Acetaminophen vs. Ibuprofen

Posted on June 19, 2026 by Patrick Hercules

Acetaminophen and ibuprofen are common over-the-counter pain relievers in our medicine cabinets. We use both medications for many things, such as getting rid of headaches or reducing a fever. However, acetaminophen and ibuprofen work differently, and it is important to know which medication to use when you need to alleviate pain, as they are not interchangeable.

Acetaminophen is an analgesic, which means it reduces pain signals within the nervous system and not at the site of the pain itself. It can reduce pain for conditions such as:

Headaches

Sore throat

Osteoarthritis

Acetaminophen can have many side effects, including:

Nausea

Vomiting

Headache

Acetaminophen is metabolized by the liver and isn’t a great pain relief option for people who have issues with their liver.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that blocks the production of prostaglandins, which are the chemicals that cause inflammation. It reduces inflammation symptoms such as swelling, redness, heat, pain, and/or loss of function at the site or source. Ibuprofen can relieve pain for conditions such as:

Muscle sprains and strains

Menstrual cramps

Sinus infections

Back and neck pain

Earaches

Toothaches

Common side effects of ibuprofen include:

Heartburn

Constipation

Nausea

Stomach pain

Taking ibuprofen at high doses or for a long time can increase the risk of more serious side effects, such as:

Blood clots

Kidney damage

Heart attack and/or stroke

Ulcers

Ibuprofen is metabolized by the kidneys and isn’t a great pain relief option for people with kidney issues.

Most research suggests that acetaminophen and ibuprofen bear similar results when used to control fevers in adults. However, ibuprofen works better as a fever reducer for children. It is important to follow the dosage guidelines on the label for your child’s age and weight before giving them ibuprofen.

The recommended max dosage for adults taking acetaminophen is 3,000 to 4,000 milligrams per day, and 2,400 milligrams of ibuprofen per day.

Acetaminophen and ibuprofen can also be hidden in several over-the-counter medicines, including cough and cold medications, if you are taking more than one medication. Read the drug labels carefully for active ingredients and use the medications that fit your symptoms and type of pain you have, so you don’t go over the recommended dosage.

If you are experiencing pain and would like help determining which medication is best for relieving your pain, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

How as Few as Two Cigarettes Per Day Increases Risk of Heart Disease

Posted on June 18, 2026 by Patrick Hercules

Smoking tobacco products, such as cigarettes, is the leading preventable cause of disease and death in the United States. According to the American Cancer Society, an estimated 480,000 people die from cigarette smoking in the U.S. each year, with many of them dying from cancer. What’s more, people who smoke die about ten years earlier than those who have never smoked.

Smoking doesn’t just cause cancer. It can also cause several other diseases and can damage nearly every organ in the body, including the lungs, blood vessels, reproductive organs, bones, mouth, eyes, and skin.

Smoking tobacco can also damage the heart, as it can increase a person’s risk of developing heart disease.

According to a study conducted by researchers at Johns Hopkins University, who looked at the smoking habits of more than 300,000 adults for almost twenty years, it was discovered that men and women who smoked as few as two cigarettes daily had a 60 percent increased risk of death from any cause compared to those who never smoked.

Additionally, the study also found that the group of smokers participating in the study had a 50 percent risk of heart disease.

According to Dr. Jennifer Miao, a cardiologist at Yale University, “tobacco use is a very well-established risk factor for heart disease. It really damages the blood vessel lining and accelerates the development of plaques and coronary disease.”

Smoking can also cause heart rhythm issues, such as atrial fibrillation and stroke.

Unfortunately, the study found that cutting back on cigarette smoking may not be enough to undo the harm it causes. Despite current smokers having a higher risk of death than former smokers, former smokers still had an increased risk of heart disease more than twenty years after they had stopped smoking, according to the study.

According to the Centers for Disease Control and Prevention, quitting smoking is the most important action a person could take to improve their health, as it reduces the risk of premature death and smoking-related diseases, such as heart disease, cancer, and chronic obstructive pulmonary disease (COPD).

Treatments such as smoking cessation counseling and nicotine replacement therapy medications, including over-the-counter patches, gum, lozenges, and prescribed inhalers and nasal sprays, can help manage nicotine withdrawal symptoms and cravings, and help you quit smoking.

Flushing Hospital Medical Center provides extensive assistance for people willing to quit smoking. It offers a free smoking cessation support group and one-on-one sessions, both in person and by phone. For more information, please call 718-206-8494.

