Exploring birth choices: Finding the option that's right for you

Whether you’re excited, nervous, or a little bit of both leading up to  your due date, finding the right birth option for you can help you feel more prepared. 

What are the stages of labor and delivery?

Every birth is different, but all birthing people experience three stages of labor and delivery: labor, pushing, and delivering the baby, and then delivering the placenta. If a vaginal delivery becomes unsafe for you or baby, you might need a Cesarean (C-section) delivery. It can take anywhere from a few hours to a few days for your baby to be born.

The three main stages of labor and delivery are:

1. Labor: This stage is made up of three phases called early labor, active labor, and transitional labor.
2. Pushing and delivery: This stage starts with pushing and ends with the arrival of your baby!
3. Delivering the placenta: During this stage, you will push out your placenta or it will be removed by your OB-GYN.

What are the types of delivery methods?

It’s hard to know exactly what will happen when you give birth. Most people have a plan in mind for how they hope their labor and delivery goes. When it comes to delivering your baby, it’s good to know there are many methods pregnancy providers use. Types of delivery include:

• Vaginal delivery
• Assisted vaginal delivery (vacuum or forceps).
• C-section (Cesarean birth).
• VBAC (vaginal birth after cesarean).

What is a vaginal delivery?

In a vaginal birth, your baby is born through your vagina or birth canal. It’s the most preferred and most common way to deliver a baby because it carries the lowest risk (in most cases). A vaginal delivery occurs most often between weeks 37 and 42 of pregnancy. A vaginal delivery has three stages: labor, birth and delivering the placenta.

Some benefits of a vaginal delivery include:

• Faster recovery.
• Often safest for the pregnant person and the baby.
• Lower rates of infection.
• Babies are at lower risk for respiratory problems and have a stronger immune system.
• Lactation and breastfeeding are usually easier.

‍A vaginal delivery can be spontaneous or induced:

• Spontaneous vaginal delivery: A vaginal delivery that happens on its own and without labor-inducing drugs. Going into labor naturally at 40 weeks of pregnancy is ideal.
• Induced vaginal delivery: Drugs or other techniques start labor and soften or open your cervix for delivery. Pregnancy providers often recommend inducing labor when a pregnant person has a medical condition or is past due. 

What is an assisted vaginal delivery?

An assisted vaginal delivery is when your obstetrician uses forceps or a vacuum device to get your baby out of your vagina. Assisted deliveries often happen when:

• You’ve been in labor a long time.
• Your labor isn’t progressing.
• You become too fatigued to continue pushing.
• You or your baby are showing signs of distress.

The procedure your obstetrician recommends will depend on the conditions that arise while you’re in labor. Assisted delivery procedures can include the following:

• Forceps delivery: Forceps are a tong-like surgical tool obstetricians use to grasp your baby’s head in order to guide them out of the birth canal.
• Vacuum extraction delivery: In a vacuum extraction, your obstetrician places a small suction cup on your baby’s head. The cup is attached to a pump that pulls on your baby while you push.

Vacuum extraction and forceps delivery are similar in their advantages and disadvantages, and often the choice between them comes down to the experience and recommendation of your obstetrician.

What is a C-section?

During a C-section birth, your obstetrician delivers your baby through surgical incisions made in your 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 your labor if certain problems arise. There are about 1.2 million C-section deliveries in the United States each year.

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Your provider may recommend a planned cesarean delivery if you:

• Had a previous C-section delivery.
• Are expecting multiples.
• Have placenta previa,  a condition during pregnancy where the placenta blocks all or part of your baby’s exit from your vagina.
• Have a breech baby.
• Have a baby with fetal macrosomia or a large baby.
• Have a uterine fibroid or other obstruction.
  
  

Sometimes, your labor and delivery changes, and a cesarean birth becomes necessary for the health and safety of you or your baby. An unplanned C-section might be needed if any of the following conditions arise during your labor:

• Fetal distress (your baby isn’t tolerating labor).
• Labor isn’t progressing.
• Umbilical cord prolapse.
• Placental abruption.
• Hemorrhage or excessive bleeding.

Risks of C-section deliveries

Like any surgery, a cesarean birth involves some risks. In general, there is more risk associated with a C-section than with a vaginal delivery.

These might include:

• Infection.
• Loss of blood or need for a blood transfusion.
• A blood clot that may break off and enter the bloodstream (embolism).
• Injury to the bowel or bladder.
• Longer recovery and longer hospital stay.
• Abdominal adhesions.

Benefits of C-section deliveries

Some people prefer a C-section birth because it gives them more control on choosing a due date. This is called an elective C-section. Some providers may allow elective C-sections for nonmedical reasons, however, this is usually discouraged. In most cases, a C-section birth occurs because it’s medically necessary. The American Congress of Obstetrics and Gynecologists (ACOG) recommends that scheduled cesareans not be performed before 39 weeks gestation, unless medically indicated.

Some benefits of a C-section as compared to a vaginal delivery are:

• Lower risk of your baby having trauma from passing through your vagina.
• Less risk of your baby being oxygen-deprived during delivery.
• Possible lower risk of incontinence or sexual dysfunction.

What is a VBAC?

If you’ve already had a cesarean birth, you may be able to have your next baby vaginally. This is a VBAC, or vaginal birth after cesarean. Because a surgical cut results in a scar on your uterus, the concern is that the pressure of labor in a vaginal delivery could cause your uterus to open (rupture) along the previous C-section scar. For this reason, certain criteria must be met in order for your obstetrician to attempt a vaginal birth after C-section.

Can I have a baby vaginally after a C-section?

People who have had a cesarean delivery might be able to deliver vaginally in a future pregnancy. If you meet the following criteria, your chances of a successful vaginal birth after cesarean (VBAC) are high:

• Your obstetrician made a low transverse incision during your cesarean. This is the typical way to perform a C-section, unless they need to deliver your baby in a hurry.
• You don’t have other uterine scars or abnormalities.
• You had a prior vaginal delivery.
• You haven’t had a previous uterine rupture.

Making your birth plan

A birth plan is a written record of what you would like to happen during your labor and after the birth. It can also include things you’d like to avoid. A birth plan is a way for you to tell your team what kind of labor you’d like, what you want to happen and what you want to avoid. Your birth plan can cover anything about labor and birth that is important to you. Your plan is personal to you. It will depend on what you want, your medical history, your circumstances and what is available at your maternity service.

You may want to include:

• Who you want as your birth partner
• What positions you’d like to use during labor
• What type of pain relief you want to use during labor
• If you would like any music playing while you give birth
• How you would like to deliver the placenta 
• How you would like to feed your baby after birth
• If you’d like any special facilities, such as a birthing pool
• What your preferences are about having skin-to-skin time with your baby and delayed cord clamping
• If you have any special requirements, such as needing a sign language interpreter or you would like certain religious customs to be observed.

Looking for more support while you think about your options for birth? Join Maven today to talk to providers like OB-GYNs, doulas, midwives and more—with wait times of less than 2 hours.