10/02/2026
PLANNING FOR CHILDBIRTH: WHAT DETERMINES HOW YOU DELIVER?
A Medical, Evidence-Based Perspective
Childbirth outcomes are rarely determined on the day of labour alone. In clinical practice, the likely mode of delivery is often anticipated during pregnancy through systematic assessment and risk evaluation.
Effective birth planning is a core component of quality antenatal care and is strongly associated with reduced maternal and neonatal complications (WHO; ACOG).
FACTORS IDENTIFIED DURING PREGNANCY
Several key factors assessed during pregnancy influence how a woman delivers:
•MATERNAL HEALTH CONDITION such as hypertension, diabetes, anaemia, or cardiac disease
•FETAL FACTORS, including size, growth pattern, presentation, and overall wellbeing
•PLACENTA LOCATION,such as placenta previa or placenta accreta
•HISTORY OF PREVIOUS DELIVERIES, including prior Caesarean section
•PELVIC UTERINE FACTORS,identified through clinical evaluation
These assessments allow healthcare providers to anticipate potential complications and plan appropriately—rather than respond to emergencies.
RISK STRATIFICATION IN ANTENATAL CARE
Risk stratification is a structured process used to classify pregnancies as LOW-RISk or HIGH- RISK.
According to WHO and ACOG guidelines:
•Low-risk pregnancies may be suitable for planned vaginal delivery
•High-risk pregnancies require closer monitoring, specialist care, or planned operative delivery
In Nigeria, where delays in emergency obstetric care contribute significantly to maternal mortality, early identification of high-risk pregnancies is critical (NDHS, 2018).
BIRTH PLANNING AND INFORMED CONSENT
Birth planning involves shared decision-making between the pregnant woman and her healthcare provider. This includes:
•Discussing the expected mode of delivery
•Explaining potential risks and benefits
•Preparing for alternative outcomes if complications arise
•Addressing cultural beliefs, fears, and misconceptions
Informed consent is a cornerstone of ethical medical practice and is emphasized by international obstetric bodies (ACOG; RCOG).
ROLE OF SKILLED BIRTH ATTENDANT
The presence of a skilled birth attendant—a trained doctor, midwife, or nurse—is one of the most effective interventions for reducing maternal and neonatal deaths.
Evidence shows that skilled attendance is associated with:
•Lower rates of birth complications
•Early recognition of labour abnormalities
•Timely referral and intervention when needed
WHO identifies skilled birth attendance as a key strategy for achieving safe motherhood, particularly in low- and middle-income countries.
THE NIGERIAN CONTEXT
According to the Nigeria Demographic and Health Survey:
•A significant proportion of maternal deaths occur due to delayed decision-making and delayed access to care
•Poor birth planning contributes to emergency presentations during labour
Strengthening antenatal birth planning reduces unplanned emergencies and improves survival outcomes for both mother and baby.
KEY MESSAGE
BIRTH PLANNING IS NOT ABOUT CHOOSING A DELIVERY METHOD- IT IS ABOUT PREPARING FOR A SAFE OUTCOME
When pregnancy risks are identified early, delivery can be planned appropriately, reducing emergency interventions and improving maternal and neonatal outcomes.
📍 Pregnant women are encouraged to engage in early and continuous antenatal care to enable informed birth planning with skilled healthcare providers.
