How does baby borns

What happens to your body during childbirth

Childbirth is challenging and complications occur, but women's bodies are designed to give birth. The shape of the pelvis, hormones, powerful muscles and more all work together to help you bring your baby into the world - before, during and after childbirth.

How your body prepares for labour

Here are some of the ways your body will prepare both you and your baby for the birth ahead.

Braxton Hicks contractions

In the weeks or days before you start having proper contractions, you may experience Braxton Hicks contractions. This is your uterus tightening then relaxing. These contractions don't usually hurt and are thought to help your uterus and cervix get ready for labour.

Braxton Hicks contractions may become more regular as you get closer to the time of birth, but unlike labour contractions, they don't change the shape of the cervix and are sometimes referred to as 'false labour'. Your midwife can tell you if you're experiencing Braxton Hicks contractions or if you are in labour by doing a vaginal examination to look at your cervix.

Changes to the cervix

As labour gets closer, your cervix softens and becomes thinner, getting ready for the dilation (widening) that will allow the baby to enter the vagina. You may also see a 'show', which is a pinkish plug of mucus, stained with blood.

Engagement

Your baby may move further down your pelvis as the head engages, or sits in place over your cervix, ready for the birth. Some women feel they have more room to breathe after the baby has moved down. This is called 'lightening'.

Rupture of the membranes, or 'waters breaking'

Some women find the sac of amniotic fluid containing the baby breaks before labour, contractions start and the fluid runs (or gushes) out of the vagina. This is referred to as rupture of the membranes, or 'waters breaking'.

Let your maternity team know when your waters have broken and take notice of the colour of the fluid. It is usually light yellow. If it is green or red, tell your maternity team since this could mean the baby is having problems.

If your waters have broken but you have not started having regular contractions within 24 hours, you may need your labour to be induced because there is a risk of infection. Your midwife or doctor will talk to you about this.

How will you know when labour has started?

Movies often show women suddenly being struck by painful contractions and rushing to hospital. In real life, many women are not sure if they have actually started their labour.

You may feel restless, have back pain or period-like pain, or stomach disturbances such as diarrhoea.

Labour officially begins with contractions, which start working to open up the cervix. You should phone your midwife when your contractions start, although you probably won't be encouraged to come to the hospital or birthing centre until your contractions are closer together.

In preparation for labour, your baby may move further down your pelvis as the head engages, or sits in place over your cervix.

How the pelvis is designed for childbirth

Your pelvis is located between your hip bones. Women typically have wider, flatter pelvises than men, as well as a wider pelvic cavity (hole) to allow a baby to pass through.

The organs sitting in a woman's pelvis include the uterus, cervix and vagina, which are held together by a group of muscles. During childbirth, the muscles at the top of your uterus press down on the baby's bottom. Your baby's head then presses on your cervix which, along with the release of the hormone oxytocin (see 'How hormones help you give birth', below), brings on contractions. Your cervix should dilate so your baby can pass through it.

Your pelvis has bones and ligaments that move or stretch as the baby travels into the vagina. Your baby also has spaces between the skull bones called 'sutures', and the gaps where the sutures meet on the skull are called fontanelles. This allows for the baby's head to mould as the skull bones meet or overlap, allowing it to fit more easily as it travels through your pelvis.

How hormones help you give birth

Your body produces hormones that trigger changes in your body before, during and after childbirth. Here's how they work to help you deliver your baby.

Prostaglandin Before childbirth, a higher level of prostaglandin will help open the cervix and make your body more receptive to another important hormone, oxytocin.

Oxytocin This hormone causes contractions during labour, as well as the contractions that deliver the placenta after the baby is born. These post-birth contractions, including more that can occur during breastfeeding, help your uterus shrink back to its normal size. Oxytocin and prolactin are the two main hormones that produce and let down breast milk for your baby. Skin-to-skin contact between a mother and baby helps to release more of these hormones.

Relaxin The hormone relaxin helps soften and stretch the cervix for birth, while helping your waters break and stretching the ligaments in your pelvis to allow the baby to come through.

Beta-endorphins During childbirth, this type of endorphin helps with pain relief and can cause you to feel joyful or euphoric.

'Baby blues' After birth, your hormone balance can change again, and this is believed to cause the ‘baby blues’ in some women. You may feel teary, anxious and irritable and your mood can go up and down.

