Labor, Delivery, And Postpartum Period

Content provided by Healthwise

Topic Overview

Is this topic for you?

This topic provides basic information about normal labor and delivery, and the postpartum period. If you need information on pregnancy or other types of childbirth, see the following topics:

• Pregnancy
• Preterm Labor
• Cesarean Section
• Breech Position and Breech Birth
• Vaginal Birth After Cesarean (VBAC)

What is labor and delivery?

At the end of the third trimester of pregnancy, your body will begin to show signs that it is time for your baby to be born. The process that leads to the birth of your baby is called labor and delivery. Every labor and delivery includes certain stages, but each birth is unique. Even if you have had a baby before, the next time will be different.

Giving birth to a baby is hard work. That’s why it’s called labor. It can also be scary, thrilling, and unpredictable. Learning all you can ahead of time will help you be ready when your time comes.

What are the stages of labor?

Labor is divided into two phases: early labor and active labor. Delivery is part of active labor.

During early labor, the muscles of the uterus start to tighten (contract) and then relax. These contractions help to thin (efface) and open (dilate) the cervix so the baby can pass through the birth canal. (See a picture of cervical effacement .) Early contractions are usually irregular, spaced from 5 to 20 minutes apart, and last less than a minute.

Early labor can be uncomfortable and long, sometimes lasting 2 or 3 days. Walking, watching TV, listening to music, or taking a warm shower may help you manage the discomfort.

During the first stage of active labor, contractions become strong and regular. They happen every 2 or 3 minutes and last longer than a minute. This is the time to go to the hospital or birthing center.

The pain of contractions may be moderate or intense. Having a support person, trying different positions, or using breathing exercises may help you cope. Many women ask for pain medicine during this time. Even if you plan on natural childbirth, it can be comforting to know that you can get pain relief if you want it.

Once the cervix is fully effaced and dilated, your body changes to "push" mode. During this second stage of active labor, the baby is born. Pushing to deliver the baby may take from a few minutes to several hours. It is likely to be faster if you have had a baby before. Contractions continue until the placenta is delivered.

What can you expect after childbirth?

Now you get to hold and look at your baby for the first time. It is common to feel excited, tired, and amazed all at once.

If you plan to breast-feed, you may start to introduce the baby to the breast soon after birth. Don't be surprised if you have some trouble at first. Breast-feeding is something you and your baby have to learn together. You will get better with practice. If you need help getting started, ask a nurse or breast-feeding specialist (lactation consultant).

In the hours after delivery, you may feel sore and need help going to the bathroom. Especially if you have given birth before, you may have sharp, painful contractions called afterpains for several days as your uterus shrinks in size.

During the first weeks after giving birth (called the postpartum period), your body begins to heal and adjust to not being pregnant. It's easy to get overtired and overwhelmed. Take good care of yourself. Make sure you get as much rest and help as you can.

• Try to sleep when your baby does.
• Let family and friends bring you meals or do chores.
• Eat healthy meals to build up your strength.
• Drink extra fluids if you are breast-feeding.

It is common to feel very emotional during the postpartum period. But if you have "baby blues" that last more than a few days or you have thoughts of hurting yourself or your baby, call your doctor right away. Postpartum depression needs to be treated at once.

Your doctor or midwife will want to see you for a checkup 2 to 6 weeks after delivery. This is a good time to discuss any concerns, such as birth control. If you do not want to become pregnant right away, use birth control every time you have sex, even if you are breast-feeding. Talk to your doctor about which type is best for you.

How can you prepare for labor and delivery?

Getting regular exercise during pregnancy will help you handle the physical demands of labor and delivery. Try adding Kegel exercises to your daily routine. They strengthen your pelvic floor muscles. This helps prevent a long period of pushing during labor.

In your sixth or seventh month of pregnancy, consider taking a childbirth education class with your husband, partner, or support person. A class can reduce your stress both before and during labor and delivery by preparing you to deal with what might happen. It can teach you ways to relax and the best ways for your support person to help you.

There are many decisions to make about labor and delivery, so it is a good idea to write a birth plan before your baby is due. It is not possible to predict exactly what will happen during labor and delivery. But a birth plan gives you a chance to state how you would most like things to be handled. You can change your mind at any time.

Things to put in a birth plan include:

• Where you want to have your baby. Most women choose to work with a doctor and have their baby delivered in a hospital. Hospitals offer experienced staff in case problems arise and also a wide range of pain relief options. Women at low risk for problems may choose to work with a midwife and have their baby at a birth center or at home. This may be less expensive, but it may not be covered by insurance.
• Who you want to be with you. You may want to have family and friends around you or only the baby’s other parent or another support person.
• What comfort measures you want to try. Breathing techniques, laboring in water, trying different positions, and having one-on-one support may help you manage pain.
• Your preferences for medical treatments. You can state what type of pain medicines you would prefer and your feelings about having an episiotomy, which is a cut sometimes done to widen the birth canal. It is a good idea to learn about the medical options, although you may not always get to choose.
• How your baby will be cared for after delivery. This might include having your baby stay in the room with you rather than going to the nursery, delaying some tests and procedures, and not giving the baby water or formula right away if you plan to breast-feed.

Frequently Asked Questions

E-mail This | Print This Previous Chapter | Next Chapter

Last updated:	December 19, 2005
Author:	Lila Havens
Reviewed By:	Kathleen Romito, MD - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Michele Cronen