Delivery. This is the event that a momma has waited for, for what feels like eternity. This is the end of the long journey of growing, nurturing, and willing your baby to come to life. Delivery has evolved significantly in the past few decades with new evidence and research coming to life, and ways of the old are being phased out (than goodness). The method of delivery is either going to happen one of two ways. The baby is either going to come out of your vaginal canal, or surgically out of your abdominal cavity. Now there are pros/cons to both methods of delivery, and every woman is entitled to their own birth plan for their experience. So now that we have established two main methods of delivery, there are other medical interventions that can be utilized during childbirth to help with delivery.
Childbirth can occur in a hospital, a birth center, or within your own home. So depending on what setting you choose to give birth in, will dictate which scenarios are most likely. Hopefully you are spending time educating yourself about all possible scenarios relevant to you/your baby’s health history in order to create a thorough birth plan. Now, onto the good stuff…
Let’s talk about vaginal deliveries first, and there is so much information to be covered, so we will truly just be going over the basics. In a hospital setting during modern times (thanks COVID) they will only allow 2 visitors, and they have to be the same visitors the entire time. Typically this is a spouse/partner and a support role, either a parent or doula. So depending on if you are in a hospital bed or water tub will depend on how many people can fit around you, but typically for a vaginal delivery you will have your support persons, a medical doctor or midwife (will not be there until last possible second), an OB nurse and another nurse that is responsible for taking the babies vitals and such after birth. Now that we have set the scene – imagine you are 10 cm dilated in whatever delivery position you choose, and they cue you to push! Now, a couple of things can happen:
So 1 & 2 happen pretty frequently, usually it is some variant of number 2… But think, what happens with 3? What are your options? Momma, you are going to be in pain, tired, angry, crying, potentially pooping yourself in front of multiple people, all staring at your vagina… Trust me, it will be better to think of how you want to handle this BEFORE getting in this situation. Your options include:
The vacuum assisted delivery is still the most utilized technique to help guide the baby out of the birth canal. It has its own risks such as scalp swelling, a more cone shaped skull, shoulder dystocia and jaundice. The forceps have similar risks including bruising, swelling, very rarely facial nerve impairment, or internal bleeding. Typically all of these interventions are going to start becoming options when the mother is fatiguing and it’s hindering her ability to push, or if there is a heart condition or dangerously elevated blood pressure for the mother. The other possibility is the fetus is beginning to show distress through it’s heart rate or BP, which are constantly monitored throughout L&D.
Cesarean delivery is a surgical intervention that has been used when the fetus is in distress for a safe delivery for both mother and baby. It has grown in popularity, and whereas it was primarily used when fetus or mother was distressed to now it can be an option for multiple different reasons. Many women do not opt into the C-Section unless they have to, but it has become more popular in recent years to NOT have a C-Section. So mommas are advocating for themselves to do every possible intervention before resorting to a C-Section.
Although a C-Section sounds like the easy route, it really isn’t. It is a very involved abdominal surgery that involves a full OR team, and recovery can be quite extensive from it. There are it’s own risks involved such as bleeding, infection, scarring, 7 layer cutting, increased pain afterwards, and lifting restrictions post-birth. However a big negative of a C-Section a few years ago was the saying, “Once a C-Section, always a C-Section”. That’s no longer the case with rising advocacy and success with VBAC (vaginal birth after cesarean).
In year 2019 the total Cesarean delivery percentage equaled 31.7%, VBAC was 13.8%, and I honestly could not find a percentage of vaginal births, but what I did find from a reliable source was in the United States in 2019 there was: 2,558,882 vaginal deliveries, and 1,186,397 C-Section deliveries (per the CDC health statistics).
There has been a positive trend with VBAC births in the United States, with increase from 12.4% in 2016 to 13.3% in 2018. So if something happens with your first birth experience and you have to have a C-Section for medical reasons, there is an opportunity to have a VBAC for your next birth experience!
This blog was just the tip of the giant iceberg of scenarios that could happen in a birth experience… ranging from beautiful to traumatic. If you have a had a unique birth experience, PLEASE feel free to share in the comments or send it to me in an email and I can post it anonymously! The more women can hear about what is possible, and what resources/education is available, I believe the better we can serve mothers-to-be as a whole.
Disclaimer: this is not to be used as medical advice in any way shape or form. This is for informational purposes only and if you have any questions, comments or concerns, please feel free to leave a comment or send an email and I will be happy to discuss it with you! Otherwise please communicate with your healthcare team for your birth plan wishes!