Scoliosis Awareness Month

Posted on June 12, 2026 by Patrick Hercules

June is Scoliosis Awareness Month, a time to raise awareness, share stories, and advocate for early detection and treatment of scoliosis, a spinal disorder that causes an abnormal curvature of the spine resembling the letters “S” or “C”.

The most common type of scoliosis is idiopathic scoliosis, which means the cause is unknown but is thought to be genetic. There are three types of idiopathic scoliosis:

Infantile idiopathic scoliosis- occurs from birth to three years old.

Juvenile idiopathic scoliosis- occurs from three to nine years old.

Adolescent idiopathic scoliosis- occurs from 10 to 18 years old.

Some other forms of scoliosis include:

Congenital scoliosis- when scoliosis is present at birth.

Neuromuscular scoliosis- when scoliosis is caused by an underlying systemic condition such as cerebral palsy, muscular dystrophy, spina bifida, spinal cord tumors, or paralysis.

Syndromic scoliosis- when a unique group of spine conditions causes scoliosis. The most common diseases that cause syndromic scoliosis are:

Marfan’s syndrome

Ehlers-Danlos syndrome

Osteogenesis Imperfecta

Neurofibromatosis

Prader-Willi syndrome

Arthrogryposis

Riley-Day syndrome

Scoliosis affects one in 40 children and up to one in three adults. Many have gone undiagnosed for years. That is why earlier detection is important, as it can lead to improved treatment options and a better quality of life.

There is a wide range of causes and ages at which scoliosis can occur. However, scoliosis may appear during the main growth years for children (years 10 to 12), which is the growth spurt period for children before puberty.

During this time, scoliosis will often present with the following symptoms:

One of the child’s shoulder blades is higher than the other.

The appearance of the child’s head is not centered on the rest of the body.

Uneven hips or one hip may stick out more than the other.

Pushed-out ribs

Difficulty breathing due to a reduced area for lung expansion.

Back pain and discomfort

When the child bends forward, it appears that the two sides of the back are at different heights.

The main goal for patients with scoliosis is to get an early diagnosis. Scoliosis is diagnosed when a pediatric orthopedist uses a physical exam and X-rays to diagnose early-onset scoliosis.

Scoliosis can be treated non-surgically and surgically. Some non-surgical treatments for scoliosis include:

Observation

Bracing

The Risser cast

Some surgical treatments for scoliosis include:

Spinal fusion surgery

The growing rod technique

Scoliosis is treatable, and the sooner a child is diagnosed, the less likely they will need surgery and the healthier they will be.

If you think your child may have an abnormal spine curvature, you can visit Flushing Hospital’s Pediatric Ambulatory Care Center. To schedule an appointment, call (718) 670-3007.

How to Reset and Regulate Your Nervous System

Posted on June 11, 2026 by Patrick Hercules

Our nervous system is our biological survival system, our first line of defense that is designed to respond to any stimuli, such as an environmental or psychological threat that we may encounter. It works to protect and keep us safe, as it continually processes information and responds to both internal and external stimuli.

The autonomic nervous system controls all automatic or involuntary functions of the body. It is made up of two main parts, the sympathetic and parasympathetic nervous systems.

The sympathetic nervous system, or “fight-or-flight” system, is responsible for preparing the body to respond to anything that may be seen as a threat, triggering the release of the stress hormones adrenaline and cortisol. These hormones activate our automatic survival responses, which include fight, flight, freeze, or fawn, causing us to experience symptoms, such as rapid heart rate, shallow breathing, and upset stomach, among others.

The parasympathetic nervous system, or “rest and digest” system, plays an essential part in counteracting the fight-or-flight response and regulating the body’s stress response. It promotes relaxation and recovery, which helps the body calm down.

It is important to note that our nervous system doesn’t know the difference between a real threat and a non-life-threatening stressor.

Stress can be healthy, as it can motivate us into action and help us rise to any challenges. However, many people are being pushed beyond the desirable levels of stress and into a state of distress. Our sympathetic nervous system gets sent into high gear because we continue to be on high alert, constantly reacting to stressors after stressors, and not giving our parasympathetic nervous system time to do its job to calm the body. Due to this, many people are not recovering as they may need to.

Without sufficient ways to reset and recover, we go from manageable stress to unmanageable distress. This persistent trigger can gradually lead to anxiety, irritability, fatigue, exhaustion, and eventually burnout.

There will always be times when our fight-or-flight response gets triggered. That’s why it is important to have ways to engage the parasympathetic nervous system and regulate the body back into a state of calm and balance so that we can function properly.

