Surgical Interventions

There are essentially three types of surgical intervention offered to women to assist with the safe delivery of the baby:

Forceps Delivery

These are blunt instruments which are used to assist with vaginal delivery of the baby. They are usually used when it is obvious that the baby can be born by the mother alone. Perhaps the babies shoulder might be stuck or the mothers pelvis might be on the small side and the baby might be larger. The other reason to use forceps is if the mother has been sedated with pethidine or is very tired after a long and unproductive labour.

They are only used when there is a medical indication to do so.

Ventouse

This technique was developed in France and is used in similar circumstances as forceps. However the babies head has to be presenting for Ventouse to be used so this technique will not be used for the birth of a breech baby (upside down in the womb).

It consists of a suction cup which is placed upon the babies head and this is attached to a chain and handle. Suction is applied to the cup on the babies head and it allows the obstetrician to pull the baby out during a difficult delivery. It is relatively non traumatic and can be very helpful if there are problems birthing the baby. Again it is only used when medically necessary.

Caesarean Section

There has been so much written about the rising caesarean section rates in the press that you probably know a lot about the procedure already. Caesarean section when medically indicated is a life saving operation and without it many babies and mums would not be alive today. The scope of this web site does not allow us to expand fully upon all the indications for a caesarean section but we will briefly cover what the procedure is and what happens during one.

There are essentially two types:

An elective caesarean or an emergency caesarean.

An elective caesarean is where the procedure is planned and an emergency caesarean is not planned. You might be offered an elective caesarean section for one of the following reasons:

• If you have had one previously
• If you have a very small pelvis
• If you have pre-eclampsia
• If there is a foetal abnormality
• If you have a breech baby
• If you have a multiple pregnancy
• If you are two weeks over due and request one
• If you want one

You may need an emergency caesarean for one of the following reasons. This is not exhaustive and there may well be many other medical reasons why a caesarean section will be suggested.

• If the baby is distressed (the heart rate falls) and blood oxygen is reduced
• If the mother is exhausted from a long and unproductive labour
• Failure to progress (labour stalls and does not re-start)
• If there is muconium (babies faeces) in the amniotic fluid
• If infection is suspected or confirmed
• If the cord is around the babies neck and cannot be released

With a caesarean you might be offered two options for your anaesthetic. A spinal or epidural (with or without sedation) or a general anaesthetic (where they put you to sleep).

For an emergency caesarean section, if you have not previously had an epidural then you may well need to have a general anaesthetic especially if it is an urgent procedure.

A bikini line incision is made and the baby is delivered through your tummy. A paediatrician (baby doctor) will check the baby over and make sure that he/she is breathing and that the babies heart rate and reflexes are ok. If everything is OK you will be able to hold and feed your baby as soon as you are awake. If you have a spinal or epidural then they will bring the baby over to you straight away.

You will need several weeks to recover from the operation and you will want to rest and not lift anything heavy for several weeks after the operation. Unless it is medically indicated it is not a procedure to choose lightly and you will want to seriously consider the alternatives with your midwife before deciding upon an elective caesarean without a medical indication.