- by Motherhood Hospital
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- Feb 25 2017
Types of Delivery
Vaginal Delivery (Natural Birth)
A vaginal delivery occurs when your baby is born through your vagina (birth canal). There are three stages of labor that occur during a vaginal delivery. At Motherhood we recommend our expecting Mothers to plan for vaginal birth unless there is a medical reason for a cesarean.
- The first stage begins when you start having contractions, the tightening of your uterine (womb) muscles.
- The second stage begins when your baby enters your birth canal and ends when your baby is born.
- The third stage begins after your baby is born and ends when your placenta is delivered. The placenta provides oxygen and food to your baby during pregnancy.
Benefits of Vaginal Delivery:
- Shorter hospital stays
- Lower infection rates
- Quicker recovery
- Babies born vaginally have a lower risk of respiratory problem
A vacuum extraction is a procedure sometimes done during the course of vaginal childbirth. During vacuum extraction, a health care provider applies the vacuum (a soft or rigid cup with a handle and a vacuum pump) to the baby’s head to help guide the baby out of the birth canal.
A forceps delivery is a type of operative vaginal delivery. It’s sometimes needed in the course of vaginal childbirth. In a forceps delivery, a health care provider applies forceps (an instrument shaped like a pair of large spoons or salad tongs) to the baby’s head to help guide the baby out of the birth canal.
Caring For The Episiotomy Wound
The perineum is the skin between the vagina and the anus, which thins out and stretches as the baby is delivered. Many women will need stitches to repair any tears or cuts (episiotomy) of the perineum that occur during childbirth. The perineal tear usually heals in two to three weeks, depending on the size of the incision and the type of sutures used to close the wound.
- Keep the wound clean by washing with water, dry and dab gently after every toilet visit.
- Change sanitary pads every two to three hours.
- Reduce discomfort by:
- Using Epikool (pads with cooling gel)
- Lying on the bed or resting on your side every few hours. Avoid sitting for long periods.
- Taking prescribed painkillers to help control any pain.
- Use a sitz bath:
- Add two teaspoons of salt into cool/ lukewarm water in the sitz bath basin.
- Ease yourself in the basin until water touches your perineum.
- Immerse yourself for approximately 20 minutes, three times a day.
- The stitches will dissolve on their own and do not need to be removed.
Please consult your doctor if you experience any of the following:
- Pus-like/ foul-smelling discharge from vagina
- Bleeding from episiotomy wound
- Fever and/ or chills
- Severe or increased perineal pain
A c-section, or cesarean section, is the delivery of a baby through a surgical incision in the mother’s abdomen and uterus. In certain circumstances, a c-section is scheduled in advance. In others, it’s done in response to an unforeseen complication.
Sometimes it’s clear that a woman will need a c-section even before she goes into labor.
You may require a planned c-section if:
- You’ve had a previous cesarean or more than one previous c-section. Both of these significantly increase the risk that your uterus will rupture during a vaginal delivery.
- If you’ve had only one previous c-section with a horizontal uterine incision, you may be a good candidate for a vaginal birth after cesarean, or VBAC.
- You’ve had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal of fibroids).
- You’re carrying more than one baby. (Some twins can be delivered vaginally, but most of the time higher-order multiples require a c-section.)
- Your baby is expected to be very large (a condition known as macrosomia). This is particularly true if you’re diabetic or you had a previous baby of the same size or smaller who suffered serious trauma during a vaginal birth.
- Your baby is in a breech (bottom first) or transverse (sideways) position. (In some cases, such as a twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby may be delivered vaginally.)
- You have placenta previa (when the placenta is so low in the uterus that it covers the cervix).
- You have an obstruction, such as a large fibroid, that would make a vaginal delivery difficult or impossible.
- The baby has a known malformation or abnormality that would make a vaginal birth risky, such as some cases of open neural tube defects.
- You’re HIV-positive, and blood tests done near the end of pregnancy show that you have a high viral load.
Note: Your surgery will be scheduled for no earlier than 39 weeks,unless there is a medical reason to do so in order to make sure the baby is mature enough to be born healthy.
Emergency C- section
You may need to have an emergency c-section if problems arise that make continuing or inducing labor dangerous to you or your baby. These include the following:
- Your cervix stops dilating or your baby stops moving down the birth canal, and attempts to stimulate contractions to get things moving again haven’t worked.
- Your baby’s heart rate gives your practitioner cause for concern, and she decides that your baby can’t withstand continued labor or induction.
- The umbilical cord slips through your cervix (a prolapsed cord). If that happens, your baby needs to be delivered immediately because a prolapsed cord can cut off his oxygen supply.
- Your placenta starts to separate from your uterine wall (placental abruption), which means your baby won’t get enough oxygen unless he’s delivered right away.
- You have a genital herpes outbreak when you go into labor or when your water breaks (whichever happens first). Delivering your baby by c-section will help him avoid infection.
Caring For The Caesarean Wound
- In the first week after operation, always keep the dressing clean and dry.
- If it gets wet, visit the nearest GP clinic/ polyclinic to change it.
- Removal of dressing is to be advised by nurses or as indicated by your doctor.
- Removal of stitches depends on the type of sutures used and is to be done according to the doctor’s instructions.
- Observe for bleeding, redness or pus around the wound area, which may suggest wound infection. Please return to the hospital if you have any of these symptoms and/ or fever.
- Do not lift heavy objects for at least two months.
- Avoid strenuous activity that may cause injury or pain. This will allow your wound to heal promptly.
As one grows old, threshold to bear pain also reduces but epidural anaesthesia increases chances of having normal deliveries. Epidural anesthesia is the most popular method of pain relief during labor.
What is epidural anesthesia?
Epidural anesthesia is a regional anesthesia that blocks pain in a particular region of the body. The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body.
Benefits of Epidural Anesthesia
- Allows you to rest if your labor is prolonged.
- By reducing the discomfort of childbirth, some women have a more positive birth experience.
- Normally, an epidural will allow you to stay alerted and remain an active participant in your birth.
- If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery.
- When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability, and fatigue. An epidural can allow you to rest, relax, get focused, and give you the strength to move forward as an active participant in your birth experience.
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