Techniques for inducing labor
The expected time has come, and your baby will be ready to look to the outside world. But before there is a final stage, the birth, and not all occur in the same way. Get to know the different ways of bringing a child into the world.
Regardless of where the delivery to develop (in some cases not you can choose because the mother has no time to get to the hospital, although this happens rarely), this may be vaginal (the baby out through the vagina, as its name suggests) or abdominal (in the event that needed a cesarean to remove it). Among the types of labor existing, we have that it can also be spontaneous or induced, premature (if it occurs before the time considered normal), natural (when mother decides the position in which you want to give birth), childbirth without pain (when administered sedatives to MOM to decrease the sensation of pain).
If the pregnancy has elapsed without complications, some moms decide to give birth at home. It is important to seek the opinion of the specialist who has taken control of your pregnancy if you choose this option, and learn about possibilities to solve any problem that arises at the last moment.
In the following sections have information about various ways to bring the world to your baby, and thus decide which is best suited to your needs and preferences, always relying on the opinion of medical professionals, who know how to advise you what is best for you and your baby. These are the most common types of delivery:
· Natural childbirth
· Preterm birth
· Induced labor
Numerous studies attest that the upright posture of the mother encourages childbirth, while the horizontal hinders it. Upright shortens and extends the birth canal, and the force of gravity makes the descent of the baby. In any case, if the woman can decide the position in which you want to give birth, it will choose that rendered him the instinct and more comfortable.
In Spain this practice is not widespread and there are few clinics where carried out natural childbirth. But if you are interested in, the College of nursing and midwifery provides information about natural childbirth and the centers where it is practiced.
A form of natural childbirth is which takes place in the water:
The main advantage offered by is that water promotes the dilation and the mother can adopt more natural poses that help her to relax and reduce the perception of pain. The temperature of the water (37 °) also benefits the baby because it is very similar to the amniotic fluid, so it does not need to adapt to the sudden change which is the temperature of the operating room.
These are some of the benefits of water birth:
· Natural childbirth without drugs.
· It reduces the use of invasive procedures.
· The birth occurs in a quiet and intimate atmosphere with minimum interferences of medical personnel.
· The father is actively involved in labour.
· Hot water relaxes the muscles of the mother and facilitates the production of endorphins (neurotransmitter produced by the pituitary gland that contribute to reduce the perception of pain).
· The child suffers less stress because it comes out to a very similar environment, with a temperature similar to that was in the womb.
Another case is the immature birth, which is that which occurs between week 20 and 28 of pregnancy.
Before week 20 is considered abortion.
The more premature is the baby, there are less likely to survive, and if you get it, it will face major difficulties: mental retardation, cerebral palsy, respiratory, digestive problems, loss of vision and hearing, delays in development, and learning and behavioral problems.
· Diseases of the mother: infections of systemic, vaginal or urinary tract, kidney, heart disease, diabetes, severe anemia, thyroid alterations...
· Previous miscarriages or preterm births.
· Uterine anomalies such as fibroids or cervical incompetence.
· Age of mother below 18 years or above 35.
· Haemorrhage, placenta praevia, Placental Abruption.
· Work hard and stressful.
· Multiple pregnancy.
· Malformations in the fetus.
· Diseases of pregnancy (pre-eclampsia or gestational diabetes), preterm labor interruption may be advisable.
· Smoking (> 10 cigarettes a day).
· Poor nutritional status.
· Obesity.
· Low socio-economic level.
· Consumption of alcohol or drugs.
· Domestic violence (physical, sexual or emotional abuse).
· Excessive physical activity.
In any case, the mother meets one or more of these risk factors does not mean that it will have a preterm birth.
· Feeling pelvic pressure (feeling that the child pushed down or heaviness).
· Vaginal bleeding.
· Pain in the hips or back.
· Break the bag of waters.
· Sore belly (with or without diarrhea).
· Similar to the menstrual discomfort.
· Changes or increases of vaginal discharge (brownish color flow or bloody).
· Cramping abdominal (with or without desire to vomit).
Synthetic prostaglandins, which are usually applied in the vagina in the form of eggs or gel They are used for the same purpose. Prostaglandins are also produced naturally in the body and cause vibrations that modify the cervix so that labor can develop.
· In pregnancies with placenta previa (a complication of pregnancy which consists in that the placenta is situated in the area lower uterus, totally or partially covering the exit to the cervix).
· When the mother has scars on the uterus.
· If you suffer from certain types of cancer of the cervix or infections such as genital herpes.
· In the case that the fetus is misplaced, is very large (fetal macrosomia), there is a disproportion between the head and the maternal pelvis, or at imminent risk.
· Placental Abruption. Medications that are used to cause the contractions can be more dangerous for women who have previously given birth by caesarean section or other types of surgery in the womb. A Placental Abruption can occur if the contractions are too intense.
