Vaginal Delivery: What To Expect

In this article:

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Vaginal delivery is the natural way to give birth to a baby. It usually takes place in a hospital or birthing center.

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There are three stages of a vaginal birth: labor, pushing, and delivery of the baby. Many more changes and stages than these occur during pregnancy and in labor. However, these are the basics.

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Stage 1: Labor

Labor is the process of the cervix dilating (opening) and the baby moving down into the vagina. Labor can be divided into two parts: the latent phase and the active phase.

The latent phase is the beginning of labor when the cervix begins to open, and this phase can last for hours or days. The active phase is when the cervix opens more quickly, and the contractions become stronger.

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Amniotic sac

The fluid-filled membrane surrounding your baby, called the amniotic sac, almost always ruptures before the baby is born. This is what people describe as your "water breaking." However, it sometimes remains intact until delivery. When your water breaks, contact your doctor or midwife and follow their instruction.

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Contractions

The tightening and releasing of your uterus that helps your baby push through the cervix are called contractions. Contractions aren't a reliable indicator of labor. The general rule of thumb is that you're in labor when you have contractions that last for a minute, come five minutes apart, and have been so for an hour.

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Cervix dilation

The cervix is the lowest part of the uterus that opens into the vagina. During labor, the role of the cervix changes from keeping the uterus closed to dilating enough to allow the baby through.

This fundamental change results in the softening of cervical tissue and thinning of the cervix. True labor is when the cervix is dilated three centimeters or more.

Stage 2: Birth

Eventually, the cervical canal opens until the cervical opening itself has reached 10 centimeters in diameter so the baby can pass into the birth canal. The mother pushes using abdominal pressure while pushing out her baby through contractions (efforts without bearing down). 

As the baby's head emerges, there is some relief from the pressure.

Your healthcare team will likely ask you to stop pushing momentarily to suction the baby's mouth and nose to clear out amniotic fluid and mucus. It's important to do this to let the baby start to breathe and cry.

Usually, the doctor may rotate the baby's head to align with the baby's body still inside you. Then, you'll start pushing again to deliver the shoulders.

The baby is born when the head and body are delivered. The average time it takes to deliver a baby vaginally is about an hour. The delivery process can go very quickly or slowly, depending on how engaged the mother is and how much water is left in the membranes.

Stage 3: Delivery of the placenta

The last stage of vaginal birth is the delivery of the placenta, which can happen spontaneously or may take as long as half an hour after the baby is born. While you may need to push to deliver the placenta, there will be significantly less pressure. The placenta is the organ that nourishes the baby during pregnancy, and it is usually expelled through the vagina. 

Your healthcare provider inspects the placenta to ensure it is delivered in full. Occasionally, some of the placenta may remain adhered to the uterus wall. In this instance, your provider will remove the leftover pieces to prevent heavy bleeding resulting from a torn placenta. 

Suppose you choose to preserve stem cells from your umbilical cord and placenta for future stem cell treatments for your baby. In that case, this happens in this stage of delivery. Your healthcare team can use the Anja Health Stem Cell Safe to collect the cord blood while the placenta is still attached in the first two minutes after the baby is born.

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If you opt for a medication-free birth

If you decide to deliver without pain medication, you'll experience all sorts of sensations, primarily pain and pressure. As the baby descends into the birth canal, the feeling of pressure changes from intermittent contractions to constant and increasing pressure, like a strong urge to have a bowel movement.

If you choose to have an epidural

If you have an epidural, the sensations you feel during labor will depend on the effectiveness of the epidural block. If the medication properly numbs the nerves, you may not feel anything. If it's moderately effective, you may still feel some pressure.

There are other pain relief and medication options also available during vaginal delivery. A woman can choose to have an epidural, a spinal block, or medication through an IV. Some women also use gas and air (Entonox) to relieve pain. It should be noted that epidural and spinal blocks are ineffective if you choose a VBAC (vaginal birth after cesarean). You will need all your strength for successful pushing.

If you deliver in a hospital, your doctor or midwife can discuss the options with you and give recommendations based on your situation before going into labor naturally so that you feel prepared for what choices are best for you and your baby.

The possbility of tearing

The cervix may tear during the dilation process. Vaginal tissues are soft and flexible but can tear if delivery occurs rapidly or with excessive force. Studies show up to 70 percent of birthing people having their first baby will have an episiotomy or vaginal tear. Still, in most cases, lacerations are minor and easily repaired. 

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How to reduce the chance of tearing during birth:

• Protect your perineum warm by using a warm compress during pushing. Studies show that warm compresses applied during the second stage of labor increase your chances of intact perineum and reduce your risk of episiotomy.
• Ask your providers to keep their hands off. Manipulating the perineal tissues during pushing increases swelling and your risk of tearing.
• Slow down as baby crowns. Allow your body's fetal ejection reflex to do the work for you. Slowing down allows your tissues to stretch to accommodate your baby's noggin' as it comes through.

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Immediately after vaginal birth, the baby is placed on the parent's abdomen. A tie-to-skin clamp may remain used on either side when wrapping up, so no cords come off with him and to give an appearance of a longer umbilical cord. In some rare cases, there may only be loose filaments hanging down, which means they have not been clamped from one end. If this is the case, it should be clamped soon. The baby is then dried off and wrapped in a warm blanket. The room is now clear except for the parent(s) and baby.

Usually, within the first hour, the baby will breastfeed. Suppose the baby doesn't want to breastfeed. In that case, they will be given a bottle of formula or breast milk but never taken away unless medically directed by doctors until about six hours after nursing stops completely; babies start to tire out and can easily sleep through the night.

There are no restrictions on what the parent can do during this time except for walking around. Within the first hour, the nurses will complete all necessary baby work and document Apgar scores, footprints, and measurements. Then the baby is ready to go to the nursery.

It can take almost five months for one centimeter of episiotomy scarring/healing time postpartum before you feel like your old self again. Six months is when you'll likely feel back to your old self, or at least your new normal. 

After giving birth, you will be sore and tired. Here are some tips to help you heal and feel like yourself again:

• Ice packs. Use ice throughout the recovery area, including breasts (not directly over nipples), to reduce swelling and pain.
• Sports bras/ supportive underwear. These will help to prevent tightness and pain in the areola and surrounding areas while recovering from surgery (and breastfeeding).
• Keep a running to-do list. This will help keep you motivated and on track during your healing process.
• Encourage baths. Lots of water will help to decrease swelling and reduce pain.

Take your time. Healing takes time, so be patient and let your body do its thing!

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Some people opt for vaginal childbirth, while others choose a c-section. What are the pros and cons of vaginal birth?

Vaginal childbirth is more natural, and the baby can pick up beneficial bacteria from the mother's vagina. However, there is a higher risk of tearing, and an episiotomy may be necessary. If there are no severe problems with your pregnancy or labor, a vaginal birth may be the safest choice. Vaginal births often mean shorter hospital stays and quicker recoveries for birthing parents. Babies are less likely to need special care.

A note from Anja Health

Many expectant parents find it helpful to work with their doctor or midwife to create a comprehensive birth plan that ensures that the parent's desires for delivery are known and understood by everyone involved. One of the decisions in your birth plan may be banking your cord blood. 

Cord blood banking is a process of collecting stem cells from the umbilical cord and placenta and storing them for future stem cell treatments for cancer, blood diseases like anemia, and some immune system disorders. The Anja Health Stem Cell Safe makes it easy for your healthcare team to collect your cord blood.

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