Delivering by a vaginal birth simply means your baby enters the world through the birth canal, or vagina. Although it might seem like there’s only one way to deliver vaginally, they can be spontaneous, assisted, operative, instrumental, or induced. No matter the adjective, vaginal delivery involves three stages: labor, delivery, and the delivery of the placenta. Here’s a general summary of the three mains stages of vaginal delivery and an explanation of the different types.
Labor is the first stage of childbirth and is comprised of two phases: the latent and active phase. The latent phase of labor involves the complete thinning of the cervix, or opening of the uterus, and a cervical dilation to three centimeters -- this can take hours or days to accomplish.
During the active stage of labor, the cervix dilates from three to ten centimeters, which is considered fully dilated. This usually takes about six hours, or one hour per centimeter. Dilation from seven to ten centimeters is the transition phase. The transition phase is named so because your baby is getting ready to transition from life in the womb to life outside.
Delivery begins as contractions become increasingly stronger and closer together, accompanied by an urge to bear down or push -- much like the need to have a bowel movement. Your baby's face should be turned down, towards your bottom, when it passes through the birth canal. Your doctor or midwife will guide you through this pushing stage, often with a partner or loved ones assistance.
After delivery, the umbilical cord is clamped and cut, and you’ll finally get to meet your newborn. After delivery, your doctor will help your body deliver the placenta. If delivery caused any tearing or required an episiotomy, your delivery team will stitch you up and dispose of fluids and waste. A pediatrician or pediatric nurse will likely be there to weigh and measure your newborn, and administer immediate shots and vaccinations.
Every woman’s body is different, and every birth equally so. Spontaneous vaginal delivery occurs when the use of labor induction techniques and delivery instruments are unnecessary. The mother goes into labor, experiences the stages of cervical dilation, and eventually delivers both baby and placenta.
Operative vaginal delivery may also be referred to as assisted or instrumental delivery. This type of vaginal delivery involves the use of certain birthing instruments to ensure a safe and successful labor and delivery. For example, forceps or a vacuum assisted delivery may be needed to help get the baby out safely.
Induced vaginal delivery refers to the use of induction techniques to incite labor. This might be the planned choice of mother and obstetrician -- either for means of scheduling once the baby has reached full term or because of health risks that make immediate delivery important. Induction techniques might involve manually breaking the amniotic fluid sack (water), or stripping or sweeping the membranes. Pharmaceutically, prostaglandins or Pitocin (oxytocin) may be used, separately or in tandem with manual methods.
VBAC births start with a trial of labor after cesarean (TOLAC). Essentially, you’ll make plans with your obstetrician to deliver vaginally, but must accept it may still be necessary to have a C-section. Many women safely deliver vaginally after a previous cesarean, but it’s important to understand the option just might not be there.