Medical Decisions to Make for Your Labor and Delivery

Medically Reviewed By William C. Lloyd III, MD, FACS
Pregnant woman and husband at doctor

If you’re expecting a child, it’s important to know that every birth experience is different and it’s impossible to plan every detail. However, it is wise to consider some medical decisions you and your partner may face during labor and delivery. Discussing some of these issues in advance can help you make thoughtful decisions and take some of the stress out of childbirth. 

Do I want to induce labor?

Sometimes your doctor may recommend inducing labor because of concerns about your health or that of your baby. However, elective induction—choosing to induce labor for no medical reason—has become more common. Some choose to induce to avoid discomfort, solve scheduling problems, or reduce concerns that waiting may lead to complications. 

Talk with your doctor if you’re thinking about elective induction. There are different methods used to induce labor, such as breaking your water (rupturing the amniotic sac), using suppositories that help soften and thin the cervix, and taking Pitocin—a medication that acts like oxytocin, a hormone your body makes to begin contractions.

Historically, labor induction has been associated with a potentially greater risk of cesarean section and problems for both the mother and baby. However, a recent large study showed inducing labor with oxytocin at 39 weeks for first-time pregnancies reduced the rate of C-section compared to the rate for women who underwent normal labor management. Labor induction also did not lead to more complications. Women with a history of pregnancy and labor and delivery were not part of the study. If you are interested in labor induction, discuss all the risks and benefits of elective induction before making a decision. 

Should I get an epidural?

It’s normal to be anxious about the pain of childbirth. But there are many options available to help control the pain. One of them is an epidural. This medication, given through a catheter placed in the lower back, next to the spinal cord, allows most women to fully participate in delivery with little pain. Be aware, however, that getting an epidural may slow down your labor. 

Most women can safely have an epidural. However, if you use blood thinners, have a blood or back infection, or have a spinal abnormality, you may not be a candidate. If you have concerns, ask your doctor. 

If you plan to have natural childbirth, it’s still wise to learn about the benefits and risks of an epidural. Although many women experience a successful labor and deliver without one, every childbirth experience is different. You have the right to change your mind and request pain relief at any time. 

When is the right time to opt for a cesarean section? 

Approximately 1 in 3 births today is by cesarean delivery. Many of these are planned C-sections, but most C-sections are performed when problems arise during labor. Because every labor is different, it’s impossible to know in advance if and when you should opt for a C-section.

Your doctor may recommend a cesarean section if he or she believes it would be safer for you or the baby than a vaginal birth. This may occur if you have dangerously high blood pressure, problems with the shape of your pelvis, issues with the placenta or umbilical cord, or other concerns.

If your doctor recommends a C-section, ask for the reasons and make sure the benefits outweigh the risks. Most babies born by C-section are healthy. However, cesarean delivery is major surgery, which usually requires a lengthier recovery than natural birth and carries potential medical risks of its own. 

Should we donate the baby’s cord blood?

The blood in the umbilical cord, which is full of blood-forming cells, has the potential to save someone’s life from a life-threatening disease. You can choose to donate your cord blood to a public cord blood bank. It doesn’t affect your labor or delivery and costs you nothing. The blood, which is left in the umbilical cord after birth, is otherwise discarded. 

If you choose to donate, talk with your doctor about three months before delivery and find out if your hospital collects cord blood. When you go to the hospital to have your baby, tell your nurse you want to donate your cord blood. 

You also have the option of saving your cord blood for your family’s private use. You have to pay the private bank’s fee for this service. Unless an immediate family member has a disease that requires a stem cell transplant, the American Academy of Pediatrics suggests against private cord blood banking.  

Do I want immediate skin-to-skin contact with my baby?

Today, most hospitals encourage mothers to hold their babies next to their skin as soon after delivery as possible. Research shows this helps calm the baby, promotes bonding, and helps encourage breastfeeding, if you choose to nurse. Even though you may be tired after delivery, skin-to-skin contact can be a wonderful experience for you and your baby. This also holds true for women delivering their baby by C-section. In a movement towards a more family-centered C-section, the delivery team places the baby skin-to-skin on the mother’s chest as soon as both are stable. And don’t forget that fathers can participate, too. 

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  1. About skin-to-skin care. American Academy of Pediatrics. www.healthychildren.org/English/ages-stages/baby/preemie/pages/About-Skin-to-Skin-Care.aspx?nfstatus...

  2. Anesthesia options for labor and delivery. American Association for Nurse Anesthetists. https://www.aana.com/patients/all-about-anesthesia/anesthesia-options-for-labor-and-delivery

  3. Cord blood donation. National Cord Blood Program. www.nationalcordbloodprogram.org/donation/public_vs_private_donation.html

  4. Donating umbilical cord blood to a public bank. Health Resources and Services Administration, U.S. Department of Health and Human Services. http://bloodcell.transplant.hrsa.gov/CORD/Options/Donating/index.html

  5. Get ready for labor. March of Dimes. www.marchofdimes.org/pregnancy/inducing-labor.aspx

  6. Having a C-section. March of Dimes. www.marchofdimes.org/pregnancy/having-a-c-section.aspx

  7. Labor and birth. Office on Women’s Health, U.S. Department of Health and Human Services. www.womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.html

  8. Options for umbilical cord blood banking & donation. Health Resources and Services Administration, U.S. Department of Health and Human Services. http://bloodcell.transplant.hrsa.gov/cord/options/index.html

  9. Your baby’s first hours of life. Office on Women’s Health, U.S. Department of Health and Human Services. www.womenshealth.gov/pregnancy/childbirth-beyond/baby-first-hours.html
  10. Grobman WA, Rice MM, Reddy UM, et al. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. N Engl J Med 2018;379:513-523. https://www.ncbi.nlm.nih.gov/pubmed/30089070
  11. Practice Advisory: Clinical guidance for integration of the findings of The ARRIVE Trial: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. American College of Obstetricians and Gynecologists. https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Advisories/Practice-Advisory-Clinic...

Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 16
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