Giving birth is one of the miracles of life. After 9 months of waiting, a woman finally gets to meet that mysterious creature that has been in there for so long waiting to meet his/her parents. When the water breaks, it signifies the start of a cascade of events the lead to birth of the baby. Easier said than done, there is a lot of pain, worry and overwhelming feelings involved in the hours before the baby actually comes out.
Women are advised to rush to the hospital when their water breaks, which is sound advice, because a doctor needs to examine the mother and baby and determine which stage of labor she is in. Some women have very bad contractions, others start with bearable ones for a long time and do not realize that the birthing process has already begun.
The excitement from the water breaking is mixed with worry, particularly if the woman is going through her first labor. She can't wait for it to be over so she can meet her baby, but at the same time she's terrified because she has no idea what is about to happen. Even mothers who have been there realize that it is not the same every time.
Whatever the labor scenario is, one thing is for sure – the baby is about to come out. This alone makes this process a memorable moment in the parents’ lives, something that will never be forgotten. Another sure thing is the physical sequence of changes that happen in a woman’s body in preparation for this glorious moment.
15 The Amniotic Sac Breaks
The amniotic sac is the fluid-filled sac in which the baby is kept in utero. It protects the baby and helps vital organs, such as the lungs and digestive system, develop. The fluid inside the amniotic sac is what the “water” is made of when the water breaks.
Some women experience it as a sensation of wetness or increased secretions from the vagina, while others feel a gush of pale or yellow liquid that overflows and wets their clothes, legs and feet.
In rare cases, the water breaks before contractions even begin. Usually, when the water breaks, the body continues to synthesize more water during the labor process itself. Lack of fluid is dangerous for the baby, and if it happens early, may require that the mother be monitored in the hospital.
Amniotic fluid increases throughout pregnancy and could reach 1 litre at birth. It also protects the baby from infections during labor.
14 Everyone Gathers Around!
At this point, when the news spread that a woman’s water broke, everyone starts gathering around. Some women need their mothers and partners around them, and therefore ask them to stay close, moving into the same city if they do not normally live there, throughout the last two weeks of the pregnancy just in case.
This is the time when everyone who will attend the birth gets ready, drops what they are doing and rearranges their plan to be there for the mother.
Support for the birthing mother is not less important than medical care. In a vaginal birth, the mother plays an active role. Therefore, her well being and feelings are not to be underestimated.
Also, this is a special day that will always be memorable to her, so everyone who is around her, from close family to professional medical care providers, need to make sure she is as comfortable and relaxed as her case and labor stage permits.
13 The Hospital Stay
While it is not a confirmatory sign that a woman needs to rush to the hospital, some of them are not prepared for this day. Some women have their hospital bags prepared and ready weeks before the birth, others are taken by surprise.
In this case, they gather the most important items for their stay in a bag and head to the hospital, especially if they suspect that they are already late and labor is in an advanced stage that needs medical attention.
It is common for the spouse/family member involved to go back and forth getting things that are forgotten, but this does not ruin the moment. It is actually something to laugh about later. Usually, the hospital is able to provide blankets for babies and if there is no breastfeeding, they provide the baby’s first can of formula, along with any medications he/she might need.
12 Those Freak'n Contractions
Contractions typically begin before the water breaks, but after it does, contractions get more frequent and stronger because labor has already started. It's ideal that the baby is delivered 24 hours or less after the water breaking, because from this point, amniotic fluid is decreasing and the baby is at risk of infection and of lack of oxygen.
When a baby is born, the airways are cleared and breathing is initiated. A baby remaining inside the womb without amniotic fluid cannot breathe.
Labor goes on anywhere from an hour or two to a whole day. During this period, contractions are ongoing until the baby is delivered. Contractions that are 10 minutes or less apart are a standard for medical attention. A woman in labor might be too tired to count, so she should get help from her partner in timing contractions, because this is very important information for the doctor.
11 Baby Descends
The baby is usually in a position where the head is down and the legs are up. This is because the baby comes down head first and all the rest of the body follows. Optimally, the baby curls his/her back over, and tuck his/her chin into his/her chest. This position encourages cervix dilatation and production of hormones necessary for labor to continue.
