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Induced labour and cesarean sections The Labour processFinally, after 9 months of excitement, anxiety, planning and anticipation, the day you dread the most will finally arrive and bring an end to your pregnancy ordeal. The childbirth process however doesn't always go as planned or occur when you are expecting it. Either way you first have to deal with the labour process. Typically your labour period will last up-to 20 hours, although it can be much shorter. Preparing for labour is the first important step to ensure the birth goes smoothly and is relatively painless. Ante-natal classes will give you an idea of what to expect and the sort of decisions that you and your partner may need to take regarding labour and childbirth. It will covers aspects such as where you would like the birth to happen, what pain relief you would like, what sort of delivery you would like and any interventions you may have to consider. Obviously your midwife might advise you otherwise, according to circumstances. There are three stages to the labour process.
Early or latent labour Usually the longest phase, there is not much you can do during this part of labour except try to relax and get some sleep. Contractions of between 45-60 seconds in length will occur (although these are often confused with Braxton Hicks contractions which are common during the third trimester), and the cervix opens to about 3cms. A blood-tinged mucus may be passed, this is simply due to the dislodging of the mucus plug at the cervix entrance. Your water may also 'break', meaning the fluid-filled membranes protecting your baby has burst. It is impossible to predict when full labour will occur, but occasionally the doctor may induce labour using the naturally-occurring hormone Oxytocin. When this stage begins don't panic, but get yourself to the hospital quickly and safely. Active labour You will definitely know that you are in labour now because contractions are much stronger, more painful and closer together - lasting up-to a minute with only 3-4 minutes between them. At this point the cervix will have now have opened to 7cms. There are a whole host of techniques, devices and drugs available - outlined in the ante-natal classes - to help you cope with labour pain. Transition During this period, your cervix will open from 7 centimetres to the full 10 centimetres that is needed for delivery of your baby. Contractions are strong and almost continuous, possibly leaving you sick, sweaty or cold, shaky or even sleepy, and exhausted. Luckily this stage normally only lasts between 15-60 minutes until the final childbirth 'push'. Foetal monitoring Your doctor may wish to monitor your baby's heartbeat and other vital signs during the labour to ensure that the baby is not suffering stress from the contractions. This varies according to the doctor and commonly they either use a pinard stethoscope or internal probe. If any stress is detected in the baby, a caesarean section may be considered.
Induced labour and cesarean sectionsInduced labour Pregnancies seldom run like clockwork, particularly labour, and sometimes it's necessary to induce labour. You may have passed your due date, your 'water' may have 'broken' (amniotic sac) or you may be suffering pre-eclampsia. Typical symptoms of pre-eclampsia include: high blood pressure, protein in the urine, headaches, swelling, and stomach pain. Seeking immediate advice from your GP is important as full eclampsia can affect the health of both you and your baby. There are several medical methods used to induce labour, depending on the preferences of your GP.
There are however some natural ways to induce labour, and some women prefer to take the initiative themselves.
Some babies feel quite comfortable inside mum and need a little encouragement to face the real world, induced labour is perfectly natural and decreases the risk of complications.
A cesarean section is a major abdominal surgery conducted when complications arise that make it difficult or impossible for a regular vaginal birth. Your GP may decide upon this at any late stage of the pregnancy and it is a necessary, life saving, technique to protect both mother and infant Typically, less than one in five births require a cesarean section (this statistic includes repeat cesarean births), and modern techniques have made the process safe and efficient, saving the pregnant woman from the painful childbirth ordeal. In a simplified explanation, an incision is made in the woman's lower front abdomen in order to remove the baby from the womb. Cesarean sections will be discussed with you in detail during the ante-natal classes and most decisions are made with sufficient notice for you to be fully briefed on the procedure. A cesarean section does however pose small risks to the mother's health, including infections, hemorrhage, transfusion, injury to other organs, anesthesia complications, psychological complications, and a maternal mortality two to four times greater than that for a vaginal birth. The most common reasons for requiring a cesarean section are; dystocia (non-progressive labour); breech presentation (where the baby hasn't fully turned) and fetal distress. Women who have previously had a cesarean section may be advised to have it again during further births. Cesarean sections are sometimes also performed for other than maternal or fetal well-being, such as avoidance of patient pain, patient convenience, even legal concerns. Cesareans can delay the opportunity for early mother-newborn interaction, breastfeeding and the establishment of family bonds, and can cost twice as much as a regular birth.
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Waters are broken forcibly by inserting a surgical instrument into the amniotic sac, inducing contractions.
