Fetal Distress – Causes And Treatment

Fetal Distress – The Causes And Treatment

Two words that strike fear in every mother's heart – fetal distress.  Rather than sit in fear, let's learn some basic facts about fetal distress and how it is treated.

Fetal distress describes any time that the baby is failing to thrive inside the womb or during labor and delivery. Something has changed and has caused the developing fetus to have difficulties.

Indications of Fetal Distress

One of the conditions that mothers are keenly aware of is a reduction in fetal activity. After a certain length of time, the baby will start to move around within the amniotic sac. It is an exciting time for the expectant parents as the movement of the baby is felt for the first time.

Each time you go to the doctor, you will listen for the baby’s heartbeat. You will also be asked by your doctor about the baby’s movement. If any decreased movement is noticed, this could signal that the baby is in distress. The doctor will investigate immediately to see what the cause may be.

Incidents of fetal distress may occur during the time of labor. The baby’s heartbeat is monitored during labor. A decreased heart rate after a strong contraction could be the result of fetal distress. One cause may be that the umbilical cord is wound around the baby’s neck, reducing or cutting off proper blood supply to the baby.

Meconium is the baby’s first feces. This may occur in the womb if the baby is experiencing some sort of stress such as a prolapsed umbilical cord or a breech position. Meconium aspiration is possible under these conditions. This causes breathing problems that have to be handled immediately upon delivery.

Multiple births can lead to fetal distress. More than one fetus in the womb increases the chance that one or more babies may have some sort of distress during delivery. 

Treatment

When a baby is in distress, everyone in the delivery room acts quickly. Time is of the essence to safely delivery the baby. The first and most desirable course of treatment is delivering the baby immediately. For a baby who is experiencing distress before full term, that can mean a premature birth. Drugs given to speed the development of the lungs will often give the distressed baby a  greater chance of survival outside the womb.

When multiple birth babies show signs of fetal distress, cesarean section is a viable solution. Delivering multiple babies who are distressed by a vaginal birth is risky as the medical team may not reach all the babies fast enough or the umbilical cords could be prolapsed. With cesarean delivery, multiple babies can be delivered with the least amount of added stress.

Fetal distress is serious, but can often be monitored with a successful outcome.  Sometimes labor is induced with early delivery being the best option.  You and your doctor will work closely and quickly together to give your little one a good, healthy start in the world.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

The Debate Over An Episiotomy – Is It Necessary?

The Debate Over An Episiotomy – Is It Necessary?

Childbirth is painful – there's no getting away from that.  There are several pain issues to deal with before, during, and after delivery.  One of the most debated procedures during delivery is the episiotomy.  This incision is often described as the “unkindest cut of all.”  It can often make recovery more painful than believed is necessary.  What is it and is it necessary at all?  Let's look at the debate and you be the judge.

What is an Episiotomy?

Vaginal delivery is the natural form of birth. During this birthing process, when a mother pushes, she bears down so that she can move her baby through the vagina, or birth canal, and out into the world. The process can lead to possible stretching of the vaginal muscles, hemorrhoids, and weakness in the pelvic floor muscles.

In an effort to decrease the amount of pressure needed to push the baby through the birth canal, doctors may perform an episiotomy. This is an incision into the tissues of the perineum, the small area between the vaginal opening and the anal opening. The incision is believed to make birth easier with less stretching and damage.

If the mother is using natural, drug free, childbirth techniques, a local anesthetic is injected in the tissues of the perineum. A scalpel is used to incise the tissue. Once the baby is delivered, the area is sutured up.

There are different degrees of episiotomy performed depending on how large the child is or how difficult the labor. Usually the area is only cut halfway between the vagina and the anus with minimal skin layers incised. This is considered a second degree episiotomy. A fourth degree cut completely incises the skin layers.

What Now?

Who is right and who is wrong about the necessity of an episiotomy? Women who have had an episiotomy may disagree with the reasoning behind performing this procedure. Post-delivery, the episiotomy wound is difficult to deal with for many reasons.  Simply urinating becomes a frightfully painful event, not to mention a bowel movement.  Any straining or pushing during the healing process becomes unbearable.  The wound stings, burns, and is often too sore to comfortably sit without some sort of 'donut.'

There is no clear scientific evidence that supports having an episiotomy over not having one.  Many women who have delivered babies with big heads or shoulders have recovered without any adverse effects and given birth quite successfully again. The vagina is made to stretch for the birth of a baby, so the reasoning behind an episiotomy is questioned by mothers as well as the medical profession.  So, the debate continues.  Let's look at some possible side effects of having an episiotomy:

·         Infections

·         Uncomfortable or painful scar tissue

·         Painful intercourse afterwards

·         Longer recovery from delivery

So, is an episiotomy the “unkindest cut of all?”   Discuss this procedure like you would any other with your doctor.  An episiotomy should not be done as a matter of course, rather it should be approached as any other surgical procedure – with knowledge and caution.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

Water Birth – Is This Alternative For You?

