How is childbirth
Childbirth | Stages of Labor | Effacement
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When you are ready to have your baby, you'll go through labor. Labor is the process of giving birth. Signs that you might be going into labor include:
- Contractions that are regular then start to come closer together
- Leaking fluid or bleeding from the vagina
- Low, dull backache
- Abdominal cramps
Call your health care provider if you have any of these signs, even if it is before your due date. Preterm labor can start before 37 completed weeks of pregnancy.
Labor happens in three stages. The first stage begins with contractions. It continues until your cervix has become thinner and dilated (stretched) to about 4 inches wide. The second stage is the active stage, in which you begin to push downward. Crowning is when your baby's scalp comes into view. Shortly afterward, your baby is born. In the third stage, you deliver the placenta. The placenta is the organ that supplied food and oxygen to your baby during pregnancy.
Mothers and babies are monitored closely during labor. Most women are able to have a baby through normal vaginal delivery.
If there are complications, the baby may need to be delivered surgically by a Cesarean section.
NIH: National Institute of Child Health and Human Development
- Labor and Birth (Department of Health and Human Services, Office on Women's Health) Also in Spanish
- Stages of Labor (March of Dimes Birth Defects Foundation) Also in Spanish
- What Is Labor? (Eunice Kennedy Shriver National Institute of Child Health and Human Development) Also in Spanish
- Contractions and Signs of Labor (March of Dimes Birth Defects Foundation)
- Cord Blood Testing and Banking (National Library of Medicine) Also in Spanish
- Monitoring Baby's Heart Rate during Labor (American Academy of Family Physicians) Also in Spanish
- Water Breaking: Understand This Sign of Labor (Mayo Foundation for Medical Education and Research) Also in Spanish
- Dealing with Pain during Childbirth (Nemours Foundation) Also in Spanish
- Apgar Scores (American Academy of Pediatrics) Also in Spanish
- Birthing Centers and Hospital Maternity Services (Nemours Foundation) Also in Spanish
- Birthing Classes (American Academy of Family Physicians) Also in Spanish
- Elective Deliveries Before 39 Weeks: Is It Worth It? (American Academy of Pediatrics)
- Why at Least 39 Weeks Is Best for Your Baby (March of Dimes Birth Defects Foundation)
- Assisted Vaginal Delivery (American College of Obstetricians and Gynecologists)
- Cesarean Section: MedlinePlus Health Topic (National Library of Medicine) Also in Spanish
- Episiotomy: When It's Needed, When It's Not (Mayo Foundation for Medical Education and Research) Also in Spanish
- Induction of Labor at 39 Weeks (American College of Obstetricians and Gynecologists)
- Labor Pain (American Society of Anesthesiologists)
- Natural Childbirth (Nemours Foundation) Also in Spanish
- FastStats: Births -- Method of Delivery (National Center for Health Statistics)
- PeriStats: Perinatal Statistics (March of Dimes Birth Defects Foundation)
- ClinicalTrials.
gov: Delivery, Obstetric (National Institutes of Health) - ClinicalTrials.gov: Labor, Obstetric (National Institutes of Health)
- Article: A comparison of the effect of Swedish massage with and without.
.. - Article: Effect of implementing a birth plan on maternal and neonatal outcomes:...
- Article: Micturition in the toilet compared with bedpan in laboring Nulliparas: a.
.. - Childbirth -- see more articles
- Department of Health and Human Services, Office on Women's Health Also in Spanish
- Find an Ob-Gyn (American College of Obstetricians and Gynecologists)
What happens to your body during childbirth
What happens to your body during childbirth | Pregnancy Birth and Baby beginning of content7-minute read
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Key facts
- Female bodies are designed to give birth, and changes during the last weeks of pregnancy help prepare your body for labour and delivery.
- The shape of the pelvis, hormones, powerful muscles and more all work together to help you bring your baby into the world.
- Many different types of hormones work together to prepare your body for labour and birth.
- Your baby’s skull can also change shape to better pass through your birth canal.
How does my body prepare 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 are sometimes referred to as 'false labour'.
Braxton Hicks contractions may become more regular as you get closer to the time of birth. Unlike labour contractions, they don't change the shape of the cervix.
Your midwife can tell you if you're experiencing Braxton Hicks contractions or if you are in labour by doing a vaginal examination.
Changes to the cervix
As labour gets closer, your cervix softens and becomes thinner, getting ready to dilate (widen). This will allow your baby to enter your vagina during birth. You may also see a ‘show’, which is a pinkish plug of mucus that may be bloodstained.
Engagement
Your baby may move further down your pelvis as the head engages, or sits in place over your cervix, ready for the birth. You may feel that you have more room to breathe after the baby has moved down. This is called ‘lightening’.
Rupture of the membranes, or ‘waters breaking’
During labour, the sac of amniotic fluid containing the baby breaks, and the fluid leaks (or gushes) out of the vagina. This is called rupture of the membranes or 'waters breaking'. In some cases, this happens before labour.
Let your maternity team know when your waters have broken and take notice of the colour of the fluid.
It is usually clear or tinged pink. If it is green or red, tell your maternity team since this could mean the baby is having problems.
If your labour doesn’t start within 24 hours of your waters breaking, there is a risk of infection. If this happens, your doctor or midwife may recommend inducing your labour.
How will I know when labour has started?
Movies often show labour starting with sudden, painful contractions and a rush to hospital. In real life, labour usually starts gradually. It’s common not to be sure if your labour has actually started.
You may feel restless, have back pain or period-like pain, or digestive issues such as diarrhoea.
