Definitions

Active Birth Centre

Set up originally by Janet Balaskas, its aim is to provide education and supportive classes for those women particularly interested in achieving a natural, active birth. www.activebirthcentre.com

Association for Improvements in Maternity Services (AIMS)

AIMS advocate "normal birth" and provide independent support and information about maternity choices with a view to raising awareness of current research on childbirth and related issues. www.aims.org.uk

British Medical Journal (BMJ)

The aim of the BMJ is to "publish rigorous, accessible and entertaining material that will help doctors and medical students in their daily practice, lifelong learning and career development. In addition, it seeks to be at the forefront of the international debate on health". bmj.bmjjournals.com

Caesarean Section (CS)

An operation involving an incision in your abdominal wall (through your abdomen and uterus) to deliver your baby.

Catheter

A thin, sterile tube. In the case of a urine drain this is inserted into your bladder. In the case of an epidural it is inserted into your spine.

Cranial Osteopathy

A branch of osteopathy that concentrates on the fine movements of the cranial bones. The brain is immersed in a fluid called Cerebro Spinal Fluid (CSF). This bathing process is vital to tissue function as it helps nourish and maintain brain tissue health. Any locking of cranial joints will affect the flow of CSF, and therefore the health of the brain. Through subtle and gentle techniques an osteopath can facilitate the movement between cranial bones, and thereby re-establish normal cranial rhythms, allowing the body to restore normal health. During birth significant pressure is placed on the body (the skull and neck in particular for vaginal deliveries). It is thought that treatment can help with crying, colic, sleep and feeding issues in babies and young children. www.cranial.org.uk

Doula

A person specially trained to help during labour and after the birth of a baby. www.doula.org.uk provides information about their services and s search tool for locating a Doula in your area. A doula might also help a new mother to breastfeed, or cook, clean, and care for older children.

Deep Vein Thrombosis (DVT)

A blood clot (thrombus) that develops in a deep vein, usually in the leg. This can happen if the vein is damaged or if the flow of blood slows down or stops. DVT can lead to complications if the clot breaks up and travels to the lungs in the bloodstream. In pregnancy and birth changes to hormone levels make the blood clot more easily as well as because the baby puts added pressure on the veins of the pelvis. There is also risk of injury to veins during vaginal delivery or caesarean. The risk is at its highest just after childbirth.

Elective caesarean

Refers to those occasions where a caesarean is conducted with advanced planning either as a result of an obstetricians recommendation or a mother's request.

Emergency caesarean

A confusing term, because in fact an 'emergency' caesarean just means one which was not planned at the start of labour, regardless of whether mother or baby were in immediate danger. An emergency caesarean therefore refers to occasions where labour has commenced but your baby now needs to be delivered urgently for medical reasons.

Endometriosis

A disease that affects many women and it is not clear whether having a caesarean can cause it. Endometriosis occurs when tissue like that lining the uterus is found outside the uterus i.e. in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus or the area between the vagina and rectum and outer surface of the uterus or lining of the pelvic cavity. Other sites for these endometrial growths may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars (i.e. a caesarean scar). Less commonly they are found in the lung, arm, thigh, and other locations.

This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterus does i.e. each month the tissue builds up, breaks down, and menstrual blood flows. In the uterus the tissue can leave the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. The result is internal bleeding, inflammation, pain, scar tissue formation (adhesions), and bowel problems, it can also lead to infertility.

For more information see www.endometriosisassn.org

It is thought that the likelihood of developing endometriosis, as a result of a caesarean procedure, is reduced "where the caesarean is planned rather than emergency and where there is a lower duration of membrane rupture, shorter labour prior to the caesarean and a lower number of pelvic examinations. The use of prophylactic antibiotics are also thought to decrease the likelihood of post-caesarean rate of endometriosis by 5%" 96.

Episiotomy

A surgical cut in the perineum between the vagina and the anus. You are usually given a local anaesthetic to numb the perineum before the episiotomy is carried out. Your midwife might suggest one if your baby is becoming distressed and needs to be born quickly, or if she thinks that you may tear very badly unless the opening from the vagina is carefully enlarged.

A great deal of research now suggests that it is actually better to tear rather than be cut as a natural tear heals more quickly. An episiotomy is sometimes recommended if you need to have a forceps or ventouse assisted delivery. If you wish to avoid having an episiotomy, make a clear note of this in your birth plan and remind your midwife during labour.

Forceps

These are paddles placed on either side of your baby's head (before the head has been born) which enable the doctor or midwife to pull your baby down onto the perineum to speed up the delivery. Research has shown that vacuum extraction (ventouse) is preferable to forceps in almost all cases as it causes less trauma to mother and baby 31.

Midwife

A midwife is generally the main provider of care to pregnant women throughout pregnancy, childbirth and the early postnatal period. Their expertise is in 'normal' pregnancy, childbirth and postnatal care and in making referrals to appropriate medical professionals and others if they detect deviations from the norm.

National Childbirth Trust (NCT)

A charity whose aim is to "help all parents enjoy an experience of pregnancy, birth and early parenthood which enriches their lives and gives them confidence in being a parent." www.nctpregnancyandbabycare.com

National Institute for Health and Clinical Excellence (NICE)

An independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. On 1 April 2005 NICE joined with the Health Development Agency to become the new National Institute for Health and Clinical Excellence (also to be known as NICE). www.nice.org.uk

Patient Controlled Analgesia

A machine which contains a syringe of pain control medication as prescribed by your doctor. The syringe is attached to tubing and connected directly to your intravenous (IV) line. When you feel pain or discomfort, you can press the button on your machine and it will give you additional medication. The machine is set up as prescribed by your doctor and will give only small, measured amounts. The total amount you can give yourself each hour is within a safe limit.

Pre-eclampsia

A condition characterised by high blood pressure, swelling that happens suddenly and is perhaps accompanied by rapid weight gain in the second half of pregnancy and protein in the urine. Pre-eclampsia can range from mild to severe and although it cannot be cured, it can be managed. Since it reduces the flow of blood to the placenta, it can be quite dangerous for your unborn baby. If you have any reason to suspect that you might have pre-eclampsia, contact your doctor or midwife immediately. If pre-eclampsia develops into eclampsia your blood pressure will become extremely high and both you and your baby will be at risk.

Tokophobia

Tokophobia is derived from the Greek tocos (childbirth) + phobos (fear). It can manifest itself in several ways: nightmares, physical complaints, difficulty concentrating etc. For some women it can turn pregnancy into a nightmare and for others it may be extreme enough to prevent them from ever deciding to become pregnant. Of those women who do become pregnant, some request a caesarean in order to avoid the labour experience and on rare occasions may abort a wanted baby because they cannot contemplate the delivery. Primary tokophobia is the dread of childbirth that pre-dates pregnancy. Secondary tokophobia usually results from previous experience of traumatic birth, poor obstetric practice or medical attention, previous postpartum depression or other personal concerns and anxieties 97.

Vaginal Birth After Caesarean (VBAC)

VBAC stands for Vaginal Birth After Caesarean. It is pronounced vee-back. There are a number of organisations whose aim is to support the rights of women to chose this birth option.

Ventouse

A suction cup applied to your baby's head and held in place while the suction draws the skin on the scalp firmly into the cup. It is used to assist your delivery if they baby is not progressing down the birth canal as desired. Handles attached to the ventouse are used to turn your baby and pull it out. You will still need to assist by pushing 32.