Birthing options Most women prefer hospital delivery, and most health care practitioners recommend it because unexpected maternal and fetal complications may occur during labor and delivery or postpartum, even in women without risk factors. About 30% of hospital deliveries involve an obstetric complication (eg, laceration, postpartum hemorrhage). Other complications include abruptio placentae, abnormal fetal heart rate pattern, shoulder dystocia, need for emergency cesarean delivery, and neonatal depression or abnormality. Nonetheless, many women want a more homelike environment for delivery; in response, some hospitals provide birthing facilities with fewer formalities and rigid regulations but with emergency equipment and personnel available. Birthing centers may be freestanding or located in hospitals; care at either site is similar or identical. In some hospitals, certified nurse-midwives provide much of the care for low-risk pregnancies. Midwives work with a physician, who is continuously available for consultation and operative deliveries (eg, by forceps, vacuum extractor, or cesarean). All birthing options should be discussed. For many women, presence of the father, partner, or another support person during labor is helpful and should be …show more content…
If fetal heart pattern does not improve in a reasonable period and delivery is not imminent, urgent delivery by cesarean is needed Pain control Agents given in intermittent doses for systemic pain control include the following: • Meperidine, 25-50 mg IV every 1-2 hours or 50-100 mg IM every 2-4 hours • Fentanyl, 50-100 mcg IV every hour • Nalbuphine, 10 mg IV or IM every 3 hours • Butorphanol, 1-2 mg IV or IM every 4 hours • Morphine, 2-5 mg IV or 10 mg IM every 4