We’ve covered the various stages of pregnancy in a previous instalment of this series, but now it’s time to delve into the actual process of childbirth. You must have heard the phrase ‘going into labour’ thrown around in the context of deliveries, but what does labour truly involve? If you’ve ever pondered that question and are still largely ignorant as to the answer, read on to find out.
Though, with the advent of modern technology, the process of delivering a baby has become diverse and, in multiple cases, modern and efficient. But in a traditional vaginal childbirth (often termed the “normal” delivery), ‘labour’ is usually the duration of time from which the cervix begins to dilate to the actual birth of the baby. It’s usually divided into three rough stages, all of which involve different reproductive processes.
The first stage of labour begins with the beginning of the contractions that cause progressive changes in your cervix and ends when your cervix is fully dilated. It is further divided into three more phases, the ‘early’ phase, the ‘active’ phase and the ‘transitional’ phase. In the ‘early stage’, the cervix gradually thins out and then eventually opens, dilating to zero to up to three or four centimetres. In the active stage, the cervix starts dilating more rapidly, and the contractions are longer, stronger, and are closely timed. The tail-end of active labor is what is called ‘transition’, because it leads to considerable changes to size and shape of the cervix.
The beginnings of labour can be both subtle and dramatic, depending on both the state of the vagina or the timing of the pregnancy. If it’s a full-term pregnancy, chances are that the process will be relatively smoother, but if your labour starts suddenly and you go from no contractions to fairly frequent and regular contractions right away, it can get slightly tricky to navigate. However, both processes are normal and if there’s a trusted doctor to guide you through it, you’ll be absolutely fine by the end of it.
Contractions start off mild and somewhat irregular, but with the progression of this stage, become more rapid and painful. As the cervix dilates, the "water breaks", which is nothing but the rupture of the cervical membranes, leading to the discharge of fluids.
Once your cervix is fully dilated, then comes the time to push and release the baby. At the beginning of the second stage, the contractions may slow down a little, and become a little further apart, giving you a few moments of rest. In fact, many women find the second stage contractions easier to handle because to bear down and actively try to push sometimes offers relief. But quite a few women also don’t enjoy the pushing part. Either way, it’s important to practice breathing and relaxation exercises during this stage so as to maintain a rhythm and ensure smoother passage of the baby.
As the uterus contracts, it exerts pressure on the baby, helping it move down the birth canal. Sometimes, if the movement comes more easily, the mother can take it slow and let the uterus do its job until there’s an active urge to push again. But in the opposite situation, doctors and caregivers usually recommend exerting more pressure so as to speed up the contractions and ensure a faster descent for the baby.
With each contraction, the force of the uterus, combined with the force of the abdominal muscles if the pushing is more active, exerts pressure on the baby to continue to move down through the birth canal. With the conclusion of each contraction, the uterus will be slightly relaxed and the baby's head will recede slightly in a "two steps forward, one step back" kind of progression. After a time, the perineum (which is the tissue between the vagina and anus) will begin to bulge with each push, and soon enough, the baby's scalp will become visible. This is often called ‘crowning’, a process where the baby continues to advance until the widest part of its head is finally visible.
After the baby's head emerges, its mouth and nose will be suctioned, and its umbilical cord will be searched for, and finally, cut.
This is when the birth is finally complete; when the baby has emerged, followed swiftly by the ejection of the placenta (which is the organ that was formed inside the uterus during pregnancy to provide oxygen and nutrients to the baby). The discharge of placenta is often also called ‘afterbirth’.
After the delivery of the placenta, the uterus goes back to its earlier normal state, contracting to become very firm. This contraction of the uterus helps seal the open blood vessels where the placenta was previously attached and has now been removed from. If the uterus doesn't contract properly, these blood vessels will continue to bleed profusely, leading to various complications. Hence, in case the uterus doesn’t become firm post-delivery, oxytocin is prescribed to help it contract. But if there’s too much internal bleeding, then other surgeries or stronger medication may be required.
If it’s a first time delivering a baby, the post-birth contractions (after the delivery of the placenta) will be felt only briefly, but if it’s a second or third (or so on) child, then the occasional contraction might last for a day or two, leading to what’s often called ‘afterbirth pains’. Sometimes, doctors prescribe painkillers for it, but more often than not, they go away on their own.
Some mothers prefer to breastfeed the baby immediately (and usually, that’s what’s recommended, so that the baby gets its nutrition at once), but there are others who prefer to not. That’s a whole other debate altogether, but breastfeeding, in general, is always good for the health of the newborn.
Childbirth is not an easy process. Even if it takes place in a matter of hours, there’s so much that goes on inside your body during the process that if even the slightest of things go wrong, it may lead to large-scale repercussions. Hence, it’s important to remain informed about it, especially if you’re an expecting mother, and to know what the risks and the benefits are.