Why Does Childbirth Start And How Does It Happen?
In most cases, childbirth begins naturally, but sometimes childbirth must be initiated to ensure the health of the mother and child and to avoid complications. In fact, starting a birth is more common than many imagine. In Finland, childbirth is started even for every fourth pregnancy.
Every expectant mother at some point in her pregnancy thinks about how the birth will progress and whether there will be complications. For example, a woman may wonder if it is possible for her to refuse a possible birth, whether a birth that occurs more often than a naturally onset labor, and whether it is more difficult to recover from a labor that has started.
The internet in particular is full of a variety of pregnancy and childbirth stories, myths and misinformation, so it’s no wonder even if the expectant mother isn’t sure what to believe. Spontaneous childbirth is always the best option, but as we have already mentioned, in some cases, initiating childbirth is necessary for the well-being of both mother and baby.
What does it mean to start labor?
Initiation of labor refers to the tendency to undergo labor by inducing contractions before the natural onset of labor. The cervix should soften and open to accommodate the baby. Cervical immaturity increases the risk of failures, prolonged and stopped labor, and lack of oxygen during fetal labor.
The cervix can be matured either medically or mechanically, and the actual initiation of labor is initiated by puncturing the fetal membranes. There are various ways to initiate labor, of which the use of prostaglandins is the most common. The method chosen depends on the maturity of the woman’s cervix.
According to the Medical Society Duodecim, the methods of initiating childbirth in Finland are:
- Prostaglandin vagitorium
- Oral prostaglandin tablets
- Oxytocin drip
- Puncture of membranes
- Balloon maturation
- Combinations of the above
In which cases is childbirth started?
Each pregnancy is individual, and the exact course of pregnancy and childbirth is impossible to predict. Even if the pregnancy goes well in all respects, childbirth may have to be started for a variety of reasons. Initiation of labor is necessary in a situation where the risks of continuing the pregnancy to the mother and fetus are greater than the risks associated with initiating labor and terminating the pregnancy.
The most common reasons for starting labor are:
- Maternal complication or illness during pregnancy. These may include, for example, pre-eclampsia, gestational hepatosis, persistent bleeding, heart problems, or gestational diabetes. Maternal illness also endangers the health of the unborn child.
- Fetal problems. Examples of these are growth retardation, abnormal heart rate curve, inflammatory state of the uterus, or lack of amniotic fluid.
- The amniotic fluid is gone, but the contractions have not begun. The midwife may wait for the birth to start spontaneously, but if this does not happen, the birth will be started.
- Prolonged pregnancy, i.e. the duration of pregnancy exceeds 42 weeks of pregnancy. Prolonged pregnancy jeopardizes the fetal food intake.
- The fetal sac does not break down naturally. In this case, childbirth does not start spontaneously either.
- Baby’s large size. Delivery may be initiated to avoid prolonged, exhausting, and potentially injurious labor.
Spontaneous onset vs. initiated labor
Some women are afraid to start giving birth, thinking it will cause more complications either for themselves or the baby than for a spontaneous birth. In general, however, such fears are completely futile.
- Initiating childbirth, as the name implies, only initiates childbirth, not completely defines it. Once childbirth has begun, it proceeds just like any other childbirth, except in situations where childbirth has had to be initiated due to a complication.
- According to some, episiotomy, or cutting of the perineum, is more common in initiated labor, but this is not the case.
- One of the risks of initiating labor is that the baby does not descend into the birth canal, which can cause stress in the fetus. In such cases, the midwife and doctor will assess the situation and will likely end up in caesarean section. The purpose is to guarantee a safe birth for both mother and child.
