What is a vaginal birth? Stages, timing and what to expect

A vaginal birth means your baby is born through the birth canal. Every birth unfolds a little differently, so other people's stories can be a guide but do not have to be a measuring stick. Here is the general picture.

Why does labour begin?

Exactly what triggers labour is still not fully understood. The baby's maturing, hormone shifts and the womb getting ready to contract all play a part. For most people, labour starts on its own between 37 and 42 weeks.

Stage one: dilation

This is the longest stage. The cervix first thins out, then opens to about 10 centimetres. You can think of it in two phases:

• Early phase: Contractions are mild and irregular, and slowly become more regular. Most people spend this phase at home. Walking, a shower, a light snack and rest often help.
• Active phase: Contractions become more frequent, longer and stronger, and the cervix opens faster. Many people want to concentrate, go quiet or ask for support at this point.

In a first birth this stage usually takes hours. After a previous birth it is often shorter. That is a tendency, not a rule.

Stage two: the birth of your baby

Once the cervix is fully open, the pushing phase begins. You may feel an urge to push along with the contractions. Your midwife or doctor will guide you on position and breathing. Side-lying, squatting, all fours or a semi-seated position can all be discussed.

As the baby's head appears, the team often suggests slow, controlled pushing. After the birth, babies are usually placed straight onto your chest; skin-to-skin contact helps calm both of you.

Stage three: the placenta

After your baby is born, the womb keeps contracting and the placenta separates and comes out. This stage is usually short. The team watches your bleeding and how well the womb contracts. Sometimes they may suggest managing this stage with a medical method; you can ask them why.

What can happen during labour?

Not every birth needs every intervention, but some may come up depending on need:

• Intermittent or continuous monitoring of your baby's heartbeat
• Support methods for pain or an epidural (covered in a separate article)
• A drip or methods to support contractions when needed
• In some cases an episiotomy or repair of a tear

You have every right to ask which of these is suggested and why. Listening to your team's reasons and deciding together can build trust in the birth.

The first hours afterwards

After your baby is born, the team keeps checking you and your baby. During skin-to-skin contact many babies start to look for the breast by themselves; if you wish, you can ask for help with the first feed. If you have a tear or an episiotomy, it will be stitched. In the following days it is usual for bleeding to ease over time, for the womb to cramp as it shrinks, and for you to feel tired. Give yourself and your baby time.

When to contact your doctor

Contact your hospital without delay if:

• Regular contractions that keep getting closer together begin (see the next article for when to head to the hospital)
• Your waters break, especially if the fluid is green, brown or bloody
• You have vaginal bleeding
• You notice a clear drop in your baby's movements
• You have severe, constant abdominal pain that does not ease
• Regular contractions start before 37 weeks

In an emergency such as fainting, difficulty breathing or very heavy bleeding, call 112 (or your local emergency number).

What you can do

• Pack your hospital bag in good time; the hospital bag checklist in the app can help.
• Join a birth class or the hospital's tour.
• Try breathing and relaxation exercises beforehand.
• Talk with your partner or support person about what you need.
• Gather your preferences in a birth plan, but stay flexible.

Whatever way your baby is born, what matters is your health and your baby's health. This article is for information only; your doctor's and midwife's advice for your own situation comes first.