Labour officially begins with contractions, which start working to open up (dilate) the cervix. It’s a good idea to phone your midwife when your contractions start. However, you may not 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.
You and your baby’s bodies work together during labour and birth.
Your pelvis is located between your hip bones. Females typically have wider, flatter pelvises than males, as well as a wider pelvic cavity (hole) to allow a baby to pass through.
During childbirth, the muscles at the top of your uterus contract and push your baby towards your cervix. If your baby is facing head-down, the head will press on your cervix.
This, along with the release of the hormone oxytocin (see 'How hormones help you give birth', below), brings on contractions. The bones and ligaments of your pelvis also move or stretch as the baby travels into the vagina.
Your baby’s skull is made up of 5 separate bones, which can cross over each other during labour. This allows your baby's head to fit more easily through your birth canal.
Which hormones help me 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, and during breastfeeding.
- Relaxin — The hormone relaxin helps soften and stretch the cervix for birth. It helps your waters break and allows the ligaments in your pelvis to stretch to allow the baby to come through.
- Beta-endorphins — During childbirth, this type of endorphin helps with pain relief and may cause you to feel joy or euphoria.
- Adrenaline and noradrenaline — These ‘fight or flight’ hormones are released just before birth, causing several strong contractions and a surge of energy that help you birth your baby.
When childbirth doesn’t go to plan
Despite your best efforts, sometimes, labour and birth do not go to plan.
This could be because of complications before the labour, such as your waters breaking early, problems with your placenta, or issues with your baby’s position, health or progress during labour. If this happens, your midwife or doctor may recommend intervening to ensure a safe birth for both you and your baby.
Some of the more common interventions include:
- external cephalic version (turning your baby so they are in a better position for birth)
- induction or augmentation of labour
- assisted delivery
- episiotomy
- caesarean section
It’s your choice whether to have interventions in your labour. You can ask your doctor or midwife about the benefits and risks of any intervention they recommend.
Talk to your doctor or midwife if you have questions about your body. They can give you more information and help you understand what you're experiencing.
You can also call Pregnancy, Birth and Baby for free advice, support and guidance from our maternal child health nurses.
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
Sources:
Mater Mothers’ Hospital (Labour and birth information), National Childbirth Trust (Hormones in labour: oxytocin and the others – how they work), NSW Government (Having a baby), QLD Health (How your body prepares for labour), Royal Australian and New Zealand College of Obstetricians and Gynecologists (Labour and birth), Stat Pearls (Anatomy, Abdomen and Pelvis), You and Your Hormones from the Society for Endocrinology (Hormones of pregnancy and labour)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: August 2022
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Need more information?
Pregnancy: premature labour & birth | Raising Children Network
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Labour and Birth
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A birth plan is a written summary of your preferences for when you are in labour and giving birth.
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Premature babies and birth | Raising Children Network
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How childbirth proceeds
So, if you have contractions or amniotic fluid has poured out, go urgently to the hospital.
In the admission department of the maternity hospital, you will be met by an on-duty midwife who will complete the necessary documents, measure blood pressure, body temperature, pelvic dimensions, and listen to the fetal heartbeat.
Sanitization: shaving of pubic hair and cleansing enema is carried out only at your request.
In the admission department, a doctor will examine you, perform an ultrasound scan, and then you will be taken to the maternity ward.
If you were admitted to the maternity hospital not fully examined or you have any infectious disease (ARVI, influenza, kidney disease, lung disease, etc.
), i.e. there is a possibility of pregnancy complications and a threat to the fetus and mother, you will be hospitalized in a specialized obstetric observational department, where highly qualified specialists successfully treat and safely deliver high-risk women, minimizing the adverse effects of infection on the mother and fetus.
The obstetric observation department is a mini-maternity hospital in a maternity hospital, equipped with all the necessary equipment for high-quality and most favorable delivery and management of the postpartum period.
Observational obstetric department is isolated from other departments and premises of the maternity hospital.
Conducting and receiving childbirth in the maternity hospital around the clock is carried out by a team of highly qualified specialists with many years of experience, consisting of 8 doctors: 4 obstetrician-gynecologists, 2 anesthesiologists, a neonatologist, a neonatologist-resuscitator. In the maternity block, midwives are constantly on duty, who are personally responsible for the woman in labor.
Childbirth is taken on a special bed in the position of a woman on her back with her legs bent and spread apart or in a vertical position (in the absence of contraindications - varicose veins of the lower extremities, external genital organs, elephantiasis) - which provide for the free behavior of a woman in childbirth, the possibility of taking soul, holding the second stage of labor in a “vertical position”, which allows the baby to be born independently, atraumatically, more physiologically.
After birth, the baby is placed on the mother's stomach and applied to the breast. Mom has the opportunity to take the child in her arms in the first minutes of life. The umbilical cord is crossed after the cessation of pulsation.
In the delivery room, in order to prevent gonoblenorrhea, a solution of albucid is instilled into the conjunctival sac of the newborn (eyes) and the genital slit (for girls).
After childbirth, washing the newborn under a tap with water, as it was before, is not performed.
Removal of the original lubricant is not performed.
In order to prevent infectious and inflammatory skin diseases in newborns during the first three days of life, skin folds are treated once a day with a 0.5% solution of chlorhexidine.
Within two hours after the birth, the mother and child are in their birth box, then they are transferred to the postpartum ward.
It is important for a woman in childbirth to conduct the so-called "partner birth", when a husband or close relative is present throughout the birth, creating psycho-emotional comfort and a sense of "home environment".
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. Pregnant women, who are well aware of all the stages of the birth process and are psychologically prepared for the upcoming event, give birth incomparably easier than 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.
The 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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