Medicated Vaginal Birth – With a Medicated Vaginal Birth, a woman may choose to use medication as listed below for her birthing experience.

• IV pain medication (opiates in the form of morphine, Stadol or Demerol)
• Neuraxial Analgesia- Epidural and Intrathecal (use of opioids combined with local anesthetic)
• Epidural and Intrathecal are used placing an epidural catheter into the epidural space to provide pain relief without losing the ability to deliver the infant when it is time to push.

Non-Medicated Vaginal Birth– With a Non-Medicated Vaginal Birth, a woman may choose to use alternative methods for pain management for her birthing experience such as:

•  Relaxation and Breathing Techniques
•  Distraction such as music, warm showers, use of hot or cold packs
• Massage
• Ambulation
• Birthing Balls (used to sit or rock on) 

Scheduled Cesarean Section – Women who have had a cesarean section previously or have pregnancy complications may choose to schedule the procedure. Some instances where a scheduled cesarean section is performed include:

•  Mother’s choice of elective Cesarean Section
•  Mal-Presentation
•  Multiple Pregnancy
•  Placenta Previa

Unplanned Cesarean Section– Mothers may have a need for an unscheduled cesarean section for many different issues, some are listed below.

• Fetal Distress (baby is not tolerating labor)
• Failure to Progress (contractions are not causing labor to progress)
• Mal-presentation (baby is not in correct birth position)

Emergency Cesarean Section– Emergent delivery is sometimes indicated and can be alarming. All ARH delivering hospitals are equipped to preform emergency deliveries. An Emergency Cesarean Section would occur when:

• Fetal Distress (infant is not tolerating labor)
• Prolapsed Cord (the umbilical cord drops into the vagina or is compressed by the infants head)
• Maternal Hemorrhage
• Placenta Abruption (the placenta pulls away from the uterine wall)
• Uterine Rupture (the uterus tears along a previous Cesarean Section scar)

If a mother was unable to deliver by vaginal birth with a previous pregnancy and wishes to try to have a vaginal birth after cesarean section, she can discuss with her physician her desire to have a vaginal birth after cesarean section (VBAC).

When a pregnancy has reached term or the physician feels that an early delivery is warranted, the doctor can schedule an induction of labor. There are many different types of methods used for induction or cervical ripening to get labor started:

• Medications used are Cervidil, Cytotec, Pitocin, and Prepidil Gel
• Physicians may sweep the membranes, rupture the membranes (break the bag of water), or place a balloon in the cervical opening of the uterus.