Know You Birthing Options
An easy birth and a perfectly executed birth is ideal. But, we know that even the most carefully planned birth can take twists and turns. In those cases, it’s important to be prepared for alternative delivery methods.
Vaginal delivery is the method of childbirth most health experts recommend for women whose babies have reached full term. There are three stages of labor:
- The first stage of labour is from the onset of labor until the cervix is fully dilated
- The second stage of labor occurs from when the cervix is fully dilated till the delivery of the baby.
- The third stage is from the delivery of the baby till delivery of the placenta and membranes.
Cesarean Section (C-Section)
A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother’s abdomen. In the United States, almost one in three women has their babies this way. Some C-sections are planned, but many are done when unexpected problems happen during delivery.
Reasons to have a C-Section:
- You’ve had a previous cesarean with a “classical” vertical uterine incision (this is relatively rare) or more than one previous c-section.
- You’ve had some other kind of invasive uterine surgery, such as a myomectomy.
- You’re carrying more than one baby.
- Your baby is expected to be very large.
- Your baby is in a breech or feet-first position.
- Your baby’s heart rate gives your practitioner cause for concern
- Your cervix stops dilating or your baby stops moving down the birth canal, and attempts to stimulate contractions to get things moving again haven’t worked.
Vaginal Birth After Cesarean
If you have had a cesarean delivery before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC. A woman who chooses VBAC is closely monitored. As with any labor, if the mother or baby shows signs of distress, an emergency cesarean section is done. For many women, VBAC is an option. In fact, research on women who attempt a trial of labor after cesarean (TOLAC) shows that about 60 to 80 percent have a successful vaginal delivery.
Benefits of VBAC:
- Shorter length of hospital stay and postpartum recovery (in most cases)
- Fewer complications, such as postpartum fever, wound or uterine infection, thromboembolism (blood clots in the leg or lung), need for blood transfusion
- Fewer neonatal breathing problems
Risks of VBAC:
- Failed attempt at labor. Labor can results in a repeat C-section.
- Uterine rupture. Rarely, the uterus might tear open along the scar line from a prior C-section.
During vacuum extraction, a health care provider applies the vacuum — a soft or rigid cup with a handle and a vacuum pump — to the baby’s head to help guide the baby out of the birth canal. This is typically done during a contraction while the mother pushes.
After a vacuum extractor delivery, there may be some bruising or swelling on the baby’s scalp. This technique can only be used if the baby is born head first and is at full term; it can be dangerous for premature babies.
In a forceps delivery, a health care provider applies forceps — an instrument shaped like a pair of large spoons or salad tongs — to the baby’s head to help guide the baby out of the birth canal. This is typically done during a contraction while the mother pushes.
Reasons for forcep delivery
Even after your cervix is fully dilated (open) and you have been pushing, you may still need help getting the baby out. Reasons include:
- After pushing for several hours, the baby may be close to coming out, but needs help to get through the last part of the birth canal.
- You may be too tired to push any longer.
- A medical problem may make it risky for you to push.
- The baby may be showing signs of stress and need to come out faster than you can push it out on your own
No matter your preference, it’s important to gather enough information to make a decision that best fits your personal needs. Contact Ko’olau Women’s Healthcare in Honolulu, HI today to schedule your appointment.