Childbirth is a natural occurrence in the lives of women. And labor is unpredictable.
Natural birth are births that are not planned, works according to its own timetable and progresses naturally. Natural birth has none to minimal use of medical (obstetrical) and surgical procedures and interventions such as anesthesia, the use of forceps, vacuum extractions, inductions, epidurals, episiotomies and/or caesarean section (C-section).
Natural births can take place either with an obstetrician-assisted hospital birth or a birth at home with the help of a midwife or a completely unassisted birth.
Labor alone can be an incredibly powerful and overwhelming experience for any woman giving birth as it can create a feeling of having lost control of the situation. It gets worse and frightening when an unexpected situation adds up wherein the baby is in danger and an emergency surgery or some other kind of medical intervention becomes inevitable.
Women who are healthy are often made to take tests, have drugs, or opt for surgery and/or other interventions that can be easily avoided even after the mom-to-be or the baby doesn’t show the need for it. These interventions are disruptive, uncomfortable and puts a woman in utter distress while giving birth, making it to be a traumatic or difficult birth.
Here are 12 ways natural birth can be hard to come back from:
In an emergency, caesarean delivery becomes an inevitable intervention when something goes awry during labor and the baby starts showing signs of distress. In such cases, general anesthesia is considered to be the fastest method to deliver the baby as medication is given through the vein to make the woman lose consciousness and the baby is taken out safely without any pain. Sometimes the woman can be made to inhale gases to be put to sleep.
General anesthetics are not used that often now as they have serious side-effects, like: a mother’s breathing could slow down or stop; there could be a change in heart rate; blood pressure could probably drop; contractions of the uterus could stop abruptly and cause excessive bleeding after birth. Chances of the baby getting affected is also there, like the baby could have breathing difficulties, difficulty in latching on to suck and poor muscle tone.
Spinal anesthesia is another most used method when a need for forceps delivery or caesarean section arises. In this method, a needle is inserted well below the spinal cord and when it enters the spinal fluid, the medication is placed numbing the woman in labor from below her ribs, hips to her legs. Pain from labor contraction disappears and the numbness lasts for 1 to 2 hours until it wears off completely.
Spinal anesthesia can cause: difficulty in breathing, dizziness, convulsions, low blood pressure itching and severe headaches.
Another popular method of pain relief during labor is ‘Epidural anesthesia’, a regional anesthesia given through a catheter that is placed just outside the spinal canal. When administered, it blocks the nerve sensitivity from the lower spine decreasing any kind of pain and sensation to that part of the body. An epidural can be given for labor, vaginal delivery or for C-section. Over 50% of women giving birth at hospitals prefer epidural anesthesia over general anesthesia.
Though popular, this method can go wrong as it may cause the blood pressure of the woman in labor, to suddenly drop; may cause severe headache due to the leaking of the spinal fluid; may cause labor to slow down or stop. Epidurals can also make it difficult for the woman to push, thereby forcing her to opt for additional medications or interventions like forceps, vacuum or a Cesarean birth and/or the woman might experience backache, soreness, shivering, nausea or difficulty in urinating. Rarely, a woman might experience permanent nerve damage.
As far as to-be-born babies are concerned, it is debated, that they might experience respiratory depression, or an increase in fetal heart fickleness leaving no option but to opt for either forceps, vacuum, episiotomies or cesarean delivery. Studies also suggest that few newborns find trouble in ‘latching on’ leading to difficulty in breastfeeding.
Working parents with busy schedules look for a convenient method of birthing and hence ‘induction of labor’ has been on the rise, but since, this method is not a natural birthing process, medical interventions become apparent. Pregnant woman, with complications like preeclampsia, gestational diabetes, hypertension; or with ruptured amniotic sac; or a pregnancy prolonged beyond 42 weeks; or with an infection in her uterus and/or when the baby is in danger due to a decrease in the supply of nutrients from the placenta, has to be induced for labor.
Either suppositories (medications) are inserted into the vagina or low doses of medication in the form of the hormone ‘oxytocin’ is administered through an IV to stimulate contractions in a mom-to-be so that she can go into labor.
Other methods of inducing labor are: manual separation of the amniotic sac from the lower part of the uterus; the use of prostaglandins; Foley catheter or cervical ripening balloon; and/or breaking of the amniotic sac with a small hooked instrument inserted through the cervix.
