Manipulation has such a strong connotation. Nobody likes to be manipulated. It’s an awful feeling. It is defined in part as the devious management of someone or something to benefit the self. Sounds dark and sinister, doesn’t it? In actuality, most times when a woman’s labor is about to be manipulated, there are no such evil and sinister ambitions. There are times however, when a doctor will want or need to manipulate a woman’s labor. The reasons vary from the selfish, to the personal, to the imperative. Anytime the baby’s life is in danger, the doctor will use all his ability to manipulate labor in such a way as to preserve both anxiously laboring mom and distressed sweet baby.
Most women will have their labor manipulated in some way or another. Doctors are trained to deliver healthy babies safely and effectively in an almost assembly line like manner. Doctor is also obligated to himself and his needs to mitigate his risks during delivery also, as obstetrics is one of the highest litigated medical fields.
Most women won’t mind having their delivery manipulated, even if they aren’t aware of it, so long as it means delivering a healthy baby. Whether it’s because of mom or dad’s military or work schedule, a planned vacation or something much more serious like an unexpected early labor; there are many reasons and ways doctor and mom might chose to change the timing and direction a woman’s labor is taking.
Doctor Wigwam is a very athletic man. At every visit he tells mom about his past and future sports activities. Last week it was an amazing golf game, this week he’ll be spelunking off the side of a cliff. It’s great that doc is so interested in staying fit. He has such a stressful job, delivering babies and treating women for all sorts of ailments is both physically and mentally taxing work. Everybody needs an outlet for stress.
Mom went into labor like 12 hours ago and progress is not rapid. After every check down there, Wigwam shakes his head and looks at his watch. What the heck is up with the watch? Turns out tee time for our health nut doctor is at 9 a.m. today and there’s no chance mom is popping that baby out in time. Now, to ensure he’s got baby out with enough time to get to the golf course an “emergency” c-section needs to be performed. He convinces mom she’s too tired to push. He’s called the anesthesiologist and is getting mom next in line for surgery. It’s an emergency after all.
Today’s technology allows us to predict, with pretty good accuracy, the due date of baby. No longer do we have to rely on the memory of mom’s last visit from ‘Aunt Flo.’ Sometimes baby decides to hang around for some time after that predicted due date. Unless baby is on the smaller end of average, which is unlikely, if you live in the United States, mom will be unbearably uncomfortable.
There are a few things doctor might recommend or do if mom and baby are both healthy and overdue by more than a week or so. Doc might strip the membranes surrounding the mucous plug, which would in turn weaken the plug and allow mom’s water to break. Rigorous sex might be recommended to encourage contractions. Some old wives tales recommend rosehip oil or laxative herbs to bring on contractions also. Talk to the doula, midwife, herbalist or doctor about those options.
Another reason that doc might manipulate mom’s labor is if she’s whining and complaining, but only if she and baby are in optimal good health. Manipulating labor is not really a good option unless there is a really good reason. Babies are meant to cook for a certain amount of time and mom’s body has a built in timer, a pop out one just like the Thanksgiving turkey. Once that cork pops, it could be a few hours until mom and baby are face to face.
Provided mom and baby are okay, Doctor Wigwam might concede to the whining and begging and strip mom’s membranes or do something else to help labor move forward. Most doctors will not do so just to stop mom’s whining. Baby needs to be completely ready to be born and pointed in the right direction for doctor to consider doing anything.
If doctor or mom had a vacation planned like a year ago, well before a pregnancy, both might feel pressure to manipulate the labor and delivery of baby. If mom and baby again are in good health and full term, doc might opt to induce labor with the use of labor inducing medications. Some medications doctor might use are oxytocin, Cytotec, Pitocin, Cervidil or mysoprostal. Some medications are used as a suppository, others are administered intravenously. No matter the route of administration, each medicine is used to help prepare the cervix for delivery by producing strong and regular contractions.
A c-section is another option if there is a specific time frame in which baby needs to be born. C-sections are considered major surgery and despite being common in the United States, is not a natural way to be born. Baby picks up vital flora in the birth canal. There are also studies that suggest moms who delivered via c-section are more likely to develop postpartum depression. Choose wisely and be prepared for a long recovery. At least mom will be on vacation for it.
