Case Studies

First- time Mothers’ are Encouraged for the Natural Birth

The story of the new mother Rochelle Owen could have been presented as a candidate for a tough labor leading to a caesarean section delivery. When she was in 38 weeks of her pregnancy, her blood pressure was high enough to be a worry and sparked the decision to induce the labor early.

For many first-time mothers in the past, induction has been a reasonably unpleasant experience and the first step in a cascade of interventions often leading to the need for a surgical delivery.

But thanks to the use of a new induction drug named Misoprostol, it has not been happening so much lately in the Palmerston North Hospital. This medicine is taken orally once every two hours with regular monitoring until labor is well established.

At that stage, hospital staff handed Owen’s care back to her midwife who assisted with the normal delivery. Her baby, weighing 2.57 kilograms was born 25 hours after the induction began.

Owen said the process was much less invasive than she had been led to expect from other mothers who had experienced induction.

She was keen to avoid having a C- section. She said, “I did not want to have to go through the recovery time- for six weeks you cannot drive and cannot lift anything heavier than the baby.”

Not only that, having a C- section hugely increases the risks of requiring another with subsequent babies. At Palmerston North Hospital, 30 percent of C- sections are women who have had one before.

The new drug regime for inductions was induced at MidCentral Health by Obstetrician Pelle Kempe amd the result has triggered the interest of other district health boards and international observers. It won the team an innovation prize from the Health Roundtable- a knowledge-sharing collective drawing on quality improvements in health in Australia and New Zealand, the UK, the United States and Canada.

MidCentral’s statistics for C- sections had been stubbornly high for decades with 21 percent of first-time mothers with babies presenting in the head-down position having one, compared with rates of 5 to 7 percent in Norway and Sweden.

The earlier MidCentral figures showed that if a woman’s first labor was induced, there was a 41 percent chance they would end up having a caesarean. Two years later, those chances dropped to 22 percent.

The likelihood of the women needing an epidural or instrumental assistance in birth dropped slightly without any increase in the incidence of sphincter tears or babies needing neonatal care.

Healthy women, children and youth clinical executive Jeff Brown said although the drug was part of the improvement, regular monitoring and the expectation induction would lead to a normal birth also helped. He was delighted for the women who had the normal delivery. They hoped for and for what it meant for their next labors.

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