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Types of Delivery

Sometimes you have a choice about how your baby will enter the world; other times (due to medical necessity or emergency) you do not. As you wait out your pregnancy, it's a good idea to learn about possible types of delivery so that you can make an educated choice when you have an option. The basic methods of delivery are (1) natural, (2) medicated, and (3) cesarean.

Natural Childbirth

Baby Talk

Natural childbirth is delivery without benefit of powerful pain medications.

Natural childbirth is any delivery without powerful pain medications. Whether your child is born naturally after careful preparation in natural childbirth classes or born on the way to the hospital in the back of your car without benefit of medication or medical assistance, it is a natural birth.

Today, there are many natural childbirth methods, programs, and classes to help you prepare to give birth without pain or medication. If a natural birth is something you would like to experience, make sure you take the time to prepare well in advance of your due date. With proper training, a natural birth can be very rewarding and personally satisfying. Without advance preparation, however, it can be a painful and traumatic experience.

Medicated Childbirth

Daddy Alert!

Learn all you can about the medication options available for delivery. This will help you feel more involved and knowledgeable when your partner goes into labor and asks for pain relief.

Not all women care for the idea of natural childbirth. They prefer to use medication to dull or completely eliminate the pain of labor and delivery. Choosing a medicated delivery is neither a good nor bad decision; it's simply another option for women today.

If you're interested in a medicated delivery (or even if you plan a natural birth, but want to know all the options), consider the various kinds of pain relief available. Then talk to your doctor. Her experience and expertise can help you understand the possibilities. You'll find that most doctors have the option of a variety of choices, depending on your specific needs. Most likely your doctor will choose the best pain relief for you from a number of analgesics, tranquilizers, and anesthetics. General anesthesia might also be necessary in a complicated case.

Analgesics

Baby Talk

Analgesics are medications that relieve pain.
Anesthetics are medications that produce a loss of sensation.

You're familiar with analgesics such as aspirin and Tylenol. These are drugs that relieve pain. During childbirth stronger analgesics such as Demerol are frequently used. These drugs are usually given intravenously, through an IV drip. In this case the medication is "dripped" slowly through a needle that has been inserted in one of your veins or muscles (the buttocks, for example) after labor is well underway. Medication is fed to the needle through a tube connected to a plastic bag.

The effect of analgesics on the newborn depends on the dosage and how close to delivery the drug is administered. Some infants are born sleepy and unable to suck; others might have trouble breathing and need oxygen. These side effects are not dangerous and quickly wear off.

Anesthetics

Baby Talk

A forceps delivery is one that uses an obstetrical instrument that resembles a pair of tongs to gently grab hold of and pull the infant's head out of the birth canal.

Daddy Alert!

If your partner delivers your baby under general anesthesia it is unlikely that you will be allowed in the delivery room. Find out in advance so you know what to expect if this happens.

Drugs that produce a loss of sensation are called anesthetics. These medications interrupt the pathway of nerves that carry sensations of pain to the brain. In effect they "block" pain messages and are commonly called "nerve blocks." During delivery your doctor can choose a nerve block that will completely numb you from the waist down or one that numbs a smaller vaginal area.

The most frequently used blocks are the epidural, pudendal, spinal, and caudal. Let's look at each in turn:

General Anesthesia

If you'd really like to be completely knocked out during your labor and delivery, you're not alone. Lots of women would be very happy to miss the birth, wake up, and jump right into motherhood. In years passed you might have gotten your wish. But today, general anesthesia (causing unconsciousness) is reserved in obstetrics for only a few dire cases.

General anesthesia is used only in special cases because…

Convinced? Unless general anesthesia is absolutely necessary, you will be awake during your delivery. The state of "absolutely necessary" occurs when a nerve block is not an option. This includes…

General anesthesia is also considered when…

You should discuss medication options with your doctor/midwife before your delivery so you have an idea of what will happen when you go into labor. After that you have to trust your doctor to make the right decisions based on your immediate needs at the time of delivery.

Cesarean Birth

Cesarean birth (also called a C-section) is childbirth through an incision in the mother's abdomen and uterus. This is major surgery and carries its own potential for complications. But when a cesarean is necessary, it is the safest form of delivery for the baby. Many healthy babies who are born through a C-section would not have survived a vaginal delivery.

The reasons for a C-section birth are many and the final decision is up to the doctor. Although some women ask for a cesarean in hopes of avoiding the pain of a vaginal birth, it is not an elective operation. C-sections are performed for very specific, medically sound reasons, such as…

Daddy Alert!

If your partner delivers your baby by cesarean section, she'll need lots of support. Reassure her that she did a wonderful job and that having a C-section takes away nothing from her status as a champion mother. Make sure she has help when she returns home.

Cesarean delivery is a last resort. It is avoided if possible because it can cause complications that affect both infant and mother. It is major surgery and therefore causes greater blood loss and higher anesthetic risk. It also requires a longer, more expensive hospital stay, a greater need for blood transfusions, and a prolonged recovery period. But if your doctor knows in advance that you might need a cesarean, you should feel gratified that this medical option is available to give your baby the best chance of a healthy delivery. If you expect to have a vaginal delivery, you probably will, but you should also know what a C-section is so that if a medical emergency during labor makes a cesarean necessary, you'll know what's going on.

Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

To order this book visit Amazon's website or call 1-800-253-6476.


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