Normal Delivery

Most women give birth between 37 to 42 weeks of pregnancy. To help you prepare for the birth of your baby, you may want to do the following prior to going into labor:

• Talk with your doctor about exactly what to expect.
• Consider taking a childbirth class.
• Choose a support person to be with you during labor and delivery.
• Consider writing a "birth plan" that outlines how you would ideally like the birth of your baby to occur.

Once you reach active labor, it is just a matter of time until your baby is born. Of course, no one knows exactly how much time. First babies generally take longer to be born than subsequent babies.

The Birthing Process

When your doctor determines that your cervix is fully dilated and that your baby is moving down the birth canal, you will most likely be moved to a delivery room. However, in some hospitals, you will remain in the room you've been laboring in for your actual delivery.

Your doctor and the hospital nurses will be there to make you feel as comfortable as possible and to assist with the delivery of your baby. Your support person will also be there to offer assistance and to comfort you.

After preparing you for the birth by washing your vaginal area with an antiseptic solution, you will be encouraged to get into the position that feels the most comfortable for you. The nursing staff and your support person may hold your legs in a comfortable position to help you push. Your doctor will instruct you when to push and how hard to push.

The first view you see of your child will most likely be the tip of his or her head seen with the help of a mirror. When your baby's head is first seen at the opening of your vagina, it is called "crowning." Once your baby has crowned, the doctor may ask you to push more slowly.

Depending on what you have requested and your doctor's recommendation, your doctor may massage your perineum (the area between the bottom of the vagina and the top of the rectum) and gently try to stretch it in order to fit your baby's head through without tearing this area. If necessary, you may be given an episiotomy so that your baby can be delivered without tearing your perineum. With an episiotomy, your doctor makes a surgical incision into the perineum to widen the vaginal opening for delivery.

Once your baby's head is out (the most difficult part of the delivery), you will be asked to stop pushing while your baby's nose and mouth are suctioned clean of all fluids. The doctor will then instruct you to push so that you can deliver the rest of your baby. After another, more thorough suctioning of your baby's nose and mouth, your baby will be handed to you to hold. The umbilical cord will be clamped and cut - a process that is totally painless for your baby and can often be performed by your support person.

Even after your baby is born, you will continue to experience contractions. This is your body's way to deliver the placenta - the tissue that has protected and nourished your baby throughout your pregnancy. Within about 20 minutes of birth, the placenta will detach and pass through the birth canal. Your doctor will make sure that the entire placenta has been detached and delivered.

What You May Feel

While every birth is unique, there are some physical sensations that most women report feeling during the birth process. Remember that your doctor will provide you with pain relief if requested.

• You may have a strong urge to push or bear down with each contraction.
• The baby's head is likely to create great pressure on your rectum.
• You may need to change positions several times to find the position in which you feel most comfortable.
• When you baby's head passes through your vagina (crowns), you may feel a burning pain.

Your Baby's Appearance

When the doctor hands you your baby, do not be surprised to see a white cheesy substance called vernix covering your baby. This protective coating is produced toward the end of pregnancy by the sebaceous (oil-producing) glands in your baby's skin. Your baby will also be wet with amniotic fluid from the uterus. Your baby's skin, especially on the face, may be quite wrinkled from the wetness and pressure of birth. Your baby's skin color may be a little blue at first, but will gradually turn pink as breathing becomes regular. In addition, your baby's head may be slightly cone-shaped from passing through the birth canal.

You may also notice that your newborn's breathing is irregular and very rapid. While adults normally take 12 to 14 breaths per minute, your newborn may take as many as 60. An occasional deep breath may alternate with bursts of short, shallow breaths followed by pauses. Don't be alarmed - this is normal for the initial days after birth.

After The Birth

After your baby is born, the following may be done before you are moved to your room:

If there were no complications, you will most likely stay in the hospital one or two nights.
• If your perineum has torn or if you had an episiotomy, the incision or wound will be closed with stitches.
• A nurse may massage your abdomen to help your uterus clamp down and decrease bleeding.
• Your vaginal area, perineum, and rectum will be washed to remove all of the birth fluids and blood.
• You may be given an ice pack to apply to your perineum to reduce pain and decrease swelling.
• You may require a shot of Pitocin to help decrease bleeding.
• You may be given pain medications by mouth, injection, or IV.