Roots of life - More procedures in childbirth
Let nature take its course
The best birth experiences for mothers are usually those that allow nature to take its course. Studies show that even babies have a lot to gain when they go through the contractions of a natural birth. The work of the uterus prepares them better for survival than when they are taken out of their mothers by an operation. Some hospital systems believe this to the extent that they encourage mothers to go through the trial of labour even when a cesarean section is expected. Every pregnancy and birth is individual and should be treated as such.
Induction
Sometimes, there are reasons when a birth has to be induced, that is, started off artificially. The mother may be well past her due date, though some obstetricians consider 42 weeks as normal. The mother may be experiencing high blood pressure, which is not safe either for her or her baby, and perhaps the placenta is showing that it is not nourishing the baby well enough. These are indications that the baby may be better off outside than inside the mother, and are good reasons for induction. Other reasons that have nothing to do with the safety of the mother and the baby, such as to plan work shifts or holidays, or to have a Christmas baby, or to share a birthday with grandma, are surely not to be considered, as like all other things in life, inductions carry with them a negative side which needs to be discussed before decisions are taken.
Induction is usually done by artificial rupture of membranes. The care-giver ruptures the bag of waters using her fingers or a small apparatus for this purpose. This used to be quite commonly used, but is now considered not to be the best method as one cannot be sure that contractions will start automatically. Both baby and mother will be more open to infection, and the need for further intervention becomes very probable.
Another method is applying prostaglandin gel or as a tablet into the cervix. The hormones usually cause the cervix to soften, so it prepares the way better for other interventions that may be necessary.
Induction is also induced by drip. The hormones that are normally expected to be present in the labouring mother are given in a concentrated form through an IV drip. This gives stronger contractions and may be controlled via the drip as necessary.
There are tricks of the trade that a mother may learn to help stimulate labour as naturally as possible. Complimentary medicine may also help. These may or may not work, depending on the timing and the response of the mother's body. The truth is that no harm is done in trying natural non-invasive ways before the mother is admitted for the medical intervention.
Augmentation
Sometimes labour begins normally, but the progress is slow and disheartening. Oxytocin may be used medically at any time during labour to increase contractions and speed up labour.
Episiotomy
Another kind of intervention during the birth is an episiotomy, a surgical incision that is made into the perineum from the vagina toward the rectum, either midline or mediolateral, usually performed just before the birth of the baby's head. The intention is to avoid a tear that may happen as the baby is being born. There are several disputes regarding this procedure. Some studies question whether it is really as necessary as often as it is performed.
Most midwives pride themselves in their ability to help babies be born without the need of cutting the mother. As an episiotomy obviously causes discomfort after the birth and may cause problems with breastfeeding and caring for the baby, it may prove helpful trying to decrease the need for it by learning techniques learned during pregnancy classes. Slowing the baby as it is being born diminishes the need for an episiotomy. This may be efficiently done with good communication and cooperation under the midwife's guidance.
Pain relief in childbirth
Especially when labour is artificially induced or augmented, contractions are expected to be strong. Mothers who have prepared well and have all the support they need, may still be able to remain in command of contractions, though this is certainly not easy. It is good for the mother to keep an open mind on this. She needs to be flexible and allow herself to change her preconceived ideas as the need arises.
Having said this, for those mothers who want a pain-free labour and birth, having a baby while asleep or while reading the newspaper has today become a reality. Various efficient painkillers may be used during the whole process of birthing. However, it needs to be pointed out that this decision is not as easy as it seems, as all painkillers affect both mother and baby in their own way. Before making up one's mind and rushing towards the dream idea of being freed of labour pains by the use of available painkillers, one needs to consult the obstetrician, the anaesthesiologist and also perhaps a paediatrician for full information about the pros and cons. One needs to remember also, that there is discomfort to be felt post natally. Mastering various skills at coping with pain before or after the birth is always a good idea for the mother, as her need to use these skills may become necessary at any time.
On the other hand, talking of pain killers, it is good to know that when circumstances are favourable, the mother's body itself produces natural painkillers during the birth! Not only does the body become partially immune to pain, but even the memory of the pain is somehow dulled. Most mothers declare that the minute they saw the baby, they had already forgotten the intense feeling they had just been through. Needless to say, this is a great asset for mothers who want to be fully conscious and in control of what is happening in their body during labour, birth and afterwards. Some professional carers, especially male obstetricians, and also male partners, find this difficult to comprehend. They simply cannot understand why mothers prefer to feel the birth, when they may easily be saved the "trouble" and spared the pain. It certainly takes a mother to understand a mother!
As we have seen before, the perception of the mother towards the experience of childbirth has a great impact on the outcome. Not only do some mothers not perceive the birth as "trouble", but they simply do not want to be robbed of the wonderful experience that childbirth offers. These mothers need to be respected and helped as far as possible to achieve their goals. Studies show that the fulfillment the mother feels after an active birth controlled by herself, with the support of the people around her, affects the process of future parenting. For example, problems with the ability to breastfeed after a difficult birth, may affect the weaning and feeding process in the months and years that follow. This is a cascading effect of negativity that all mothers can do without. For this reason, it is more than worth considering and respecting the mother's choices during the birth.
