Common Procedures During Childbirth

Content provided by the Faculty of the Harvard Medical School

Common Procedures During Childbirth

Nature may take its course, but sometimes it needs a helping hand. Here are some common procedures used during childbirth:

Fetal monitoring is a method to have your baby's well-being electronically evaluated during delivery. If your cervix has not yet dilated and your membranes are intact, an external monitor is the only option. An ultrasound transducer is strapped over your abdomen to pick up the baby's heartbeat, which is continuously recorded on a paper strip. A second detector is then strapped to the top of your abdomen to record the frequency and power of your contractions. These two measurements give detailed information about how your baby is faring during labor.

An internal monitor can be used only after the bag of waters has broken and your cervix is sufficiently dilated. A tiny, spiral-shaped electrode is inserted through your vagina into your baby's scalp (a relatively harmless procedure that has an extremely small risk of causing a scalp infection) and/or a catheter is placed in your uterus to measure the strength of your contractions. The internal monitor gives a slightly more accurate record of the baby's heart rate and your contractions than an external monitor. Your baby also can be monitored by having a doctor or nurse listen to the baby's heartbeat with a special stethoscope or ultrasound equipment.

Episiotomy consists of making a surgical incision in the area between the vagina and rectum. Episiotomies are done with the mother under local anesthesia to facilitate delivery and to prevent tearing of the muscles of the vagina and the surrounding area, usually when the baby's head is crowning. You should discuss the possibility of an episiotomy with your doctor, since there is some medical disagreement about the value of this procedure.

Vacuum extraction is a technique in which a soft plastic device that resembles an ice cream cone is used to apply suction to the top of the baby's head during delivery. It may be used to assist in delivering the baby in the event of fetal distress or maternal exhaustion.

Forceps look like salad spoons and are medical instruments used to guide a baby's head out of the birth canal. Like vacuum extraction, forceps also can be used when the second phase of labor is unusually long, if you're having trouble pushing the baby or if the baby is showing signs of distress. The choice between using vacuum or forceps is usually one of provider preference and/or expertise.

Last updated:	September 29, 2004
Reviewed By:	Faculty of Harvard Medical School