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Natural (Vaginal) Delivery

Obstetrics Types of Delivery, Natural Vaginal Delivery, Menopause Center Los AngelesA vaginal delivery is when a baby is born through the mother’s birth canal, and exits out her vagina. A vaginal delivery is considered the more “natural” method of delivery, as opposed to a Cesarean delivery – a delivery performed by a doctor through a surgical incision in the mother’s abdomen and uterus. A vaginal delivery involves several stages of labor, which can be facilitated by a doctor and nurses as well as a doula and/or your birthing partner. Talk with your gynecologist about your desires, questions, and concerns for vaginal delivery.

Labor

Labor is the process a pregnant woman’s body undergoes in order to prompt the delivery of a baby. Labor can last anywhere between a few hours to a few days, in extreme cases.

Typically labor is marked and measured by certain biological milestones. It’s important to understand these signs and what they mean so you can clearly understand the changes your body is going through as you prepare for vaginal delivery.

Contractions

The rhythmic tightening and relaxing of your pelvic muscles that prepare the baby for birth. Although contractions can range from uncomfortable to extremely painful, they are completely natural and necessary for vaginal delivery.

Dilation

Maternity care providers will measure the progress of your labor by the dilation of your cervix. The cervix is the small donut-shaped organ located at the bottom of your uterus, at the entrance to the birth canal. During labor, the cervix naturally and gradually opens to allow the baby to pass through the birth canal. Dilation is the diameter of the cervical opening in centimeters. The baby is ready to come out at 10 cm dilation.

Early Labor

In most cases, labor begins with the rupture of the amniotic sac, also known as the moment the woman’s “water broke.” The amniotic sac is the pocket of fluids that surrounds and cushions your baby in the womb. When the water breaks, a clear, odorless liquid will stream out of the vagina. There should be no cause for alarm, unless:

  • The liquid is smelly
  • It has a green, yellow, or brown color.

Contact your doctor right away if you believe something is wrong.

You will start to feel contractions during early labor. Some women start to get contractions as early as 24 weeks – these are known as Braxton-Hicks contractions and they don’t usually indicate the start of labor. Typically, a woman is considered “in labor” if she’s experiencing regular minute-long contractions, in approximately 5-minute intervals, for 60 minutes.

Some other signs of labor include:

  • Achy back
  • Cramping
  • Pressure and warmth in your lower belly
  • Diarrhea or indigestion
  • Bloody show – vaginal discharge mixed with a little blood
  • Dilation of at least 3cm

Active Labor

In active labor, your contractions will increase in intensity and frequency. They may become very painful and you may want to start using your pain management techniques, whether that involves medication or relaxation exercises. This stage of labor usually only lasts for a few hours. Your medical staff will continue to check up on you, but will allow you and your birthing partner space and privacy as long as everything is going smoothly. If your water did not break during early labor, chances are good that it will break during active labor.

Signs of active labor include:

  • Worsening pain in the pelvis and back
  • Contractions lasting up to 60 seconds, occurring 3-4 minutes apart
  • Discomfort and pressure in the legs
  • Feeling fatigued, anxious, excitable, or emotionally drained
  • Dilation approximately 7cm.

During this active labor, you and your supporters should take steps to help you relax. You may:

  • Ask for medication, if this is a part of your birthing plan.
  • Practice breathing exercises.
  • Have a light snack and drink plenty of fluids. Keep cool by sucking on ice chips or a popsicle.
  • Walk around the room or switch positions periodically to keep the blood flowing.
  • Urinate normally. With all the pressure on your pelvis, you may not always feel the urge to pee during labor. Try to use the restroom at normal intervals – a full bladder may slow the process of labor.

Note that if you are using an epidural, you will be numb from the waist down and won’t be able to walk around. You will also have a catheter to keep your bladder empty.

Transitional Labor

During the final phase of labor, your contractions will suddenly intensify, becoming extremely painful and lasting up to 90 seconds. The intervals between contractions will last only a couple minutes, giving you very little time to rest. Luckily, this is the shortest phase of labor, lasting between 15-60 minutes on average.

Signs of transitional labor may include:

  • Intense pressure in the lower belly and rectum, sometimes involving the urge to push
  • Heavy “bloody show,” as some cervical capillaries begin to burst
  • Chills, hot flashes, and sweats
  • Nausea, vomiting
  • Feeling shaky and crampy, especially in the legs
  • Drowsiness and fatigue between contractions
  • Restlessness and overwhelming emotions, including irritability, frustration, and exhaustion
  • Cervical dilation 7-10cm

Once your cervix has reached 10cm dilation, it’s time to deliver the baby. Your medical staff will move you to the delivery room or your bed will be prepared to facilitate delivery.

Pushing During Labor

The urge to push may feel like the urge to have a bowel movement. This is because the same nerves that detect pressure in your colon are sensing the baby. If you have an epidural, the sensations will be significantly numbed and you will need to listen to your doctor to know when it’s time to push. Your doctor will be able to tell you if you need to push harder or take it easy: Sometimes pushing too forcefully can cause a tear in your vaginal tissues. If you’d like, you can ask for a mirror to see your baby’s progress.

It’s important for you to speak up about your needs and feelings. If you need to hold someone’s hand, or if you don’t want to be touched, don’t hesitate to ask. You have the hardest job in the room, and everyone close to you will be working to make sure that you are as comfortable as possible. Keep breathing, listen for when your doctor tells you to push, and try to focus on that moment when you get to meet your baby!

After Birth

After your baby is born, your doctor will clear his or her airway and the umbilical cord will be cut and tied. If your baby appears healthy, you’ll be able to cuddle him or her close to your chest right away, and you may want to try breastfeeding.

Within about 5-30 minutes, you will need to deliver the placenta as well. This will be much easier than delivering your baby! You will likely continue to have small contractions, and your doctor may massage your belly to help it along. You may need to push again to completely expel the placenta.

Your doctor will examine the placenta to make sure that nothing was left behind in your uterus. If any bits remain, they will need to be removed to avoid an infection. Your doctor will also check to see if there are any tears in your vagina or vulva, and stitch them up to control bleeding and facilitate healing.

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