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Methods of
Delivery - Dr.Satheesh
Labor is the climax of
the nine-month long ordeal of pregnancy. There are many methods by which a delivery can be
conducted. This article intends to give an overview of the various options.
Vaginal Delivery:
This is the natural and
the best method of delivery. The child is born via naturalis i.e., through the normal
reproductive tract of the mother.
The main force that
expels the baby is by the increased Intra-abdominal force brought about by straining. This
force pushes the baby through the pelvis of the mother. Normally the anatomy of the pelvis
allows the child to be delivered with just this force alone. When there is some
abnormality in either the structure of the pelvis or the size and position of the baby or
the natural forces that expel the baby, vaginal delivery has to be aided.
Defects in the anatomy
of the pelvis:
Nature is such a great
architect that it keeps the function of a structure in mind when it builds it. There are a
lot of differences between the male and the female pelvis. The male pelvis is more rugged
and thicker than the female one. Such a type of pelvis is called android pelvis. The
elasticity of the female pelvis allows the passage of the child through it without causing
any damage to the baby. When a female has a male like pelvis (android pelvis), natural
delivery becomes difficult.
The doctor after
examining you decides if your pelvis is suitable for normal delivery. The extent of defect
in the pelvis determines if the child has to be delivered by caesarian section or by
assisted delivery.
Assisted delivery:
The assistance that a
doctor provides you in the labor ward could be classified as routine and occasional.
The routine assistances
that are provided in almost all the deliveries are Episiotomy and drugs. The drugs aim at
increasing the expelling the force of the uterus and opening the mouth of the uterus
(cervix). Episiotomy refers to the process by which the pelvic opening is enlarged
providing a larger exit for the baby. This is done by cutting the pelvic floor muscles.
The occasional
assistances are provided for the complicated deliveries like abnormal pelvis, large baby
(together called as cephalo pelvis disproportion) maternal problems (high BP, diabetes,
etc.). The most common ones are forceps delivery and vacuum extraction. Both these are
instruments which aid the delivery of the baby. Further explanations on these are beyond
the scope of this article and will be provided as separate articles later. It is very
important to understand that the indications for assisted vaginal delivery and caesarian
section are the same and only the severity of the indication decides the method chosen.
Caesarian Section:
It is believed that
Julius Caesar was born tearing his mother's abdomen. This is why the surgery to deliver a
baby is called caesarian. The indications for caesarian sections are many. A few to name
would be;
Extreme Cephalo pelvic
disproportion i.e., either the baby is bigger than the mother's pelvis, or it could be
because of a small maternal pelvis.
The uterus failing to
contract properly (uterine inertia).
Dangerous condition of
the baby due to some disease of the mother or the baby (fetal distress).
Dangerous condition of
the mother due to some disease of the mother (maternal distress).
Mal-presentations i.e.,
the baby is not in the normal position inside the mother's uterus (e.g., transverse lie).
Listed here are only the
common indications for caesarian. A more detailed article on caesarian will be published
later.
Whatever be the mode of
delivery, proper maternal care (antenatal care) and new born care (neonatal care) is very
important to maintain the health of the mother and child. |
