What to Expect During Labor & Vaginal Delivery

What to Expect During Labor & Vaginal Delivery

It’s time! Here’s what to expect when your labor starts, how it progresses and the process of childbirth.

Labor starts when you first begin to feel regular contractions. These contractions, which get more intense over time, cause the cervix to dilate, soften and thin (also called effacement), allowing the baby to move through the birth canal.

If you’re getting towards the end of your third trimester, you’re probably feeling a bit anxious about labor and the delivery process. Beth Fjeldheim, CNM at Rochester Regional Health, walks through the stages of labor and what you can do to promote comfort.

Early labor

“During early labor, your cervix opens and effaces,” Fjeldheim said. “You’ll likely feel mild and irregular contractions. Most of our patients stay at home during early labor – as it can last for hours or even days.”

To stay comfortable during early labor, we recommend taking a bath, going for a walk and trying to stay relaxed. We encourage you to eat and stay hydrated during this stage. Give your provider’s office a call once your labor starts and again as contractions intensify and grow closer together, if your water breaks or if you experience any significant vaginal bleeding.

Getting induced

Some families will be recommended to have an induction of labor based on certain medical conditions or risk factors. In these cases when labor hasn’t start on its own, your provider will discuss the most appropriate medical interventions to help your body enter labor. Early in this process, they may give you medications to soften and dilate your cervix in order to prepare your body for active labor. These interventions include medications such as Cytotec and Cervidil or even an intracervical foley balloon. Once your cervix is ready for labor, you may be started on Pitocin – a medication given through an IV that will help you have stronger, more regular contractions. If your water has not yet broken, we may offer to break the bag of water around the baby.

Things to know about your induction:

• Inducing labor can be a lengthy process, and each woman’s body responds differently to the techniques we use. We tell our patients to mentally prepare for up to 3 days.
• Depending on your risk factors and where you are in the labor process, solid foods may be restricted. Small meals may be offered between breaks in interventions and clear liquids offered during labor. We encourage you to try to eat a large meal before you arrive for induction.
• We encourage movement in labor! If you have an epidural or are restricted in movement for any reason, we have peanut balls, birth balls and Cub chairs to facilitate fetal passage through the birth canal. When appropriate, we may offer a Bluetooth remote monitoring system to you and your baby to assist with keeping you mobile while also insuring safety. Some movement may be limited by connection to IV for various treatments—ask your nurse and provider for help navigating labor while connected to IV.

Active labor

Active labor covers the time from when your cervix dilates from 6 centimeters to fully open at 10 centimeters. During active labor, your contractions become stronger and closer together. Pain and pressure typically intensify during this stage.

Active labor typically lasts between 4 – 8 hours or more, with the cervix dilating on average one centimeter per hour. During this time, you may want to ask your labor team for anesthesia via an epidural or pain medication. We’ll also help you with breathing, positioning and relaxation techniques and highly recommend a childbirth class to practice these ahead of time. 

“At all of our Rochester Regional Health facilities, we’ll have tools and teams available to help you feel as comfortable as possible,” Fjeldheim said. “We’ll have birthing balls in your room, help you to change positions, run a warm shower or bath or guide your support person to give a gentle massage between contractions.”

The end of active labor, transition, can be particularly intense. Your contractions become closer together and last longer. You’ll experience more pressure in your rectum and lower back. Your provider will work with you through this phase and help you get ready to push.

Birthing your baby

It’s time to push! You and your provider will work together to guide your pushing efforts. Typically pushing occurs while you are contracting, so your strength works with the strength if your uterus. You can push from a few minutes to several hours – with it taking a bit longer for first-time moms and those who have had an epidural. Your care team will help you try different positions until you find one that works best for you.

As you get to the end, you’ll be asked to push more gently or stop completely, as your vaginal tissues stretch and your baby’s head is delivered. Once the head is delivered, the rest of his/her body will follow shortly after. Your provider will help stimulate the baby by drying them with a blanket—this will help your baby begin to clear their airway but letting out their first cry. If baby and mother are stable, this will be done while they are skin to skin with their parent. After cord has stopped pulsing, your providers will assist you and your family in cutting the umbilical cord.

Delivering the placenta

After your baby is born, your provider will likely pass the baby so you can enjoy skin-to-skin bonding and possibly start breastfeeding.

During this time, you’ll deliver the placenta. You may feel some pressure and mild contractions as this happens and will be asked to push one last time to deliver the placenta. Your provider will check to make sure your placenta has been delivered fully and that your uterus is contracting as it should. They’ll also make any repair to tears of your vaginal region if needed.