Posts Tagged ‘stage of labour’

Why isn’t the baby out yet?
assisting the birth
What is an assisted delivery?
An assisted delivery is one that uses either forceps or a ventouse, or suction cup (see p.204), to help extract the baby from the birth canal if the baby is not making good progress during labour or there are complications during the second stage of labour in a vaginal delivery You will still be helping to deliver your baby with your contractions, but the instrument used will be helping to guide the baby out of the birth canal.
How is an assisted delivery carried out?
Assisted deliveries are carried out using either forceps or ventouse (vacuum extraction) by a doctor (or specially trained midwife) Forceps are metal instruments specially shaped to fit around the baby’s head, whereas in the ventouse method, a vacuum is created by attaching a cup-like fitting to the head and using a mechanism to create suction to help draw your baby out.
How do they decide whether to use ventouse or forceps? Will it be my choice?
Both forceps- and ventouse-assisted births are relatively safe procedures and, although each has pros and cons, it’s best to be guided by the doctor, as the choice of instrument usually depends on the position of the baby and the doctor’s preference or experience, although your opinion will be taken into consideration. Although forceps used to be the most widely used instrument, ventouse has increased significantly in popularity. Many consider ventouse easier to use and less likely to cause damage and tearing to the mother. However, this method is also more likely to cause swelling to the baby’s head where the cup was placed
What is a “prolonged second stage” and does this mean that the delivery will be assisted?
It is difficult to define a ”prolonged second stage” as it depends on certain factors, for example if it is your first baby the position and size of the baby, if you have an epidural, if the contractions are effective and how often they are coming, how well you are pushing, and if the pelvis is an adequate size There is some evidence to suggest that if the baby has progressed further into the pelvis, and there is no sign of distress. then there is no need to put a time limit on labour. However, it does tend to be the case that hospitals have guidelines as to how long they will allow a woman to push for before deciding that intervention may be necessary Usually, after about one and a half hours, doctors may decide to assist the delivery to reduce the risk of fetal distress and of the mother becoming exhausted.
I had a forceps delivery as in the end I was too tired to push. Is this likely to happen again?
An assisted delivery is more common during a first birth than in subsequent ones. The first pregnancy and birth causes the pelvic ligaments to stretch, which can make subsequent births easier, and the uterus is often more efficient in contracting the second and subsequent times around, which also means that labour is usually shorter Often, even if the baby’s head is not in the best position for birth, for example if the baby is in a posterior position, where the back of the head is towards the mother’s spine and lower back, it may be delivered without assistance during a second delivery Therefore, it is likely, but by no means certain, that you will have a normal vaginal delivery next time.
Can I refuse to have forceps or vacuum extraction and what are the alternatives?
No-one can go against your wishes if you do not want to have a particular procedure. However, it’s usually best to have a flexible approach to labour. Although you may wish for certain things not to take place, the doctor or midwife is likely to have a good reason for wanting to carry out a procedure and has your and -your baby’s best interests at heart. If an assisted delivery is suggested, asking the midwife or doctor to explain and support this decision can help you to come to terms with it. Usually the only other alternative to an assisted delivery would be a Caesarean section: however, this may be difficult if the baby has gone too far into the pelvis
Will I have an anaesthetic before they use the forceps?
Suitable pain relief, such as a local anaesthetic injection, or an epidural, will be given before the procedure The doctor will then help to pull the baby out while the mother pushes. The forceps and ventouse cup are removed after the head has been delivered, and the body is delivered normally,
What can go wrong at an assisted birth?
Forceps and ventouse can cause bruising, swelling, and marks on the baby’s head or face, although these usually resolve without any problems within a few days In rare cases, cuts and severe bruising on
Assisted delivery
An assisted delivery, using forceps or a ventouse vacuum extraction, may be carried out for one or more of the following reasons:
* The mother is exhausted from a long labour and has insufficient energy to push.
* The baby is showing signs of distress during the second stage of labour.
* The baby’s head is in a slightly wrong position -if you are in the second stage of labour, forceps or ventouse can often be used to turn the head around and deliver the baby.
