Children birth delivery

Methods of Childbirth & Delivery Explained

Written by WebMD Editorial Contributors

What Are the Types of Delivery?

Unassisted Vaginal Delivery/Natural Childbirth

Vaginal delivery is the most common and safest type of childbirth. You’ll probably hear the term “natural childbirth” used to describe a vaginal delivery without medication for pain or to start or speed up labor. Some mothers will still choose to have other medical help during labor 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. Vacuum delivery is similar to forceps delivery. In this procedure, the doctor uses suction to apply a plastic cup to the baby's head and gently pull the baby from the birth canal.

Episiotomy. This is a surgical cut in the tissue between your vaginal opening and anus. This tissue is called the perineum. Doctors once thought it prevented large vaginal tears during childbirth, but newer research suggests that’s no longer true. Today, many doctors will only do the procedure if they need to quickly deliver your baby.

Amniotomy. This is also known as “breaking your water.” The doctor uses a small plastic hook to make an opening in your amniotic sac. You may feel a warm rush of fluid.

Induced labor. This is when the doctor starts contractions before labor begins on its own. They may suggest this if they’re concerned about your or your baby’s health.

Cesarean Section

Vaginal delivery may not always be possible. Caesarean delivery (C-section) may be necessary for the safety of you and your baby, especially for one or more of these reasons:

Your baby isn’t in the head-down position. Instead, they are in a breech or transverse position.
The baby is too large to pass through the pelvis.
Your baby is in distress.
You’re carrying more than one baby.
Your placenta covers the opening of your cervix. This is called placenta previa.
Your labor isn’t progressing.
The umbilical cord slips through your cervix before the baby does.
Your placenta has separated from the inner wall of your uterus before delivery. This is a placental abruption.
You’ve had a previous C-section.

Vaginal Birth After C-Section (VBAC)

Most women who have had a C-section may be able to have a vaginal birth later on. Your chances go up if:

The surgeon made a horizontal incision in your uterus during your C-section called a low transverse incision.
Your pelvis is large enough to fit an average-sized baby.
You’re pregnant with one baby instead of multiples.
Your first cesarean was due to a breech labor.

Most often, the need for a cesarean delivery is not determined until after labor begins. Once you have a cesarean delivery, your risk of uterine rupture goes up during future vaginal deliveries.

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Childbirth Options, Differences & Benefits

Overview

What are the types of delivery methods?

It’s hard to know exactly what will happen when you give birth. Most people have a plan in mind for how they hope their labor and delivery goes. When it comes to delivering your baby, it’s good to know there are many methods pregnancy care providers use. Types of delivery include:

Vaginal delivery.
Assisted vaginal delivery (vacuum or forceps).
C-section (Cesarean birth).
VBAC (vaginal birth after cesarean).

What type of delivery is best?

A vaginal delivery is the safest and most common type of childbirth. Vaginal deliveries account for about 68% of all births in the United States. Most medical organizations and obstetricians recommend a vaginal delivery unless there is a medical reason for a C-section.

Vaginal delivery

What is a vaginal delivery?

In a vaginal birth, your baby is born through your vagina or birth canal. It’s the most preferred and most common way to deliver a baby because it carries the lowest risk (in most cases). A vaginal delivery occurs most often between weeks 37 and 42 of pregnancy. A vaginal delivery has three stages: labor, birth and delivering the placenta.

Some benefits of a vaginal delivery include:

Faster recovery.
Safest for the pregnant person and the baby.
Lower rates of infection.
Babies are at lower risk for respiratory problems and have a stronger immune system.
Lactation and breastfeeding are usually easier.

A vaginal delivery can be spontaneous or induced:

Spontaneous vaginal delivery: A vaginal delivery that happens on its own and without labor-inducing drugs. Going into labor naturally at 40 weeks of pregnancy is ideal.
Induced vaginal delivery: Drugs or other techniques start labor and soften or open your cervix for delivery. Pregnancy care providers often recommend inducing labor when a pregnant person has a medical condition or is past due. Labor is usually induced with Pitocin®, a synthetic form of the drug oxytocin.

What happens if you don’t push during a vaginal delivery?

