May 21, 2012
Can You Recognize a Labor Room Dilemma?
I’ve just returned home after traveling over 1900 miles to attend my cousin’s baby shower and oh, what a joyous event. There was great food, laughter, a zillion gifts along with a spirit of generosity that revealed the power of true friendship. In the next 30 days my cousin will embark on a new journey called motherhood with all of its associated peaks and valleys. She clearly loves her baby and I want to make certain that she arrives safely.
My cousin appears to be receiving good prenatal care but I want to leave nothing to chance. When she is finally admitted in labor, I will be calling for updates and a status report. Why? Because obstetrics is a specialty that frequency involves the unexpected. I will inquire at least every two hours regarding her progress in labor. Is she dilating 1.2 centimeters every hour? And if not, are her contractions regular? If her contractions are not regular, and she’s less than 4 centimeters, will they encourage her to walk? If she’s more than 4 centimeters and having irregular contractions, will she receive Pitocin (a medicine that helps the uterus contract)? And if she receives Pitocin, is the baby tolerating it, meaning is the fetal heart rate between 120 to 160 beats per minute?
I will encourage my cousin to ask for pain medication because a pain-free mother progresses faster in labor than a woman writhing in pain. I will ask her about weight gain during the pregnancy not for embarrassment but because the answer has clinical significance. If she gained more than 40 pounds, it’s quite possible that the baby might be larger than expected, thus increasing the possibility of a shoulder dystocia. And if there is a shoulder dystocia, I hope the nursing staff will put my cousin’s knees to her chest and encourage her to push. I also hope her physician will be well versed in the maneuvers that are necessary to handle this type of emergency.
If the fetal tracing looks suspicious meaning, flat, or “U-shaped,” I hope the nurses will have the good sense to inform the physician immediately and not wait to the 11th hour. I also hope her hospital has 24-hour anesthesia coverage and a level 3 NICU. Lastly, I will emphasize to my cousin that a C. Section is not a failure. Iin the event of an emergency it could mean the difference between having a healthy baby or one who is brain damaged and physically disabled for the rest of its life.
Do you know how to handle a labor room dilemma? You will, if you read The Smart Mother’s Guide to a Better Pregnancy.A healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.