Here are a few ways to reset and regulate our nervous systems:

Breathwork is a deep breathing practice that signals safety to the brain, helping to calm the body and mind. Examples of breathwork include:

Long exhale breathing

Physiological sighing

Birthday cake breathing

Physical movements, such as walking, gentle stretching, or yoga, can reduce cortisol levels and promote the release of endorphins, and get rid of the stress and tension that has accumulated in the body

Spending time in nature can start to re-regulate your nervous system, as it helps lower blood pressure, reduce stress hormones, and improve mood

Crying is a self-soothing behavior that helps to expel stress hormones from the body, providing relief.

Prioritizing sleep is an important way to give the brain and body time to repair and restore themselves

Social connections with people who make you feel safe, calm, and supported can help regulate the nervous system

Intentionally slowing down your pace to signal to the brain that there isn’t any immediate danger

Many of us may spend a lot of our days in an increased state of activation, as we continually react to the stressors around us, instead of responding to them. Stress is inevitable. However, having ways to reset and regulate our nervous system can help us better cope with our stress.

To find out more about our mental health services or to schedule a virtual appointment, call (718) 670-5316 to speak with our intake coordinator or call (718) 670-5562 to reach the clinic.

Ebola Disease

Posted on June 8, 2026 by Patrick Hercules

Ebola disease is a rare and severe illness that can be fatal if it isn’t immediately treated. Ebola disease is caused by a group of viruses known as orthoebolaviruses, which are primarily found in sub-Saharan Africa. They include:

Ebola virus (EBOV), which causes Ebola virus disease

Sudan virus (SUDV), which causes Sudan virus disease

Bundibugyo virus (BDBV), which causes Bundibugyo virus disease

Orthoebolaviruses can cause serious and often deadly diseases, with a mortality rate as high as 80-90 percent.

Ebola doesn’t spread the same way as other respiratory viruses, such as the flu and COVID. You cannot get it from being near someone.

People can get infected with Ebola disease in two ways:

Through direct contact with the blood or bodily fluids of a person who has been infected or has died from the disease

Through direct contact with objects or surfaces that have been contaminated with bodily fluids from a person sick with the disease

People can’t transmit the disease before they have symptoms. However, they will remain infectious as long as their blood contains the virus.

The incubation period from infection to the onset of symptoms varies from two to 21 days. However, symptoms begin eight to ten days after exposure to the virus.

The symptoms of Ebola disease can be “dry” in the early stages of the illness and become “wet” as the illness progresses. Dry Ebola disease symptoms include:

Fever

Aches

Pains

Fatigue

Sore throat

Wet Ebola disease symptoms include:

Diarrhea

Vomiting

Unexplained bleeding

Loss of appetite

If you live in or are traveling to regions where Ebola disease has been diagnosed, or is suspected, it is important to take steps to protect yourself, such as:

Avoiding direct contact with the bodily fluids of people who are sick, which include their blood, urine, feces, saliva, sweat, vomit, breast milk, amniotic fluid, semen, and vaginal fluid

Avoiding direct contact with items that have touched an infected person’s blood or bodily fluids, such as their clothes, bedding, needles, medical equipment, or any other items that may be contaminated

Avoiding direct contact with the body of someone who was suspected or confirmed to have had Ebola disease, such as part of any funeral or burial practices

Avoiding the blood, fluids, or raw meat from bats, forest antelopes, primates, or unknown animals

Wearing personal protective equipment (PPE) if you encounter people who are sick or have died from Ebola disease, their blood and bodily fluids, or objects contaminated with their blood or bodily fluids

Monitoring your health for 21 days after returning from an area with an ongoing Ebola disease outbreak. It is important to get medical care immediately if you develop symptoms of Ebola disease

Healthcare providers can diagnose Ebola disease in people who are alive by ordering a polymerase chain reaction (PCR) blood test. They can also perform blood tests for orthoebulavirus antibodies to determine whether a patient recently had Ebola.

The U.S. Food and Drug Administration (FDA) approved Ervebo, a vaccine that prevents Ebola disease in 2019, and two treatments, Inmazeb and Ebanga, to treat an Ebola disease infection in adults and children in 2020.

Additionally, other treatments such as fluids and electrolytes administered by mouth or intravenously, medicine to support blood pressure, reduce vomiting and diarrhea, to manage fever and pain, and treatment for other infections give patients a better chance of surviving an Ebola disease infection.

If you or a loved one is experiencing symptoms of Ebola disease, immediately call your local health department or the nearest hospital emergency room, before visiting in person.

