Birthing options: Determining what’s right for you

Just as each woman is unique, so is her pregnancy, labor and delivery. Some women also have specific preferences for how they want to deliver their baby and control their pain.

Just as each woman is unique, so is her pregnancy, labor and delivery. Some women also have specific preferences for how they want to deliver their baby and control their pain.

Jennifer Smith delivered her two boys naturally, meaning with no pain-relieving medication, although that method wasn’t her original plan.

“I had seen women giving birth and it looked terrifying. On the other hand, I also was afraid of needles,” Smith said. “But the more I learned about natural childbirth, I realized it was the right choice for me and didn’t have to be an insurmountable hurdle.”

The majority of women in this country choose a form of pain control called an epidural, which lessens pain without completely stopping it. Analgesics are delivered through a catheter in the epidural space of the spinal column, according to Reed Nett, M.D., obstetrics and gynecology.

“The goal is to provide a sensory block in order to facilitate birth much more comfortably. It is a continuous infusion designed to deliver pain control throughout labor and delivery,” Dr. Nett said. “Studies have found this to be safe for mother and child.”

Most women are candidates for an epidural, but certain blood disorders, spinal conditions or medications may preclude its use. A complete history with the woman’s health care provider should identify these issues, according to Dr. Nett.

Like Smith, many women are now opting to attempt natural childbirth.

“This plan does need some preparation,” Dr. Nett said. “I recommend getting instruction on pain coping mechanisms, such as a natural childbirth class or Lamaze. Some patients consider a birth coach, or Doula, to facilitate the process. It also is important to discuss these plans with your delivery provider to ensure each of you knows what to expect at delivery.”

When the time came for Smith to deliver, she was prepared, had practiced what she learned in natural childbirth classes and had a strong support system in place – all important keys regardless of the birthing plan.

“Overall it was painful, but in the end it was such a positive experience – it was a spiritual experience,” Smith said. “The pain is worth it for the euphoria and that feeling of accomplishment. I had to push myself and rely on my support people, but it is an amazing feeling that I would never want to miss.”

“Natural childbirth is best for women who have had a healthy pregnancy and are in good physical and emotional shape,” Dr. Nett said.

“I liked that I could be in control, the baby would be more alert and recovery would be quicker,” Smith said. “And because I didn’t have an IV, I could get out of bed and labor standing up and using a labor ball, which helped manage my pain.”

Cesarean section is another option and accounts for 20 to 30 percent of deliveries in this country. Because it is a surgical procedure in which the baby is delivered through an incision in the abdomen, a stronger pain block is required, usually through an epidural or spinal block. There is a longer recovery period to heal from a large abdominal incision.

“During a C-section, surgical pain is controlled while allowing mom to be an awake participant in the birth,” Dr. Nett said. “Rarely emergency cesarean delivery will not allow time for a spinal or epidural, and general anesthesia is used, which can affect the infant’s respiratory drive.”

The bottom line is your delivery method is a personal decision, and there is no right or wrong answer. It’s important to consider your options well in advance, have an obstetrician/provider who will listen to your desires and choose a birthing facility that will fulfill those wishes.


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