Different Ways to Give Birth

Uncomplicated vaginal birth

Considered the "natural" option for expectant mothers, vaginal birth is also known as natural delivery and most commonly occurs between 37 and 42 weeks of amenorrhoea. It can happen spontaneously or be induced for medical reasons, and involves the baby being delivered through the vaginal canal. Vaginal birth takes place in three stages: labour, birth, and delivery of the placenta. It is the most common method of childbirth: in France, nearly 80% of women give birth vaginally (1).

Labour is the longest stage of childbirth (on average 8 hours) and is characterised by the onset of contractions, during which the cervix shortens and opens: this is cervical dilation. Once the cervix is dilated to 10 cm, the baby's head can engage in the vaginal canal: this is the pushing stage. This stage is important as it triggers the secretion of oxytocin. This hormone facilitates uterine contraction to release and expel the placenta. Similarly, it is during the baby's delivery that the perineum is stretched to its maximum and the risk of episiotomy is greatest. The final stage of a vaginal birth corresponds to the expulsion of the placenta: this is the delivery of the placenta. 

A fourth stage of childbirth is sometimes referred to, designating the recovery time needed by the new mother, during which certain care may be provided to her. 

Vaginal birth has many advantages: 

Antenatal preparation classes offer essential resources for approaching this experience and the first days with your baby. They include exercises for managing pain and explanations of childbirth from a physiological perspective. The co-parent is also invited to certain sessions to support the mother-to-be. 

Vaginal birth with medical intervention (forceps, ventouse)

During a vaginal birth, the medical team may need to use instruments. Instrumental delivery is considered by the obstetrician when labour has been ongoing for many hours without progressing, but also to prevent exhaustion in the mother-to-be and foetal or maternal distress. In France, approximately 12% of births require instrumental intervention via the vaginal route (7).

By definition, instrumental delivery is therefore "the assistance of a baby's birth through the natural passages using an appropriate instrument, in response to an unexpected and more or less urgent situation, requiring the patient's active participation following informed consent” (7).

The decision to perform an instrumental delivery is made at the end of labour and as an urgent measure, during the pushing stage, and is generally carried out under epidural anaesthesia. Certain conditions must be met before resorting to instrumental delivery: the waters must have broken, the cervix must be fully dilated (open to 10 cm), and the baby's head must be engaged. Three instruments may be used: forceps (a grasping instrument), spatulas (a propulsion instrument), and the obstetric ventouse (a traction instrument). The choice of instrument depends on the obstetric situation, and only the obstetrician present can make this decision at the moment the indication arises.

Foetal or maternal complications are rare, and instrumental delivery does not in itself increase the rate of episiotomy. The risk of vaginal, perineal, or anal sphincter tears is increased, linked to the use of forceps or spatulas, but is also related to the presentation, the baby's size, and the indication for delivery. The obstetrician present will decide at the time whether an episiotomy is necessary to protect the maternal perineum.

Once an instrumental vaginal birth is complete, pain is managed by the medical team. The postnatal recovery period will be longer if there has been a tear or an episiotomy. Some professionals recommend booking a few osteopathy sessions to reposition the pelvic bones.

Vaginal birth after caesarean: what do the studies say?

The belief that having a caesarean section necessarily means having one every time afterwards is no longer current thinking (8)! If the reasons for your previous caesarean are not related to an irreversible anatomical issue, there is no reason not to attempt a vaginal birth. Recommended by the French National Authority for Health, today more than one third of women give birth vaginally after a caesarean (9)! 

The success of a vaginal birth after caesarean (VBAC) depends above all on the reasons that led to the first caesarean and on how the current pregnancy has progressed. Several factors are associated with successful VBAC: a maternal age under 40, a normal body mass index, a gestational age under 40 weeks, and a gap of at least 2 years between births. 

To minimise complications during childbirth, there are contraindications to vaginal birth after caesarean. A previous high vertical uterine incision, placenta praevia, multiple pregnancy, a history of caesarean sections, or a previous uterine rupture are risk factors that your doctor will take into account (10). Whilst VBAC is not recommended if the mother has a history of uterine rupture (11), the risk of uterine rupture following a VBAC remains low, at under 0.5% (12,13). 