* Forceps are sometimes used to protect the delicate head of a premature baby during birth
* Forceps are sometimes used to deliver the head of a breech baby
* If the baby is particularly large - this can be the case when the mother has had gestational diabetes .
the baby can occur. The paediatrician, a doctor who specializes in babies and children, may prescribe a paracetamol-based medicine to ease any discomfort that the baby may feel There is also an increased
risk of the baby developing jaundice, where the baby looks yellow due to the presence of the waste product bilirubin (see p.164), particularly in cases of severe bruising The levels of bilirubin in the baby will be checked if the doctor is concerned and the condition can be treated, if necessary
For the mother, the two main concerns are that there is an increased risk of tearing or being cut during the procedure - and hence an increased risk of more bleeding (which can be dealt with straight away) - and, rarely, damage may occur to the tubes that lead from the bladder.
If the situation warrants an assisted delivery, the benefits of delivering babies by these methods far outweigh the risks. If the procedure is not successful, an emergency Caesarean may be necessary.

Helping your baby’s birth

A delivery may be assisted using either vacuum extraction (or ventouse), which involves a small suction cap (metal or plastic) being placed on the back of your baby’s head and very gently pulled, or forceps, metal tongs that guide the baby out.
Why might this be necessary? There are several reasons why the obstetrician, and in some units the midwife, will advise this type of birth.  Generally an assisted delivery is carried out because the mother is too tired to carry on pushing after a prolonged second stage of labour, and the ventouse suction cap or forceps can help accelerate the baby’s progress through the birth canal. An assisted delivery may also be necessary if your blood pressure has risen suddenly or if there are signs of fetal distress You will be given either an epidural or local anaesthetic before the procedure is carried out
Is it safe? This is a safe way for your baby to be born, although there is a very small chance that your baby may bleed under his scalp and may need to go to the neonatal unit to be cared for and monitored after the birth, After vacuum extraction, most babies will have a little bump (a ”chignon”) where the soft cup has been attached to the head, and the baby s head may look slightly elongated Babies delivered by forceps may have marks on the sides of the head where the tongs were. However, any swelling or marks should disappear within a few days
Will I need an episiotomy? An episiotomy - a cut made between your vagina and back passage to make more space for your baby to be born in order to prevent tearing - is sometimes carried out if you have an assisted delivery, and is more likely with a forceps delivery.

Episiotomy
An episiotomy is an incision, or cut, made with scissors into the area called the perineum, which is the piece of tissue between the vagina and the anus. This area stretches and thins during the birth to allow for the baby’s head to be born with ease An episiotomy is performed only in an emergency situation An example of this is if the baby needs to be born quickly, or sometimes during an assisted delivery for example with forceps (see opposite), to prevent uncontrolled tearing Before the procedure is performed, a local anaesthetic is gently injected into the muscle to reduce the discomfort or pain during the procedure. An episiotomy will need stitching afterwards, and this is usually done by the midwife who has been involved in your delivery or by the obstetrician involved in the birth. Although episiotomies used to be routine around 10 to 15 years ago, they are now performed only when really necessary You should be informed why one is being recommended and give your verbal consent before the procedure is carried out.

MEDIO-LATERAL CUT:
What is an episiotomy and why might this be done?
An episiotomy is a cut along the muscle between the vagina and anus, known as the perineum, to widen the area where the baby will be delivered (see above) This is done only when absolutely necessary and will not be performed without your consent. There are several reasons why an episiotomy may be recommended including if the baby is in distress, to speed up the delivery of the head; in cases of forceps or ventouse deliveries! if the baby’s head is too large to pass through the vagina; if the perineum has not stretched sufficiently by the end of the second stage of labour to allow the smooth passage of the baby’s head through the vagina; if there is a complication in the vaginal delviery of a breech baby: or if the mother is finding it difficult to control her pushing while the baby’s head is crowning (see p. 186), which means she is more likely to tear significantly during the delivery
Usually, local anaesthetic is injected into the muscular area first and the procedure is performed at the strongest part of the contraction, as this distracts you from what is being done and assists with a quick delivery
The thought of having a cut down there is terrifying. What can I do to prevent this?