When childbirth doesn’t go to plan

Sometimes, complications can occur before or during childbirth that mean things don’t go as expected.

Sometimes, labour needs to be induced or started. There are a few ways to induce labour, including the mother being offered synthetic prostaglandin. This is inserted into the vagina to soften the cervix and start contractions.

If contractions slow down or stop during labour, the mother may be offered synthetic oxytocin from a drip to increase the contractions. In both these cases contractions can come on strongly and more pain relief may be needed. Your maternity team should explain the benefits and risks of this with you before you agree to it.

The baby could be in a posterior or breech position, not ideally placed above the cervix before the birth. Your maternity team may need to use forceps or a vacuum to help turn the baby or help the baby travel out of the vagina. Sometimes a caesarean is needed.

In rare cases, a mother may experience cephalopelvic disproportion (CPD), which is when the baby’s head is too big to fit through the pelvis. A diagnosis of CPD is usually made when labour hasn’t progressed and synthetic oxytocin has not helped. A caesarean is usually the next step.

More information

If you have any questions about childbirth or pregnancy, you can call Pregnancy, Birth and Baby on 1800 882 436, 7 days a week, to speak to a maternal health nurse.

Learn more here about the development and quality assurance of healthdirect content.

Your baby in the birth canal Information | Mount Sinai

Shoulder presentation; Malpresentations; Breech birth; Cephalic presentation; Fetal lie; Fetal attitude; Fetal descent; Fetal station; Cardinal movements; Labor-birth canal; Delivery-birth canal

During labor and delivery, your baby must pass through your pelvic bones to reach the vaginal opening. The goal is to find the easiest way out. Certain body positions give the baby a smaller shape, which makes it easier for your baby to get through this tight passage.

The best position for the baby to pass through the pelvis is with the head down and the body facing toward the mother's back. This position is called occiput anterior.

Childbirth is really a series of four stages that culminate in the actual birth and short period thereafter. For more specific information regarding emergency delivery see the information on childbirth, emergency delivery.

Emergency measures are indicated when childbirth is imminent and no health care professional is present. Indications of late labor include rupturing of the amniotic sac, dilation of the cervix, and appearance of the baby's head at the vaginal opening.

Cephalic (head first) presentation is considered normal, but a breech (feet or buttocks first) delivery can be very difficult, even dangerous for the mother and the baby.

In a normal pregnancy, the baby is positioned head down in the uterus.

The term fetal presentation refers to the part of your baby's body that is closest to the birth canal. In most full-term pregnancies, the baby is positioned head down, or cephalic, in the uterus.

Information

Certain terms are used to describe your baby's position and movement through the birth canal.

FETAL STATION

Fetal station refers to where the presenting part is in your pelvis.

The presenting part. The presenting part is the part of the baby that leads the way through the birth canal. Most often, it is the baby's head, but it can be a shoulder, the buttocks, or the feet.
Ischial spines. These are bone points on the mother's pelvis. Normally the ischial spines are the narrowest part of the pelvis.
0 station. This is when the baby's head is even with the ischial spines. The baby is said to be "engaged" when the largest part of the head has entered the pelvis.
If the presenting part lies above the ischial spines, the station is reported as a negative number from -1 to -5.

In first-time moms, the baby's head may engage by 36 weeks into the pregnancy. However, engagement may happen later in the pregnancy, or even during labor.

FETAL LIE

This refers to how the baby's spine lines up with the mother's spine. Your baby's spine is between his head and tailbone.

Your baby will most often settle into a position in the pelvis before labor begins.

If your baby's spine runs in the same direction (parallel) as your spine, the baby is said to be in a longitudinal lie. Nearly all babies are in a longitudinal lie.
If the baby is sideways (at a 90-degree angle to your spine), the baby is said to be in a transverse lie.

FETAL ATTITUDE

The fetal attitude describes the position of the parts of your baby's body.

The normal fetal attitude is commonly called the fetal position.

The head is tucked down to the chest.
The arms and legs are drawn in towards the center of the chest.

Abnormal fetal attitudes include a head that is tilted back, so the brow or the face presents first. Other body parts may be positioned behind the back. When this happens, the presenting part will be larger as it passes through the pelvis. This makes delivery more difficult.

