FAQ: Vaginal Birth
Labor and delivery are experiences that inspire lots of questions from moms-to-be, who might feel both nervous and excited about what lies ahead. As an expectant mom, you'll want to know as much as possible about childbirth ahead of time, even though you can't predict exactly what will happen in your own situation. Reviewing these frequently asked questions about vaginal birth may help you feel a little more prepared for the delivery of your baby.
How Long Does a Vaginal Birth Take?
Every birth is different, and factors like the size and position of the baby and the progress of cervical dilation can all affect the time it takes for the baby to be born.
For first-time moms, labor may take anywhere from 12 to 18 hours, and perhaps longer. For moms who have given birth before, labor can sometimes be shorter; however, each birth is different. Some babies are born in several hours; others might take 10 hours or longer.
What Are the Stages of Labor for a Vaginal Birth?
If everything goes according to plan, you can expect to go into labor in the third trimester between weeks 38 to 42. There are many signs of labor to look out for, and once you are in labor, there are four stages.
Stage 1. Preparing for Birth
This first stage ranges from a few hours to 12 to 15 hours on average, and transitions through three phases:
Early Phase Labor: cervix dilates from 0 to 5-6 cm; contractions are 15 to 5 minutes apart You will start to feel contractions (tightening of the uterus) as your cervix dilates. They may initially come at 15-minute intervals, slowly increasing in frequency until they are 5 minutes apart. Each contraction usually lasts less than a minute to start with and gets progressively longer, up to about 60 to 90 seconds. Early phase labor generally lasts between 6 and 12 hours, so it's often recommended to stay home where you are most comfortable. Your water may break (also called rupture of membranes) during this phase or later on in the active labor phase. It is relatively common for your water not to break naturally; this procedure may be done by your healthcare provider once you are admitted to the hospital.
Active Phase Labor: cervix dilates from 5-6 cm to 10 cm; contractions are consistent and intense Your contractions will grow stronger and more frequent as your cervix dilates. When your contractions are 5 minutes apart and regular, it's a good sign that you are making progress. Your healthcare provider may have already given you instructions on when to head to the hospital, or can be in touch by phone for advice on when to leave. It's a good idea to have had your hospital bag packed in advance, so when the time comes, you're ready to go.
Transition Phase Labor: cervix 10 cm dilated; contractions are at their strongest This is typically a short phase, lasting less than an hour. Your contractions will be at their strongest during this phase, as your body gets ready to move your baby through the birth canal.
Stage 2. Birth of the Baby
As you reach 10 cm dilation, you enter the second stage of labor and can begin pushing in time with your contractions to help your baby move through the birth canal. This stage can last less than an hour, especially if you have given birth before, but it may last as long as two or three hours, particularly if it's your first baby. Once the baby is born, the umbilical cord will be cut, and your baby will be handed to you to hold and cuddle. Then the staff will take your baby to check on her health.
Stage 3. Delivery of the Placenta
After the birth, you might think you're all done, but you still have the delivery of the placenta. This could take a few minutes or even 20 minutes. You might experience some contractions as you gently push the placenta out, but these will be milder than those you felt during labor.
Stage 4. First Hour Postpartum
Also known as the "golden hour," the first hour is a special time to bond with your newborn. If your medical situation and the hospital's policy allow it, you can have the baby on your chest starting right after birth. This can help promote breastfeeding and bonding, and can also help regulate the baby's breathing and body temperature. You might like to read more about the importance of skin-to-skin contact and ways you can bond with your baby.
When Does Labor Need to Be Induced?
Sometimes labor needs to be induced. This can happen if you haven't gone into labor naturally by week 41 or 42, if there are complications that affect your health or that of your baby, or if you experience premature rupture of membranes (your water breaks too early). Your physicians might help your cervix dilate and rupture your membranes, which can promote the start of labor, or you might be given a medication that is similar to the labor-inducing hormone oxytocin.
What Are My Pain Relief Options?
There are many options to help manage your pain, from massage to medication, which you might want to consider if the pain becomes too intense. Discuss the options with your medical team beforehand so that you know what to ask for during labor and birth.
For women who choose medication to stay comfortable during a vaginal birth, one popular method of pain relief is an epidural block. During an epidural, pain medications are administered through a small tube placed in the lower back, which numb the feeling in the lower half of the body to minimize the pain. You'll remain awake and alert during labor and should be able to "push" when it's time to deliver your baby. There are some potential side effects, and you'll want to discuss these with your physician before you decide to go with an epidural or any other pain relief option.
Read more about labor pain relief to better understand the options available to you.
Do I Need a Birth Plan, and What Should It Include?
Many moms-to-be prepare a birth plan, which is then shared with their entire medical team in advance. Birthing plans list preferences regarding pain relief, support person(s), any desire to move and change positions during labor, requests relating to food and fluids, and information about preferred comfort measures, such as music.
