Obstetrics is a branch of medicine that deals with assisting human birth. It mainly involves midwives and obstetric nurses, as well as gynecologists in medical emergencies.
What is obstetrics?
Obstetrics is a branch of medicine that deals with assisting human birth. It mainly involves midwives and obstetric nurses, as well as gynecologists in medical emergencies. The work of medical obstetrics begins from the onset of pregnancy and ends with the postpartum care of the woman. During pregnancy, obstetric care provides for various check-ups and, in the case of women in high-risk groups, further supplementary examinations to ensure the health of mother and child. These are mainly performed by a gynecologist. As soon as a pregnancy is known, a midwife can be called in for supplementary examinations of mother and child. The earlier the midwife takes over part of the obstetric care during pregnancy, the better, because she will also accompany the woman during the birth. During the birth itself, midwifery professionals monitor the progress of the birth, labor, cervical activity, and the general condition of the mother and baby. Of course, midwives also help the birthing woman mentally to cope with the birth, but this is not their main task. In addition to medical obstetrics, other professions have developed specifically for this purpose, such as that of the doula, who serves as a spiritual support for the woman. The gynecologist intervenes in obstetrics only in emergencies and is usually present during the pushing contractions in order to be able to intervene quickly in case of complications. Birth operations are the responsibility of the gynecologist. Aftercare of the mother is also done by the gynecologist in the first step, and later by the accompanying midwife.
Treatments and therapies
Obstetric care begins when the pregnancy is established. For this purpose, the gynecologist takes blood when pregnancy is suspected and examines the HCG level. Pregnancy can be determined on the basis of this hormone. Thereafter, he undertakes regular ultrasound examinations, examines blood and urine samples at various times and offers the woman supplementary, optional examinations depending on the risk group. During the first trimester, the obstetrician checks the woman’s supply of vital nutrients; furthermore, she can still be vaccinated against rubella and other diseases at this time. The urine and the smear of the cervix are examined for infections every four weeks. During ultrasound examinations, the child can be monitored for health. Thus, early detection of malformations is considered part of obstetric care during the first months of pregnancy. The gynecologist may perform complementary examinations, such as amniocentesis, to detect or rule out diseases. If the decision to have an abortion is made during this time, the woman leaves the obstetrics area and is referred to surgery. Accompanying the gynecological examinations, a pregnant woman may have the services of a midwife, who also examines the mother and child by ultrasound as well as palpation. She can provide the woman with tips and aids during pregnancy to make everyday life easier. During the birth itself, both the accompaniment of a normal birth and the intervention in a problematic birth belong to the spectrum of obstetrics. While normal births are merely accompanied in a supportive manner, problematic births result in surgical interventions by the attending gynecologist. At best, perineal incisions are sufficient; at worst, emergency cesarean section is performed.
Diagnosis and examination methods
Basically, obstetrics knows the following diagnostic, examination and treatment procedures:
- Blood examination
- Urine examination
- Smear of the cervix
- Ultrasound
- Histological examinations
- Nutritional supplements during pregnancy (oral, intravenous).
- Surgical procedures before and during childbirth
- Pain management during childbirth
- Direct postpartum care
Obstetric care before birth regularly examines the health of the mother and baby.She clarifies whether dangerous infections exist, which can easily arise due to the reduced activity of the immune system of a pregnant woman. She treats these according to the possibilities during an existing pregnancy. The obstetrics department can partially combat undesirable developments and risks or identify them in time for treatment, but can also rule them out or facilitate the decision to terminate the pregnancy due to undesirable development of the child. In the course of pregnancy, obstetrics recognizes unfavorable positions of the child by means of ultrasound examinations and can prepare the birth accordingly or support the woman in a necessary decision for the type of birth. Blood tests are used to determine the woman’s supply of important nutrients necessary for her own health and the development of her child. If necessary, the gynecologist can prescribe a nutritional supplement in tablet form; in cases of severe deficiencies, intravenous administration can also provide rapid relief. Especially in cases of severe iron deficiency, iron infusions may be considered, as they act more quickly. In the last, physically strenuous third of pregnancy, supports from the medical supply store, for example for the back and abdominal muscles, are often considered in obstetrics. Furthermore, the baby’s heartbeat is now regularly monitored by means of CTG. During the birth, obstetricians use labor recorders and physical examinations to monitor normal progress. In many natural births, an episiotomy is performed during the birth; interventions with a suction cup or forceps are less common. Furthermore, the woman may receive an epidural for pain relief. In an emergency or at the explicit request of the woman, a cesarean section is performed. Depending on the type of birth, different aftercare measures are required, ranging from sitz baths for episiotomy to wound care after cesarean section.