In most cases, once your cervix is fully dilated and your healthcare team is in place, your provider will ask you to push during a contraction. Pregnancy care providers have differing opinions on when to push, how long to push, delayed pushing or waiting until you feel the urge to push.

It’s hard to say what will happen if you don’t or can’t push during a vaginal delivery, because your birthing experience is so unique. However, studies show that resisting the urge to push or delaying pushing (laboring down) can cause complications like infection, bleeding or damage to your pelvis.

It’s best to discuss pushing with your pregnancy care provider ahead of time so you know what to expect during labor.

Assisted vaginal delivery

What is an assisted vaginal delivery?

An assisted vaginal delivery is when your obstetrician uses forceps or a vacuum device to get your baby out of your vagina. Assisted deliveries often happen when:

You’ve been in labor a long time.
Your labor isn’t progressing.
You become too fatigued to continue pushing.
You or your baby are showing signs of distress.

Assisted deliveries only occur when certain conditions are met.

What are examples of assisted deliveries?

The procedure your obstetrician recommends will depend on the conditions that arise while you’re in labor. Assisted delivery procedures can include the following:

Forceps delivery: Forceps are a tong-like surgical tool obstetricians use to grasp your baby’s head in order to guide them out of the birth canal.
Vacuum extraction delivery: In a vacuum extraction, your obstetrician places a small suction cup on your baby’s head. The cup is attached to a pump that pulls on your baby while you push.

Vacuum extraction and forceps delivery are similar in their advantages and disadvantages, and often the choice between them comes down to the experience of your obstetrician.

C-section

What is a C-section?

During a C-section birth, your obstetrician delivers your baby through surgical incisions made in your abdomen and uterus. A C-section delivery might be planned in advance if a medical reason calls for it, or it might be unplanned and take place during your labor if certain problems arise. There are about 1.2 million C-section deliveries in the United States each year.

Your provider may recommend a planned cesarean delivery if you:

Had a previous C-section delivery.
Are expecting multiples.
Have placenta previa.
Have a breech baby.
Have a baby with fetal macrosomia or a large baby.
Have a uterine fibroid or other obstruction.

Sometimes, your labor and delivery changes, and a cesarean birth becomes necessary for the health and safety of you or your baby. An unplanned C-section might be needed if any of the following conditions arise during your labor:

Fetal distress (your baby isn’t tolerating labor).
Labor isn’t progressing.
Umbilical cord prolapse.
Placental abruption.
Hemorrhage or excessive bleeding.

Risks of C-section deliveries

Like any surgery, a cesarean birth involves some risks. In general, there is more risk associated with a C-section than with a vaginal delivery.

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.
Longer recovery and longer hospital stay.
Abdominal adhesions.

Benefits of C-section deliveries

Some people prefer a C-section birth because it gives them more control on choosing a due date. This is called an elective C-section. Some providers may allow elective C-sections for nonmedical reasons, however, this is usually discouraged. In most cases, a C-section birth occurs because it’s medically necessary. The American Congress of Obstetrics and Gynecologists (ACOG) recommends that scheduled cesareans not be performed before 39 weeks gestation, unless medically indicated.

Some benefits of a C-section as compared to a vaginal delivery are:

Lower risk of your baby having trauma from passing through your vagina.
Less risk of your baby being oxygen-deprived during delivery.
Possible lower risk of incontinence or sexual dysfunction.

VBAC (vaginal birth after cesarean)

What is a VBAC?

If you’ve already had a cesarean birth, you may be able to have your next baby vaginally. This is a VBAC, or vaginal birth after cesarean. Because a surgical cut results in a scar on your uterus, the concern is that the pressure of labor in a vaginal delivery could cause your uterus to open (rupture) along the previous C-section scar. For this reason, certain criteria must be met in order for your obstetrician to attempt a vaginal birth after C-section.

Can I have a baby vaginally after a C-section?

People who have had a cesarean delivery might be able to deliver vaginally in a future pregnancy. If you meet the following criteria, your chances of a successful vaginal birth after cesarean (VBAC) are high:

Your obstetrician made a low transverse incision during your cesarean. This is the typical way to perform a C-section, unless they need to deliver your baby in a hurry.
You don’t have other uterine scars or abnormalities.
You had a prior vaginal delivery.
You haven’t had a previous uterine rupture.

