Pregnancy
Patient Education

Patient Guide

Delivering Your Baby

When it comes to delivery, there are many different variables that can effect the birth. Some methods and treatments are optional, and some will become a necessity as your labor progresses. Read more in this patient education guide.

Delivery Methods

Delivery method	How it Works
Induction	Occasionally an enema is all that is needed to stimulate labor. More commonly evoked by IV infusion of pitocin to bring on regular contractions. After labor has commenced, an internal electrode may be inserted on the fetal head for a more accurate reading by rupturing membranes.
Episiotomy	Incision through vaginal wall and perineum, made when: Birth at hand and perineum is tight Baby is distressed Instrument delivery needed Baby is breech and room is needed After delivery the incision is sutured (which heals better than a ragged tear that needs sewing)
Spontaneous	Natural labor with rhythmic contractions and progression of the baby through the birth canal and delivered without instruments or prompting.
Forceps	Metal instrument with tongs and spoon-shaped edges molded to fit around the baby's head. Forceps are used to: Hasten delivery if distress seen Patient can no longer push Safe delivery of the head during breech birth
Vacuum Extraction	Device with cone-shaped synthetic, pliable suction cup which is placed over the baby's head and attached to a pump, creating vacuum which has measured pressure applied. This enables the physician to hold the baby in place with each push, barring the baby from receding between contractions.
Caesarean Section	This is an operative delivery with an incision (either horizontal or vertical) made between the umbilicus and pubic bone, and carried down to the uterus, which is incised above the lower uterine segment. The baby is delivered within 5 minutes and the placenta is then manually removed. The remainder of the 45-60 minutes entails sewing the various layers to restore normal tissue integrity. Indications include: Fetal distress Large baby size Cord prolapse Preeclampsia Malposition of baby Placenta previa

Anesthesia Options

There are two reasons why one would opt for anesthesia to be given.

In the first scenario, a patient may not be knowledgeable in deep breathing or natural birthing techniques that lessen pain or the patient may find it inadequate for the amount of pain that she is perceiving.

In the second case, anesthesia techniques are induced in order to relax the patient and the muscles so that delivery may be more easily affected.

Type	How it Works
Local Anesthetic	Medication injected subcutaneously to numb a specific area prior to episiotomy or for mending a tissue tear in the perineum. It does not alter contraction pain.
Cervical Block	Local anesthetic injected into the cervix at four quadrants to lessen the pain associated with dilation and effacement of the cervix.
Pudendal Block	Local anesthetic is injected into the vaginal wall to numb the tissue between vagina and anus. Given in advanced labor and is effective in 10-20 minutes
Epidural Block	After lying or sitting on your side with back curved outward, a local anesthetic is injected to numb the lower back at the site of planned epidural needle entry. Medication is injected into the epidural space surrounding the spinal cord and becomes effective in 10 minutes. Sensory function is numbed while often retaining motor skills.
Spinal Block	Used in conjunction with instrument delivery. You sit or lie on your side and medication is injected with a spinal needle into the sac of fluid below the spinal cord, effective within minutes.
General Anesthesia (inhalation gases)	Administered by the anesthesiologist, this is a gas that is passed through a special machine and dosage regulated. Because it can sedate the baby, this is given when immediate sedation is needed as in imminent Caesarean section for fetal distress.