The head is usually the biggest part of the body and the hardest to deliver, but that does not mean that things don’t get difficult or complicated after it’s born.
During contractions, the baby descends slightly into the pelvis. The baby does not cross the cervix to the vagina until full dilatation which is at the final stages of labor. Some women are able to feel the baby’s head as it descends, because it exerts pressure on the pelvic area and makes walking extremely uncomfortable, if it is possible at all.
Usually the descent is faster in second and subsequent births.
10 The Mucus Plug
The mucus plug is a glob of mucus that blocks the cervix throughout the entire pregnancy. This plug has antibacterial properties, which means it protects the baby against infections. It starts forming as soon as the fertilized egg is implanted in the uterus. Passage of the mucus plug is not an indication of the start of labor and does not require immediate rushing to the hospital, unless it is accompanied by cramps or heavy bleeding. Labor can occur more than a week after the plug falls.
The timing of the passage of the mucus plug is confusing for many women. It may fall out as normal vaginal discharge, often with a tint of blood. Sometimes it falls piece by piece with no noticeable changes. Some women see it pass with urination and bowel movement, other do not see it at all. Under normal conditions, no pain is felt when the mucus plug passes.
9 Cervical Changes
The cervix is actually a part of the uterus, but made up of extracellular connective tissue, specifically collagen. During pregnancy, the cervix is sealed. As labor begin, the cervix dilates (opens) and thins (called effacement). This is in preparation for opening for the baby to be pushed out.
The cervical dilatation is what doctors measure to detect how far labor has gone and what the next necessary step is. A dilatation of four centimeters indicates active labor, but actual birth does not begin before 10 centimeters.
Cervical changes can begin a few weeks before labor. They are controlled by two factors. First, the body produces prostaglandins, which are responsible for the thinness of the cervix. The second factor is the contractions. Contractions also decrease collagen fiber strength in the cervix, allowing it to relax and thin.
Much of the work of labor is to actually open up the cervix, with contractions playing the major role.
8 Embrace The Unexpected
Birth usually goes according to plan. However, sometimes there are complications involved, whether due to something related to the mother’s health or the baby’s position. Some births are complicated and take more time and effort to deliver the baby. In other cases, getting a C-section or an artificial labor induction is required.
When something changes halfway through the labor, women get terrified. No wonder, they have spent months reading pages and pages about labor and preparing themselves for a scenario that is suddenly changed.
It gets very intimidating, but with the right support and medical care, things should proceed smoothly. If such cases are suspected, they should be discussed with the doctor in charge. If not, a woman must still be ready emotionally and understand that no labor is as smooth as the book. She needs to understand that changes happen anytime and that as long as she and her baby are safe and cared for, there is no cause for apprehension.
Transition is the last part of the first phase of labor. In this stage, the cervix starts dilating in preparation for pushing the baby out. Each contraction lasts longer and the contractions keep getting closer and closer. A woman feels extreme pressure in the abdominal and rectal area, with increased blood flow from the vagina.
Some women feel hot and sweaty, others feel cold and start to shake.
With contractions coming less than three minutes apart, fatigue is inevitable. Women at this point feel dizzy and exhausted. Some women feel nauseated and vomit. Deep rhythmic breathing may help calm the mother. A full cervical dilatation of 10 cm is an indication that delivery has begun and women are usually transferred to the delivery room at this point.
Transition lasts from a few minutes to a few hours and is faster in second and third births than in the first one.
6 Baby’s Position Changes
Ever heard of anterior and posterior positions for unborn babies and how women make a big deal out of them? I bet! The baby’s position is a crucial factor in how well the labor goes. The ideal position for a baby is the anterior position, where the head is down and the face is facing the mother’s front.
The largest part of the head encourages further dilatation and everything moves smoothly without extra needed help (except the mother’s pushing, of course!). At this position, the widest part of the head goes through the widest part of the pelvis, making things go easier for the mother.
In an unfavorable situation, the baby’s head is facing the spine (Ouch!). Imagine the biggest part of a baby pressing on the back of the mother, who has already been uncomfortable for 9 months and is now waiting for relief. The head pushes against the spine making labor difficult and makes back pain during deliver almost unavoidable.