What else should I know about delivery?

There are several other terms you should be familiar with in case your pregnancy care provider discusses them during labor and delivery.

Episiotomy

An episiotomy is a surgical incision that widens the opening of your vagina. This allows your baby’s head to pass through more easily. Most people will not need an episiotomy.

There are two types of episiotomy incisions: the midline, made directly back toward your anus, and the mediolateral, which slants away from your anus.

Amniotomy (breaking your bag of waters)

An amniotomy is the artificial rupture of the amniotic membranes, or sac, which contains the fluid surrounding your baby. Your pregnancy care provider may artificially rupture your membranes (AROM) to:

Induce or progress labor.
Place an internal monitor to assess your contractions.
Place an internal monitor on your baby’s scalp to assess their well-being.
Check for meconium (a greenish-brown substance, which is your baby’s first poop).

Your provider will use an amniohook, which looks like a crochet hook, to rupture the sac. Once the procedure is complete, delivery should take place within 24 hours to prevent infection.

Fetal monitoring

Fetal monitoring is the process of watching your baby’s heart rate during labor. This can be external or internal. Knowing how your baby is handling labor helps your pregnancy care provider decide if labor can continue or if delivery is necessary.

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.
Internal monitoring involves the use of a small electrode to record your baby’s heart rate. Your membranes must be ruptured before the electrodes can be attached to your baby’s scalp. A pressure sensor can also be placed near your baby to measure the strength of contractions.

Frequently Asked Questions

Which type of delivery is most painful?

This may come down to personal opinion. There are many factors involved — for example, using pain medication, the type of pain medication or your pain tolerance. You should discuss pain relief with your pregnancy care provider before labor so you know the risks and benefits of each type.

There are two general options: no medication (drug-free or natural delivery) or using pain medications.

A drug-free delivery means you intend to give birth vaginally without any pain medication. You can’t have a C-section without medication.

Your options for pain relief during childbirth could consist of:

Analgesics: Analgesics relieve pain without causing complete loss of feeling or muscle movement. The most common example of an analgesic used during childbirth is an epidural. You can receive an epidural for a vaginal or a cesarean delivery.
Anesthetics: Anesthetics (or anesthesia) keep you from feeling pain by blocking signals from your brain. These drugs are given as a shot or through an intravenous (IV) line. During a C-section, you may receive general anesthesia, which puts you to sleep. Another option during childbirth could be local anesthesia, which involves a shot of medication in a specific area of your body, like the nerves in your vagina and vulva.

Another factor in deciding what type of delivery is most painful is the recovery. Generally, a vaginal delivery is easier to recover from than a C-section delivery.

A note from Cleveland Clinic

Your labor and delivery experience will be unique to you. During pregnancy, it’s a good idea to familiarize yourself with the different types of delivery and other terms associated with childbirth. Your pregnancy care provider will recommend the safest delivery method based on your medical history and pregnancy.

We give birth like at home - articles from the specialists of the clinic "Mother and Child"

Zimina Natalya Nikolaevna

Obstetrician-gynecologist

MD GROUP Clinical Hospital

Presentation of home birth

The most typical arguments of supporters of home births:

A woman's body is designed specifically to give birth to children. By nature, it has all the necessary strengths and capabilities to give birth to a healthy child on its own, which means that the help of a doctor in this process is completely unnecessary. nine0016
The maternity hospital is not needed, because the atmosphere in it is official, hospital, and this does not contribute to relaxation in contractions and the opening of the cervix.
When giving birth at home, you can take any position that is comfortable for the woman.
And at home, you can give birth in the water (in the bath), or at least just relieve contractions by immersion in water.
During home birth, not strangers (doctors, midwives) will be nearby, but the husband, relatives or friends.