DELIVERY PRESENTATION

Delivery presentation describes the way the baby is positioned to come down the birth canal for delivery.

The best position for your baby inside your uterus at the time of delivery is head down. This is called cephalic presentation.

This position makes it easier and safer for your baby to pass through the birth canal. Cephalic presentation occurs in about 97% of deliveries.
There are different types of cephalic presentation, which depend on the position of the baby's limbs and head (fetal attitude).

If your baby is in any position other than head down, your doctor may recommend a cesarean delivery.

Breech presentation is when the baby's bottom is down. Breech presentation occurs about 3% of the time. There are a few types of breech:

A complete breech is when the buttocks present first and both the hips and knees are flexed.
A frank breech is when the hips are flexed so the legs are straight and completely drawn up toward the chest.
Other breech positions occur when either the feet or knees present first.

The shoulder, arm, or trunk may present first if the fetus is in a transverse lie. This type of presentation occurs less than 1% of the time. Transverse lie is more common when you deliver before your due date, or have twins or triplets.

CARDINAL MOVEMENTS OF LABOR

As your baby passes through the birth canal, the baby's head will change positions. These changes are needed for your baby to fit and move through your pelvis. These movements of your baby's head are called cardinal movements of labor.

Engagement

This is when the widest part of your baby's head has entered the pelvis.
Engagement tells your health care provider that your pelvis is large enough to allow the baby's head to move down (descend).

Descent

This is when your baby's head moves down (descends) further through your pelvis.
Most often, descent occurs during labor, either as the cervix dilates or after you begin pushing.

Flexion

During descent, the baby's head is flexed down so that the chin touches the chest.
With the chin tucked, it is easier for the baby's head to pass through the pelvis.

Internal Rotation

As your baby's head descends further, the head will most often rotate so the back of the head is just below your pubic bone. This helps the head fit the shape of your pelvis.
Usually, the baby will be face down toward your spine.
Sometimes, the baby will rotate so it faces up toward the pubic bone.
As your baby's head rotates, extends, or flexes during labor, the body will stay in position with one shoulder down toward your spine and one shoulder up toward your belly.

Extension

As your baby reaches the opening of the vagina, usually the back of the head is in contact with your pubic bone.
At this point, the birth canal curves upward, and the baby's head must extend back. It rotates under and around the pubic bone.

External Rotation

As the baby's head is delivered, it will rotate a quarter turn to be in line with the body.

Expulsion

After the head is delivered, the top shoulder is delivered under the pubic bone.
After the shoulder, the rest of the body is usually delivered without a problem.

Barth WH. Malpresentations and malposition. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 17.

Kilpatrick SJ, Garrison E, Fairbrother E. Normal labor and delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 11.

Last reviewed on: 12/3/2020

Reviewed by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The process of childbirth

This event must be approached with self-confidence, one's strengths, capabilities and reliability of information received about childbirth during pregnancy. Tuning in the right way and doing everything right, knowledge helps. It is incomparably easier for pregnant women who have a good idea of all the stages of the birth process and are psychologically prepared for the upcoming event than for those expectant mothers who are poorly aware of what will happen to them.

Childbirth is divided into three periods:

Disclosure period . As a result of regular contractions (involuntary contraction of the muscles of the uterus), the cervix opens.
The period of expulsion of the fetus from the uterine cavity. Attempts are added to the contractions - arbitrary (that is, controlled by the woman in labor) contractions of the abdominal muscles. The baby moves through the birth canal and is born.
Follow-up period . The placenta and membranes are born.

First stage of labor

The fact that labor has already begun or is about to begin is indicated by the appearance of regular contractions and / or the outflow of amniotic fluid. Contractions are involuntary periodic contractions of the muscles of the uterus, aimed at shortening and opening the cervix. Normally, the length of the cervix is 3-5 cm, and the diameter is only a few millimeters. And for the birth of a child, it is necessary that the cervix completely shorten and open up to 9-10 cm.

The period of dilation is the longest in the process of childbirth. In the natural course of childbirth, this period lasts 10-11 hours for primiparas, 6-7 hours for multiparous ones.

