Vaginal DeliveryAll attempts at vaginal delivery are just that, attempts. The best intentions in the world and the most vigorous perineal massage will not always get a 37cm head circumference through your pelvis. But let’s be positive and consider some of the aspects of getting the baby out.
- Sitting Up / Reclining Back is the commonest position for women to choose. It provides good access to and visualisation of the baby.
- All Fours is also popular as the legs are automatically opened as you squat backward and push.
- On The Side is a little awkward for helpers but for many women works a treat.
- Squatting for long periods increases your risk of large tears, especially through the anus. This is because it promotes tissue swelling at the vaginal entrance and this swollen tissue does not stretch. It tears more like wet tissue paper.
PAIN RELIEFThere is no magic formula for this. You either need pain relief or you don't. You either want it or you don't. Whether you use water, gas, pethidine, hypnosis or have an epidural is less important than staying focused and in control.
EPISIOTOMY30% of all first timers manage to deliver without requiring stitches. The rest will either tear or require an episiotomy. Because a tear by its nature is more traumatic to your tissues, I prefer to perform an episiotomy if a tear starts to develop.
I try to avoid sutures where possible and this means I try to avoid episiotomies.