09 Mar Instrumental Births and C-Secton Births in Ireland
Sometimes ‘the baby makes the plan’…. And that’s okay!
Every year there are more normal vaginal births than any other mode of birth, and it is important not to lose sight of that while reading this blog. However, it is important to be aware of the other ways by which your baby might come into this world.
At The Baby Academy we know that knowledge is power, and in the lead up to birth there are actually things that we can do (and not do) which will help ensure that our babies are in the best position for birth… this alone can hugely increase your chances of a nice, smooth labour and birth, as if your baby is entering your pelvis in an optimal position it makes sense that it will be an easier journey for him to navigate.
So, what are these magic do’s and don’ts:
- Keep upright, especially in last 6 weeks of pregnancy
- Sit with your knees lower than your hips… and avoid long car journeys
- When sleeping, lye on your left side with your upper leg forward so the knee touches the mattress
- Go swimming or walking
- Try not to sit with your legs crossed
- If your baby is in a ‘back to back’ position, try a hands and knees position x 20mins daily
- If your baby is in a breech position, try www.spinningbabies.com
If, despite following all these suggestions, your baby runs into a bit of bother during your labour…. And as we know sometimes the best made plans do not always run smoothly, I can promise you that you will find it much easier to keep calm if you have a little awareness around what to expect.
So, put simply:
Why might my baby be born by Emergency C-Section?
Firstly, just to clarify, an emergency C-Section describes any C-Section that wasn’t the original birth plan. The two most common reasons for an emergency C-Section are 1) Failure to Progress in the 1st Stage of labour and 2) Fetal-distress in the 1st Stage of labour. In the 1st stage of labour the cervix is not yet fully open a C-Section can be the only option. From time to time a C-Section might be performed at 10cm dilated, there are a few reasons why this might happen but typically it would be a decision your obstetrician might make based on their expertise and good foresight.
- Failure to progress in the 1st Stage is the terminology used to describe a cervix that is simply not opening as we would expect it to, and despite us trying every trick up our sleeve (artificial rupture of membranes and an oxytocin drip) there has been no change. Babies are only designed to be in an actively labouring womb for a finite amount of time-so sometimes, we need to make the tough call to perform a C-Section.
- Fetal-distress in the 1st Stage describes a baby who is showing signs of distress both when we observe his heart rate and also on analysing a blood sample from his head… we can actually use this blood sample to check your baby’s O2, CO2 and PH levels which will give the bigger picture when planning for delivery.
If a C-Section is recommended you will be brought to the operating theatre, where your partner will in most cases be welcome to join you. Once baby is born he will be passed to the paediatrician, where he will have a head to toe check, his weight measured, a Vitamin-K injection, and then brought back to his Mummy for a snuggle and a bit of skin to skin. We always aim to have your baby breastfeeding within the 1st hour of birth and a C-Section is absolutely no different.
After a C-Section you will be in hospital for 4-5 days and you will have a small abdominal wound (approx. 10cm long). We recommend after having a C-Section that you lift nothing heavier than your baby for the first 6 weeks and to wait for your GP to let you know when you are fit to drive and return to exercise.
Why might my baby be born using an instrument? (Ventouse / Vacuum or Forceps)
The two most common reasons for an instrumental delivery are 1) Failure to Progress in the 2nd Stage of labour and 2) Fetal-distress in the 2nd Stage of labour. As the cervix is now fully open and your baby is more than likely in the birth canal it is possible to use an instrument to aid delivery when needed.
1) Failure to progress in the 2nd Stage is the terminology used to describe a situation whereby your baby is not moving down through the birth canal as we would expect, and despite us trying every trick up our sleeve (changing your position, giving advice on pushing technique) there has been little or no movement. Babies are only designed to be in the birth canal for a finite amount of time-so sometimes, we need to make the call to assist this stage using an instrument.
2) Fetal-distress in the 2nd Stage describes a baby who is showing signs of distress when we observe his heart rate while he is making his way down through the birth canal. Baby’s are designed to withstand a little bit of distress in the 2nd stage however once they surpass these normal boundaries any concern should be acted upon.
If an instrumental delivery is recommended, it is your baby’s position which will determine the choice of instrument used. Your obstetrician will apply the instrument to baby’s head and with the next contraction you will push as normal while your obstetrician gently guides baby through the birth canal (your midwife will be supporting you during this stage). Once your baby is born he will be passed to the paediatrician, where he will have a head-to-toe check, and then brought back to his Mummy for a snuggle and a bit of skin to skin. We always aim to have your baby breastfeeding within the 1st hour of birth and an instrumental birth is absolutely no different. Once baby has had a feed and an hour of skin-to-skin we can measure his weight and give his Vitamin-K injection.
After an instrumental birth you will be in hospital for 2-3 days, similar to a normal vaginal birth. If you required any perineal sutures it might be helpful to know that they will always be dissolvable and will take approx. 6 weeks to heal fully.
We know that C-Sections and instrumental births aren’t typically a choice that parents opt for, and it’s important that our parents know that midwives and obstetricians are always mindful of this, believe it or not we rather the normal too!! These special considerations are only considered when there is a concern around either the Mum or the babys wellbeing as the most important thing is a happy healthy Mum and a happy healthy baby.
If you have any questions around your birth it is really important that you ask these questions as soon as you think of them, ideally before you go home. A midwife or doctor will happily discuss your birth with you… questions answered will help you to process the whole situation.