Will I have a normal vaginal birth?

by Dr. Derrick Thompson (Obstetrician and Gynaecologist)

You are more likely to have  a normal vaginal birth if:

• there has been normal growth of your baby, reducing the risk of fetal distress in labour
• your baby’s head is engaged prior to labour
• the onset of labour is spontaneous
• your labour is progressing well (more than one cm per hour) and the fetal head is descending into the pelvis
• your membranes have ruptured spontaneously, especially if your cervix is nearly or fully dilated
• your baby’s head is well flexed and in an anterior position
• your baby’s head appears at the entrance to your vagina (introitus) and is on view without a contraction
• if you give birth in an upright or lateral position

A review of birth positions has found that women who adopt an upright or lateral position for birth had a reduced duration of second stage  of labour and were less likely to need an instrumental birth.

Conversely, you are less likely to have a normal vaginal birth if:

• you have a big baby – more than 4 kg (greater than the 90th percentile on the growth chart)
• your baby’s head remains well above the brim of your pelvis
• you are overdue, especially if it is your first pregnancy
• your membranes rupture before the onset of labour
• you have irregular contractions, commonly known as in-coordinate labour
• progressive descent of the head into the pelvis does not occur and the head is deflexed and in the posterior position
• you have a prolonged labour
• there is fetal distress, which is often associated with a small baby suffering from placental insufficiency
• your baby’s head does not spontaneously come “on view” at the introitus

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