Some studies have shown that massaging the perineum regularly in pregnancy, using an unscented vegetable oil, can reduce the risk of tearing (see p.111) as this helps to make the area more flexible and may consequently help to stretch the area as the head is being born Wash your hands thoroughly before massaging the perineum. Although an episiotomy may be a worrying prospect, if you are advised to have one, this may prevent uncontrolled tearing.
Why might they do an emergency Caesarean section?
Emergency Caesareans are carried out for several reasons. The baby may be showing signs of being very tired, picked up by the fetal heart monitor or a blood test carried out during labour, and this could lead to the baby being distressed, known as fetal distress, in which case a Caesarean may be recommended Rarely, the umbilical cord comes down before the baby, a condition known as cord prolapse, and this is an emergency that requires immediate delivery by Caesarean.

Glossary
Abruption The detachment of part of the placenta from the wall of the uterus during late pregnancy, which may result in bleeding. Accelerated labour The artificial augmentation of contractions, after the cervix has started to dilate, by the injection of oxytocin through an intravenous drip Often used to speed up a long labour. Active birth An approach to childbirth that involves upright positions and movements during labour.
Active management of labour The constant monitoring and technical control of labour to monitor its duration
Alphafetoprotein (AFP) A substance produced by the embryonic yolk sac, and later by the fetal liver, which enters the mother’s bloodstream during pregnancy Alveoli Milk glands in the breasts, which produce a flow of milk when they are stimulated by prolactin and the baby’s sucking.
Amniocentesis The surgical extraction of a small amount of amniotic fluid through the pregnant woman’s abdomen. This procedure is usually carried out as a test for fetal abnormalities.
Amniotic fluid The fluid that surrounds the fetus in the uterus. Ultrasound scans may be done in late pregnancy to ensure that enough is present
Ammotomy The surgical rupture of the amniotic sac, often done to speed up labour This is referred to as ARM (artificial rupture of the membranes).
Anaemia A condition in which there is an abnormally low percentage of haemoglobin in the red blood cells, it is treated by iron supplements
Anaesthetic Medication that produces partial or complete insensibility to pain Anaesthetic, general Anaesthetic that affects the whole body, with temporary loss of consciousness.
Anaesthetic, local Anaesthetic that affects a limited part of the body
Analgesics Painkilling agents not inducing unconsciousness
Antenatal Before the birth
Anterior position See Occipital anterior Antibiotics Substances capable of
destroying or limiting the growth of micro-organisms, especially bacteria Antibodies Protein produced naturally
by the body to combat any foreign bodies, germs or bacteria
Anti-D An injection of antibodies given to women who have a Rhesus negative blood group if it is thought they may have been exposed to Rhesus positive fetal blood cells
Antihistamines Tranquillizers that are used in the treatment of nausea vomiting and certain allergies.
Apgar scale A general test of the baby’s wellbeing given shortly after the birth to assess the heart rate and tone respiration blood circulation, and nerve responses. Areola The pigmented circle of skin surrounding the nipple.
ARM See Ammotorny
Bile pigment See Bilirubin.
Bilirubin Broken-down haemoglobin, normally converted to nontoxic substances by the liver. Some newborn babies have levels of bilirubin too high for their livers to cope with See also Jaundice, neonatal. Birth canal See Vagina
Blastocyst An early stage of the developing egg when it has divided into a group of cells. Braxton Hicks contractions Practise contractions of the uterus that occur throughout pregnancy, but which may not be noticed until towards the end. Breast pump A device for drawing milk from the breasts.
Breech presentation When the position of the baby in the uterus is bottom down rather than head down
Caesarean section The delivery of the baby through an incision in the abdominal and uterine walls
Candida See Thrush,
Cardiotocograph (CTG) An electronic monitor that is used to measure the progress of the mother’s contractions and the baby’s heartbeat during labour.
Carpal tunnel syndrome Numbness and tingling of the hands arising from pressure on the nerves of the wrist In pregnancy it is caused by the body’s accumulation of fluids
Catheter A thin plastic tube that is inserted into the body through a natural channel to withdraw fluid from, or introduce fluid into, a particular part of the body This can be used to draw off urine from the bladder after an operation, or to maintain a constant input of fluids into a vein, or to introduce anaesthetic into the epidural space.
