Types of delivery
Essentially, there are only two types of deliveries that can happen, but there are variations among these types. It is important to keep in mind that though you may have planned for a normal delivery procedure, it might not go according to plan and things may have to change at the last minute. Below are some of the types of delivery possible:
i. Vaginal delivery:
This is considered the safest and most preferred method of birthing for mothers and doctors alike. There are many advantages to birthing a baby through the birth canal naturally as opposed to a cesarean section, such as improved immunity for the baby and better expansion of the baby’s lungs.
A vaginal delivery might sometimes require medical intervention. Sometimes, a woman may not be able to bear labour pains and ask for pain-relieving treatment such as an epidural. Though this might not mean a painless normal delivery, it can relieve a lot of labour pain symptoms. Sometimes, if a baby’s head is not passing smoothly enough through the birth canal, an episiotomy is required. An episiotomy is an incision made in the perineum, which is the tissue between the vaginal opening and the anus, to help avoid tears and bring the baby out safely. This is not done for every birth, but is assessed during the birthing process and decided upon in the moment.
ii. Natural birth
A natural birth is one that avoids all pain medications and medical interventions during the delivery. Some women choose this as they feel it is the most natural way of birthing, and hence the healthiest. Moreover, some women are at risk for lowered blood pressure when they opt for an epidural, which in turn affects the baby and the entire birthing experience.
A completely natural delivery is encouraged for women who have a low-risk, uncomplicated pregnancy. Talk to your doctor before choosing this option.
iii. Cesarean section
A cesarean section, also known as a c-section, is when a doctor makes a horizontal incision on the lower abdomen where the uterus is and removes the baby through it. Sometimes, even when a woman has chosen to deliver vaginally, some unforeseen circumstances and complications lead to an unplanned c-section. In some cases, you can even schedule your c-section beforehand. This is done especially in the case of high-risk pregnancies.
iv. Induced Labour
Normally, a woman naturally achieves labour once her gestation period of 40 weeks is done. However, it is also possible that sometimes a woman can be in her 41st or 42nd week of pregnancy with no signs of labour yet. In this case, the doctor will induce labour.
Some other reasons to induce labour are:
- Concern about placenta’s effectiveness
- Baby is making slower and fewer movements
- Your water has broken but contractions haven’t started
In this case, a doctor may believe it is best to induce labour for you and your baby’s health. Induction may be done by breaking the water manually,
mechanically opening the cervix, or by medications that kick-start contractions.
v. Forceps Delivery
Sometimes, a doctor may have to use forceps to bring the baby out through the vaginal canal. This is done only when the mother is no longer able to push, or the baby is having trouble coming through the birthing canal. These days, forceps delivery is becoming increasingly rare as there is a risk of injury to the baby.
vi. Vacuum Extraction
Much like with forceps, a baby that is having trouble coming out or a mother having trouble pushing will be helped by inserting a small vacuum that safely cups a baby’s head and gently brings it out into the world.
vii. Vaginal delivery after c-section
Doctors generally advise women who have had c-sections with past births to continue having a c-section with subsequent births. However, it is more and more common now for doctors to encourage women to deliver vaginally even with a c-section history. Mothers may also prefer a normal delivery after having longer recovery times after a previous c-section. When a woman delivers normally after a c-section, it is called a VBAC.
When is normal delivery recommended?
Generally, any healthy woman with a healthy pregnancy and low-risk birth factors is recommended to have a normal delivery. Some women are considered “high risk”, and may not be recommended to have a normal delivery. High-risk factors include:
- Carrying multiple fetuses
- Older than 35 years of age
- A history of medical conditions, such as diabetes, preeclampsia, or blood-clotting disorders
- A history of surgery on the uterus, such as a previous cesarean section.
- Complications during pregnancy, such as placental issues or fetal growth restriction
- The size of your baby
- A baby in breech position (feet first and not head first through the birth canal)
However, even with some high-risk factors such as age, many women are able to have a successful normal delivery. Before deciding which is the best option for you, talk to your doctor about all your options and preferences. Once your health and state of pregnancy is evaluated, both you and your doctor can create a plan together for the best course of action for your pregnancy.
