Vacuum deliveries use a plastic or metal cup that fits on to the top of the baby's head to guide the baby's head out of the vagina. The cup is attached to a tube that runs to a machine, which creates the vacuum. Like forceps delivery, vacuum delivery is an effective means of delivering the baby if you become tired while pushing and the pushing stage becomes prolonged. Since the cup uses vacuum suction to attach to the top of your baby's head, vacuum deliveries often cause scalp bruising. There is also a risk that you may end up having a serious tear. However, most evidence at present suggests that the risk is some what less with vacuum delivery than it is with forceps delivery. The risk of injury to your baby is the same or slightly less with vacuum than with forceps delivery.

Tear Repair

If you tear when your baby is born, your care provider will sew up the laceration with stitches that absorb by them selves, no suture removal is needed. If you have epidural analgesia, you should not feel much discomfort while this is done. If not, your care provider will inject local anesthetic in to the area around your tear, numbing the area before placing the stitches. After you deliver, your postpartum nurse will show you how to wash the area and take care of your stitches. Usually your care provider will suggest that you hold off on sexual intercourse for at least 6 weeks so that your stitches can heal.

Cesarean Delivery

Cesarean delivery in labor is usually recommended if your labor is not progressing or if there are signs of fetal stress. Women over 35 are two to three times more likely than younger women to have a cesarean delivery. If this is your first pregnancy, your risk of a cesarean delivery is around 30-40 percent if you are in your mid to late 30s or older. If you have had a previous vaginal birth. you chance of a cesarean falls to about 25 percent. A cesarean section is an operation and must be performed by a qualified physician; if a midwife was caring for you, a physician will need to become involved. Your partner or other support person should be able to come in to the operating room and sit with you during the procedure.

Anesthesia

For most cesarean deliveries, you will be awake during the procedure, but numb from the top of your abdomen down. This can be accomplished with either spinal or epidural analgesia. Although you are numb to pain, you will feel the doctors touching you and pressure, don't panic if you can feel some sensations. How It Is Done

The doctor usually makes a side to side incision just above your pubic bone (bikini cut). Your abdominal muscles are not cut, but are spread to the side. Next, the uterus is cut, usually also side to side. Your baby is delivered through the incision in your uterus and abdomen, thc cord is cut, and your baby is handed over to your nurse. You will probably have to wait until after the operation to hold your baby, but your partner should be able to hold the baby close to you shortly after birth. The time from the first incision to your baby being born is usually less than 10 minutes, especially if this is your first cesarean delivery. After your baby is born, the placenta is removed and the uterus is sewn back together using one or two layers of absorbable stitches. During this stage of the operation, it is common to feel nauseous or even to vomit.

Next, a second layer of stitches is placed in the tough material that holds your abdominal wall together, called the fascia. Finally, your skin is closed using either absorbable stitches or staples. Putting everything back together usually takes about 20 to 30 minutes. If you have staples, these are usually removed 2 to 4 days after your operation, right before you go home. Having the staples removed is not painful, but feels like taking an earring out of your ear.

Emergency Cesareans

If an emergency cesarean delivery is needed, everything happens much faster. The important differences are that there may not be time for you to get spinal or epidural analgesia, and you may need to be put to sleep for the procedure. Another important difference is that sometimes an up and down (vertical) cut is made on the skin, since it may speed up delivery. Usually doctors will still make a side to side incision on the uterus. Occasionally a vertical (classical) incision will be made on your uterus if your baby is very premature and in an unusual position. Doctors usually try to avoid classical incisions because they are more likely to break open in later pregnancies.

Ways To Avoid A Cesarean Delivery

Being older raises the chances of a cesarean delivery. However, if there are things you can do to reduce this.

Get in to shape before you get pregnant. This will mean you are more likely to be able to cope with labor and be able to push effectively.

Avoid induction of labor if there's no medical reason.

Hire a doula for extra labor support.

Keep your pregnancy weight gain to below 351b (16kg).

Drink plenty of fluids if you can during labor or have an intravenous line to keep you hydrated. This has been shown to shorten labor in many women.

Stay at home until you are in active labor as long as your baby is moving well, your bag of water is not broken, and you are not bleeding.