The stages of vaginal delivery
From the first contractions to the moment you hold your baby in your arms, the stages are long. Because it is important to project yourself and visualize this great day, we present you in this article the main stages of the birth.
Step 1: The expansion or working phase
This stage is called the labor phase, meaning that contractions begin and act on the cervix by shortening it. This will allow the cervix to open. The woman's water may have broken or be broken during this phase.
"You're two steps away"
This sentence doesn't mean anything to you, that's normal. The midwife measures the opening of the cervix not with a decimeter but with her fingers. 1 finger corresponds to 1 centimeter. "2 fingers" corresponds to the possibility for the midwife to place two teeth on your cervix. A total dilation, that is, the large opening of the cervix, is 10 centimeters.
The first few centimeters can be long, even very long, but rest assured that the last few are quicker to arrive. In general it is from 3 cm that the mother-to-be is taken to the labor room.
This is where a monitor is installed to listen to the baby's heartbeat. In practice, the monitor is a device with two electrodes and an elastic belt. If the baby's heart rhythm is disturbed, a midwife is immediately informed.
It is also at this time that the pain becomes complicated to manage. Indeed, this phase can be long, from a few hours to 2 days. It is important to be prepared for the pain and to put in place methods.
To cope with the pain here are some tips:
- Take a childbirth preparation course beforehand
- Use a swiss ball and mobilize on the ball
- Varying positions including squatting
- Breathing, relaxation and visualization techniques. Remember to breathe in with your stomach inflated.
- Use of hot or cold compresses
- Ask your spouse to massage your lower back
- Epidural ? if the pain is too unbearable you can ask for an epidural if it has not already been offered.
Step 2: expulsion of the baby
When the cervix is fully dilated, your baby will descend about 7 to 9 centimeters. There is no rule as to how long this stage lasts, for some this phase lasts less than 10 minutes and for others it can last 45 minutes.
But don't worry, you won't be alone, a midwife or a doctor will be there to coach you during this phase.
In order to let the baby's head pass through first (except in the case of a breech birth, i.e. through the buttocks), your perineum will stretch. Sometimes it can tear and sometimes it is the medical team that can decide to cut it to let the baby through, this is called an episiotomy. Once the head is out, the medical team will take the rest of your baby out.
The presentation of the baby to the parents
If your baby is doing well, the medical team will immediately place your baby against the mother. Skin-to-skin contact is highly recommended, which will help increase the secretion of the so-called maternal attachment hormone, oxytocin. It is this hormone that will help the uterus to contract in order to detach the placenta and thus avoid the risk of hemorrhage. This first contact is also important for the establishment of breastfeeding.
Umbilical cord clamping: late calming
Delaying the clamping allows to maintain the blood circulation between the placenta and the baby. According to studies, this would improve the child's iron intake for a period of 6 months and thus fight against infantile anemia
The purpose of the umbilical cord throughout pregnancy is to bring vascularization and nutrients to the baby. During the few minutes following the delivery.
All this time, your baby is still connected to his or her umbilical cord if the medical staff allows it. In fact, many studies show the importance of late umbilical cord clamping. Late clamping is when the cord is cut more than one minute after delivery. The WHO recommends 1 to 3 minutes. Late clamping is not always possible when emergency care is needed for the baby.
The Newborn Examination:
After a few moments, the medical staff proceeds to the examination of the baby. This examination is standardized and makes it possible to establish the Apgar score registered on the health booklets:
Other tests are performed such as reflexes, hip mobility, etc.
Step 3: The delivery
It is important that women about to give birth be aware of this step because despite the birth of the baby, there is still a last step that is just as important, but less painful.
Delivery takes place about 15-20 minutes after the birth. New small contractions will start, enabled by maternal oxytocin. In some hospitals, in order to prevent the risk of postpartum hemorrhage, synthetic oxytocin is injected directly into women. These contractions allow the placenta to detach.
The medical staff will help you remove the placenta, which looks like a large bloody cake. Once out, it will be placed on a table so that the medical staff can check that it is complete and that a piece has not remained inside.
If a piece is inside, it means that the mother continues to bring blood to the placenta, but since the placenta is no longer connected to anything, it will cause bleeding. This is the risk ofpostpartum hemorrhage.
In this case, the midwife or doctor will perform what is called a uterine revision, which means that she will plunge her hand into your uterus in order to remove any pieces of placenta. This maneuver is not systematic but is quite painful.
Step 4: Recovery
Congratulations, your baby is born. The mother will have to rest while being supervised by the medical team who will regularly check her health (blood pressure, bleeding, etc.) as well as that of the baby.
Before being taken to her room, the mother usually spends 2 hours in the birth room.
Marie Messager
Osteopath D.O
2 rue Alexis de Tocqueville
78000 Versailles
