The idea of something going wrong during labour is terrifying, but most problems can be caught early and solved by your team of medical professionals. By Georgina Guedes
If a problem during labour and delivery arises, one of the simplest solutions is a C-Section. This is often referred to as an emergency Caesar, which makes it seem more alarming than it really is. In truth, the team of medical professionals looking after you, are trained to pick up any early warning signs that something might be wrong, and deal with them before there’s a problem.
We look at 8 of the most common birth complications that can arise and what to expect:
Although doctors and midwives support the mother’s perineum (the area between the anus and the vagina) as much as possible during labour, and use a lubricating gel to try and reduce friction during delivery, it’s possible for the tissues to tear as the baby’s head moves down.
“Vaginal tearing is one of the conditions that’s difficult to predict and therefore prevent,” says gynaecologist, Dr Peter Koll. “But a very bad vaginal tear is extremely rare, and small tears heal rapidly.”
A mild vaginal tear will heal with virtually no complications. A more serious tear, can lead to incontinence, but, while painful, usually heals fast. In some instances, where the perineum isn’t stretching sufficiently to allow the baby to pass, the gynae will perform and episiotomy – a controlled incision of the perineum – which can then be repaired with stitching. In most cases, the solution is suturing or surgery afterwards.
In most cases, vaginal tears represent a passing, only moderately painful inconvenience and are rarely a dangerous issue.
During labour in hospital, a non-stress test will assess how your baby’s heart rate responds to its own movements and rest. If the heart rate isn’t varying, it suggests that the baby isn’t getting sufficient oxygen.
“When these characteristics point to the possibility of cord compression, we turn the mother to relieve the pressure,” says Dr Tom Mokaya, a gynaecologist who practices at the Sunninghill Hospital in Johannesburg. “If they still persist, we then consider performing a C-Section if delivery isn’t imminent.”
If the baby’s oxygen supply is compromised during a prolonged labour, the possibility of brain damage or even death exists.
An emergency C-Section.
C-Sections present no great risk to the mom or her child.
Your baby’s in distress
This wording is used to describe the early warning signs that the baby isn’t coping well with the labour. “If we see the baby’s heart rate dropping or there’s meconium, the baby’s poo – visible in the ruptured waters, we will perform a C-Section unless the delivery is imminent,” says Mokaya.
If foetal distress isn’t detected early, there’s a risk of foetal brain damage or death.
An emergency C-Section.
If it’s picked up early, there’s a very low risk to both the mom and her baby.
You’re in distress
“Moms are generally distressed by the pain of labour, having pushed for too long, or anxiety,” says Mokaya.
This can lead to elevated blood pressure, and can usually be resolved with reassurance or different forms of pain relief.
Maternal distress is unsettling, but not dangerous, and isn’t harmful to the baby unless the labour has been prolonged and the mom hasn’t taken in sufficient food or water.
Reassurance and pain relief.
Although temporarily distressing, there’s very few long-term negative outcomes reported.
Most doctors agree that active labour, after the cervix has dilated 4cm, shouldn’t take longer than 10 –12 hours.
Labour can also be sped up with a pitocin or syntocinon drip, or by rupturing the waters. “If this doesn’t work, then we assume that the baby’s head is too large to pass through the birth canal, and we advise
a C-Section,” he says.
A prolonged labour can be potentially life threatening for mom and baby.
A quick C-Section to deliver the baby.
With early intervention, both the mom and baby will recover well.
Most pregnant women have heard of preeclampsia, a condition that they’re monitored for, after week 20 of their pregnancy.
If preeclampsia is detected through pain, blurred vision and protein in urine, the pregnancy will be closely monitored.
Preeclampsia is the precursor for eclampsia. “Eclampsia is seizures or convulsions in a pregnant woman that aren’t related to a pre-existing brain condition,” explains Dr Koll.
When eclampsia takes place during labour, the outcome isn’t good unless the situation is closely monitored.
Organ damage, coma and maternal or foetal death.
Careful management by a medical practitioner and a C-Section.
If detected early and managed carefully, both mother and baby should recover. In the long-term, the mother may suffer from a greater risk of heart disease, stroke or diabetes.
Baby getting stuck
Any mom who has contemplated the size of a newborn’s head and the size of her own birth canal has wondered whether the baby might get stuck during birth, but this is rare. Some gynaes recommend a C-Section if they suspect cephallopelvic disproportion – although it’s hard to be sure before the commencement of labour.
“Babies can get stuck in the birth canal,” says Mokaya. “Then we deliver with vacuum suction – forceps aren’t used much these days – but if this doesn’t work, we perform a C-Section, usually under
Without intervention, this could be fatal, but medical practitioners will act long before this becomes a concern.
Birth by quick C-Section.
Baby in breech
In almost all cases, a baby that is breech – lying with its head facing upwards instead of down into the birth canal – will be delivered by a C-Section. “If the baby is breech, but the mother is determined to have natural birth, she’ll be advised to deliver in a specialised unit by an experienced professional,” says Mokaya. “This will usually only be allowed if the baby isn’t
too big, and if it’s not
the mom’s first baby.”
Some babies also face upwards (if the mom is lying on her back), which is known as stargazing. Although the head is in the downward position, this isn’t the ideal position for birth, as the crown doesn’t come down on the cervix during contractions. “It is possible to give birth with the baby in this position, but if the labour takes too long, a C-Section is safer,” says Mokaya.
The risks are very slight because the problem can be picked up in advance.
Managed, specialised delivery or a C-Section.
Almost always a good one as this isn’t a risky procedure for mom or baby
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