Vaginal Birth - Types, Advantages, and Disadvantages

What Is Vaginal Birth?

Vaginal delivery is the natural method of childbirth that does not require significant medical intervention. It is recommended for women when the babies have reached full term. When compared to the cesarean section (C- section), vaginal birth is considered the simplest method. There are relatively fewer contraindications to vaginal delivery so most women and the medical health care providers recommend vaginal birth.

What Are the Types of Vaginal Delivery?

There are different types of vaginal delivery that include:

1) Natural Childbirth or Unassisted Vaginal Delivery- When a pregnant woman delivers a baby through the vagina without using any drugs or any other techniques to induce labor and or using any types of equipment like forceps, vacuum extraction is referred to as natural vaginal delivery.

2) Assisted Vaginal Delivery - When a vaginal delivery occurs with the use of specialized instruments or any medication to induce pain is referred to as assisted vaginal delivery. It has a different type that includes:

• Vacuum Delivery - In this procedure, the doctor uses a soft vacuum suction device, which is placed on the head of the baby and gently pulls the baby out of the birth canal.

• Forceps Delivery - In this procedure, a specialized instrument called forceps is used to cup the baby's head and gently pull the baby out of the birth canal.

• Episiotomy - For quicker delivery of the baby, a small surgical incision is made between the vaginal opening and the anus.

• Amniotomy - This procedure is also called breaking the water. A small plastic hook is used to break the amniotic sac.

• Induced labor - By this procedure, the doctor uses medicine to start the contractions before the labor begins on its own.

What Is an Episiotomy?

An episiotomy is a surgical incision done in the perineum (the space between the anus and the vagina) during childbirth. This is done to enlarge the vaginal opening before you deliver the baby. It is a normal part of childbirth, but it is less commonly used nowadays. In the past, it was done to prevent extensive vaginal tears during delivery as well as an episiotomy would heal sooner than a spontaneous or natural tear. But recent research says that episiotomy may cause more problems like the risk of infection, lengthy recovery, and other complications.

The two most common types of episiotomy are,

• Midline Episiotomy - In this type, a cut is made straight down from the middle of the vaginal opening toward the anus. Fastened wound healing, reduced pain, blood loss, and easy repairing are advantages of this technique. An increased risk of tears extending into the anal muscles is a disadvantage. This type of injury can lead to fecal incontinence.

• Mediolateral Episiotomy - In this type of episiotomy, the incision begins from the middle of the vaginal opening and extends at a 45-degree angle downwards toward the buttocks. There is less risk of anal muscle tears in this type of episiotomy. However, the disadvantages of mediolateral episiotomy include increased blood loss, prolonged healing, severe pain, and long-term discomfort.

What Is an Operative Vaginal Delivery?

Operative vaginal delivery is also called assisted vaginal delivery. In this method, specialized instruments are used to facilitate vaginal delivery.

It is of two types that include:

• Vacuum Extractions - In this procedure, when the baby is in the vagina or the birth canal, a soft cup with a handle, is placed on the head of the baby and using a hand-held pump, suction is created that will help to facilitate delivery. The healthcare professionals then apply gentle, well-controlled traction to pull the baby with each uterine contraction to facilitate delivery. The advantage of operative vaginal delivery is that there is a lower risk than a C-section delivery in case of prolonged fetal distress. However, the drawback of this procedure is minor scalp injuries, bleeding of the scalp, or trauma.

• Forceps-Assisted Deliveries - In this procedure, curved instruments are used in the delivery progress of the baby through the birth canal or vagina. Forceps that resemble two large spoons are inserted through the vagina and placed around the baby’s head. Then with gentle traction, the baby’s head is guided out of the vagina. The mother is instructed to keep on pushing, with each uterine contraction. It is indicated when the mother is too exhausted during pushing. It is also used when the baby has to be delivered faster than the naturally occurring process. Forceps delivery is not indicated if the baby is in breech position.

How to Induce Labor?

There are various methods to induce labor. Depending on the condition of the mother and baby, the medical care provider will choose the appropriate procedure.

The following are the different procedures employed to induce labor:

• Sweep the Membranes of the Amniotic Sac - It is also called stripping the membranes. The health care provider uses a gloved finger to sweep the amniotic sac covering near the baby. This separates the amniotic sac from the cervix and might help start labor.

• Ripen the Cervix - Prostaglandins-like chemicals are placed inside the vagina or taken orally to ripen the cervix. The contractions and baby's heart rate are monitored after giving prostaglandins.

• Rupture the Amniotic Sac - This procedure is also called amniotomy. A small cut is made in the amniotic sac which leads the water to break and initiate labor. It is done if the cervix is thinned and partially dilated. The baby's heart is monitored along with the procedure.

• Inject a Medication - A health care provider might inject oxytocin (a hormone that causes contraction of the uterus) into a vein. It helps in speeding up labor. The contractions and the baby's heart rate are monitored.

Is Vaginal Delivery Possible After Cesarean Delivery?

Vaginal birth after C-section (VBAC) is possible, but many factors must be considered before delivery and the doctor decides if it is the right choice for the mother and baby. The safety of the mother and the baby is the main thing to consider before vaginal birth. VBAC is often preferred due to fewer complications of the surgery, shorter recovery time, less blood loss, reduced chance of infection, injury to the bladder or bowel can be reduced, and fewer problems with future childbirth.

In the following conditions, VBAC is contraindicated,

• Stalled labor.

• Obesity.

• Preeclampsia.

• Advanced maternal age.

• Previous delivery within one year.

• History of more than two C-sections.

• A pregnancy that continues after 40 weeks.

What Are the Advantages of Vaginal Delivery?

The advantages of vaginal delivery include:

• Less respiratory problems during birth and even afterward.

• Faster recovery for mothers.

• Lower infection rate.

• A shorter hospital stay.

• Engage in breastfeeding very early when compared to C-sections.

• Less likely to develop future complications in pregnancies.

• Economical.

What Are the Disadvantages of Vaginal Delivery?

There are very few disadvantages to vaginal delivery, which include:

• Risk of perineal tearing.

• In some medical conditions, vaginal delivery is contraindicated.

Conclusion:

Vaginal delivery is often preferred by most doctors and pregnant women because of fewer complications and faster recovery. There are different types of vaginal delivery. The health care providers choose the preferred one depending on the health conditions of the mother and the baby.