Perimenopause

Posted on April 18, 2026 by Patrick Hercules

Perimenopause is the transitional period before menopause. During this time, a woman’s body is preparing to stop having periods.

During this transition, the number of hormones a woman’s ovaries produce varies. Perimenopause can last two to eight years. The average is about four years. The hormone changes can cause symptoms that include:

Irregular periods

Vaginal dryness

Hot flashes

Night sweats

Sleep problems

Mood changes

Trouble finding words and remembering, also known as brain fog

Dry skin, dry eyes, dry mouth

Worsening premenstrual syndrome (PMS)

Breast tenderness

Decreasing fertility

Changes in sexual function

Loss of bone

Changing cholesterol levels

Perimenopause is caused by changes in two key female hormones: estrogen and progesterone. As a woman goes through perimenopause, these hormones fluctuate, and many of the changes they have during perimenopause are caused by lower estrogen.

Menopause can happen earlier in some women than in others, like before the age of 40, or between the ages of 40 and 45. Certain factors may make it more likely for perimenopause to start at an earlier age, such as:

Smoking

Family history

Cancer treatment

Hysterectomy

Some health conditions may make early menopause more likely, such as:

Thyroid disease

Rheumatoid arthritis

Other autoimmune diseases

Perimenopause is a gradual change, and there is no single test or symptom that tells it has started. A healthcare provider looks at many things to diagnose perimenopause, including:

Menstrual history

Noticeable symptoms or body changes

Some healthcare providers may order tests to check hormone levels. However, other than checking the thyroid, which affects hormone levels, hormone testing isn’t usually helpful to know if a woman is in perimenopause. That is because hormone levels in perimenopause change unpredictably.

The treatment for perimenopause usually consists of medicines that treat perimenopausal symptoms, such as:

Hormone therapy

Vaginal estrogen

Antidepressants

Gabapentin

Fezolinetant

Oxybutynin

Birth control pills

If you are experiencing symptoms of perimenopause, call (718) 670 8994 for more information about gynecological services at FHMC’s Center for Obstetrics and Gynecology.

What is Dry January?

Posted on January 9, 2026 by Patrick Hercules

New Year’s has come and gone, and we are all trying to stick to the resolutions we made. For some, a common resolution is giving up alcohol.

Heavy social drinking can often be considered binge drinking. Binge drinking is when a man drinks five or more drinks and a woman drinks four or more drinks in one sitting.

This is why many people commit to Dry January, which is when a person gives up drinking alcohol for the entire month.

Dry January has become a very popular New Year’s resolution over the past few years. Recent research indicates that younger Americans are generally drinking less than previous generations. According to a poll released last summer, conducted by the analytics company Gallup, the percentage of Americans who said they drink fell to a record low of 54%. This is one percentage point lower than the previous record low in 1958.

There are several health benefits to participating in Dry January, including:

Increased energy levels

Lower blood pressure and heart rate

A decrease in liver inflammation

Clearer skin and decreased facial puffiness and bloating

A decrease in calorie consumption

It helps shift your perspective and understanding of your relationship with alcohol

There are many tips to help you succeed during Dry January, including:

Reduce your alcohol consumption by half before you start

Write down the goals you want to achieve and document your progress

Abstain from drinking alcohol longer if you can

Ease back into drinking alcohol if you choose to go back to drinking, and drink in moderation

Surround yourself with supportive friends and family

Be mindful of withdrawal symptoms. Symptoms of withdrawal include:

- Abdominal cramping

- Anxiety

- Dizziness

- Headaches

- Nausea

- Shaking

- Sweating

- Vomiting

Avoid any situations that may tempt you to drink

Participate in hobbies and other interests that don’t involve drinking alcohol

Seek out extra help and resources if you need them

At Flushing Hospital Medical Center, our Psychiatry Department features a Division of Addiction Services where you or your loved one can receive comprehensive assessments and treatment for alcohol and chemical dependency. For more details about our unit, contact us at (718) 670-5693 or (718) 670-5540, or for additional information about our Reflections treatment program, please get in touch with us at (718) 670-5078.

From Preconception to Menopause

Posted on November 21, 2025 by Patrick Hercules

Whether considering starting a family or experiencing menopause, a woman must understand the best ways to navigate through each phase of life.

Each phase of a woman’s life requires specific care as her body and healthcare needs evolve. A committed healthcare provider can help guide a woman through the care they needs from preconception, pregnancy, childbirth, menopause, and beyond.

