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Imminent bowel motion in labor: Is that happening?
One of the common and desperately worrying sensation is the strong urge to open bowel. This sensation is, in fact, the effect of the pressure of the baby in the birth canal transmitted to the rectum, which is immediately adjacent.
Even when the rectum is empty, a strong feeling of an imminent emptying of the bowel
may be there. Many women find this hard to cope with because, culturally, opening
the bowels is a very private thing. It should really never be a worry because midwives
and doctors are used to it and half-
Ideally, a woman should go in labor with an empty rectum but this does not always happen and should never be a cause for worry.
Sometimes, when a woman is seen in the latent phase of labor and is examined vaginally, a loaded rectum may be felt. Since there is still time, a suppository or even an enema may then be administered, to facilitate a bowel movement before the establishment of labor.
Catheterization to empty the bladder during labor
Sometimes it is necessary to pass a catheter to empty the urinary bladder during labor. A full bladder may impede both contractions and the descent of the baby down the birth canal. In the first stage of labor, normally the woman will be encouraged to pass urine herself from time to time. If an epidural has been used, then she may lose the sensation and therefore a catheter will be left in place to continuously drain the urine.
In the late first stage and in the second stage, it is usually very difficult and sometimes impossible for the woman to pass urine herself. If her bladder is rather full, then a catheter may need to be used for the reasons explained above.
Episiotomy
An episiotomy is the incision or cut that is made on the perineum to increase the size of the opening, thereby facilitating delivery. It is not always necessary. To do or not to do an episiotomy is one of the most important (and quick) decisions the person assisting delivery has to make.
An episiotomy is meant to prevent a perineal and/or vaginal tear and also hasten delivery. It is also believed to prevent future urinary problems, to some extent, by protecting the pelvic support muscles from damage that may be caused by overstretching.
It is, however, unnecessary to perform an episiotomy where progress in the second stage is smooth and the risk of a tear is deemed minimal. This is a judgment call.
It is impossible to be precise every time in this assessment and sometimes the judgment is wrong and a tear occurs where it was least expected.
