Labor and delivery are the stages of pregnancy that result in the birth of the baby. During labor, a pregnant woman experiences various signs and symptoms as the baby moves lower into the pelvis in preparation for the birthing process. Labor unfolds in three stages, with the final stage ending with the delivery of the baby and the placenta from the woman’s body.

Babies are delivered in one of two ways:

• Vaginal birth. The baby is delivered through the vagina. As the baby’s head appears at the vaginal opening, the tissue of the vagina thins and becomes tightly stretched. In some cases, it may be difficult for the baby’s head to fit through the vagina without severely tearing the mother’s skin and muscles. To prevent this – and to ease pressure on the baby’s head – the physician may perform an episiotomy, in which a small cut is made in the vaginal tissue.
  
  Controversy has arisen about whether episiotomies are always medically necessary, and in some cases they can cause prolonged postpartum discomfort including pain during sexual intercourse (dyspareunia) or rectal problems (e.g., bowel incontinence).
  
  The American College of Obstetricians and Gynecologists (ACOG) recommends the procedure only in cases where it is absolutely necessary, such as to avoid severe maternal lacerations or facilitate and speed up difficult deliveries. Some studies also have shown that women who do not have episiotomies suffer only a small tear to their vaginal tissue that easily heals. Episiotomy can sometimes be avoided through the use of lubricants and perineal massage during labor.
  

  

• Caesarean delivery. In some cases, the baby cannot be delivered through the vagina. Instead, an incision is made in the abdomen and uterus, and the baby is delivered through the opening. This procedure is known as a Caesarean or C-section.
  
  A physician may suggest a C-section prior to labor. Situations that might indicate the need for this procedure include:
  
  
• Position of the fetus in the uterus makes a vaginal delivery difficult.
  
  
• Mother has a medical condition that makes a vaginal birth risky (e.g., hypertension, certain sexually transmitted diseases).
  
  
In other circumstances, a C-section becomes necessary because of an unexpected difficulty during labor. Examples of such developments include:


• The baby is discovered to be too large to fit through the vaginal opening
  
  
• The dilation of the cervix is slow or incomplete
  
  
• The baby struggles to cope with the stress of labor
  
  
• The baby’s heart rate drops or slows for an extended period
  
  
• The mother experiences a health threat, such as severe bleeding

Women who take the necessary preparatory steps can make the sometimes difficult labor and delivery process a bit easier. After the baby is born, the mother and child may spend a short period of time in the hospital as the mother recovers from the demands of labor.