A vaginal birth is a reasonable goal for the majority of women. During a vaginal birth, a woman’s cervix dilates and contractions slowly increase in frequency. The contractions will become stronger as your body prepares to move the baby. Your provider will assist you in determining when to push and help the baby progress through the birth canal. Once the baby is born, the umbilical cord will be cut and baby will be handed to you for skin-to-skin contact. You may still experience some contractions as you gently deliver the placenta.

Being Induced

If you have a medical issue, you may have your labor induced. This means that your healthcare provider helps your uterus to start having contractions. To help start labor, your healthcare provider may break your water. Your body makes a hormone called oxytocin that makes the uterus contract. If you are not having contractions, your healthcare provider may give you a medicine that can start contractions or speed up labor.

In a cesarean birth, the baby will come out through an incision in your belly. It is a major surgery. Cesarean births typically, take less than one hour. Your partner may be able to join you in the room. You may not plan to have a cesarean birth, but it may be the best thing for you and your baby.

Reasons for a Cesarean Birth

The following situations may make a vaginal birth risky for the baby:

• The baby's head is too large to pass through mother's pelvis
• The baby is positioned buttocks-first (breech)
• Medical conditions of the mother, such as hypertension, preeclampsia or eclampsia
• Premature labor
• Multiple babies
• Problems with the cervix, birth canal, umbilical cord or placenta
• A labor that stalls or progresses very slowly
• The fetal heartbeat slows, speeds up or becomes irregular during labor.

If the Cesarean is Planned

Typically, if you are having a scheduled induction or cesarean, you will be asked not to eat at least eight hours before the procedure or the procedure may be rescheduled. You will be prepared approximately two hours prior to the procedure. You'll receive a general or regional anesthetic (such as a spinal or an epidural) that numbs the lower half of your body but leaves you awake and alert.

During the surgery, your provider may take up to 10 minutes to deliver your baby and then placenta. Then your provider will close the incisions in your uterus and belly, which in total typically takes about an hour.

If an Emergency Cesarean is Needed

If an emergency cesarean is needed, your doctor may use general anesthesia, which takes effect almost immediately and renders you unconscious. In an emergency cesarean, it may only take two minutes for your baby to be born.

Gentle Cesareans

For those that need to have a cesarean birth, several of the Texas Health hospitals offer a type of cesarean that aims to create a birth experience similar to a vaginal delivery, called a gentle cesarean. During the surgery, the blue drape that is placed at the mom’s chest, which obstructs her view of the doctor and the delivery, can be replaced with a clear drape or a drape with a window. With the clear drape in place, the mother and support person can watch the baby being born, similar to seeing the birth of a baby during a vaginal delivery.

Please be aware that this option is not available at all the hospitals. If you are interested in this type of experience, please discuss it with your doctor.

Cesarean Birth Class

Texas Health offers a class to help families prepare for cesarean births.

Today, it’s not unusual for a woman to have a vaginal delivery after a previous cesarean, called a VBAC. Be sure to discuss the pros and cons with your doctor.

Candidates for VBAC Births

According to the American College of Obstetricians and Gynecologists (ACOG), the following women could be candidates for a VBAC:

• The woman has had no more than one prior low-transverse cesarean delivery (This refers to the cut on your uterus, not the one on your belly)
• The woman has had no other uterine scars or ruptures, whether from previous cesareans or other surgeries
• The woman has a pelvis large enough to allow a vaginal delivery
• Delivery will be at an institution with a physician immediately available throughout active labor who can monitor the fetus and perform an emergent cesarean if needed
• Delivery at an institution where anesthesia and staff is immediately available if an emergency cesarean needs to be performed.

How to Request a VBAC

ACOG has specifically stated that whenever a woman is planning a VBAC delivery, there should be an appropriate medical team available, the resources to monitor a VBAC delivery and resources to provide an emergency cesarean if needed. Talk with your doctor about this option so they can help assemble the team needed to support your birth.