after the surgical delivery. This is not a pain which deteriorates quickly, but it is more permanent in nature. Also, for the baby, the chances of respiratory infection are higher. This is primarily because respiration is triggered in babies by the contractions of labour, and when amniotic fluid is expelled from the lungs as the baby passes through the birth canal, processes which does not take place in a caesarean delivery. In the case of VBAC, the baby passes well through the birth canal which results in lesser neonatal breathing problems.
Hence, along with the American College of Obstetricians and Gynecologists, the National Institutes of Health also recommends VBAC for the women who have a low transverse uterine incision and no medical problem. Technologies like the fetal monitor help track the progress of labour and increases the success rate of VBAC. They also eliminate the complication of fetal distress. The process of VABC may involve the administration of medications to induce labour or improve contractions.
How Shall I Prepare for It?
You may be a little hesitant towards opting for a VBAC but rest assured that most women who have had a C-section can successfully deliver vaginally. After a thorough discussion with your doctor, you may take your time to get prepared for VBAC in the following suggested ways:
1. Speak to Your Doctor and Discuss Your Case
The doctor is the best person to find out whether you should go for it or not. Don’t shy away from voicing any concerns you may have and getting any doubts clarified
2. Get Updated about VBAC
You may read a lot on the internet and through journals and related studies. The more aware you are, the more confident you will be
3. Know Your Options
There are medicines available to stimulate labour and also epidurals and medication to manage labour pains. You must know that epidurals do not affect the chances of a successful VBAC. However, be aware that some medical studies have documented increased uterine rupture rates in women who undergo labour induction. Thus, you should discuss any possible complications of induction with your doctor.
4. Be Prepared
You can take classes on the childbirth especially relating to VBAC. They may guide you on the exercises to prepare for VBAC.
What is the VBAC Success Rate?
The VBAC success rate depends largely on factors including the following:
1. The Reason for Your Earlier C-Section
If you had a Caesarian delivery earlier because of a complicated reason like a uterine abnormality, then you may have to go for a Caesarian delivery again. But if your previous C-section was done because of a non-recurring and less severe issue like a low-lying placenta, etc., you can successfully opt for VBAC.
2. If You Have Had a Previous Vaginal Birth
If you have ever had a vaginal birth in any of your previous deliveries the chances of a successful VBAC increase. The chances are very bright and almost up to 80% if you've had one or more vaginal delivery in the past or especially if it was VBAC.
3. If Your Pregnancy is Not Complicated
if you already have problems in your ongoing pregnancy, then you may be prescribed to go for a Caesarean delivery by your doctor, but in the absence of any complications, the success rates of VBAC are high.
The chances of successful VBAC are low if you have given birth only by C-section delivery, or you had your BMI more than 30 at the start of the pregnancy. In these cases, the chance of a successful VBAC drops down below 40%.
For other specifications pertaining to your unique case, it is best to get in touch with your doctor to find out the expected VBAC success rate in your case.
Can I Have VBAC after 2 C-Sections?
VBAC can be successful for women who had one, two, or three C-sections in the past. The chances of VBAC after two C-sections are brighter if:
If the head of the baby is positioned down
The baby is not too large
If you have ever had a successful VBAC in the past
No serious medical problem in this pregnancy
Low transverse uterine incision
Labour beginning naturally
The due date has not already passed
No vertical incision
No history of uterine rupture
In any other case of complication, there are always increased VBAC risks after 2 C-sections, and your doctor may prescribe another Caesarean delivery for you.
How to Increase the Chances of VBAC?
You can always try to deliver you next baby naturally after one or more previous C-sections. Some suggested ways are:
Make sure that you conceive at such a time so that the delivery time is at least after 18 months of the previous C-section delivery
You must reduce your weight if you are already obese
Keep your BP within a recommended range. High BP can affect the success of the VBAC
Low-stress levels help. You must perform some relaxation or breathing exercises to prepare for VBAC.
You need to keep yourself patient and cheerful
Is It Possible to Have VBAC at Home?
Yes, you can have a VBAC delivery at your home in the presence of a midwife or a doctor. In fact, in some cases it may be a better option as it keeps the stress level low and gives better care. In addition, there is lesser risk of emotional dystocia, a condition where blood circulation in the placenta reduces as a result of a rise in catecholamines due to the mother’s emotional stress during labour.
But having a baby in the hospital has its own advantages and may have lesser VBAC complications due to the provision of continuous Electronic Fetal Monitoring (EFM), immediate scar treatment, etc. in the hospital.
It is best to get in touch with the doctor or an expert midwife to explore the chances of natural VBAC at home. They will be able to tell you if you are a good candidate for VBAC. Read more
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Complete Vaccination Guide For Your 4 Months Old Baby
All of 4 months now, you baby has had a few shots already by now. But have you learn about future doses yet?
