Delivering a child

How to Deliver a Baby (If You Absolutely Have To)

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Last weekend, a woman who was eight and a half months pregnant gave birth on a New York City–bound Amtrak train in Aberdeen, Maryland. When she unexpectedly went into labor on the train, she found a “Good Samaritan” to help her until they could stop for EMT help. By then, there was no time to get to the hospital, so she had her baby on the train.

If I were that Good Samaritan, I would have been stumped. I’m a woman, and a mother, but I have no idea what to do for a woman in labor. I know CPR, including what to do if someone is drowning; I know the Heimlich maneuver; I learned how to do a tourniquet in high school; I was tested on how to make a flotation device out of my own pants. And though I’ve never used any of these skills, I value them in theory. But never once in all my travels have I been instructed, in any rudimentary sense, what to do for a woman in any stage of labor. (I gave birth to my daughter via C-section, and the likelihood of me needing a Caesarean was guessed at early enough in the pregnancy that I never did that part of the reading).

I suspect that we’re all still a little bit uncomfortable with the process of bringing life into the world, and most of us only ever learn about it when absolutely necessary. So I did everyone a favor: I investigated exactly what to do if you’re stuck on a bus with a woman who needs to have a baby right now. And I’m going to share what I’ve learned.

Step 1: Call 911 and resist the urge to panic.

The first thing to do is get some EMTs on the scene. Unless medical help is hours away, they’ll probably arrive before the baby is born. In the meantime, Rita Wagner, a certified nurse midwife with Lower Manhattan Obstetrics and Gynecology at Weill Cornell, says, “You just have to stay calm.” Sure, this is a stressful situation for you, but think about how it feels for the mother-to-be! The best thing you can do for her, Wagner says, is “be present” and “with the woman,” which, it turns out, is literally what the word midwife means.

You’ve heard this over and over: People have been having babies for thousands of years; our bodies know what to do! That is supposed to be reassuring, and most of what Wagner says is reassuring. In the year 1900, almost all U.S. babies were born outside of a hospital. By 1944, that number was 44 percent, and by 1969, 99 percent of babies were born INSIDE hospitals. Presumably, most of our common knowledge of how to birth a baby slipped our minds, but we can get it back! Even though you’re not a doctor, you will get through this. Just stay very, very calm.

A woman in advanced stages of labor — her water has broken, her contractions are very close together — often senses what to do. Wagner says there is something “instinctual” in all of this. Hopefully, in your surprise baby-delivery scenario, that will be true, leaving you with the job of keeping her comfortable and relaxed.

Step 2: Support her through early labor and gather provisions.

Labor advances largely at its own pace — for some women it moves quickly, for others, it does not. You, the helper, aren’t likely to be able to slow things down. So, if the baby really is coming, it will be very obvious. There are three stages of labor, but the first stage is unhelpfully divided further into two phases: stage one, “early labor,” which is when the pregnant woman is like, “Oh, wow, I think something is going on down there. ” This is when contractions — which start pretty mild and are comparable to menstrual cramps — begin.

In the second part of the first stage, “active labor,” the contractions get more intense: They are stronger, longer, and more frequent. The second stage of labor is the part you see in movies. It ends with active “pushing” (which shouldn’t go on too long) and the baby being born. We’ll get to the third phase, but for now, let’s pretend your laboring stranger is moving into second stage, i.e, the baby is being born, imminently, even if you don’t know exactly when.

The reason that babies are sometimes born, say, en route to the hospital rather than in the hospital is because stage one is extremely variable in length. If it’s the woman’s first baby, this phase can last anywhere from six to 12 hours. Many women prefer to do a bit of this stage at home, and are even encouraged to do so by their doctors and doulas (birthing coaches). In this stage, timing contractions (timing the beginning of one to the beginning of the next gives you the frequency, while timing individual contractions from start to finish gives you the duration) is important, but so is resting and keeping hydrated. That said, stage one of labor often slides into stage two fairly rapidly, catching the mom off guard.

