If a baby is slow in coming through the birth canal, or becomes stuck, it is necessary to ensure that the baby is delivered as quickly as possible, often within a few seconds. In these situations forceps or a vacuum device (ventouse) may be attached to the baby’s head. Forceps may also be used to protect a delicate skull in premature babies, or assist the birth of the head when the baby is breach (bottom first). Forceps cannot crush or damage a baby’s skull as they have a lock on them that prevents them from closing too far. They come in different sizes and shapes to suit both mother and child. The two arms of the forceps are slid separately around the baby’s head, and are then locked into position on the outside. Once in position, the baby’s head can be turned to a more favourable position, and easily slid out of the birth canal (vagina). A ventouse is a suction cap that fits onto the baby’s scalp and applies traction to the head as the mother pushes. The doctor cannot pull too hard because the vacuum seal will break if s/he does so. This form of intervention is far more uncomfortable for the mother than the baby, as the baby is being removed from a trapped position into the outside world. Additional pain relief or anaesthetics are usually given to the mother during the procedure.
About one in five babies are now delivered in this manner. There are obvious situations where a Caesarean section is the only choice for the obstetrician. These include a baby that is presenting side on instead of head first, a placenta that is over the birth canal, a severely ill mother, a distressed infant that may not survive the rigours of the passage through the birth canal, and the woman who has been labouring for many hours with no success. Caesarean sections may also be performed if the mother has had a previous operative birth, if she is very small, if previous children have had birth injuries or required forceps delivery, for a baby presenting bottom first, if the baby is very premature or delicate, in multiple pregnancies where the two or more babies may become entangled and a host of other combinations and permutations of circumstances that cannot be imagined in advance. The decision to undertake the operation is often difficult, but it will always have to be up to the judgment and clinical acumen of the obstetrician, in consultation with the mother if possible, to make the final decision.
The operation is extremely safe to both mother and child. A light anaesthetic is given to the mother, and the baby is usually delivered within five minutes. The anaesthetic is then deepened while the longer and more complex task of repairing the womb and abdominal muscles is undertaken. In many cases, the scar of a Caesarean can be low and horizontal, below the bikini line, to avoid any disfigurement. The latest innovation is epidural anaesthesia, where a needle is placed in the middle of the mother’s back, and through this an anaesthetic is introduced. The woman is feels nothing below the waist, and althoughsedated, is quite awake and able to participate in the birth of her baby, seeing it only seconds after it is delivered by the surgeon. Most doctors and hospitals allow husbands to be present during these deliveries. Recovery from a Caesarean is slower than for normal child birth, butmost women leave hospital witin ten days. It does not affect breast feeding, the chances of future pregnancies or increase the risk ofmiscarriage.
Other names :
Labour, confinement, accouchment.
May be natural through the vagina, interventional through the vagina (eg: forceps, ventouse), or interventional by Caesarean section. Other rarely used techniques exist.
Ultrasound probes monitor the baby’s heart rate during labour. Monitors may also check the mother’s blood pressure and pulse.
You notice that you have lost some fluid, as you have ruptured the membranes around the baby, and labour should start very soon. The Branxton-Hicks contractions (the contractions that occur in the last six weeks or so of pregnancy) wake you more than usual. Soon after the membranes rupture you can feel the first contraction grinding through your abdomen. Every ten to fifteen minutes more contractions occur. Most are mild, but some make you stop in your tracks for a few seconds. When two contractions have occurred only 7 minutes apart, you should head off to hospital. On arrival you change into a nightie and answer questions. Despite it being a meal time you are not in the slightest bit hungry, and you are given an enema to clear your bowels.
The obstetrician calls in to see how you are progressing when the contractions are occurring every 3 or 4 minutes. S/he examines you to assess how far the cervix (the opening into the womb) has opened, how far down the birth canal the baby has progressed, and the position of the baby’s head. This examination will be repeated regularly by doctors and midwives throughout labour. As events progress, you are moved into the delivery room. Sensors are attached through the vagina onto the baby’s head to monitor its health. The contractions become more intense, and if the pain in your tummy doesn't attack you, the back ache does. Massage can ease the back ache, and breathing exercises you were taught by the physio at the antenatal classes prove remarkably effective in helping you with the more severe contractions. A pain relieving injection or breathing anaesthetic gas on a mask when the contractions start, make them more bearable.
Eventually you develop this irresistible desire to start pushing with all your might, and expel the baby that has slowly grown in your tummy. The obstetrician returns and is dressed in gown, gloves and mask. You are being urged to push, and even though it hurts, it doesn't seem to matter any more, as you labour with all your might to force the head of the baby out of your body. Another push, and another, and another and then a sudden sweeping, elating relief, followed by a healthy cry. You have your very own baby!
Birth is a very natural act, and the traditional method has served womankind well for millions of years, and is still by far the best way to have a baby, but some women have complications that make medical intervention essential. Complications can occur very suddenly and unexpectedly, which makes birth away from a centre where adequate facilities are available risky for both mother and child.
The vast majority of pregnancies end successfully in modern centres. The perinatal mortality (death rate of babies) in Australia is now less than 9 in a thousand. Maternal deaths are now extremely rare in developed countries, but a century ago, and in third world countries today, one third of all female deaths were due to childbirth.
Physiotherapists conduct antenatal classes at all maternity hospitals and in many private clinics on what to expect, and how to cope in childbirth. All mothers should attend such classes. Childbirth Education Associations exist in all major cities.
Medical curiosity :
Julius Caesar was purportedly delivered from his dead mother, alive and well, after her belly was cut open immediately upon her demise, giving rise to the common name for the operative delivery of a baby.
Pregnancy & Childbirth Information for Patients
This condition is called halitosis. It affects 60 million people world-wide. Bad breath can lead to a lot of social embarassment and shame. However you do not have to let halitosis rule your life-style.
Causes of bad breath
Poor oral hygiene: The main cause of bad breath is plaque. If plaque is not removed daily, it will cause decay of the teeth and bad breath. Cavities invite food to lodge in them thereby emanating a foul odour. Food impaction in between teeth is also responsible for halitosis.
Medical conditions: Stomach problems, liver conditions, ulcers in the stomach, sinus infection, throat infections, cancer can cause bad breath. Diabetic patients have a sweet-smelling odour. Liver conditions cause dead rat odour.
Medications: There are certain medications like anti-depressants, anti-parkinsonï¿½s drugs and anti-histamines which cause bad breath.
Habits: Chewing tobacco and smoking lead to bad breath.
Foods: Certain foods like onion and garlic cause a strong oral odour.
The best way to stop bad breath is to prevent plaque build-up by brushing at least twice a day, flossing at least once a day and regularly visiting the dentist for a check-up and for cleaning. Rinsing with a deodarant mouth-wash will help to a certain extent. Avoid eating strong smelling foods like onions and garlic. If there is any underlying medical problem it should be treated.