Mariah Dolenc

If you’re anything like me, you want to know everything about birth as soon as you get pregnant (maybe even before). Before you have actually given birth it’s quite impossible to know what labor will feel like from beginning to end. As a first-time mom this could be the number one thing that you think about when anyone mentions labor. Curiosity, fear, dread, anticipation, all those lovely feelings usually follow. I think my idea was that it was going to be something like intense period cramps. And to some extent it was, until I hit somewhere around 5cm dilated. Keep in mind that every woman is different. For the women who are planning a natural birth and are looking for some insight, I hope I can give it here. It’s important to note that many of the tips I list are only available to you if you find a care provider who is willing to support your wishes. I refused to go to any hospital or birth center that didn’t agree to my birth plan. In the end, I found a birth center who not only agreed to all my wishes, but told me that that was how they normally encourage women to birth. Success!

At this point I can only relate from my own experience of my first birth and give examples from other women’s experiences. Labor pains and sensations vary greatly on which stage you’re in and also vary woman to woman. Some women have a high pain tolerance. Some don’t and manage on sheer grit alone. Some find relief in other natural methods. Some of the things I felt at 3cm can be very different than another woman at the same stage. Many women feel something called the “ring of fire” or a burning sensation as the baby’s head comes out, I did not. While you can’t read one woman’s experience and know how your own birth will feel, you can read from several women’s stories and get a good idea. When getting information for your natural birth, remember that your emotional and psychological state is very important. When I was reading women’s stories and comments on their births if it was negative or frightening I stopped reading. Realistic is fine, but sometimes women express birth in a terrifying way and fear is your worst enemy in birth. It’s important to fill your mind with positive stories that support your goals for birth. This is a realistic, but not fear-inducing, account.

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Stage 1 – 1-10cm dilation

I. Early Labor Phase: 1-3cm dilated

The Physical: Contractions at this point are very mild in intensity. Usually they feel like a light period cramp or tightening. If you were to feel your baby bump during one of these contractions it may feel hard and tight because the muscles are contracting. There is very little pain at this point for most women. Contractions are short and can be 8-15 minutes apart.

The Emotional: You may be very happy at this point that your contractions have started, especially if you are near or past your EDD. You can easily manage these contractions and talk to people at the same time. You may feel anxious, mostly from anticipation that you will finally be meeting your new baby! You may feel like announcing to everyone that labor has started, but it may be wise to wait. If the labor slows or stops it can be very discouraging and then having everyone asking you about it makes it worse.

Tips: Stay up and active. Clean your home, do some light preparations, or any last minute details that need attention. Don’t strain yourself. Just move your body! If there hasn’t been any noticeable progression after 2 hours, but your contractions are consistent, consider taking a nap. If this will be a marathon, you will need the rest.

II. Active Labor Phase: 3-7cm dilated

The Physical: This is when the contractions become more intense, more painful, more regular. Some women experience quite a bit of pain and some not as much. From 3-4cm contractions can feel like more intense period cramps. Around 5cm is usually when it feels like an actual “contraction” where you feel it slowly begin, peak in intensity, and diminish in intensity. The entire contraction can last 30-50 seconds and be several minutes apart. If you are examined and feel like you’re not as dilated as you had hoped, don’t worry! There are no rules to dilation and you can dilate quickly or slowly or both. You can be at 3cm for 5 hours and then jump to 8cm in one hour. Women have experienced it all.

The Emotional: At the end of this phase you may not want to speak or walk during your contractions. In between them, you can still regain yourself and feel good. It’s good to have positive energy from your partner. It’s getting more serious and now is when you can feel like, “Oh my gosh, this is a lot!” But don’t worry and don’t let yourself get anxious. Say your affirmations or have your partner say them to you. Just keep thinking, “I’m doing great!” Find things that make you feel good to help you cope emotionally if you need it. If you start feeling overwhelmed find a position or remedy to make you feel like you are back in control of your situation. This can happen especially if during this phase you left your home to go to the birth center or hospital.