Water Birth – Is This Alternative For You?

Water birthing is a relatively new concept in the United States. Basically, a mother gives birth to her baby while being partially immersed in warm water. Water births have more typically been done during home deliveries, but have now entered the mainstream birthing hospitals.

What to Expect - Preparation

Proponents of water birth say that it is a more natural process. A baby has been living in water for nine or ten months already. Coming into this world in the same kind of medium is believed to be less traumatic and an easier transition.

The mother will use a pool or tub that is partially filled with water. The water must be maintained at a certain temperature. Ideal temperature is equal to the internal environment of the body (98.6 degrees Fahrenheit). Keeping the water at body temperature prevents the mother’s temperature from rising too high and endangering the baby.

The water is also continually changed to keep it crystal clear. The doctor or midwife needs a clear view of the cervix and the baby as it passes out of the birth canal so that any potential problems can be detected early and resolved.

The water level is also important. The mother's lower half is submerged in water when she sits, but her body needs to remain stable, not buoyant, so that she can push when the time comes. Too much water will cause her to float and lose her position.

What to Expect - Birth

According to experts in water birthing, immersion in water eases the pain of the contractions. Any mother would love that. The body begins to relax somewhat so the mother's cervix can dilate without as much pain.

Doctors who advocate the water birth method don’t recommend that a mother enter the birthing pool until after early labor. Immersion before five centimeters of dilation is too early. When you first enter the water, contractions seem to speed up due to natural oxytocin in the body. This increased flow can last for a couple of hours, long enough to dilate to delivery size. If a woman sits in the water too long, the surge stops and labor is stalled. Getting closer to full dilation makes a better use of that oxytocin spike.

Many mothers believe there are advantages to letting their baby emerge from water in the womb to water in the birthing pool. For women who want an alternative to the delivery bed, water birth may offer the calm, quiet delivery she is hoping for.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

What Is Epidural Anesthesia And How Is It Administered?

What Is Epidural Anesthesia And How Is It Administered?

The birthing room is the final frontier; after all the preparation, classes, and waiting, here you are.  The decisions you've made during the course of your pregnancy have been put into action.  Choosing the method of delivery and the drugs to use before, during, and after delivery are topics you have already discussed with your doctor.

No matter what drugs you may need for childbirth, choosing to use them is not a decision that any mother makes lightly.  Many mothers opt for natural (drug free) delivery with a back up plan of anesthesia.  Some mothers may be able to stick with that plan while others may need to go to Plan B and choose anesthesia. 

Trying to hang in there and tough it out with the contractions is a noble cause, but it is one that you and your doctor will have to face together.  There are times and situations when strength alone will not prevail. That force of will can break down even the strongest of women, and there can be medical reasons why epidural anesthesia may be the best course of action.

Your doctor should discuss anesthesia with you ahead of delivery time so that you have the necessary information and the anesthesiologist can be standing by when your delivery time comes. The most common form of anesthesia used in childbirth is the epidural.

Administering the Medication

Just what does an epidural entail? In medical terms it is a form of regional anesthesia or block. This means that only certain areas of your body will be affected by the medication.

The epidural is given in the lower back, blocking pain below the waist. This may already sound grim.  How will they get to your lower back when contractions have rendered you rather unapproachable? The doctor will probably ask you to roll on your side and curl up in the fetal position. This “curling up” increases the amount of space between your vertebrae so the doctor can administer the medication safely.

Because you are hooked up to a monitor, the doctor can see when a contraction is happening. Once one contraction has passed, the doctor can begin the procedure. It is very important that you don’t move. Have your partner assist you by holding your shoulders, your hand, and offering a pillow to squeeze or whatever it takes so you remain still.

A long needle is inserted into your back in the space above the spinal cord (epidural space) in which a long tube is then inserted to administer the anesthetic. If you feel anything other than the pin prick of the needle it will be pressure as the medicine goes in. Once the procedure is finished, it may take a few minutes for the drug to take effect.

Women who have been in labor for extended hours can now rest until it is time to push. An epidural takes away the pain below the waistline. Your monitors will let the doctor track your contractions and let your and your doctor know when it is time to push.

Epidural anesthesia is one option when natural childbirth doesn’t seem to be working out to the advantage of the mother or baby. It eases the pain and gets the mother ready for the final push to bring her baby into the world.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

Drugs Used To Advance Labor

Drugs Used To Advance Labor

Labor, the process leading up to delivery, is a necessary part of childbirth. If we could skip the long labor and proceed straight to the delivery, that would be easier, wouldn't it?  But labor, especially those contractions, are what sets the stage for delivery.

What happens during labor? The baby turns and makes itself ready for departure. This process takes time, and the contractions are what prepares the body for delivery.

