Stages of Natural Childbirth: What to Expect

Introduction

Natural childbirth is a complex, yet rewarding and emotional experience for the mother. She must be physically, emotionally, and mentally prepared for this process to deliver her child with passion and confidence. This article explains the three different stages of natural childbirth, starting with early labor until the delivery of the placenta. (1–4)

First Stage: Early and Active Labor

Labor is the body’s natural way of preparing the body for childbirth. Although the duration of labor varies between women, it is the longest stage, usually lasting 12-24 hours. Labor consists of the following phases:

1.      Early (Latent) Labor

The early stage begins when the cervix starts to dilate (opens to less than 6 cm) and efface (making the cervix softer, thinner, and shorter).

• Mild, irregular contractions occur every 5-20 minutes, lasting for 30-60 seconds for a duration of several hours to days, especially in first-time pregnancy, ranging from slightly uncomfortable to more painful and stronger contractions.
• Vaginal discharge (mucus plug) may be seen as clear, pink, or slightly bloody.
• Discomfort, backache, cramps, and pelvic pressure can occur during this phase

The expectant mother should do the following:

• Stay as relaxed as possible at home.
• Stay energized by eating and well-hydration.
• Change positions regularly.
• Try to sleep.
• Take a walk to help the cervix dilate.
• Practice breathing techniques, gentle massage, or having a warm bath to relieve the pain.
• Prepare the hospital bag if it isn’t already ready.

2.      Active Labor

Over time, contractions become regular, stronger, and closer, as they occur every 3-5 minutes for 45-60 seconds, lasting for a total of 4-8 hours. The cervix reaches 6-10 cm in dilation.

• The backache intensifies.
• The vaginal bloody discharge increases.
• The amniotic member can rupture (water breaking) during this phase, causing much stronger contractions.
• Hospitalization usually occurs during this phase, where healthcare providers can provide painkillers.
• During the active labor phase, the mother needs to stay calm, focus on breathing, and rely on the partner’s support.

Second Stage: Pushing and Delivery

Once the cervix dilates to 10 cm, the second stage begins, which may last for several hours. During this phase, the baby moves down the birth canal, ready to be born.

1.      Pushing

The contractions will slow down to every 2-5 minutes, lasting for 60-90 seconds, and will become lower in intensity.

• The urge to push increases, and each contraction, combined with the abdominal muscles, helps pressure the baby down the birth canal, depending on the position of the baby,
• The mother can squat, kneel, or rest on her hands and knees to help push. She is also recommended to take deep breaths before and after each contraction.
• The physician instructs the mother to push with each contraction. This is called laboring down. Proper and effective pushing helps reduce the risk of rupture and tearing and enhances the delivery processes.
• Taking an epidural injection can reduce the urge to push until the baby’s head has descended.
• The descent can be gradual in first-time pregnancies.

2.      Delivery

Finally, the baby’s head appears, a process called crowning, followed by the rest of the baby’s body. The healthcare provider guides the mother when to push gently and when to pause to ensure a smooth and tear-free delivery.

Third Stage: Delivery of the Placenta

After the baby is born, it is essential to deliver the placenta to prevent serious complications.

1.      Expulsion of the Placenta

The placenta is separated from the uterine wall by mild contractions and then pushed out through the vagina. This process is the shortest stage of childbirth and usually occurs within 5-30 minutes after the baby is born. Delivering the entire placenta is important to prevent complications, such as postpartum hemorrhage and infections.

2.      Post-Delivery Care

After the baby is born and the placenta is delivered, the mother may be administered some medications to help the uterus contract and prevent excessive bleeding. Any tears are also stitched during this phase to enhance healing.

References

1. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/stages-of-labor/art-20046545
2. https://www.ncbi.nlm.nih.gov/books/NBK544290/
3. https://www.webmd.com/baby/pregnancy-stages-labor
4. https://www.babycenter.com/pregnancy/your-body/stages-of-labor_177

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