At the beginning of this period there are regular contractions that last 15-20 seconds with an interval of about 15 minutes. As the cervix dilates, the contractions intensify, become longer, and the intervals between them shorten. When the break between contractions is 10 minutes, you need to go to the maternity hospital.

During the opening period, it is recommended to walk, move, breathe properly, take a warm shower or bath. These measures contribute to a faster opening of the cervix, while reducing pain. You can ask your husband or midwife to massage the lumbar region - this will reduce the discomfort from contractions.

Second stage of labor

Most women agree that the end of the dilation phase, before the onset of the second stage of labor, is the most difficult. Contractions become frequent and painful, anesthesia by this moment usually ceases to act, fatigue accumulates, it is still impossible to push. The state of many women at this moment is described by one single phrase: “That's it! I can not anymore!". The only consolation is that it doesn't last long.

After the cervix is fully dilated, the doctor allows the mother to push. A woman usually herself feels strong urges to "push" the child out of the birth canal. These urges are called pushes.

In order for pushing to be effective, you need to push properly and breathe properly. Before pushing, you need to get more air into the lungs, hold your breath and try to push effectively. It is important not to strain your face and legs during attempts, but on the contrary - to relax as much as possible. Between attempts, you also need to relax and rest.

The second stage of labor lasts from 15 minutes to two hours, and in multiparous this stage is shorter than in primiparas. During this period, doctors especially carefully monitor the condition of the mother and fetus (they regularly listen to heartbeats, etc.).

Meanwhile, the baby is moving along the genital tract. At the height of one of the attempts from the genital slit, the lower pole of the head (or buttocks - in breech presentation) is shown, after the end of the attempt, the head is hidden in the genital slit. This process - cutting the head - continues for some time. At a certain moment, the pole of the head remains in the genital gap and in between attempts. Under the influence of continuing attempts, the eruption of the head begins, which continues until its full birth. There is very little left. A few more attempts - and the whole child is born.

The newborn is placed on the mother's belly (ideally) and they get to know each other for a while, resting after the birth. The midwife or doctor then cuts the umbilical cord and takes the baby away for proper treatment, bathing, weighing and examination by a pediatrician.

10-15 minutes after the birth of the baby can be applied to the breast. This promotes uterine contraction and milk production.

Third stage of labor

The last stage of labor - the birth of the placenta - is the shortest. Usually, the afterbirth is born 10-20 minutes after the birth of the baby. Mom might need to push a little for this.

If the placenta does not separate for more than 30 minutes, doctors diagnose the retention of the placenta in the uterus and begin to take emergency measures.

The delivered placenta is carefully examined for its integrity. If everything is fine, that is, the placenta has separated completely, the woman is sewn up with tears or incisions (if any). After that, a heating pad with ice is placed on her stomach and observed for some time in the delivery room (1.5-2 hours).

This is where the birth process ends and a new life begins for mother and baby.

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How your baby is born: the whole process step by step - Parents.ru

Photo: Mustafagull/Getty Images/E+

neonatologist

It is up to the baby to decide when to be born. It is his endocrine system that triggers the birth mechanism, stimulating the production of the main birth hormone, oxytocin, in the mother. Normally, this happens when all the systems and organs of the child are already fully prepared for independent life - usually at the 38-40th week of pregnancy.

In order for the birth of a baby to go smoothly, the process must be gradual, and therefore preparation for it begins in advance, about 2 weeks before the decisive day. Under the influence of the hormones of the child's body, in particular, those produced by the adrenal cortex, more and more oxytocin is produced in the mother's body, which causes contractions of the muscles of the uterus, estrogen (they increase uterine tone) and relaxin (it softens the muscles and ligaments). At the 38th week, the baby's head moves closer to the exit from the uterus, and the expectant mother notices that the stomach has dropped a little. The uterus is increasingly contracting - but so far these irregular preparatory contractions do not cause discomfort to either the child or the mother and usually go unnoticed by them.

Photo: kieferpix/Getty Images/iStockphoto

The first stage

Birth is stressful and hard work for a little man. The walls of the native dwelling, where the baby spent 9 months, suddenly begin to put pressure on their inhabitant, he is irresistibly drawn somewhere down, where he has to squeeze through a narrow winding labyrinth, and besides, in the process of childbirth, the supply of oxygen and nutrition stops every now and then. As in an adult in moments of physical and mental stress, a child during childbirth sharply increases the level of "stress hormones" catecholamines (adrenaline, norepinephrine and dopamine). Fortunately, wise nature has provided a number of protective measures that make it easier for the baby to be born. So, along with catecholamines, endorphins and enkephalins are intensively produced in the child's body - substances that create an analgesic effect and help the body mobilize forces.

