Complications of labour

Sometimes surgical intervention is required

The majority of babies are born vaginally, but an increasing number are born by Caesarean section.

The government has ordered research into the reasons for the recent increase in the use of Caesareans.

The National Childbirth Trust fears that part of the reason is doctors' lack of confidence in women's ability to deliver naturally and their fear of being sued if something goes wrong. But doctors argue that medical advances and better technology mean that they can intervene at earlier stages and save babies which would otherwise have died.

Induction:

About 10% of babies are currently delivered prematurely - before the 37th week of pregnancy.

In some cases, doctors have to induce the birth because of a risk to the baby or the mother, for example, if the blood supply to the baby is not adequate or the mother's blood pressure is high.

Induction involves either inserting a pessary or gel into the vagina and/or a hormone-type drug into the arm or breaking the bag of membranes and releasing the amniotic fluid around the baby.

The pessary or gel softens the cervix, encouraging labour to start.

The hormone-type drug sets off contractions. These usually begin quite soon after the procedure is undertaken and there is no gradual build-up as with natural childbirth.

Caesarean section:

This involves making an incision in the mother's abdomen and into the womb.

The cut is usually below the bikini line and is not very visible afterwards.

Women can choose to go for a Caesarean, but they have to have a sound medical reason, such as complications during a previous delivery or high blood pressure.

However, some develop complications during natural childbirth and have to undergo an emergency Caesarean.

Usually the mother can have an epidural and stay awake during a Caesarean, but, if there is an immediate danger to the baby or mother, she may have to have a general anaesthetic.

With an epidural, the pelvic area is numb and the woman does not feel any pain.

Her partner is usually allowed to be present at the birth.

Mothers who have Caesareans generally have to stay in hospital for at least four days after the operation so that they can be monitored for blood clots, high blood pressure or other possible complications.

Since a Caesarean involves major surgery, they are not allowed to drive for six weeks or lift heavy objects.

Forceps/Ventouse:

Some women who give birth vaginally can develop problems during labour, requiring extra help to get the baby out.

For example, the baby can become stuck in an awkward position and become distressed or the woman may get so tired during the labour that she cannot push hard enough.

Babies born in the breech position - where the bottom comes out first - will usually be delivered by Caesarean if the doctor cannot turn the baby around beforehand, but if they are born naturally forceps are likely to be used.

The woman may then be given a local anaesthetic and forceps inserted around the baby's head or a suction cap or ventouse fitted to the baby's head.

The doctor will then try to pull the baby out.

Both these methods of delivery may leave marks on the baby's head, but these fade soon after birth.

Many women who need a forceps or ventouse delivery require an incision to be made in the vagina/perineum area known as an episiotomy. This requires stitches to repair the incision following delivery.