Well, ideally, supporters of home births present them like this: effective contractions begin at 40 weeks, the first stage of labor lasts no longer than 10-12 hours. At this time, the woman in labor behaves in a way that is convenient for her, takes comfortable postures, uses techniques to anesthetize contractions (massage, breathing, water). Then comes the complete opening of the cervix, water spontaneously pours out, there are attempts, during which a healthy baby is born without much effort. The child is immediately applied to the mother's breast - he sucks it as much as he wants, the umbilical cord is cut only after the end of the pulsation. Mom has no breaks, the child is absolutely healthy. In general, everyone is satisfied and happy. nine0003

Actually

The picture of home birth is presented, of course, idyllically. And how happy ordinary women would be, and doctors too, if every birth went that way. But it’s not always possible to give birth the way you breathe. In childbirth or immediately after them, various unpleasant situations can arise with a woman or a child. We will not list them so as not to upset anyone. Let's just say that often the life and health of a mother and baby depend precisely on how quickly they received medical assistance . But what can be done at home in such a situation? The only thing is to call an ambulance, because it is impossible to help a child with asphyxia or a woman with bleeding or high blood pressure without certain drugs, equipment, and simply medical skills. But after all, one of the specialists will be present at the birth with the expectant mother? Good obstetricians and gynecologists are well aware of the high risk of home births, so they do not accept births at home, and a midwife, even with experience, will only cope with the simplest situation. In addition, many so-called spiritual obstetricians, as a rule, do not even have a higher, often secondary medical education, and, of course, they do not bear any legal responsibility for the outcome of childbirth. And it happens that sometimes in home births there is no midwife at all (did not come or the woman was convinced that she was not needed). Therefore, of course, we can agree that the home environment helps a lot, but will it be possible to give birth in it in the event of some non-standard or difficult situation? nine0003

Natural childbirth is possible

But how then to ensure naturalness in childbirth and are there such childbirth at all? In fact, today, natural childbirth is widely carried out in most maternity hospitals, and is not only carried out, but also actively promoted . If everything goes well, if the birth proceeds correctly, if the baby’s heart beats evenly, and the mother feels good, the doctors of the maternity hospital do not interfere with the birth, but simply observe their course. A woman gives birth on her own, as nature dictates. But what about the notorious home comfort in childbirth? Turns out today many maternity hospitals provide natural childbirth "at home" :

Almost everywhere now free behavior during childbirth is actively practiced : a woman in labor does not have to lie on the bed all the contractions, but can choose any position.
In many maternity hospitals there are various devices to facilitate contractions : transforming beds, balls, ropes (with their help you can take different positions in contractions), and in some, in addition to the shower, there is even a jacuzzi in which you can spend the first stage of childbirth. nine0016
Of course, not all, but already many Russian maternity hospitals have either been renovated or built in accordance with modern ideas about beauty and comfort . Even in free maternity hospitals there are cozy double rooms with a private bathroom, fresh renovation and beautiful linens. What can we say about childbirth under a contract or in a commercial clinic - the conditions there are more than excellent.
According to the order of the Ministry of Health of the Russian Federation, in any maternity hospital where there are separate maternity boxes, a husband, girlfriend, personal midwife or even a psychologist can be present at the birth, and absolutely free of charge . So, the expectant mother will not be left without support.
Today, in all maternity hospitals, babies are immediately applied to the mother's breast; it is also possible for mother and baby to stay together in the postpartum department.
Now you can easily find a maternity hospital where you can live together with your husband after childbirth in a comfortable family room . All this, of course, is not free - but if you really want it, then it is quite feasible.

So do not be afraid of the maternity hospital: it has all the conditions for natural and safe childbirth. And home birth is an unjustified risk and an unknown result.

Have you read at least one story about childbirth at home that ended unsuccessfully? Hardly. And if they read it, it is not enough. And the reason for this, as a rule, is the same: with an unfavorable development of childbirth and problems with the child, a woman is aware of her carelessness and simply keeps silent about it.

“They used to give birth in the field” is one of the popular arguments of supporters of home births. They gave birth, but only the mortality rate in childbirth (both children and mothers) was extremely high.

