It's been hours since you started labor, and you're expecting a baby. But there's still no sign of the baby coming? Sometimes labor progresses slowly, or it stops halfway. At times like these, doctors take steps to speed up the delivery process to help you and your baby. Today, we're talking about something that many people don't know about, but that's called 'assisted childbirth.'
What is Augmentation of Labor?
Simply put, this means speeding up the process of labor that has already started naturally, but is slow or has stopped halfway. Imagine, your contractions are coming, but the contractions are not very strong, or the time between contractions is too long. Or, after a while, the contractions stop. At such times, prolonging labor is not good for both you and the baby. That's when doctors use drugs or other methods to help the baby's birth by strengthening the contractions of the uterus a little, increasing their frequency.
Are 'Augmentation' and 'Induction' two different things?
Yes, this is where many people get confused. These are two completely different things. Let's see what the difference is between the two.
| Fact | Induction of labor | Acceleration of childbirth (Augmentation) |
|---|---|---|
| Purpose | Inducing a fever by administering external medications when the fever has not yet started . | Helping and accelerating the natural process of growth when it gets stuck. |
| Usage | When the baby is not born even after the full day, when the water breaks and the baby is not born, or when the mother or baby needs to deliver the baby quickly due to some health problem. | When labor does not progress even after 18-24 hours of labor. (Failure to progress). |
Who needs Augmentation of Labor?
This method may be necessary if you have started labor naturally, but are stuck in labor. There are several main reasons why labor may not progress:
- Weak or irregular contractions: The contractions are coming, but they are not strong enough to open the cervix. Or they are coming in waves, not in a row.
- Complete cessation of contractions: If contractions come and go for a while and then suddenly stop.
- The amniotic sac is not broken: When this, which we call the "bag of waters," breaks, the baby's head presses directly on the cervix. This causes the cervix to open quickly. Sometimes, even if this doesn't break, labor can be slow.
Are there any situations where this method cannot be used?
Yes, this method is not suitable for everyone. Your doctor may not recommend this method in the following situations:
- Baby's position: If the baby is in a position other than head down. For example, if the baby is in a breech or transverse lie .
- Uterine scarring: If you have had a previous cesarean section (C-section) or other uterine surgery and have scars. This is because there is a very small risk of uterine rupture through these old scars when medications are given to strengthen contractions.
- Asherman syndrome: A condition in which scar tissue forms inside the uterus.
How to speed up childbirth?
There are several methods that doctors use to speed up labor. The method you choose will depend on your situation.
| Methodology | What happens to it? |
|---|---|
| Breaking the bag of waters (Amniotomy) | The doctor uses a special instrument to break the amniotic sac (bag of water) surrounding the baby. As the amniotic fluid is released, the baby's head presses directly against the cervix. This pressure causes the cervix to open more quickly and contractions to become stronger. |
| Giving medicine | A synthetic drug (such as Pitocin® ) that mimics the hormone oxytocin naturally produced in the body is given to you through a saline solution. This causes and strengthens uterine contractions. |
| Balloon catheter | A catheter (a thin tube) is inserted through the cervix and a balloon at the end is inflated. The pressure from this balloon gradually opens the cervix. When the cervix is dilated enough, the balloon and catheter fall out on their own. |
Most importantly, you and your baby's heartbeat are continuously monitored electronically (electronic fetal monitoring) while using these methods. This means that if there is a problem, the medical team can find out quickly.
What are the benefits of this?
The main advantage is that it increases the chance of a natural vaginal birth, avoiding a cesarean section (C-section). The recovery time after a C-section is usually longer and the pain is more intense. Therefore, it is best to have an assisted birth, unless absolutely necessary.
What risks can arise?
As with any medical procedure, there are some very small risks involved. But remember that these are very rare and doctors are prepared to manage them.
- Hyperstimulation of the uterus: Sometimes, the oxytocin medication can cause the uterus to contract more than usual. This excessive pressure can cause fetal distress . This means the baby may not get enough blood and oxygen. Doctors can manage this condition by adjusting the dosage of the medication and monitoring it closely.
- Infection: When the bag of water is broken artificially, a bacterial infection (chorioamnionitis) can very rarely occur. This also carries a risk of infection in the newborn (newborn sepsis) . Therefore, you and the baby will be given antibiotics if necessary.
- Umbilical cord prolapse: When the bag of waters breaks, there is a very small risk that the umbilical cord will slip into the vagina before the baby's head. If this happens, the umbilical cord can become compressed and the baby will no longer get oxygen. This is an emergency and requires an immediate C-section.
What are the symptoms that require you to call your doctor immediately?
If you experience any of the following symptoms after you go home after giving birth, inform your doctor immediately or go to the nearest hospital's Emergency Department (ETU) .
| Symptom | Description |
|---|---|
| Chest pain | Sudden, severe chest pain. |
| Dizziness or fainting (syncope) | Blue eyes, feeling dizzy or fainting. |
| Heavy vaginal bleeding | If you bleed so heavily that a sanitary napkin is completely soaked within an hour. |
| A foul-smelling vaginal discharge | If there is an unusual, foul-smelling discharge. |
| Signs of infection | Symptoms include fever, chills, and shivering. |
| Difficulty breathing (dyspnea) | If you feel difficulty breathing. |
| Swelling (edema) | Unusual swelling of the legs, arms, or face. |
Take-Home Message
- Augmentation is the medical use of forceps to help a labor that has already begun progress slowly or has stopped.
- The main goal of this is to keep both you and your baby healthy and safe, and to successfully complete the delivery.
- There is no need to worry because the medical team will always monitor you and your baby closely.
- If you have any questions about childbirth, pain medication, or this procedure, don't be afraid to ask your doctor.
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