Contractions signal that the baby is beginning its journey. The cervix begins to dilate so that the baby can pass through. Once the cervix dilates to a certain size, the mucus plug will be discharged and some bleeding may occur. The cervix continues to dilate and efface (thin), preparing itself to pass the baby through.

For some women, the contractions during labor can be prolonged for various, uncontrollable reasons. In this case, drug treatments may be used to help the process along.

Common Drugs Used

So, how will the doctor help? There are drugs that can be administered intravenously to speed up your contractions. As contractions increase in intensity and duration, the cervix responds by dilating.

Know that increasing contractions means increasing the pain. Your doctor will only suggest this method when it is absolutely necessary.  The following are considered the most common drugs your doctor would use to increase contractions.

Pitocin – This is the drug of choice to augment, speed up and improve, your labor. When the strength of the contractions is no longer effective, this drug may be given. It will increase the force of the contractions to wake up the cervix and move along the dilation process. Pitocin is a synthesized form of oxytocin which is a natural hormone in the body that causes muscular contractions in the uterus.

Cervical Gel – The common name is Cervidil. Sometimes the cervix is not thinning and “ripening” like it should when preparing for birth. This gel acts like prostaglandins in the body. They are responsible, during labor, for dilation and smoothing out the cervix. It can be administered directly on the cervix. Keep in mind that a common side effect to this drug may be nausea or vomiting.

There is no way to really tell when your baby is ready for delivery; each delivery is different.  But, you and your doctor will know when the normal process of contractions and dilation is slowed or halted. This is when drugs can be useful to ensure your baby has a safe passage into this world, and mother and baby finally get to meet!

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

The 3 Stages Of Labor

The 3 Stages Of Labor

The time has finally come. Now you are ready for that little one to be born. If you are a first-time mother, you might not know what to expect. We don't want you to be unprepared for the experience, so here is the information you need about the 3 stages of labor.

Let’s stop here for just a moment to tell you that this event is not without discomfort and pain.  For some decades past, the media portrayed pregnancy and delivery as a quiet, unseen event.  When mentioned at all, the delivery was typically without the mother's involvement whatsoever as she was 'knocked out', unconscious, during delivery. 

Chances are good that you will not awaken from a blissful sleep with a bundle of joy magically appearing at your side without your full knowledge of how the delivery went.  So, since you will be involved in your baby's delivery, let’s get down to the nitty-gritty.

Stage 1 - Early Labor

This is when the contractions begin. It can feel like finger-like projections of discomfort or pain that start at your back and radiate outwards towards the center of your belly. Many women experience false labor pains called Braxton-Hicks contractions, but the contractions of stage 1, known as early labor, have a couple of characteristics that distinguish them from Braxton-Hicks, or false labor.  These early labor signs are:

• ·         Regular intervals
• ·         Cervical dilation
• ·         Effacement (cervix begins to thin)

You will probably call your doctor just to let him or her know when you are in the early stages of labor. There is usually no reason to go to the hospital immediately.

If you are experiencing these contractions earlier than about 37 weeks, then you will proceed according to your doctor's advice.  You and your doctor will make a plan according to what is medically necessary.

Stage 2 - Active Labor

While you will be mostly at home when early labor hits, active labor is another story. During early labor, your cervix has begun to dilate but not much (only about 4 centimeters).

When the cervix reaches five centimeters, you are entering stage 2 of labor, or active labor. Call your doctor first before hopping in your car and heading for the hospital.  If your water hasn’t broken, your doctor may not advise you come to the hospital just yet.

This is also where you start using those breathing techniques you learned in childbirth class. They won’t stop the pain of the contractions, but will help keep you calmer, quieter, and more relaxed.

Once your water breaks, you will want to head to the hospital. Once you are admitted, your doctor or your doctor's staff should meet you there. The doctor and staff will begin to check you and see how your labor is progressing. Even though you may long to relax in your hospital room and lay in bed, your doctor may suggest you walk the halls if your dilation is going slow. This moving about may actually feel good to some mothers about to deliver.  Stage 2, or active labor, can take a couple of hours to several hours.

Stage 3 - Transition

You are almost fully dilated at stage 3. The baby has descended into the birth canal and is ready to be pushed out. The doctor is watching closely to confirm that you are fully dilated and the baby is in the correct position to be safely delivered. The doctor's orders are crucial in this stage and you must listen carefully.  

Many mothers are ready to push that little one out into the world, but the doctor will guide you and let you know when it's the right time to push. This can be hard especially with the contractions coming on fast and furious, and the desire to push seems overwhelming.  Once given the order to 'push' the delivery moves very quickly and, right there amidst all the pain, the delivery suddenly comes to a quiet halt, and your little one is wailing to beat the band!

Labor is a natural process.  The body knows what to do to ready itself for delivery of this new life. Knowing what your body is doing to prepare for this event is important.  Knowledge of the 3 stages of labor will help you rest easier and be ready when your body is!

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site or any other site.