Abnormal Labor

Abnormal Labor: Types of Labor

Normal labor is the term used to describe normal vaginal deliveries, cesarean sections, and other medical procedures. Normal labors are often associated with women’s choices or lifestyle choices rather than any inherent physical problem within the mother. Some doctors believe that these types of births are more common in certain ethnic groups due to cultural beliefs or traditions.

Others believe that there may be genetic factors involved in causing some mothers to have such a birth type.

The most common types of labor include:

Vaginal Delivery (V) – Vaginal deliveries are the majority of all labors. They occur when the baby enters through the birth canal and exits through the woman’s body. V-sections are usually performed after 36 weeks gestation.

Most women prefer vaginal deliveries because they require less pain medication and generally result in shorter hospital stays compared to C-section deliveries. However, vaginal deliveries do carry their own risks. Women who choose vaginal deliveries tend to experience fewer complications than those who opt for C-sections.

Cesarean Section (CS) – Cesareans are surgical procedures that involve cutting open the abdomen to remove part of the uterus and fallopian tubes. These surgeries are done in cases where it is determined that a child would not survive outside the womb. The surgery can also be used to bypass any complications that may occur during childbirth.

The baby is removed from the uterus and then the incision is stitched up with medical sutures. When a cesarean section is performed, the woman must spend two to three times longer in the hospital than she would for a vaginal delivery. Because of this, cesarean sections are not favored among women who desire natural childbirth experiences.

Induction of Labor (IOL) – IOLs are medical procedures that kick start the birthing process. In instances where a baby is unable to pass through the birth canal, or in cases of medical complications such as high blood pressure, IOLs can be used to expedite the delivery process. A common IOL method involves doctors giving a woman a drug known as oxytocin.

This drug causes the uterine muscles to contract and eventually push the baby out. The drug begins working within one hour and can cause serious complications in some women.

Cord Prolapse (CP) – A cord prolapse happens when the umbilical cord drops into the opening of the birth canal ahead of time. This type of delivery is an emergency situation and requires immediate medical assistance. Because of this, most women diagnosed with a cord prolapse are immediately sent to the operating room for a cesarean section.

Fetal Stress (FS) – In cases of fetal stress, a fetus will experience multiple complications such as extreme heart rate changes, low amniotic fluid, and extreme breathing complications. When this happens, doctors may suggest inducing labor or performing a cesarean section to ensure the baby’s safety.

Placenta Previa (PPV) – This condition occurs when the placenta attaches itself over the opening of the womb. This prevents the baby from entering the birth canal and requires a cesarean section to deliver the infant.

Internal Version (IV) – An internal version is performed when a baby is in a transverse lie position. During this procedure, doctors use their hands to turn the baby into a head-down position within the uterus. This procedure is not always successful and it is common for babies to revert back to their original positions.

Obstetrical Forceps (OB) – In some cases, a baby may not be able to pass through the birth canal due to the size of its head. This is known as a shoulder dystocia and would require doctors to perform an obstetrical forceps delivery. During this procedure, medical personnel would use special instruments to grab hold of the baby’s head and gently pull it out.

It is also common for doctors to apply traction with the baby’s body. Shoulder dystocia often results in injuries to the baby’s shoulders and upper back.

Vacuum Extraction (VE) – The vacuum extraction procedure is similar to an obstetrical forceps delivery except that it uses a specialized instrument known as a vacuum extractor. This device uses a rotaryiong suction cup to gently pull the infant out of the birth canal.

Episiotomy (EPI) – An episiotomy is a surgical incision made in the muscular area between the vaginal opening and the rectum. This procedure is only necessary when delivering an infant that is too large to pass through the vaginal opening. An episiotomy is often used in conjunction with other methods of assisted delivery including forceps and vacuum extraction.

Forceful Extraction (FX) – This is a rarely used method of delivery. Forceful extraction involves doctors making a series of surgical cuts in the vaginal area to manually pull the infant out. In most cases, a combination of forceps and vacuum extractor are used instead.

C-Section (CES) – This is the most common method of delivery in premies due to multiple complications that may arise during labor. A cesarean section involves making a surgical cut in the mother’s abdomen and uterus to remove the infant.

