There are a number of interventions that can be considered to help make labour or your baby’s birth easier, or to ensure a better outcome for both of you.
This breakdown of the 5 most common assisted birth methods will help you know what to expect:
1. Inducing labour
If labour is taking a long time to get started, or your membranes have ruptured naturally without you being in labour, your obstetrician or midwife may discuss the option of inducing labour with you. This is usually done using prostaglandins, which have a hormonal effect and help to soften and ripen the cervix and bring on contractions to start labour. Prostaglandins come in gel form, which is inserted through the vagina using a thin plastic tube and deposited right next to the cervix. This is not a painful procedure.
2. Breaking of waters
Your baby is protected by a sac of water in your womb called the amniotic sac. If labour is not progressing very well, your obstetrician or midwife may consider breaking this sac open to speed up labour. Once your waters are broken, your contractions will become more intense and gravity will help your baby move further down into your pelvis. Your midwife or obstetrician will break your waters by inserting a small plastic hook through the cervix and scratching at the membranes until they break. The procedure is considered to be more uncomfortable than painful.
3. Augmenting labour
Augmentation of labour is usually done using oxytocin in order to encourage your cervix to dilate quicker. Oxytocin is a hormone that is given intravenously through a drip in your arm and works by increasing labour contractions, which in turn helps your cervix to dilate. It can also be used to induce labour. Using oxytocin means that you will need to have continuous foetal monitoring to ensure that your contractions are not too severe and that your baby does not become too tired.
4. Foetal monitoring
This is done using a machine consisting of two probes that are placed on your tummy – the one probe monitors your contractions to ensure they are appropriate for the stage of labour you’re in, and the other monitors the baby’s heartbeat to ensure that he is not displaying any signs of distress. If your midwife or obstetrician is concerned about the wellbeing of your baby, you can expect to have this machine on your stomach for a long time while they monitor the situation closely to help them decide whether they need to augment labour or take you for an emergency C-section.
5. Having an epidural
An epidural is one of the most effective means of pain relief for women in labour. It is a regional anaesthetic, given as an injection into the epidural space of the spinal column. It results in you feeling numb from the top of your womb downwards. The anaesthetist leaves a catheter in place so that the epidural medication can be constantly topped up to keep you numb for as long as you need it. The procedure is not considered to be painful; most women describe it as a feeling of pressure over the spine when the catheter is inserted. Your anaesthetist will give you an injection of local anaesthetic to the area before doing the epidural to ensure the area is numb. A drawback of the epidural is that it makes you so numb that you can’t feel your contractions. This makes it difficult to know when and how hard to push. Your midwife or obstetrician will guide you through this and advise you on when and how to push. However, epidurals often result in assisted deliveries such as a vacuum delivery.
6. Emergency C-section
A C-section is a procedure that should be done for specific, medical reasons. Most commonly, this could be due to foetal distress or prolonged labour. It’s performed in an operating theatre where a surgeon cuts through the layers of your abdomen until he gets to the womb to surgically deliver your baby. While it carries the same risks as any surgery, it has saved the lives of both moms and babies when used appropriately.