Cephalic presentation (Vertex presentation) The position of a baby who is head down in the uterus The most common presentation. Cephalopelvic disproportion A state in which the head of the fetus is larger than the cavity of the mother’s pelvis Delivery must therefore be by Caesarean section
Cervical dilatation See Dilatation.
Cervical incompetence A disorder of the cervix, usually arising after a previous mid-pregnancy termination or damage to the cervix during a previous labour, in which the cervix opens up too soon, resulting in repeated mid-pregnancy miscarriages. It is sometimes treated by suturing to hold the cervix closed. Cervix The lower entrance to the uterus, or neck of the womb
Chloasma Skin discolouration during pregnancy, often facial.
Chorion The outer membranous tissue that envelops the fetus and placenta
Chorionic gonadotrophin See Human chorionic gonadotrophin (HCG).
Chorionic villus sampling A method of screening for genetic handicap by analysis of tissue from the small protrusions on the outer membrane enveloping the embryo that later form the placenta.
Chromosomes Rod-like structures containing genes occurring in pairs within the nucleus of every cell. Human cells each contain 23 pairs. See also Gene
Cleft palate A congenital abnormality of the roof of the mouth
Club foot A congenital abnormality in which the foot is painlessly twisted out of shape. Colostrum A kind of milk, rich in proteins, formed and secreted by the breasts in late pregnancy and gradually changing to mature milk some days after delivery
Conception The fertilization of the ripened egg by the sperm and its implantation in the uterine wall.

Congenital abnormality An abnormality or deformity existing from birth, usually arising from a damaged gene, the adverse effect of certain drugs or the effect of some diseases during pregnancy
Contractions The regular tightening of the uterine muscles as they work to dilate the cervix in labour and press the baby down e birth canal
Cordocentesis A fine needle is passed trough the mother’s abdomen into the fetal –vein in the umbilical cord. The technique allows fetal blood to be tested, facilitates intra-urine blood transfusions, and enables drugs to be injected directly into the baby Corpus lutuem A glandular mass that forms n- the ovary after fertilization It produces progesterone. which helps to form the placenta, and is active for the first 14 weeks of pregnancy
Crowning The moment when the baby’s head appears in the vagina and does not slip back again.
CVS See Chorionic villus sampling.
D and C The surgical dilatation (opening) of the cervix, and curettage (removal of the contents) of the uterus
Dehydration A physical condition caused by the loss of an excessive amount of water from the body, often resulting from severe vomiting or diarrohea
Depression, respiratory Breathing difficulties in the newborn baby
Diabetes Failure of the system to metabolize glucose, traced by excess sugar in the blood and urine.
Diamorphine A narcotic opium derivative used as an analgesic.
Dilatation The progressive opening of the cervix caused by uterine contractions during labour.
Distress See Fetal distress
Dizygotic See Twins
Domino scheme A scheme operated by some hospitals in which community midwives provide antenatal care and are present at hospital for the delivery.
Doppler A method of using ultrasound vibrations to listen to the fetal heart
Doula A supportive woman helper who provides physical and emotional support during childbirth
Down’s syndrome A severe congenital abnormality caused by an incorrect number
of chromosomes that produces physical abnormalities and reduced intelligence. Drip See Intravenous drip.
Eclampsia The severe form of pre-eclampsia, which is characterized by extremely high blood pressure, headaches, visual distortion, flashes, convulsions and, in the worst cases. coma and death The condition is now rare since the symptoms of pre-eclampsia are treated immediately See also Pre-eclampsia.
Ectopic (Tubal pregnancy) A pregnancy that develops outside the uterus, usually in one of the Fallopian tubes. The mother has severe pain low down on one side in her
abdomen at any time from the 6th to 12th week of pregnancy. The pregnancy must be surgically terminated.
EDD The estimated date of delivery Electrode A small electrical conductor used obstetrically for monitoring the fetal heartbeat during labour.