Skin-to-Skin Contact (SSC) – This refers to an infant’s first contact with the outside world. Immediately after delivery, a medical professional will briefly wipe the baby clean and then place it on the mother’s bare chest. This promotes bonding and provides the infant with its first source of warmth and nutrition.

Newborn Jaundice (NJ) – Newborn jaundice refers to a condition in which an infant’s skin and eyes have a yellowish tint. This condition occurs when the infant’s liver isn’t functioning properly, which causes it to retain bilirubin. Newborn jaundice is common and harmless, and normally goes away within a few weeks.

Apgar Score (APS) – The Apgar score is a rating system used to measure the health of newborn infants immediately after birth. A score between 0 and 10 is given for each of the five criteria: heart rate, respiration, muscle tone, reflexes and color. A score of 10 is considered ideal, while a score lower than 7 may indicate the need for resuscitation or additional medical attention.

Blood Type (BT) – There are four major blood types: A, AB, B and O. A person’s blood type is determined by the presence or absence of certain proteins on the surface of red blood cells. Each different blood type can be transfused to another person of the same blood type.

For example, a person with type AB blood can accept donations from other people with AB blood. They can also accept donations from people with type A or B blood, but in this case, the transfusion recipient may develop an antibody reaction against the other blood type. Transfusions between donors and recipients of different blood types are not commonly used and require transfusion of additional red blood cells to prevent problems.

Immunizations (IMM) – These are medical treatments that enhance the body’s natural defenses against disease. Immunizations work by exposing the body to a weakened or dead form of a virus, so that it builds up antibodies to fight the real thing.

Vaccinations (VAC) – These are medical treatments that introduce a weakened or killed form of a virus into the body. The purpose of a vaccine is to give the body a head start on building up antibodies to fight an infection. Vaccinations are available for many common and dangerous viruses.

Healthcare Proxy (HCP) – This is a document in which an individual names another person to make health care decisions if he becomes unable to do so himself.

Living Will (LW) – This is a document in which an individual outlines his wishes for things like life support and organ donation in the event that he becomes unable to communicate his wishes himself.

Do Not Resuscitate (DNR) – This refers to a physician’s order that no attempt should be made to restart the patient’s heart if it stops.

Advance Directive (AD) – This is a set of instructions written by an individual while they are able to communicate their wishes to their physicians about the treatment they want in the event that they become unable to do so themselves. It may take the form of a Living Will, or it may involve instructions for a health care proxy.

Passive Euthanasia (PETH) – This is a medical order to withhold life-prolonging measures.

Active Euthanasia (ACT) – This is the termination of life by another person, at the request of the patient. It is illegal in most countries.

CPR – This stands for Cardio-Pulmonary Resuscitation. It is a procedure that involves specially trained individuals applying manual pressure to the chest, electric shocks and breathing into the patient’s mouth in an attempt to restart the heart of a person whose heart has stopped.

Respirator (RESP) – This is a device that pumps air in and out of the patient’s lungs by mechanical means. It is only used in the event that a patient’s respiratory system is not working properly.

Organ Donation (ORG) – This is the removal of healthy organs from one person for implantation in another person. In some countries, organ donation is used as an alternative to the death penalty.

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Sources & references used in this article:

Is abnormal labor associated with shoulder dystocia in nulliparous women? by SH Mehta, E Bujold, SC Blackwell, Y Sorokin… – American journal of …, 2004 – Elsevier

An objective approach to the diagnosis and management of abnormal labor. by EA Friedman – Bulletin of the New York Academy of Medicine, 1972 – ncbi.nlm.nih.gov

Normal and abnormal labor progress: I. A quantitative assessment and survey of the literature. by RJ Sokol, J Stojkov, L Chik… – The Journal of reproductive …, 1977 – europepmc.org

Practice environment is associated with obstetric decision making regarding abnormal labor by MW Carpenter, D Soule, WT Yates… – Obstetrics & …, 1987 – journals.lww.com

Cesarean delivery for abnormal labor by MS Mancuso, DJ Rouse – Clinics in perinatology, 2008 – Elsevier