Making a decision about the delivery method is crucial because you need to be mentally prepared for the method of childbirth you and the doctor have decided. The priority is different in each case, it may be safety, painless delivery or going with the nature.

Natural Delivery

Gynaecologists advise natural childbirth because it helps you get back in shape after pregnancy faster because there are no surgical procedures involved. You let nature take its course during the labour contractions.

For a natural delivery, certain conditions are important.

• The vaginal passage must not be narrow.
• The baby must be in a correct position (head first).
• The labour must start the natural way and the uterine contractions must not stretch too long.

Natural delivery may be unsafe or may become impossible in case there are certain prenatal complications like the position of the baby and the mother's health.

There are ways to reduce the other disadvantage of natural childbirth - the pain. The Lamaze birthing technique with controlled breathing, underwater natural delivery and birth tools like birthing chair can relieve pain to a large extent.

C-Section (Caesarean Section) Delivery

This is a surgical procedure of delivery where a 4-6 inch wide incision is made on the lower abdomen to get the baby out. A c-section is advised when natural delivery is not possible due to complications. These days c-section deliveries are done on maternal request for women who want a safer and painless option.

A c-section delivery can be planned any time after the eighth month of pregnancy. In some situations, a C-section delivery is a must.

• The baby lies in a transverse position (across the uterus instead of normal head-down position).
• The placenta is positioned below the baby near vaginal passage.
• It is a breach baby (the baby lies bottom down and head up).
• The pelvic passage is narrow and the mother can't push the baby out. This is why short women often need C-section delivery
• The mother has had more than two C-section deliveries in the past.
• It is a twin or multiple pregnancy.
• If there are signs of foetal distress, placenta around the neck of the foetus, prolonged labour or accidental haemorrhage.

Forceps / Suction Cap Delivery

In this method of delivery, the gynaecologist pulls out the baby's head with the help of tong-like forceps or a suction cap. This method is used when the mother doesn't have enough energy to push the baby's head out. Forceps delivery is not frequently used any more because there is a risk of the forceps bruising the baby's face. Suction cap delivery is similar to forceps delivery, but there is no fear of injury to the baby. Compared to forceps delivery, suction cap is a less invasive procedure.

In forceps delivery method, the doctors need to make a small cut at the back of the mother's vagina. This may harm the mother's vagina. It is good to ask the gynaecologist about the pros and cons of forceps or suction cap delivery before going in for it.

Delivery with Epidural Anaesthesia

This is a local anaesthesia injected in the lower body so to avoid labour pain. Despite the absence of pain, the mother is able to push the baby out by applying pressure. Epidural anaesthesia is also used in caesarean section deliveries.

One of the undesirable but rare side effects of the epidural anaesthesia is a sudden drop in the blood pressure of the mother. This drop can affect the baby's heart rate too. Some mothers may feel dizzy or have a severe headache due to the anaesthesia. A well-trained and experienced anaesthetist should be present throughout the delivery to ensure that nothing goes wrong.

With inputs from Dr Kiran Coelho, senior gynaecologist, Lilavati Hospital