Different Child Birth Options: Know before you choose

You should be so proud of yourself that you are doing this. Giving birth to a new life is one of the most phenomenal things in nature and hence it will not be that easy. The anticipation of the due date brings with it the expectation of the wonderful process of childbirth.

Your child is your and so is the decision of the childbirth option you would like to opt for. You have a big decision to make so you need to know all the options available which this post will help you with. 

Even if you are aware of all the options there are some factors will affect your decision and you need to consider before making one:

• Any complications in pregnancy
• The place where you live, the hospitals available nearby
  
• Childbirth option available with the hospital.
  
• Your insurance cover terms & conditions.
  

The majorly available child birth options are:

1. Natural Birth

• Water Birth

2. Vaginal Birth

• Episiotomy
• Vacuum delivery
  
• Forceps delivery
  
• Induced Labor
  

3. Caesarian section (C-Section)

• Planned
• Unplanned
  

4. Vaginal birth after Caesarian (VBAC)

1. Natural Birth:

It was one of the only option available in olden days for delivery but with the advancement in the medical profession the number of people who are opting for it was reduced drastically. The procedure is again gaining popularity due to the natural aspect associated with it.

The natural birth is basically a procedure with no medical procedure or invasive therapy involved in it. A mid-wife play a key role in this type of procedure as she will guide the mother throughout the delivery process.

Natural birth is preferred because of various reasons:

• There is no medical procedure involved at all.
• The recovery is very quick.
  
• The skin to skin contact with the baby is almost immediately which helps to build a stronger bond between mother and baby.
  
• Lower rate of infections in the newborn.
  

If you are healthy, having a normal pregnancy and have given birth previously you can opt for a natural birth as an option but need to keep a fact in mind that complications can arrive any time so you need to have an option of moving to a hospital immediately.

There are some conditions in which it is best to avoid natural birth:

• You have health problems such as diabetes or high blood pressure.
• You are trying for VBAC.
  
• You have multiple pregnancies (twins or more).
  
• Your physician feels that you have a high-risk pregnancy.
  

The delivery in a warm water bath in a tub is gaining popularity as the warm water acts as a pain-reliever or relaxing agent during delivery.

2. Vaginal Birth:

When the birth happens through the natural birth canal it is termed as vaginal delivery. In this type of delivery, we are not sure when the labour might start but usually, the delivery will happen in between 38-41 weeks of pregnancy. The best of the professionals suggest that you should opt for vaginal delivery unless there is some medical reason to go for caesarean.

The key benefits of vaginal delivery are:

• The hospital stay is short so mother and baby can return to their home early.
• Lower infection rate.
  
• The recovery from delivery stress is fast.
  
• The baby born vaginally has lower chances of getting respiratory problems.
  

The women can decide whether they want to go for non-drug delivery or delivery with drugs beforehand to combat the labour pain. Just as labour duration varies in each person, the amount of pain experienced by women also varies. The position, size of the child and the intensity of contractions decide the strength of pain.

A. Non-drug / no medication delivery:

Some of the most popular non-drug options available for pain relief includes acupuncture, breathing exercises, relaxation techniques, birthing ball, massage, changing position during labour. Even if you decide on non-drug delivery, you can always ask for medications at any point during delivery.

B. Delivery with medications (Drugs):

Some drugs can be used to relieve the pain during labour & delivery. These drugs have been tested for safety in pregnant women but can be associated with some other non-fatal side-effects. These drugs fall into 2 categories: Analgesics & Anesthetics

a. Analgesics:

These drugs relieve the pain without the loss of consciousness or feelings or muscle movement. These can be given systemically into veins or muscles by injection or regionally by injection into the lower back to numb the lower body. In case of epidural, a single injection or a continuous flow of medication through catheters can be done in epidural space near the spinal cord for relieve of pain but is associated the side-effect of lowering blood pressure and can lower the baby heart rate and can cause a headache.

b. Anesthetics:

These drugs block consciousness, feeling, muscle movement and even pain. Depending on the medical condition, baby condition and hospital protocols you might be given general, spinal or epidural anesthetics for pain relief.

