Labor

Your Delivery Options

By Beth Howard, Babytalk Mom-To-Be

Will I need a c-section?

About one in five births is performed by cesarean  -- one may even be planned if your baby is in a breech (feet/bottom first) or transverse (sideways) position, or if you have preeclampsia or an active herpes infection. Surprise cesareans happen when labor stalls or problems arise in the womb. If you need one, you'll most likely have an epidural or spinal rather than a general anesthetic; the former options offer "the chance to see the baby right away," says M. Kelly Shanahan, M.D., an ob-gyn and chief of staff at Barton Memorial Hospital in South Lake Tahoe, California. During a c-section, a doctor usually makes a horizontal incision through the skin and abdominal wall, moves the muscles aside, and opens the uterine wall. The incision is closed with stitches that dissolve in the body.

How do I feel about electronic fetal monitoring?

The word on fetal monitoring is that it's constricting  -- and that makes many moms-to-be want to avoid it. In the early stages of labor, nurses will often go the low-tech route, using a stethoscope or handheld ultrasound device to check the baby's heart rate at set times. But if you plan to give birth in a hospital, you can pretty much expect an encounter with a fetal monitor at some point, particularly in the later stages of labor.

External fetal monitoring involves the placement of a pair of belts around your abdomen; they're connected to equipment that measures the baby's heart rate as it responds to your contractions. On the upside, such a contraption doesn't necessarily confine you to bed. If it's used in early labor, you may be monitored for as little as 15 to 20 minutes an hour. Cordless and even waterproof models may allow you to move around more freely. Even if you're tethered to a machine by cords, you may still be able to get out of bed while being monitored in order to, say, sit in a rocker. But once you're in active labor or you've been induced, you and the monitor are likely to become fast friends.

Most restrictive of all is internal monitoring: It involves an electrode being inserted through the vagina and attached to the baby's scalp. Not surprisingly, it requires you to stay planted in bed  -- which may not be optional, anyway, since this method is most often used when external monitoring suggests that the baby may be in trouble. "We also use it if the mother is extremely overweight, in which case it's harder to track the heart rate externally," says Michelle Sang, M.D., an ob-gyn in private practice and an associate clinical professor at Oregon Health Sciences University in Portland.


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