Exploring Birth Options

The childbirth option which a patient prefers is a personal choice. The key is to learn all you can about the birthing process and to get insight into the delivery process. Exploring birth options is vital, and exploring birth options allows you to make the choice that is right for you. There are two options; namely normal vaginal delivery and a caesarean section. Dr Annemie Shuda explains:

Normal Vaginal Delivery

Most women are healthy enough to cope with giving birth to their babies via the vaginal route. During the normal vaginal delivery, certain procedures are performed as part of the process:

• Vaginal examinations are performed regularly during the labour to monitor the progress.
• Enemas may be given to empty the colon.
• An intravenous line may be inserted into the mother’s arm to administer fluids, medication and painkillers.
• Catheterization of the bladder during the late stage to prevent bladder injury by the baby’s head.
• Foetal monitoring will be done to monitor the baby’s well being during the labour and the delivery.

Nature may take its course, but sometimes it needs a helping hand. Here are some common procedures used to assist during childbirth:

Inducing labour or “getting started”. Uterus contractions are stimulated by using medications. Among the reasons for inducing labour are post-term pregnancies, pregnancy induced high blood pressure (hypertension), diabetes mellitus, previous stillbirth or the premature rupture of membranes.
Episiotomies whereby an incision, under local anaesthetic, is made to enlarge the vaginal opening to facilitate delivery. It also prevents tearing of the muscles of the vagina and the surrounding area during birth. It is usually performed when the baby’s head is “crowning” (pushing through).
Vacuum extraction is when a soft plastic cup is placed upon the baby’s scalp and suction is applied. It is used to assist the mother if she becomes exhausted or if the baby shows signs of distress.
Forceps are medical instruments used to guide the baby’s head out of the birth canal.
• If these methods are inappropriate or ineffective, then a caesarean section may be required.

Caesarean Section

A Caesarean Section is a surgical method of delivering a baby (or babies) through an incision (cut) made in the abdomen and then the uterus. The procedure takes approximately 30 minutes and during this operation the mother receives a general or spinal anaesthetic.

A Caesarean Section is often required when:
• The contractions of the uterus are not strong enough.
• The cervix (mouth of the womb) doesn’t fully dilate (open).
• The baby’s head does not descend into the birth canal.
• If the baby becomes distressed during labour.
• The position of the baby is unsuitable for a vaginal delivery – when the baby is not in the “head down” vertex position.

If the baby is premature
The decision to do a Caesarean Section can be made before labour. Conditions which will influence this decision include: placenta previa, a very big baby (i.e. diabetes), a pelvis that is too small for the baby’s head to fit through, certain foetal malformations or abnormalities or scarring of the uterus.

Conclusion
No matter how well prepared you are for childbirth, no matter how healthy or confident, the possibility always exists that something can go wrong. It may be that medical intervention (an episiotomy or an emergency caesarean section) becomes an absolute necessity for your well being or that of your baby. Eploring birth options and learning about all the options of childbirth, the better equipped you will be to make the best possible decisions during the labour and delivery.

Remember that your ultimate goal is a healthy, happy baby, no matter how she/he arrives!

By Dr Annemie Shuda

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