Acupuncture

Acupuncture involves the insertion of extremely thin needles through your skin at strategic points on your body. A key component of traditional Chinese medicine, acupuncture is most commonly used to treat pain.

Traditional Chinese medicine explains acupuncture as a technique for balancing the flow of energy or life force — known as qi or chi (CHEE) — believed to flow through pathways (meridians) in your body. By inserting needles into specific points along these meridians, acupuncture practitioners believe that your energy flow will re-balance.

In contrast, many Western practitioners view the acupuncture points as places to stimulate nerves, muscles and connective tissue. Some believe that this stimulation boosts your body's natural painkillers and increases blood flow.

Why It’s Done 

  • Dental pain
  • Fibromyalgia
  • Headaches, including tension and migraine headaches
  • Chemotherapy-induced and postoperative nausea and vomiting
  • Labor pain
  • Low back pain
  • Neck pain
  • Osteoarthritis
  • Menstrual cramps

Risks

The risks of acupuncture are low if you have a competent, certified acupuncture practitioner. Possible side effects and complications include:

  • Soreness
  • Organ Injury- particularly a lung
  • Infections
  • Bleeding disorders
  • Having a pacemaker
  • Being pregnant

Results

The benefits of acupuncture are sometimes difficult to measure, but many people find it helpful as a means to control a variety of painful conditions.

Several studies, however, indicate that some types of simulated acupuncture appear to work just as well as real acupuncture. There's also evidence that acupuncture works best in people who expect it to work.

Since acupuncture has few side effects, it may be worth a try if you're having trouble controlling pain with more-conventional methods.

General Anesthesia

General anesthesia makes you both unconscious and unable to feel pain during medical procedures. General anesthesia is commonly produced by a combination of intravenous drugs and inhaled gasses (anesthetics).

The "sleep" you experience under general anesthesia is different from regular sleep. The anesthetized brain doesn't respond to pain signals or surgical manipulations.

An anesthesiologist is a specially trained doctor who specializes in all types of anesthesia, including general anesthesia. After you're asleep (unconscious), your body's vital functions are monitored and your breathing is assisted and controlled.

In many hospitals, an anesthesiologist and another team member, a certified registered nurse anesthetist (CRNA), work together throughout your procedure to carry out these tasks.

Why It’s Done 

Besides general anesthesia, other forms of anesthesia may provide only light sedation or use injections to numb only a small area (local anesthesia) or a larger region (regional anesthesia) of your body.

Your doctor will discuss with you the risks and benefits of the various options for anesthesia. Doctor may recommend general anesthesia for procedures that:

  • Take a long time
  • Include significant blood loss
  • Expose you to a cold environment
  • Affect your breathing, such as chest or upper abdominal surgery

Risks

Some of the factors that can increase your risk of complications include:

  • Smoking
  • Obstructive sleep apnea
  • Obesity
  • High blood pressure
  • Diabetes
  • Other medical conditions involving your heart, lungs or kidneys
  • Medications, such as aspirin, that can increase bleeding
  • History of heavy alcohol use
  • Drug allergies
  • History of adverse reactions to anesthesia
  • Temporary mental confusion
  • Lung infections
  • Stroke
  • Heart attack
  • Death

Labor Induction

Labor induction — also known as inducing labor — is a procedure used to stimulate uterine contractions during pregnancy before labor begins on its own. Successful labor induction leads to a vaginal birth. A health care provider might recommend labor induction for various reasons, primarily when there's concern for a mother's health or a baby's health.

Labor induction carries various risks, including infection and the need for a C-section. Sometimes the benefits of labor induction outweigh the risks, however. If you're pregnant, understanding why and how labor induction is done can help you prepare.

Why It’s Done 

Labor induction might be recommended if:

  • You're approaching two weeks beyond your due date, and labor hasn't started naturally
  • Your water has broken, but you're not having contractions
  • There's an infection in your uterus
  • Your baby has stopped growing at the expected pace
  • There's not enough amniotic fluid surrounding the baby (oligohydramnios)
  • Your placenta has begun to deteriorate
  • The placenta peels away from the inner wall of the uterus before delivery — either partially or completely (placental abruption)
  • You have a medical condition that might put you or your baby at risk, such as high blood pressure or diabetes

Risks

Labor induction carries various risks, including:

  • The need for a C-section
  • Premature birth
  • Low heart rate
  • Infection
  • Umbilical cord problems
  • Uterine rupture
  • Bleeding after delivery

In addition, if you've had a prior C-section with a low transverse incision and have labor induced, you'll be closely monitored. If you've had a prior C-section or major uterine surgery and have labor induced, your health care provider will avoid certain medications to reduce the risk of uterine rupture.

How you prepare

Labor induction is done in a hospital or birthing center, where you and your baby can be monitored and labor and delivery services are readily available. However, some preparatory steps may be done before admission.

What you can expect

There are various methods for inducing labor. Depending on the circumstances, your health care provider might:

  • Strip or sweep the amniotic membranes. With this technique, your health care provider inserts his or her gloved finger beyond the cervical opening and rotates it to separate the amniotic sac from the wall of your uterus. This technique can be done during an office visit and doesn't truly induce labor. However, it might speed the beginning of spontaneous labor — especially if your cervix has already begun to dilate. You might experience intense cramping and spotting. If bleeding becomes heavier than a normal menstrual period, contact your health care provider.
  • Ripen your cervix. Sometimes synthetic prostaglandins, which can be taken by mouth or placed inside the vagina, are used to dilate the cervix. In other cases, mechanical dilators are used — such as a small balloon-tipped catheter or small rods made from seaweed (laminaria). The balloon-tipped catheter is inserted beyond the cervical opening. Saline injected through the catheter expands the balloon, causing the cervix to widen. Dilators inserted into the cervix absorb moisture and get thicker, opening the cervix. Use of laminaria can cause cramping. Cervical ripening techniques are typically done in the hospital. After prostaglandin use, your contractions and your baby's heart rate will initially be monitored.
  • Break your water. With this technique, also known as an amniotomy or rupturing the membranes, your health care provider makes a small opening in the amniotic sac with a thin plastic hook. You might feel a warm gush of fluid when the sac opens. An amniotomy is typically done only if the cervix is partially dilated and thinned and the baby's head is deep in the pelvis. Your baby's heart rate will be monitored before and after the procedure. Your health care provider will examine the amniotic fluid for traces of fecal waste (meconium).
  • Use an intravenous medication. In the hospital, your health care provider might give you a synthetic version of oxytocin (Pitocin) — a hormone that causes the uterus to contract. Oxytocin is more effective at inducing labor if your cervix has already begun to dilate and thin. The medication is also used to augment or stimulate contractions if labor isn't progressing. Your contractions and your baby's heart rate will be continuously monitored.

Keep in mind that your health care provider might also use a combination of these methods to induce labor.

How long it takes for labor to start depends on how your body responds to the induction techniques. If your cervix needs time to ripen, it might take two days before labor begins. If you simply need a little push, you might be holding your baby in your arms in a matter of hours.

Contractions might become stronger and more painful earlier in induced labor than they would in a naturally occurring labor. If relaxation and breathing techniques aren't enough to control the pain, ask for relief. Your health care provider might recommend an epidural block or other options.

After the procedure

In most cases, labor induction leads to a successful vaginal birth. If labor induction doesn't lead to delivery, a C-section might be needed.

The issues that lead to an induction might require special care during recovery. If you have a successful vaginal delivery after induction, there might be no implications for future pregnancies. If the induction leads to a C-section, your health care provider can help you decide whether to attempt a vaginal delivery with a subsequent pregnancy or to schedule a repeat C-section.