Childbirth Services

Childbirth Services

One of the most challenging events in life is giving birth to a baby. Additionally, many women and their partners find the nine months of pregnancy to be an exciting period. They could experience emotions ranging from happiness and optimism to worry and fear: How will things turn out? Do I have this right? How will things change after the baby is born?

A woman's body undergoes a lot of astounding changes as she gets ready to carry and grow a new life, from conception to delivery. To provide the unborn kid with what he or she requires, a new organ called the placenta is produced. More water is retained by the woman's body, and more blood is circulating than previously. Early on, both of these alterations manifest in an early increase in body weight. The breasts' mammary glands become ready to start making milk. To enable natural birth, connective tissue, ligaments, tendons, and muscles become more flexible. Hormones are responsible for causing and maintaining all of these changes. The body makes more hormones during pregnancy than at any other point in its existence.

 

What is Childbirth?

Childbirth usually referred to as labor and delivery, is the end of pregnancy in which one or more babies leaves the birthing parent's body naturally or through a Cesarean section. There were roughly 140 million births worldwide in 2019. While most births in the developing world took place at home, most in the developed world took place in hospitals.

 

What are Childbirth Services?

The following comprise the main childbirth services offered by most hospitals and childbirth centers:

  • Labor Services {including normal vaginal delivery and cesarean section)
  • Fetal monitoring during childbirth
  • Postpartum care (the care after delivery of the baby)

 

Who Oversee Childbirth?

Childbirth

Hospital childbirth is supervised by a range of medical personnel:

  • Obstetrician/gynecologists (OB/GYNs) are medical professionals who have completed at least four additional years of training in women's health and reproductive issues, including both surgical and medical care. They can perform C-sections as well as manage problematic pregnancies.
  • A board-certified obstetrician has successfully passed an examination administered by the Board of Obstetrics and Gynecology. Maternal-fetal specialists, also known as perinatologists, are board-certified obstetricians who take additional education in high-risk pregnancies.
  • A certified nurse-midwife (CNM) may also be available to you if you give birth in a medical facility. Registered nurses with graduate degrees in midwifery are known as Certified Nurse-Midwives (CNMs), and they are prepared to manage low-risk pregnancy and delivery. Although some CNMs perform home deliveries, the majority deliver babies in hospitals or birthing facilities.
  • To care for the mother and child, registered nurses (RNs) may attend childbirth. A teaching hospital may have medical students or residents present if you give birth there. Some family physicians also perform deliveries and provide prenatal care.

Anesthesiologists will give anesthesia (a numbing agent) as needed. The hospital setting offers a range of pain-control options, including pain medication and local, epidural, and general anesthesia.

 

Childbirth at Hospital

Childbirth at Hospital

The most typical choice is still traditional hospital births. This implies that the expectant mother transitions from a labor room to a delivery room, then, following the birth, to a semiprivate room. In a birthing facility:

  • If a woman needs painkillers during labor and delivery, they are available.
  • If needed, labor can be induced.
  • Usually, the infant is continuously monitored throughout the entire labor process.

Doctors manage childbirth procedures alongside their patients. A birth plan can assist a woman in stating her choices, and her doctor will try to accommodate these.

Nowadays, many hospitals provide more choices for low-risk deliveries, also referred to as family-centered care. These could consist of birthing suites, which are private rooms with bathrooms where women can give birth without having to be transferred.

Still on hand are a doctor and medical personnel. However, the rooms provide a nurturing environment with soft, warm colors and features that attempt to mimic a homey atmosphere that may be extremely pleasant for new mothers. It's also more typical to room in, which is when the infant spends the majority of the time with the mother rather than in the nursery.

Numerous hospitals provide parenting sessions after birth as well as childbirth and prenatal education sessions to prepare parents for childbirth.

Depending on the hospital, birth may be attended by a variety of persons. Three support people at the most could be present during a vaginal birth in more-traditional environments. More family members, friends, and occasionally even children may be permitted in a family-oriented setting. Typically, only one support person is permitted during a routine or nonemergency C-section.

 

Childbirth at Birth Center

Childbirth at Birth Center

Most women who give birth in birth centers have already given birth without issue or are pregnant with low risk (meaning they are in good health status and are not likely to have complications).

Prenatal care is provided at the birth center to women who have undergone careful screening early in pregnancy to track their health.

Birth centers typically do not provide epidural anesthesia. So, while a woman is giving birth, she is free to move around, adopt the positions that are most comfortable for them, spend time in the jacuzzi, etc. Comfort measures are frequently employed, including hydrotherapy, massage, warm and cold compresses, visualization techniques, and relaxation techniques.

Birth centers employ a range of healthcare workers, including registered nurses, CNMs, and doulas (trained professionals who give labor support and postpartum care). Medical interventions are uncommon, and a doctor is typically not present. However, the majority of birthing facilities collaborate with obstetric and pediatric experts. During a woman's pregnancy, labor, and delivery, nurse-midwives offer care. She has access to OB/GYN consultants in case she experiences issues that raise her risk level.

