Vaginal Delivery

A natural process and the most common type of childbirth, a vaginal delivery occurs when a pregnant woman gives birth through her vagina (the birth canal). During a vaginal birth or natural delivery, the uterus contracts and thins the cervix which then opens, allowing the baby to be pushed out of the birth canal. It is generally the safest form of delivery and usually occurs between weeks 37 to 41 of pregnancy. 

There are 3 types of vaginal delivery, namely:

• Spontaneous vaginal delivery: occurs naturally and spontaneously without the need for any labour-inducing medications.
• Induced vaginal delivery: occurs due to the intervention of labour-inducing medications      or other techniques to prepare your cervix for delivery.
• Assisted vaginal delivery: assisted vaginal delivery  usually occurs with the help of forceps or vacuum extraction and can assist both spontaneous and induced vaginal delivery.

Although a vaginal delivery is the most preferred option, it may not be possible or safe for some pregnant women. For example,

• If your baby is breech
• If you have a low-lying placenta (placenta previa) or other complications with your placenta
• If you have an ongoing infection such as genital herpes

Before a vaginal delivery, your cervix is long and firm. But when your body is ready to deliver, you will experience contractions which thins and opens the cervix, this is when you will go through the 3 stages of labour. 

First stage of labour

• Timing: longest stage of labour, it can last anywhere from an hour or less to more than 36 hours.

• Mucus plug: discharge of a plug of mucus which can be tinged with blood or thick and stringy. This can occur shortly before the onset of labour to a week before.

• Water breaks: occurs when the amniotic sac surrounding your baby bursts. You may experience a gush of water, wetness around your vagina, or a trickle of fluid.

• Contractions: when your contraction begins, they are short and irregular but as it progresses, it may last for more than a minute and may be 3-5 minutes apart. They can feel like mild period cramps or sharp and intense.

Second stage of labour

• Cervix: your cervix is usually closed and tight, but when contraction begins your cervix softens and begins to dilate. Once your cervix dilates to 10 cm in diameter and your baby’s head has entered the pelvis, you are ready to start pushing.
• Birth: your baby’s head will descend into the birth canal as you begin to push. This process may take 30 minutes to an hour or longer.

A small number of pregnant women may require some assistance to deliver their baby, this may come in the form of forceps or vacuum extraction. Your obstetrician will advise you accordingly.

Third stage of labour

The final stage of labour is the delivery of the placenta and can occur in 2 ways:

• Active management: involves giving a drug to help contract the uterus shortly after the birth. This helps to speed up the delivery of the placenta and helps to prevent excess blood loss. 

• Physiological management: means waiting for the placenta to be delivered naturally and is suitable only if you are at a low risk of blood loss.

What are the benefits of vaginal delivery?

Vaginal delivery is usually the preferred form of birth as there are many benefits, these include:

• Shorter hospital stay
• Faster recovery
• Less postpartum pain
• Lowers the chance of your baby developing respiratory conditions

What are the possible complications or risks of vaginal delivery?

Although vaginal delivery causes less risk, there are a few complications that may arise in some women. 

These are:

• Irregular non-reassuring foetal heart rate: when your baby’s heart rate slows down due to compression of their head or umbilical cord.
• Failure to progress: occurs when your cervix stops dilating or when your labour stops. 
• Bleeding: excessive bleeding during delivery.
• Vaginal tearing: tears that occur around your vagina and rectum during delivery.

Deep vein thrombosis: development of blood clots that occur in your legs or pelvis after delivery.