When a woman goes into labor, the last thing on her mind is the decisions she may or may not have to make. For a good portion of her labor, mothers don’t see their doctors. The physicians usually don’t show up until the final stages are in motion. Doctors are touted as the decision makers when it comes to labor, but mothers should be aware that while many behave as though they don't need consent, they really do and should be giving Mom that opportunity. Labor is the hardest part of bringing a child into the world—aside from raising them—and it’s vital that they feel comfortable throughout the entire process. Still, sometimes physicians are scolded for making split-second decisions that are sometimes costly, but when it comes to bringing babies into the world, they are usually trusted.
Birth can be worrisome, especially for a first-time mom. That being said, it is essential that they are aware of everything a doctor could potentially be doing while in the delivery room. Nothing is that worrisome if there is some level of preparation and Mom is well-informed and educated on everything that could happen and her role in the decision-making process. This is a list of procedures that every mom should be prepared for because they are necessary sometimes, and some doctors won’t even warn Mom before engaging in many of them.
19 Fetal Monitoring Conundrums
When a mother goes into labor, and the baby is getting ready to descend the birth canal, it is possible for he or she to go into distress. Monitoring the baby can be uncomfortable for mom with all the straps on her contracting tummy, but it’s sometimes necessary—at least intermittently. According to ACOG, the heartbeat of an unborn baby can change within a matter of seconds. There are two types of fetal monitoring: checking every once in a while, and electronic fetal monitors which are strapped to mom's belly.
It is often painted as though it is at the doctor's discretion as to when and how Mom has to be monitored. Truth be told, Mom always has a choice, but she may have to fight for it.
18 Amniotomy Woes
Most of the time, a mother knows she is in labor if her water breaks—sending her to the hospital. It’s important to keep in mind though that sometimes contractions come first and the water will break later in labor. Some babies are born while still in their sac—en caul, to be exact, according to What To Expect—which keeps them extra safe during the birthing process.
If the doctor feels it is necessary to jump-start labor, they may decide to break Mom’s water in hopes of moving things along. Mom can always decline this.
She should note in her birth plan that she wants to allow her water to break on its own, which is safest since AROM can cause cord compression and stalled labor that significantly increases the risk of needing further interventions like a C-section and Pitocin.
17 Time To Speed Things Up
When we find out about a pregnancy, a due date comes along with it. Some moms go into labor way before, while some go past. If the pregnancy goes over 42 weeks, the baby is in danger, or if the water has been broken for a few days and there is no sign of labor, induction is sometimes needed, according to the American Pregnancy Association. Induction is done using medications such as prostaglandins or Pitocin to jump-start labor.
But sometimes a doctor will use Pitocin to also speed up a slowed labor, and that Pit pump can be turned up during labor without really making sure Mom is given the opportunity for informed consent.
16 Vacuum Extraction Happens Fast
Because labor is such an exhausting process, some mothers have a hard time keeping their energy up throughout the entirety of it. It is possible for babies to get stuck while making their way down the birth canal.
If the baby does get lodged somewhere, making it difficult to continue pushing, doctors can use a vacuum to help the baby into the world.
The vacuum is attached to the child's head and is traditionally used during a contraction while mom is pushing, according to WebMD. Pushing something out of a small area is exhausting, and some moms need a little help.
15 Not A Crystal Ball
Doctors often claim checking Mom's cervix can help things along and help them predict when labor may start. Moms can do it themselves to see when they are most fertile, and doctors use it to determine dilation. According to Baby Chick, cervical checks during labor are used to understand effacement and station. The doctor will want to know what stage a laboring mother is in to understand how the labor is progressing and when it is time to help bring the baby into the world.
Women can say no to these dilation checks on a regular basis, and many do since it actually tells us nothing about how soon a baby will be here.
But when it is time for the little one to come, cervical checks may be necessary—not because they actually help anything at all, but because many providers are no longer skilled in supporting birth otherwise or gauging progression without doing such.
