Preparing for Pregnancy


Episiotomy is the procedure of enlarging the vaginal opening to accomodate the birth of the baby. With an episiotomy, a doctor or midwife cuts the perineum as the fetal head is about to be born. The perineum is the tissue between the opening of the vagina and the anus. As the baby’s head is about… »

Pain Relief in Labor

Only in some very rare individuals is labor not associated with considerable pain. The pain that most women experience during childbirth has been written and talked about for centuries. It makes quite an impression on almost all women. Most women remember their labor and birth experiences with exquisite detail. This is not to say that… »

Forceps and Vacuum Extractors

Occasionally, during the pushing stage of labor (second stage), a baby will be close to being born, but “not quite there yet”. This is often the most stressful time for a mother or baby. A mother may be exhausted or nearly so, and a baby may show signs of head and cord compression (which usually… »


Throughout history, blood loss after delivery and its associated complications have accounted for more maternal deaths than any other reason except infection. This is no longer the case when a woman is cared for by a competent clinician supported by a reasonably modern health care system. Overall, approximately 6% of women will have an estimated… »

Shoulder Dystocia

In a small percentage of births, the baby’s shoulder will become locked under the mother’s pubic bone immediately after delivery of the head. The doctor or midwife may be unable to deliver the baby with the usual hand skills. Every doctor and midwife is trained in the handling of this emergency, and there are several… »

Fetal Distress

Fetal distress is the term applied to the condition of the fetus who is exhibiting heart rate signs of poor oxygenation. Another synonymous phrase is “fetal intolerance to labor”. Both of these terms emerged with the advent of the electronic fetal monitor (EFM). Until the early 1970’s it was quite difficult to assess the health… »

Cephalo-Pelvic Disproportion

“Cephalo-” means head, and refers to the fetus’s head. CPD refers to a fetal head which is too big to fit through the mother’s pelvic bones. Cases of true CPD will not result in vaginal birth. Borderline cases of CPD may allow the head to emerge (after “molding”) only to have the shoulders become stuck… »

Failure to Progress

This term, failure to progress, is simply that. Dilatation of the cervix and descent of the fetus fail to occur despite efforts to correct it. In the recent past, this diagnosis has taken some criticism due its use (or overuse) to justify high c-section rates. There was a time in recent history (and to this… »

Protractions and Arrests of Descent

Once the cervix is fully dilated, the baby goes through an elaborate dance, called the “mechanisms of labor”, to negotiate and descend through the mother’s pelvic bones. Usually, this process of descent takes 30 minutes to 2 hours. During this period, most women feel a tremendous urge to push the baby out, and do just… »

Protractions and Arrests of Dilatation

Protractions and arrests of dilatation happen much more commonly with first-time mothers than with experienced mothers. It’s as though the uterus is inexperienced during the first labor. As many as 30% of first-time mothers will have a protraction or arrest of the progress of labor. Often the body is just taking a rest, or has… »