If mom is severely overweight, has diabetes, cancer, is older or is in general poor health Doctor Wigwam is going to want to have this baby delivered in the most controlled environment as possible. If baby is at any risk at all, despite what Wigwam has said in the past, he will try to convince, if not manipulate, mom to forgo a traditional labor and delivery. Wigwam, our hyper athletic doctor, works in a profession with a very high rate of litigious action and wants to mitigate risk to mom, baby and his practice.
It makes sense though doesn’t it? If mom and baby are in any risk of injury or death, just trust Wigwam. It’s in his best interest to deliver a healthy baby to a healthy momma. This c-section might not be what mom was looking forward to but bringing a healthy baby into the world is more important.
This is a potentially deadly condition for both mom and baby. Many women have died from this condition over the years, prior to the general knowledge of its existence. A disease that is only present in pregnant women, is cured by the delivery of baby. A symptom of preeclampsia is hypertension or high blood pressure. Another symptom is high protein in the urine. Both are checked for on a regular basis by most ob/gyns.
First time moms, very young moms (under 20), older moms (over 40) or obese women are at high risk of developing preeclampsia. Gestational hypertension might be a precursor to the condition, but not necessarily a cause. If a close family relative had preeclampsia, mom might be at risk too. Keeping tabs on swelling, water retention and blood pressure, along with blood and urine tests by Doctor Wigwam will give everyone a clear picture of what needs to be done in terms of developing a plan for a safe labor and delivery.
Having a huge baby in the United States is not unheard of. Babies born in the US are bigger, in general, than in any other developed nation in the world. Whether it is to be blamed on obesity of the parents or a high amount of nutrition, is yet to be determined. Either way, big babies bring big issues with delivery and labor.
If baby is packing in at over a certain size be prepared for doctor to offer a c-section as an option. Mom knows what part a baby comes out of and it’s pretty tiny. Yes, it does stretch but only so far, then there’s either tearing or cutting. Neither one is fun. C-sections aren’t a cake walk either. Doctor, again trying to mitigate risks might highly recommend a C-section or at minimum, an episiotomy. Do some research if that kiddo is coming in large and know the options.
The various miraculous procedures that give the joy of parenthood to couples struggling to conceive are such a blessing! Couples, for whom adoption might have been the only way to have a child, are now able to birth one that is genetically the same as them. The flip side of many of these amazing procedures is the increased chance of becoming pregnant with multiples, in some cases more than just two at a time.
With such a limited space in the womb for so many heads, arms and legs, doctor will more than likely suggest a planned delivery. This planned delivery might include induction drugs like Pitocin or oxytocin that bring on strong contractions that ready the cervix for delivery. Another route for the planned delivery of the babies is a C-section where mom will be given an epidural injection in her spine and doctor will deliver via an opening made in the uterus itself.
Not all science is perfect, not even with all the ultrasounds and blood tests can the due date be predicted with 100% accuracy. It’s possible that baby is very small or very large for its gestational age or that mom had no idea she was pregnant until later on in her pregnancy. Either way, doctor might need to manipulate the labor and delivery of baby to ensure all things go as smoothly as possible.
If doc assumes mom is way overdue, he might strip her membranes or encourage some activities that might stimulate true contractions and cervical dilation. Induction medications are another option. C-sections are yet a third option too. It’s important that mom stay calm during this time and tries to focus on baby. Being as honest with her doctor and birth team as possible is very important during this time. A perinatologist might be called in to do an ultrasound to get a better picture as to how long baby has been cooking.
Infections in the uterus can be very harmful to baby. Actually called chorioamnionitis, these infections are caused by a breach in the protective womb in which baby has been living. Through this opening bacterium like e-coli or strep b can travel up through the vaginal canal and into baby’s home, causing an infection to develop.
To test for a uterine infection during pregnancy mom will have to undergo an amniocentesis. Amniocentesis is a procedure in which the doctor or another perinatal specialist will use an ultrasound machine to guide a needle into the womb via the mother’s belly. Using this needle, an amount of amniotic fluid will be drawn and tested. If the fluid tests positive for infection certain steps will be taken.
This infection might be slowed by the administration of antibiotics. Antibiotics might be administered orally, vaginally or intravenously to the mother. Infections of the uterus can cause preterm labor if left untreated or treated too late. Doctor will want to deliver baby as soon as it’s safe to do so. Most likely mom will be looking at a c-section birth, but given the circumstances it might be necessary.