When active labor starts, the contractions are much more frequent and often very painful. It can last a really long time, too — sometimes eight or nine hours, but it can be as short as an hour. This is how people get caught in cars and subways: Labor is totally unpredictable. In the U.S., at this point, many hospitalized women opt for pain medication — often an epidural — at this point. In our scenario, that isn’t an option, so although it’s been said a bunch of times, your main job is to help the laboring woman breathe and manage her situation. Validation will get you a long way here: Don’t argue or disagree with her, or even try to overcalm her at this point. You know from film depictions that some women scream obscenities and lash out in anger at whoever is around. Everyone’s labor is different, but your job as the Good Samaritan is to keep your cool. This is really your last chance to get any provisions — clean towels, blankets, washcloths, and buckets of water — before things get incredibly busy.

Step 3: She’s going to push and you (yes, you) are going to catch the baby.

At some point, a laboring woman will move to the end of the transitional phase of labor. This is the hardest part, and it’s when they begin to feel the unmistakable and uncontrollable urge to really PUSH. At this point, if the woman is wearing pants, it’s definitely time to remove them. Wagner says any position that the woman feels comfortable pushing in is okay, that she should “do what feels right” — but most women opt for some sort of sitting or squatting position. “The urge to push is unmistakable,” Wagner says. Women “usually bear down uncontrollably. It is rare for someone to not know when to push when unanesthetized.” In fact, she says, some women feel this way before it’s really time, which can result in them tiring themselves out. A professional usually knows how to manage and help a woman know when to push and when not to. In a surprise scenario, just let nature guide the woman in labor. This feeling — the unmistakable urge to push — arises as the baby descends into the birth canal.

Someone — let’s say it’s you — needs to support the baby as it comes out of the mother’s vagina. If you have a full view of the proceedings, you will know the baby is coming right this exact minute when you see the top of its head. This is called crowning. At this point, if she’s not already, you should instruct the mother to push — to bear down with each contraction. Ideally, the pushes will be less short — less than ten seconds each, with a little break in between. This is the most intense part of birth, but it doesn’t usually last very long.

You should support the baby’s head as it comes out of the vagina, but you should not pull on anything, including the umbilical cord. Once the baby’s head is out, it usually rotates a bit to one side. With the next push, one shoulder will emerge, then the other. Once the shoulders are out, keep supporting the baby and lift it very slightly toward the mother’s stomach. The rest of the body will come out easily. The baby will be slippery! Be careful!

Step 4: Keep the baby warm.

As long as the baby is breathing — it should be obvious, most babies cry at least a little upon contact with their new atmosphere — it should be placed directly onto its mother’s chest immediately. Wagner says, “There is no need for routine clearing of mouth and nose at birth unless mucus or fluids are preventing baby from breathing.” The easiest thing, she says, is simply to wipe the baby’s face with a cloth. The most important thing you can do is “dry the baby and keep it warm.” This is why skin-to-skin contact is ideal. Wrapping the baby in a towel or blanket or a coat overtop of its mother will help — “babies lose A LOT of heat when wet, especially from their heads,” Wagner says, so keeping them covered is a must.

The baby, at this point, will still be attached to its mother via an umbilical cord. There’s no need to detach it, Wagner says. So in any reasonable situation — where medical help is en route, the cord can be left undisturbed.

Step 5: Do not mess with the placenta.

The third and final stage of delivery is when the placenta comes out, and it’s also the most dangerous part if you’re not a medical professional, because it can lead to hemorrhaging. You’ve already done so much: Do you really need to know about this? Well, it won’t hurt. After the baby has been born, if medical help is actually not on the way — we’re talking about a Walking Dead scenario here now, which is pretty unlikely but — why not have at least an inking of what happens next?

