3.4: Medical Interventions in Childbirth
- Page ID
- 233830
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Sometimes women cannot go into labor on their own and/or deliver vaginally. In this case two procedures will be considered -
- Induction of labor
- Cesarean Section
Induction of Labor
Sometimes a baby’s arrival may need to be induced before labor begins naturally. Labor induction means getting the uterus to contract before labor begins on its own. It's sometimes used for a vaginal birth. There are a number of ways to induce labor including the use of medication or physical intervention.
The main reason to induce labor is concern for the health of the baby or the health of the pregnant person. If a healthcare professional suggests labor induction, it's most often because the benefits are greater than the risks. If you're pregnant, knowing why and how labor induction is done can help you prepare.
Induction of labor may be recommended for a variety of reasons when there is concern for the health of the mother or the baby. For example:
- mother is approaching two weeks beyond her due date and labor has not started naturally
- mother’s water has broken (premature rupture of the membranes), but contractions have not begun
- baby has stopped growing at the expected pace (fetal growth restriction)
- not enough amniotic fluid surrounding the baby (oligohydramnios)
- placenta peels away, either partially or completely, from the inner wall of the uterus before delivery (placental abruption)
- mother has a medical condition that might put her or her baby at risk
- high blood pressure
- diabetes
- kidney disease
- infection
Cesarean Section (C-section)
A C-section is surgery to deliver the baby by through surgical incisions made in the abdomen and uterus. Most C-sections are done when problems occur during delivery unexpectedly. These can include:
- health problems in the mother (heart, brain)
- changes baby's heart rate shows signs of distress in the baby
- prolonged labor (labor dystocia)
- prolonged first stage (prolonged dilation or opening of the cervix)
- prolonged second stage (prolonged time of pushing after complete cervical dilation)
- not enough room for the baby to go through the vagina
- baby is in a breech presentation where the feet or buttocks (instead of the head) enter the birth canal first
- placenta is covering the opening of the cervix (placenta previa)
- loop of umbilical cord slips through the cervix in front of the baby (prolapsed umbilical cord)
- a blockage
- large fibroid blocking the birth canal, a
- pelvic fracture
- baby who has a condition that can cause the head to be unusually large (severe hydrocephalus) might be reasons for a C-section.
C-sections are also more common among women carrying more than one baby. Although the surgery is relatively safe for mother and baby, it is considered major surgery and carries health risks. Additionally, it also takes longer to recover from a C-section than from vaginal birth. After healing, the incision may leave a weak spot in the wall of the uterus. This could cause problems with an attempted vaginal birth later. In the past, doctors were hesitant to allow a vaginal birth after a C-section. However, now more than half of women who have a C-section go on to have a vaginal birth later. This is referred to as a Vaginal Birth After Cesarean (VBAC).
Sources
- Lally, Martha and Suzanne Valentine-French. Lifespan Development: A Psychological Perspective. Licensed under CC BY-NC-SA 3.0
- Mayo Clinic Staff. Labor Induction. Mayo Clinic.
- Mayo Clinic Staff. C-Section. Mayo Clinic