Tanmay Hospital

Child Birth

WHAT ARE THE TYPES OF DELIVERY?

"Natural childbirth" used to describe a vaginal delivery without medication for pain or to start or speed up labour.

Unassisted Vaginal Delivery

Vaginal delivery is the most common and safest type of childbirth. Some mothers will still choose to have other medical help during labour like a monitor for the baby's heart.

Assisted Vaginal Delivery
Forceps delivery:

Sometimes the doctor has to use forceps (instruments resembling large spoons) to cup your baby's head and help guide the baby through the birth canal.

Vacuum extraction:

In this procedure, the doctor apply a plastic cup with suction to the baby’s head and gently pull the baby from the birth canal.

WHAT ARE SOME ASSISTED DELIVERY PROCEDURES THAT MIGHT TAKE PLACE DURING MY LABOUR?

The procedure your doctor might use will depend on the conditions that might arise while you are in labour. These assisted delivery procedures can include the following:

Induced labour:
Induction of labour usually means that labour needs to be started for a number of reasons. It is most often used for pregnancies with medical problems or other complications. Labour is usually induced with medications given intravenously OR gel/ pessary/tablet kept vaginally

Medical reasons for inducing labour might include:

  • Diabetes
  • High blood pressure
  • Ruptured membranes
  • Small baby
  • Post-date pregnancy
  • Decreased fluid around baby

Episiotomy:
An episiotomy is a surgical incision made in the perineum (the area of skin between the vagina and the anus). The incision enlarges the vaginal opening to allow the baby's head to pass through more easily and to prevent tearing of the mother's skin. A local anaesthetic might be used in mothers who do not opt for an epidural during labour.

FETAL MONITORING

Fetal monitoring is the process of watching the baby's heart rate. This can be external or internal. In external fetal monitoring, an ultrasound device is placed on your abdomen to record information about your baby's heart rate, and the frequency and duration of your contractions. This can be used either continuously or intermittently.

A caesarean delivery - also known as a C-section or caesarean section - is the surgical delivery of a baby. It involves incision in the mother's abdomen and the uterus.

A caesarean delivery might be planned advance if a medical reason calls for it, or it might be unplanned and take place during your labour if certain problems arise.

Planned caesarean delivery if any of the following conditions exist:
  • Cephalopelvic disproportion (CPD): The baby's head or body is too large to pass safely through the mother's pelvis, or the mother's pelvis is too small to deliver a normal-sized baby.
  • Previous caesarean birth
  • Multiple pregnancy
  • Placenta Previa - The placenta is attached too low in the uterine wall and blocks the baby's exit through the cervix.
  • Transverse lie - The baby is in a horizontal, or sideways, position in the uterus.
  • Breech presentation
Unplanned caesarean delivery might be needed if any of the following conditions arise during your Labour:
  • Failure of labour to progress
  • Cord compression - The umbilical cord is looped around the baby's neck or body, or caught between the baby's head and the mother's pelvis, compressing the cord.
  • Prolapsed cord
  • Abruptio placentae - the placenta separates from the wall of the uterus before the baby is born.
  • Abnormal Fetal Heart Rates
  • Baby has passed meconium in early stage of labour

Before the surgery, your abdomen will be cleaned and you'll be prepared for receiving intravenous (IV) fluids into your arm. This allows doctors to administer fluids and any type of medications you may need. You will also have a catheter put in to keep your bladder empty during the surgery.

If the caesarean delivery is not an emergency, the following procedures will take place. You will be asked if you consent to the procedure, and in some hospitals, you might be asked to sign a consent form. The anaesthesiologist will discuss the type of anaesthesia to be used. You will have a heart, pulse, and blood pressure monitor applied. Hair clipping will be done around the incision area. A catheter will be inserted to keep your bladder empty. Medicine will be put directly into your vein.

From beginning to end, a caesarean takes nearly 50-60 minutes.

After your caesarean delivery, you and your new-born will stay in the hospital for about three days. Immediately after surgery, you will remain on an IV. This allows for adjusted levels of painkillers to be delivered into your bloodstream while the anaesthesia wears off.

Your doctor will encourage you to get up and walk around. This can help prevent blood clots and constipation. A nurse or doctor can teach you how to position your child for breastfeeding so there's no additional pain from the caesarean delivery incision area.

Your doctor will give you recommendations for home care after the surgery, but you should generally expect to:

  • Take it easy and rest, especially for the first few weeks.
  • Use correct posture to support your abdomen.
  • Drink plenty of fluids to replace those lost during your caesarean delivery.
  • Avoid sex for four to six weeks.
  • Take pain medications as needed.
  • Seek help if you experience symptoms of postpartum depression, such as severe mood swings or overwhelming fatigue.

Call your doctor if you experience the following symptoms:

  • Breast pain accompanied with a fever.
  • Foul - smelling vaginal discharge or bleeding with large clots.
  • Pain when urinating.
  • Signs of infection — for example, fever over 100°F, redness, swelling, or discharge from the incision.

Because the caesarean is major surgery, it will take you longer to recover from this type of delivery than it would from a vaginal delivery. Depending on your condition, you will probably stay in the hospital from 2 to 4 days.

Like any surgery, a caesarean section involves some risks. 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.
  • A cut that might weaken the uterine wall.
  • Abnormalities of the placenta in subsequent pregnancies.
  • Difficulty becoming pregnant again.
  • Risks from general anaesthesia (if used).
  • Fetal injury.

The majority of women who have had a caesarean delivery might be able to deliver vaginally in a subsequent pregnancy. If you meet the following criteria, your chances of vaginal birth after caesarean (VBAC) are greatly increased:

  • A low transverse incision was made into your uterus during your caesarean.
  • Your pelvis is not too small to accommodate a normal - sized baby.
  • You are not having a multiple pregnancy.
  • Your first cesarean was performed for breech presentation of the baby.