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Intervention during labour and birth

Like the babies they result in, every labour is different. While some women will give birth naturally, without any intervention at all, others need a little extra help along the way. Here’s a look at some of the procedures and other forms of assistance you may encounter…

Having your waters broken
Your baby sits in a bag of fluid inside your uterus called amniotic fluid or your ‘waters’. Breaking the waters manually (called amniotomy) is often used to bring labour on if things aren’t coming along as they should be. So if you need to be induced for whatever reason, part of the process will include breaking the bag of waters. If your labour has slowed then your midwife or doctor may also suggest breaking the waters to get your contractions going again.

To break your waters, your midwife or doctor will insert two gloved fingers into your vagina and pass a small, flat hook into your cervix opening, which she will use to break the bag. The process isn’t painful, but you may find the vaginal examination a little uncomfortable. Once the bag is broken you’ll feel a warm gush of fluid and will need to wear a pad. After your waters have been broken, you are then committed to giving birth within a certain time frame to avoid the risk of infection.

Emily had her waters broken during the birth of baby Mason.

Receiving a syntocinon drip
Oxytocin, a hormone that’s produced in the brain, is responsible for starting and maintaining contractions in labour. Syntocinon is the man-made form of this hormone and is similarly used to get labour started, or to keep it going if your contractions slow or stop. Your midwife or doctor will put a small plastic tube into a vein so a drip can be started and the syntocinon can be added.

Many women say syntocinon brings contractions on more strongly, so pain relief is often required when it’s administered. Too much syntocinon can affect bub, so it’s given in a controlled manner to ensure you don’t get too much too quickly.

When Rebecca needed to be induced due to gestational diabetes, a syntocinon drip helped get her labour started.

Having a vacuum used
A ventouse is a suction device which is used to help deliver bub when there’s a delay in the second (pushing) stage of labour.

This device is often used when the baby’s head can be seen but won’t come out the whole way. The doctor applies a small cap to bub’s head, through which suction gradually builds until it holds to the scalp, then, when you have your next contraction, the doctor will assist your pushing by pulling on the cap. This is the preferred form of assisted delivery as it’s gentler on bub, and your internal passage, than forceps. After a ventouse birth, it’s normal for swelling to develop on bub’s head in the shape of the cup. This is not painful and will disappear in just a few days. Generally, if bub has not progressed after three pulls, forceps or a caesarean will be advised to help get him out.

Needing forceps
Forceps are instruments used to help deliver your baby when there’s been a significant delay in the second stage of labour. The forceps are shaped and fitted to cause minimal damage to the baby’s head, however if they aren’t applied properly they can cause some bruising to the face and head. The ventouse is generally used prior to forceps as it’s less traumatic for both mum and bub, but in an emergency forceps can be lifesaving. If the doctors are concerned about whether they’ll be able to deliver your baby with forceps they may choose to move you to theatre for the delivery in case you need a caesarean.

When baby Hayley got stuck, doctors used forceps to help her into the world.

Having a caesarean
The caesarean rate is very high in Australia (around one in three births), so most hospitals have introduced guidelines that encourage vaginal births. However, caesareans do have their place and can be lifesaving if needed. The process requires a specialist obstetric doctor to cut through the lower abdomen to deliver the baby and is usually performed under an epidural. Like any surgery it carries risks, such as infection and blood loss, and may have an effect on your future births – but remember one caesarean doesn’t mean that all of your babies will be born this way.

When Kylie's heart rate got out of control, doctors performed an emergency caesarean to get baby Emma out quickly.

Receiving an epidural
Many women have epidurals for pain relief during labour. An epidural is classed as an intervention as it can lead to additional procedures as a result of side effects – you may need a drip to combat low blood pressure, a tube inserted into your bladder because of reduced sensation to pee, or you may require syntocinon if your contractions slow. If you do end up needing any of these, don’t worry – remember that they’re common and just what you need to get your baby out.

Andrea had an epidural during the delivery of her twin daughters Ebony and Phoebe.

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