Electronic fetal monitoring The continuous monitoring of the fetal heart by a transducer placed on the mother’s abdomen over the area of the fetal heart, or by an electrode inserted through the cervix and clipped to the baby’s scalp
Embryo The developing organism in pregnancy from about the 10th day after fertilization until about the 12th week of pregnancy, when it is termed a fetus Endometrium The inner lining of the uterus. Engaged (Eng/E) The baby is engaged when it has settled with its presenting part deep in the pelvic cavity. This often happens in the last month of pregnancy
Engorgement The over congestion of the breasts with milk. If long periods are left between feeds, or the baby is not well latched on painful engorgement can occur. This can be relieved by putting the baby to the breast or expressing the excess milk Entonox A mixture of 50 per cent oxygen and 50 per cent nitrous oxygen, breathed in through a mask during tabour, that gives pain relief as contractions peak
Epidural (Lumbar epidural block) Regional anaesthesia used during labour and for Caesarean sections, in which an anaesthetic is injected through a catheter into the epidural space in the lower spine. Episiotomy A surgical cut in the perineum to enlarge the entrance to the vagina.
External version (External cephalic
version, or ECV) The manipulation by gentle pressure of the fetus into the cephalic position This may be done by an obstetrician at the end of pregnancy if the baby is breech or transverse
Fallopian tube The tube into which a ripe egg (ovum) is wafted along after its expulsion from the ovary along which it travels on its way to the uterus
False labour Braxton Hicks (rehearsal) contractions, which are so strong and regular that they are mistaken for the contractions of the first stage of labour,
Fertilization The meeting of the sperm with the ovum or egg to form a new life See also
Conception.
Fetal distress A shortage in the flow of oxygen to the fetus, which can arise from numerous causes
Fetus The developing child in the uterus, from the end of the embryonic stage at about the 12th week of pregnancy until birth FH Fetal heart.
Fibroid A benign (non-cancerous) muscle growth in the uterus.
Forceps Metal tong-like instruments placed either side of the baby’s head during labour to help deliver the baby
Hormone A chemical messenger in
the blood that stimulates various organs to action.
Human chorionic gonadotrophin (HCC) A hormone released into the woman’s bloodstream by the developing placenta from about six days after the last period was due. Its presence in the urine means that she is pregnant
Hyperemesis gravidarum Almost continuous vomiting during pregnancy Hypertension (High blood pressure) During pregnancy this can reduce the fetal blood supply.
Hypnosis A state of mental passivity with a special susceptibility to suggestion. This can be used as an anaesthetic, and can be self-induced.
Hypotension Low blood pressure.
Identical twins See Twins
Implantation The embedding of the fertilized ovum or egg within the wall of the uterus
Induction The process of artificially starting off labour and keeping it going.

Insulin A hormone produced by the pancreas that regulates the level of carbohydrates and amino acids in the system. It may be used as a means of controlling the effects of diabetes.
See also Diabetes.
Internal monitoring See Electronic fetal monitoring
Intravenous drip The infusion of fluids directly into the bloodstream by means of a fine catheter introduced into a vein Intravenous injection An injection into a vein
Invasive techniques Any medical technique that intrudes into the body
In vitro fertilization (IVT) A type of assisted conception where fertilization occurs outside of the womb and fertilized embryos are tranferred back into the womb.
Jaundice, neonatal A common complaint in newborn babies which is caused by the inability of the liver to break down successfully an excess of red blood cells See also Bilirubin
Lanugo The fine soft body hair of the fetus Lateral position Transverse lie or horizontal position of a fetus in the uterus (sometimes occurring if the mother has a large pelvis), where the presenting part is either a shoulder or the side of the head
Let-down reflex The flow of breast milk into the nipple.
Lie The position of the fetus within the uterus Linea nigra A line of dark skin that appears down the centre of the abdomen over the rectus muscle in some women during pregnancy
Lochia Postnatal vaginal discharge Longitudinal lie The position of the fetus in the uterus in which the spines of the fetus and the mother are parallel
Low-birthweight baby A baby who weighs below 2,5 kg (57 lb) at birth.
Meconium The first contents of the bowel, present in the fetus before birth and passed during the first few days after birth The presence of meconium in the amniotic fluid before delivery is usually taken as a sign of fetal distress
Miscarriage The spontaneous loss of a baby before 24 weeks of pregnancy
Monitoring See Electronic fetal monitoring Monozygotic See Twins.
