Is an Assisted Delivery Still a Natural Birth? Exploring Options and Birth Experiences

The term “natural birth” is often associated with the idea of a childbirth process that occurs without medical interventions such as pain relief or assisted delivery techniques. However, what happens when interventions like forceps, vacuum extraction, or even an episiotomy are necessary? Does this change the status of the birth? With the rise of medical advancements in childbirth, many expectant parents are left wondering whether an assisted delivery is still considered a natural birth. In this article, we explore what assisted delivery means, its role in antenatal care, and whether it can be classified as a “natural” birth. Understanding Natural Birth A natural birth typically refers to a vaginal birth that occurs without the use of medication, pain relief, or surgical intervention. The primary goal is to allow the birth process to unfold as it naturally would, relying on the body’s intrinsic ability to manage labour and delivery. For many, it represents the ideal birth experience, focusing on minimal medical intervention and the empowerment of the mother. Some of the key features of a natural birth include:

• No epidural or other pain relief medications: Women who opt for a natural birth typically avoid interventions like epidurals, spinal blocks, or other forms of analgesia.
• Vaginal delivery: The baby is delivered through the birth canal rather than through a cesarean section (C-section).
• Minimal or no medical interventions: This can mean avoiding techniques such as the use of forceps, vacuum extraction, or episiotomies unless medically necessary. While many women desire a natural birth, it’s important to recognise that each birth is unique, and complications or health concerns may arise that necessitate medical interventions for the safety and well-being of both mother and child. What is an Assisted Delivery? An assisted delivery occurs when medical interventions are used to help facilitate the birth. These interventions are typically required if the baby is not progressing through the birth canal on its own or if the mother is too exhausted or in distress to continue the pushing phase of labour. Assisted deliveries are typically considered when the use of instruments is needed to support a vaginal delivery. Some common forms of assisted delivery include:
• Forceps delivery: Forceps are specialized tongs used by healthcare providers to help guide the baby out of the birth canal during the second stage of labour. Forceps are generally used if the baby’s head is too high in the birth canal or if the mother is unable to push effectively.
• Vacuum extraction: A vacuum extractor uses a suction cup that attaches to the baby’s head to assist in pulling the baby out of the birth canal. This method is often used when there is a prolonged or difficult labour.
• Episiotomy: An episiotomy is a small surgical cut made in the perineum (the area between the vaginal opening and the anus) to enlarge the birth canal and prevent tearing. While it is becoming less common with the rise of techniques like perineal massage, it is still used when deemed necessary for the safety of the baby or mother. An assisted delivery is usually done to prevent a C-section and is often considered when there is a concern for the baby’s health or the mother’s ability to push the baby out successfully. Is Assisted Delivery Considered a Natural Birth? The classification of whether an assisted delivery is considered “natural” is not a straightforward question, as it depends on one’s perspective on what constitutes “natural.” From a clinical standpoint, any intervention that is used to aid in the birth process – such as forceps, vacuum extraction, or an episiotomy – could be seen as deviating from a completely natural childbirth. However, there are several key points to consider in evaluating whether assisted deliveries can be considered part of a “natural” birth experience.

The Role of Antenatal Support in Assisted Deliveries

A key component of antenatal care is preparing mothers for all types of childbirth experiences, including the possibility of an assisted delivery. Pregnancy care professionals, including obstetricians, midwives, and doulas, offer education on the potential outcomes of labour and help expectant parents navigate the options available to them. Antenatal support typically includes discussions about pain management, delivery options, and potential interventions. During antenatal appointments, healthcare providers often go over the risks and benefits of various methods, including assisted deliveries, so that families are fully prepared for any complications or deviations from their birth plan. By receiving adequate antenatal education, parents can feel empowered in making decisions about interventions, should they become necessary. Understanding how interventions are sometimes needed to ensure the safety of both the mother and the baby can shift the focus away from idealizing a “perfect” natural birth and toward prioritising the health and well-being of both parties.

The Spectrum of Birth Experiences

Birth is often unpredictable, and many factors can affect how labour progresses. For some women, assisted delivery is simply a way to achieve the goal of a vaginal birth when complications arise. An assisted delivery can still involve the mother delivering her baby vaginally, which is often the most important aspect of a “natural” birth for many people. Additionally, the use of certain interventions may be necessary for medical reasons, such as:

• A prolonged labour with little progression.
• A baby showing signs of distress, requiring rapid delivery.
• The mother being unable to push effectively due to fatigue, health conditions, or other factors. In these cases, an assisted delivery is often the safer option, ensuring that both mother and baby can get through the delivery safely without the need for a C-section.

The Psychological Aspect of a Natural Birth

Many women who choose a natural birth do so because of the sense of empowerment it gives them to trust their bodies. However, women who experience an assisted delivery often report similar feelings of empowerment, as the decision to proceed with intervention is still made in partnership with healthcare providers, who work to ensure the best outcome. For many mothers, the experience of having a birth plan and trusting their body’s natural process, even if medical interventions are required, can still feel fulfilling. Ultimately, the psychological experience of the mother during labour plays a significant role in how she views her birth. Women who feel informed, supported, and in control—whether their birth is “natural” or assisted—are more likely to have a positive experience.

Assisted Deliveries and Postnatal Recovery

One key aspect of any birth, assisted or not, is the postnatal recovery process. Assisted deliveries may require more significant recovery time than a typical vaginal birth due to the potential for perineal tears or the use of an episiotomy. In these cases, it’s essential for new mothers to receive support and care, which includes prenatal vitamins and postnatal care to ensure healing. Additionally, antenatal massage or pregnancy massage can help relieve tension and prepare the body for labour, reducing the likelihood of complications during delivery. Postpartum care is also an important aspect of recovery, regardless of how the delivery took place. Many mothers benefit from discussing their experience with a professional postnatal care team to address any emotional, physical, or psychological effects that the birth process may have had on their well-being. In the end, whether or not an assisted delivery is considered a “natural birth” is subjective and depends on one’s definition of “natural.” For some, a natural birth is one without any medical intervention, while for others, it is the experience of delivering their baby vaginally, with or without assistance. Regardless of the method, the focus should always be on ensuring a healthy outcome for both the mother and the baby. Antenatal care provides expectant parents with the information and support they need to navigate all aspects of childbirth. Understanding the nuances of assisted deliveries and how they fit into the broader spectrum of birth experiences can help parents feel confident in their decisions, knowing that their health and safety are the top priority.