Expecting the Unexpected: When Your Delivery Doesn't Go As Planned

by Brenda Stokes

Genital Trauma: When intervention procedures are required during delivery due to fetal distress, a breech baby, or other birthing problems, genital trauma can occur through the use of delivery instruments such as forceps, vacuum extraction, or the episiotomy procedure. However, "lacerations to the perineum, labia, or peri-urethral area may occur with either spontaneous or instrumented delivery," says Dr. FitzSimmons.

Fetal Distress: When your baby's heart rate becomes irregular or slows in the womb, emergency action often is taken. Any time the fetal heart rate becomes unpredictable or makes your practitioner uneasy, intervention procedures may become a necessity.

Fetal heart rate can become worrisome to your practitioner when it falls outside the normal levels due to lack of oxygen. Should this occur, C-section, the use of delivery instruments, or induction may be required for a safe delivery.

Meconium Staining: This condition occurs when your baby has passed his first bowel movement while still in the uterus, says Robin Elise Weiss, LCCE, author of The Everything Mother's First Year Book. At birth, there is the risk that baby will breathe in the meconium, causing meconium aspiration syndrome or pneumonia, says Dr. Broussard.

As meconium staining is a potential sign of fetal distress, doctors often monitor these laboring moms much more closely. For example, a baby who is not getting enough oxygen will have a relaxed sphincter, causing meconium to be released. At delivery, the caregiver must be prepared to suction to remove as much meconium as possible before Baby takes his first breath, says Dr. Broussard.

Infection: Infection is possible both prior to and during delivery, especially of the amniotic sac or the uterus. Such infections can cause preterm labor, membrane rupture, and miscarriage in serious cases. A single vaginal infection can often spur on more serious infections, which is why regular prenatal exams are important. A good round of intravenous antibiotics for the laboring mom and sometimes postpartum mom and child typically beat the infection.

Postpartum Hemorrhage: Sometimes after giving birth, new moms lose a large amount of blood resulting in postpartum hemorrhage. This condition occurs when the uterus fails to contract strongly enough to either detach and deliver the placenta, or compress vessels in the area to stop them from bleeding freely. Close monitoring is required in this stage, as surgery may be required. Oftentimes, manual massage of the abdomen to help encourage the uterus to contract can solve the problem. If surgery is necessary, procedures include the removal of placental pieces, the insertion of sterile sponges to compress and stop the bleeding, the tying off of blood vessels, and in severe cases, hysterectomy.

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