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Pregnancy

Vaginal Delivery

Vaginal Delivery

What is a Vaginal Delivery?

Vaginal delivery is the birth process in which the baby is delivered through the vaginal canal.

How Does a Vaginal Delivery Begin?

Vaginal delivery begins when the uterus starts to contract rhythmically and regularly, causing the cervix to dilate, allowing the baby's head to descend into the birth canal.

How is a Vaginal Delivery Performed?

Vaginal delivery is a natural process that progresses in its own time and manner.

With rhythmic contractions of the uterus, the cervix dilates on its own, and simultaneously, the baby's head advances in the birth canal. The amniotic sac may rupture either early in labor or as labor progresses.

When the cervix reaches full dilation, also known as 10 cm, the mother may assist the baby’s progress through the birth canal by pushing if she wishes. When the baby's head reaches the vaginal opening, the doctor or midwife helps to control the baby’s head as it emerges. After the head, the rest of the body follows. After the baby is fully born, the placenta is delivered, completing the birth process.

At What Week Does Vaginal Delivery Occur?

Vaginal delivery is expected and preferred to occur after the 37th week of pregnancy, when the baby’s lungs have matured. Most vaginal deliveries happen between 37 and 40 weeks. However, in some cases, preterm labor and early delivery may occur.

Deliveries after 24 weeks are associated with potential viability, but because they often require prolonged neonatal care and pose numerous complications for the newborn, they are generally not desirable and efforts are made to delay or prevent them. Sometimes, however, babies may not be ready to arrive.

In such cases, labor induction with artificial oxytocin (Pitocin) is often attempted between 40 and 41 weeks, to initiate the vaginal delivery process.

Vaginal Delivery in Ankara

Vaginal delivery is a natural process that progresses in its own time and manner. With rhythmic contractions of the uterus, the cervix dilates on its own, and simultaneously, the baby’s head advances in the birth canal. The amniotic sac may rupture either early in labor or as labor progresses.

When the cervix reaches full dilation, also known as 10 cm, the mother may assist the baby’s progress through the birth canal by pushing if she wishes. When the baby's head reaches the vaginal opening, the doctor or midwife helps to control the baby’s head as it emerges. After the head, the rest of the body follows. After the baby is fully born, the placenta is delivered, completing the birth process.

Vaginal Delivery or C-Section?

Vaginal delivery is usually a natural process that occurs without the need for medical intervention. However, a cesarean section (C-section) is a surgical delivery method that is lifesaving for both the mother and the baby when things don’t go as planned during vaginal delivery. When there are no risk factors present, vaginal delivery is generally recommended as the first option.

Babies born vaginally tend to experience fewer respiratory problems after birth and have a healthier gut microbiota in the long term. However, when vaginal delivery is not possible or if there are emergency situations for the health of the mother or baby, a C-section should be performed without delay.

Can Everyone Have a Vaginal Delivery?

Not everyone can have a vaginal delivery, but it’s often difficult to determine whether a vaginal delivery will be successful until it’s attempted.

There are certain parameters that we assess and evaluate during the process, such as the baby’s weight, the mother’s pelvic exam, and the overall health of both the baby and the mother. If the baby’s weight is 4500 grams or more in the presence of gestational diabetes, or 5000 grams or more without gestational diabetes, a C-section is recommended.

If the baby is in a breech position or has a developmental anomaly that would prevent vaginal delivery, a C-section is also advised. Conditions such as low amniotic fluid or abnormal fetal heart rates on the non-stress test (NST) may also necessitate an emergency C-section.

One of the maternal factors considered is pelvic constriction, which may be detected during a pelvic exam around the 37th week. Other maternal conditions, such as high blood pressure, proteinuria-associated preeclampsia (toxemia of pregnancy),or intrahepatic cholestasis of pregnancy with widespread itching and elevated liver enzymes, may also require a C-section if vaginal delivery is deemed unsafe or if immediate delivery is necessary.

If there are medical conditions like a herniated disc or brain cyst, or if the mother has cardiovascular issues, a consultation with the relevant medical specialties is necessary to decide on the safest mode of delivery.

Sometimes, even when the conditions for vaginal delivery are favorable, the baby’s head may enter the birth canal at an incorrect angle, preventing descent, or there may be changes in the baby’s heart rate that require an emergency C-section. The most crucial factor for a successful vaginal delivery is the mother’s desire and motivation to undergo vaginal delivery. Although the pain from uterine contractions can reduce motivation, focusing on breathing and the joy of welcoming the baby can help ease the process.

What Are the Benefits of Vaginal Delivery?

After a vaginal delivery, the mother typically recovers quickly and returns to her daily life faster. Recovery from a C-section, which is a major abdominal surgery, generally takes longer. C-sections also carry the risk of internal adhesions, and the risk of complications increases with repeated C-sections. For women planning to have multiple children, vaginal delivery is generally more advantageous.

As the baby passes through the birth canal, secretions in the airways are expelled more efficiently, reducing the likelihood of respiratory problems after birth. Additionally, it has been shown that babies born via vaginal delivery have a healthier gut microbiota later in life.

How Long Does a Vaginal Delivery Take?

In first-time pregnancies, vaginal delivery may take about 12 hours from the onset of regular, rhythmic contractions felt in the lower abdomen. However, there are rare instances where labor progresses very quickly, resulting in delivery within 4-5 hours. In second and subsequent pregnancies, delivery often occurs within 4-5 hours.

However, these times can vary among women. From a cervical dilation of 3-4 cm, a normal progression would involve the cervix dilating by about 1 cm per hour and the baby’s head descending by 1 cm per hour. After reaching full dilation, or 10 cm, delivery is expected within 2 hours.

Does Vaginal Delivery Cause a Lot of Pain?

Uterine contractions cause pain that is felt in the lower abdomen and is typically more intense than menstrual cramps. However, these contractions and the resulting pain are essential for the vaginal delivery process.

Although the pain can be demotivating, focusing on breathing and the baby’s arrival rather than the pain can make the process easier. If the pain becomes unbearable, epidural anesthesia can be administered. While epidural anesthesia does not completely eliminate pain, it can reduce its intensity and increase comfort.

Is Anesthesia Used in Vaginal Delivery?

Epidural anesthesia, commonly known as spinal anesthesia, can be administered after the cervix has dilated to 3-4 cm. However, additional doses are not recommended as delivery approaches to avoid interfering with the mother’s ability to push.

Why Are Stitches Used in Vaginal Delivery?

In first-time deliveries, a small incision, called an episiotomy, is usually made to prevent uncontrolled tearing of the surrounding tissues as the baby’s head emerges. This small incision is then sutured in multiple layers. The incision site heals quickly with proper care.

How Long Do Mothers Stay in the Hospital After Vaginal Delivery?

Mothers are generally monitored for 24 hours in the hospital after vaginal delivery.

Is Bleeding Normal After Vaginal Delivery?

Bleeding is expected after vaginal delivery. The placenta, which nourishes the baby, is a vascular structure. After the baby is delivered, the placenta detaches from the uterus, causing some bleeding.

Following the placenta’s detachment, the uterus contracts to limit the bleeding. However, in some cases, the placenta may not detach completely, or the uterus may not contract adequately, leading to excessive bleeding. This bleeding can sometimes be very severe. Postpartum hemorrhage can occur after both vaginal delivery and C-section.

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Assoc. Prof. Dr. İlknur Selvi GümüşDoç. Dr. İlknur Selvi GümüşObstetrics and Gynaecology Specialist
+90 501 331 41 30
+90 501 331 41 30