Imagine giving birth in an MRI machine? Well that’s exactly what a German woman did as a volunteer for a scientific study according to the American Journal of Obstetrics and Gynecology (AJOG).
In November 2010, 1 24 year old woman who had 2 previous children was admitted to a German hospital with regular contractions. She received an epidural for pain management and was allowed to labor in a magnetic resonance imaging (MRI) suite. She delivered a 2585 gram boy whose Apgar scores were 9 after one minute and 9 after 5 minutes. Both baby and mother did well and were discharged home after 2 days in excellent condition.
Most physicians and midwives were taught about the birth process through books and clinical exams. We’re taught that the labor process has three stages:
- The first stage involves active labor that begins at approximately 4 centimeters and continues until the mother is 10 centimeters, also known as fully dilated. During this first stage, the baby has to make certain movements through the birth canal called the cardinal movements. These movements are called engagement, descent, flexion, internal rotation, extension, external rotation and expulsion. So, just like mom is working during the labor process, the baby is working as well.
- The second stage involves pushing once the mother has reached 10 centimeters. This process usually takes 2 hours and slightly more if it’s the mother’s first baby. However, after 2 hours, the labor process needs to be evaluated. Is the baby too big? Or is the pelvis too small for a vaginal delivery? It is at this point that a decision needs to be made whether the mother should have a cesarean section.
- The third and final stage involves the expulsion of the placenta that should occur within 30 minutes after the baby is born.
Now, this entire process has been recorded on a video and has revealed a real-time version of labor that provides a tremendous amount of information regarding the mother’s pelvic anatomy as well as the baby’s. What we learned is that the baby has to navigate a 90-degree turn within the birth canal, extends and then rotates its head before coming out of the womb.
Why is this information important? Because it can allow us to determine who will require a cesarean depending on what we see. It will also allow us to provide a more individualized approach to the labor process. Although MRI observation in the labor room may not happen tomorrow, it certainly has a potential role for the birth process in the future.