Preconception healthcare is the care a woman receives before she becomes pregnant. It is recommended for a woman to receive preconception healthcare. This may help address issues linked to heavy bleeding and extremely painful periods that are caused by conditions such as endometriosis or fibroids. After this diagnosis, a healthcare provider may create care plans to protect fertility.

To prepare for preconception healthcare, you will have to:

Learn about your family history, as many conditions are hereditary or genetic

Stop smoking, drinking alcohol, and using certain drugs

Avoid toxic substances and environmental contaminants

Reach and maintain a healthy weight

Get mentally healthy

Prenatal healthcare is the medical care a woman receives during their pregnancy. At each prenatal visit, their healthcare provider will check the health of the mother and their baby.

To prepare for prenatal care, you will have to:

Schedule your first prenatal care checkup as soon as you think you are pregnant

Work with your healthcare provider to get the essential prenatal tests scheduled, such as screening for sexually transmitted diseases. Sexually transmitted diseases, such as congenital syphilis, occur when a mother passes the infection to her baby during pregnancy. Transmission of this disease has increased by 15% since 2019 and 254% since 2016

Postpartum healthcare is the time after a woman has delivered their baby, and their body slowly returns to its nonpregnant state. In addition to physical changes and medical issues that may occur during this period, healthcare providers should be aware of the mental and psychological needs of the postpartum mother.

To prepare for postpartum healthcare, you should:

Listen closely to your body, so you will know if anything feels wrong

Advocate and/or speak up for yourself. If you are feeling unwell, you shouldn’t hesitate to be consistent with your communication with your physician

Educate yourself on postpartum complications so you will know if anything feels wrong

Menopause is the time that marks the end of a woman’s menstrual cycles. It is diagnosed after a woman has gone 12 months without a menstrual period. It can happen in a woman’s 40s or 50s; however, in the U.S., the average age a woman starts to experience menopause is at 51 years old.

To prepare for care during the menopausal stage, you should:

Take care of your bones as bone density begins to decline after menopause due to the loss of bone-protective estrogen. Taking a daily vitamin D3 supplement of 1,000 IUs is recommended

Be mindful of your weight, as your metabolism will slow down as menopause approaches. This can make gaining weight more probable and losing it more difficult. It is important to maintain a healthy weight because it helps protect your bones, as constant weight gain and weight loss can put stress on them

Do exercises to strengthen your pelvic floor muscles, such as Kegels, which can help prevent the sudden and frequent urge to urinate, and the occasional leakage of urine, called urinary incontinence. Urinary incontinence can become common during perimenopause for some women and can get progressively worse as changes in the vaginal tissue, urethra, and pelvic floor occur

Take care of your heart’s health. Research shows that controlling whatever risk factors you can before the onset of menopause can ensure a healthy heart after menopause

If you are planning to get pregnant, are pregnant, are postpartum, or are going through menopause, it is important to prepare for each stage as much as you can.

Flushing Hospital’s Women’s Health Center offers comprehensive, multi-disciplinary, and culturally sensitive care. Our services are provided by a highly skilled team of the best OBGYNs in Queens who specialize in all aspects of women’s health. For more information about gynecological services at FHMC’s Center for Obstetrics and Gynecology, call us at (718) 670-5562.

Will Having Shingles Effect My Pregnancy?

Posted on March 27, 2017 by Zakiya Hazel-Jemmott

Almost 1 out of every 3 people in the United States will develop shingles. Shingles is the term used for a skin rash that is caused by the herpes-zoster (varicella) virus, the same virus that causes chickenpox. In some cases it can reactivate and cause shingles. Anyone who has had chickenpox may develop shingles, including pregnant women and even children.

As a new or expecting mother there are a lot of concerns for staying as healthy as you can for you and your baby during pregnancy. Although you can’t give anybody shingles, you can pass the virus on as chickenpox. Whereas shingles is harmless in pregnancy, chickenpox can cause problems for an unborn baby. For this reason, stay away from other pregnant women while you have shingles.

If you are pregnant or trying to get pregnant:

First, get a blood test to find out if you’re immune to chickenpox. If you’re not immune, you can get a vaccine. It’s best to wait 1 month after the vaccine before getting pregnant.
If you’re already pregnant, don’t get the vaccine until after you give birth. In the meantime, avoid contact with anyone who has chickenpox or shingles.
If you’re not immune to chickenpox and you come into contact with someone who has it, tell your doctor right away. Your doctor can treat you with medicine that has chickenpox antibodies.
Tell your doctor if you come in contact with a person who has shingles. Your doctor may want to treat you with an antiviral medication. Antiviral medication will shorten the length of time that the symptoms will be present.

