What You Need to Know About Giving Birth

Giving birth is the process of pushing the baby out from your uterus. When you are ready to do that, you will go through labor, which consists of three stages. Signs like contractions that are becoming more regular and closer together, water breaking, and cramps will signal to you that it’s time for you to deliver your baby.

Preterm labor can start before the full 37 weeks of pregnancy. Your baby will only be seen as viable (able to survive) after the 24^th week of pregnancy. The longer your baby remains in the uterus, the better. Babies have the best chances of survival when born at full term.

Vaginal delivery is the most common way of giving birth, but some people may need medical assistance to help with the process of labor.

As far as what triggers labor, preterm labor could be triggered by trauma or other complications. In full-term and preterm babies, the exact cause of labor remains unknown, but it’s believed to be a combination of hormonal and DNA signals from the baby.

Stages of Labor

Labor is divided into three stages and begins well before the delivery happens:

• Stage 1: Early labor and active labor
• Stage 2: Delivery of the baby
• Stage 3: Delivery of the placenta

In the weeks before labor begins, your body will prepare in subtle ways to give birth. Your cervix will shorten and soften, and the ligaments in your pelvic area will relax.

You enter active labor when you have regular contractions that are increasing in frequency and won’t go away with activity or movement.

During pregnancy, your baby is protected by a fluid-filled membranous sac called the amniotic sac. When labor begins, sometimes your membranes will rupture (water breaking). For some, their water breaks hours before contractions begin, while it does not break until they are more advanced in labor in others.

Stage 1

The first stage of giving birth begins with regular contractions and ends with full cervical dilation (opening). This process could take hours, as your contractions help your pelvis and cervix open to make way for the baby.

At this stage, you may be connected to a fetal heart monitor, but if you don’t have a high-risk pregnancy or complications, you may be free to walk and move around. Upright positions can help move the dilation along, unless you have received epidural pain management.

If your labor slows down, pauses, or fails to progress after you have reached 6 cm dilation, your healthcare provider may take a number of steps. If your water is not yet broken, that may be done. Or your practitioner may consider the use of medications, such as oxytocin, to accelerate labor.

If your labor still does not progress despite this, your healthcare provider may discuss the option of a Cesarean birth. This is suggested when there has been no progress for four hours of adequate contractions and your amniotic sac has already ruptured, or six hours if your contractions are not adequate.

The first stage of labor is notoriously painful. Your healthcare provider or midwife may offer a variety of pain management methods during this time:

• Massage
• Acupressure
• Audioanalgesia
• Hypnobirthing
• Aromatherapy
• Water delivery
• Systemic opioids
• Nitrous oxide
• Epidural anesthesia

Stage 2

You have entered the second stage of active labor when your cervix is fully dilated at 10 cm. Sometimes the head of the fetus may have dropped below the pubic symphysis at this point and may be visible at the opening of the cervix. When the baby’s head is visible, this is called crowning.

You will be coached through the pushing process, where you will bear down to push the baby out from your vagina. In some cases, you may be assisted through this process with the use of vacuum extraction or forceps.

A Cesarean delivery may be considered if you have been pushing for more than two to three hours with no progress. Episiotomy, surgical cutting at the opening of the vagina, is not routinely recommended, but may be done under certain circumstances.

Once the baby’s head is delivered, your healthcare provider or midwife will help get the rest of the baby out, making sure that the umbilical cord is not wrapped around the baby’s neck.

When the baby is fully delivered, the cord will be cut. However, cord cutting may be delayed for 30 to 60 seconds or more. Ideally, skin-to-skin contact between mother and baby should happen as soon as possible after delivery.

Once the baby takes their first breath, a number of changes occur in their lungs and circulatory system:

• Increased oxygen to the lungs
• Decreased blood flow resistance to the lungs
• Fluids draining from the respiratory system
• Lungs inflating and beginning to exchanging gases on their own
• Changes in fetal blood flow
• Closing of the natural opening in the upper chambers of the heart, triggered by respiration

Stage 3

This stage usually lasts less than 15 minutes. This is where the delivery of the placenta takes place. You may still feel contractions, and you will continue to be monitored for complications.

The biggest complication at this stage is maternal hemorrhage. Postpartum hemorrhage is blood loss of 1,000 mL or more after delivery.

Risk factors for postpartum hemorrhage include:

• Assisted labor
• Chorioamnionitis
• History of previous postpartum hemorrhage
• Surgical delivery
• Overdistended uterus
• Preeclampsia
• Prolonged labor
• Rapid labor
• A period of longer than 18 minutes to deliver the placenta

Complications

As you and your baby navigate the delivery process, there are a number of complications you could both face, including:

• Labor that stops progressing, requiring further intervention
• Tears of the perineum
• Umbilical cord problems
• An abnormal heart rate in the baby
• Water breaking too early
• Disruptions to the baby’s oxygen supply during birth or during labor
• Baby becoming stuck in the birth canal (shoulder dystocia)
• Maternal hemorrhage

After the Delivery

After delivery, you will remain in the delivery area for at least one hour. During this time, you will be monitored closely for complications and begin bonding with your baby. You may be encouraged to breastfeed right away.

If your baby requires additional care, this may occur in the room or in a separate area. Babies who require a higher level of care may need to be moved to a neonatal intensive care unit.

Within hours of the birth, you will be moved to a postpartum room, where you and your baby will continue to be monitored. The hospital may want you to schedule a follow-up visit with a pediatrician and obstetrician before you are discharged.

Your length of stay will vary based on your and your baby’s condition, but the typical hospital stay in the United States is about 48 hours for a vaginal birth and 96 hours for a Cesarean birth.

A Word From Verywell

There's a lot you may worry about when it comes to giving birth. So many things could go wrong, but so many things can go right.

Talk to your healthcare provider about your fears and concerns during your pregnancy, and have a strong support system by your side on delivery day. Above all, try and enjoy the moment as you welcome your baby into the world.