All about Pregnancy

        Medical interventions during labor & delivery  
 



Reliable information on
pregnancy topics
by Heisje de Jong,
Certified Lactation Consultant

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 Pregnancy Week-by-Week
When to contact your doctor
What to ask your obstetrician
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    And your Packing Guide!
Pain relief in labor & birth
Medical intervention during
    labor and delivery
Post partum exercises
Breastfeeding

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There are definitely times when medical interventions are appropriate and necessary, but when they are overused or simply used as a routine procedure they may cause more problems than they solve. Before submitting yourself to any kind of medical intervention, you should understand the benefits, the potential risks, how the procedure is done and the possible alternatives.

I have made an overview of the most common medical interventions that are being used today.

 

Amniotomy

Amniotomy is the artificial rupture of the membranes. These membranes or the amniotic sac surround the baby during your pregnancy. When an amniotomy is performed, the membranes are punctured with an amniohook, a small tool like a crochet hook. This is not painful. Contractions usually increase in intensity after an amniotomy because the baby's head is pressing now against the cervix and this causes strong contractions.

The main reason for amniotomy is to start of, or speed up labor. Rupturing the membranes also gives the doctor the chance to see the amniotic fluid. When the baby is in distress it passes meconium and this can be seen in the amniotic fluid that is released during an amniotomy. Another reason for performing amniotomy is to install electronic fetal monitoring equipment on the baby's scalp.

Drawbacks of an amniotomy include:
· higher possibility of pressure on the cord which may hinder the flow of blood.
· Increased risk of infection.
· Increased risk of cord prolapse.
· Your doctor may order you to stay in bed.

Some doctors perform amniotomy as a routine procedure. If you want to avoid this you can request that it is only done if really necessary, for example if the baby is showing signs of distress.

Intravenous drip

In many hospitals, a drip is given to all women in labor. The reason is that if an emergency arises the drip is already in place. Drugs can be given through the drip as well. Being hooked-up to an intravenous drip restricts you in your mobility during labor. You will most probably be confined to your bed and dealing with the contractions will be more difficult if you cannot move around freely. I believe a drip should not be given as a routine procedure but only when necessary.

Episiotomy

An episiotomy is an incision made in the perineum to enlarge the birth opening. The incision is either midline (towards the anus) or medio-lateral (off to one side). A local anaesthetic is given before the episiotomy is performed. Unfortunately, many doctors still perform an episiotomy to all first time mothers. Their reasons are that it speeds up birth, prevents the perineum from tearing, repairs easier than a tear and prevents pelvic floor relaxation and incontinence. However, the validity of these reasons has never been proven. " There is no evidence that routine episiotomy reduces the risk of severe perineal trauma, improves perineal healing, prevents fetal trauma or reduces the risk of urinary stress incontinence" Sleep, Roberts and Chalmers 1989.

The disadvantages of a routine episiotomy are: increased risk of infection, discomfort after birth and painful intercourse.

Fortunately, with skilled guidance at the delivery more and more women now avoid having an episiotomy and this makes a big difference in how you feel in the first days and weeks after childbirth. Kegel exercises and perineal massage can also be very helpful.

There are of course also valid reasons to have an episiotomy. For example when a breech baby is born, when the baby needs to be born quickly or with a forceps delivery.

PLEASE BOOKMARK THIS SITE NOW SO THAT YOU MAY RETURN AT YOUR CONVENIENCE

There are definitely times when medical interventions are appropriate and necessary, but when they are overused or simply used as a routine procedure they may cause more problems than they solve. Before submitting yourself to any kind of medical intervention, you should understand the benefits, the potential risks, how the procedure is done and the possible alternatives.

I have made an overview of the most common medical interventions that are being used today.

Amniotomy

Amniotomy is the artificial rupture of the membranes. These membranes or the amniotic sac surround the baby during your pregnancy. When an amniotomy is performed, the membranes are punctured with an amniohook, a small tool like a crochet hook. This is not painful. Contractions usually increase in intensity after an amniotomy because the baby's head is pressing now against the cervix and this causes strong contractions.

The main reason for amniotomy is to start of, or speed up labor. Rupturing the membranes also gives the doctor the chance to see the amniotic fluid. When the baby is in distress it passes meconium and this can be seen in the amniotic fluid that is released during an amniotomy. Another reason for performing amniotomy is to install electronic fetal monitoring equipment on the baby's scalp.

Drawbacks of an amniotomy include:
· higher possibility of pressure on the cord which may hinder the flow of blood.
· Increased risk of infection.
· Increased risk of cord prolapse.
· Your doctor may order you to stay in bed.

