4 Common Delivery Day Dilemmas

Keep reading for the latest research on these frequent childbirth scenarios.


When it's time to deliver your baby, you'll want the most current information dictating how your OB-GYN or midwife handles your birth.

Most everyone agrees that evidence-based medicine, or practices shown in high-quality studies to be best for moms and babies, should rule in labor and delivery rooms.

However, sometimes policies to prevent lawsuits or a medical professional's personal experience, or simply old habits, reign supreme—and the most current procedures aren't put into practice.

"Women have a right to accurate information on risks, benefits and alternatives before any procedure is performed," explains Knoxville, Tenn.-based nurse-midwife Jill Alliman, C.N.M., chairwoman of the legislative committee of the American Association of Birth Centers. "It's all about women having informed consent." The more you know, the more comfortable you'll be with decisions made on delivery day, so keep reading for the latest research on four frequent childbirth scenarios.

Eating and Drinking in Labor

Old thinking: Laboring women were allowed ice chips only. If a woman has to undergo general anesthesia in an emergency Cesarean section and has a full stomach, there is a slight risk that she could vomit and the contents could be drawn into the lungs. This is a potentially fatal complication.

New thinking: In 2009, the American College of Obstetricians and Gynecologists relaxed its drinking restrictions. Women in labor are allowed to quench their thirst with water, pulp-free juice, sports drinks, soda, black coffee or clear tea.

Today, general anesthesia is rarely used in childbirth. If it is, clear liquids are much less of a risk than solids, says OB-GYN Joshua Copel, M.D., professor of obstetrics, gynecology and reproductive sciences, and pediatrics at Yale School of Medicine in New Haven, Conn.

What to do now: Because the energy demands of labor are so great, the World Health Organization recommends that health care providers should not interfere in women's eating and drinking during labor. Meanwhile, a 2012 review of research by The Cochrane Library concluded that women at low risk of needing anesthesia should be allowed to eat and drink as they wish. Before delivery day, be sure to discuss eating and drinking in labor with your health care provider.

Preemie Delivery

Old thinking: C-section is the preferred delivery method for premature babies. The reason? Small, preterm babies are fragile and should not undergo the stress of a vaginal delivery.

New thinking: Vaginal delivery may be preferred. A recent study comparing the health of small-for- gestational age infants born between 25 weeks and 34 weeks found that those born vaginally had significantly lower rates of respiratory distress than those born via C-section. Otherwise, there were no significant differences in infant health.

What to do now: There are many factors to consider when deciding on the delivery mode of a premature infant. Sometimes, the mother or baby is in immediate risk, and an emergency C-section is needed. If you are facing an early delivery, ask your doctor to explain the benefits and risks of induction versus C-section.

Keep Reading: Overdue pregnancies, inducing labor, and VBACs

Overdue Pregnancies

Old thinking: Watch and wait until you're 42 weeks along, at which point you are officially "post-term." This belief stemmed from the fact that due dates can be wrong and some women have longer pregnancies.

New thinking: Delivery is induced between 41 weeks and 42 weeks. Perinatal mortality (defined as the death of a baby immediately before or within seven days of birth) at 42 weeks is twice that at 40 weeks, according to a study of all deliveries in Sweden from 1987 to 1992.

What to do now: If your due date does come and go, don't fret. Most practitioners will want to perform some tests, such as an ultrasound, and check on you twice a week. You should also call your doctor or midwife if your baby is kicking noticeably less often.

C-section Versus VBAC

Old thinking: Once a C-section, always a C-section. Because of the risk of the C-section scar breaking open during labor and endangering the mother and baby, the vaginal birth after Cesarean section (VBAC) rate dropped from a high of 28 percent in 1996 to 8.5 percent in 2006.

New thinking: Attempting a VBAC is an appropriate and safe choice for most women, according to the American College of Obstetricians and Gynecologists. The risk of the scar opening, called uterine rupture, is less than 1 percent, research shows.

What to do now: Women who have had a previous vaginal birth are more likely to have it work post- C-section as well. You should also wait a minimum of 18 months after a C-section before trying for a VBAC, says Alliman.

It's important to know the type of incision you had: Women who have had one or two previous C-sections via a low, transverse incision are potential candidates for VBAC. Alliman also recommends working with a midwife or OB-GYN who has a 70 percent or greater success rate with VBAC deliveries.