The Process of Delivery

Vaginal Delivery

The first stage of labor is typically the longest. The First Stage of labor begins with uterine contractions that may initially last about 30 seconds and be spaced 15 to 20 minutes apart. These increase in duration and frequency to more than a minute in length and about 3 to 4 minutes apart. Typically, doctors advise that they should be called when contractions are coming about every 5 minutes. Some individuals experience false labor or Braxton-Hicks contractions, especially with the first child. These contractions may come and go and tend to diminish when the individual begins walking around. Real labor pains tend to increase with walking.

During this stage, the cervix or opening to the uterus dilates to 10 centimeters or just under 4 inches. This may take around 12-16 hours for first children or about 6-9 hours for individuals who have previously given birth. In one in 9 labors, it takes over 24 hours for the cervix to dilate completely. Labor may also begin with a discharge of blood or amniotic fluid. If the amniotic sack breaks, which happens for one out of eight pregnancies, labor will be induced if necessary to reduce the risk of infection.

The second stage involves the passage of the baby through the birth canal. This stage takes about 30 minutes to 3 hours. Contractions usually come about every 2-3 minutes. The individual pushes and relaxes as directed by the medical staff. Normally the head is delivered first. The baby is then rotated so that one shoulder can come through and then the other shoulder. The rest of the baby quickly passes through. The baby’s mouth and nose are suctioned out. The umbilical cord is clamped and cut.

The third stage is relatively painless in comparison to the other stages. During this stage, the placenta or afterbirth is delivered. This typically occurs within 20 minutes after the delivery of the baby. If tearing of the vagina occurred during birth, the tear may be stitched at this time.

Video 5.4 Normal Labour & Vaginal Birth animates the process of vaginal delivery.

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Cesarean Delivery

Cesarean section, also known as C-section, or cesarean delivery, is the use of surgery to deliver babies. A cesarean section is often necessary when a vaginal delivery would put the baby or parent at risk. This may include obstructed labor, twin pregnancy, high blood pressure in the pregnant parent, breech birth, or problems with the placenta or umbilical cord. Cesarean delivery may be performed based upon the shape of the parent’s pelvis or history of a previous C-section. A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that cesarean section be performed only when medically necessary. Some C-sections are performed without a medical reason, upon request by someone, usually the pregnant individual.

In recent years, some hospitals have begun to offer an adapted form of the C-section, termed a family-centered C-section or a gentle C-section. This method of birthing arranges for the C-section to occur using less restrictive equipment and for the newborn to be placed on the parent’s chest following birth allowing for earlier skin-to-skin contact.