Medical indication
An obstetrician is only authorized to supervise a normal pregnancy and delivery. She has been trained to distinguish when something is still 'normal', or when there is an increased risk and complications (could) occur.
RISK SELECTION
When someone has an increased risk, or complications arise, there is a medical indication. Then you will be referred to a gynecologist. Sometimes only consultation with the gynecologist is necessary (consultation) and some additional examinations are performed. This is called risk selection.
If everything appears normal, you will be referred back to the midwife. Sometimes it is also necessary for the gynecologist to guide you further. During the pregnancy, you will then remain under supervision in the hospital, and you will also have to give birth there (clinical delivery).
PREGNANCY
The most common referrals in pregnancy are:
- High blood pressure
- Abnormal growth of your baby
- A breech presentation at 37 weeks
- A burdened medical history, medical problems
- Problems during a previous pregnancy or delivery
- Feeling less life, reduction of child movements
BIRTH
The most common referrals during labor are:
- Meconium-containing amniotic fluid, the baby has pooped in the amniotic fluid
- A too slow dilation phase, opening your cervix takes too long. This is called a non-progressive access (NVO).
- The pushing takes too long. This is also referred to as not progressing the exorcism (NVU).
- The baby's heart sounds are not optimal
- The mother loses too much blood after birth. This is called flux.
IN THE HOSPITAL
In the hospital you must deal with gynecologists, doctors who are in training for gynecologists, physician assistants, interns and nurses. It is important that, even if you have become 'medical', you talk about your personal wishes and expectations about pregnancy and childbirth. Even though everything will not always be possible, you should speak out.