There isn’t a cure for shingles but a physician will usually prescribe medications to make the symptoms less intense. If you have questions about shingles send them to

To learn more about prenatal treatments please call the Department of Obstetrics and Gynecology at Flushing Hospital Medical Center, 718-670-8994.

Why is the cesarean rate so high, and how can I increase my chance of a natural birth?

Posted on March 3, 2017 by Georges Sylvestre MD

In the field of obstetrics and gynecology, there is no more debatable topic than the increased rate of cesarean (C-section) deliveries. The C-section rate is the percentage of all births that take place surgically, whereby a baby is delivered via an incision on the abdomen. Over the last few decades, this rate has increased tremendously. Up to the 1970’s, the rate of cesarean in the U.S. was less than 5% but in the subsequent few years, it climbed to 33%.

While the cesarean delivery has become a safer operation than it used to be, it is still a major abdominal surgery which should be avoided when a vaginal delivery is an option for both baby and mother. Sadly, rates of complications such as cerebral palsy have not decreased much despite the 600% increase of cesarean deliveries in the last three decades. So why then, has the cesarean rate climbed so much?

There are several factors explaining the increase the cesarean rates and there is no single answer. because so much has changed in the last two of three decades, in terms of medical, social and legal aspects. Let’s look at a few factors:

Breech babies: Few doctors deliver breech babies vaginally because recent studies suggested that C-section births are less risky for them.
Fewer patients attempt a VBAC (vaginal birth after cesarean): Women with a previous C-section are either not interested or not encouraged in having a vaginal birth after cesarean. There are risks involved in attempting a VBAC, but very often, they can be minimized by close fetal surveillance in labor.
Less patience for prolonged labor: Although 24-48 hour labors are often ultimately rewarded by a natural birth, many women prefer to have a cesarean now as opposed to waiting several more hours for a possible natural birth. Sometimes, it’s best to let nature do its work and wait, but physicians and women are often impatient, not tolerant of long (but natural) labor.
C-section delivery has become a much safer operation than it used to be decades ago: Long-term complications or serious short- term complications remain rare. This is mainly attributed to proper use of antibiotics, better and safer anesthesia techniques, and safe blood banking.
Women wait longer to have children: Increasing age is linked to a higher risk of developing complications such as high blood pressure, placenta previa and diabetes, just to name a few. These conditions increase the risk of cesarean.
More multiple births: The rates of twins and triplets have increased by 200-300%. 3-5% of all pregnancies are now twins (or triplets) as opposed to 1% years ago. These high risk pregnancies are associated with a much higher risk of cesarean. The majority of twin pregnancies and nearly all triplets are born via cesarean.
Cesarean delivery on maternal request: Some women feel that women should be entitled to make decisions about their body, and about how they want to deliver and at times, women ask for a cesarean delivery In the absence of a medical indication.,

The WHO (World Health Organization) has been advocating since 1985 to reduce the C-section to10-15 percent since 1985. Here are some tips for women who want to achieve this goal and reduce their chances of having a C-section.

Don’t be tempted to have a “scheduled” induction: while sometimes, labor inductions are medically necessary to prevent an adverse maternal or fetal outcome, many physicians and patients are tempted to “schedule” a delivery at a set time, without a medical reason.
If your baby is breech (baby’s bottom is down instead of the head): attempt an external version. A simple procedure called External Cephalic Version may turn the baby from breech position to head down, simply by turning the baby externally, by an experiences obstetrician.
Be patient. Labors can be long, sometimes very long, so be prepared for it and be patient. Bring a good book, movies, music and try to rest when you can (this is especially possible when you have a well working epidural).
Bring a coach: Having a supportive person during your labor (your spouse, your mother or a trained labor coach, called a Doula) has been shown to decrease the risk of cesarean and also to improve your perception of labor. They will keep you distracted during the often very long process.
Good life habits: women who are physically fit and are within their ideal body weight are less likely to develop diabetes, high blood pressure and excessively large babies during their pregnancy. So if you have healthy life habits, keep up with them! There is no reason to stop exercising during your pregnancy.
Don’t eat excessively: your baby is a magnet for the calories you ingest, so there’s no reason to eat excessively to feed your baby. Don’t believe your mother, aunts or anyone else who force you to eat in order to have a big baby and tell you that “a big baby is healthier”. It simply isn’t true. Six pounds babies are just as healthy as a ten pound ones.