Throughout labor, the baby's heart rate is frequently checked using a portable Doppler device. The medical supplies needed to treat unwell newborns and mothers are provided in birth centers, including IV lines and fluids, oxygen for the mother and the child, and other items.

A birth center can offer both natural pain relief and pain relief with non-addictive narcotic medications. However, a woman must be transported to a hospital if she decides she wants an epidural or experiences complications.

Birth centers offer a comfortable environment for the woman, the baby, and the larger family. They are mostly standalone structures, though some are attached to the hospital. They frequently have facilities including individual rooms with dim lighting, baths, whirlpool spas, and a family kitchen.

Choose a birthing facility that has earned the Commission for the Accreditation of Birth Center (CABC) seal of approval. Make sure the birth facility you choose has all the necessary certifications because certain states regulate birth centers.

 

Labor Services

Labor Services

The three stages of labor that constitute childbirth, the dilatation stage, the expulsion stage, and the placental stage, typically begin with contractions. Every woman experiences childbirth differently and at her own pace.

 

Dilation Stage

The dilatation stage is the first phase of labor. To let the baby descend into the vagina and be delivered at this point, the cervix, or neck of the womb, must pull to either side and open.

The cervix opens up by 10 cm (fully dilated) from its closed state. The baby cannot be delivered until it has fully dilated.

There will be some blood-tinged vaginal discharge, also known as the bloody show, as the cervix dilates. This is a sign that the baby's head pressure and the impact of the contractions are causing the cervix to dilate. Any time throughout labor your waters could burst, however, this normally happens during the active phase of the dilatation stage.

The latent phase, which initiates the dilatation stage, is the first and longest stage of labor. When your regular contractions are less than 10 minutes apart, this phase begins. At first, the contractions are far apart, but over time, they get stronger and happen more frequently.

Labor enters the active phase when the cervix has dilated to about 4-5 centimeters. The cervix opens faster as the contractions get more intense.

 

Expulsion Stage

Now, you'll be pushing your baby out with each contraction. You will be pushing your baby down into your vagina and out, contraction by contraction, with the help of the force of the contractions. You must discover laboring positions that allow you to rest in between contractions and push during the following one.

In this stage of labor, it can be beneficial to switch up your delivery positions. This aids in your baby's rotation and pelvic passage downward. The midwife will assist you in determining delivery positions that are beneficial to you and speed up labor.

The moment the baby's head and body are about to be delivered; the midwife will instruct you on how to push. To make the birth as comfortable as possible for the baby and to avoid you tearing, you and the midwife will need to work together at this point. The tissue between your vagina and anus (perineum) will be supported by the midwife as the baby's head and body are delivered.

 

Placental Stage

Although your kid has been born, the delivery process is still ongoing. Additionally, the placenta and fetal membranes must be delivered. This typically occurs within the first hour or so of the baby's birth. The fetal membranes and placenta are expelled from the womb and fall toward the vagina.

You might experience a slight contraction when the placenta separates, and there might be some vaginal bleeding. You must push the placenta out once it has detached internally, just as you did when you gave birth to your child. Although it may be uncomfortable, this is not painful.

There will be a wound where the placenta was attached to the uterus, which results in menstrual-like bleeding and also causes the uterus to contract as it should. The midwife must examine the vaginal canal for any tears after you have given birth. You'll receive anesthesia if any tears require stitching. The stitches do not need to be removed because the thread used to tie them dissolves on its own.

As soon as your child is delivered, you will take him or her into your arms. Babies begin to seek out their mother's breast as soon as they are born. You, the father, or another caregiver must enjoy undisturbed quiet time with the infant.

After going through childbirth and all those emotions, you'll need to relax. To find your breast and feed for the first time, your baby needs silence, calm, and your entire attention. This is a crucial moment that shouldn't be unnecessarily disrupted.

 

Childbirth with Cesarean Section

Cesarean Section

Cesarean sections can be carried out either as a planned surgery or as an emergency operation, but they should only be conducted when required and when there is a legitimate medical justification for doing so.

 

Planned Cesarean Section

If a cesarean section is recommended, the baby will be delivered a few days ahead of the due date established during the week 18 scan. Depending on the need for the procedure, the date of the cesarean section will be chosen toward the end of your pregnancy.

Following the selection of the cesarean section date, you will receive instructions regarding the time to report to the hospital, the preparations required before the procedure, and the general guidelines you must adhere to following the procedure.

The day before or a few days before the procedure, you will typically be requested to visit the hospital so that blood tests can be obtained and you can meet with the obstetrician, anesthesiologist, and midwife. After this, some patients leave the hospital and return in the morning on the day the operation will be performed, while others choose to spend the night there.

 

Emergency Cesarean Section

An emergency cesarean section may be required if there are difficulties during labor. If a cesarean section is necessary and, if so, how quickly, the procedure should be done, will be determined by the obstetrician.

For you and your companion, the primary distinction between a planned and an emergency cesarean section is the time the medical team has to get everything ready and explain it to you.

