By Dr. Chitra Ganesh
All roads lead to a destination, and for pregnancies, that means delivering the baby. But still, it is not so simple, and nowadays there are several ways in which a delivery can happen such as
- Vaginal delivery (also known as natural or normal delivery)
- Assisted vaginal delivery (vaccum or forceps) – instrumentation delivery
- Cesarean section delivery ( C- section )
Vaginal Delivery
Vaginal delivery is always the most preferred as it is the natural way of child birth and also it carries the lowest risk of complications (in most cases), and caesarean section is generally done for medical indications that might complicate or render a vaginal delivery difficult. In a vaginal birth, baby is born through the vagina / birth canal. Process of vaginal delivery gets initiated once the fetus reaches term ( 37 weeks and above ) . It has three stages: labor, birth and delivering the placenta. Vaginal delivery can be spontaneous or induced. In a spontaneous vaginal delivery, the process is spontaneous without labor-inducing drugs. In an induced vaginal delivery, drugs or other techniques start labor and soften or open the cervix ( mouth of the uterus ) for delivery. Pregnancy care providers often recommend inducing labor when a pregnant person has a medical condition or is past the due date.
Assisted Vaginal Delivery
An assisted vaginal delivery is when the obstetrician uses forceps or a vacuum device to get the baby out of the vagina. Assisted deliveries often happen when:
- Labor has been going on for a long time.( prolonged labor )
- Labor isn’t progressing ( non progress of labor )
- Mother becomes too fatigued to continue pushing.
- Mother or baby are showing signs of distress.
Assisted deliveries only occur when these conditions are met with.
Cesarean Section Delivery
During a C-section birth, the obstetrician delivers the baby through surgical incisions made in the mother’s abdomen and uterus. A C-section delivery might be planned in advance if a medical reason calls for it, or it might be unplanned and take place during labor if certain problems arise. Indications for planned cesarean delivery:
- Multiple gestations ( twins, triplets etc )
- Placenta previa. ( placenta covering the internal opening of the cervix )
- Breech presentation ( Head up )
- Large or macrosomic baby – disproportion between the fetal head size and mothers pelvic inlet
- Presence of uterine fibroids or other obstruction at the passage
- Has had a previous cesarean section/ sections .
Sometimes, complications might arise during labor that render a C – section necessary for the health and safety of the mother or baby. Indications for an unplanned C-section include:
- Fetal distress (Baby isn’t tolerating labor).
- Labor isn’t progressing.
- Umbilical cord wound tightly around neck- presenting as lowered fetal heart rate
- Placental abruption.
- Hemorrhage or excessive bleeding.
Vaginal birth after C-Section ( VBAC )
- It is possible to have a vaginal delivery following a c-section during the previous pregnancy if
- Previous c-section occurred through a low transverse incision
- Mother doesn’t have other uterine scars or abnormalities.
- Mother has had a prior vaginal delivery.
- Mother hasn’t had a previous uterine rupture.
Constant monitoring and looking out for signs of previous uterine scar rupture is mandatory if VBAC is attempted
Regardless of how they give birth, women should be as informed as possible about their childbirth options so they can have a voice in the process, advocate for what they want and make the most informed choice.
(The author is a HOD and Senior consultant, Fetal Medicine, Maa Kauvery, Kauvery Hospital (Electronic City) Bengaluru. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
