If you are in the last trimester of pregnancy and childbirth is approaching, you will be interested to know how your baby's birth will develop and what will happen at each moment to arrive as prepared as possible.
Its usually called delivery at the time the baby is born, but the truth is that the birth begins much earlier. Consists of five phases, four plus the last one - when you finally have your baby in your arms - that should be considered as part of the process. We tell you what happens in childbirth step by step.
Phase one: Early or latent dilation
The first phase of labor is dilatation, in which we can differentiate a first moment of early, latent or passive dilation, which is when cervical opening begins.
This stage is usually the longest and luckily the least intense; in fact, most women will not even notice its incipient dilation until the gynecologist explores them in their pre-delivery consultations.
The erasure, softening and dilation of the cervix up to 3 centimeters that characterize this stage can be achieved in a period of days or weeks without annoying contractions.
Oxytocin passes gently into the blood and the woman begins to have poorly noticeable contractions. These contractions are common from the 35th week of gestation, but they do not become regular, progressive or intense enough to think that the time for delivery has arrived and go to the clinic. However, they are a sign that the day is coming.
The symptoms that can be perceived are back pain (either with each contraction or constantly), pelvic pain similar to menstruation, indigestion, diarrhea, sensation of heat in the abdomen ...
To a large extent the quality of our delivery may depend on this stage, since it is not the same to reach true contractions with three centimeters "of advantage" and with the cervix erased, that is, already thinned and shortened.
In Babies and more, will I be in labor? How to differentiate contractionsPhase two: active dilation
Early or latent dilation gives way to the active dilation phase. Here the cervix will go from 3 to 10 centimeters dilated to open the birth canal and allow the baby to leave.
In this phase, the contractions are already rhythmic, strong and more followed, although in each woman its intensity and rhythm will vary, resulting in dilatations of very different duration. One centimeter per hour can be dilated, but it can also be advanced more quickly, especially if it has already been delivered before.
It will expand until it reaches approximately 10 centimeters, which will be when the baby can already poke the head and leave in the next phase, the expulsive. At this time it is convenient to implement all the techniques to relieve pain, such as breathing and other non-pharmacological techniques, or to decide if we want the epidural.
Mental attitude and relaxation is also important, since I was able to help overcome an agonizing dilation and make it more bearable. The father has a fundamental role in this regard and also the hospital staff to accompany us if this is the case.
The pain that accompanies this phase is because the efforts of the uterus are very concentrated and when the uterus contracts strongly it tends to expel all the blood that is in its muscle fibers, which are squeezed. The absence of blood produces a lack of oxygen in the muscle and that is what determines the pain.
When the contraction ends the muscle expands, relaxes and returns to receive the blood supply, oxygenating again, being when the pain ceases momentarily.
During this period of erasure and dilation, the amniotic bag is usually broken and two stages can be distinguished: accelerated dilation up to 5-6 centimeters and advanced dilation up to 10 centimeters. Let's look at each of these stages.
Dilation up to 5-6 cms.
We are in a period of acceleration is in which the contractions begin to become more painful. We go from the initial centimeters achieved in the latent dilation phase to the true labor of labor. During the contractions the pain is considerable, and the mother may not be able to speak while suffering or need to squeeze something with her hands. It helps many women to focus on breathing work. Each mother will cope with these moments differently, and the perception of pain will also not be the same or located in the same places (it can be more intense in the abdomen, in the kidneys, spread through the legs ...).
Between contraction and contraction, the pain usually disappears and the mother can take the opportunity to continue with her pain relief and relaxing techniques, because it is convenient to take strength for the next stage in which we will not have rest.
It is at these times when the epidural is usually administered in the event that the mother wishes, since after 5 centimeters the process will go much faster.
Dilation of 5-6 to 10 cms
It is also called advanced active dilation or transition dilation, since it takes us to the next phase, the expulsion. This is the maximum speed stage, when It expands in a short time at high speed and increases the sensation of pain due to the increase in the intensity of contractions. It is probable that the mother already finds few moments of absence of pain, since the contractions practically arise chained to each other, although one must always try to remain calm.
At this time the hospital staff usually considers that the administration of the epidural is no longer convenient. Let us think that it is usual for the last 3 centimeters of dilatation to occur in 15 or 20 minutes. And the baby is about to be born.
The mother usually feels great pressure on the lower back and / or on the perineum, which causes her an intense desire to push, and although it is not yet time to do so, you just have to wait a little longer. If we push when the cervix is not yet fully dilated we could cause it to swell, which could lengthen the delivery.
