The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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OPTION 5: Vaginal hospital birth with drugs
“I was a little disappointed that I needed an epidural and Pitocin, but they really helped my labor speed along with little pain. And the actual birth was wonderful! I pushed, and everyone cheered me on like it was a sporting event.” —Raven, a writer and mother of one in New York
“I think women are prouder when they have natural childbirth; it’s a nice accomplishment. It’s like, hello, this is the closest to nature we get; it really is our core essence.” —Laurie, a tutor and mother of two in Brooklyn, N.Y.
Who chooses it > Women for whom controlling their physiology is more important than controlling the experience; the most mainstream of all options.
What you get > The opportunity to regulate the level of pain and to move along a labor that won’t get started or is taking too long to progress.
What you give up > The opportunity to experience a natural childbirth. In exchange for pain relief and the ability to speed labor, you will be subject to a steady stream of medical interventions. The drugs used are not without possible side effects, and small amounts may reach your baby.
What you need to know > New research shows that with modern techniques and drugs, epidurals given early in labor are no more likely to result in a C-section, forceps or vacuum delivery than late epidurals and may in fact speed labor because the mother is more relaxed.
OPTION 6: Medically advised preplanned C-section
“With my first child, I had an emergency C-section after 13 hours of labor, and I felt so guilty and depressed that I couldn’t have a vaginal birth. When I had my second child, I didn’t want to go through a long labor only to wind up having an emergency C-section again. So I went in for a planned C-section. It was so easy, it was like the reward for the difficulty of the first one.” —Kara (not her
real name), A stay-at-home mother of two in Portland, Ore.
“When I found out my daughter was breech and I would need a C-section, I was upset that it was going to be so technical and scheduled. I wanted that surprise of my water breaking and going into labor.” —Julie, An artist and mother of two in New York
Who chooses it > Women whose doctor is concerned about complications such as multiples, a baby in a breech position or placenta previa, or women who’ve had a previous C-section and thus face a small potential risk for uterine rupture if they attempt a subsequent vaginal birth (VBAC).
What you get > Control over a situation that might have otherwise jeopardized your or your baby’s health; the time, date and amount of pain experienced during delivery; and the ability to plan for a C-section rather than having to undergo one at a moment’s notice.
What you give up > The idea of a natural, exciting start to labor. Also, breastfeeding and cuddling may be delayed for a few hours while you recover from surgery.
What you need to know > A 2004 study in The New England Journal of Medicine found that uterine ruptures occurred in less than 1 percent of VBACs. Having labor induced increases rupture risk, as does forceps- or vacuum-assisted delivery. C-sections pose an increased likelihood of infection, bleeding and risks to the baby.
OPTION 7: Maternal-choice C-section
“I was 44 when I had my son, and I found out that women my age had more than a 40 percent chance of having a C-section. My doctor also had her first child after 40, and had a very difficult labor, so she thought a scheduled C-section was a wise idea for me.” —Marie, A former lawyer and mother of one in New York
“I wanted to talk to my sister and my best friend about my decision to have a C-section, but when I mentioned the possibility, they immediately dismissed it as crazy. I felt like I had to keep it a secret until after I had a healthy baby to show them.” —Carmen (Not her real name), a stay-at-home mother of one in Chicago
Who chooses it > Women who want to avoid the pain and possible complications of labor and vaginal delivery.
What you get > Control over your delivery date and avoidance of having a C-section after hours of laboring in vain. Some research indicates that women who’ve not given birth vaginally have a lower risk of pelvic-floor problems later in life.
What you give up > You may be subjected to criticism from friends, family and others who see this as a controversial choice.
What you need to know > Elective C-sections involve fewer complications and an easier recovery than C-sections after attempted vaginal birth. Since each surgery leaves the uterus more prone to rupture, elective C-sections should be performed only on women who plan to have no more than two children.
For more on choosing what’s best for you, see “10 Tips for the Most Satisfying Birth Possible”
Marisa Cohen is a Fit Pregnancy contributing editor and mom to Bellamy, whose birth took 21 hours, and Molly, who was almost born in a taxi.