Stages of labour
Labor is usually a long drawn out process and takes place in multiple stages. Understanding what these normal labour stages are can help you learn what to expect and take away some of the fear of the unknown. It will also help you understand what your body is going through during the labour process and will help you create a birthing plan to help you during each stage.
First stage: Cervix dilation
The first stage of labour is the longest one, lasting anywhere from a few days to a few hours. Every woman’s body is different, hence every woman’s pregnancy experience is different.
One of the first symptoms of labour pain is mild discomfort in the lower abdominal area. When a woman is ready to give birth, the cervix softens, thins and begins to open. This part lasts the longest time. At the beginning, some women may not even feel this. However, as time goes on, she may start feeling some pain and discomfort, but the contractions are irregular as opposed to timed and predictable contractions later. All women are different, so some may feel the signs of labour approaching, and some may not.
Some of the early signs of labour to look out for are:
As your labour progresses, your contractions become stronger and closer. You may start feeling restless, more tired, and the pain becomes more intense. During contractions, the pain comes in waves, first starting small, reaching a high point, and ending quickly after that. You may be in active labor if your contractions happen at least every 5 minutes, last for 1 minute each, and have been happening consistently for at least 1 hour, this is the time you need to go to the hospital. At the end of the first stage of labor, your cervix is dilated to 10cm, and your contraction pains are very high. This is a labour symptom that signals that your body is ready to give birth.
Second stage: Birth of baby
The second stage of labour is from the time the cervix is fully dilated to when the baby makes its way out of the birth canal. It is normal to feel pain during delivery during this time. Some of the common experiences of the second stage of labour are:
- Cramps, nausea, vomiting
- Increased pressure at your bottom
- Longer and more powerful contractions, with only 1-2 minutes in-between
- A strong urge to push
- Burning and stretching sensations in your vagina
Once you are fully dilated and your body is ready, you begin to feel an overwhelming urge to push. This is completely natural and your body’s way of telling you that the second stage of labour is active. On average, it can take an hour to 3 hours from the pushing stage to the birth of the baby. This can be longer for first time mothers as well as women who have had an epidural. It may go more quickly for mothers who have already given birth once.
Apart from the urge to push, you may also experience the following:
- Pressure on your bottom and a strong urge to pass stools
- The baby’s head moving downwards
- Stretching and burning in the vagina
Once you begin to push, during the baby delivery process, concentrate on your breathing. Try to not hold tension in your face and body, rather give into your body’s signals and push when the urge and delivery pain is at its highest. Your doctor will guide you on how to push, sometimes asking you to do it more gently to give your vagina time to recover and stretch, thus helping to reduce tearing.
Once the head of the baby is out, the rest of the body follows very soon. As soon as the baby is out, the second part of labour is over. In some cases, your doctor might have to clear your baby’s airway manually. The doctor will also cut the umbilical cord once the baby is born.
Third stage: Expelling placenta
Once your baby is born, you may feel a lot of relief and a sense of accomplishment. Depending on your birth plan, you will get to hold your baby or lay him/her on your chest. It is a very powerful experience for a mother. This is also when the next stage of labour begins, as you still need to deliver the placenta to finish the entire normal delivery process.
During this time, your doctor may ask you to push once again to deliver the placenta. You’ll likely still have mild contractions. You may also be given medication to help in expelling the placenta as well as minimise the bleeding.
Once the placenta is delivered, the doctor will examine it to make sure all of it is out. Any fragments remaining in your uterus will need to be removed to prevent infection and bleeding. The uterus may have mild contractions once again as it returns to its normal size. A doctor may massage your abdomen at this time to feel if the uterus has remained firm and that there are no problems. After an examination of your vagina is done, you may need some stitches, which will then be addressed.
You may choose to breastfeed your baby when your doctor is examining you. This is the time to bond with your baby and partake in the miracle that is birth.
– The normal delivery process is broken down into three stages of labor. The first stage is contractions, when your water breaks and your cervix dilates
– The second stage is the actual birth, when the baby is extracted through c-section or birthed through the vaginal canal
– In the final stage, the mother expels the placenta from the uterus
Consult a top gynaecologist on MFine to know more about how normal delivery works