If mom starts to experience symptoms like a stabbing pain in her tummy, her stomach feels very hard like a board or severe bleeding during the second trimester or bleeding after sex; she might have placenta previa. Otherwise known as low lying placenta, this is a condition when the placenta covers the cervix either in part or entirely.
The placenta is the sac like temporary organ that protects baby and delivers food, oxygen and removes waste during pregnancy. Doctor will most likely recommend bed rest for mom if placenta previa is diagnosed before going into labor.
There are several risk factors in developing placenta previa. Having an unusually large baby, having had previa in the past or an odd shaped uterus are some contributing factors to mom developing this condition. Oddly, being of Asian descent makes this condition more likely. Previous uterine surgeries such as a c-section also increase the risk for placenta previa. There are also different degrees of the condition, some of which will not require a c-section. Good ole’ Doc Wigwam will need to discuss all aspects of mom’s case with her and develop a plan.
The placenta is the protective sac that surrounds the baby during gestation. Inside of the placenta is a pool of amniotic fluid. Amniotic fluid has several purposes such as cushioning baby from external blows and bumps, like that from an older sibling jumping on mom.
Ever see a watermelon that was grown in a box? They were all the rage in Japan a few years back. When the watermelon was quite small, it is placed in a box to grow. Guess what happened when it is finally full grown. It was shaped like a cube of course! Unlike a box, the amniotic fluid and sac are soft, allowing baby’s body to grow in a symmetrical and unrestricted fashion.
Amniotic fluid also helps to regulate baby’s body temperature and limit the effects that fever or chills from mom might have. Baby also practices breathing in and out with the amniotic fluid. Important exercise for when they enter the world.
Unexpected loss of this amniotic fluid might cause doctor to want to induce labor if baby is ready. Doctor Wigwam might also be interest in performing a c-section. The amount of fluid can be estimated by a sonogram, most likely done by a perinatologist. After the results of the sonogram are evaluated, then doctor will discuss mom’s options.
What exactly is fetal distress? Being that baby can’t tell us what is going on we need to rely on monitors to relay information about baby’s well being. Fetal distress is commonly used to describe low oxygen levels in the baby. Symptoms of fetal distress are low fetal heart rate, presence of meconium , abnormal substances in the amniotic fluid like an infection or a change in labor. If labor had been progressing but has suddenly come to a halt, fetal distress might be to blame. That belly strap heart rate monitor and maybe a scalp monitor on baby will help to let the pros know what is going on in the inside of mom’s tum.
In an attempt to save baby, doctor will try to figure out exactly what is causing the distress. It could be from a breech position or that the chord has wrapped itself around baby’s neck. After a vaginal smear or ultrasound, if there’s time, or just a digital exam; doc will have some answers. Doctor might try to birth baby breech, manually unwrap the cord or decide on a c-section.
Although most children are born with little to no real deformities or abnormalities, some do arrive in this world with less than what is required to survive on their own. If during the pregnancy doctor notices a heart defect, neurological defect, limb deformities or spina bifida, doctor will try to manipulate the labor to limit the chances of further physical stress on baby during delivery. If it’s predicted that baby will require surgery after being born, doc will want to do a c-section so baby can be whisked off as soon as possible and a special surgeon and team can be prepared.
Severe birth defects occur in less than 1 out of 33 live births in the United States and are considered relatively rare. But, thanks to technology in the field and awareness, most defects can be detected well before the due date and accommodations to deliver a healthy baby can be made.
The final reason nice Doctor Wigwam might try to manipulate labor is that baby is coming out hind first. Normally, a baby will go head first out through the birth canal. Makes sense doesn’t it? There are times though when baby moves into a different position, either breech, hind end, or transverse, lying sideways. Now, some doctors might opt just for the c-section at this point, in some opinions, unnecessarily. Unless baby is in the utmost danger, mom is too exhausted and the her waters have burst, a c-section is not always be necessary when baby is in a transverse or breech position.
Wigwam, being slightly old school, decides to try an old technique called External Cephalic Version. During this procedure Doctor Wigwam will attempt to turn baby to the correct birthing position by firmly pushing on mom’s tummy. After mom has been given medication to slow contractions, doc will proceed to push on mom’s belly where the baby’s hind and rear are located encouraging baby to move to a better position. If at any time fetal heart rate drops, the procedure is stopped. Version might be tried several times before the towel is thrown in and mom is prepped for a c-section.