How many caesarean sections can you have?

There is no limit to the number of caesarean sections you can have. However, the risk of some complications during pregnancy and birth is higher if you have had one or more caesarean sections before. This is because having a caesarean section produces a scar on your womb where the incision is made.

Having had one or more caesarean sections can also slightly increase the risk of complications for your baby in later pregnancies. For example, the risk of stillbirth is two in 1000 for women who have never had a caesarean section compared to four in 1000 for women who have. However this is still a very small risk.

When you are due to give birth, your doctor will take account of your preferences and priorities, the overall risk and benefits of caesarean section, or vaginal birth, and the risks to you and your baby's health around the time of the birth. If you are advised to attempt a normal delivery you will be monitored very closely through your labour to ensure that there is no undue pressure placed on the old scar site or the baby.

The medical reasons for having a caesarean section far outweigh the potential risks to any future pregnancies, or to the health of you and your baby.

Sometimes, it may not be possible to have a vaginal birth if you have had one or more caesarean sections in the past. This is because there is a chance that your womb could tear along the scars from any previous caesarean sections (a uterine rupture) when you give birth. If you have had a caesarean section previously your obstetric team will be prepared to carry out an emergency caesarean section if complications develop during a vaginal birth.

I have just found out I am pregnant. When can I find out the sex of my baby?

Your first scan is carried out at around 10-14 weeks. This will give you the first glimpse of your baby. The main purpose of this scan is to check that your baby is growing and developing normally.

An ultrasound scan transmits high-frequency sound waves through your uterus. The sound waves bounce off your baby and are translated by a computer into an image on a screen, showing your baby's position and movements

The second scan is carried out at around 18-22 weeks and, if you want to know, it can usually determine the sex of your baby, but the view can sometimes be difficult to give a cast- iron guarantee.

If you want to know the sex of your baby, you should ask your sonographer (the person who carries out the scan). It is best to ask them at the beginning of the scan so that they are aware that they need to check.

It is important to be aware that it is not possible for your sonographer to be 100% certain about your baby's sex. For example, if your baby is lying in an awkward position, it may be difficult, or impossible, to tell whether your baby is male or female. This is not just the operator not wishing to tell you!

Some hospitals have a policy of not telling patients the sex of their baby. If your hospital does not routinely inform parents about their baby's sex, you may be able to pay privately for a scan to find out. Speak to your sonographer, or midwife, to find out more.

What is insomnia?

Insomnia is difficulty getting to sleep or staying asleep for long enough to feel refreshed the next morning.

This happens despite having enough opportunity to sleep.

The most common problem in young people with insomnia is difficulty falling asleep (sleep-onset insomnia). An insomniac may also experience:

€¢ Waking in the night (most common in older people).

€¢ Not feeling refreshed after sleep and not being able to function normally during the day, feeling irritable and tired and finding it difficult to concentrate.

€¢ Waking when you have been disturbed from sleep by pain or noise.

€¢ Waking early in the morning (the least common type of sleep disturbance).

Nearly everyone has problems sleeping at some point in their life and it is thought that a third of people in the UK have bouts of insomnia. Insomnia appears to be more common in women and more likely to occur with age.

There is a lot of useful information on the www.nhsinform.co.uk site on insomnia but if you are worried you can speak to your GP.