The D-day has arrived. Since the day you conceived, you have spent endless hours imagining how your baby looks and are anxiously waiting for its arrival. You may have prepared well for labour and also have a detailed birth plan chalked out to help out during labour. But sometimes, your labour might be quite different from what you had expected it to be. Therefore, it always pays to be informed and prepared for the various complications that may arise during a delivery and interventions they likely require.
Induction
Sometimes, pregnancy stretches far beyond the due date and could become unsafe for both the mother and the baby. Such situations require that labour be induced artificially and caesarean can be avoided. Pre-eclampsia is one such indication that can be cured by induction.
Labour can be induced by inserting a drug called "prostaglandin" into the vagina in a pessary form every six hours to stimulate cervical opening or using a Syntocinon drip that mimics oxytocin and causes contractions to begin.
If the mother has gestational diabetes, there usually isn’t any alternative to avoid induction for medical reasons. However, if the woman is overdue, the midwife may suggest a "cervix sweep," which involves detaching the membranes surrounding the baby by inserting a finger into the vagina and sweeping around the cervix, thereby releasing natural prostaglandins to stimulate contractions.
Augmentation
Sometimes, women go into labour around the right time, but the labour proceeds much slower than expected, causing stress to the mother and baby. In such cases, augmentation may be necessary to reduce physical stress that a long labour may cause to both participants.
Augmentation is done by artificially breaking waters (i.e by inserting a small plastic stick to pop a hole into the amniotic sac draining the amniotic fluid out). This again causes natural prostaglandins to increase contractions.
Staying at home for as long as possible is less stressful than a hospital environment. Staying stress- free for as long as possible helps hasten labour and avoid artificial intervention.
Forceps
This is an instrument that resembles salad servers and is used when the baby is unable to come out due to weak contractions or an uncomfortable position. Forceps are placed on either side of the baby’s head to turn the baby to a more optimal position. This pulling of the baby by the doctor needs to be co-ordinated with the mother’s push. If the mother is too exhausted, a syntocinon drip can be used to cause stronger contractions.
Ventouse
This instrument resembles a cap that has suction and is placed on top of the baby’s head and used to gently suck the baby out of the birth canal. Ventouse is softer on baby compared to a forceps and is therefore often a preferred choice for delivery. However, it does not offer a firm grip like a forceps and therefore may be avoided in cases where the delivery needs to be urgent.
Ventouse is connected to a machine that controls the amount of vacuum suction. Ventouse cups come in different sizes that match the size of the baby’s head.
Episiotomy
This is an artificial cut made in the space between the vagina and the anus (also called the perineum), in order to create space for the baby to come out. This is often done during a forceps delivery wherein inserting the instrument also requires additional space.
Emergency C-Section
This is done in situations where the doctor believes that a vaginal delivery might be too risky for either the mother or the baby. In cases where the baby is passing meconium, the baby's heart rate has slowed down, or the baby is showing signs of distress before the cervix dilates completely, an emergency c-section is advised.
This procedure can be performed using an epidural where the mother is awake and both she and her partner participate in the baby’s birth. Most often, she will be given her baby to hold while she is being sewn up. However, in more complicated cases, a general anaesthetic needs to be administered to ensure a rapid delivery.
Most of the above procedures are performed in response to sudden situations that arise during labour. It is important to bear in mind that these decisions are made keeping in mind the health and safety of both the mother and the baby baby. Being informed of such interventions is a better way to approach labour and stay in control should such a situation arise.
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