It is very important to schedule all the required 4-month vaccinations for your little one because getting these done on time is the recipe for many years of great health! These are the vaccinations at the four month mark:
1. DtaP/DtwP
Your baby is due now to get the third dose of the DtaP/DtwP shot. This shot protects your baby against diphtheria, tetanus and pertussis. By this time, you will have already finished off with the first shot and the second one and your baby's body will have started producing antibodies already.
2. Hepatitis B
Your baby will need to take the second dosage of Hepatits B vaccine only if the first dose was at 2 months and not at birth. If the first dose was at birth, then the dosage will have been completed already.
3. Hib
To protect your baby against headache, fever, cough and stick necks, the Hib vaccine is highly recommended. This vaccine attacks the Haemophilus Influenzae virus that can even cause respiratory conditions, sometimes life threatening.
4. PCV
Meningitis and pneumonia can be life-threatening in babies, which is why the PCV vaccine is prescribed. However, not all paediatricians suggest it so you may want to check with yours before putting this on your list of vaccines due.
5. Rotavirus
Diarrhea is a common problem in a baby’s life. However, while in adults diarrhea is not fatal, a baby’s fragile body cannot handle dehydration easily. You may have already finished one or two doses of this vaccine and will now be at your last one. This is one of the most important vaccines so make sure all doses are complete.
6. Polio
Polio is a condition that causes paralysis mainly in the limbs. To avoid polio from affecting your baby, four doses are spread out over time. Check with your paediatrician and schedule your appointments in advance.
Vaccinations may be painful but the cost of not taking them is a lot worse. So, don't forget to take your baby for all his shots on time and you'll be the proud mommy of a healthy and happy baby who can fight diseases with no stress at all! Read more
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Know What it Takes to Survive Adultery in Marriage
Dealing with adultery can be difficult. When trust is broken, it takes a lot of hard work to gain it back. The philandering spouse should be willing to end the affair and work on making the marriage work. Being honest is essential for the re-building process.
Infidelity can be a hard thing to digest. It doesn't just shake up your faith in the relationship, but also makes you question a sea of things. Your children too can bear the brunt of this turmoil. However, you can tide over this sore spot with a little faith, a lot of patience, and the will to bury the hatchet. Here are some ways to overcome adultery the smart mature way, so your family remains tight and you are one with your husband again.
Overcoming Adultery: The Path to Take
1. Ask to Stop the Affair
You need to ask your husband to end the affair before reconciliation can take place. He should be willing to sever all ties with his lover and focus attention on working on your marriage. When he reveals all his secrets, you will be better equipped to find a way to forgive him. When you are honest, it paves the way for a healthy re-building process. Let him know that only when he can be trusted will the relationship heal. Let your children understand this cooling off period, before they assume and harbour negative emotions against either of you.
2. Build Transparency
While the details of your husband's affair will not be pleasant to hear and assimilate, they must be laid out bare if amends are to be made. When coping with adultery, don't be afraid to ask questions about the illicit affair. Try to have these discussions when the kids have been put to sleep. While you may think sharing the sordid details could be emotionally draining, it will instead be cathartic. Besides, you will be appreciative of your husband's honesty and his willingness to speak out. This feeling of transparency will help build trust in your partner and also mend the relationship.
3. In for the Long Haul
If you want to fix things and heal after you've suffered adultery in a marriage, you will have to be patient. You should be able to allow your partner to answer questions and clear doubts six months down the line, if that's what he wants. Don't push. Let him know that if, like you, he too wants to save the marriage, you wouldn't mind waiting for him to open up. Keep in mind – the healing process will not be an overnight success. It will take months, maybe years of work for a relationship to finally feel right again. While you wait through the period, behave normally with your partner in front of the kids. Don't let your issues ruin what you share or do as parents.
4. Balanced Approach
Ensure that you keep your emotions in check. While it's natural to feel rage and a multitude of other emotions, try to keep your head together if you want your partner to open up to you. Your erratic behaviour may make him want to run away from a confrontation or even a talk. Also, you don't want your children to see you in that state. It could scar them emotionally for life and they may never look at you the same way again. If you control your emotions, your partner will be more willing and comfortable disclosing the details of the affair. This will help you get a sense of closure and make healing possible.
5. When You Think it Fit, Forgive
Forgiveness doesn't come cheap and neither should it when its infidelity you're dealing with. It needs to be earned. When you feel right about moving on and forgiving, only then should you do it. However, maintain a cordial relationship with your spouse in front of the children during the reconciliation process. Try to take a family vacation to rediscover and relive the joy that your family once knew. However, never pressure yourself to forgive. Dealing with adultery is never easy and you shouldn't be scared to accept this. Only when you're ready to let go of the negativity and the pain can forgiveness be your next logical step. So, take your time!
