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Delivery Methods During Pregnancy and Labor

Most of us think of only two ways for a baby to be delivered Ė either vaginally or by Caesarean section. There are, however, two additional types of assisted delivery that are also used during the childbirth process.

A vaginal delivery is the most common type of delivery. It may be spontaneous, which means that labor and delivery begin on their own, or induced, in which medication is given to begin and augment labor. However, there are certain conditions where a vaginal delivery isnít possible, or isnít advisable. A vaginal delivery isnít possible, for example, if the baby is positioned in such a way that it canít pass through the mother's pelvis. On rare occasions, a baby can be too large to safely pass through the mother's pelvis.

Generally, breech babies Ė babies that are positioned feet or bottom first Ė arenít delivered vaginally. Or, if a baby is in distress and needs to be delivered quickly, a Caesarean section is performed. In addition, if the placenta is covering the cervix, a Caesarean delivery will usually be performed before labor begins to lessen the risk of placental abruption Ė a condition which can be fatal to both mom and baby.

A Caesarean section delivery occurs when a baby is removed via a surgical incision into the mother's abdomen and uterus. This incision is most commonly made horizontally across the lower part of the abdomen and the uterus. Because the baby doesnít have to pass through the mother's pelvis, this is the delivery method of choice for babies who arenít in an optimal position for delivery or that are thought to be too large to fit through the mother's pelvis.

Suspected macrosomic babies, in which the abdomen may be larger than the head, are also delivered via Caesarean section. And although itís frequently used, itís important to remember that Caesarean section deliveries are major abdominal surgeries and should only be used when there is a clear medical indication Ė not for the convenience of the health care provider or the mother.

In addition, either vaginal or Caesarean deliveries may be assisted by either forceps or a vacuum device. Forceps resemble large salad tongs Ė one cup-like side is placed on either side of the baby's head as the doctor then guides and pulls the baby to delivery. Fewer doctors today are familiar with forceps deliveries, so vacuum deliveries are actually more common. In a vacuum delivery, a suction cup is applied to the baby's head and, again, the doctor guides and pulls the baby to delivery. Although the use of forceps and vacuums is less common in Caesarean deliveries than in vaginal deliveries, they are sometimes used when a Caesarean is performed.

Whenever an assisted or Caesarean delivery is to take place, the mother will be given the appropriate anesthesia. This may take the form of an epidural or spinal block or, in the case of an assisted vaginal delivery, possibly a pudendal or saddle block anesthetic. In addition, an episiotomy is always performed in the event of an assisted vaginal delivery.

It is important to note that either form of assisted delivery poses some risk to the baby Ė including bruising and brain injury Ė and to the mother, including bruising to the vagina and bladder and the possibility of nerve injury.

Overall, the best way to avoid a Caesarean or assisted delivery is to have a healthy pregnancy thatís as low risk as possible. Try to stay active and upright during labor and delivery and avoid pain medication, which can decrease the effectiveness of your contractions and pushing efforts.

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