Morula A stage in the growth of the fertilized
egg when it has developed into 32 cells. Moulding The shaping of the bones of the baby’s skull, which overlap to allow the baby to pass through the birth canal.
Mucus A sticky secretion.
Multigravida A woman in her second or subsequent pregnancy
Multiple pregnancy The development of two or more babies, See also Twins Mutation A damaged genetic cell. This can occur naturally or more commonly as an effect of outside agents, such as radiation. Neural tube defects Abnormalities of the central nervous system See also
Anencephaly, Hydrocephalus Spina bifida. Nicotine A highly poisonous substance that is present in tobacco During pregnancy this can enter the bloodstream of a woman who smokes and may affect the efficiency of the placenta, which often results in a lowbirthweight baby
Nucleus The central part or core of a cell, containing genetic information.
Occipital anterior The position of the baby in the uterus when the back of its head (the crown or occiput) is towards the mother’s front (anterior)
Occipital posterior The position of the baby in the uterus when the back of its head (the crown or occiput) is towards the mother’s back (posterior)
Oedema Fluid retention, which causes the body tissues to be puffed out.
Oestriol A form of oestrogen.
Oestrogen A hormone produced by the ovary
Opioids (Narcotics) Painkilling drugs that induce drowsiness and stupor,
Ovary One of the two female glands, set at the entrance of the Fallopian tubes, which regularly produce eggs until the menopause Ovulation The production of a ripe ovum or egg by the ovary
Oxytocin A hormone secreted by the pituitary gland that stimulates uterine contractions during labour and stimulates milk glands in the breasts to produce milk Palpation Feeling the parts of the baby through the mother’s abdominal wall. Pelvic floor The springy muscular
structure set within the pelvis that
supports the bladder and the uterus, and through which the baby descends during tabour,
Pelvis The pelvis is a solid ring of bone at the base of the abdomen: it shields the bladder and portions of the genital tract. Perinatal The period from the 24th week of gestation to one week following delivery Perineum The area of soft tissues surrounding the vagina and between the vagina and the rectum.
Pethidine See Analgesics
Phototherapy Treatment by exposure
to light, which may he used when a baby has jaundice
Pituitary gland A gland set just below the brain that among other functions, secretes various hormones controlling the menstrual cycle. In late pregnancy it releases a hormone, oxytocin, into the bloodstream, which stimulates uterine contractions and also the milk glands.
Placenta The organ that develops on the inner wall of the uterus and supplies the fetus with all its life-supporting requirements and carries waste products to the mother’s system.
Placental insufficiency A condition in which the placenta provides inadequate life support for the fetus, often after 40 weeks, resulting in a baby at special risk.
Placenta praevia A condition in
which the placenta lies over the cervix at the end of pregnancy. This part of the uterus stretches in the last few weeks of pregnancy, but the placenta cannot stretch, so it may separate, the result is bleeding during late pregnancy, A woman with a complete placenta praevia is delivered by Caesarean section
Posterior See Occipito posterior
Postnatal After the birth.
Postpartum After delivery.
Post-traumatic stress disorder Panic and anxiety experienced by some women after traumatic and disempowering childbirth Pre-eclampsia (Pre-eclamptic toxaemia or PET) An illness in which a woman has high blood pressure, oedema, protein in the urine, and often sudden excessive weight gain See also Eclampsia.
Premature A baby born before the 37th week of pregnancy and weighing less than 2.5 Ing (5 lb)
Presentation The position of the fetus in the uterus before and during labour,

lying directly over the cervix
Preterm See Premature
Primigravida A woman having her first pregnancy.
Progesterone A hormone produced by the corpus luteum and then by the placenta Progestogen A synthetic variety of the hormone progesterone used in oral contraceptives.
Prolactin A hormone that stimulates milk production for breastfeeding Prostaglandins Natural substances that stimulate the onset of labour contractions. Prostaglandin gel may be used to soften the cervix and induce labour
Proteinuria The presence of protein in the urine, which may be a sign of pre-eclampsia. See also Pre-eclampsia
PTSD See Post-traumatic stress disorder Pubis The bones forming the front of the lower pelvis.
Quickening The first noticeable movements of the fetus felt by the mother.
Respiratory depression See Depression, respiratory.
