Have you considered your labor and delivery options yet? When you're pregnant, it can be easy to overlook the major event that will occur after nine months: the baby coming out. One reason women don't think about labor itself is fear. Horror stories are passed down to pregnant women who try to avoid thinking about these worst-case scenarios. It is best to remember that every woman and every delivery is different, and that yours will probably be fine. Complications do occasionally arise that make back-up plans a necessity. Being prepared and knowing your options can help to alleviate some of your fear and make delivery a smoother, calmer process.
Vaginal Birth
Most women plan to have a traditional vaginal birth. Certain circumstances call for a planned C-section, such as a multiple birth or a medical concern. Some women are now choosing to plan a C-section, although this isn't the norm and many doctors advise against it.
A vaginal birth, although natural, is not without pain. Because of this, many women opt for pain medication. The most common is an epidural, which reduces feeling in the lower half of the body while leaving you fully conscious. While effective, some moms choose to forego the epidural because of its many risks and side effects.
There is always a chance of complications with vaginal birth that require medication or surgery. Although an intervention may not be what you'd prefer, it could be the best thing for you and your baby. Talk to your doctor well before your due date. Discuss different scenarios and how they might be handled. Have as much information as you need before delivery so that you're prepared to make any emergency decisions that are needed.
Medications
There are a variety of medications designed to reduce pain during labor or an intervention related to labor. Analgesia is a medication that alters your perception of the pain. It does not cause numbness. Examples of analgesia are Demerol, Tylenol, Stadol and Nubain.
Anesthesia removes pain. Anesthesia can be regional, as with an epidural, or local, as with Lidocaine to repair an episiotomy. General anesthesia causes unconsciousness and is rarely used during labor. Some of the more common side effects for an epidural include headache, back ache, itchiness, nausea and vomiting. In rare cases, a severe allergic reaction, cardiac arrest or respiratory arrest is possible. Be sure to discuss any known allergies with your doctor to reduce the risk of a severe reaction.
IV/Saline Lock
Many hospitals will insert a small catheter into your body, generally in your arm, to allow for the quick administration of medications or fluids, should they become necessary. This is done simply as a precaution. A saline lock gives you freedom to move around.
Catheter
A catheter inserted into your bladder will help your bladder to stay empty. This is used for several procedures, including a C-section. Your hospital may also use one if you have difficulty going to the bathroom after birth.
Fetal Monitoring
Fetal monitoring measures your baby's heart rate during labor and delivery. There are different types of fetal monitoring used, depending on your level of risk, the hospital where you're delivering and how your delivery is going. Types of monitoring include a fetoscope or stethoscope, a handheld Doppler, intermittent external monitoring, continuous external monitoring or continuous internal monitoring.
Amniotomy
Your doctor may choose to break your water if it hasn't broken on its own. Amniotomy is performed by placing an amniohook inside the vagina and scratching the bag until it ruptures. It is done to speed up labor, although studies vary on its effectiveness. At times it is used to determine whether the baby has passed meconium or to allow for internal fetal monitoring.
Episiotomy
In this procedure, your doctor makes an incision in the perineum to provide a larger opening for the baby to pass through and lower the risk of tearing. This can be unpleasant, and there are some things you can do to avoid an episiotomy. Try massaging the area both before and during labor. Push using slow, controlled movements. Talk to your doctor beforehand about other ways to avoid having an episiotomy.
Operative Deliveries
In some cases, the doctor needs to intervene in the delivery process. This happens when the baby cannot descend further into the birth canal, if the mother becomes too exhausted to push or if a medical complication threatens the life of the baby. Doctors will use either forceps or vacuum extraction to help in these situations.
Forceps help to turn the baby into a different position or can help get the baby out, although this is becoming less common. If necessary, your doctor would slip the forceps, one at a time, into your body and place them around the baby's head. As you push, your doctor will pull. Forceps pose an increased risk of hemorrhage or infection to the mother and can very rarely cause head injuries in babies.
Vacuum extraction uses a cup attached to a suction device. The doctor uses vacuum extraction as an alternative to forceps; after attaching the device to the back of the baby's head, the doctor will pull while you push. The baby's head must be partially descended into the birth canal for vacuum extraction to be considered. There is almost no risk to the mother with this procedure, but there is a very slight risk of subdural or intercranial bleeding in the baby.
Cesarean Section
Commonly referred to as a C-section, cesarean sections account for almost a third of all deliveries in the United States. A C-section is major surgery and comes with some risks, which you should discuss with your doctor. Common reasons for c-sections include fetal distress, placenta abruption, placenta previa at term, an active herpes infection or a previous cesarean birth.
There are several types of pain medication you can use when having a C-section, including spinal anesthesia, epidural anesthesia and general anesthesia. General anesthesia is usually saved for emergency situations.
C-sections can be painful afterward for the mother, and they require a longer healing time than vaginal delivery. Talk to your doctor about when you can resume normal activity after a C-section.
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