In the hospital, drugs are often administered to help this next part, but not always. The point is that after birthing a baby, the uterus needs to contract in order to separate the placenta from the inside of the body. The most common sign that the placenta is coming — it can happen within ten minutes after birth or take up to an hour — is a “gush of blood,” says the midwife. She also cautions more than once that placental delivery is serious business, and an “untrained professional” should not facilitate this process. But, in an end-of-the-world scenario, after the gush of blood, the woman will again have the urge to push, which is helpful to the process. The placenta will come out as she pushes. Firmly massaging the stomach after this — which will probably hurt her a little — will help to slow down the bleeding.

Congratulations! You birthed a baby!

Or maybe you just sat with the mom and helped her stay calm while help arrived! Either way, take a minute to celebrate, you Good Samaritan, you.

A word about complications: There are so many hundreds of “What if” scenarios that to even present a tiny fraction of them would make any attempt to explain the process of birth completely useless. Most babies are born without complication; many are born in unexpected circumstance and turn out fine. But there are some complications that occur all the time — like when the baby is feet first (breech) or when the umbilical cord is wrapped around its neck — and aren’t much of a threat in the presence of a professional but would be a real problem on Amtrak. So the advice above is for “standard” births, at least as “standard” as a birth on a moving vehicle/during a zombie apocalypse could possibly be.

The reality is you will probably never ever need to deliver a baby. But that doesn’t mean you shouldn’t at least try to be prepared.

How to Deliver a Baby

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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.

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Provision by the Social Insurance Fund of the Russian Federation to citizens entitled to receive state social assistance in the form of a set of social services, state services for the provision, if there are medical indications, of vouchers for sanitary-resort treatment carried out in order to prevent major diseases, and free travel on intercity transport to place of treatment and back (in terms of filing an application with
Free provision of ownership of certain categories of citizens of land plots that are in municipal ownership
Registration of citizens of the Russian Federation at the place of stay and at the place of residence within the Russian Federation (in terms of receiving and issuing documents on registration and deregistration of citizens of the Russian Federation at the place of stay and at the place of residence within the Russian Federation)
Registration and issuance of passports of a citizen of the Russian Federation, proving the identity of a citizen of the Russian Federation outside the territory of the Russian Federation (in relation to a born child)
State service for the appointment and payment of benefits for pregnancy and childbirth in the event of termination of activity by the insured on the day the insured person applies for the benefit for pregnancy and childbirth, or if it is impossible to pay it by the insured due to insufficient funds in his account with a credit institution and the application of the write-off order funds from an account provided for by the Civil Code of the Russian Federation
Issuance of a certificate for regional maternity (family) capital
Appointment of a one-time allowance for women registered in medical institutions in the early stages of pregnancy
Assignment of a one-time allowance at the birth of a child
Assignment of a one-time allowance for the birth of two or more children
Assignment of a monthly allowance to student families with children
Provision of subsidies for housing and utility bills
Assignment of benefits for pregnancy and childbirth
Assignment of child benefit
Assignment of a monthly allowance to families with five or more children
Provision of funds from the regional maternal (family) capital
Issuance of electronic transport cards to citizens living in the Omsk region (in relation to members of a large family)

Psychologist told why couples are increasingly postponing the birth of a child - Moscow 24, 08/18/2022

With the development of medicine, pedagogy and psychology, the attitude towards the birth of children is reaching a more conscious level every year. Therefore, lovers are in no hurry to become parents, which, of course, surprises the older generation. About why more and more couples are postponing the birth of a child, says psychologist, Gestalt therapist Anna Devyatka.

Financial stability

Photo: depositphotos/Wavebreakmedia

People used to fall in love and immediately decide to have children. Sometimes this happened even before official marriage. At the same time, they were little bothered by thoughts about where to get the money to raise and educate the baby. After all, families often lived with the parents of the bride or groom, and these worries were shifted onto the shoulders of grandparents. Now young people are trying to live separately and take more responsibility for their lives, so they plan the birth of a child in accordance with their capabilities.