Some doctors perform amniotomy as a routine procedure. If you want to avoid this you can request that it is only done if really necessary, for example if the baby is showing signs of distress.

Intravenous drip

In many hospitals, a drip is given to all women in labor. The reason is that if an emergency arises the drip is already in place. Drugs can be given through the drip as well. Being hooked-up to an intravenous drip restricts you in your mobility during labor. You will most probably be confined to your bed and dealing with the contractions will be more difficult if you cannot move around freely. I believe a drip should not be given as a routine procedure but only when necessary.

Episiotomy

An episiotomy is an incision made in the perineum to enlarge the birth opening. The incision is either midline (towards the anus) or medio-lateral (off to one side). A local anaesthetic is given before the episiotomy is performed. Unfortunately, many doctors still perform an episiotomy to all first time mothers. Their reasons are that it speeds up birth, prevents the perineum from tearing, repairs easier than a tear and prevents pelvic floor relaxation and incontinence. However, the validity of these reasons has never been proven. " There is no evidence that routine episiotomy reduces the risk of severe perineal trauma, improves perineal healing, prevents fetal trauma or reduces the risk of urinary stress incontinence" Sleep, Roberts and Chalmers 1989.

The disadvantages of a routine episiotomy are: increased risk of infection, discomfort after birth and painful intercourse.

Fortunately, with skilled guidance at the delivery more and more women now avoid having an episiotomy and this makes a big difference in how you feel in the first days and weeks after childbirth. Kegel exercises and perineal massage can also be very helpful.

There are of course also valid reasons to have an episiotomy. For example when a breech baby is born, when the baby needs to be born quickly or with a forceps delivery.

PLEASE BOOKMARK THIS SITE NOW SO THAT YOU MAY RETURN AT YOUR CONVENIENCE

There are definitely times when medical interventions are appropriate and necessary, but when they are overused or simply used as a routine procedure they may cause more problems than they solve. Before submitting yourself to any kind of medical intervention, you should understand the benefits, the potential risks, how the procedure is done and the possible alternatives.

I have made an overview of the most common medical interventions that are being used today.

Amniotomy

Amniotomy is the artificial rupture of the membranes. These membranes or the amniotic sac surround the baby during your pregnancy. When an amniotomy is performed, the membranes are punctured with an amniohook, a small tool like a crochet hook. This is not painful. Contractions usually increase in intensity after an amniotomy because the baby's head is pressing now against the cervix and this causes strong contractions.

The main reason for amniotomy is to start of, or speed up labor. Rupturing the membranes also gives the doctor the chance to see the amniotic fluid. When the baby is in distress it passes meconium and this can be seen in the amniotic fluid that is released during an amniotomy. Another reason for performing amniotomy is to install electronic fetal monitoring equipment on the baby's scalp.

Drawbacks of an amniotomy include:
· higher possibility of pressure on the cord which may hinder the flow of blood.
· Increased risk of infection.
· Increased risk of cord prolapse.
· Your doctor may order you to stay in bed.

Some doctors perform amniotomy as a routine procedure. If you want to avoid this you can request that it is only done if really necessary, for example if the baby is showing signs of distress.

Intravenous drip

In many hospitals, a drip is given to all women in labor. The reason is that if an emergency arises the drip is already in place. Drugs can be given through the drip as well. Being hooked-up to an intravenous drip restricts you in your mobility during labor. You will most probably be confined to your bed and dealing with the contractions will be more difficult if you cannot move around freely. I believe a drip should not be given as a routine procedure but only when necessary.

Episiotomy

An episiotomy is an incision made in the perineum to enlarge the birth opening. The incision is either midline (towards the anus) or medio-lateral (off to one side). A local anaesthetic is given before the episiotomy is performed. Unfortunately, many doctors still perform an episiotomy to all first time mothers. Their reasons are that it speeds up birth, prevents the perineum from tearing, repairs easier than a tear and prevents pelvic floor relaxation and incontinence. However, the validity of these reasons has never been proven. " There is no evidence that routine episiotomy reduces the risk of severe perineal trauma, improves perineal healing, prevents fetal trauma or reduces the risk of urinary stress incontinence" Sleep, Roberts and Chalmers 1989.

The disadvantages of a routine episiotomy are: increased risk of infection, discomfort after birth and painful intercourse.

Fortunately, with skilled guidance at the delivery more and more women now avoid having an episiotomy and this makes a big difference in how you feel in the first days and weeks after childbirth. Kegel exercises and perineal massage can also be very helpful.

There are of course also valid reasons to have an episiotomy. For example when a breech baby is born, when the baby needs to be born quickly or with a forceps delivery.