Normal Vaginal Delivery

Vaginal or Normal delivery is the birth of a baby by way of the vagina. According to the National Institutes of Health, the majority of women are healthy enough to deliver their babies vaginally, though some do experience complications that require surgical delivery known as a cesarean section. Normal vaginal births begin with labor, which is different for every woman. Many women elect to take childbirth classes to prepare them for the miracle of childbirth. Depending on your health, the health of your baby, and the policies of your delivery center, you may be offered pain-relieving medications to help alleviate discomfort leading up to delivery.

Did you know…

that vaginal delivery is recommended because of its significant health benefits for both mother and baby? According to the American College of Obstetricians and Gynecologists, women who deliver their babies vaginally experience faster recovery times, fewer infections, and less time in the hospital than women who deliver via cesarean section. Furthermore, babies who are born vaginally have been shown to exhibit fewer respiratory complications than c-section babies.

Am I a candidate for a normal vaginal delivery?

You are more likely to have normal vaginal delivery if you have experienced a healthy pregnancy free of major complications, or previous successful vaginal deliveries. However, there can be many indications your doctor may recommend a cesarean birth instead, such as if you are delivering more than one baby, you have had a prior c-section, or your baby is breech.

What should I expect during normal vaginal delivery?

Your vaginal delivery will begin with labor contractions or leakage of clear fluids from your vagina. The contractions will increase gradually. Your cervix will begin to thin and open during this time to 10 centimeters. Once it reaches full dilation, you will begin pushing your baby through the vagina. The vast majority of babies are born head down, and most are born within minutes of the scalp coming into view.

During delivery, the healthcare provider will assist the baby’s head and chin out of the vagina when it becomes visible. Once the head is delivered, the healthcare provider applies gentle downward traction on the head to deliver the shoulder, followed by the rest of the body.

In some cases, the vaginal opening does not stretch enough to accommodate the baby. It may be necessary to speed up delivery, for example, if the baby is in distress. In such cases, the healthcare provider may perform an episiotomy. This is a cut through the vaginal wall and the perineum. An episiotomy is done to help deliver the fetus. Episiotomies are not needed for every delivery and are not routinely performed.

After the delivery of the baby, the placenta is delivered during next few uterine contractions. Once the placenta is delivered, any tear or episiotomy is repaired. The mother is usually given oxytocin. This is a drug given either by an injection into the muscles or intravenously that is used to contract the uterus. The uterus is then massaged to help it contract, and to help prevent excessive bleeding.

Possible complications of normal delivery?

Although serious complications are rare during labor and delivery, some problems can develop during this time. Some of the more common complications include:

Fetal meconium

When the amniotic sac ruptures, the normal color of the amniotic fluid is clear. However, if the amniotic fluid is greenish or brown in color, it may show fetal meconium, which is normally passed after birth as the baby’s first bowel movement. Meconium in the amniotic fluid may be associated with fetal distress. A woman should talk with her healthcare provider immediately.

Abnormal fetal heart rate

The fetal heart rate during labor is a good sign of how the baby is handling the contractions of labor. The heart rate is usually electronically monitored during labor. The normal range varies between 120 and 160 beats per minute. If a baby appears to be in distress, immediate action can be taken. The mother can be given oxygen, increase fluids, and change her position.

Abnormal position of the baby during birth

The normal position for the baby during birth is head-down, facing the mother’s back. However, sometimes a baby is not in the right position, making delivery more difficult through the birth canal. There are several abnormal positions for a baby, including the following:

• Positioned head-down but facing the mother’s front.
• Positioned with the face down into the mother’s pelvis, instead of the top of the fetal head.
• Positioned with the brow down in the mother’s pelvis.
• Positioned breech, where the buttocks or feet are down first in the mother’s pelvis.
• Positioned with one shoulder in the mother’s pelvis.

Depending on the position, a healthcare provider may try to deliver the baby as it presents itself, attempt to turn the baby before delivery, or perform a Cesarean delivery.

Vaginal bleeding and tears

Hemorrhaging (bleeding) that occurs during and after childbirth can be a major hazard if severe, and will need immediate medical attention. Ordinarily, the woman loses about 1 pint of blood during and after vaginal delivery. Blood is lost because some blood vessels are opened when the placenta detaches from the uterus. The contractions of the uterus help close these vessels until the vessels can heal.

In vaginal deliveries, loss of more than about 1 pint of blood during or after the third stage of labor (when the placenta is delivered) is considered excessive. Excessive blood loss usually occurs soon after delivery but may occur as late as 1 month afterward.

Around 90% of women tear during childbirth; however some women can suffer from more severe forms of tearing. Unfortunately, it is not always possible to predict or prevent these types of tears.

Do I need to follow any post-delivery recovery guidelines?

Yes. Recovery from a normal vaginal birth is usually quick and easier than recovery from C-Section birth, but there are still some guidelines you must follow to protect your health. If you have any vaginal tears or stitches during your delivery, you must keep it clean. For at least six weeks after delivery, you should avoid taking baths or swimming. However you may take shower normally. You should also abstain from sex for the same duration. Contact your doctor if you pass blood clots larger than golf balls, have difficulty urinating, experience uterine tenderness, or have a fever.