· Uterine infections. The risk of uterine infections by handling suffered during induction.
· Caesarean section. Increases chance to end in caesarean section or instrumental vaginal delivery, so in these cases would be added to the risks involved in such procedures, such as infection, pain, bleeding and tears of the birth canal.
Another possible complication (though rare) is the prolapse of the umbilical cord, which consists of cord precedes the fetus in their passage through the birth canal and, when this comes out, press the cord, thus limiting the supply of oxygen and blood, which can have fatal consequences for the baby.
Types of delivery
The expected time has come, and your baby will be ready to look to the outside world. But before there is a final stage, the birth, and not all occur in the same way. Do you know the different types of childbirth that exist?Regardless of where the delivery to develop (in some cases not you can choose because the mother has no time to get to the hospital, although this happens rarely), this may be vaginal (the baby out through the vagina, as its name suggests) or abdominal (in the event that needed a cesarean to remove it). Among the types of labor existing, we have that it can also be spontaneous or induced, premature (if it occurs before the time considered normal), natural (when mother decides the position in which you want to give birth), childbirth without pain (when administered sedatives to MOM to decrease the sensation of pain).
If the pregnancy has elapsed without complications, some moms decide to give birth at home. It is important to seek the opinion of the specialist who has taken control of your pregnancy if you choose this option, and learn about possibilities to solve any problem that arises at the last moment.
In the following sections have information about various ways to bring the world to your baby, and thus decide which is best suited to your needs and preferences, always relying on the opinion of medical professionals, who know how to advise you what is best for you and your baby. These are the most common types of delivery:
· Natural childbirth
· Preterm birth
· Induced labor
Natural childbirth
Natural childbirth is one in which, except for complications, is not used any type of drug and it allows the woman to decide which position to give birth.Numerous studies attest that the upright posture of the mother encourages childbirth, while the horizontal hinders it. Upright shortens and extends the birth canal, and the force of gravity makes the descent of the baby. In any case, if the woman can decide the position in which you want to give birth, it will choose that rendered him the instinct and more comfortable.
In Spain this practice is not widespread and there are few clinics where carried out natural childbirth. But if you are interested in, the College of nursing and midwifery provides information about natural childbirth and the centers where it is practiced.
A form of natural childbirth is which takes place in the water:
Waterbirth
The French physician Michel Odent pioneered this type of delivery. In 1970, he began to introduce maternity cases in a tub with hot water and discovered that it was beneficial, because it decreased the pain and favored cervical dilatation. In the early 1980s, this practice started to become fashionable in the United States as an alternative option to give birth.The main advantage offered by is that water promotes the dilation and the mother can adopt more natural poses that help her to relax and reduce the perception of pain. The temperature of the water (37 °) also benefits the baby because it is very similar to the amniotic fluid, so it does not need to adapt to the sudden change which is the temperature of the operating room.
These are some of the benefits of water birth:
· Natural childbirth without drugs.
· It reduces the use of invasive procedures.
· The birth occurs in a quiet and intimate atmosphere with minimum interferences of medical personnel.
· The father is actively involved in labour.
· Hot water relaxes the muscles of the mother and facilitates the production of endorphins (neurotransmitter produced by the pituitary gland that contribute to reduce the perception of pain).
· The child suffers less stress because it comes out to a very similar environment, with a temperature similar to that was in the womb.
Preterm birth
Preterm delivery appears in 5-10% of pregnant women; defined as a birth that occurs between 28 to 37 weeks of pregnancy, and it is a problem not only obstetrician, but also neonatal, since it is associated with a high rate of problems for the newborn, including the death of it.Another case is the immature birth, which is that which occurs between week 20 and 28 of pregnancy.
Before week 20 is considered abortion.
The more premature is the baby, there are less likely to survive, and if you get it, it will face major difficulties: mental retardation, cerebral palsy, respiratory, digestive problems, loss of vision and hearing, delays in development, and learning and behavioral problems.
Risk factors for preterm delivery
A single cause is not known, but there are risk factors that predispose to preterm delivery, and you need to try to prevent or avoid. The most important are:· Diseases of the mother: infections of systemic, vaginal or urinary tract, kidney, heart disease, diabetes, severe anemia, thyroid alterations...
· Previous miscarriages or preterm births.
· Uterine anomalies such as fibroids or cervical incompetence.
· Age of mother below 18 years or above 35.
· Haemorrhage, placenta praevia, Placental Abruption.
· Work hard and stressful.
· Multiple pregnancy.
· Malformations in the fetus.
· Diseases of pregnancy (pre-eclampsia or gestational diabetes), preterm labor interruption may be advisable.
· Smoking (> 10 cigarettes a day).
· Poor nutritional status.
· Obesity.
· Low socio-economic level.
· Consumption of alcohol or drugs.
· Domestic violence (physical, sexual or emotional abuse).
· Excessive physical activity.