An individual approach to the future mother and her baby, living together, free behavior during childbirth, the opportunity to choose a doctor and midwife, take a husband to give birth - all this is now available in many Russian maternity hospitals

5 signs that you are having a natural birth in the hospital

Freedom of movement: in the maternity box there is a multifunctional bed-transformer, balls, ropes.
Presence of a partner: a future father, girlfriend or psychologist is welcome at the birth.
Natural Pain Relief: The delivery room has hydromassage baths or showers to ease contractions during the first stage of labour.
Living together with the child: in the maternity hospital, the constant presence of the baby with the mother and breastfeeding are practiced. nine0003
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03/15/2018

God loves trinity
Zimina Natalya Nikolaevna Normantovich Tatyana Olegovna

Why childbirth is so hard and dangerous
- Colin Barras
- BBC Earth
27 April 2017

Sign up for our 'Context' newsletter to help you sort things out. nine0003
Image copyright iStock

For a long time, scientists believed that the reason for such difficult childbirth in women is the upright posture of a person. However, recent research shows that this is not the only thing, says BBC Earth columnist .

The birth of a child is a long and painful process, and sometimes deadly. According to the World Health Organization, about 830 women die every day due to complications during pregnancy and childbirth (which, however, is 44% lower than in 1990 years).

"These statistics are astounding," says Jonathan Wells of University College London, who studies infant nutrition. "Female mammals have never had to pay such a high price for offspring."
- Russian woman who gave birth to 69 children: truth or fiction?
- Pregnancy and childbirth in the UK: free and without a doctor
- Is it possible to determine the sex of a child by the size of the mother's belly?
- "Age - one day": the first hours of a new life
But why is childbirth so dangerous for women? And what can we do to reduce the death rate?

Scientists first began to think about the causes of such dramatic childbirth in women in the middle of the 20th century. They quickly, as it seemed then, found an explanation.

Problems with childbearing began as early as the earliest members of our evolutionary branch, the hominins, who split from other primates about seven million years ago.

These were animals that had little in common with us today, except, perhaps, for the fact that already in those distant times, like us, they walked on two legs. nine0003
Photo copyright, JUAN MANUEL BORRERO/naturepl.com
Photo caption,
For millions of years, hominins moved upright

Walking upright caused the hominins' skeleton to change - it stretched, and this affected the shape of the pelvis.

In most primates, the birth canal is relatively straight. Among the hominins, they soon changed quite markedly. The hips became narrower, and the birth canal curved.

Thus, at the dawn of our history, hominin babies had to twist and turn in order to squeeze through the birth canal. This made the birth process very difficult. nine0003
But things soon got worse.

About two million years ago, our hominin ancestors began to change again. They lost their ape-like features and became more like modern humans.

Their bodies have become a little longer, their arms have shortened, and their brains have noticeably enlarged. And this last detail was bad news especially for women.

Image copyright, Science Photo Library
Image caption,
Around two million years ago, our hominin ancestors began to lose their ape-like features and become more like modern humans

It seems that evolution has begun to contradict itself. On the one hand, the pelvis of women had to narrow so that they could move on two legs, on the other hand, the babies they carried had an enlarged head, complicating the process of passing through the already narrow birth canal.

Childbirth turned into an incredibly painful and potentially dangerous business, which it has remained to this day.

In 1960, anthropologist Sherwood Washburn called this theory the "obstetrical dilemma" and this explanation satisfied many scientists. But not everyone. nine0003
Holly Dunsworth of the University of Rhode Island was initially fascinated by Washburn's theory, but later realized that there was a lot that didn't add up.

According to Washburn, when the human brain expanded two million years ago, the woman's body began to adapt to this, and the duration of pregnancy was noticeably reduced.

Photo credit, Science Photo Library/Alamy
Photo caption,
Many women use pain relief during childbirth

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And it seems like a pretty logical hypothesis: babies began to be born at an earlier stage of development, and anyone who has ever seen a newborn baby will attest to how helpless and vulnerable he is.

However, Dunsworth believes that this is simply not true. nine0003
"Our babies are born fairly large, and female pregnancies last 37 days longer than monkeys of the same size," explains the researcher.

The same applies to the size of the brain. Females give birth to babies with larger heads than females of other primates, with about the same body weight as females. And this means that the key points of Washburn's hypothesis are false.