The use of epidural anaesthesia during a VBAC is subject to debate — whilst it offers the significant benefit of pain relief, the oxytocin injection required to restart labour increases the risk of uterine rupture. It may be possible togiving birth without an epidural. 

Ultimately, choosing between VBAC and a repeat caesarean is not straightforward. The decision on the method of birth following a previous caesarean should be discussed in consultation with a doctor, taking into account each mother's individual circumstances.

To protect the mother from a difficult and painful birth for both her and her baby, less "natural" methods are sometimes used. A caesarean section is a method of delivery in which the baby is surgically removed from the mother's womb via an incision made in the lower abdomen (at the level of the abdomen and uterus). It is also referred to as an "upper segment delivery", as opposed to a "lower segment delivery" describing vaginal birth. In France, nearly one in five women gives birth by caesarean section. 

The reasons leading to a caesarean section are varied, but in all cases serve to safeguard the health of both baby and mother, and to support the smooth progress of the birth. In some cases, the doctor may decide to plan a caesarean section to prevent certain complications. In other cases, the decision to perform a caesarean section is made during labour. This is then referred to as an emergency or semi-urgent caesarean section, depending on the situation (4).

How does a caesarean section take place?

Carried out in the operating theatre, a caesarean section most often takes place under loco-regional anaesthesia via an epidural (injection of the anaesthetic into the nerves of the spinal cord). In certain cases, it is necessary to perform the caesarean under spinal anaesthesia or even under general anaesthesia. Nevertheless, wherever possible, loco-regional anaesthesia will always be preferred, as it is associated with lower maternal mortality, a smaller quantity of medication required, a more direct experience of the birth, faster development of the bond between mother and newborn, lower blood loss, and excellent post-operative pain control with the use of central opioids (5). For a standard caesarean, the incision of the abdominal wall is made horizontally, at the pubic hairline.

In France, 40% of caesarean sections are performed under epidural anaesthesia, 60% under spinal anaesthesia, and fewer than 5% under general anaesthesia (6). 

What happens after a caesarean birth?

A caesarean section is a very common surgical procedure, but it is not without risk. It remains associated with an increased risk to the mother's health compared with a vaginal birth. A caesarean involves a longer recovery period for the mother due to the surgical nature of the procedure, which itself heightens the risk of infection (at the wound, in the uterus, and urinary) and considerably increases the risk of post-operative pain. Blood loss, which can sometimes be significant, may lead to iron deficiency in the mother. 

The decision to give birth by caesarean or vaginally is reassessed throughout pregnancy and during labour. While many mothers imagine giving birth vaginally, a caesarean can become a genuine source of anxiety and disappointment. It is important to talk about it with the medical team to receive professional support, and also with other mothers who have been through it, in order to feel reassured.

You can also find all our advice for good healing in our article: caesarean scar. 

Still fairly uncommon today,water birth affects 10 to 15% of women! It involves the mother giving birth to her baby while remaining immersed in water during the pushing stage as well as during delivery (16). According to studies, this method is associated with several benefits for the mother:

• A better overall birth experience, described as positive and pleasant (17).
• A reduction in pain felt of around 84% during labour due to the properties of water (18,19), which leads to a reduced need for analgesics and a decrease in the use of epidurals (20).
• A higher likelihood of vaginal birth (21) and a lower risk of episiotomy or perineal tears (22)
• A potentially shorter labour (50 minutes less!) (23)

For the baby, although studies do not clearly demonstrate tangible benefits, there is also no evidence of increased risks. Babies born in water are generally less likely to be transferred for hospital care after birth, or in the first 6 weeks of life (24).

However, bear in mind that there are risks associated with water birth, including an increased risk of first and second-degree labial tears for the mother and a rare but serious risk of umbilical cord rupture for the baby. As with any medical procedure, there is also a risk of infection, although appropriate aseptic precautions can reduce this.

Water birth is only accessible to expectant mothers whose pregnancy presents no risks that would compromise the safety of this powerful experience.

Thehome birth, while less common in France compared to our European neighbours, is entirely possible for women in good health with no high-risk pregnancy (twins, congenital abnormalities, diabetes, hypertension...) (15). In 2019, 910 home births were recorded, representing 0.14% of total births (14). This option is often chosen by women who wish to give birth in an intimate and familiar environment, where they feel more comfortable and surrounded by their loved ones.

