Preparing for labor: Medical interventions during labor and birth
External electronic fetal monitoring
An ultrasound device is used to record your baby's heartbeat. This assesses your baby's well-being during and between contractions and records the contraction pattern. A pressure-sensitive device is used to record the strength of contractions. Both are held in place on the abdomen by a band or belt. This may be done constantly or on-and-off during labor.
The birth center staff may also monitor your baby's heart rate with a doptone, which is a hand-held monitor used from time to time, rather than constantly.
Internal fetal monitoring
When your baby or your contractions are difficult to monitor externally or when more accurate information about your baby's heart rate and reaction to contractions is needed, a small coiled wire electrode is placed on your baby's scalp to record the heartbeat.
A small tube may be placed inside your uterus to measure the strength of your contractions or add fluids inside your uterus.
IV (intravenous infusion of fluids or medicines)
To give fluids or medicines or to induce labor, you may have a small tube placed into a vein in your arm or hand. A needle is used to guide the placement of the tube and then is removed.
Medicines may be a valuable aid in labor, helping to reduce or relieve pain and allowing you to rest. But they are only one option available to you.
The choice of what to use for pain relief and relaxation is up to you and your health care provider. You are free to request or refuse medicines. But remember that medicines can only be given at certain times during labor, so they may not always be appropriate.
Suggestions from your health care provider and nurse about medicines are just that -- suggestions. Weigh their advice with your own choices. Many parents find it helpful to discuss pain medicine with their health care provider ahead of time.
Because some kinds of medicines may slow down labor, it's generally a good idea to put off taking them until you feel you can no longer work with your contractions and you can't rest between them. On the other hand, tensing and fighting the contractions can slow your progress.
When you take pain medicine can be as important as what you take. Babies are affected by medicine taken by the mother, but the extent to which babies are affected depends on the timing and the type of medicine. If enough time passes between the time you receive pain medicine and the time your baby is born, your body will process the medicine and your baby will have minimal effects from the medicine.
Your health care provider wants your baby to be as healthy and as active as possible. Your health care provider is familiar with the advantages and disadvantages of each medicine option and will share his or her knowledge with you. Your health care provider can tell you when it is safe and when it is not safe to take medicines and will carefully review with you the pros and cons of each.
If an anesthesiologist arrives to give medicine, the potential side effects and the desired results will be reviewed with you, too. Your questions are welcome. For more details, see Medicines used during labor and birth.
To prevent tearing and to speed up birth, an incision called an episiotomy may be made to enlarge the vaginal opening. It is made straight back toward the rectum, or off to one side. A local anesthetic or block is used to numb the perineal area, if needed.
Some health care providers regularly perform episiotomies. Others do so less often. Talk to your health care provider about why an episiotomy might be performed, and express your preferences.
To help move your baby down the birth canal or to speed up birth, a vacuum extractor may be used.
- A small plastic suction cup is placed on your baby's head.
- As you push, your baby is guided out of the birth canal.
This is used when the health care provider wishes to help lift your baby out. Your baby may have swelling and/or bruising where the extractor was applied.
When pushing is not helping to bring your baby down the birth canal, or to facilitate a speedier birth, forceps may be used.
Forceps look like two large, metal spoons. This pair of metal instruments may be used to guide your baby out of the birth canal.
Your baby may have some bruising that will last for a few days.