Life after adultery is difficult. While some couples resort to drastic measures, some endeavour to sort things out. The latter, which is also the preferred option, requires patience, trust, and effort. Think of your children as one of the main motivating factors to help you work on your relationship. Your little ones deserve a united family, not a broken home. Read more
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How to Use your Credit Card Right
Credit cards can be of tremendous help when you don't have enough cash and need to buy something urgently. But, people often forget that along with the advantages of having a credit card, there are disadvantages as well. Find out what they are and learn how to use yours properly.
We sometimes don’t use a facility judiciously and this is what lands us in trouble. Facilities like credit cards are designed so that we can buy things when we don’t have cash. However, instead of taking the pains to use them wisely, we forget that they come with risks.
Some of the Pros and Cons of Having a Credit Card
1. If You don’t keep Your limit low, You Could Go Broke!
How much you use with your credit card should always be proportionate to your income. A simple rule to keep you from suffering the disadvantages of using a credit card is to limit your spending to not more than 20 percent of your annual income. It’ll prevent you from racking up huge bills that are tough to pay off.
2. Making Payments on Time can Boost Your Credit Rating
Even with care, it’s sometimes easy to get stuck in the trap of loans. But where credit cards are concerned, you can balance your debt-to-limit ratio and make payments easier. Using your credit card wisely and always clearing payments on time will also make it simpler to apply for loans as your credit rating will stand you in good stead. This is one advantage of having a credit card and using it properly.
3. Identity Theft is A Real Issue
It's very important to practice credit card safety tips. Always try to use services that provide you surveillance and credit monitoring. Internet scanning services check websites where your personal information can be at risk. These services monitor changes and can look for any unusual activity in online transactions. Such companies also tell you how to keep credit card information safe through regular tips and updates.
4. Spend Wisely, Save Money!
To enjoy the benefits of having a credit card, always carry cash and limit spending to cash payments as much as possible. Knowing that you’ve just spent Rs. 500 on a haircut and are left with Rs 1,500 to shop for groceries can help you spend money smartly. Even if your friends are all about using no cash, don’t go with the flow. Be the smart one and follow these credit card usage tips!
Credit cards can be your friends or your enemies. Rather than viewing them as free passes to spending without abandon, practice how to keep your credit safe and how to use it wisely. See it as a backup for cash and always remind yourself not to go beyond a limit. Use it to your advantage, but don’t take advantage of it! Read more
Anu Sharma has added a new answer
Expecting Father due in 3 months
4 hours ago
Q. My wife taking tablets for UTI it caused fever last week she took paracetamol and Pan D in IV and now for the past 5 days taking Nitrofurantoin tablet IP I have two questio
1) Will this tablets and IV affect my baby in any way and it's growth inside
2) She says still feeling some pain groin and abdomen area comparatively lesser than previous days
3) Any diets to avoid this UTI in future
Read moreAnu Sharma
Mom of a 1 yr old boy
3 hours ago
A. UTI infection is common in pregnecy. Better to consult gyne
Dr Ghouse has added a new answer
Guardian of 0 children
4 hours ago
Q. ma lmp 28.9.2023 edd date 5.7.2024 ma age 25.7.1999 ma beby boy or girl plsss tell me mam
Dr Ghouse
Paediatrician
4 hours ago
A. be not possible to tell. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr. Minal Acharya has added a new answer
Expecting Mom due in 5 months
3 hours ago
Q. Hii...., Is it safe to eat jackfruit in 4th month of pregnancy, daily 2 ...
Dr. Minal Acharya
Nutritionist
3 hours ago
A. dear mam, you can eat jackfruit during the 4th month of pregnancy. there is no problem in having it. you can eat all types of seasonal vegetables and fruits even green leafy vegetables.
shahin has added a new answer
Expecting Mom due in 2 months
2 hours ago
Q. is that positive result??? my Due date is tommoro I am having vomitting and nausea and back pain etc please reply asap
shahin
Mom of a 6 m old boy
1 hour ago
A. yes
Dr Laxmi Chavan-Sawant has added a new answer
Guardian of 0 children
1 hour ago
Q. Hi I'm in 23weeks pregnancy
my afi is 26 I have no diabetes or any other issues
is that risky ? what to do for making normal delivery possible
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
1 hour ago
A. yes AFI level is very high and yes you need to be very careful to have regular follow up with your doctor take the precautions advised by your doctor and regularly keep a watch on baby movements
Dr Laxmi Chavan-Sawant has added a new answer
Guardian of 0 children
1 hour ago
Q. nasal congestion during 9th week pregnancy is normal or something serious?
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
1 hour ago
A. it's ok . take steam twice daily or you can use nasal drops
You should have proper consultation with your treating doctor , as some examination or investigations may be needful, so that proper medications can be given And the treatment can be done very properly.
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