Inducing labor is generally safe but not risk-free. They vary according to the condition of an individual and the methods being used. Especially, when a pregnant woman is induced with oxytocin or prostaglandins, contractions become difficult to manage and labor progresses too quickly, making it a traumatizing experience for her and the baby-to-be-born. In rare cases, placental abruption or even uterine rupture has been witnessed.
To help pull the baby out of the birth canal, an obstetrician has to make use of either forceps (a pair of spoon-shaped surgical tongs) or vacuum device. Such a delivery is known as ‘Assisted vaginal delivery’ and is generally conducted when the mom-to-be is completely worn-out after struggling long and hard to push the baby out. This method can also be used if the baby’s heart rate becomes non-reassuring while it is half way out of the canal.
An episiotomy, a small cut between the vagina and anus, is needed to make room for the forceps to be inserted. A flexible, rounded cup may also be used on the head of the baby. This cup is either connected to an electric suction pump or a small handheld pump that creates vacuum pressure to hold the cup securely on to the head of the baby. While the mom-to-be pushes hard, the obstetrician would gently pull the handle attached to the cup thereby pulling the baby out of the birth canal.
The use of forceps or a vacuum device can cause a bruise to the baby’s head and this will take few weeks to heal. Though rare, facial nerve injury can also be caused to the baby through these instruments. But, such assisted deliveries can be riskier for a mom as they can tear her cervix, vagina, perineum and the anal sphincter.
Caesarean (C-section) is the most common planned surgery in the US and make up to 30% of all births taking place in the US. In fact, every 30 seconds a C-section is performed in the US. In this method, a cut in the abdomen is made to deliver the baby because the baby is unable to be born through the birth canal. When an unexpected problem arises during labor and the baby-to-be born is in distress and needs to be delivered immediately, emergency C-section needs to be conducted.
C-section can have long-term side effects like: chronic shock, bonding deficiencies and invasion-control complexes. The recovery period is generally longer in caesarean birth and the new mom could feel sore around the wound (cut) for several weeks. When a caesarean birth becomes unplanned and imperative in some women, they may become traumatized with mixed emotions since they could not birth their baby as expected.
Babies who are born through unplanned C-section are reported stiff when held and touched and startle easily when moved suddenly.
An incision (episiotomy) is made in the tissue between the vagina and the anus (perineum) during childbirth. This method, although not recommended by doctors, is used rarely in cases where the baby is large or is in an abnormal position.
Research now suggests that episiotomy doesn’t prevent any problems that were initially believed to help prevent like extensive vaginal tears during childbirth. Neither does it heal faster than a natural tear nor helps preserve the muscular and connective tissue support of the pelvic floor.
Women who have to undergone episiotomy, tend to lose enough blood at the time of delivery. It becomes even more traumatizing for the woman in particular, after the procedure because the recovery makes her uncomfortable and the incision more painful than a natural tear. It could also create, after childbirth an infection, urinary and/or fecal incontinence and pain during sex.
During a vaginal delivery, immense amount of pressure is exerted on the perineum as it gets stretched to accommodate the baby’s head leading to a bruise or a tear. It may even need a cut (episiotomy) by the obstetrician to widen the vaginal opening. The natural tear or episiotomy can turn out to be deep, and so it may need stitches to help heal quickly.
Even if the birth takes place without any natural tear or episiotomy, the perineum area may still be swollen and/or tender due to the pressure exerted by the push. The deeper and the longer the cut, the longer is the recovery time.
A lot of discomfort can be felt by the new mom for weeks. And, if the cut/episiotomy is extended to the rectum, the pain would prolong for over a month. New moms who get pain in the perineum area can have trouble sitting for long hours, urinating and passing bowel movements. There are more chances of having incontinence of urine, gas and feces and this problem can continue for several months or even years.
Medical studies have evaluated that obstetric interventions have caused traumatizing experiences in many first-time moms especially during their first childbirth creating psychological effects, making them vulnerable to grief, post-traumatic distress, depression and shock.
Women who have had either forceps-assisted vaginal births or an unplanned caesarean seem to suffer from poor health and psychological impact on their wellbeing post childbirth. Psychological impacts like a lack of control, anxiety, prolonged period of labor or a kind of uncertainty during labor and after childbirth are generally reported by women who have undergone such traumatizing experiences.
Even babies who had traumatic births are likely to be psychologically affected. Studies have found such babies to be anxious and aggressive. They are claimed to grow up with lack of confidence and self-esteem.
