Gynecology and Obstetrics


Birth

Birth is a process in which a baby ready to live in the external environment is expelled from the body of the baby's mother.

Natural childbirth

Birth is not a process which is over and done with, especially the first delivery may take up to 20 hrs. However, delivery can be performed in a controlled manner and in shorter periods using medications.

In the hospital, whether delivery has started is understood by softening and dilation of the cervix. The contractions which signal that the birth has started are regular and increase in frequency.

As known, birth is a painful process and pain relief methods can be applied. Most frequently, epidural anesthesia is used; in this technique, lower part of the body of the pregnant woman is anesthetized and sense of pain is eliminated, facilitating delivery.

In addition, episiotomy is applied to the genital area, in other words, an incision is made with scissors after local anesthesia so that the baby's head passes through the vaginal opening much easily and uncontrolled tears are prevented. In addition, episiotomy is also performed if the baby is too large or if forceps or vacuum will be applied. The episio is repaired with stitches after birth.

Labor Induction

Labor induction is an intervention by which childbirth contractions are started using various methods.

It is most frequently used in cases where the pregnancy has gone past the normal date of birth. Moreover, it can be provided in a controlled manner where the baby will have difficulty due to a delay in the process of giving birth. It is a frequently applied method for the mother to give birth in a short time when the mother is weak and cannot endure prolongation of the process of giving birth and in the case of certain conditions of the mother.

Assisted delivery (vacuum and forceps)

During normal delivery, the baby can not be pushed down by the mother and an intervention may be required without putting the baby at risk. For this purpose, vacuum or forceps is applied.

The selection of either forceps or vacuum applications is related to the physician's experience; there is no significant difference in results between the two methods.

Forceps consists of two separate pieces of spoon-like metal and it is placed around the baby's head and delivery is performed by the doctor by pulling the baby. The vacuum device consists of a pipe that can create negative pressure with a suction cup on its tip to be placed onto the head of the baby. This sup is placed onto the head of the baby and then a negative pressure is created.

If vacuum/forceps procedures fail, the baby is delivered by caesarean section.

Delivery by Caesarean section

During delivery by Caesarean section, the baby is removed from the mother by a surgical procedure performed on the mother's abdomen. It is usually performed when normal labor is risky. However, it can be applied upon request.

Conditions impeding natural childbirth and requiring caesarian sections are listed below:

  • Mismatch between the baby's head and the mother's roof (roof stenosis)
  • Decreased heart rate in the baby
  • That the baby's poop is mixed with the mother's water
  • Failed vacuum or forceps delivery
  • Pregnancies conceived by IVF
  • Advanced age pregnancies
  • Previous Caesarean section
  • Multiple pregnancy
  • Abnormal presentation of the baby (breech or transverse positions)
  • Large baby (weighing more than 4000 g) or small baby (weighing less than 1500 g)
  • That the mother has genital warts or herpes
  • That the mother has previously undergone vaginal surgery or has had myoma resected.

Caesarean delivery may take 30-60 minutes depending on the situation . Recovery may take up to 6 weeks. It is often performed under general anesthesia. But in recent years, anesthetizing the lower region of the body, i.e. epidural anesthesia is commonly performed. Thus, the risk of general anesthesia is eliminated.