Every mother-to-be hopes for a healthy pregnancy. Sometimes they are not so fortunate and have to deal with things that they never dreamt would happen to them.
Life has risks; so does birth. The goal of informed decision making is not zero-risk choice, but the choice with the risk most acceptable to the woman.
Also known as premature rapture of the membrane where the amniotic sack breaks before the 37 weeks’ gestation period and before labour starts.
This may occur as a result of infections in the amniotic fluid, bleeding from placental abruption, prior history of preterm labour, smoking, illicit drug use and low BMI or abnormalities on the shape of the uterus. Women who experience it will often report a large gush of fluid that has the consistency of water. It is diagnosed with a simple speculum exam or ultrasound showing low fluid.
Umbilical cord problem
Families are told every day that umbilical cord issues don’t cause problems yet this is the most common answer given on reasons for stillbirth. This hypocritical approach is not acceptable. During delivery, if the umbilical cord is compressed, the child suffers hypoxia which is lack of oxygen. The baby has to go to NICU to undergo body cooling in attempts to reduce the swelling of the brain. During prenatal visits, the ultrasound may show umbilical cord wrapped round the neck and arm. Extra tests are done to establish if the baby is in distress, then a C-section can be scheduled at 38 weeks of gestation.
Position of the baby
A baby’s head is the largest part of the body, when baby delivers head first the rest of the body follows. This position is helpful because the head can pivot up against the pubic bone, allowing the chin’s appearance to finish the delivery of the full head. There are variations from the standard head-first position, such as shoulder-first, transverse lie or breech presentation - a feet or buttocks-first presentation. Even if the baby presents head-first the face can be pointing down, up, even face-first.
A breech occurs when there is a problem and the lower uterus is not the biggest space. A low-lying placenta can occupy enough space so that there is more space higher in the uterus. Delivery is then effected via C-section. Obstetricians believe that successful vaginal deliveries of breech babies result in soft neurological signs – not brain damage, but Attention Deficit Disorder, dyslexia and hyperactivity.
Cephalopelvic Disproportion (CPD)
This is where baby’s head is too big to pass through the mother’s pelvis resulting in failure to progress and requiring a C-section. Causes of CPD include a large sized baby with can be caused by unusual presentation, contracted pelvis, gestational diabetes, pelvic exostoses (body growths on the pelvis) and spondylolisthesis (where a bone in the spine slips out of its proper position into the bone below it).
Some women are more prone to CPD and its risk factors include mothers older than 35 years, shorter than 5’3’’ in height, over 42 weeks gestational age and any history of pelvic bone tumours.
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