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Birthing Options and What to Expect in Labor and Delivery

Updated on April 24, 2017
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NurseFlood is a self-proclaimed birth nerd with three babies and 8+ years of nursing experience, most of which is in women's health.

Childbirth Options for You

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You're pregnant and overwhelmed with information overload. Let's take a look at the different birthing options and what to expect in labor and delivery.

We will discuss the following options in this article:

Natural childbirth is childbirth without pain medication. There is an emphasis on avoiding routine medical interventions and maintaining autonomy during labor- including eating, drinking, and giving birth in a position she desires.

Pain medication in childbirth: The major option is opiate pain medication, which is generally given through an IV or in an injection. Nitrous oxide is another example of pain medication used in labor.

Epidural anesthesia: is currently the most popular anesthesia method during labor. It's medication that is fed through a catheter that is inserted into the epidural space in the spine. It can reduce discomfort by blocking pain receptors involved in labor and childbirth.

Cesarean delivery (C-section): a surgical procedure to birth a baby through an incision in the uterus and abdomen. This is done for a number of medical and elective reasons.

Vaginal Birth After Cesarean (VBAC): is discussed in the c-section category.

Natural Child Birth

  • Find a supportive provider who will try to avoid unnecessary induction of labor and pain medication, and one who is open to different positions and movements for laboring and birth.
  • Find a supportive birth place. There are options like birth centers, home births, and hospitals. Do your homework on the safety of each of these. If you choose a hospital, ask about natural childbirth accomodations and c-section rates.
  • Exercise throughout pregnancy. The more stamina and flexibility you have mentally and physically, the better your chances are of having an unmedicated birth. Yoga, swimming and walking are excellent options.
  • Get a doula! Doula's reduce the likelihood of medical interventions in labor, and increase your likelihood of having an unmedicated child birth. She can provide help in finding natural pain relief method and often knows where to touch you to improve your pain!
  • Learn coping techniques beginning earlier in pregnancy. Options include music, aromatherapy, birthing balls, positioning, warm water, meditation, deep breathing, and progressive relaxation.
  • Eat! If your hospital doesn't allow eating, eat on your way in. Drink lots of water. Make sure that you stay nice and hydrated. Labor and birth is hard work!
  • It's normal to feel like you want to give up. When that happens, you are normally in the transition phase of labor and ready to begin pushing.
  • Trust your body! It instinctively knows what to do.
  • Let it go. If you don't have the birth of your dreams, look at the positive outcomes. Focus on your strengths, and snuggle that sweet little baby!

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Epidural anesthesia

What is epidural anesthesia?

Epidural anesthesia is also known as regional anesthesia. This mean that it blocks pain receptors in only a specific region of your body. Epidural anesthesia gives both pain relief and decreased sensation in the portion of your body that works so hard during labor!

Epidural medications usually combine local anesthesia, typically your "numbing" medications: bubivacaine or lidocaine. They may be given concurrently with narcotics like fentanyl.

What do I need to know before I get an epidural?

In order to have an epidural, you will have to have an intravenous (IV) catheter inserted and fluids given. You will need to have had your complete blood count recently checked to make sure your platelets are an adequate level. This will help ensure there's no issues with clotting or bleeding.

The anesthesiologist or nurse-anesthetist is the professional who inserts your epidural. You will be positioned on your side or while sitting to place the epidural catheter. You will push your back out like an angry cat. You will feel a cold sensation as an antiseptic solution will be used to wipe your back. This cleans your back and reduces the chances of infection. After that, an injection of local anesthesia (numbing solution) is injected into your back. This may feel like a pinch or bee sting. A needle is next inserted into your back, and a small catheter is placed through the needle into the epidural space. The needle is taken out, but the catheter remains to provide medication constantly or by periodic injections. The catheter is taped down very well.

Pain Medication Options

What are pain medication options?

  • Opiates: An analgesic or medication given to relieve pain. These are considered after traditional measures like deep breathing, massage, and movement have been tried. These medications are given in small doses and early on in labor to avoid side effects to the infant at birth. They may reduce the overall pain level, but will not effect a patients ability to push. Side effects include nausea, vomiting, itching, dizziness, and respiratory depression.
  • Nitrous Oxide: Women who use Nitrous may still have an awareness of labor pain, however it can help women to relax, reduce anxiety, and decreases the perception of the strength of pain. It is self-administered, so the woman can choose how big of a dose of the medication to use. It's effects disappear within five minutes after stopping. Nitrous generally has fewer side effects than opiates.

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Cesarean Section: Operative Delivery

There are several types of c-sections:

  • Scheduled (planned)
  • Urgent
  • Emergent

Scheduled: If you have had a c-section in the past, you may schedule a repeat cesarean. You also have the option of a vaginal birth after cesarean (VBAC). VBAC candidates may have to meet specific criteria, like a provider who performs VBACs and 24-hour anesthesia. Other requirements include a healthy BMI, adequate spacing between children, and the type of incision from your first surgery.

If you have certain pregnancy complications, like placenta previa, the baby will usually be delivered by c-section.

Finally, if you have a breech (bottom first baby) presenting baby, and an external cephalic version fails, your provider is not skilled in breech birth, you may be scheduled for a c-section.An external cephalic version is where they try to manually turn the baby from outside of your stomach.

Urgent: A timely cesarean delivery performed due to deteriorating maternal or fetal state, but not impending risk of maternal or fetal harm.

Emergent: A cesarean delivery performed due to imminent fetal or maternal demise, where every effort is made to expedite the time between decision for surgery to surgical birth.

This discussion of childbirth options covered:

  • Natural childbirth
  • Pain medication in childbirth
  • Epidural anesthesia
  • Cesarean delivery (C-section)
  • Vaginal Birth After Cesarean (VBAC)


I hope you understand your birthing options and what to expect in labor and delivery. Did you encounter another child birth option? Was your experience different than discussed? Let me know in the comments!

© 2016 Caitlin Goodwin

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