Among the methods that were previously widely used by obstetricians, there are two well-known mothers at the hearing: imposing forceps and vacuum extraction.
Obstetric forceps is a metal tool that resembles a spoon. They are placed on both sides of the baby’s head, or rather, on the ears and the surrounding area. This procedure requires a great skill and experience from an obstetrician: if the spoons are not on the lateral parts of the skull, they can damage the eyes or the back of the head.
Having set the spoons, the doctor takes the baby’s head closer to the exit with neat strokes, and as soon as she is born, immediately removes them, and then the child gets out on his own.
The vacuum extractor is a soft suction cup connected to a vacuum pump. It attaches to the head of the baby and pretty tightly wraps it around.
As in the case with the forceps, the doctor helps the child with careful strokes, and as soon as the head of the small one comes into the world, it removes the instrument.
Doctors used to use the obstetric forceps and the vacuum extractor in the following cases: the baby does not have enough oxygen and needs to get it out as quickly as possible; his mother’s attempts remain too weak even after the administration of drugs; a well-placed placenta exfoliates prematurely; For some reason, the health of the future mother is deteriorating rapidly. But both of these methods are fraught with complications for both mother and her baby.
If in a woman they can cause trauma to the soft birth canal and bleeding, then in a child there is a traumatic brain injury and bleeding in the brain and cranial cavity.
If in the 1970s – 1980s, obstetric forceps and a vacuum extractor were used quite often, in the 2000s, this happens in Russian clinics only 0.6% of cases.
What alternative to forceps and vacuum extractors exist now? Obstetricians make emergency caesarean section to patients.
Today, this operation has become safer, and the emergence of a new, non-inflammatory suture material and modern antibiotics that prevent complications has made it a good alternative to many other interventions. Therefore, today, obstetricians mostly make a choice in favor of a more predictable option – cesarean section.
The main task of modern obstetricians is to make childbirth as safe as possible for the child and his mother. So, to exclude all that may pose at least some risk: unsafe manipulation, traumatic tools, drugs with side effects.
Imagine a common situation: a woman opens her cervix too slowly. About 30 years ago, doctors would have opened it themselves: either with their hands, or with the help of a device of a metreireinter – a rubber balloon, which was injected into the cervical canal, filled with saline, and the load was suspended from outside.
The contractions intensified, and the neck opened up, but, besides the fact that such an intervention was painful for the woman, it also increased the risk of problems. A damaged fetal bladder is a gate for infection, and moreover, the umbilical cord could fall into the opened “exit”, and the outcome of labor became unpredictable.
How do obstetricians act today if the cervix dilates slowly or does not open at all?
- First of all, the expectant mother is undergoing anesthesia, usually epidural anesthesia. After all, long painful contractions increase muscle spasm, and the cervix shrinks even more. Pain relief not only relieves discomfort, but also relaxes the muscles, and the cervix gradually opens.
- Prostaglandin hormones are injected into a woman – these are natural participants in the labor process that help her develop more actively.
- In the cervix place sticks of kelp seaweed. They gradually swell inside the body, slowly and carefully expanding the “way out”.
- If these methods have failed, and the fetal bladder is already damaged, the doctors will not wait for the cervix to open for more than 4-6 hours and will have a cesarean section. Long waiting is fraught with the development of infection and lack of oxygen for the child.
- with a weak opening of the cervix, it was spread with fingers or a metreirinter;
- in the transverse position of the child, they made him the so-called “turn on the leg”;
- Twins and premature babies were more often born naturally with a risk of complications;
- if a woman couldn’t be strained due to cardiovascular diseases, myopia, or other problems, the forceps were applied to her.
- In all these cases, doctors use the Cesarean section with success and without risk.
Another situation, on the example of which one can clearly see how the obstetric methods have changed, is the lateral position of the child. This position of the baby, in which his head and legs are located on the sides of the uterus. If a large child was expected, the woman was given a caesarean section, but if the baby was of medium size, the previous obstetricians often acted differently.
Doctors waited for complete disclosure of the cervix, injected the expectant mother with anesthesia, opened the fetal bladder and removed the child with their hands. This manipulation was called “a turn on a leg”: the kid was grabbed by the leg, turned to the exit and pulled out first one leg, then the other, then the torso, arms, shoulders, head. It is not difficult to imagine how difficult and risky this procedure was: the child could get injuries to the cervical vertebrae, hip joints, and the woman could injure the uterus.
Nowadays, there is no need to risk it this way, primarily because doctors determine the position of the child, its weight and internal dimensions of the pelvis mothers long before the birth with the help of ultrasound and other research. Now obstetricians and gynecologists assess in advance whether a baby can easily come to the light by himself – this is possible when he lies with his legs down (pelvic presentation).
But if there is the slightest risk of hardship, the expectant mother will be prepared for a cesarean section.