Giving Birth - Special Intervention

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Inducing labour

Labour can be induced either because of:

  • A medical condition.
  • If the waters have broken and there is thought to be a risk of infection.
  • Pregnancy has reached 42 weeks and labour has not started.

Sweeping the membranes

This is usually the first thing that is done to try and induce labour. It is a vaginal examination that can trigger contractions. It doesn’t have to be carried out in hospital.

Prostaglandin pessaries

These help to ripen the cervix and start it dilating. Once the pessaries are inserted, you may have to wait up to 6 hours for them to take effect. If the first application of the pessary is unsuccessful, you will be given a second pessary. If this still has no effect then you will probably be put on a syntocinon drip and have your waters broken.

Rupturing the membranes

This is also known as breaking the waters. It is carried out with a device that looks like a crochet hook. This is done to either speed up labour when you are already having contractions, or along with a syntocinon drip. Breaking the waters can cause contractions to become more intense and painful.

Syntocinon drip

This can bring on contractions quickly, which are usually stronger than normal contractions. Your labour will be monitored and the drip will be adjusted accordingly. You will still be able to move around as the drip is attached to a mobile stand. You may want to request an epidural if you are having the syntocinon drip due to the strength of the contractions.

Natural ways to induce labour:

  • Raspberry leaf tea; it tones up the uterus and can only be taken from 37 weeks. It is available in tablet form now, which is great as the tea tastes hideous.
  • Reflexology; go to the Federation of Holistic Therapists website www.fht.org.uk to find a therapist.
  • Aromatherapy treatments can help to bring on labour, but do not try to use oils yourself unless blended especially for you by a qualified aromatherapist. To find one in your area see www.fht.org.uk .
  • Acupuncture can also help. The British Medical Acupuncture Society will be able to give you information www.medical-acupuncture.co.uk .
  • Sex (not a great thought at this stage) due to the prostaglandin in semen, which softens the cervix.
  • Stimulating your nipples. You can save your energy and get your hubby to do it.
  • Curry; it is said spicy food can start contractions, but god help the midwife on the receiving end.
  • Fresh pineapple; much more pleasant for that midwife
  • Gentle exercise
  • If you are having contractions, walking can help bring the baby into position.
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Caesarean section

A caesarean section is when your baby is delivered through an incision made in your lower abdomen. This operation can either be done using an epidural or a spinal block, during which you will be awake and a screen will be placed to block your view of the surgical proceedings. Or you will be given a general anaesthetic before surgery.

Emergency caesarean

If a problem is detected during labour and a caesarean carried out this is classed as an emergency caesarean. If you have already had an epidural then this will probably be topped up, if not you may have to have a general anaesthetic.

Reasons for an emergency caesarean include:

  • Foetal distress
  • Pre-eclampsia
  • If no progress is made during labour
  • If the mother is fatigued
  • Cord prolapse
  • If the baby’s head is too big to fit through the pelvic opening

Elective caesarean

If the caesarean is planned then this is an elective caesarean.

Reasons for an elective caesarean are:

  • Multiple birth
  • Placenta praevia
  • If the baby is transverse (lying across the opening of the womb)
  • If the baby’s head is found to be too large to fit through the mother’s pelvis
  • Breech baby
  • Pre-eclampsia
  • Premature delivery
  • If the placenta comes away from the womb too early, causing bleeding

During a caesarean you will have a catheter to drain the bladder. The top of your pubic hair shaved so that an incision can be made in that area. An intravenous drip is inserted and a monitor attached. After the incision is made, the amniotic fluid is drained away and the baby will be lifted above the screen for you to see. The placenta will then be delivered. The operation takes 30-40 minutes.

Afterwards you will be given strong pain relief. An average hospital stay after a c-section is five days and recovery is slower than after a vaginal birth. You will be advised to wait until your 6 week check up before driving or lifting. Eating well, taking it easy and doing your postnatal exercises will aid recovery.

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Forceps delivery

Forceps are used to assist baby’s delivery. You will be given a local anaesthetic and an episiotomy. The forceps are placed in the vagina, either side of baby’s head, to help ease your baby out during contractions.

Reasons forceps are used:

  • Baby becoming distressed
  • Baby’s positioning causing problems
  • Mum becoming tired
  • Weak contractions

Forceps can leave marks on the side of baby’s head but these fade during the first few days.

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Ventouse delivery

Ventouse or vacuum extraction as it is also called, is used as an alternative to forceps. Again, normal procedure is to give a local anaesthetic and an episiotomy. A small cap is then placed on your baby’s head and suction applied. As with forceps the baby is gently pulled out working with your contractions and your pushes.

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Episiotomy

An episiotomy is a small cut made between the vagina and the anus, done under local anaesthetic. Reasons for an episiotomy are; the risk of a substantial tearing or if you are having a forceps or ventouse delivery. After birth the cut will be stitched. In the past it was standard procedure to give an episiotomy during delivery, but now under normal circumstances, midwives tend to believe it is better to allow you to tear naturally.

Massaging your perineum (the area between your vagina and anus) can help the skin to stretch, lessening your risk of an episiotomy or tearing.

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Monitoring your baby

During labour your baby’s heartbeat will be monitored to see how she is coping with the delivery process. Although it used to be standard procedure to monitor all babies with a CTG machine, this is not the case in straightforward deliveries now. As the electronic pads that are attached to your tummy during CTG monitoring, mean that you are practically immobile for 20 minutes at a time, it can be very uncomfortable during labour. Your midwife may use a hand held monitor at regular intervals, to check on your baby instead. This will allow you more movement during labour.

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Turning your baby

If your baby remains in a breech position (bottom or feet first) then a practise called ECV (External Cephalic Version) can be carried out. This involves your consultant pressing on your stomach to turn your baby, so that she is head down. It is effective and very safe. ECV is usually carried out after 37 weeks of pregnancy.

During twin deliveries, if the second twin is breech she can be turned after twin one is born.