And that's not all. The central assumption of the obstetrical dilemma is that the size and shape of the human pelvis, in particular in women, has changed greatly due to our habit of walking in an upright position. nine0003
However, if evolution were to solve the problem of childbirth in humans, it would certainly have already made women's hips and, accordingly, the birth canal a little wider.

In this case, our ability to walk on two legs would not be affected at all.

Photo credit, Visuals Unlimited/naturepl.com
Photo caption,
Men's (left) and women's (right) pelvises

In 2015, researchers from Harvard University conducted an experiment that involved men and women with different body types. nine0003
The researchers observed the physical activity of volunteers in the lab and found that those with wider hips had no problem walking or running.

So, if nature, through evolution, made women's hips a little wider and thus facilitated childbearing, women's ability to move would not deteriorate.

According to Dunsworth, the duration of pregnancy in women is not determined by the size of the baby's brain, as the obstetric dilemma suggests. nine0003
The fact is that a woman's body is simply not able to feed a fetus that requires too much energy for longer than 39-40 weeks.

This means that the reason for this length of pregnancy is not the difficulty of passing the child through the birth canal, as Washburn believed.

Image copyright, iStock
Image caption,
Fetus on CT scan

What then is the true cause of difficult labor in women? In 2012, researcher Jonathan Wells of University College London and his team began to study the history of childbirth and came to a startling conclusion. nine0003
For most of human evolution, it was obviously much easier to have a baby than it is now.

From the little evidence that remains today, it follows that in early hunter-gatherer societies, childbirth was one of the smallest problems.

Archaeologists find almost no skeletons of babies from this period, which indicates a relatively low mortality rate in early childhood.

But the situation changed dramatically a few thousand years ago, when people switched to a sedentary lifestyle. nine0003
Many more newborn bones appear in the archaeological evidence from the early agricultural era.

Photo copyright, Volker Steger/4 million years of man/SPL
Photo caption,
Homo erectus, the immediate ancestor of modern humans, could have had a much easier birth process. ..

On the one hand, living in a more populous community led to outbreak of infectious diseases, and newborns, as the most vulnerable, became their victims.

On the other hand, the diet of farmers with a high content of carbohydrates began to differ markedly from the diet of hunter-gatherers, which was dominated by proteins. nine0003
This provoked changes in the body structure: the farmers, as evidenced by archaeological finds, were significantly shorter than the hunter-gatherers.

And scientists who study childbirth are well aware that the shape and size of a woman's pelvis directly depends on her height.

The smaller the woman, the narrower her hips - hence, the transition to agriculture has complicated the process of childbearing.

On the other hand, a diet rich in carbohydrates has made babies gain weight faster in the womb, and it is much more difficult to give birth to a large baby. nine0003
Photo copyright, Jose Antonio Penas/Science Photo Library
Photo caption,
Farming has once again changed our bodies

Thus, about 10 thousand years ago, childbirth, which for millions of years was a relatively easy process for humans, suddenly become a problem.

However, according to Holly Dunsworth, this is not the end of the story.

Scientific evidence shows that a woman's pelvis is at its best for childbirth around the age of 20, when she reaches her peak fertility, and stays that way until about 40 years of age. nine0003
After that, it gradually changes its shape, preparing for menopause, and becomes less suitable for the birth of a child.

The question arises: if so many evolutionary factors influenced the characteristics of childbirth, maybe this process continues to this day?

Image copyright, iStock
Image caption,
Pregnancy is sometimes debilitating for a woman

In December 2016, scientists Fischer and Mittereker published a sensational paper on this topic.

Previous studies have suggested that larger babies are more likely to survive, and that infant size at birth is to some extent a hereditary factor.

The growth of a medium-sized fetus is evolutionarily limited by the width of the female pelvis. But many babies are now being born by caesarean section.
- Top of evolution: caesarean section lets the weak survive
Consequently, Fischer and Mittereker believe that in societies where caesarean section is gaining popularity, babies will be born ever larger. nine0003
Image copyright, iStock
Image caption,
In some parts of the world, the female body may be evolving towards larger babies

Theoretically, the number of times a baby is too big to be born naturally could increase by 10-20 % within just a few decades, at least in some parts of our planet.

Or, in other words, the body of a woman in these societies may evolve towards the birth of larger babies.
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