Make sure you discuss your birth plan with your doctors well ahead of labor, and have printed copies with your medical team, as well as a few spares in your hospital bag, just in case.
Keep in mind that it's hard to know how your labor will turn out, and that you'll need to be flexible. Stay open to unexpected developments, and go with the flow of how you're actually feeling during labor.
Will I Need Vaginal Stitches After Childbirth?
You may need vaginal stitches after childbirth if you experience vaginal tearing during birth. Even a little tear of the skin around the entrance to the vagina might require some stitches, while a more severe tear will definitely require stitches. Vaginal tears are more common for a first birth, and also during a quicker birth where the vaginal tissue has had less time to stretch.
What Is the Recovery After a Vaginal Birth Like?
You might be wondering how long it takes to recover from vaginal birth, but there's no one-size-fits-all answer or time frame. Vaginal birth recovery is usually quicker and less uncomfortable than it is for Cesarean birth recovery, with a shorter hospital stay.
If you have had a more severe tear, you might experience pain for several weeks. However, after any vaginal delivery, you will feel some vaginal pain after birth, especially when sitting or going to the toilet.
After a vaginal birth you might experience swelling, bruising, soreness, and itching around the tear (if you have one), and general discomfort in your vaginal area. It will help with healing after childbirth to chill the pelvic area, for example with cold packs, in the first 24 hours. The swelling and bruising will go down with time.
Many women find that the first few bowel movements after the birth can really hurt. To help with constipation or painful gas, you can take short walks, drink lots of fluids, and eat foods that are high in fiber. Kegel exercises can help tighten the pelvic muscles, and this will help with incontinence and restoring rectal function.
How long you bleed after vaginal birth depends, but many women experience some bleeding for several weeks. Plan ahead by having lots of high-absorbency sanitary pads on hand. If you have bleeding that's heavier than a normal menstrual period, or if the amount of bleeding increases, call your healthcare provider.
What Happens Once My baby Is Born?
Once your baby is born, your medical professional will review your newborn's health before she is placed on your chest for skin-to-skin cuddles. While you are locking eyes with your baby and absorbing her smell, your placenta will be delivered, and any tearing or episiotomy that you may have had during delivery will be repaired. An episiotomy is an incision your doctor may make in the area between your vagina and anus (called the perineum) to help deliver your baby and to avoid extensive tearing. For more detail, read about what else you can expect after the birth.
Can I Breastfeed Right After a Vaginal Birth?
Yes, you'll want to start breastfeeding as soon as possible after birth, so your baby can start practicing latching on and sucking. Your baby's first food will be a nutritious liquid called colostrum, which is what your breasts produce prior to breast milk. Colostrum lasts for a few days after labor, and is a yellower, thicker substance than breast milk, which comes in after a few days.
Are There Risks of Complications?
Yes, there are risks associated with vaginal birth, such as vaginal tearing and pelvic floor muscles weakening. The tearing can be stitched up by your doctor, and Kegel exercises can help tighten those muscles.
Some complications that arise mid-vaginal birth may result in an emergency cesarean being recommended to ensure the mom and baby's health. Some potential complications of vaginal birth can be avoided by scheduling a cesarean in advance.
Can I Have a Vaginal Birth After a Cesarean?
You may be able to have a vaginal birth after a c-section (a VBAC) if you are otherwise a "good candidate" for a vaginal birth, and if your earlier cesarean wasn't such that it would make a vaginal birth more dangerous. Let your healthcare provider know early in your pregnancy if you are interested in having a VBAC, so you can become informed about the benefits and risks that would apply to your situation.
I’m Pregnant With Twins; Can I Have a Vaginal Birth?
Yes! Many women who are pregnant with twins give birth vaginally. However, if one or both of your babies are breech, then a c-section may be advised. Generally, a vaginal triplet birth is rarer, as it is for higher order multiples, because the risk of complications is greater.
Can I Have My Partner With Me During the Birth?
It's important to have a good support person during vaginal labor to help you with breathing and relaxation techniques, timing your contractions, and even being there just to hold your hand. This, of course, doesn't have to be your partner. Many women ask a close relative or friend. Some women choose to hire a doula, a trained labor support professional.
Also, your partner doesn't have to stay with you the whole time. Many partners choose to take some breaks, or step out during the final stage of delivery. It all depends on a very personal decision regarding what you and your support person are comfortable with.
Whether or not your partner is actually with you at the moment of delivery, there are plenty of other ways that special person in your life will be able to support you both during and after the birth – from running errands and taking your phone calls and messages, to helping out with diapering and watching over your newborn while you get some much-needed rest.
Above all, remember, women have been giving birth for thousands of years, so trust the medical professionals around you, and don't forget that the female body is built to do extraordinary things.
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