The home birth process involves close monitoring by a midwife throughout pregnancy, labour and the post-partum period. Strict criteria must be met, including proximity to a maternity unit, the mother's good health and the absence of pre-existing complications for both her and the baby. In addition, psychological preparation involving the second parent is recommended to ensure a positive, reassuring and safe experience.

Home birth offers a familiar and intimate environment, where you feel at ease and supported by your loved ones. This atmosphere can help reduce stress and encourage a more relaxed and positive birth experience. It also generally allows certain unnecessary medical interventions to be avoided, offering the possibility of a more natural birth experience (16). A relationship of trust is built with the midwife throughout the process, providing personalised and continuous support for your needs. Finally, the data show that the risks of perinatal complications are low during home births, with reduced rates of perineal tears and episiotomies, thereby promoting a faster recovery for the mother (16). 

However, challenges remain, including the limited number of midwives offering this option, the use of more natural pain relief methods and the need for transfer in an emergency. Despite these challenges, studies show that home birth is as safe as hospital birth for low-risk pregnancies. In France in 2019, complication rates were low, with only 0.46% of births requiring an emergency transfer.

TheHypnoNaissance® emerges as a revolutionary approach in the field of childbirth, offering a refreshing perspective on how women can approach this pivotal moment in their lives. By transforming the fears and questions so often associated with childbirth into an experience of calm and serenity, this method invites expectant parents to explore the depths of their own consciousness. 

Drawing on principles of hypnosis and pain management, HypnoNaissance® aims to free women from the grip of the fear-tension-pain syndrome, thus offering the possibility of a more natural and less medicalised birth experience. At the heart of this approach is a redefinition of the birth partner's role: by being fully involved, they become an essential pillar of support for the labouring mother-to-be and a guardian of the intimacy of this sacred moment. 

Through a 5-session preparation programme, HypnoNaissance® offers expectant parents the opportunity to connect deeply, both with themselves and with the miraculous process of birth, promising births filled with love and gentleness.

Are you considering a natural birth, that is, without medical intervention (or as little as possible) and without an epidural, and you are wondering where to begin? Here are five valuable tips to help you on this incredible journey.

• First of all, understand the magic of your body during labour. Learn more about the physiology of this process and the hormonal mechanics that come into play during labour. This will help you cultivate a deep trust in yourself and in your ability to give birth. 
  Two recommended books for this purpose are "J'accouche bientôt: que faire de la douleur ?" by Maïtie Trélaün, and "Ina May's Guide to Childbirth" by Ina May Gaskin. Reading these books should help you reconnect with your abilities as a woman through the physiological, sexual and spiritual dimensions of natural birth.  
• Then choose a birth preparation method that suits you. Whether it is hypnobirthing, prenatal yoga or another breathing method, find what calms and prepares you mentally and physically for labour. Thepregnancy acupuncture is also an effective method. 
• Don't forget to write your own birth plan. This will allow you to set out your wishes and create an environment that respects your choices during labour. However, bear in mind that letting go will be one of the keys to a successful birth, despite the possibility of the unexpected.  
• Create a safe and intimate space for the big day. You will need to feel supported and at ease to welcome your baby in serenity. 
• Finally, prepare your body with natural techniques such as a pregnancy supplement or raspberry leaf infusion (tones the uterus and increases the efficiency of contractions) and aromatherapy (helps to foster a positive mindset and relax in times of stress). These methods can help you to relax and physically prepare for labour.

By following these tips, you will feel better prepared and more at ease for your natural birth!

The birthing process has evolved considerably over the years to better meet the needs and preferences of pregnant women. More natural approaches, such as vaginal birth, allow expectant mothers to regain a sense of control over this important event whilst still benefiting from medical support when needed. 

The emergence of options such as home birth, or the use of techniques like HypnoNaissance®, offers women greater choice and control over their birth experience. However, these approaches require adequate preparation and careful medical monitoring to ensure the safety of both mother and baby.

Ultimately, the choice of birth method should be an informed decision, made in consultation with healthcare professionals and taking into account each woman's individual needs.