Ketosis can lead to the woman needing to have her labour
augmented. This can increase her chances of experiencing a possible 'cascade' of unnecessary interventions. Therefore it is important to prevent ketosis, by keeping up an adequate intake of food and fluids during labour.
A typical scenario that can unfold when a woman becomes dehydrated, or 'ketotic', can be as follows:
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The woman becomes dehydrated and exhausted, often developing a fever and a fast pulse, the uterus doesn't contract efficiently, slowing down the progress of her labour. |
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An intravenous (IV) drip is inserted into her vein in the delivery suite (meaning a transfer if you were planning to birth in a birth centre or at home) and fluids are given for dehydration and ketosis. |
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Intravenous oxytocin (or Syntocinon) may be given through another drip to augment the labour or speed up, strengthen and coordinate the contractions. |
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If an oxytocin drip is being used to augment the labour, a continuous electronic fetal monitor (CTG) may be started to make sure the baby does not become distressed, in case the uterus becomes over stimulated. Two belts are placed around the woman's belly so that the baby's heartbeat can be tracked. |
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The woman's movements are restricted because her baby is being monitored, making it necessary for the woman to remain relatively still on the bed. Some other forms of pain relief are now not possible, like the bath or shower. |
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If the woman's movements are restricted, and she needs to stay relatively still she may find labour more uncomfortable and be more inclined to need medical forms of pain relief. |
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Augmenting the labour, and some medical forms of pain relief can increase the woman's chances of needing forceps, a ventouse, an episiotomy or a Caesarean. |
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Large volumes of fluids given by the vein have the potential to overload the woman's system with excess fluids. This can increase the chances of fluid accumulating in her (and her baby's) lungs. This can make the mother quite unwell and mean the baby has increased breathing rates at birth, needing observation in the intensive care nursery. This is called 'transient tachypnoea' or wet lung.
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