The distress a mom and baby faces during labor, the post-trauma stress felt by a mom after childbirth, can affect the early bonding between the mom and her baby. It can dwell upon the new mom that she is completely isolated with no social life and can start feeling angry, irritable, depressed and lonely. These symptoms may make it even more difficult for the moms to bond with their babies.
Conception and pregnancy brings in a huge transition in the life of a woman where the nine months of her pregnant life revolves around a complex mix of many moods and emotions that are either of excitement and joy of nurturing a baby or of being worried, terrified and impatient about the approaching due date and motherhood.
Pregnancy brings in a lot of changes in the hormones of a woman. Hormones like estrogen and progesterone play a major role in making a pregnant woman more sensitive to the ongoing changes thereby making her vulnerable to irritability.
Some of the emotional impacts are: mood swings; fear of having a miscarriage, fear for the well-being of her growing baby; fear of not being able to be a good mother and taking good care of her newborn. Along with such fears, hormonal fluctuations may cause anxious thoughts and forgetfulness; some women become weepy most of the times and too much of crying leads them to depression. Some women wonder at their rapidly changing body during pregnancy; develop concerns over their appearance and start lacking in their self-esteem and confidence; Lastly, some moms-to-be experience a sense of loss when the childbirth doesn’t take place as expected, when she is not able to experience and participate in the birth of her baby and also when she is not able to remain conscious during her childbirth. All these reasons can impact a mom-to-be very emotionally.
A mom-to-be, who experiences severe distress, helplessness or lack of control during childbirth tend to develop Post Traumatic Stress Disorder (PTSD), a condition where the new mom has symptoms of anxiety, flashbacks and nightmare. When a mom-to-be actually experiences a threat to her life or witnesses a threat to the life of her newborn, it impacts her so deeply that she is shaken out of her wits giving her immense stress that can lead to PTSD. New moms are then troubled by invasive thoughts and disturbing memories that could interfere with their daily life.
Studies say that some such women start to miss their routine medical care and check-ups to avoid reexperiencing the traumatizing childbirth they had to go through. They also seem to fear conception for the second time and so avoid sex.
In some cases, it has been observed that women suffering from PTSD, experience serious concern over the health of their babies and a constant fear lurks in them that they could die. PTSD caused by a traumatic birth experience adversely affects breastfeeding.
Other symptoms of PTSD include weepiness, irritability, panic attacks, feelings of detachment from loved ones, bad dreams, frightening thoughts and insomnia. In extreme cases, the feeling of something going to go wrong can manifest itself into suicidal thoughts.
Another huge risk factor is ‘maternal stress’ during pregnancy. Prenatal stress in a mom-to-be can significantly affect the developing fetus leaving a lasting impression on the newborn’s health, development and function of the immune system; and the cognitive (ability to think) development of the newborn.
The types of stress that can have drastic consequences on the mother and her fetus are some real-life events like the death of a close family member, being unemployed, and/or going through some marital discord.
Such stressful consequences in a mom-to-be not only influences the cognitive, behavioral and physical development of her fetus, it may also expose the baby to other mental health disorders, such as autism, schizophrenia and depression. Newborns may also show difficulties with paying attention and can be aggressive.
Recent findings have demonstrated that obstetrical complications, low birth weight, and delayed physical development may all be influenced by prenatal maternal stress.
Labor and delivery whether it is through vaginal or C-section, affects the muscles and nerves in the pelvis of a new mom. When the baby starts moving down towards the pelvis and its head gets fixed, the cervix dilates, and labor begins. The mom-to-be who is waiting for the contraction to start, when she feels it, holds her breath and pushes down as hard as possible so that the baby is pushed out of the birth canal. This hard pushing presses the baby’s head against the wall of the pelvis and exerts more pressure on the muscles and nerves of the mom’s pelvis to such an extent that the normal flow of blood is cut off temporarily until that the mom stops/pauses to push, depriving oxygen and nutrients to the tissues and making it more susceptible to injury.
Two nerves, pudendal and the pelvic that lie on each side of the birth canal within the muscles of the pelvis, are nerves that are supposed to carry signals from the brain to the muscles that hold the bladder and rectum in place. When these nerves get crushed during a prolonged labor due to the pushing of the baby’s head against them, they get injured and the signals which are meant for the muscles around the bladder, vagina and rectum are not transmitted properly. Gradually, these muscles become weak and loose, over time and with age, and so does the normal supporting tissues of the bladder, rectum and uterus weaken resulting in what is called as incontinence of urine or stool, or prolapse.
Sources: Parents.com, MidwiferyToday.com