- How Painful Is It?
- Natural Childbirth
- Vaginal Birth VBAC
- Home Birth
- Water Birth
- Hospital Birth
- Assisted Births
- Birthing Center
What to know about childbirth and delivery methods
- Childbirth delivery options include natural unassisted childbirth, assisted childbirth, and delivery by Cesarean surgery (C-section).
- Childbirth delivery locations include at home, in a birth center, or in a hospital.
- Vaginal births without medication can be less painful, and smoother if the mother and partner learn breathing techniques and other strategies in a birthing class. Lamaze Method or the Bradley method are two common childbirth classes.
- The risks and benefits of each delivery method must be weighed along with the mother's preferences to determine what is right for her.
- Nearly 4 million babies are born in the U.S. every year. Childbirth care in the U.S. is very good. Less than 600 women die annually due to complications during childbirth.
Is childbirth painful?
Every woman's experience is unique, but most mothers would honestly say, yes, childbirth is painful. However, it is short-lived, and there are many methods to effectively reduce the intensity of childbirth pain. Women can choose a method that makes them most comfortable and that makes sense for their personal and medical situation.
What are natural at-home childbirth methods?
Natural childbirth at home was the normal (and only) childbirth delivery option until about 75 years ago. Natural childbirth emphasizes an unrushed, supported process, with minimal interference and less invasive monitoring.
Women who prefer unassisted childbirth often attend classes to learn what to expect and how to be prepared. There are a number of different childbirth classes to choose from. In any class, you learn about the stages of labor, breathing, and relaxation techniques, what happens to the vagina after childbirth, and how to be prepared for the delivery and new baby.
What is vaginal delivery with no medication?
A vaginal birth without medication benefits both mother and baby. The microbiome, or bacterial environment, is established by birth method2. There is some research that suggests the development of the infant microbiome is associated with the likelihood of developing allergic diseases during childhood, but the association isn't clear.
Benefits of vaginal delivery
- Infants born vaginally tend to have fewer respiratory problems.
- Other benefits of vaginal delivery include a quicker recovery for the mother and avoidance of abdominal surgery and the associated risks that come with a C-section.
- Vaginal childbirth has a lower rate of infection and a shorter hospital stay.
Disadvantages of vaginal delivery
- The disadvantages of a vaginal birth may include tearing of the perineum.
- Sometimes, a vaginal birth may not be recommended for medical reasons.
What is a home birth?
Only about 2% of women in the U.S. opt for a home birth. It can be a safe and relaxing natural childbirth delivery method for women with a normal, low-risk pregnancy. Home births are vaginal deliveries with no medication, and a variety of mind-body techniques and preparation methods are used to reduce childbirth pain and promote easy labor and delivery
Home births are attended by a certified professional midwife, a licensed nurse-midwife, or a naturopathic midwife. Sometimes a support professional called a doula attends home births. These birth professionals also work in birth centers.
Benefits of home birth
Many women find it relaxing and comforting to be in their own home environment. Other advantages include:
- Not having to worry about being transported to the hospital while in labor or being transported home after the baby's birth
- Having a baby at home means having all of the comforts of home, including snacks and changes of clothing readily available.
- The recovery and transition to breastfeeding can be easy because the environment is comfortable and familiar.
- The mother can invite whomever she wants to attend the birth.
- Many women feel more comfortable with home birth if they need to yell or vocalize.
Disadvantages of home birth
- If special birthing assistance, such as a water birth tub, is desired, this will need to be brought to the home and prepared in advance.
- If the home is very remote or the weather is bad, it may be difficult for the midwife to reach the home in time (although it would be difficult to drive to the hospital in these same circumstances).
- If the birth plan does not progress normally, it may require transport to a hospital.
- Some women are not comfortable with home birth, and it is not a good option unless it is a low-risk pregnancy, and the mother prefers it.
What is the Lamaze method?
The Lamaze method is typically known for controlled breathing techniques but it includes a number of comfort strategies that can be used during labor. Breathing techniques increase relaxation and decrease the perception of pain. In addition to breathing, other information about preparing for childbirth is covered. Lamaze is taught in a series of classes attended by both the mother and her partner, when possible. The Lamaze method doesn't explicitly encourage or discourage medications but seeks to educate women about their options so they can make a birth plan that suits their individual needs.
Benefits of the Lamaze Method
- Lamaze training prepares the mother and her partner with a number of tools to use to get through labor and delivery naturally.
- The breathing and relaxation techniques reduce the perception of pain and keep labor moving smoothly.
- The Lamaze courses help the couple be prepared with what to expect over the first few days and weeks together.
Disadvantages of the Lamaze Method
- Learning the Lamaze method takes time. The couple must plan ahead and attend classes starting in the second trimester of pregnancy.
What is the Bradley method?
