What Really Happens During Childbirth

Mucus Plug and Water Breaking

As you near the end of your 40 weeks, and even after 40 weeks, you may be watching for signs of labor. These signs of labor are good indicators that your baby is ready to be born.

Parent

• You may lose your mucus plug all at once or slowly before labor begins. Sometimes it comes out in a big chunk, or you may simply notice an increase in mucus discharge as you get closer to your due date.
• You do not need to save the mucus plug. Sometimes you will not see the mucus plug until labor is well ​underway.
• Some people notice increased vaginal discharge as labor nears.
• While your labor may start with the breaking of the bag of waters, this is not as common as you might think.

Baby

• You may notice that your baby feels like they are down lower. This is called dropping or lightening. This may not happen until labor has started.

Contractions During Childbirth

Contractions during childbirth are what is best known about labor. A contraction is simply the uterine muscle tightening and releasing and opening the cervix, the mouth of the uterus.

Parent

• The discomfort or pain caused by contractions can often be alleviated by changing positions.
• You may use relaxation, visualization, vocalization, and other comfort measures to decrease the pain of contractions as well.

Baby

• Your baby is still moving during labor. There is typically less movement than before labor, but many moms can still notice the movements that their baby is making.
• Fetal monitoring may be used to monitor contractions as well as your baby's heart rate.

The Cervix Opens

As your labor progresses, the contractions of labor will change the cervix. Your cervix needs to open or dilate to 10 centimeters before your baby can be born vaginally.

Parent

• Your labor contractions will come at regular intervals that get stronger, longer, and closer together.
• Your cervix thins out (effaces).
• Your cervix opens (dilates).

Baby

• Your baby moves down in your pelvis as labor progresses (known as your baby's station).

Fetal Head Molds

Contractions also help your baby's head mold, which is how your baby is able to fit through your pelvis.

Parent

• Movement may help your baby's head to mold more quickly.
• Changing positions helps you with pain management of contractions in labor and childbirth.

Baby

• The baby keeps moving downward in a normal vaginal labor and delivery, which creates the pressure needed to mold the bones of the baby's skull.
• This pressure is what gives some babies a cone-shaped head. This molding is generally slight and goes away without any treatment within a few hours or days of birth.

If an Epidural Is Used

Some people will choose to use epidural anesthesia. You may make this decision prior to labor or during labor.

Parent

• You will be given an IV and IV fluids prior to the epidural.
• The epidural catheter will be placed.
• After the epidural has taken effect, a urinary catheter may also be used.
• After the epidural is placed, you will be restricted to bed, but you can still use some different labor positions.
• If your labor slows, interventions, such as Pitocin or breaking your water (amniotomy), may be used to speed labor.

Baby

• Your baby will be monitored constantly during the epidural procedure and afterward.
• Some babies will experience changes in heart rate with any medication. The nursing staff will be watching your baby for signs of fetal distress.

Time to Push

This is an intense part of labor. It is time to start the work of getting baby down and through the birth canal. There is excitement, hard work and, well, labor, to be done.

Parent

• You are now in what is called the second stage of labor which lasts from when you are fully dilated or 10 cm until the baby is born. There is no denying this is physically the hardest part of labor.
• You will get support encouragement and coaching from your labor nurse, doctor or midwife and your doula if you have one.
• How long this part of labor will last depends on a several things including number of prior deliveries, how effective you are at pushing, position of the baby, and whether or not you have an epidural.
• On average, if this is your first baby and you have an epidural, it is not uncommon for the second stage of labor to last 3 hours.

Baby

• The force of contractions and pushing efforts will help the baby get into the right position to move down through the birth canal.
• As the baby gets lower into the pelvis there can be some reflexive decreases in heart rate as the baby's head is compressed.

Baby's Head Is Born

This is the final part of the second stage of labor. It is an exciting and possibly very painful part of labor. The baby is about to be born.

Parent

• You may need to slow your pushing efforts.
• You may feel the "ring of fire" as the baby is crowning.
• You will usually feel a great release, and a decrease in pain, as the baby's head and shoulders are born.

Baby

• Your baby makes final twists and turns to be born.
• Some babies need suctioning for meconium if it is present.
• Your baby can come immediately to your belly or breast after birth.

Delivering the Placenta

Typically everyone is so caught up in the baby that the placenta is usually only monitored by the midwife, doctor, or nurses.

Parent

• The uterus continues to contract even after baby is born.
• The placenta will usually detach on its own from the uterus within five to 30 minutes after delivery.
• Holding and nursing the baby will speed the process.
• You may be asked to push to aid in the expulsion of the placenta.

Baby

• Your baby will be breathing and crying.
• Your baby can be settling with you, skin to skin.
• Your baby will likely attempt to breastfeed.

Bonding With Your Baby

This time immediately after birth is a special time. The American Academy of Pediatrics recommends that your baby nurse immediately after birth.

You can have your doula or nurses help you with breastfeeding, but usually holding the baby skin-to-skin in this newborn period is enough to get your baby seeking the breast and nursing without a lot of assistance.

Parent

• You may shiver from the birth; warm blankets help.
• The uterus continues to contract, and nursing will help the process of involution.
• You may be excited, tired, and happy all at once.

Baby

• Babies are usually in a quiet, alert state right after birth.
• It is best if baby is placed directly skin-to-skin with mom for warmth and bonding.
• Your baby will actively seek the breast if unhindered by clothing, bedding, medication, and age (premature babies may need special care immediately after birth).