The generation of children born or lived in the 1990s remembers well how hard it was for their parents. At that time, mothers and fathers often worked two jobs and were very tired. Children are very impressionable, so in families where it was especially difficult, teenagers learned a lesson - you first need to get on your feet and achieve financial stability. Only then can you think about becoming parents yourself. Therefore, many of the families who are postponing the birth of a child want and plan to have children, but later, when there is stability with money.

“My partner and I started making good money not so long ago. But in the coming years, I want to pay more attention to my self-realization, career and communication with my partner,” says 27-year-old Elena.

Why do I need a child?

Do you remember the parable about the centipede? She was asked about how it is possible to walk with so many legs - she thought about it and fell. By analogy, no one had asked before the question of why planning the birth of children - this was accepted.

Now people are thinking more about their desires. Many understand that before making important decisions, you need to prepare and research information on the topic. Now in social networks and on forums there are many real stories about how life changes after the birth of a child. Therefore, it becomes clear to young families that raising children is not easy and requires a lot of emotional and physical investment.

Since men and women of similar age share their experiences on the Web, there is always the opportunity to try on the role of fatherhood or motherhood and feel if you want the same. For example, Nikita is 25 years old and he still thinks more about parties.

I see how the feed in social networks is changing - more and more acquaintances have become parents and post photos of children instead of parties. They take responsibility for the child, teach him how to live. And I just recently started to figure out with my own, what kind of children do I have?

Nikita

The young man clearly understands that he is not yet ready to become a parent, so he postponed this question until a better moment.

Possibility for divorce

Photo: depositphotos/Elnur_

Maxim is 30 years old and has been married for several years. But mentally, this does not oblige him at all, because while there is no child in the family, for him these relationships are considered frivolous. A young man can always get a divorce.

His personal story is tragic - his father left him and his mother in childhood and left for another woman. Maxim was then five years old, and he still remembers how in the kindergarten they sympathized with the fact that dad left the family. Therefore, he absolutely does not want his child to go through similar experiences. A young man wants to choose a companion with whom he can definitely be for the rest of his life.

However, he still doesn't understand how to do it - he can't calculate all the risks for 30-50 years ahead, so he suffers. This situation is not limited to men. Women also want to be confident in their partner and get strong guarantees that they will be fine together in years to come. While there are doubts, the couple does not dare to have a child, but they cannot fully enjoy happiness either.

The mistake of the doubters is an attempt to plan for something that cannot be foreseen in advance. The family is affected by internal and external crises. For example, the last three years of the pandemic have clearly shown us how important flexibility and the ability to negotiate in pairs, to go through metaphorical fire, water and copper pipes together.

That's why you need to choose a partner not as a thing in the store "it will do - it won't work", but through the desire to go through life hand in hand, overcoming obstacles together. Of course, no one is safe from divorce, but many fathers, even far from the family, continue to stay in touch with the child.

Postpartum depression

Only lazy people don't know about postpartum depression and how it changes a woman's life. Naturally, this adds anxiety to the already existing doubts - "whether I will become a good mother" and "whether my husband will leave if the figure deteriorates. " Therefore, some women begin to prepare for motherhood in advance and, even before conceiving a child, devote time to working through fears.

Olga is 23 years old and has just started thinking about children. The girl watched with interest as the popular blogger was pregnant. Then her idol had a daughter, but everything did not go as planned. Instead of the long-awaited happiness of motherhood, Olga was bombarded with content from stories about depression, tears and complaints, which is very difficult with a child.

The girl was impressed. The fear that the same thing might happen to her crept into her soul. Olga thought about it and decided - for now it’s better to put aside thoughts about motherhood and work out a career.

Inability to have a child

Photo: depositphotos/stokkete

There is another really painful situation when a couple cannot conceive a child and no IVF helps. At this point, it becomes clear that one of the partners is infertile, and this fact has a truly destructive effect on the relationship.

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