The Bradley method focuses on preparing the mother for natural childbirth coached by her partner. The emphasis is on being prepared for an unassisted vaginal birth without medication. The method is taught over 12 weeks along with reading a workbook. Midwives often recommend the Bradley method preparation classes. In addition to learning ways to reduce the pain of vaginal birth, the method teaches about nutrition and other aspects of natural health.
Benefits of the Bradley Method
- The Bradley method is beneficial to prepare parents for unassisted births.
- It helps the couple be prepared with techniques to reduce the perception of pain and stay relaxed through natural unmedicated childbirth.
- It also teaches the couple about things they need to know to take care of themselves as new parents and what to expect when the infant arrives.
Disadvantages of the Bradley Method
For couples who are uncertain if they want to try for an unassisted vaginal birth without medication, the Bradley method might not be best. The course and training take quite a long time. Couples need to begin classes in the second trimester.
What is a water birth?
A water birth means the mother goes through some or all of the stages of childbirth in a portable tub similar to a hot tub. The baby can be delivered underwater or the mother can get out of the water and deliver in a different position. Women chose water births because it can be more relaxing, and less painful to be in the water. Birthing tubs can be brought into the home for a home birth, and they are often found in birthing centers. Some hospitals may have birthing tubs as well.
Benefits of water birth
- A water birth is thought to be less painful and more relaxed for many women. It allows the woman to move into a variety of positions that can feel more natural and less painful.
- The partner can also get into the tub with the mother to support the delivery.
Disadvantages of water birth
- Some critics say a water birth can increase the risk of infection, but as long as the water is fresh and clean, water births are not any riskier than non-water births.
- Unless the water birth takes place in a birth center with established tubs, there are logistics involved in setting up the tub and warming the water for a water birth.
- If the birth plan at home does not progress normally, it may require transport to a hospital.
What types of childbirth and delivery methods are available in the hospital?
Women giving birth in the hospital have most of the same options as home births, she has quicker access to surgical interventions if an emergency occurs. Women giving birth in a hospital or birth center have the option to attempt a vaginal delivery with or without medication.
Benefits of hospital delivery
- Ready access to emergency interventions such as a Cesarean section
- Advanced monitoring for high-risk pregnancies
- More pain management options including epidural anesthesia
Disadvantages of hospital delivery
- The risks of a hospital delivery can include a higher chance of unwanted intervention.
- Sometimes the hospital setting can lead to rushing through the stages of labor, resulting in a higher chance of incision of the perineum during childbirth, and requiring a Cesarean.
- Other risks of hospital childbirth (and any stay in the hospital) include a higher chance of infection.
What are assisted births?
Natural births are not always an option, and if a complication develops, women now have a number of options to assist them with a safe birth. Sometimes C-sections are planned in advance. The other assisted options discussed here typically apply in the case of unexpected complications.
According to the Centers for Disease Control (CDC), about 1/3 of births are delivered by C-section, although rates are highly variable by hospital and region.3 The World Health Organization (WHO) says the rate of Cesarean deliveries should be about 10%-15%; the higher level is because of both elective Cesareans and overuse in the U.S.4 A C-section involves a horizontal incision across the lower abdomen through which the infant is delivered. The typical hospital stay is three days after a Cesarean to ensure the incision is healing. Full recovery can take 8 weeks. One advantage of a C-section is that the delivery date can be planned ahead of time.
A vacuum-assisted delivery involves attaching a soft cup to the head of the infant while it is in the birth canal and a hand-held pump is used to create suction to facilitate delivery.
- The advantage is that this assisted birth option has a lower risk than a C-section of prolonged fetal distress.
- The risks of this method include minor scalp injuries or more serious trauma or bleeding of the head.
A forceps-assisted delivery means that curved instruments are used to facilitate the progress of the infant in the birth canal. Forceps cannot be used if the infant is breech, but it can be an option if the mother is too exhausted or if the infant has to be delivered more quickly than is naturally occurring.
What is vaginal birth after C-section (VBAC)?
While it used to be considered unwise, women have the option to attempt a vaginal birth for their subsequent child after a C-section. Not all women are candidates for a vaginal birth after C-section (VBAC).
What types of childbirth delivery and delivery methods are available in a birthing center?
Some people consider a birthing center delivery the best of both worlds. The setting is relaxing and home-like, and mind-body support options for childbirth pain such as hypnosis, water births, and doulas are readily available. Unassisted deliveries using these support techniques are the focus. The emphasis is on ensuring the mother has the birth experience she wants.
All of the labor and delivery options we have discussed thus far are available in birthing centers except C-sections. Typically, women are transferred to the hospital (or to a different part of the facility if the birth center is within a hospital) if they require an unexpected C-section.
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Switzerland. World Health Organization. "WHO statement on caesarean section rates." Apr. 2015. <http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/>.
United States. Centers for Disease Control and Prevention. "Pregnancy-Related Deaths." Jan. 12, 2016. <http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm>.
United States. U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. Hamilton, B.H., et al. "Births: Final Data for 2014." Dec. 12, 2015. <http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf>.