14 Iodine Down Under
Doctors use iodine before internal exams and usually before birth to cleanse the lady bits. This may sound odd to some who don’t understand what it is or what its used for, but it can be beneficial. Doctors use it the majority of the time to protect mothers-to-be from infection, which can occur during childbirth or any examination. Mothers can have infections or postoperative fever. An infection down there is the last thing a woman wants to deal with at any time, but especially when she is trying to look after a newborn, according to HelloFlo.
13 Fetal Scalp Monitoring
There are several ways to monitor a baby while they are in the uterus, and one of those is scalp monitoring.
An electrode is attached to the baby’s head for the medical team to keep tabs on everything during labor at all times.
Other monitors are detecting average heart rate while this internal one detects an actual heartbeat, according to Medscape. Doctors usually choose to use this type for high-risk pregnancies when something could quickly go wrong. Ultimately, each pregnancy is different, but it is super important for the baby to be safe and healthy at all times, which is what the monitors are used for.
12 Tear and stitch
Sometimes, mothers will tear while giving birth to a baby. Some mothers get out scot-free, while others need a lot of stitching. The doctor attending the birth has to take the time to check the area after Mom has given birth for any tearing. There are a few types of tears, the most common being: first degree, which usually will heal naturally, and second-degree tears, which can be characterized by episiotomies made by the doctor and large tears which happen naturally during birth, according to East and North Hertfordshire.
While first-degree tears don't typically necessitate stitches, others generally do and the doc may start that process without really telling Mom what's about to happen.
11 Releasing The Cord From Around The Neck
The umbilical cord is what keeps the baby healthy during the entire pregnancy. The cord provides the baby with food and oxygen, and when the little one is on its way out, it is common for the cord to wrap itself around the baby’s neck, which can potentially cut off their oxygen but generally is harmless as it can be moved aside. The tough thing about this is that it's undiagnosable until the baby’s head emerges, according to the New Kids Center. The doctor is the first to witness the head. Therefore, they are responsible for immediate action if the cord is anywhere near the neck.
10 Let's Hear It, Baby
Babies should cry seconds after birth. For some little ones, it takes them a few minutes before taking their first breath after coming into the world. It is pretty standard for the doctor to seemingly "smack" the baby around a little bit to produce the cry that everyone wants to hear. It’s possible for them not to make any sounds, but that can be scary—it leads us to feel as though they aren’t healthy or their lungs aren’t developed enough.
If the doctor doesn’t hear crying in the first few seconds, they are likely to rub the baby’s back or even tap them on the bottom, according to Kind Mommy.
9 The Membrane Debacle
Also known as membrane sweeping, stripping the membranes is used as a part of the induction process. A doctor will complete this procedure using their fingers to separate the bag of waters from the uterus, as reported by Medscape. It is often recommended to have a physician strip the membranes more than once when a mother is nearing the end of her pregnancy, especially when she is becoming overdue. However, moms are rarely educated on the process and that it can cause premature rupturing of the membranes, infection, and can even irritate the cervix causing progression that has been made to close back up. Some doctors will strip a woman's membranes without telling her beforehand. It's important to be clear up front if you do not want this procedure, and many women who decline it just decline cervical checks altogether since they have no medical purpose and only pose risks.
8 The Family Has Got To Go
When a mother is giving birth, it is more than likely that they will want familiar support in the room with them. This usually is the father of the baby and one other person, although in some cases it is more than that. It depends on what the mother is comfortable with and what is allowed at the hospital. According to Verywell Family, there is usually no limit on how many people can be in the room while she is laboring, but when active pushing starts, the limit is typically two. The birth of a child can be quick and easy or long and difficult. It doesn’t help when there are too many opinions and bodies in the room—it may make it hard for the doctor to focus.
