Birth Plans and Delivery Choices in the Cayman Islands

Vaginal delivery is the most well-known and familiar way to give birth. Babies are primarily born in the head-down position. The baby moves down into the birth canal when the mother starts pushing on her contractions. A lot of the time, vaginal birth is the safest birthing method for both the mother and baby. But there can indeed be risks for some women that vaginal birth is unsafe. Assistance may be needed to deliver the baby vaginally, or a caesarean section may have to be done. So, what are the choices available to women in the Cayman Islands regarding their birthing plan? We break this down with some insight from Dr. Marinova, Paediatrician and Neonatologist of Integra Healthcare.

Normal Vaginal Delivery

Standard vaginal delivery is when a woman goes into labour after 37 weeks gestation with the presence and assistance of a birthing team. This is without any intervention, which is how most babies are born. In modern times regarding neonatal care and obstetrics, risks have been identified that can lead to an outcome that isn’t good for both the mother and baby. This is why pregnancies are so closely monitored. Because observations are so frequent, healthcare professionals can intervene if labour needs to be induced due to complications.Labour is no walk in the park; for this reason, women may opt for an epidural to help reduce or remove the pain of contractions. An epidural helps reduce the stress levels of a woman’s hormones and can improve the birthing experience for the mother. A downside to the epidural is that it may make it seem difficult for the mother to push effectively. In this case, an assisted delivery is more than likely needed.

Assisted Delivery

An assisted delivery is when the mother needs help delivering the baby, especially if the baby is becoming distressed. Assisted delivery included using forceps or the vacuum to get the baby out faster due to slow progression while pushing. Dr Marinova says, “Around 30 to 50% of women having an epidural have an assisted vaginal delivery Having an epidural does not increase the risk of an emergency caesarean.”

Planned Caesarean

For some women, a planned C-section is the safest birthing option. This could be for several reasons; for example, the mother could be very unwell, or the baby is not turning their head down. Dr. Marinova says, “It’s not clear what percentage of planned caesarean section is acceptable and safe for the population. But it’s probably around 10 to 15% with a further 15 to 20% of women needing an emergency caesarean.”There are both pros and cons to having a c-section though many have the misconception that it is safer than a vaginal birth. Women must remember that when all is said and done, like any operation, a c-section carries risks. After c-sections, the risk of placenta praevia is increased. It increases the risk of a blood transfusion and an emergency hysterectomy during delivery. But bear in mind that this is an uncommon but severe risk. C-sections are only recommended if an obstetrician recommends this.

Delivery Choices After Previous Caesarean Section

If a woman has a c-section with her previous birth, it may be safe for her to have a vaginal delivery with later pregnancies. Dr Marinova explains: “There is a consensus between the Royal College in the UK and the American College of Obstetrics and Gynaecology that vaginal birth after caesarean section (VBAC) is safe for the majority of women.”Out of approximately 75% of women who attempt to have a VBAC, have a successful vaginal delivery. This rises to around 90% if the woman has had previous vaginal deliveries. If pregnancy is uncomplicated for both the mother and the baby, the best time to have a repeat c-section is after 39 weeks.It is important to remember that childbirth is safe by whichever method is used, especially here in the Cayman Islands. Your obstetrician is the best person to discuss the pros and cons of birth. They will be able to best advice specific to your circumstances.

Birthing Preferences

Planning for delivery is an exciting time and being informed of the process will help ensure you know what to expect and keep a clear mind. Below we outline topics to speak with your OBGYN or midwife about prior to delivery.