Each woman’s labor and delivery experience is different, but during a normal vaginal delivery, everyone goes through the same stages. Your cervix softens and opens, your water breaks, and contractions begin. As your contractions become stronger and more frequent, you progress through three stages of labor:

• First stage: begins with regular contractions and ends when the cervix is completely dilated
• Second stage: begins with complete dilatation and ends with delivery of your baby
• Third stage: begins after birth and ends with delivery of the placenta

Your medical team keeps a constant and vigilant watch on every aspect of labor and delivery, while keeping you and your family actively updated and involved as you go through every stage. A few examples of the health issues monitored during delivery include:

• Baby’s heart rate
• Baby’s station and position
• Length of time in each stage
• Medications for pain control
• Need for augmented labor
• Need to consider assisted vaginal delivery
• Need to consider cesarean section

Assisted vaginal delivery, or operative vaginal delivery, is only needed in about 3% of all deliveries. One of the two types — forceps-assisted and vacuum-assisted — may be considered when labor doesn’t progress or your doctor has concerns about the baby’s heart rate.

You can count on your doctor to explain what’s happening and why you may need to consider an assisted delivery or cesarean section to ensure the health of your baby.

Cesarean delivery can be planned, but it often becomes a choice that’s made as health concerns arise during labor. The most common medical reasons for a cesarean include:

• Labor doesn’t progress
• Fetal distress
• Breech presentation
• Large baby
• Multiple babies
• Placenta problems
• Medical condition of the mother
• Presence of infection
• Previous C-section

The primary concern about vaginal delivery after a cesarean section (VBAC) revolves around potential muscle weakness at the site of your cesarean scar. While uterine rupture is rare, there’s a chance that the previous incision may reopen under the pressure of muscle contractions during delivery.

If your incision was horizontal along the bikini line, chances are you can consider a trial of labor after cesarean (TOLAC). Your doctor at Rosh Maternal & Fetal Medicine evaluates your overall health and talks with you about the risks and benefits. TOLAC is well-planned and you’re closely monitored throughout labor for signs of problems.

Come visit your Manhattan OBGYN.