What to do if the baby does not want to be born?
Pregnancy has a average duration of 40 weeks, but babies born between 38 and 42 weeks are also considered full term, ie with a difference of fifteen days before or after the presumed date of delivery. However, if the pregnancy continues beyond the expected mother and baby are subjected to continuous checks and monitoring to verify their state of health and if 10-14 days beyond the DPP (presumed date of birth) are exceeded, the gynecologist decides to intervene by administering drugs to induce the labor and childbirth.
We have come to an end, tired and weary and we can't wait for the baby to be born. The suitcase is ready, the layette as well, but he just doesn't want to know about coming into the world! So our gynecologist decides to keep us under control, he makes us perform the "traces" (cardiotocography or monitoring) to monitor the baby's heartbeat and to see if the device detects any contraction but nothing seems to move it. So one fine day, when we are now in 42st week the gynecologist explains the situation: the placenta is now old and continuing to carry on the pregnancy could mean making the baby lack nourishment and oxygen, in addition, the amniotic fluid could also drop too far below normal levels (oligohydramnios) creating problems to the child, so you have to intervene ... INTERVENE?? HOW? There are several methods and also in other cases, if it occurs that the child is growing too much (fetal macrosomia) or if the mother suffers from pregnancy diabetes or gestosis (in this case even before the 41st week) it is decided to give her birth with a little help.
Read also: Childbirth after the deadline
Pregnancy beyond the term, what to do
- The induced delivery
In this case, specific drugs are used that induce the initiation of labor in childbirth artificially stimulating the onset of contractions. Naturally, the pregnant woman must be monitored constantly as well as the baby, therefore the administration of drugs (prostaglandins) to start labor must be done under strict medical supervision, who will decide on a case by case basis whether to continue or intervene in other ways.
- The guided birth
If labor has started but the contractions are not strong or rhythmic enough to not allow proper dilation of the uterine cervix, the gynecologist may decide to pilot the birth, guiding its progress through specific drugs (oxytocin) which regulate contractions and labor. This technique it is used only where labor has already started spontaneously, but help is needed to shorten the time
- The drugs that help us
If the gynecologist decides to intervene, depending on the situation, they will be used prostaglandins and oxytocin. Prostaglandins are natural substances generated by the body, but in this case where the woman does not produce them or not enough to trigger labor, they are administered artificially produced, in the form of gel or glow plugs. They are introduced into the vagina at intervals of 6/12 hours, 2/3 times; these have the task of softening the cervix helping it to dilate and to initiate contractions. Through these substances the cervix prepares for childbirth
L'oxytocin is a hormone produced by the pituitary and is used to cause contractions where they do not appear spontaneously, but also to regulate them in the event that the labor is already started. It is administered in the form of an intravenous drip and the quantity depends on the response given by the body of the individual pregnant woman.
- How they control us in the event that the birth is induced or controlled
La pressure of the mother must be constantly monitored as due to these drugs it could undergo a sudden rise, especially if the mother already suffered from arterial hypertension; The collaboration on the part of the parturient is fundamental, who must immediately inform the medical staff of the appearance of any signs such as migraine, nausea, drowsiness, blurred vision, etc. In these cases, in fact, it could be decided to immediately suspend the drugs. The baby, on the other hand, must be kept under control with the cardiotocograph, which detects the heart rate highlighting any suffering, checking the quantity of the amniotic fluid through ultrasound of the flap and amnioscopy that allows you to check if the amniotic fluid is "clean" or if it has traces of meconium, blood etc.
- Sometimes amnioressi is needed
Amniorexis is the artificial rupture of the amniotic sac. From personal experience I can guarantee that it is absolutely painless and indeed of immense relief as once the sack is broken the baby will take very little to be born! To practice l'amnioressi the gynecologist or midwife will use a small pointed instrument that, touching the membranes, will break them causing the loss of the mucous plug and amniotic fluid. In this way the contractions will become more regular and labor will become faster and shorter
- When should these methods not be used?
If the mother suffers from severe eye problems, if she suffers from asthma, if she has placenta previa (ie in front of the "exit"), if there is bleeding in progress, if the baby's estimated weight is under 2 kg or if it is too large and a fetal-pelvic disproportion is suspected or if the trace shows a fetal suffering. Sometimes also in other cases, if the pregnancy is twins or if the pregnant woman has undergone a caesarean section at a close distance, the possibility of inducing birth by natural means can be excluded.
- What if an emergency caesarean is needed?
In some cases, when problems arise during labor, whether it arose spontaneously or was induced, it is considered necessary to resort to cesarean section (emergency cesarean).
The cases are these:
- the baby has the umbilical cord around the neck which prevents its influx;
- the baby's heart rate suddenly drops, revealing pain;
- the cervix does not dilate enough despite the drugs administered;
- a detachment of the placenta occurs;
In these cases the parturient is prepared for the surgery and if the situation is not critical she will be able to see the newborn baby because spinal anesthesia will be done.