Labor and Birth

As you get ready for your baby’s delivery, you will probably have lots of questions about what’s going to happen. Your doctor will be able to provide you with answers to all of your questions so be sure to write them down as they come to mind and bring them to your appointments. You may also choose to take childbirth classes, which are offered at many hospitals, to help you prepare.

There are two ways to deliver a baby—vaginally or by cesarean section (c-section). In a vaginal delivery, you push the baby out through your vagina. A c-section is an operation to take the baby out by making an incision (cut) in your belly to take the baby directly out. Sometimes a c-section is necessary if the baby is not in the right position, or there are other complications. Your doctor will decide if it’s best for you and your baby to have a c-section.

About Pain

It’s not a secret that childbirth can be painful—people have probably already told you that. The amount of pain differs from woman to woman, and depends on many things. There are both natural and medical ways to manage your pain. Natural ways can include breathing and relaxation exercises, medical ways can include epidurals (spinal block) or painkillers. Discuss how you’d like to manage pain with your doctor. It’s best to talk with your doctor about all of your options and decide how you want to manage your pain before you are in labor. If this is your first pregnancy, it is hard to know what to expect. Be open to changing your pain management plan based on how you feel when you are actually in labor.

Signs of Labor

The following are signs of labor. If you have any of these signs, call your doctor immediately, even if it is very early—you could be going into pre-term labor.

Contractions that become stronger and closer together at regular intervals. Contractions are your body’s way of pushing the baby out and feel like a tightening in your belly (your belly gets hard, then soft again). It is normal to have contractions all during your pregnancy—these are called Braxton Hicks contractions and they come and go. Contractions that are signs of labor are constant, happen closer and closer together, and can get more painful.

Lower back pain and cramping that feels like strong menstrual cramps and doesn’t go away.

Your water breaks.

You have a bloody mucus discharge.

Stages of Labor

The First Stage of Labor

Labor occurs in three stages. The first stage is the longest, usually lasting 12-19 hours. During this phase you will have signs of labor (described above), and your cervix begins to dilate (open) and stretch to 10 centimeters (four inches) to make it easier for the baby to come out. During the first part of this stage many women stay at home-your doctor will tell you when it’s time to go to the hospital. Time how far apart your contractions are, and call your doctor to keep him/her updated.

Once you are at the hospital, your doctor will keep track of how much your cervix has dilated, and the position of your baby. During the last part of the first stage, your contractions will get stronger, last longer and come closer together. When your cervix dilates completely (called transition) you will begin the second stage of labor.

The Second Stage of Labor

The second stage of labor is when you deliver your baby and usually lasts from 20 minutes to two hours.  You will start to push during your contractions, and rest in between. You may find some positions more comfortable to push in than others. When your baby “crowns” (the top of the head appears from your vagina) your doctor will instruct you on how and when to push to deliver your baby. When the head is out, the doctor will clean out the baby’s nose and mouth so the baby can take its first breath. You may be able to see this with a mirror. The doctor will then tell you when to push again, to deliver the baby completely. After the baby’s nose and mouth are cleaned out again, he or she may be given to you to hold. After your baby is born, the umbilical cord will be cut.

The Third Stage of Labor

After your baby is born, there is still one more thing to do: deliver the placenta that surrounded your baby while it was in your stomach. After birth, you will experience contractions to deliver the placenta. This usually is not painful and does not take more than 30 minutes. When the placenta is out, you are all done with giving birth!