In a vaginal birth, the baby will come out through the birth canal. Most women give birth at around 38-41 weeks of pregnancy. However, there is no way to know exactly when you will go into labor.
Labor is the process that positions the baby for birth, delivers the baby out of the birth canal, and passes the placenta after birth.
Your doctor will review a list of possible complications, which may include:
Some factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before giving birth.
During pregnancy you should:
Before "true" labor begins, you may have periods of "false" labor. These are irregular contractions of your uterus, called Braxton Hicks contractions. They are normal but can be painful. They are usually also felt in the stomach and not the back. Timing the contractions is a good way to tell the difference between true and false labor. Note how long it is from the start of one contraction to the start of the next. Keep a record for an hour. If the contractions are getting closer together, longer, stronger, and are being felt in your back, then it may be true labor. If you think you are in labor, call your doctor.
During this process, you will prepare to deliver your baby. At the beginning of labor, the uterus (where the baby grows during pregnancy) will begin to contract, moving the baby down the vagina (birth canal). The cervix, the opening of the uterus into the vagina, will slowly enlarge to a diameter of about 10 centimeters. This will allow the baby to pass through and be delivered through the opening of the vagina. This process usually takes a while. However, if you have delivered vaginally before, labor can be very quick.
Labor can cause severe pain, but keep in mind that every woman's labor is different. Everyone experiences pain differently. While planning the delivery, talk to your doctor about your options for pain relief.
There are many medical options for pain control. All treatments to relieve pain during labor have risks and benefits. Make sure you discuss these with your doctor:
Once the cervix is fully dilated (opened) and the baby seems to be heading down the birth canal, the nurses will help prepare you for delivery. Your legs may be draped with cloths. Some doctors will clean the area around the vagina with an antiseptic solution.
You may put your legs into holders, especially if you have an epidural. The nurses and your support people may hold your legs in a comfortable position. This will help you to push. Your doctor may encourage you to find a position that is right for you. Each time you have a contraction, you will be instructed to push. This involves you bearing down, like you are trying to have a bowel movement.
"Crowning" is when the baby's head is seen at the opening to the vagina. When this happens, you may be asked to slow your pushing. Depending on your delivery plan, the doctor may massage your perineum to gently stretch it. An episiotomy is not routinely done, but in some cases, it is necessary.
Once your baby's head is out, you will be asked to stop pushing. The doctor will check to make sure that the umbilical cord is not around the baby's neck. Then, you will be able to push the rest of the baby out. If the baby appears healthy and is breathing well, he may be placed on your stomach. The umbilical cord will be clamped and cut. Within the next 20 minutes, the placenta will be delivered.
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Sometimes the baby's head does not move as expected through the birth canal. If this happens, your doctor may use forceps or vacuum extraction to move the baby.
The average time for you to deliver your first baby and the placenta is 12 hours. This can vary greatly, though.
Labor causes severe pain during contractions. There may be brief periods of relief after each contraction. Talk to your doctor about your options for managing pain.
The usual length of stay for a vaginal delivery is 1-3 days. Your doctor may choose to keep you longer, however, if complications arise.
Having a baby will change you physically and emotionally.
Physically, you might have the following:
Emotionally, you may be feeling:
After you leave the hospital, contact your doctor if any of the following occur:
In case of an emergency, call for medical help right away.
The American Congress of Obstetricians and Gynecologists
American Pregnancy Association
Women's Health Matters
Depression during and after pregnancy. Women's Health.gov website. Available at: http://www.womenshealth.gov/faq/postpartum.htm . Updated April 2005. Accessed June 11, 2008.
Epidural anesthesia. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/epidural.html . Updated August 2007. Accessed June 11, 2008.
Obstetrics: Normal & Problem Pregnancies . 3rd ed. New York, NY: Churchill Livingstone; 1996.
Spinal block. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/spinalblock.htm . Updated December 2006. Accessed June 11, 2008.
2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Beckmann M, Garrett A. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2009;CD005123
12/4/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Marín Gabriel M, Llana Martín I, López Escobar A, et al. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr . 2009 Nov 12. [Epub ahead of print]
4/29/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Hjelmstedt A, Shenoy ST, Stener-Victorin E, Lekander M, Bhat M, Balakumaran L, Waldenström U. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol Scand . 2010;89(11):1453-1459.
12/9/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Hodnett ED, Gates S, et al. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013 Jul 15;7.
Last reviewed September 2013 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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