Instead of thinking about what we have left, we can look back and see everything we have already gone through, the great road we have already traveled. Take out strengths of weakness and keep the mood. In a few minutes you will see your baby for the first time.
Phase three: Expulsion
If in the early stages of childbirth the contractions had the function of opening and lengthening the cervix, during the period of expulsion they are a kind of propulsion force rather than help the baby be born. They are associated with the pujo and are accompanied by a sensation of pressure due to the baby's head oppresses the rectum.
The contractions of this stage are more regular than the previous ones, last between 60 and 90 seconds and they can be further apart. The perception of pain at this time is very different according to the woman, sometimes they feel like contractions more painful than the previous ones, sometimes the fact of pushing makes the pain feel less.
The sensations of the mothers at the moment are very diverse, they can go from the recovery of energies to the knowledge that they can already push and begin their more active participation in childbirth, to the feeling of depression due to fatigue and pain. But what matters is not to decay and think that there are few minutes left to see our baby.
There are several positions to carry out this stage of expulsion, and it is becoming increasingly evident that the traditional hospital posture, lying on the delivery table with legs apart and feet on stirrups placed at the end of the table, is One more option, not always the most suitable as we have seen. Vertical delivery, sitting or squatting, is another option.
To push, in each contraction the mother must take a deep breath, hold her breath and push two or three times, resting until the next contraction.
If necessary during this stage, episiotomy, an incision in the perineum would be practiced to favor the passage of the baby, and although this technique is applied routinely on many occasions, this application is not accepted by the World Health Organization (WHO).
Throughout this phase the baby progresses in stages. In the births in which the baby is positioned head, the head begins to leave the uterus, crosses the pelvis and, once the muscles that separate the vagina from the rectum (perineum) distend, the vagina dilates and the head appears by the vulva. When the head is released, the shoulders come out and finally the rest of the body. Birth has occurred, we can see our baby for the first time.
This phase of expulsion can be of very variable duration, approximately between 30 and 60 minutes when it comes to the first birth and between 15 and 30 minutes when there have been other deliveries. If the expulsion phase is prolonged, and if the mother is suffering intensely, she may feel frustration, or the need for the suffering to end, in a kind of "despair", a normal and transient reaction that professionals and companions can help mitigate with your understanding and advice.
In Babies and more Orgasm in childbirth: yes, it is possible and we tell you why and how it is producedPhase Four: Birth
After the baby leaves, and while they are being given the first care and placed on the mother's chest, the uterine contractions return to get the expulsion of the placenta, membranes and the rest of the cord.
In this phase of delivery it is not necessary to resort specifically to an external help factor, you just have to keep the body at rest, which will not be difficult after the effort and when we are finally with our baby.
The contractions, which at this stage are not just painful, will do the rest, and between 5 minutes and 1 hour after birth the baby will place the placenta. This passes to the lower segment of the uterus and to the vagina, which can be removed. Once the placenta is expelled, the doctor will take care of suturing any tear or episiotomy if it has been performed.
If the mother has given birth with epidural anesthesia, she will barely notice the discomfort. Otherwise, you will perceive pain similar to those of the period of dilation, but less intense and lasting.
At this stage the mother's feelings can be very varied, but in general the fatigue and pain gives way to happiness for having the baby already with us. Hunger, thirst, chills, tremors, impatience, relaxation, anxiety ... each mother will describe these moments in a different way, but probably what they agree on is that all previous suffering is forgotten.
After checking that the uterus has contracted well and does not bleed excessively, the hospital staff cleans and disinfects the mother's genital area. Then, they move her to her room, or to an observation room if she has been given any anesthesia.
In Babies and more Babies are not born dirty: the first bath can waitPhase Five: Immediate Postpartum
Ideally, the mother should be allowed to establish the first links with the baby thanks to direct contact and an environment as intimate and relaxed as possible.
After expulsion and while the placenta is delivered, the baby is placed on the mother's chest so that a first bond is established. It is a very emotional moment, the first time you have your baby in skin-to-skin contact with your body, feeling its warmth, its smell, seeing its face for the first time.
The power of instinct is so strong that if the baby is placed on the mother's abdomen, he is able to crawl to the chest without any help.
In some hospitals after the first contact they take the baby to clean it, weigh it and do the first tests, including the Apgar Test, but it is recommended that this protocol be performed near the mother, to avoid separating them.
The first hour after childbirth, even the first two hours are spoken are sacred to the mother and the baby. It is a particularly sensitive period in which early contact between the mother and the baby has both immediate and long-term positive effects. At that time it is established what is known as affective imprint which favors the link between the two and the establishment of breastfeeding
