Giving Birth

Giving Birth

Many pregnant women feel nervous or frightened about giving birth. True, childbirth can be painful. If you don't know what to expect, it can even be scary. But, giving birth can also be an amazing experience. And when it's over, you'll meet your baby for the first time!

This article will deal primarily with normal labor and delivery. Click here for a LoveToKnow article about C-sections.

How the Baby Gets Ready

Before labor begins, the baby gets into position to be born. During pregnancy the baby floats in a liquid called amniotic fluid. This protects the baby and lets him/her move around and exercise developing muscles. The baby can move his/her arms and legs, turn around, and even flip over. A few days or weeks before labor begins, the baby settles down into your pelvis with his/her head pointing downward.

Occasionally, the baby doesn't make it into the right position. When the baby is upside down, or buttocks first instead of head first, it's called a breech presentation. Babies can also present face first, shoulder first, or with an arm or leg coming out ahead of the body. Some positions are ok for a vaginal delivery, but some are too dangerous and require delivery by C-section.

How Your Body Gets Ready

At the beginning of labor, your cervix will begin to thin and dilate. The cervix is the entrance to your uterus and the exit for your baby. As your contractions get stronger and closer together, your cervix opens up more and more.

The plug of mucus that sealed your cervix will come out in the form of a blood-tinged vaginal discharge called "bloody show." The membranes which surround the baby and hold in the amniotic fluid will rupture, releasing a trickle or a gush of fluid. This is your "water breaking." It can happen early or late in labor.

You may have nausea, diarrhea, or back pain in the early part of labor. Contractions will start out weak and far apart, and gradually get stronger and come more quickly. As labor progresses, they can be very painful. Walking, taking a warm shower, having a massage, and changing position are some ways to help lessen the pain. You can also ask for pain medicine at any point during labor, up until it's time for the baby to be born.

The Baby's Birth

The actual birth of the baby usually takes less than an hour. Your contractions will be coming very quickly, sometimes even without a break in between. You will probably feel pressure on your lower back and in your rectum. You'll feel a strong urge to push the baby out. To avoid tearing, it's important not to push until the cervix is completely dilated. Your doctor or midwife will help guide you. If you've chosen to have an epidural, the sensations will not be as strong. In that case, your doctor or midwife will tell you when to push.

If the baby is positioned properly, his/her head will be the first part to appear. It can take many strong pushes to get the baby's head to come out. After that, the rest of the baby's body usually slides out fairly quickly and without much more effort.

During birth, the tissues of the vagina can tear. To minimize tearing, your doctor or midwife may massage or stretch the tissue and may gently press on the baby's head to slow down the birth. Some prefer to make a small cut in the vagina to widen the opening. This cut is called an episiotomy. It's intended to prevent a larger tear from happening. Episiotomies are controversial; many doctors and midwives believe they are not necessary in most cases. However, if the baby is very large or is having trouble and must be delivered right away, an episiotomy may be unavoidable.

After the Baby Is Born

Once the baby is out, the next step is cutting the umbilical cord. Many doctors and midwives will let the father do this. Clips are placed in two places on the cord, one near the baby and one farther out. Then, the cord is cut with a pair of scissors.

The final stage of giving birth is the delivery of the placenta. Many women are so caught up in meeting the baby that they don't even notice this stage! The placenta is a bundle of tissue and blood vessels that helped support the baby while he/she was in your body. After the baby is born and the cord is cut, the placenta gradually detaches from the uterus and is expelled from your body. You can expect some contractions at this stage, but they are usually much gentler than when you pushed the baby out.

If you had an episiotomy or any tears to your vaginal tissue, your doctor or midwife will now use stitches to repair the damage. He or she will also check your cervix to make sure it is intact.

For More Information

To learn about pain control while giving birth, visit the LoveToKnow articles on Anesthesia, Epidurals, and Vaginal Birth.

Medline Plus, a service from the National Institutes of Health, recommends these web sites for information about labor and giving birth:

• The American Pregnancy Association
• The Nemours Foundation
• The Mayo Clinic