Rhesus factor A distinguishing characteristic of the red blood corpuscles. All human beings have either Rhesus positive or Rhesus negative blood If the mother is Rhesus negative and the fetus Rhesus positive, severe complications and Rhesus disease (the destruction of the red corpuscles by antibodies) may occur, unless prevented by anti-D gamma globulin.
Rooting The baby’s instinctive searching for the breast
Rubella (German measles) A mild virus that may cause congenital abnormalities in the fetus if it is contracted by a woman during the first 12 weeks of pregnancy
Scan (Screen) A way of building up a picture of an object by bouncing high-frequency soundwaves off it. The sonar or ultrasound scan is used during pregnancy to show the development of the fetus in the uterus. See also Transducer.
Show A vaginal discharge of bloodstained mucus occurring before labour, resulting from the onset of cervical dilatation. A sign that labour is starting
Small-for-dates Babies who are born at the right time but who for a range of reasons have not flourished in the uterus. See also
Placental insufficiency
Sperm (Spermatozoon) The male reproductive cell that fertilizes the female ovum or egg.
Spina bifida A congenital neural tube defect in which the fetal spinal cord forms incorrectly, outside the spinal column Spinal anaesthesia An injection of local anaesthetic around the spinal cord.
Steroids Drugs used in the treatment of skin disorders, asthma, hay fever, rheumatism, and arthritis. Because they alter the chemical balance of the metabolism they may very rarely cause fetal abnormalities if used extensively during pregnancy
Stillbirth The delivery of a dead baby after the 24th week of pregnancy
Streptomycin A broad-spectrum antibiotic that should not be taken in pregnancy See also Antibiotics
Stretch marks Silvery lines that sometimes appear on the skin after it has been stretched during pregnancy
Supplementary feeding Additional bottles given to a breastfed baby.
Surfactant A creamy fluid that reduces the surface tension of the lungs so that they do not stick together when deflated. Preterm babies may have breathing difficulties if surfactant has not developed sufficiently Suture The stitching together of a tear or a surgical incision.
Syntocinon A synthetic form of
oxytocin, which is used to induce or accelerate labour.
TENS machine See Transcutaneous electronic nerve stimulation
Term The end of pregnancy this is measured at 38-42 weeks from the first day of the last menstrual period. Tetracycline A wide-spectrum class of antibiotic that should be avoided during pregnancy. because it can affect the development of the fetal teeth and hones See also Antibiotics.
Thrombosis A blood clot in the heart or blood vessels.
Thrush A yeast infection that can form in the mucous membranes of the month, genitals, or nipples.
Toxoplasmosis, congenital A parasitic disease that is spread by cat faeces. If it crosses the placenta during pregnancy, it can cause eye or central nervous system damage in the baby
Transcutaneous electronic nerve stimulation A method of pain relief that uses electrical impulses to block pain messages to the brain.
Transducer An instrument that translates echoes of very high-frequency soundwaves bounced off the developing fetus in the uterus to build up an ultrasound image on a monitor. See also Scan.
Transition A phase between the first and second stages of labour when the cervix is dilating to between 7 and 10 cm
Trial of labour A situation in which, although a Caesarean section may be necessary, the mother labours in order to see if a vaginal delivery is possible
Twins The simultaneous development of two babies in the uterus, either after two eggs are fertilized independently by two sperm - dizygotic or fraternal twins - or, more rarely, after one fertilized egg divides to produce monozygotic or identical twins.
Ultrasound See Scan, Transducer.
Umbilical cord The cord connecting the fetus to the placenta
Uterus (Womb) The hollow muscular organ in which the fertilized egg becomes embedded, where it develops into the embryo and then the fetus
Vacuum extractor An instrument, used as an alternative to forceps which adheres to the baby’s scalp by suction and with the help of the mother’s bearing down, can be used to guide the baby out of the vagina
Vagina The canal between the uterus and the external genitals It receives the penis during intercourse and is the passage through which the baby is delivered
VE Vaginal examination.
Vernix A creamy substance that often covers the fetus in the uterus
Vertex presentation (VX) See Cephalic presentation.
Vulva The external part of the female reproductive organs, that includes the labia and the clitoris
Water birth Birth of a baby under water.