Special Procedures and Anesthesia | White Plains Hospital

Special Procedures & Anesthesia

Special Procedures

If needed, WPH is competently staffed and fully equipped to perform a variety of special procedures during your labor and delivery. These include:

Amniotomy

An amniotomy may be necessary if the amniotic sac does not break naturally before or during labor. Following this procedure, which utilizes a special instrument called an amniotic membrane perforator, your contractions may feel stronger. An amniotomy may be needed when your physician or midwife needs to check the amniotic fluid or begin internal fetal monitoring.

Cesarean Births

A Cesarean delivery may be necessary for the health and well-being of you and/or your baby. In such cases, the baby is lifted out through a cut in the mother's abdomen and uterus. This is usually accomplished through a horizontal incision just above the pubic hairline. In rare instances, a vertical cut from the naval to the pubic area will be made.

Cesarean births are more likely when the baby is very big or the mother's pelvis is very small or if the baby is in a breech position. Cesarean deliveries are also performed in the event of increased fetal risk or abnormalities in the progress of labor.

Episiotomy

Your doctor or midwife may perform an episiotomy to prevent the vagina from tearing during birth. it can also help speed delivery and reduce pressure on the head of premature, very large or breech babies.

Following injection of a local anesthetic, the doctor or midwife will make a cut to widen the vaginal opening. This is usually done just before the baby's head emerges.

If your preference is to avoid an episiotomy, you should discuss this possibility with your physician or midwife prior to labor. Here are some suggestions to help your vaginal opening stretch by itself without tearing:

  • Sit up, squat with support, or lie on your side to give birth.
  • Bear down gently to ease your baby out slowly.
  • Ask your caregiver to lubricate and support the vaginal opening.

Fetal Monitoring

Your baby's heartbeat will be monitored frequently during labor. This may be done by external fetal monitoring, utilizing two belts placed around your abdomen. Another option, internal fetal heart monitoring utilizes a thin wire that is gently inserted into the scalp of the fetus to monitor the heartbeat. There is a slight risk of infection or bleeding with this procedure. Internal fetal monitoring devices may be used at the discretion of your physician or midwife and will be discussed with you if the need arises.

Other tools to check your baby's well-being include a fetoscope (a stethoscope specially designed for this purpose) and an ultrasonic doppler, which can magnify the baby's heartbeat. Both devices are used externally and will not cause any discomfort to you or your baby.

Internal uterine monitoring may also be recommended by your doctor or midwife. The strength of your contractions is monitored via a narrow soft catheter that is inserted through the vagina.

Forceps and Vacuum Extraction

Forceps are spoon-like metal instruments that can assist with the delivery during an emergency or if the mother has difficulty pushing the baby out by herself. They can temporarily bruise the baby's face; however, they are not used often. Another alternative, a vacuum extractor, involves a suction cup placed on the baby's head. While it generally does not hurt the baby's face, it can cause some temporary bruising or swelling of the scalp.

VBAC (Vaginal Birth After Cesarean)

It may be possible to deliver a baby vaginally after a cesarean section. Your obstetrician will counsel you about your chances for a VBAC. The staff is very supportive and experienced in helping you through a VBAC.

Anesthesia & Other Medications During Childbirth

White Plains Hospital offers multiple pain relief options during labor. These include labor support, non-pharmacologic measures, and a variety of anesthesiologist-provided services, including epidurals.

For more information about anesthesia services, see the Anesthesia Brochure and the section on anesthesia during childbirth that appears near the end of the brochure.