In any case, the mother meets one or more of these risk factors does not mean that it will have a preterm birth.
Symptoms of preterm labor
· Regular uterine contractions, with or without pain.· Feeling pelvic pressure (feeling that the child pushed down or heaviness).
· Vaginal bleeding.
· Pain in the hips or back.
· Break the bag of waters.
· Sore belly (with or without diarrhea).
· Similar to the menstrual discomfort.
· Changes or increases of vaginal discharge (brownish color flow or bloody).
· Cramping abdominal (with or without desire to vomit).
Induced labor
Why is labor induced?
There are several justifications to induce a birth:Diseases of the mother
Some disorders suffered by the mother, such as hypertension (preeclampsia) or diabetes (especially in type I), can affect the health of the fetus or the own pregnant if the pregnancy continues. Also justify an induction kidney, heart, lung or liver disease, some types of cancer, hemorrhages and infections in the uterus.Post-term pregnancy
If the pregnancy exceeds 42 weeks (gestational age is assessed with ultrasound), since the aging of the placenta can prevent proper nutrition for the baby.Premature rupture of membranes
When breaking the bag of waters, normal is that, in a short time, appear the contractions and start the dilatation. When it doesn't, and childbirth will not start spontaneously, it will be necessary to provoke him due to the risk of infection both mother and child. However, make sure before that the baby's lungs are sufficiently developed.Meconium in the amniotic fluid
If the obstetrician notes that the fluid is dyed meconium (name given to the first stool that the baby after the birth), is required to end the pregnancy because, besides being an indication that the fetus is not well (has defecated in utero), if it sucks this substance can suffer breathing difficulties.Retarded intrauterine growth (CIR)
The fetus is no longer grow at a normal rate inside the uterus. This indicates that it is producing some alteration that prevents the correct nutrition of the small, which may cause serious health problems, and even death in utero.Non-medical reasons
Sometimes decides to induce a birth for other reasons, for example, when a woman has had another previously and its development was very rapid, or lives away from the hospital and the doctor fears not arrive on time.Techniques for inducing labor
Induced labor is a labor caused by drugs or other procedures:Use of medications
Oxytocin is a hormone that releases the human brain naturally and serves to regulate various physiological and emotional processes. Prior to delivery, it increases their levels to cause contractions of the uterus. Synthetic oxytocin is a drug that is administered intravenously and is used to stimulate, artificially, the contractions of the uterus.Synthetic prostaglandins, which are usually applied in the vagina in the form of eggs or gel They are used for the same purpose. Prostaglandins are also produced naturally in the body and cause vibrations that modify the cervix so that labor can develop.
Separation of membranes
The doctor inserts a gloved in the cervix of the pregnant finger and separates the bag of amniotic fluid from the wall of the uterus. This procedure increases the natural production of prostaglandins.Artificial rupture of the bag of waters
Raises the "water break" practicing a hole in the bag containing the amniotic fluid, when already there has been a partial dilatation, to accelerate the pace of contraction. The woman is monitored to prevent possible infections.When it is contraindicated to induce labor
There are situations in which childbirth can not induce:· In pregnancies with placenta previa (a complication of pregnancy which consists in that the placenta is situated in the area lower uterus, totally or partially covering the exit to the cervix).
· When the mother has scars on the uterus.
· If you suffer from certain types of cancer of the cervix or infections such as genital herpes.
· In the case that the fetus is misplaced, is very large (fetal macrosomia), there is a disproportion between the head and the maternal pelvis, or at imminent risk.
Risks of inducing labor
Induction is an artificial procedure. Professionals use media to mimic nature and anticipate the birth of your baby in a woman that still has not started the process of childbirth. This, sometimes, is not quite perfect and can cause side effects.For mother
· Risk of uterine rupture. Since these births are longer, the woman gets tired more and are more likely to suffer fever, dehydration, and excess of contractions, which can lead to uterine rupture.· Placental Abruption. Medications that are used to cause the contractions can be more dangerous for women who have previously given birth by caesarean section or other types of surgery in the womb. A Placental Abruption can occur if the contractions are too intense.
· Uterine infections. The risk of uterine infections by handling suffered during induction.
· Caesarean section. Increases chance to end in caesarean section or instrumental vaginal delivery, so in these cases would be added to the risks involved in such procedures, such as infection, pain, bleeding and tears of the birth canal.
The baby
In a long birth, the fetus can also suffer a loss of well-being within the uterus, and therefore increases the rate of Caesarean sections in the labor. Synthetic oxytocin that is given to the mother to cause contractions, can affect the baby's heart rate decrease.Another possible complication (though rare) is the prolapse of the umbilical cord, which consists of cord precedes the fetus in their passage through the birth canal and, when this comes out, press the cord, thus limiting the supply of oxygen and blood, which can have fatal consequences for the baby.
Article contributed for educational purposes