Potential Labor and Delivery Interventions

Managing Pain

It may be hard to believe, but labor pain is a good thing. It indicates that your body is performing well, but it may need to be managed. Women experience different degrees of labor pain...you have probably heard stories, good and bad! Be sure to choose pain relief based on your own personal experience and preferences and not just based on advice from well-meaning friends or family members. Your nurses will support you throughout your labor.

Pain-relief medication

• Intravenous (IV) medications: These typically help you relax. You may still experience pain with contractions, but this will help "take the edge off".
• Labor epidural anesthetic: This technique nearly eliminates labor pain. An anesthesiologist will place a thin plastic tube into your lower back next to the membrane that covers the spinal cord. The tube delivers numbing medicine to your nerves.

Non-drug pain management possibilities

• Change your position frequently
• Walk
• Apply ice or warm packs (usually to your back)
• Focus on relaxation – good aids include music, massage, whirlpool baths, a hot shower, and breathing techniques.
• Use visualization techniques – start with a relaxation exercise, then imagine sights, sounds, smells, sensations, or tastes connected to personal memories with meaning.
• Utilize breathing techniques to ease discomfort caused by tight muscles that can slow labor. They are most effective when you can no longer walk or talk during contractions.

Inducing/Augmenting Labor

If labor needs to be started before it begins on its own, it is called inducing labor. This may be recommended for your health or the health of your baby. Common reasons for inducing labor include being over a week past your due date, labor not starting naturally after your water breaks, or preeclampsia. There are several methods used to induce labor, including:

• Amniotomy – this is the process that breaks the bag of water holding the baby, which often signals natural chemicals in the uterus to start labor. This option depends on multiple factors such as the baby's position and the state of the cervix.
• Cervidil – this is a medication that softens the cervix and stimulates the uterus. A vaginal insert is placed near the cervix by your physician and is usually removed within 12 hours. Continuous electronic fetal monitoring is required.
• Mistoprostel (Cytotec) – this medication is a tablet placed near the cervix to soften it and stimulate the uterus.
• Pitocin – this is an IV drug used to stimulate uterine contractions. Continuous electronic fetal monitoring is required.
• Foley bulb – A small rubber tube inserted through the vagina into the cervix to help it dilate.

Scheduling an Induction

If your provider determines you need labor induced, he/she will schedule you in the FHN Family Birthing Center on FHN Memorial Hospital's 4th floor. They will let you know the date and time you should plan to arrive.

In order to provide you and your baby with a quality and safe experience, your induction may need to be postponed or rescheduled for another day, based on the availability of labor rooms

In order to provide you and your baby with a quality and safe experience, your induction may need to be postponed or rescheduled for another day, based on the availability of labor rooms and nurses. Please call labor and delivery at 815-599-6221 before you leave for the hospital. There is a small chance that if your induction is unsuccessful after one or two days, your provider may send you home and plan on initiating induction again at a later date.

If you have any questions, please be sure to contact a member of your healthcare team at 815-599-6221.

Assisted Vaginal Delivery

Sometimes, healthcare providers need to be more involved in a baby’s delivery. These situations include the inability to push effectively, exhaustion, or the size of the baby. Under these circumstances, instruments may be used to assist with delivery.

• Episiotomy – a surgical incision used to enlarge the vaginal opening if it does not stretch enough to allow the baby to be delivered without tearing.
• Forceps – sterile, tong-like instruments placed on either side of the baby's head.
• Vacuum device – a small, cone-like suction cup placed on the top of the baby's head to assist with pushing efforts during contractions.

Cesarean Section

Surgery to deliver your baby is called a cesarean section (C-section). Many C-sections are scheduled prior to entering the hospital, but some are unexpected and need to be performed because of emergency circumstances such as:

• Labor not progressing
• Fetal distress
• Inappropriate baby positioning for vaginal delivery (called malpresentation)
• The baby not fitting through the pelvic bones (called cephalopelvic disproportion)
• Other health complications