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Although most births follow the same sequence of events, no two are alike. It's important that you know what is likely to happen during the birth, what you should think about in advance, and what choices you might have to make on the day.
Your birth preferences plan
During the third trimester of your pregnancy, you and your clinician will go over your birth preferences. It’s a checklist to help you think through your options regarding pain management, labor support, and the environment in which you want to bring your baby into the world. Bring your birth preferences to the hospital when it is time to give birth.
With your birth preferences, you can tell your care team:
- Who will be with you to support you during and after the birth. It could include a partner, friend, relative, or doula.
- What positions you prefer for labor and birth.
- Your pain management choices.
- If you want to defer newborn procedures to bond with your baby.
- Who can accompany your baby for medical treatments.
- Your goals regarding feeding your baby.
- Your preferences about circumcision, if you have a boy.
At the hospital, a nurse will ask you about your preferences. Your care team will do their best to follow your wishes. You can expect to be in communication with your care team throughout your labor and birth. You will work together to stay informed and to make choices that best support your needs throughout. You and your clinicians may need to adjust your birth preferences to go with the flow of your natural labor process.
When to go to the hospital
You’ll probably go through what is known as early labor at home, which is good because it can last for a few hours or happen off and on over a few days. During this stage, you’ll have mild to moderate contractions that come at irregular intervals.
When you progress to active labor, that’s when you should go to the hospital. Active labor is when your contractions intensify, come every 3 to 4 minutes, and last about 60 seconds. When your water breaks, your contractions will start coming even faster.
Who will be in the room?
A team of experienced and caring professionals will be ready to greet you at the hospital. Some of the people who will help bring your baby into the world are:
- A doctor and/or midwife.
- A labor and delivery nurse.
- An anesthesiologist or nurse anesthetist.
- A pediatrician who will do a thorough newborn exam soon after delivery.
- A lactation consultant or registered nurse to help with breastfeeding.
Positions during labor
Your care team will encourage you to move, change positions, and use supportive measures like birthing balls to help you feel less pain and discomfort.
Positions that can help you through labor include:
- Rocking or swaying.
- Squatting with your partner.
- Squatting with a chair.
- Leaning forward.
- Kneeling with a birthing ball.
- Getting on your hands and knees.
- Reclining against your partner.
- Lying on your side.
- Walking.
There are some circumstances in which your care team may need to monitor you or your baby, and this may restrict possible labor positions. However, this will be dictated by the specific circumstances of your labor.
Pain management
If your pain management needs change, there are plenty of options.
IV medications. These reduce pain and increase relaxation. You still have full use of your muscles to push during childbirth. They may not relieve all the pain, however.
Nitrous oxide. It can be started and stopped easily. You can use this anytime, and the medication itself won’t reach your baby. It has few risky side effects and can help reduce pain and anxiety. It might not be as strong as other pain relief medications.
Epidural medications. This medication is injected through a small tube placed in your lower back. You can still feel your lower body and push during birth. If you receive epidural medication, you are limited from walking during your labor.
You can change your mind about pain medication during your childbirth. Because labor may be more painful, or be longer than expected, it's fine to use methods that you may not have originally planned. The most important aspect is you and your baby's health.
Medical help during delivery
At times, your clinician may offer an assisted delivery if your baby is in distress or you’ve lost the ability to push well. This means that while you push, the doctor will use an instrument to guide the baby’s head out of the last part of the birth canal.
Your clinician will only recommend assisted delivery when there is a risk of cesarean birth without it.
When problems come up during labor, sometimes a cesarean birth becomes necessary. In cesarean birth, the baby is delivered through an incision in the belly.
Your clinician may recommend cesarean birth if the baby or you are in distress. You and your clinician may plan to have a cesarean birth if your baby is in a breech position or you have had a previous cesarean section.
Whenever possible, your care team will talk to you about your preferences in a cesarean birth, such as whether you want your partner with you and how quickly you will be able hold your baby after birth.
After you give birth
When labor is over and your baby has been born, you and the baby are together right away. First, we do a quick check on the baby by measuring:
- Heart rate.
- Breathing.
- Muscle tone.
- Reflex response.
- Color.
Afterward, your care team puts the baby on your chest, skin-to-skin. This helps your newborn transition to life outside the womb. It helps calm them and allows them to adjust to the sights, sounds, feelings, and experiences in their new world.
When you hold your baby close, both you and the baby benefit. The baby can start breastfeeding and it helps your uterus recover from the birthing process. You and your baby will likely stay in the hospital for a few days to help you on a path to recovery and health.