It will be crucial to moving promptly if the operation must be done right away due to your child's condition or your health. The length of time we have to inform you and explain what is about to happen will be shortened as a result.

 

Fetal Monitoring During Childbirth

The health of your baby can be checked on in several ways by midwives and doctors both before and during delivery. How well your pregnancy went, whether you and your baby are healthy and everything is in place for normal birth, or whether there are any factors relating to you or your baby that will require further monitoring, can all influence the level of fetal monitoring during birth.

 

Pinard Stethoscope

Pinard Stethoscope

Immediately above the area on your tummy where your baby's heartbeat is most audible, a Pinard stethoscope, which is a hollow wooden tube, is placed. The midwife or doctor can hear your baby's heartbeat using a Pinard stethoscope.

Midwives and doctors refer to the baby's heartbeat during birthing as the fetal heart sound. The frequency and regularity of the fetal heart sound are characterized. The normal range for the fetal heartbeat is between 110 and 160 beats per minute.

The fetal heart sound will give you essential information on how your baby is doing and how it is reacting to the delivery, together with data on the amniotic fluid (once your membranes have broken) and your baby's activity levels. An accurate indication of the baby's health throughout delivery will be provided by the fetal heart sound.

Throughout the birth, the midwife will keep an ear out for the fetal heartbeat. The midwife will check more frequently toward the end of labor when the baby is descending the narrowest portion of the birth canal. The baby has the biggest stress during the final stage of labor.

 

Doppler Fetal Monitor

Similar to a Pinard stethoscope, a Doppler fetal device is an electronic tool used to listen to the baby's heartbeat or fetal heart sound. The Doppler fetal device differs in that it is an electronic instrument with a speaker so that everyone in the room can hear the fetal heart sound.

The baby will be monitored, if necessary, continuously during the birth if the midwife or doctor is unsure or notices indicators that the infant may be having some difficulties.

 

Cardiotocography (CTG)

Cardiotocography

CTG is a type of electrical heartbeat monitoring for infants. Doctors can evaluate the baby's heartbeat and the frequency of contractions with the help of this monitor. This will provide you with a clear image of your baby's health and ability to handle the birth.

Two electrodes or transducers will be applied to your abdomen for CTG monitoring, and they will be secured by an elastic belt. The heart rate of the unborn child will be monitored by one, and the contractions by the other. On the CTG device's monitor, which can be printed, the heartbeat and the contractions that were recorded are both displayed.

The device itself can monitor the baby's kicks and movements, or you can record them by pressing a button each time you notice the baby move.

The infant will be continuously monitored if there are any indications that it is in distress or is likely to have problems during delivery (such as birth after a complicated pregnancy or one in which the mother or baby is unwell). Each situation will require a review of this.

An electrode needs to be directly attached to the infant to monitor the infant more precisely and reliably. The midwife or doctor will apply the electrode to the infant's skin during a vaginal examination. This will feel like a tiny prick to the infant.

 

Fetal monitoring with STAN

This approach was created to identify kids whose developing cardiac muscles under-oxygenation at birth. Compared to CTG alone, the approach offers more details regarding the health of the infant. STAN is a fetal monitoring technique applied to high-risk deliveries that occur at full term.

In addition to CTG, STAN is utilized during active birth to analyze the baby's ECG. ECG is a technique for evaluating how well the heart is working; it is used, for instance, to determine if the heart muscle cells are receiving enough oxygen.

 

Postpartum Care

Postpartum Care

Management of the mother, newborn, and child during the postpartum period is included in postpartum care. Although this time frame is typically thought of as the first few days following delivery, it covers the six-week window following labor up to the mother's postnatal check-up with her healthcare practitioner.

A new mother suffers significant physical and mental changes right after giving birth. She might spend as little as 24 to 48 hours in the hospital or childbirth facility following delivery. The postpartum care a woman receives both physically and emotionally can have an impact on her for the rest of her life.

 

Vaginal Birth after Cesarean Section (VBAC)

The majority of women who have undergone a C-section may later be able to give birth vaginally. You have a better probability if:

  • During your C-section, the doctor made a horizontal cut in your uterus known as a low transverse incision.
  • An average-sized infant could fit in your pelvis.
  • Rather than having multiple babies, you are only having one.
  • Breech labor warranted your first cesarean delivery.

Most frequently, it takes labor to start before it is determined whether a cesarean delivery is necessary. Following a cesarean delivery, you are more prone to experience uterine rupture during subsequent vaginal deliveries.

 

How Much Does Childbirth Cost?

The average cost of vaginal birth in the United States is $13,000, which includes typical prenatal and postnatal costs such as facility and physician fees. The average cost of a cesarean section (C-section), including typical prenatal and postnatal fees, is $22,500.

 

Conclusion

Most pregnant women experience mixed emotions as labor eventually begins toward the end of the pregnancy. Many women diligently prepare for it, yet no one can predict how it will be. It's reasonable to feel a little worried at least. Only to a limited extent can a birth's course be predicted, including how long it will take, how painful it will be, and whether any complications would arise. Only when the infant is present do these things become apparent.