Ideally, in most of the cases, the labour in vaginal delivery should be straightforward, uncomplicated and smooth. This is not true in all cases, so depending on the condition, the practitioner might decide to include additional procedures to assist the vaginal delivery.

1. Episiotomy:

When during delivery the head of the baby is not coming out properly or there is chance of mother skin rupture or mother is tired and is not able to push enough an incision (a cut) is made on perineum (skin between vagina and anus) to open the vagina so that the baby head can come out easily.

2. Forceps delivery:

During the delivery, if the baby is not able to emerge out properly maybe because of some obstructions or maybe because the mother is not able to push properly due to unconsciousness. The medical practitioners use a piece of special equipment similar to forceps or salad tongs to gently grab the baby head inside the vagina and slowly pull it outwards. Rest of the delivery usually happen normally.

3. Vacuum delivery:

In this procedure, the practitioner uses a vacuum pump with a soft cup on one end which is placed on the baby head. The vacuum is applied to fix the cup on the head and the baby is guided outwards through the birth canal along with mother contractions. The procedure can leave some bruises on the baby head which should go within 48 hrs.

4. Induced Labor:

In some cases where you have passed the due date or the baby is ready and you have not gone into labour or some other medical complications the doctors can decide to artificially induce labour. The labour is induced mainly by the synthetic form of the drug called Oxytocin. Some of the medical reasons for inducing labour might include:

• High BP
• Diabetes
  
• Baby Size
  
• Past due date
  
• Ruptured membranes
  

C. Caesarean section (C-section):

Not everything goes as per plan in real life and the same applies to the childbirth. Even if you have planned for vaginal delivery, there can be complications. It is good to know that because of medical advancements there are alternate methods available like Caesarean Section or commonly known as C-Section.

The C-Section could be planned because of already known medical condition or could be unplanned due to sudden complications arising during delivery time. Irrespective of the type, this delivery procedure works by opening the abdomen and then finally opening the uterus to remove the baby. The cut is in the shape of “C” and hence the name C-Section.

The whole procedure is carried out under anesthesia which is given in the spinal cord or near the spinal area (epidural). The recovery time varies from 2-3 hours.

1. Planned C-Section:

Situations that might require planned C-Section includes:

• A very large head or body as compared to mother pelvis - Cephalopelvic disproportion (CPD)
• Multiples (twins, triplets, etc.)
  
• Some previous C-Section cases
  
• Baby is in a breech position (head up) or sideways (transverse lie) and is difficult to turn during delivery.
  
• Placenta previa – the placenta is attached too low and blocks the way of baby through the cervix.
  
• Some other medical conditions like obstruction due to fibroids etc.
  
• A conscious decision due to personal choice of a mother to avoid vaginal delivery.
  

2. Unplanned C-section:

The common situation for unplanned C-section are:

• The umbilical cord is looped around the baby neck or body and making it difficult for the baby to come out.
• The umbilical cord comes out of the cervix before the baby could.
  
• The cervix starts to dilate but stops midway before full dilation.
  
• The baby stops moving down the birth canal.
  
• The placenta separates from uterus wall before the baby is born.
  
• The baby showing unusual behaviour to stress because of labour.
  

D. Vaginal Birth After Caesarian (VBAC):

Due to surgical advancement nowadays it is possible to have vaginal birth even though you had C-section for the first delivery. Before choosing your options it is best to check with the hospitals in advance, as some of the hospitals might not have facility or staff needed for urgent C-Section in case VBAC doesn't work out the way expected.

There are some conditions which increase your chance of VBAC:

• The transverse incision was made on the lower side of the uterus during the previous caesarean.
• The pelvis is not too small for a normal-sized baby.
  
• Not having multiple pregnancies (twins or more).
  
• The reason for the first caesarean was breech or transverse position or meconium etc.
  

The different types of birthing techniques have their own advantages or disadvantages. Some of the situations don’t leave with any choice but to opt for it. What is more important is that the baby is healthy and safely delivered to the world and the mother stays safe throughout the delivery process. Before taking your decision on the birthing technique you should always consult your doctor and try and follow the recommendations to avoid issues in the long run.