When Complications Arise in Labour - Suffolk and North East Essex Maternity and Neonatal Services

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During labour things can sometimes change, which may mean the labour journey needs to be adapted. When complications arise, the maternity team is there to explain what’s happening and to help you explore your options.

Continuous monitoring with a CTG machine

If for any reason there are concerns about your baby’s heart rate, a CTG machine can be used to monitor it throughout labour. It also monitors how strong and regular your contractions are.

This will limit your ability to move around but you have options. Monitoring can be done whilst sitting on a birthing ball, standing, kneeling or lying on your side. Some maternity units have wireless monitors which make it easier to remain mobile.

Meconium Stained Waters

Meconium is the first poo that a baby does. Sometimes they do this whilst still in the womb. This will be visible when your waters break. Although this can be normal, especially if your baby is overdue, it can be a sign that your baby is becoming distressed. If this is the case your midwife would recommend listening to your baby’s heartbeat throughout labour to ensure they are well, with a CTG machine.

Fetal Distress

Your baby’s heart rate tells us how they are coping with labour. Certain heart rate patterns show that the baby is becoming tired. Sometimes we may recommend the baby is born quickly by caesarean birth or with some help – called an ‘assisted’ birth.

Assisted Birth

In the second stage of labour, there is potential for both you and your baby to become very tired. If labour is not progressing, the option of an assisted birth will be discussed with you. This would be with a ventouse suction cup or forceps.

A ventouse is a small, flexible suction cup that is applied to the baby’s head. As you continue to push, the doctor will gently pull with the suction cup to speed up the birth of your baby.

Forceps are designed to fit around your baby’s head so that when you have a contraction, the doctor can guide the baby through the birth canal more quickly.

Episiotomy

For any assisted birth, an episiotomy may be advised.

An episiotomy is when the perineum – the muscle between your vagina and anus – is cut to allow more room. This may be to speed up birth or to give more space if a ventouse or forceps is needed. It can be used to avoid a complicated tear. You would have an injection to numb the area first, and your midwife or doctor would always need your consent. This is not a routine procedure.

Slow Progress in Labour

Sometimes, labour can slow down. This can be for many reasons, but at some point your midwife will discuss ways to help labour progress again.

Breaking your Waters

This is also known as artificial rupture of membranes (ARM). A midwife or doctor uses a tool called an ‘amnihook’ to break the sac of water your baby is lying in. This does not hurt you or the baby. A small amount of water is released to help your baby’s head sit more snugly on the cervix. This will produce stronger and more intense contractions and should shorten your labour by about an hour.

Oxytocin Drip

This will be suggested if contractions have slowed down and your cervix is not opening. A drug called oxytocin is given via an intravenous (IV) drip. Having an IV drip means the drug will go straight into your veins and start to work quickly. A drip uses a cannula, a thinbendy tube, that is put into a vein in the back of your hand. The oxytocin can bring on stronger, regular contractions. You should be monitored with a CTG machine to ensure your contractions do not become too strong and that your baby is coping with them. .

During your labour journey, there will be points where you may need to rethink your options. The midwives and doctors caring for you will always provide you with the information you need to help make informed choices about your care.

Explanation point

Term	Description
CTG machine	Electronically monitors babies' heartbeats and well-being, the machine also produces a paper recording of the baby's heart rate and contractions throughout labour.
Meconium	Baby's first poo, thick and greenish-black in colour.
Cervix	The lowest part of the uterus(womb); it attaches the uterus to the vagina.
Contractions	muscles in your uterus tightening and releasing. This process softens and widens the opening to your uterus, called the cervix.