TYPES OF DELIVERIES: VAGINAL DELIVERY

Most babies are born by vaginal delivery with no major complications. Labor usually begins on its own without help from your health care team. The Mayo Clinic notes that about one in five labors are induced. Doctors use medicine to start or induce labor for several reasons. For example, you might be more than one or two weeks past your due date. Labor may be induced if your water breaks but labor doesn’t start. Your doctor may want to induce labor if there is an infection or other medical reason. Doctors do not like to induce labor before the 39th week of pregnancy because the baby is still developing. But if there is a medical reason to induce labor, your doctor can explain it to you. More from the Mayo Clinic on labor induction

Sometimes labor starts on its own earlier than the doctors would like. If the baby is still growing and developing, your doctor may prescribe drugs, bed rest or other steps. Delaying labor and childbirth gives your baby the time he or she needs to be as strong as possible. This is why it is important to have regular checkups and to prevent or treat vaginal infections. Eat healthy, balanced meals--you are passing that diet along to your baby. Don’t smoke or drink alcohol and don’t take any street drugs. Make sure your health care team knows about any prescription drugs you use. Ask you health care team what else you can do to prevent premature labor.

The birthing process can cause tears in the vagina and other muscles in that area. These tears are called lacerations and obstetrical (OB) trauma. Doctors and certified nurse midwives may make a cut into the vagina and these other muscles. This cut is called an episiotomy.

Episiotomy Rates in Virginia, 1999-2008

Source: Virginia Health Information

This graph shows that doctors are using episiotomies less often. Nationwide and in Virginia, the rates are dropping. According to the American College of Obstetricians and Gynecologists "The best available data do not support the liberal or routine use of episiotomy. Nonetheless, there is a place for episiotomy for maternal or fetal indications such as avoiding severe maternal lacerations (tears) or facilitating or expediting difficult deliveries." You can ask your health care team how often and why they choose this option.

Ask this question early. Don’t wait until labor starts. In one of your checkups, you can ask for an example of when an episiotomy might be needed. Your health care provider may have some suggestions for you on how you can prepare your body for delivery and prevent or decrease vaginal tearing.

In this guide, we include information on the rate of episiotomies by doctor and by hospital. Use this along with other rate information as a starting point to discuss your wishes and needs with your doctor or other health care provider.

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