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Show Complications in childbirth High-risk births require scrutiny j Kditor's Note: The prospect of giving birth to a child can be a very exciting time, as well as a time filled with some normal apprehension ap-prehension and fears. These concerns con-cerns are relieved and forgotten as soon as a healthy bundle is placed in the eager arms of loving parents who have waited nine months for this special meeting. But what happens when imagined fears become a reality and something does go wrong? Over the next three weeks, we will take a look at this possibility in a three part series of Childbirth Complications. Com-plications. No complications were anticipated an-ticipated as a young mother, expected ex-pected her fourth child, began a well-rehearsed labor. Arriving at AF Hospital, she informed the admitting nurse thai her baby would be arriving on schedule. The hospital staff expected ex-pected to deliver an infant of approximately ap-proximately 40 weeks gestation, plus or minus two weeks. , The birth itself preceded without complications, until a premature infant was delivered with respiratory distress complications. Instead of a term delivery, a premature infant was born at 33 weeks gestation. Unable to support his respiratory needs, his immature lungs struggled with each breath, and oxygen assistance was required to prevent brain damage. It is estimated that 30-50 percent of newborns requiring Intensive Care assistance were delivered from mothers classified as low-risk. There were no previous indications (hat specialized care would be required. According to Dr. Brent Lind, OBGYN, "Most babies can be delivered any place without serious problems. However," he qualified, "many babies may encounter problems during labor and delivery which could have serious side-effects side-effects if not corrected." One method of determining pregnancy and childbirth risk factors is to identify expectant mothers as either high or low-risk. Obstetrical risk factors are based upon general characteristics of pregnant women, previous OB history, and any related pregnancy ' and medical factors. "Identification of high-risk mothers-to-be helps improve awareness and management of complications, so that adverse outcomes are prevented," explained ex-plained Dr. Lind. Like other medical specialties, obstetrics has also experienced -scientific and technological advances, ad-vances, resulting in significant improvements with maternity care. To a mother determined to be at high-risk for pregnancy or childbirth, child-birth, advances in fetal monitoring and labor management procedures dramatically improve the safety of both mother and child. Some women have reacted to this increased mechanization of childbirth as meddling and interfering in-terfering with a perfectly natural process. "Nature is not always perfect and there are times when medical assistance is required," explained Dr. William Parker, a local OBGYN. "While we recognize a woman's right to flexibility and nonintervention, non-intervention, aggressive management of labor helps the labor to progress as smoothly and as painlessly as possible. This results in fewer complicatiions, a decreased need for forceps, and a lower epidural level," he continued. con-tinued. A high-risk rating automatically leads to closer observance of both mother and fetus to' handle or to avoid any complications which might arise. The tendency is many hospitals is for the labors of low-risk mothers to be supervised by well-qualified well-qualified nurses. Physicians are then consulted if complications arise. "We are aware that ap proximately one third of i mothers may develop chi, complications unexpectedly". Parker. "At AFH, our oL physicians prefer to tab aggressive approach to 0!, i: -labor management as well Ji risk." as , "We are constantly in the how, checking on laboring mother actively supervising progress," he said, "if bf: plications arise unexpectedly0011 are able to intercede mo ' J ficiently." c In the year 1915, the ,,. Department of Health Educai and Welfare statistics indicated f 100 babies died for every 1000 ' births. Medical advances and acr intervention, both during and si child birth, have increased the birth rate per 1000 births m ! percent in 1985. "Childbirth options have becorr a popular and viable comproj' between hospital routine and hoi birth alternatives," conli J Parker. "But a nine month t vestment in a life-time of iov worth placing the safety of J mother and child above and beZ the risk of convenience when't predictable complications arise " Next issue, part 2 of the Chili birth Complications serie-Newborn serie-Newborn Intensive Care Infants ' |