• Ms Theuma is a qualified childbirth educator and school teacher. A mother of three children and a grandparent, she directs a school for parents, In the Family Way, based at Marsascala.
The school offers courses and support for parents, covering various related subjects, from pregnancy to primary and early secondary school age.
Induction
Sometimes, there are reasons when a birth has to be induced, that is, started off artificially. The mother may be well past her due date, though some obstetricians consider 42 weeks as normal. The mother may be experiencing high blood pressure, which is not safe either for her or her baby, and perhaps the placenta is showing that it is not nourishing the baby well enough. These are indications that the baby may be better off outside than inside the mother, and are good reasons for induction. Other reasons that have nothing to do with the safety of the mother and the baby, such as to plan work shifts or holidays, or to have a Christmas baby, or to share a birthday with grandma, are surely not to be considered, as like all other things in life, inductions carry with them a negative side which needs to be discussed before decisions are taken.
Induction is usually done by artificial rupture of membranes. The care-giver ruptures the bag of waters using her fingers or a small apparatus for this purpose. This used to be quite commonly used, but is now considered not to be the best method as one cannot be sure that contractions will start automatically. Both baby and mother will be more open to infection, and the need for further intervention becomes very probable.
Another method is applying prostaglandin gel or as a tablet into the cervix. The hormones usually cause the cervix to soften, so it prepares the way better for other interventions that may be necessary.
Induction is also induced by drip. The hormones that are normally expected to be present in the labouring mother are given in a concentrated form through an IV drip. This gives stronger contractions and may be controlled via the drip as necessary.
There are tricks of the trade that a mother may learn to help stimulate labour as naturally as possible. Complimentary medicine may also help. These may or may not work, depending on the timing and the response of the mother's body. The truth is that no harm is done in trying natural non-invasive ways before the mother is admitted for the medical intervention.
Augmentation
Sometimes labour begins normally, but the progress is slow and disheartening. Oxytocin may be used medically at any time during labour to increase contractions and speed up labour.
Episiotomy
Another kind of intervention during the birth is an episiotomy, a surgical incision that is made into the perineum from the vagina toward the rectum, either midline or mediolateral, usually performed just before the birth of the baby's head. The intention is to avoid a tear that may happen as the baby is being born. There are several disputes regarding this procedure. Some studies question whether it is really as necessary as often as it is performed.
Most midwives pride themselves in their ability to help babies be born without the need of cutting the mother. As an episiotomy obviously causes discomfort after the birth and may cause problems with breastfeeding and caring for the baby, it may prove helpful trying to decrease the need for it by learning techniques learned during pregnancy classes. Slowing the baby as it is being born diminishes the need for an episiotomy. This may be efficiently done with good communication and cooperation under the midwife's guidance.
Pain relief in childbirth
Especially when labour is artificially induced or augmented, contractions are expected to be strong. Mothers who have prepared well and have all the support they need, may still be able to remain in command of contractions, though this is certainly not easy. It is good for the mother to keep an open mind on this. She needs to be flexible and allow herself to change her preconceived ideas as the need arises.
Having said this, for those mothers who want a pain-free labour and birth, having a baby while asleep or while reading the newspaper has today become a reality. Various efficient painkillers may be used during the whole process of birthing. However, it needs to be pointed out that this decision is not as easy as it seems, as all painkillers affect both mother and baby in their own way. Before making up one's mind and rushing towards the dream idea of being freed of labour pains by the use of available painkillers, one needs to consult the obstetrician, the anaesthesiologist and also perhaps a paediatrician for full information about the pros and cons. One needs to remember also, that there is discomfort to be felt post natally. Mastering various skills at coping with pain before or after the birth is always a good idea for the mother, as her need to use these skills may become necessary at any time.
On the other hand, talking of pain killers, it is good to know that when circumstances are favourable, the mother's body itself produces natural painkillers during the birth! Not only does the body become partially immune to pain, but even the memory of the pain is somehow dulled. Most mothers declare that the minute they saw the baby, they had already forgotten the intense feeling they had just been through. Needless to say, this is a great asset for mothers who want to be fully conscious and in control of what is happening in their body during labour, birth and afterwards. Some professional carers, especially male obstetricians, and also male partners, find this difficult to comprehend. They simply cannot understand why mothers prefer to feel the birth, when they may easily be saved the "trouble" and spared the pain. It certainly takes a mother to understand a mother!
As we have seen before, the perception of the mother towards the experience of childbirth has a great impact on the outcome. Not only do some mothers not perceive the birth as "trouble", but they simply do not want to be robbed of the wonderful experience that childbirth offers. These mothers need to be respected and helped as far as possible to achieve their goals. Studies show that the fulfillment the mother feels after an active birth controlled by herself, with the support of the people around her, affects the process of future parenting. For example, problems with the ability to breastfeed after a difficult birth, may affect the weaning and feeding process in the months and years that follow. This is a cascading effect of negativity that all mothers can do without. For this reason, it is more than worth considering and respecting the mother's choices during the birth.
• Ms Theuma is a qualified childbirth educator and school teacher. A mother of three children and a grandparent, she directs a school for parents, In the Family Way, based at Marsascala.
The school offers courses and support for parents, covering various related subjects, from pregnancy to primary and early secondary school age.