Many women who have had a healthy pregnancy will have a vaginal birth. 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.
Read about giving birth and take a childbirth class.
Choose a support person to be with you during labor and delivery.
Write a birth plan that explains what you want and helps you to think about possible complications.
Talk to your doctor about:
Ways to contact her after hours and when you should call
Steps you should take when in labor
Whether you want pain relief during labor
Perineal massage—The perineum is the area between the anus and the vagina. Massaging it may help to reduce your chance of trauma to that area.
How you will travel to the hospital
Arrangements for home and work
Be aware of the signs of labor, which include:
"Water breaks" (amniotic fluid that surrounds the baby leaks out through the vagina)
Slight vaginal bleeding
True Versus False Labor
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.
In the early stages of labor, relaxation techniques (like meditation and rhythmic breathing) may be helpful. Some woman do not require any other pain control.
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.
Pain medicines by IV or muscle injection
Given when contractions become stronger and more painful
Given in small amounts by an anesthesiologist (a doctor who specializes in anesthesia)
Does not cross into baby's bloodstream
Decreases pain and feeling in your lower body
Provides good pain relief and allows you to continue with delivery
Can cause headaches and drop in blood pressure, as well as changes in baby's heartbeat
Injected into spinal fluid
Used for pain relief during delivery, especially if forceps or vacuum extraction is needed
Often used for C-section
Numbs lower half of the body and reduces your ability to push
Provides good pain relief and works quickly
Can cause headaches after delivery and drop in blood pressure during labor and delivery, as well as changes in baby's heartbeat
Injected into vagina or surrounding area
Used if an
episiotomy (cutting near the vagina)
Also used when vaginal tears are stitched
Does not relieve pain of contractions during labor
Description of the Procedure
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.
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.
Immediately After Procedure
Right after birth, your baby may be placed on your abdomen or chest. This skin-to-skin contact may lead to improved breasfeeding success.
You may need stitches if the perineum is cut or torn.
You may receive abdominal massage to help the uterus clamp down and decrease bleeding.
The vaginal area, perineum, and rectum will be cleansed.
An ice pack will be placed on the perineum to soothe and decrease swelling.
You may be given a shot of
to help decrease bleeding.
The doctor will give you pain medicine.
How Long Will It Take?
The average time for you to deliver your first baby and the placenta is 12 hours. This can vary greatly, though.
Will It Hurt?
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.
Average Hospital Stay
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:
Sore breasts—Your breasts may be painfully engorged when your milk comes in. Also, your nipples may be sore.
—You may not be able to move your bowels until the third or fourth day after delivery.
Stitches may make it painful to sit or walk.
—Hemorrhoids are common. They may make it painful for you to move your bowels.
Hot and cold flashes—This is due to your body trying to adjust to the change in hormones and blood flow levels.
or fecal incontinence—During delivery, your muscles were stretched. This may make it hard for you to control your urine and bowel movements.
"After pains"—The shrinking of your uterus can cause contractions. These can worsen when your baby nurses or when you take medicine to reduce bleeding. It is normal to have this after delivery.
Vaginal discharge—This is heavier than your period and often contains clots. The discharge gradually fades to white or yellow and stops within two months.
Weight—Your postpartum weight will probably be about 10 pounds below your full-term weight. Water weight drops off within the first week as your body regains its salt balance.
Emotionally, you may be feeling:
"Baby blues"—About 80% of new moms have irritability, sadness, crying, or
. This begins within days or weeks of giving birth. These feelings can result from hormonal changes, exhaustion, unexpected birth experiences, adjustments to changing roles, and a sense of lack of control over your new life.
(PPD)—This condition is more serious and happens in 10%-20% of new moms. It may cause mood swings, anxiety, guilt, and persistent sadness. Your baby may be several months old before PPD strikes. It is more common in women with a family history of depression.
Postpartum psychosis—Postpartum psychosis is a rare, but severe condition. Symptoms include difficulty thinking and thoughts of harming the baby. If you feel this way, call our doctor right away.
Sexual relations—You may not feel physically or emotionally ready to begin sexual relations right away.
Ways to Take Care of Yourself
When your baby sleeps, take a nap.
Set aside time each day to relax with a book, or listen to music.
Get plenty of exercise and fresh air.
Schedule regular time for you and your partner to be alone and talk.
Make time each day to enjoy your baby. Encourage your partner to do so, too.
Breastfeeding is encouraged unless your doctor tells you otherwise
Clean less and have easier meals. Take a break from having visitors if you feel stressed.
2/5/2009 DynaMed's Systematic Literature Surveillance
: Beckmann M, Garrett A. Antenatal perineal massage for reducing perineal trauma.
Cochrane Database Syst Rev
DynaMed's Systematic Literature Surveillance
: 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.
2009 Nov 12. [Epub ahead of print]
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