Tips: Find a position that is comfortable that allows you to focus on your breathing when the contractions get stronger, but don’t become sedentary. Move your hips if you can. Standing and moving can help progress labor or at least keep it from stalling. If you lose a sense of control or begin feeling overwhelmed, take a warm shower or have your partner give you a massage.

III. Transition Phase: 7-10cm dilated

The Physical: This is what many women describe as the hardest and most painful stage of labor. During this point you don’t want to talk, and mostly cannot talk, especially during contractions. Contractions very much are like waves: they rise slowly, become very intense, and gradually reduce. They are longer and more painful and you can have nausea during this time. You can become very hot and want cool air. The best description that comes to mind is that feeling if you have ever experienced pain that gives you that hot/cold feeling. At its most intense peak, that was what a contraction felt like for me. Managing through your contractions now becomes more difficult. If you have back labor, now is when it’s also the worst. Some women say that the pain in their back is more intense than the pain in their abdomen. Staying focused on your breathing is the most important thing to do right now. Long, deep breaths will make a huge difference in the long run.

The Emotional: This can be the most mentally and emotionally tough part of your entire journey. You won’t want your partner to leave you. You may feel very primal at this point too. This is when you can really lose control of yourself if you are not properly prepared. You may begin to think “I don’t know if I can do this!” or “I can’t do this anymore!” and that’s when you know you’re almost there! This is when your partner can have the biggest role in helping you. Massages, cheering you on, affirming your good work, all help immensely right now.

Tips: As your contractions build, take deep, slow breaths. Exhale slowly and controlled. If anything helps, like a cool rag or massage or counter pressure on your hips, make your partner do that for you. Do whatever you feel your body is telling you to do. Move around, relax, breathe, sing, whatever. Try to let the tension go out of yourself. If you’re feeling shy, give that up! Your body will birth that baby much faster if you relax. Remember that at this point it’s not about making the pain go away, it’s about breathing through it and taking it one contraction at a time. You’re baby is almost here! You CAN do it!

Stage 2 – 10cm dilation to delivery of baby

I. Pushing

The Physical: This is where it varies between women A LOT. For some women, pushing feels great. For others it doesn’t. A myth that needs to be addressed right now is that many women are told, “At 10cm you push” and that is not true. You can be at 10cm, fully dilated, and not need to push. Probably at this point to want to push and be done with this process, but this is when your body really knows the right time (provided you have not had complications). Every woman I’ve talked to who waited, instead of being told to push, said that at one point she felt a strong urge to push. Almost like an urge to defecate. It’s so strong that you cannot NOT push. Pushing prematurely can make you expend valuable energy and also increase your risk of tearing. However, if you need to push and you aren’t pushing hard enough, this can also lead to complications. If you trust your care provider to treat your body respectfully then they should give you directions here. As your baby is crowning and coming out, this is when many women feel the “ring of fire” or that burning sensation of your skin being stretched. However, not all women feel it. You could be shaky and if you are in a sitting or squatting position you may need physical support. Your contractions now are not usually any more intense or painful than they were during transition.

The Emotional: This is when you come to the end of your rope, emotionally. You’re worn, tired, and have little energy left. You may feel slightly spaced out at this point, almost unaware of what’s happening. You can go through a few pushes and wonder, “Is the head out yet?” and then, the head can come out and you don’t know it unless you’re told. If you’ve had an especially long labor then you may think to yourself, “I just can’t do this anymore.” This is another reason why it’s important not to push too prematurely (for too long) so that you have the energy to finish the job. It helps to have your partner and midwife telling you what’s happening. That you’re doing well, they can see the head, the head is out, and so on.

Tips: Close your eyes tightly when pushing and push down into your bottom. This will help prevent blood vessels from breaking in your eyes. When those blood vessels break it is almost always because the pressure is going up instead of down. If you need to push and you’re just holding your breath and gritting through the contraction or the pressure is focused in your abdomen instead of your vagina you can have complications. This is why kegal exercises are helpful because they train your body to feel those downstairs muscles.

