American Medical Association Family Medical Guide - American Medical Association [280]
Biophysical profile
A biophysical profile is an evaluation of the fetus’s health using the results of a nonstress test (which assesses the fetus’s heart rate) and an ultrasound (which assesses the fetus’s breathing, movements, and muscle tone, and the amount of amniotic fluid). This information helps the doctor determine if an early delivery is necessary, if more testing is needed, or if the pregnancy can continue naturally with frequent monitoring.
Contraction stress test
A contraction stress test may be performed in high-risk pregnancies or when a nonstress test or biophysical profile has produced abnormal results. The contraction stress test measures the fetus’s heart rate during uterine contractions to determine if the fetus will be able to handle the stress of labor. In a stress test, ultrasound is used to evaluate the fetus’s heart rate during uterine contractions, which briefly decrease the flow of blood to the placenta. To stimulate contractions, the pregnant woman is given a carefully controlled dose of a drug called oxytocin. If the fetus responds normally, the pregnancy is allowed to continue naturally. If the doctor sees signs of stress in the fetus, such as a decreased heart rate, he or she may recommend early delivery by inducing labor (see page 533) or by cesarean delivery (see page 534).
Prenatal Classes
If you are pregnant, it is important to learn not only about pregnancy but also about labor and delivery. Many organizations (such as hospitals, doctors’ offices, and community organizations) sponsor childbirth education classes such as Lamaze. Ask your doctor to recommend one. Have your partner (or a family member or close friend you have chosen to be your labor coach) attend classes with you. He or she can provide encouragement, support, and comfort during your labor and possibly during the delivery.
Natural childbirth and psychoprophylaxis are terms used for childbirth in which the pregnant woman and her labor coach learn relaxation techniques and breathing exercises to lessen the pain of uterine contractions during labor. For many women, these techniques can reduce or eliminate the need for anesthesia and pain medications. The classes usually begin during the seventh month of pregnancy. Women who attend these classes tend to have a more positive childbirth experience because they know what to expect and are more relaxed during delivery.
Planning Ahead for Labor and Delivery
Before making a decision about where and how you want to deliver your baby, discuss all the possibilities with your doctor. Most women deliver in a hospital, and some hospitals offer alternatives to traditional labor and delivery rooms. One of these hospital-based alternatives is a birthing room or center (a private room with a more homelike atmosphere than a standard hospital room) where you, with the help of your labor coach, go through both labor and delivery. If problems arise, you can easily be moved into a labor and delivery suite, which has the staff and equipment to manage complications. However, to qualify for an alternative birthing experience such as a birthing room, you must have no medical problems that could complicate your pregnancy. Some centers also require that the pregnant woman have regular prenatal care and that she and her coach attend prenatal classes.
Some women prefer home childbirth. Nurse-midwives provide a valuable service to any woman who chooses to deliver at home. However, if any complications arise that require emergency treatment, home childbirth can be risky for both the mother and baby. To minimize the potential risks involved with home births, the pregnant woman should be healthy, the pregnancy uncomplicated, and a medical doctor on call to handle any complications that could arise during labor and delivery.
Discuss with your doctor his or her recommendations