Updated: Nov 16, 2020
There is arguably nothing more exciting than the birth of a newborn baby and this has long been the case throughout human history. However, medicine has advanced, and childbirth options have developed to make it safer for mothers and babies.
We know that even the most planned birth may have some twists and turns so it is useful to empower yourself with an understanding of all types of birth.
Remember- you cannot fail at labour or birth. Birth is beautiful and is equally as momentous whichever form it may take. Women should be able to give birth in an informed and safe way free from fear or mystery.
Vaginal birth (unassisted):
Often referred to as ‘normal’ or ‘natural’ birth.
It is generally recommended to plan for an unassisted vaginal birth unless there is a medical reason why this would not be the safest option.
Your baby moves and navigates through your pelvis to reach your pelvic floor, he/she then passes under your pubic arch and through your vaginal canal to be born.
There are benefits to this type of birth including; shorter hospital stays, quicker recovery, lower risk of infection for mothers and lower risk of respiratory problems for babies.
Ventouse birth (assisted vaginal birth):
Often referred to as a ‘kiwi’ or ‘suction cup’ your baby is still born vaginally but an obstetrician provides some assistance.
For a ventouse birth your baby’s heartbeat will be monitored continuously through a machine called a CTG. You will be assisted into a position called lithotomy where your legs are supported in stirrups and a paediatrician (doctor for the baby) will likely attend. This process will usually take place in your room on labour ward.
A round plastic or metal cup with a handle is attached to your baby’s head using suction. When you have a contraction and you’re your obstetrician will gently pull to help guide your baby’s head out.
You may require an episiotomy- this is a cut on the perineum at an angle to prevent a tear that could extend into your anal sphincter muscles. This will be repaired afterwards with analgesia and dissolvable sutures.
A ventouse may be performed if your baby is close to being born but there is an indication to speed up the birth. The most common indications are- concerns about your baby’s heart rate trace or that you are exhausted.
It can leave a circular mark on your baby’s head called a chignon but this usually disappears within 48 hours. A bruise on your baby’s head called a cephalohematoma occurs in between 1-12 in 100 babies and it disappears with time. It doesn’t usually cause any further problems except for a rise in jaundice in the first few days.
Forceps birth (assisted vaginal birth):
Like with a ventouse birth your baby’s heartbeat will be monitored continuously, you will be assisted into lithotomy and a paediatrician will be present. An obstetrican will usually ask to perform a vaginal examination to ensure your cervix is fully dilated and to check the position of your baby.
Forceps may take place in your room on labour ward if your baby is in an optimal position. However more often a forceps birth will take place in theatre and this is referred to as ‘a trial’. It is called this because if the forceps birth is not successful it is often necessary to proceed to a caesarean section. You are therefore in theatre already- the correct place for a caesarean section to be performed without delay.
A forceps birth requires adequate analgesia as two metal spoon-like instruments are carefully fitted around your baby’s head and are joined together at the handles. If you already have an epidural an anaesthetist may give you some stronger medicine to make it work a little more. If you do not have an epidural, then you will be given a spinal anaesthetic in theatre to ensure that you do not feel pain during the forceps birth.
You will be encouraged to push as the obstetrician gently pulls to help your baby be born. An episiotomy is commonly performed to reduce the risk of a more extensive tear occurring.
The indications for a forceps birth mirror that of the ventouse but an additional one is that your baby may be in a slightly awkward position that makes a ventouse not possible.
Forceps may cause some superficial marks on your baby’s face that will usually fade within 48 hours and 1 in 10 babies’ may also have some small cuts on their scalp or face, though these will usually heal quickly.
A caesarean section may be performed as an elective, recommended or as an emergency procedure.
It is an operation whereby a cut is made just below your bikini line approximately 10-20cm long and your baby is born through the incision.
It usually takes around 45 minutes.
Around 25% of women in the UK give birth by caesarean section.
Indications for caesarean section include- breech position, low lying placenta, certain infections, concerns over your baby’s heartbeat or that your labour is not progressing. Some women may choose this method of birth due to a previous caesarean or tocophobia.
You will require a cannula in your hand for medicine to be administered. A catheter will be inserted to make sure your bladder is empty to reduce risk of bladder damage during surgery and because for a period of time afterwards you won’t be able to mobilise or feel the urge to pass urine.
It is performed in theatre and there will be quite a few people present. Sometimes this many people can feel overwhelming but try to remember they all have a role to play in keeping you and your baby safe.
Usually you will be awake during the operation and your birth partner will be sat next to you with a screen up so you cannot see the operation. However sometimes a general anaesthetic may be needed and then he/she may have to wait in a separate room. If you are awake and your baby is born well then delayed cord clamping can still happen and you can have skin to skin with your baby in theatre.
Recovery from a caesarean section is longer than that of a vaginal birth and hospital stay is usually 2-4 days. As with any operation there are risks including; bleeding, infection, blood clots and damage to nearby structures such as your bladder and bowel.
Birth is birth. Every journey to motherhood is amazing regardless of the path you take to keep you and your baby safe.
· Berhan, Y. and Haileamlak, A. (2015) The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta‐analysis including observational studies. BJOG. 123 (1), pp. 49-57.
· Elvander, C., Cnattingius, S. and Kjerulff, K. (2014) Birth experience in women with low, intermediate or high levels of fear. Findings from the First Baby Study. Birth. 40 (4), pp. 1-12.
· Murphy, D., Strachan, B. and Bahl, R. on behalf of the Royal College of Obstetricians Gynaecologists (2020) Assisted Vaginal Birth. BJOG. https://doi.org/10.1111/1471-0528.16092.
· NICE (2019) Caesarean Section. Available from: https://www.nice.org.uk/guidance/cg132 [Accessed 5th June 2020].
· NHS (2019) Caesarean Section. Available from:https://www.nhs.uk/conditions/caesarean-section/ [Accessed 5th June 2020].
· NHS (2017) Forceps or Vacuum Delivery. Available from:https://www.nhs.uk/conditions/pregnancy-and-baby/ventouse-forceps-delivery/ [Accessed 5th June 2020].
· O’Mahony, F., Hofmeyr, G. and Menon, V. (2010) Choice of instruments for assisted vaginal delivery. Cochrane Database of Systematic Reviews. Issue 11. Art. No.: CD005455. DOI: 10.1002/14651858. CD005455.pub2.
· Royal College of Obstetricians and Gynaecologists (2020) Episiotomy. Available from: https://www.rcog.org.uk/en/patients/tears/episiotomy/ [Accessed 5th June 2020].