During the first stage of labor, when the cervix opens under the influence of contractions, the baby is busy gradually descending from the uterine cavity to the entrance to the small pelvis. Moving head forward and pushing it like a battering ram, the child covers a distance of only a few centimeters, but this journey takes as much as 6-12 hours. Such slowness is very important, because if the process happens too quickly, it threatens the child with birth injuries.

With each contraction, the baby feels pressure from the muscles of the uterus and abdominals. But, due to the fact that the baby is surrounded by amniotic fluid, this pressure is softened. When the uterus contracts, the placenta contracts, and the blood flow to the baby for the duration of the contraction (and in the midst of childbirth, it lasts up to 1 minute) stops. To compensate for the lack of oxygen, the baby's heart begins to beat faster - up to 180 beats per minute instead of 140 at rest. At the moment of tension of the uterus, the baby freezes, in order to then take the next “step” forward.

Photo: Robert Lang Photography/Getty Images

Steep route

The baby's direct entry into the world occurs during the pushing period that occurs after the cervix is fully dilated. This stage of childbirth is considered the most time-consuming for both the child and the mother. The woman is actively pushing, straining the abdominal muscles, and the baby's head, under the influence of contractions, passes through the small pelvis and enters the genital gap. As the child moves through the narrow space of the small pelvis, the bones of his skull are on top of each other, adapting to the winding route. The torso of the baby, first of all, the chest, is also “compacted”.

On the crown and back of the head, there is swelling of the subcutaneous adipose tissue - a birth tumor that protects the baby's brain from pressure. In the most common development of events, the back of the baby's head is shown first, then the crown, forehead and face facing down towards the floor. After the birth of the entire head, the baby turns 90 °, facing the mother's thigh, and the upper and lower shoulders come out in turn. Now we can assume that the main work has already been done: after the birth of the head (the largest part of the child's body) and shoulders, the torso and legs come out without problems.

During childbirth, mother and baby work in sync. So, at the initial stage of labor, contractions force the child to move towards the exit from the uterus, and he, in turn, presses his head on the cervix, opening it from the inside. During the period of exile, the mother pushes, straining the abdominal muscles, and the baby pushes the back of the head against the pelvic floor more and more, due to which the attempts become more frequent and intense.

Cardiotocography helps doctors judge how the baby feels during childbirth. It allows you to evaluate the heart rate of the baby, as well as the tone of the uterus of his mother. The rhythm of the baby's heartbeat changes every now and then during childbirth. But doctors, knowing what changes should occur in the norm, can immediately respond if violations occur. For example, during the period of attempts, the pulse becomes less frequent when the baby's head passes the narrowest part of the mother's small pelvis. Movement in this area normally takes only a few minutes, but if the baby is delayed and the heart rate remains slow for too long, then the child needs urgent help: a caesarean section or the imposition of obstetric instruments.

Photo: Handemandaci/Getty Images

Welcome!

A baby greets his birth with a loud cry - this is a reflex reaction to a change in environmental conditions (temperature, lighting, etc. ) and the first supply of oxygen to the lungs. Thanks to this, they straighten out, and the fetal fluid that filled them before birth comes out of them. The deeper the first breath, the more the newborn cries. It is no coincidence that the loud crying of a baby is considered one of the important indicators of his health. If there is no scream or it is barely audible, then the baby has breathing problems and needs emergency help. A healthy newborn breathes frequently, actively moves his arms and legs, his heart beats quickly (more than 100 beats per minute). He screams indignantly if his heels are tickled to test his reflexes; sneezes and coughs when clearing the nose and mouth.

As soon as the baby is born, a whole flurry of new sensations falls upon him. These are the touches of human hands (before, the baby only felt the splash of amniotic fluid), bright light and loud sounds, too harsh after darkness and silence in the uterus. And yet ... cold - after all, in the uterine cavity the temperature is 37-38 ° C, and in the birth block - "only" 23-24 ° C.