This usually happens because of the shape of the mother’s pelvis. Mothers who do not have round pelvises are more prone to this occurrence.
5 Modifying The Baby’s Position
Some women are aware of this dilemma early on, while others get surprised in the delivery room. Ultrasound examination throughout the last few weeks can give an indication of the baby’s position, but it is never assurance of what will happen in labor.
Usually, the posterior position alone is not a reason to forgo vaginal delivery and opt for a C-section, but it does makes things difficult. Some activities may help a pregnant woman modify the baby’s position before labor starts.
First, leaning forward rather than backward when sitting pushes the baby forward. Second, sitting on all fours makes the baby face forward by the action of gravity. Women who work at desks need regular breaks so the baby doesn’t settle in the wrong position, and also for their own comfort.
Some women believe that lying on their back will make things worse, but that is not entirely true. It is, however, advised for mom to sleep on her back towards the end of a pregnancy.
The umbilical cord is the cord attached the stomach of the baby and to the placenta. It contains two arteries moving nutrients and oxygen-rich blood from the mother to the baby and one vein moving from the baby to the mother. It provides nutrients and removes waste from the baby’s body, because its vital organs are still unable to function.
Seconds after the baby is born, the doctors use a clamp to cut the blood flow between the mother and the baby.
When the blood flow stops, the cord is simply cut with scissors. Some women prefer that their partners get involved in the birth by cutting the cord themselves. It is a long-anticipated epic moment for the parents.
An interesting fact is that preterm labor makes doctors leave the cord for 45 seconds, rather than usual 15-20, to reduce their need for a blood transfusion, according to research in the 2000s. In 2010, research suggested that 30-60 seconds is the optimum time frame in all cases.
3 Baby Pops Out!
After all the effort and physical and emotional changes of this incredible journey, the baby finally arrives. The first cry is an important marker of normal breathing, which is very reassuring for the doctor and the mother to hear. The baby needs immediate warming, followed by a warm bath and proper clothing.
Some mothers prefer to have skin-to-skin contact with the baby before he/she is taken by nurses. Others prefer to breastfeed so they can establish the baby’s latch and start the formation of milk.
At this point, a mother will be totally exhausted, but may be too excited to sleep. Unless there are complications, a mother will focus on seeing the newborn and making sure everything went well. After that, a mother may be given painkillers and allowed a long rest while nurses and her partner and/or family attend to the baby.
Sometimes, nasal mucus will still bother the baby and nurses will work to clear it up so breathing can be as efficient as possible.
2 Birthing The Placenta
In pregnancy, the placenta is attached to the uterine wall. It provides nutrients to the baby through the umbilical cord. After the baby is delivered and the cord is cut, the placenta remains in the uterus and needs to be delivered immediately. Usually a single push at the right time, while the doctor gently pulls the rest of the cord, is enough to deliver it.
Once it is delivered, vaginal bleeding increases and becomes comparable to a heavy period.
The doctor has to confirm that the placenta is intact. If not, he/she can manually check for remains to remove them. Sometimes intravenous oxytocin is required to achieve this push and get the placenta out. By the time the baby is out, the mother has already pushed too much and is exhausted. Also, contractions often cease after the baby is born.
This is the last phase of the entire process, after which a mother can truly relax.
1 Will There Be Stitches?
After the baby and the placenta are delivered, the doctor needs to examine the perineal area for tears. Tears are not cuts made by doctors, but are a byproduct of the process. Of course, a gigantic head coming out of a small opening is bound to cause tearing. Usually, a mother is given sedatives to help her relax along with local anesthesia, so the doctor can start giving her stitches in this area.
Stitches usually fall off on their own, and are quite painful during the first urination. They do not need medical follow-up unless they are infected or something goes wrong. Women are advised to sit down slowly and not to carry heavy objects so that the stitches don’t come out earlier than they should.
With the big amount of blood flow in the area, they usually heal within 2-3 days. Some women sit on a padded cushion because they are unable to sit in the first day or two.