7 Let's Get Moving
It is common for a mother to arrive at the hospital very much in labor but still a while away from giving birth. An epidural won’t last the entire labor if it is more than 24 hours before, which means it is imperative that women find other coping skills during the birth. Walking can be one of those coping skills and is one that is recommended by physicians. Standing upright and moving throughout the labor process helps the baby move down the birth canal a lot smoother than it would if mom is confined to the bed the entire time, according to Child Development Institute.
6 Don't Push!
There comes a point in labor when the baby’s head begins to crown. It is at this time that a mother may tear if the head comes too fast. Once the crowning becomes evident, the delivering provider will have Mom slow down her pushing or stop altogether to slow the head’s movement. According to What To Expect, there are several reasons nurses and doctors will have us stop pushing. It could be because the doctor is not present yet, the cord is wrapped around the neck, or the most common—to prevent tearing. Sadly, some mothers are even encouraged to hold their legs together instead of listening to their own instincts and pushing when they feel the urge—the safest way to birth. That said, mothers who are medicated may not feel said urge at all.
5 Where Is The Doc Anyway?
Doctors headline the show, or so we are told. Truth be told, Mom is the headliner. But doctors are the ones who we meet with during appointments and those who help us deliver the baby when it is time. But when a mother is actually in labor, it is rare that the doctor will spend more than a few minutes at a time with her until she is actively pushing, though midwives are known for staying with patients the entire time. According to Parents Magazine, it is common for doctors to only check in every once in a while until the mother is ready to deliver because they will often have more than one patient giving birth. Doctors are spread pretty thin, and it’s important to remember we aren’t their only patient. Still, this is a reason many women choose midwives instead now.
4 C-Sections Galore
Giving birth by C-section is not something doctors can do without consent if the mother is awake and fully aware. But there are times when a pregnant mother will be come into the hospital unconscious or will become in danger while giving birth, and it is in these instances when a doctor can freely perform a cesarean section. This procedure can be difficult for mothers because the recovery time is a lot longer than if they were to give birth naturally. According to Glamour Magazine, mothers should be aware that there are some doctors out there who will recommend a C-section merely to speed the process up, but there are also times when the procedure is necessary for the health of mom and baby.
3 Bulb Suction The Infant
When a baby is born, it is common for them to have amniotic fluid in their mouths and up their noses. While this may be okay while in the womb—because they are surviving through the umbilical cord—once the ties to mom through the cord are severed, they must begin to breathe on their own. According to Hopkins Medicine, the baby should immediately start to turn pink and make some motions to cry within seconds, and if they don’t, it could mean they have fluids in their lungs—this is where suctioning comes in. It can be scary, but it's essential to remember doctors do this all the time.
2 We Need A Little Assistance
Sometimes, a newborn child has a tough time coming out of the birth canal, especially if mom is poorly aligned or the baby was malpositioned. Sometimes their shoulders will get stuck on a hip or something of that nature and forceps are needed to interfere and safely deliver the baby. According to Mayo Clinic, the forceps are similar to salad tongs and are placed around the baby’s head to guide it out. If Mom’s pushing is going nowhere and the baby is becoming affect—which will be evident by their heartbeat—then forceps are necessary for everyone’s safety.
1 Oh The helpful tear
During the birthing process, a baby's head can prove to be a bit big when trying to fit through the mother’s birth canal. If Mom is visibly struggling to push her baby out, the doctor may be inclined to perform an episiotomy to help deliver the baby. Doctors started to use this procedure with the mindset that a human-made tear that was controlled would be much easier to heal than a tear occurring on its own during the pushing stage, which we now know not to be true. According to the Mayo Clinic, they are quickly becoming outdated, but it is essential to be aware of the procedure since it is still being performed. It's important that women talk with their providers ahead of time and make it clear whether or not they are okay with being cut.
References: ACOG, What To Expect, American Pregnancy Association, WebMD, Baby Chick, HelloFlo, Medscape, East and North Hertfordshine, New Kids Center, Kind Mommy, Very Well Family, Child Development Institute, Parents Magazine, Glamour Magazine, Hopkins Medicine, Mayo Clinic,