The delivery
How does labor start and progress?
The big moment is finally here! Labor is starting. This is always a very special moment for us too. Bringing a new baby into the world and starting your family is so personal and intimate. Our goal is a safe delivery for both mom and baby that you'll look back on with a good feeling.
Good preparation for labor
During your pregnancy, we'll help you get ready for labor and birth. We offer classes, share helpful info, and chat about your wishes (using a personal birth plan if you'd like). Being well-prepared can boost your sense of control and ease any worries, which has a positive effect on how you experience pain and how labor progresses. Always feel free to ask us any questions that come to mind!
The start of labor
When labor actually starts is always a surprise. From 37 weeks on, we consider it a healthy time for the baby to be born. Only 3-4% of women give birth on their exact due date, and 70% go past it. If your baby hasn't arrived by 41 weeks and you'd like to wait a bit longer, we'll do an ultrasound and see you at the practice every other day for check-ups. Around 33 weeks, we'll talk with you about when is best to get in touch.
Contractions
Most births—about 90%—start with contractions. Contractions are strong, rhythmic tightenings of the womb. They push the baby further down into the pelvis and put pressure on the cervix. The cervix is like a small neck attached to the womb, similar to the end of a balloon. Because of the pressure, the cervix first gets softer and shorter, and then starts to open up. This opening process is what we call dilation.
Your waters breaking and the amniotic fluid
Over the past few months, the amniotic sac and fluid have protected your baby. About 10% of labors start with your waters breaking spontaneously. You'll notice this as fluid loss. It's not one big gush like in the movies, but rather losing small amounts of fluid little by little. Your waters might also rupture later on during labor.
Our support during labor
During labor, we'll help you with your breathing and suggest different positions. We follow your needs, keeping the health of mom and baby front and center. You can always let us know if you need anything. You can count on open and honest communication from us. We'll do our best to keep you as comfortable as possible, offer support, and build up your confidence. We completely understand that the unknown can feel a bit nerve-wracking, even though it's totally normal. Every birth is different. They all go through different phases that flow naturally into one another.
There are different phases during labor.
Transition phase
Earlier in your pregnancy, you might occasionally experience 'tight bellies,' also known as Braxton Hicks contractions or practice contractions. These can happen on their own or be triggered by exertion, stress, or the baby's head dropping lower. Your uterus is just getting ready for labor. A key sign is that these feelings usually fade away after a few minutes or hours with some rest and warmth, and they don't have a rhythmic pattern yet. We don't view this transition phase as part of active labor yet, though it can sometimes gradually turn into it.
Latent phase
The latent phase is the very beginning of labor. Contractions start and slowly become more frequent, last longer, and feel stronger. You might feel them in your belly, back, and/or legs. Try to make yourself as comfortable as possible. The nice thing about contractions is that there is a break in between them. Use these breaks to relax and give your body a little rest. In the early stages, you can try lying down while dealing with the contractions. Once they come more often, standing or moving into an upright position usually feels much better and helps things along. For extra tips and info, check out our pages on birth positions and water births.
In this phase, you won't always see dilation right away. At first, it mainly helps the cervix become shorter, softer, and move more forward, and it might open up to 2-5 centimeters. Only start timing contractions when you notice they are becoming more regular and you need to focus more on your breathing because of their strength. You'll likely contact us during this phase. We'll ask you a few questions over the phone and then come visit you at home. If you want to give birth in a hospital or birth center, we don't want to leave for it too early in this phase, as your body is still sensitive to outside stimuli. A change of environment can sometimes cause the contractions to slow down.
Active phase
Things start speeding up now! Contractions get stronger, and you'll need to actively work with their intensity. We'll be right there to help and support you every step of the way. On average, contractions come every 2-3 minutes and last a solid minute. You'll notice you get into your own little bubble thanks to endorphins—your body's natural painkillers. The baby's head moves deeper into the pelvis, and you can expect about 0.5 to 1 centimeter of dilation progress per hour. Especially if you've given birth before, this can go even faster.
Full dilation
Full dilation of 10 centimeters has been reached. Your body often indicates this itself by pushing. Because of the pressure of the head against the rectum and your tailbone, you feel like you have to defecate uncontrollably. When the head is deep enough in the pelvis, it is time to push. Take your time and follow your body. You will probably find pushing more pleasant than the dilation contractions. Instead of sucking away, you may literally "push away" the pain now. We will motivate and encourage you to adopt different postures. A vertical position often works favorably on the course. It also feels more natural than the supine position. If desired, we will give you instructions regarding pushing (and sighing to allow the head to be born slowly). On average, pushing for a first baby takes 1 hour. A second or subsequent baby often follows more quickly. The meeting between you and the baby is finally here!
Afterbirth
As soon as your little one is born, they go straight onto your chest and stay there for the first hour. The umbilical cord is cut after at least 3 minutes. Skin-to-skin contact is wonderful for bonding! If mum isn't able to do this due to certain circumstances, we make sure your birth partner gets to cuddle your baby skin-to-skin on their chest instead.
An important final step is delivering the placenta. You might feel some mild cramping in your belly again, and with just one more push, the placenta is born.