II. Baby

The Physical: With each contraction the baby’s head is coming down and then going back slightly as the contraction ends. This is OKAY and normal. It is your body’s way to prevent damage and allow you to stretch. Breathing as much as possible during the birth of the head and body will keep blood flow and circulation going, which is also important for you and baby. First the head will be born with one contraction and then you will wait for another contraction and then the rest of the baby will be birthed. This may seem very contrary to what you’ve heard and seen in movies: that the baby comes flying out in one swoosh! Some women birth the entire baby at once, but it’s rare. It’s also great for you and baby to have the progress. At any rate, you are just waiting for that final contraction. When you begin to feel it you don’t have to push immediately. Even if you don’t consciously push, the baby will come out. You don’t have to rush, you don’t have to hurry. Your body and your baby will do just fine.

The Emotional: This is a kind of limbo stage that transitions into amazing elation. When the baby’s head is out you’re happy because you’re halfway there, but not happy because you’re halfway not. It’s a bit weird to have to wait knowing the head is out. Try to smile in between and know that you did it! When your baby gets placed on you (if you’re doing skin-to-skin, which you should if you can!) the most incredible rush of emotions happen. Many women describe it as a high. It’s everything at once. Wonder, amazement, relief, joy. Many women cry or laugh or both. It can be that Oh my God Oh my God kind of shock from seeing your newborn for the first time and that you just gave birth! The great thing about natural birth is that you are so coherent for those moments and that makes them all the more extraordinary.

Tips: Keep breathing as the baby comes out to keep the oxygen and blood flowing. More oxygen and blood can mean a better ability for your skin to stretch. Have your partner tell you what’s going on and that you’re doing great and almost done. Those words are great to hear!

Stage 3 – Delivery of placenta

This is the final stage of the complete process of childbirth!

The Physical: The placenta will be birthed some time after the baby is born. It varies woman to woman, but is generally 20 minutes or so after birth. It can be 40 minutes, it can be 5, every woman is different. After the baby is born, the contractions do not immediately stop. They continue and they are painful, but not as intense as transition. These contractions are important as they help the placenta to be birthed as well as help the uterus to return to its normal size. The contractions can last for several more hours and after they are gone, you can experience them again whenever you breastfeed your baby. Some women report they did not have these postpartum contractions at all with their first child, but did experience them with their second. Hopefully the midwife will tell you that the placenta is ready to come out and then you just push again like you pushed before. However, the placenta comes out quickly with a much easier push. You don’t have to push hard. Many women are amazed at how easy and painless it is.

The Emotional: If you’ve had tearing or are still in pain you may think, Noooooo, I don’t want to push anything else out! But don’t worry! The placenta is very different from the baby. Most women are too engulfed in their first moments with their newborn to be much concerned with it. It can also feel like a great relief after the placenta is out so just cuddle your baby and then maybe take a look at the incredible organ that your body created just to keep that precious life safe.

Tips: If you give a push and it doesn’t come out ask if you can wait a few more minutes. There’s usually no rush and it should come out very easily. If you have questions about it just ask your midwife.

A word about perineal tearing…

Despite all our best efforts and precautions, it is possible to tear anyway. That’s okay. It’s not great, but you will live and heal and get through it. Women who do tear don’t all tear the same. If you need stitches you can ask about it. If it’s difficult for you then maybe ask after they have stitched you. Make sure you ask for an ice pack! They have perfect sized ones that you can put between your legs right after you put on those fancy underwear and mega pads. After a few hours when the ice pack has melted ask for another one. Keeping it iced down there will help the healing process and also minimize swelling and pain.

Conclusion

Now, considering everything you’ve read, think about your birth plan! What do you want? How would you like to give birth? Maybe your first birth didn’t go according to plan and you want the next to be different. Birth can have many plot twists and that’s okay. Write it into your birth plan! If the situation changes, how would you like to be treated? It’s good to remember that while birth can have unexpected changes one thing is certain: at the end, you get your baby. And that’s the most important part.

Share with us below your experiences during birth!